An Effort to Rid NY Hospitals of Caribbean Medical Students

This NYT piece on the push to rid New York hospitals of Caribbean medical students is worth a read. I think it's unlikely that Caribbean schools will be forced out of New York hospitals, as the financial incentive to keep the schools' funding is way too strong. It's worth considering, however, the fate and reputation of Caribbean schools.

It's interesting to note, too, that New York schools that have relied on their prestige to secure rotation slots may now be worried that they can't compete with the millions of dollars that Caribbean schools are spending to do the same.

Does Going to a Fancy School Pay Off?

Here's an interesting NYT article on whether going to elite colleges pays off financially (and emotionally). The results are a bit weak, but do suggest that elite schools can make a difference in income and graduate school placement.

January Schedule

I apologize for the delay: My January schedule is available online through the Insider Medical Admissions website. Please schedule Mock Interviews and Strategy Sessions early, as the slots get grabbed up quickly!

Thank You Notes

An applicant recently asked me to whom he should be sending thank you notes after interviews. Use this as a general guideline: If, during the interview day, you have spent more than five minutes of one-on-one time with someone from the institution, that person deserves a thank you note.

See my other blog postings on thank you notes for more information, but the bottom line is that these short notes should be handwritten (no email) and sent promptly after the interview.

The Time Pressure of Pre-Match Offers

A few of my residency applicants have already been given pre-Match offers. Can anything be done to alleviate the time pressure often associated with these early acceptances?

First of all, I'm always impressed with pre-Match offers that do not require a rapidly-forced reply from the applicant. Better programs have the confidence to afford their applicants some time to think.

If you are made a pre-Match offer, there is no down side to requesting more time to make your decision. If the program says no, nothing is lost and if they say yes, you have a bit more time to think or interview at other institutions.

I've had applicants ask me if they should accept a pre-Match offer or take their chances with the Match. Of course, there's no simple answer. Factors to consider include the strength of an applicant's candidacy, the quality of the program and the applicant's risk tolerance.

Super Duper Creepy

Here's a disturbing article in the Chronicle of Higher Education about a man who writes papers for students. (Even he is troubled by his work.)

I want to point out that I do not generate materials, and I am not a "secret weapon" for my clients. On the contrary, I am thrilled when applicants are forthcoming about my assistance. One of my clients was asked during her interview day if she had obtained professional help with her residency candidacy. When she said yes, the interviewer congratulated her on her initiative.

Contact me now for mock interview assistance. I have only a few slots left in December.

Happy, Healthy Thanksgiving

Just a quick greeting to all of my American readers. And to my international friends, have a great end of November. I'll resume my comments after the holiday!

More Options for Those Interested in Emergency Medicine

For those of you considering a career in Emergency Medicine, the American Board of Medical Specialties recently approved Emergency Medical Services (EMS) as a subspecialty. It is the sixth subspecialty available to boarded Emergency Physicians, along with Hospice and Palliative Care, Undersea and Hyperbaric Medicine, Pediatric Emergency Medicine, Medical Toxicology, and Sports Medicine. The American Board of Emergency Medicine is the sole sponsor of the EMS subspecialty.

Going Home

Here's a quick tip regarding medical school clinical rotations:

A few third years have asked me if it's kosher to take a resident up on an offer to go home early.

Very few residents are trying to trick you or test you when they tell you to get out of the hospital. The one thing I would suggest - before you leave - would be to say, "Thank you. Is there anything I can do for you or for our patients before I go?" The comment will go a long way.

Student Doctor Network Article

Here is my recent contribution to Student Doctor Network regarding planned modifications for the Scramble:

Using “SOAP” to Clean Up the Scramble

In response to persistent concerns about the “Scramble,” the two-day process when unmatched residency applicants vie for unfilled residency positions, the National Residency Match Program (NRMP) and the Association of American Medical Colleges (AAMC) have announced significant Match Week changes to start in 2012, thus affecting next year’s residency applicants. The new system, called the Supplemental Offer and Acceptance Program (SOAP), is an attempt to improve the Scramble after repeated complaints about disorganization and lack of transparency. SOAP will overhaul the Match Week calendar, so all applicants – both unmatched and, indirectly, matched candidates – will be affected by the reforms.

Read the full story here.

AMSA Featured Speaker

For the second year in a row, I have been invited to be a featured speaker at AMSA's national convention. The AMSA 61st Annual Convention will to be held in Washington, DC this spring. I'm scheduled to speak on Saturday, March 12, 2010 at 10 am. In the past the American Medical Student Association's national meetings have been the largest annual gatherings of medical students in the United States. I'll be offering an interactive lecture called "Getting Into Residency: An Insider's Tips."

See you there.

Your Dream Medical School Advisor

Make a list of the qualities that you would want in an ideal medical school advisor:

1. Someone intimately familiar with your academic background and educational pedigree.
2. Someone with a strong grasp of the residency applicant pool against whom you’re competing and a knowledge of the qualifications needed for a successful match.
3. Someone who is familiar with the logistics of the Match process.
4. Someone capable of giving critical feedback (even/especially when it’s not what you want to hear).
5. Someone who has the time and attention to focus on you.
6. Someone who offers discretion when discussing failures or shortcomings in your candidacy.

Only a small fraction of medical students have a dream advisor. The majority of will need to identify an outside mentor who can offer what their medical school cannot.

Whether you pay for a professional consultant or pursue the counsel of a trusted acquaintance, seek excellence in the mentor whose services you retain: Hold out for someone experienced, accountable and available. This individual should advocate for you and should provide the sometimes-brutal honesty to enable you to get your foot in the door with a compelling application and then dazzle your dream program once you interview.

Although friends may not be willing to make you uncomfortable in a mock interview scenario, faculty may have no qualms about doing so during your actual interview. During a residency mock interview, the proper guide can show you how to strategically navigate treacherous interview topics and how to answer open-ended questions so that you distinguish yourself from the masses.

I encourage you to make a list of those people who might help you with your candidacy for a competitive residency. If personal contacts fall short, considering hiring a professional. Ask around, check with fellow students, and look for a service where you know what and whom you are paying for.

Depression Among Student Doctors

by Michelle A. Finkel, Insider Medical Admissions

This article in the NYT called "Medical Student Distress and the Risk of Physician Suicide" covers depression in student doctors, noting that pre-meds enter medical training with mental health profiles similar to those of their peers but end up experiencing depression at greater rates.

Training is generally awful. (Why would anyone want to spend the majority of his/her time working and not sleeping?) Now that I am past my training and have many friends and colleagues who also are, I have the perspective to say that it gets better.

Please consider talking to a physician-mentor at your institution if you are feeling blue. If you are depressed, seek mental health help. (I have heard students say they are worried this will show up on their academic records, which is not accurate.) Knowing that you are not alone and that there is a light at the end of the tunnel can make a big difference.

Mock Interview Scheduling

By Michelle A. Finkel MD, Insider Medical Admissions

My open November slots are now available on my online calendar. The slots tend to go quickly, so if you are planning to hire me for Mock Interviews please do so soon. The steps to hire me can be found here for residency applicants and here for medical school applicants.

Lacking a "Social Mission"

by Michelle A. Finkel, Insider Medical Admissions

Here's a NYT article focusing on NYU's new curriculum, but examining more closely criticisms of many medical schools - a lack of patient-centered coursework. NYU, Harvard, Florida State University and other institutions are reacting to critiques that students do not get in to see patients early enough in their medical school careers and that pathophysiology is emphasized over compassionate care.

Unfortunately, until incentives are aligned (= reimbursement), practicing physicians will be forced to continue to focus on disease, rather than patient well-being. Along those lines, I recommend Atul Gawande's New Yorker article, "Letting Go" about end-of-life care.

Interviews: What to Wear

by Michelle A. Finkel MD, Insider Medical Admissions

Applicants ask me whether they can wear this-or-that suit, and I've seen entire articles written on interview attire.

But this is an easy one: Don't be noticed for your clothes. Don't wear the cartoon tie (even if you are a pediatrics residency applicant), and don't wear the orange tights in honor of Halloween. You want to be noticed for your accomplishments, not your appearance.

Email me at insidermedical@gmail.com for mock interview help.

Compulsive Email Checking

by Michelle A. Finkel MD, Insider Medical Admissions

I don't usually recommend compulsive behavior, but it's worth checking your email once a day to see if you've received interview invitations. Out of courtesy, an invite should be responded to quickly, and the sooner you contact the institution, the more likely you are to get a slot that you want. Ensure your email account is reliable and that messages aren't going to spam. (I've heard some horror stories.)

Contact me for help with Mock Interviews.

Medical School Interview Tips

by Michelle A. Finkel, Insider Medical Admissions

Congrats to those who have already been invited for med school interviews.

Getting into medical school has gotten so competitive; the interview is critical. But what are medical schools looking for during the interview process?

First, they are seeking someone distinctive. Your goal is to distinguish yourself from all of the other applicants by showcasing your accomplishments. Anyone can say s/he wants to help people or is hard working. Fewer candidates can prove it.

Second, they want to ensure you are committed to medicine and that you have an idea of what you are getting yourself into. Medical school is tough; the institutions are not seeking someone who is ambivalent and might quit. Giving examples of your clinical experience can help.

Third, the schools want to ensure you are reasonable. They want to see that you don’t have a problem personality, aren’t going to harass your colleagues, aren’t going to cause them embarrassment or extra work.

Fourth, they want to hear that you are particularly interested in their institution. You can convince them of your interest by knowing specifics about the school and city.

One would never take the MCAT without practicing first and yet, countless applicants go to interviews without preparing. Consider working with me so that you don't unknowingly undermine your chances of success with poor interview skills. I do all of my own work - not outside, anonymous "consultants."

Contact me (insidermedical@gmail.com) for help.

Scheduling Mock Interviews

by Michelle A. Finkel MD, Insider Medical Admissions

For those of you interested in Mock Interviews, please contact me the day you receive your first invitation. I still have some availabilities in September but am already scheduling into October. I have opened up weekend and late evening sessions to accommodate everyone as best as I can.

I conduct all of my own Mock Interviews. I thoroughly review your background information before the session and provide an individualized feedback document after. Live face-to-face video is an option you can add to your sessions.

Contact me at insidermedical@gmail.com for help.

When Your Debts Affect Your Dates

by guest-blogger David Z. Presser, MD, MPH for Insider Medical Admissions

A recent article in the NY Times highlights how individual debt taken on as a student has the power to adversely affect one's subsequent relationships. You can link to the article here.

You are feeling less anxious and more comfortable with the whole medical school applications game. The interviews keep rolling in. Finally, you start to receive acceptance letters from multiple schools. Suddenly you find yourself in the enviable position of having a choice between a reputable state school, where tuition is relatively low, and a reputable private school, where you will go deeply into debt. You visit the private school and see stars: the buildings are made of marble, the admissions officials wear designer suits, and the alumni network, everyone assures you, will give you a leg up in residency applications. Should financial considerations play into your decision? Should you ignore finances and follow your heart, assuming that as a future physician you'll comfortably be able to pay off any educational debt?

These are important questions. Let's look at a few numbers, accessed online on 9/7/10:

Average (2008) loan debt of a Georgetown Medical Student on graduation: $167,000

Average (2007) loan debt of a UCLA Medical Student on graduation: $98,677

Note that each of these numbers do not include debts accrued from undergraduate education. What you owe from college, you owe in addition to this.

Now let's add a touch of romance to the mix. You fall madly in love with another med student, who took out loans to attend a private undergraduate university (s/he owes $100k for that) and you both went to private medical schools ($150k each). Let's give you a pass and say your parents generously paid for all of your undergraduate education, so you personally only assumed debt for your medical education. The wedding after graduation is followed by the shocking realization that you collectively owe $400k. This does not account for the fact that your residency salaries are insufficient to let you pay off significant debt.

Were you both planning on a career in primary care? Think again - your earning potential would adversely affect your ability to pay off your loans. Compare the following starting salaries based on a 2009 American Medical Group Ass'n Survey:

Family Medicine $144,990

Urology $300,000

Anesthesiology $325,000

Internal Medicine $146,251


What if one of you has a high interest loan on a credit card because of poor financial discipline in the years before you met? What if one of you is a saver and the other is a spender? What if the medical student you marry is a U.S. citizen International Medical Graduate (IMG), where only 47.3% obtain a residency position through the match? If your partner cannot get a residency position, there is a real possibility that $250k in loans may not realistically be paid back. Despite the promise of a comfortable life as a two-physician household, your joint credit ratings may never permit you to get a home loan.

These are sobering possibilities that need to be realistically appraised early on. The debts you assume in your youth will have far-reaching consequences. So consider your choice of medical school carefully, because your debts will ultimately affect your dates.

The Role of Patient Anecdotes in the Personal Statement

by Michelle A. Finkel MD, Insider Medical Admissions


Here's another good one by guest-blogger David Presser, MD, MPH:

The temptation is great to include patient anecdotes in the personal statement. When written well, these stories can capture a sense of common human experience that transcends economic and cultural barriers and demonstrates the empathy of the author-applicant and her sincere motives for pursuing a medical career. This can only help the applicant, right? The answer (as with most situations in life) is: it depends.

The vast majority of applicants have anecdotes to share. Writing too extensively about moving patient experiences can be an opportunity cost. You are given a page to make the case for your entry into a medical training program. Does the anecdote distinguish you in some way from the masses? For example, a story that highlights your specific language abilities as an interpreter at a free clinic may be a wiser use of space than a story simply showing your general devotion to the needy. Does the vignette highlight specific strengths in your application? The experience working with Mother Theresa is more powerful when it transitions naturally into the public health degree you pursued and the parasitology research you published.

The key to judicious use of patient anecdotes in the personal statement is that they must be very concise (every excess sentence is a missed opportunity to make the case for why you are a good candidate), distinguish you from others, and concretely illustrate your attributes. If your patient anecdotes do not make the case that you are a uniquely talented applicant whom programs don't want to pass up, they may better serve you as fodder for your future novel than components of your personal statement.

Is Your Personal Statement a Little Too Personal?

by Michelle A Finkel MD, Insider Medical Admissions

I have a guest blogger today - my first ever. Dr. David Presser graduated from UCSF Medical School, completed his Emergency Medicine residency at UCLA/Olive View and his MPH at Harvard. He wrote an excellent primer on getting into an Emergency Medicine residency. Here's today's blog written by him:


Picture, if you will, a residency admissions committee member beneath a halo of light reading applicant essays in her office at midnight. Caffeine on her breath, crumpled white coat next to her desk chair, she is making steady progress on the never-ending stack of applicant files until she picks up a residency personal statement that begins, “I first became interested in Internal Medicine when Grandma was diagnosed with cancer…” Pulling out her hair by the fistful, she tosses the file into the trash. That cancer may not have killed your grandma, but it just might have killed your application.

Many students devote a significant portion of their ERAS essays to describing a universal experience that may have piqued their initial interest in a specialty. A residency admissions committee member does look for evidence of how your fundamental connection to humanity will make you an empathetic and skilled physician. The problem comes when an applicant starts to make the reader feel like s/he is providing counseling to the applicant, that is, when the candidate uses language that could strike the wrong reader as inappropriate for a professional application. The admissions committee can handle empathetic writing; however, if they suspect you mistook your essay for the journal under your pillow, they may not be forgiving.

Think carefully about the topics you choose. With all due respect to each of us who has had a family medical catastrophe, you can estimate the prevalence of cancer among the elderly and conclude that starting an essay with the description of a grandparent’s battle with cancer is not going to catch the reader’s attention. Unfortunately, just because it is genuine, it may not be compelling reading or a useful means to distinguish you from the hundreds of residency applicants whose essays share similar themes.

There are exceptions. You can be forgiven for including a common topic if it directly ties into highlighting a unique personal accomplishment. Perhaps grandpa’s prostate cancer diagnosis led you to seek out a research position with a faculty member at your local university lab where you were directly involved in sequencing a promising new molecular marker for prostate cancer. Give the generic topic a brief mention and transition rapidly into how it demonstrated that you are a mover and shaker who took a universal experience and, by virtue of your work ethic and intellectual curiosity, turned it into a contribution to science.

You get a pass on writing about universal experiences if you can pull off a convincing reason to keep the midnight reader going; otherwise, keep your essay distinctive and befitting the professional you hope to become.

Couples' Match

by Michelle A. Finkel MD, Insider Medical Admissions

I've received a few questions about the couples' match. Here is the information that the NRMP sends to applicants who inquire about it:

(Note the syntax mistakes are not mine :).)

Any two applicants may participate as a couple and may choose to link their individual rank order lists in the NRMP system so that corresponding pairs of programs may be considered together during the matching process.

Couples do not participate in a separate match. Each applicant register separately in the NRMP R3 System and then each partner must link themselves to the other partner in the “Update My Profile” Couples option, any time prior to entering their rank order lists. The rank order list function opens on January 15.

Programs consider, interview, and rank each applicant separately based on their individual merit or qualifications and not based on the fact that one is part of a couple in the Match. The NRMP does not indicate to the programs that applicants plan to enter their rank order lists as a couple.

Both applicants may rank the same or different specialties and programs. However, partners that rank the exact same program MAY possibly end up competing for the same positions in the program in this scenario.

Programs may be located at the same or different hospitals. The programs may be in any location preferred, such as the same city, neighboring cities, neighboring states or any other location of the applicants’ choice.

Prospective partners should determine early in their application process, as many acceptable locations of programs to apply to, so that they will have more workable combinations to rank (subject to interviews).

Couples have two unique options available to them in creating rank order lists:

· The same program of one partner may be ranked multiple times in combination with different programs of the other partner, increasing the possibility of one partner matching to a particularly desired program.

· After all combinations have been exhausted, one partner may also choose to go unmatched in order for the other to match to a program. The partner who is willing to go unmatched enters 999999999 opposite the corresponding program choices of the other partner. The partner who is unmatched will try to find a position through the “Scramble” for unfilled positions.

The R3 System tries to match your first choice and the partner’s first choice, your second and the partner’s second etc. until a match occurs or the entire rank order list is exhausted. Please note: The R3 System will only match you as a couple under this process. If it cannot match you as a couple, it will not try to match you as individuals. The coupling function is only done on the primary rank order lists of the two partners so any supplemental lists will be considered individually without regard for the coupling link.

Each partner of a couple will be billed $15.00. Additionally, for each program over 30 different unique program codes listed per each partner’s primary list, there is charge of $30.00 per additional program. For purposes of billing, even if the same unique program code number is used on one partner’s list more than one time in multiple combinations with different programs on the other partner’s list, it would count only as one code toward the 30 programs per list (no additional charge) limit.

Supplemental list fees per person are $30.00 per each unique program code over 30 programs ranked on all supplemental lists combined.

Please visit our website at www.nrmp.org under Residency Match and then click on the left menu on your applicant type and then on Couples to read further about the process.

Applying to Multiple Specialties

by Michelle A. Finkel MD, Insider Medical Admissions

Just a clarification for those medical students applying in multiple specialties: The program directors cannot see your ERAS Document Submission Form and will not be aware of the other programs to which you will be applying. I know this has been a question that has come up many times.

Contact me for ERAS and personal statement help.

NRMP Program Director Survey

by Michelle A. Finkel MD, Insider Medical Admissions

The results of the 2010 NRMP Program Director Survey are out. (The last survey was done in 2008.) This document is tremendously helpful, documenting what percentage of residencies (separated by specialty) use specific factors (personal statement, perceived commitment to the field, etc.) in interviewing and matching applicants. You can use this evidence to make a strategic plan for your candidacy. (Warning: The PDF is large, and the download may take a while.)

Please contact me now for help with your residency application. You want to submit as early as possible.

Double Vision

by Michelle A. Finkel MD, Insider Medical Admissions

I've had a couple of clients this season tell me that they had other professional editors revise their personal statements but that they want me to do a re-edit because they need my expertise. Instead of double paying for a second look, please come to me directly. I do outstanding work and expedite your edits. Here is my testimonials page. The number and caliber of remarks about my work says it all!

Why an Early ERAS Submission Will Help You

by Michelle A. Finkel MD, Insider Medical Admissions

When I was an Assistant Residency Director evaluating ERAS, I was impressed with residency applicants who submitted their materials early. I figured those were the people who were on-the-ball and would make reliable residents. Also, early in the season, when I had only a few applications to assess, I was able to spend extra time on each ERAS. Later in the season, when I was flooded with applications, I could only give each one its allotted time.

For those two reasons, I strong recommend submitting your ERAS on September 1. Please contact me now so that you can achieve that goal.

IMG Study

Here's an interesting article regarding a study published in Health Affairs that supports foreign-born IMGs' clinical work.

Interestingly, the research results also demonstrate concern over US-citizen IMGs' capabilities. It's worth a read.

Secondary Essays

by Michelle A. Finkel MD, Insider Medical Admissions

I've received several emails asking how to best answer the secondary essay question, "Why do you want to attend our school?"

Medical schools want to be assured that you know their institution, are seriously considering it and will fit in well there. I recommend doing your research on the school and linking something specific about you with the institution.

For example, if you tutored high school students in math, you might link your use of the Socratic method with the school's tutorial-based learning. In that way, you demonstrate a knowledge of the school, show that you connect with it and showcase an accomplishment.

Contact me for secondary essay help.

IMG Observership Letters of Recommendation

IMGs, be aware that working in a physician's office getting hands-on experience may be viewed as illegal. The Medical Board of California July newsletter has an interesting article on page five warning physicians that allowing IMGs to work in offices treating patients is "only lawful if the scope of the work is no more than a medical assistant would perform."

The article goes on to focus on letters of recommendation for residency written by physicians who work with IMGs. "While the Board understands the desire to assist the international graduate, letters written by physicians that indicate they have allowed the unlicensed international graduate to perform examinations and assist with patient care activities in their offices can result in a charge of aiding and abetting the unlicensed practice of medicine."

The article never explicitly defines a "medical assistant" but refers to the fact that this role only requires a high school diploma.

Plagiarism

by Michelle A. Finkel MD, InsiderMedicalAdmissions.com

In a recent study published in the Annals of Internal Medicine, investigators report finding “evidence of plagiarism” in personal statements in 5.2% of residency applicants to Brigham and Women’s anesthesiology, general surgery, internal medicine, OB-GYN and emergency medicine residency programs between Sept. 2005 and March 2007.

Applicants should be aware of this type of scrutiny. (I hope that candidates won't consider plagiarizing material for obvious ethical reasons!)

ECFMG ERAS Tutorials

by Michelle A. Finkel MD, InsiderMedicalAdmissions.com

The Educational Commission for Foreign Medical Graduates (ECFMG) has developed four tutorials to assist international medical graduates (IMGs) with the ERAS 2011 application process. Topics covered include

a) requesting a 2011 ERAS Token,
b) uploading a digital photograph,
c) completing an on-line Document Submission Form and
d) re-using letters of recommendation for Repeat Applicants.

You can access the tutorials here.
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MSAR Update

by Michelle A Finkel MD, InsiderMedicalAdmissions.com

I've been searching for a more updated summary of the MSAR; I still regularly use the one noted in this blog entry, but it is not this year's version. I have a summary that's more current but less clear; email me (insidermedical@gmail.com) if you're interested in it.

Bottom line: The numbers are virtually the same - only a bit higher, meaning it's gotten a little harder to get into medical school (no surprise).

Contact me for secondary essay editing.

Good Writing Means Never Having to Say, "I Want to be a Doctor"

by Michelle A. Finkel MD, Insider Medical Admissions

It's important to express to medical school admissions officers why you want to be a physician, but the key - as always - is to show, rather than tell. The content of your accomplishments and the skills and insight you have gained from them are compelling. Stating that you really, really want to be a doctor is not. (This is true for post bacc, residency and fellowship applicants too.)

Contact me for help with your medical school personal statement and secondary essays. Unlike other consultants, I do all of my own work - while maintaining quick turn around times. Here are copious testimonials about my work.

Clarifying Your Honors

By Michelle A. Finkel MD, InsiderMedicalAdmissions.com

A word to the wise: Be explicit about the honors you have earned. Although you may be aware that a position you garnered was competitive, the reader may not. For example, you could write

As an intern at the American Nonexistent Foundation, I completed two research projects.

Or you could write

Out of a pool of ninety applicants, I was awarded the selective American Nonexistent Foundation’s annual internship, where I completed two research projects.

See the difference?

Contact me for AMCAS and ERAS help. I do all of my own work (no outside, anonymous editors) and expedite my clients’ edits.

New ACGME Recommendations for Work Hours

By Michelle A. Finkel MD, InsiderMedicalAdmissions.com

The New England Journal of Medicine released last week the Accreditation Council for Graduate Medical Education (ACGME)'s latest duty hour recommendations. They are more stringent, providing more compassionate training for doctors and, hopefully, better care for patients. This table may be an easier way to visualize the changes.

I recall very clearly the week I worked one hundred and thirty-eight hours during my surgical rotation. I am still recovering :(.

Critical Care Certification

by Michelle A. Finkel MD, InsiderMedicalAdmissions.com

The American Board of Emergency Medicine (ABEM) and the American Board of Internal Medicine (ABIM) have agreed that Emergency Physicians will be able to certify in Critical Care. Currently, Emergency Physicians (EPs) can complete Critical Care fellowships, but they cannot qualify for U.S. board certification. The new certification examination program still requires approval from the American Board of Medical Specialties but hopes are high. If all goes well, the first examination should be available in 2012.

Please contact me early for Strategy Sessions and editing. The medical school, residency and fellowship application seasons continue to heat up.

Grade Inflation

Here's a really interesting article about law school grade inflation. Apparently, some schools are simply increasing their students' numbers to improve job prospects and the institutions' reputations.

Ranking Medical Schools

by Michelle A. Finkel MD, Insider Medical Admissions

Pauline Chen MD has an interesting article in last week's NYT regarding medical school rankings. Probably neither research nor social mission should be the way we rank schools.

And maybe we shouldn't judge doctors on where they attended medical school. But the current system does reward those at more competitive schools with better options for residency. Within the medical field, it's not a system that would be easily dismantled.

Contact me for medical school admissions help.

Pre-Med Clinical Experience: Think Ahead

by Michelle A. Finkel MD, Insider Medical Admissions

For those of you pre-meds seeking clinical experience, I recommend getting started early. Although you might think free clinics would be thrilled to have a pre-med volunteer, many understandably require one-year commitments.

Getting good advice early (freshman or sophomore year) can make a difference in your medical school candidacy. Contact me early to schedule a Strategy Session.

Update Letters

by Michelle A. Finkel MD, InsiderMedicalAdmissions.com

Recently I've helped a few clients who want to submit their AMCAS now, but are starting compelling extracurricular activities this summer. I do not recommend describing an activity in your AMCAS that you have not yet started. Doing so can make the reader think you feel your candidacy is weak - that you are grasping at straws. One thing you can do is send an update letter later. You cannot, however, submit one through AMCAS; it has to be sent individually to each institution.

Contact me for editing help. I complete all of my own work quickly and effectively.

My Services

by Michelle A. Finkel MD, InsiderMedicalAdmissions.com

As the medical school application cycle heats up, I wanted to make a plug for my work and describe what distinguishes Insider Medical Admissions from other residency and medical school consulting companies:

1) Relevance - I'm a former Harvard Medical School faculty member with admissions experience and a professional journalism background.

2) Value - Your medical education will cost over $100K (possibly closer to $200K). Why entrust your future to underqualified or anonymous editors? I personally edit every essay and conduct every Strategy Session and Mock Interview myself.

3) Experience - I have helped hundreds of Insider Medical Admissions clients from the strongly competitive to the sink or swim candidate.

4) Discretion - I maintain strict confidentiality.

5) Speed - I offer quick turn around times.

Please see my robust testimonials page for client comments.

AMCAS 2011 Open

by Michelle A. Finkel, InsiderMedicalAdmissions.com

You can now submit your 2011 AMCAS. Here is the web site.

Please contact me for medical school personal statement and AMCAS editing. For rolling admissions schools, the sooner you apply the better.

You Only Have One Chance to Make a First Impression

by Michelle A. Finkel, InsiderMedicalAdmissions.com

Quick tip: Ensure your personal statement can stand alone and doesn't rely on your AMCAS or ERAS activities' section for clarification. I see some personal statement drafts that subtly refer to a candidate's big accomplishment without fleshing it out. You need to assume that the reader is seeing your essay first and independent of your AMCAS/ERAS.

For medical school admissions consulting help, please contact me as soon as possible. The season is heating up. Submission to AMCAS starts June 1.

Have a great holiday weekend!

Post Baccalaureate Programs versus Supplemental Undergraduate Courses

by Michelle A. Finkel MD, InsiderMedicalAdmissions.com

Whether you matriculate into a formal post baccalaureate program or simply take supplementary courses independently, AMCAS calculates your GPA similarly: Undergraduate courses are undergraduate courses to AMCAS. So what is the advantage of a post baccalaureate program?

1. Reputation. These programs are known quantities to medical school admissions committees.
2. Ability to get quality letters of recommendation (LOR). Most post bacc professors are very familiar with writing medical school LORs.
3. Link programs. Some schools have partnerships with medical schools, so that if you maintain a certain GPA and score well on the MCAT, your application is facilitated by your participation in the post bacc program.
4. Organization and pre-med help. Not all post bacc schools have this, but many of the good ones do.

The drawbacks to these programs are a) competitive admissions and b) the cost, which can be significant.

Contact me for post baccalaureate application help. I assist with post baccalaureate personal statements and resumes/CVs.

Emergency Medicine Fellowships for Family Practitioners

by Michelle A. Finkel MD, InsiderMedicalAdmissions.com

Here's an article from an Emergency Medicine news magazine on the advent of Emergency Medicine Fellowships for Family Practitioners. As you can imagine, these training programs are rather controversial, especially amongst current Emergency Physicians. (Note that the link listed in the article is not valid.)

For residency admissions consulting help, contact me.

What is the Cost of that CT?

by Michelle A. Finkel, InsiderMedicalAdmissions.com

Check out this interesting NYT's article "Teaching Physicians the Price of Care." When I was in residency we were taught to consider whether a test would change management before ordering it, but we never explicitly reviewed prices.

What's provocative is that some systems reward physicians financially for expensive testing. That topic is notably missing from the article.

Submitting your Medical School Letters of Recommendation

by Michelle A. Finkel MD, InsiderMedicalAdmissions.com

Your medical school recommenders have several options for submitting their letters to AMCAS. You want to make the process as convenient as possible for the writers, and different ones may have different preferences. So offer each writer all feasible alternatives. If your recommender plans to send the letter by snail mail, provide him or her with a self-addressed, stamped envelope.

Here are the options:

1. AMCAS Letter Writer Application: This application enables letter writers to upload documents securely to AMCAS rather than send letters via the mail. If you are interested in this option, and can upload a PDF version of your letter, make note of the requesting applicant's AAMC ID and AMCAS Letter ID included above and go to https://services.aamc.org/letterwriter. You will need to register for your own AAMC account in order to use this service.

2. Interfolio: AMCAS can receive letters sent to Interfolio if the student requesting this letter is an Interfolio user or your
institution/organization uses Interfolio to deliver letters of evaluation/recommendation.

3. Mail your letter: If you select this option, please attach this form to your letter(s) and mail to:
AMCAS, attn: AMCAS Letters
AAMC Medical School Application Services
P.O. Box 18958
Washington, DC 20036

4. VirtualEvals (VE): VE is available to members of the National Association of Advisors for the Health Professions (NAAHP). If you are a VE user, make note of the requesting student's AAMC ID and AMCAS Letter ID included above and upload your letter(s) to VE.

AMCAS open

by Michelle A. Finkel MD, InsiderMedicalAdmissions.com

The 2011 AMCAS application is now open. It's time to start working on your written materials. Here's the AMCAS website.

Please contact me for assistance early (=soon).

Family Practitioners' Salaries

I recommend an article in the Business Section of the NYT called "Study Shows ‘Invisible’ Burden of Family Doctors." The piece reports that less than ten percent of medical school graduates choose primary care specialties. Note too that, generally, the lesser the compensation, the less competitive the residency. The converse is true too.

Accepted!

Below is the current list of medical schools to which my clients have been accepted. These are listed by descending order from U.S. News and World Report's 2010 Best Medical Schools - Research. Those not ranked are listed at the end alphabetically.

Harvard University
University of Pennsylvania
Washington University
Duke University
University of Michigan
University of Washington
Columbia University
UCLA
University of Chicago, Pritzker
Vanderbilt
Northwestern
Case Western University
Emory
University of North Carolina
University of Texas Southwestern
Baylor College of Medicine
Boston University
Dartmouth
University of Southern California
University of Minnesota
Georgetown University
Tufts University
University of California, Irvine
Medical College of Wisconsin
St. Louis University
Rush University
Virginia Commonwealth University
Wayne State University
Loyola University
University of Nevada
---------
Ben Gurion
Loma Linda University School of Medicine
Marshall School of Medicine
Mayo Medical School
Meharry Medical College
Tulane University
Pacific University of Oregon
Pennsylvania State
Philadelphia College of Osteopathic Medicine
Southern Illinois University
Touro College of Osteopathic Medicine
University of Illinois College of Medicine
University of Southern Nevada
University of Toledo

I'm tremendously proud of my clients. Please contact me for help with your application. Earlier is always better.

The Making of Erroneous Assumptions

by Michelle A Finkel, InsiderMedicalAdmissions.com

Claire Cain Miller's recent New York Times article, "Why So Few Women In Silicon Valley?" is a good read with some great anecdotes. The subject is very applicable to the medical field.

Physician - Writer

by Michelle A. Finkel MD, InsiderMedicalAdmissions.com

Sheri Fink MD just won the Pulitzer Prize in the investigative category for her article on doctors' care at Memorial Medical Center in New Orleans during Hurricane Katrina. Her article, "The Deadly Choices at Memorial" was published in the NYT in August of last year. Sheri was a colleague of mine at Harvard and completed the American Association for the Advancement of Science Media Fellowship several years after I did. Although Sheri's accomplishments are clearly exceptional, her achievement demonstrates that those with an MD can accomplish a lot in ways other than clinical.

Emailing Your Letter of Intent

By Michelle A. Finkel MD, InsiderMedicalAdmissions.com

In a previous entry, I recommended sending your letter of intent (LOI) both by snail mail and email - the latter if the institution has not explicitly banned electronic correspondence with them. If you are sending your letter by email, ensure that you send it in the body of the email - not as an attachment. Even one more step (opening the attachment) might impede your document's being read.

Contact me for LOI editing help.

Language Proficiency

by Michelle A. Finkel MD, InsiderMedicalAdmissions.com

A tip for your CV and the application process in general:

Unless you are prepared to conduct an interview exclusively in another language, use the term "proficiency" instead of "fluency" when describing your foreign language skills. You do not want to face embarrassment (or worse) regarding an overstatement of your abilities.

Regarding Previously-Open General Surgery Residency Slots

by Michelle A. Finkel MD, InsiderMedicalAdmissions.com

I've received a few emails recently asking whether there are still open General Surgery residency slots at Kaiser Permanente Fontana Medical Center (Southern California), a tip I mentioned in a March blog entry. Unfortunately, my contact says there is no funding for more slots and thus, the only applicants who might be considered now would be orphans (residents whose programs have folded and thus come with their own funding). Sorry for the news.

Residency Application Handout

by Michelle A. Finkel MD, www.InsiderMedicalAdmissions.com

I've received a few requests for the handout I created for the AMSA talk last month. If you would like a copy of my PDF "Don't Let ERAS Kick Y'ERAS" please shoot me an email: insidermedical@gmail.com.

Happiness

by Michelle A. Finkel MD, InsiderMedicalAdmissions.com

I received really bad advice when I was applying for residency: A dean told me that I would be working so hard, it wouldn't matter where I lived. He said I should choose the most competitive program regardless of location.

I couldn't disagree more. If you're applying to medical school, residency, fellowship or a post bacc program, it's essential to think about what will make you happiest. Usually, that means being near your significant other, family and friends. It might mean being in nice weather, near your religious community or in a place where you can continue your favorite hobby.

In case you don't believe me, here's an article from the NYT to back me up.

As always, contact me for help.

Salaried Positions versus Private Practice

There's an interesting article in the NYT regarding doctors' seeking salaried jobs over private practice ones. It covers differences in attitudes between established doctors and those newly in the field.

On another note, I just spoke with a first-year medical student who had the foresight to seek help now regarding how her next few years of medical school can be optimized to improved a future residency application. We discussed this year's summer opportunities, the USMLE, her research and leadership opportunities, amongst other topics.

Contact me early for admissions assistance for a long-term plan.

For "Junior" Medical Students: What You Can Do Now to Improve Your Chances of Matching

by Michelle A. Finkel MD, InsiderMedicalAdmissions.com

What can you do early in your medical school career to improve your chances of matching well? First, it’s important to show early and strong commitment to your chosen specialty. The NRMP surveyed Residency Directors in 2008, asking them which factors they use in selecting applicants to interview. Sixty-six percent of respondents listed “perceived commitment to the specialty” as a factor. Commitment can be demonstrated easily through membership in a medical school’s specialty interest group. If no club exists, a candidate can start one, demonstrating dedication to the field and leadership. Another almost effortless way to demonstrate commitment is to become a member in a specialty’s national organization.

More important, however, is demonstrating real commitment through accomplishments. These may include research, international work and community service in the field, and honors in multiple rotations in the specialty. It’s difficult to find the time for these activities during medical school. But as can be seen from the NRMP Residency Director survey, they are important.

To improve your residency candidacy fully and thus improve your chances of matching, contact me when it’s time to apply. Because applicants can unknowingly undermine their chances of success with poorly compiled application materials and underdeveloped residency personal statements, a qualified, personalized residency admissions consultant provides a great advantage. I do all of my own work, never farming my clients' materials to outside editors.

Match Success!

by Michelle Finkel MD, www.InsiderMedicalAdmissions.com

My clients have had noteworthy successes with the Match this year. Thus far, I've heard about #1 choice matches in Ortho, Derm, Radiology, Neurology, Urology and Family Medicine to name a few. Congratulations!

Contact me now to start preparing for next year's application cycle.

AMSA Conference Success

by Michelle A. Finkel MD, InsiderMedicalAdmissions.com

Thanks to everyone who attended my lecture "Getting Into Residency: An Insider's Tips." We had a huge turn out and consequently ran out of hand outs. If anyone would like a PDF version, please contact me.

AMSA lecture

by Michelle Finkel MD, InsiderMedicalAdmissions.com

I'll be speaking tomorrow at the 60th Annual AMSA National Conference at the Disney Hotel. The lecture "Getting Into Residency: An Insider's Tips" will begin at 11:30am and will be held in the North Ballroom A, Magic Tower. I hope to see some of you there!

Contact me with questions.

Causes of the PCP Shortage

by Michelle A. Finkel MD, InsiderMedicalAdmissions.com

Here's a basic but useful article in Newsweek on the causes of the primary care doctor shortage. I think the way specialists are portrayed at the end is unfair, but it's still worth a read.

Contact me for assistance.

Letters of Intent: Timing

by Michelle Finkel, MD at InsiderMedicalAdmissions.com

I've received some questions about the timing of letters of intent (LOI) for medical school and residency. I recommend the following:

Send the letter as soon as you complete your interview. That way you can knowledgeably discuss your impressions of the institution, while attempting to positively affect your candidacy before being evaluated by the committee. (As you usually don't know when your application will be discussed, sending immediately after your interview is important.)

Although I recommend sending hard-copy LOIs, if the institution has not prohibited sending emails to the admissions committee/residency administration, there is no harm in emailing your LOI in addition to sending the hard copy.


Contact me for help editing your LOIs.

Open General Surgery Residency Slots

by Michelle A. Finkel, MD, InsiderMedicalAdmissions.com

I just received a tip that the General Surgery Department at Kaiser Permanente Fontana Medical Center (Southern California) was just approved for a residency program to start this July. The institution is seeking to fill four spots for each year, PGY 1-5. Although new programs have drawbacks, this might be a good opportunity for those who are late in the process or have deficiencies that would typically limit their candidacy.

Contact me for assistance.

AMSA Conference Featured Speaker Reminder

Just a reminder that I will be speaking at the 60th Annual American Medical Student Association national conference on Saturday, March 13 at 11:30am. The conference is being held in Anaheim. My lecture will cover insider tips for optimizing applications for residency. See you there!

The Medical School Wait List: Can Anything Be Done?

Just when you’ve completed your medical school interviews and feel that you can sit back and relax because – after all – the rest is out of your hands, you may be surprised by a wait list notification. What is the next step? What can you do?

First of all, realize that medical school admissions have become increasingly competitive of late – especially in this weaker economy. Competitive applicants who would have considered business or law school are now recognizing the stability of a medical career. The number of applicants has again increased this year. Being wait listed is better than being rejected, and thus a positive, despite the anxiety is causes.

A few things you can do:
1. Send a letter of intent. Let the school know of your continued interest and your new accomplishments. Ensure the letter is well written, streamlined and brief. Be explicit about your enthusiasm, and if the school is your first choice, let the admissions committee know that.
2. Ask the school if you can set up a second look. A second visit indicates to the institution that you are serious, and it offers you more data in making your decision if you are later offered a spot.
3. Do not neglect your other options. Don’t focus all of your attention on this institution to the exclusion of others: Ensure you are well-prepared for upcoming interviews at other medical schools.
4. Plan for last minute notice. At some schools applicants are offered slots off the wait list throughout the summer. I’ve even heard of acceptances being offered the day before medical school was to begin. Would you be able to change your living situation, move your personal belongings and uproot if this were to happen?

Finally, consider working with a professional who can substantially improve your letter of intent and assist you with mock interviews. I edit all of my clients' materials. I do not hire outside editors. I conduct all mock interviews myself.

New Options for Pre-Meds

Here is an interesting article from today's NYTs regarding the opening of several new American medical schools. These may be a reasonable option for those pre-meds with lesser GPAs and MCATs.

Match: My Last Posting

Unfortunately, I notice that if you click on the Medscape link I published in my last entry, Medscape requires you to input a password. Instead Google "Dan Egan Match" and click on "How Should I Rank Choices for the Match," which is the first entry on the page.

How to Create a Rank List for the Match

Here is a great article from my friend and ex-resident Dan Egan. He was just named the Associate Residency Director for the Emergency Medicine program at St. Luke's-Roosevelt.

AMCAS Science Calculations

I receive a lot of questions about AMCAS' GPA calculations. (Please see previous blog entries on this topic.) One question in particular for those considering post-undergraduate science GPA boosts is the following: How does AMCAS calculate science classes taken after college graduation? Are they placed in the BCPM (Biology, Chemistry, Physics and Math) undergraduate or graduate category?

Post bacc courses are counted as part of the undergraduate GPA. Courses taken after graduation - unless specified as graduate courses in transcripts - are considered post bacc courses, so they are also calculated as part of the undergraduate GPA.

Hope this helps. Contact me for admissions assistance.

Contacting Medical Schools

Recently, one of my clients, who had been invited for interviews at other institutions, was rejected from a medical school he wanted to attend. Much to his credit, he emailed the Dean of Admissions and wrote a cogent note expressing his interest and requesting a second consideration. Within twenty-four hours he had been offered an interview.

I'm not saying this is typical, but generally, I do recommend politely contacting institutions if you haven't heard anything or if you've been rejected from a school for which you think you are competitive.

Contact me for help.

Do Letters of Intent Have Any Impact on the Residency Match Ranking Process?

There are no stats that letters of intent (LOI) do or don't work. (Programs do not tend to be transparent about how their ranking processes are handled.) However, because many programs do not want to go far down their rank list (mostly for reasons related to ego), they are eager to highly rank candidates who want to be at their programs. So I advise my clients to do whatever they can, including a LOI, to let a program know it is their first.

Contact me for application help.

Updating Your Activites After You've Submitted Your ERAS

This week a client emailed me to say that he recently received a new academic award and wanted to let program directors know. He asked me if there was a way to update his ERAS. Unfortunately, once you have submitted your ERAS it cannot be edited. You can send a letter to the programs or you can un-assign and assign a new personal statement at any time. (The latter option has its disadvantages at this late date.)

Contact me for help.

Scramble Service: Are They Worth It?

Please see my recent blog entries on the Scramble.

Certain companies will fax or email your information to residencies with unfilled positions. Although I cannot comment on all companies with Scramble services, generally I think it's better not to hire these businesses. You have the greatest incentive to be assertive about getting your background sent. Furthermore, the Scramble is a fast-paced system; you don't need a middleman to slow you down.

Contact me for help with your residency application. I'm conducting Mock Interviews every day of the week.

Pfizer Grant to Stanford: No Strings Attached?

Here's an interesting article on a grant Pfizer is giving to Stanford University with no strings attached. The question is: Is that oxymoronic?

How to Plan for the Scramble

As I mentioned earlier this week, I've been getting a lot of questions about how the Scramble works. So please see my last entry for a good description and a complete calendar for the process in 2010.

Now here’s a step-by-step plan for the Scramble:

1. In the weeks before, consider reworking your personal statement for a second field if you think you might Scramble into a second specialty. For example, if you are applying in Emergency Medicine and think you may not match, it might be worth reworking your personal statement for Family Medicine, if you would be happy in that field as well, as Family Medicine is less competitive. (Of course the problem with scrambling into another field is that your application as a whole will be focused toward the first specialty; however, it still might be worth a try, especially for a less competitive field.) You can upload the new personal statement to MyERAS before the Scramble without assigning it to a residency program.

2. On Monday, March 15, 2010 applicant matched and unmatched information is posted to the NRMP web site at 12:00 noon EST. If you find out then that you have not matched, plan to take the next day off.

3. Create a PDF file of your entire application for emailing and also have copies available for faxing.

4. Because, unfortunately, the Scramble occurs through two means – the official one, which is ERAS – and the informal one, which is faxing and phone calls to programs - it helps to organize a few friends and some supplies, including a phone line, a fax line and a computer, for March 16, 2010.

5. On Tuesday, March 16, 2010 at noon the NRMP's Dynamic List of Unfilled Programs is released. This list includes all of the residencies that have unfilled slots. Thus, after looking at the list, you select the programs to which you want to apply through ERAS. Remember an applicant may apply to a maximum of thirty new programs in addition to fifteen “old” programs (residencies to which s/he applied during the regular ERAS season). There is no charge for applying to programs during the Scramble.

6. Soon after selecting the programs to which you want to apply through ERAS, you begin calling your top choices, while trying to send out your PDF to those programs. This is the chaotic part of the Scramble. Knowing someone at a program can make a difference.

7. Hopefully, at that point you will connect with someone at a residency program who will offer you a phone interview. With luck, you will be offered a spot.

For help with your residency application, including mock interviews, contact me. I am holding some emergency slots open for those who have urgent requirements.

The Scramble: Organized Chaos

I'm starting a series of entries on the Scramble because I receive a lot of questions about the topic.

First, the basics: The Scramble is a process used to fill unfilled residency positions. Some residency programs will have available residency positions even after the NRMP has completed the Match. These positions become available during the Scramble period so that those applicants who did not get a residency position can vie for them.

The calendar (for 2010) is as follows:

On Monday, March 15 applicant matched and unmatched information is posted to the NRMP website at noon EST. Residency candidates can log in with their AAMC ID number and password to find out if they have matched but not where. (The list of residencies that have not filled is not yet available.)

On Tuesday, March 16 at noon EST the Scramble starts when the list of residency programs with unfilled positions is posted onto the NRMP website. This means that unmatched applicants (who submitted a certified rank order list for the Match) will be given access to the NRMP's "Dynamic List of Unfilled Programs." The list is dynamic because it is updated by the NRMP every hour to demonstrate the number of remaining positions at each residency program.

On Thursday, March 18 the Scramble ends at noon EST and the Match results are available at 1pm EST.

The Scramble is a huge and confusing topic. Please see my next entry regarding how an applicant actually scrambles. (Warning: How it's done is not pretty.)