An Excellent Question

I recently read a NYT piece called, "Why Would Anyone Choose to Become a Doctor?" by Dr. Danielle Ofri. It's a sweet essay written by a physician who describes being perplexed by the large number of medical school applicants yearly, considering her profession's numerous annoyances.

As the author considers alternatives to her career, however, she comes to the conclusion that her clinical encounters make it all worthwhile. The essay is a nice pick-me-up.

Interview Tips from an Entrepreneur

This article is currently at the top of the New York Times' most emailed list. It's written for those entering the work force, but it is very pertinent for applicants to medical school, residency, fellowship, and post bacc programs.

I hope everyone has a happy holiday season!

A Daring Journey Into Medical Anthropology

A few weeks ago, I recommended reading This is a Soul: The Mission of Rick Hodes, and today I want to highlight another must-read for the physician or doctor-to-be. The Spirit Catches you and You Fall Down was published in 1997 and promptly won the National Book Critics Circle Award for Nonfiction, among other accolades.

The book chronicles the U.S. medical experience of a Hmong family, showcasing the twisted miscommunications between the two groups. It's an excellent story and strong reminder to all medical caregivers as to how - although everyone may be aiming for the patient's best - cultural differences can spoil the doctor-patient relationship.

Happiness: Be All That You Can Be

Medical school and residency training usually decrease one's happiness for several reasons. Happiness researchers have demonstrated that a feeling of control and the amount of spare time one has both correlate with happiness. Both of those factors are limited during med school and residency. Relationships are also correlated with happiness, and those can be squashed during medical training as well.

I'm not trying to be a downer here! I want to encourage applicants to consider this happiness quotient when selecting an institution and training program. If you are able, maximizing your contentment by choosing an institution that fosters your greatest happiness is key. Geography; proximity to family, friends and community; and a location that provides an opportunity to enjoy hobbies during limited free time is significant.

Excellent training is important, but, in the end, many programs turn out equally qualified clinicians. At least consider your well-being as a factor in selecting where you might be for the next three plus years of your life.

This Is a Soul

I wanted to put in a plug for a book I'm reading called, "This is a Soul: The Mission of Rick Hodes" by Marilyn Berger. The book chronicles the work of Dr. Hodes, an American doctor who has lived in Ethiopia for over three decades assisting children with horribly severe - oftentimes lethal - spinal problems (frequently tuberculosis-related). Dr. Hodes himself has adopted several sick Ethiopian children.

During his emergency medicine training, my husband worked with Dr. Hodes and was tremendously impressed with his dedication. Here is more information about Rick Hodes and the work he does.

Mocking Optimally

This time of year I'm commonly asked when the best time to set up a mock interview with me is.

I would recommend arranging your practice session(s) with me in the month prior to your first interview. Whether you complete the mock interview(s) weeks in advance or the day before depends on how you best retain information.

More important than when you practice is that you simply do. The NRMP Program Directors' Survey, my experience at Harvard, and my work with hundreds of Insider clients all reinforce the critical nature of the interview in assessing an applicant's candidacy.

If you are planning to hire me, please do so as soon as you get that first interview invitation. My slots go very quickly, and although I try to accommodate everyone I can, I am currently scheduling several weeks in advance because of high demand.

Here is a link to my services page.

Acceptances

It's early in the season, but some of my clients have already been accepted to

UCSD
University of Chicago
Vanderbilt
Case Western
USC (Keck)
Mayo
UCI
Rosalind Franklin and
Wake Forest!

Most medical school applicants are still early in the interview process. Consider hiring me for mock interviews to improve your chances of success.

Thank You Notes: A Plug for the US Postal Service

I was recently asked by a client about the best way to send post-interview thank you notes - email versus snail mail. This client said he had read conflicting advice online.

As a former Harvard admissions decision-maker who used to receive thank you notes, I can tell you that I strongly advise sending your thank you notes by good old USPS. The reasons are twofold:

1) Email may be viewed as lazy. Hand-written thank you notes take more time, which shows.
2) To put an email thank you note in your file, the receiver needs to take the time to print out your email. You don’t want any barriers between you and your good impression.

I do recommend getting those handwritten thank you notes in quickly. The night after you’ve completed your interview or the next day is a good time to write and send.

You Never Get a Second Chance to Blow a First Impression

I receive a lot of questions about interview attire; I have two rules to guide applicants:

1. Do not be noticed for your clothes. You want to be remembered for your accomplishments, not your attire. Years later, I still remember the applicant who arrived in a Bugs Bunny tie. (This might fly for a pediatrics interview, but even then, I wouldn't recommend it.) I also recall the applicant who arrived in jeans. (He packed his interview clothes, checked his luggage, his bags were lost, and he had nothing else to wear for his early morning interview.)

2. Be comfortable. No heels that are so high you are in too much pain to take the tour. No coat so light - but stylish! - that you can't walk out of the building.

What you wear is really much less important than how you present yourself in interviews. For help, contact me. I've recently added some mock interview slots to my online calendar because of high demand.

Being the Squeaky Wheel

Several years ago I helped a strong applicant who had been rejected by a top medical school. He thought he was a very good fit for this particular institution, so he called the school to make his case. Surprisingly, after the applicant's phone call, the school granted him an interview, reversing their original rejection.

It was at this time when I met the applicant; we conducted a mock interview so he would be well-prepared.

Ultimately, after being initially rejected, this applicant was admitted to that top school.

Of course, this is an exceedingly rare occurrence. But to me, the moral of this story is that it is worth being assertive (not aggressive!) in the medical school and residency admissions processes: Send an update letter, call institutions (politely) to inquire about your status (if they do not expressly prohibit phone calls), and be proactive during your interviews.

You need to advocate for yourself in order to be noticed.

Physician Dissatisfaction in the News

Those of you who have worked with me know that I am a realist. (That term may be a euphemism for a pessimist, but hey, I'm an emergency physician.)

It's worth reading this article in the NYT, "Young Doctors Worry About Career Choices." Although job prospects are good for new doctors, there is still a lot that makes the newbies worry.

Coaching and Mentorship

Here's an article worth reading: Personal Best by Atul Gawande, MD in the October 3 New Yorker. The piece reviews the advantages of using a coach to break down performances and improve outcomes. Gawande starts by pointing out the obvious utility of coaches for certain professionals, like athletes, and then asks why we don't use them more widely in other fields - like teaching and even medicine.

Facebook and Twitter

I have re-launched my social media networks to better share relevant information with applicants. Please stay connected with me on Facebook and Twitter!

Do Interviews Matter?

There's an interesting NYT's article from this past week called "Do College Admissions Interviews Matter?" Although the article makes a convincing argument that undergraduate interviews may not matter in many cases, it does point out that many graduate school interviews do. It also recommends doing mock interviews.

The NRMP Program Directors' Survey makes it quite clear that residency interviews matter a lot, which was also my experience as Assistant Residency Director at Harvard. I remember very robust conversations about even small comments that candidates had made in their interviews that adversely affected their ranking on our Match list.

NRMP Stats

The NRMP does a really great job of collecting and distributing useful statistics about the Match. Many of you know that a document I refer to often is the NRMP Program Directors' Survey. Recently, the NRMP has published several more documents, including "Charting Outcomes of the Match - Characteristics of Applicants Who Matched to Their Preferred Specialty in the 2011 Main Residency Match." I know clever applicants who have used the data in this document to strategically apply to residency this year.

The NRMP comments as follows regarding their analysis:

"The data in this report support the following straightforward
advice one should give to an applicant.

- Rank all of the programs you really want, without regard to
your estimate of your chances with those programs.
-Include a mix of both highly competitive and less
competitive programs within your preferred specialty.
-Include all of the programs on your list where the program
has expressed an interest in you and where you would accept
a position.
-If you are applying to a competitive specialty and you would
want to have a residency position in the event you are
unsuccessful in matching to a program in your preferred
specialty, also rank your most preferred programs in an
alternate specialty.
-Include all of your qualifications in your application, but
know that you do not have to be AOA, to have the highest
USMLE scores, to have publications, or to have participated
in research projects to match successfully."

I Wish I Had Known...

I was recently speaking to a colleague who graduated with his MD from UCSF and his MPH from Harvard. He's a successful, practicing physician, and we were discussing some advice he had offered an undergraduate acquaintance who is pursuing medicine.

My colleague had advised the college student to ensure she gets to know faculty: During his undergraduate years at Stanford, my colleague had gotten acquainted with a few professors by inviting them to lunch. He had to call one or two several times before they met with him! But once they did, my colleague's opportunities really expanded. One of the professors in particular realized my colleague's potential and good nature and offered him a position on an honor committee and a strong medical school recommendation.

I wish someone had advised me early to get to know faculty. It turned out okay for me but not without having to do some hard thinking about whom I was going to ask for faculty recommendations. Acquainting yourself with faculty early in your academic career can afford you research and leadership opportunities. Of course, it can also help you with those much-needed letters of recommendation.

MD/MBAs

Here's a recent NYT article on joint MD/MBA programs. Currently 65 MD/MBA programs exist. I have several colleagues and friends who obtained their MBAs years after obtaining their medical degrees - another option for interested physicians.

ERAS: September 1

Just a reminder that today is the day applicants can start applying to ACGME-accredited programs through the AAMC’s MyERAS website.

There are several advantages to an early application: 1) You look organized, a good quality for a future resident. 2) Admissions readers may have more time to review your application thoroughly. Later in the season, the volume can get overwhelming.

ERAS Support Services at ECFMG to Start Live Chat Option

I have found the ERAS support services at ECFMG (Educational Commission for Foreign Medical Graduates) to be very helpful. The representatives respond to my questions quickly via email. On September 1 ERAS support services at ECFMG is launching a live chat option to answer questions about ERAS.

Representatives will be available to live chat M-F 8a-5p EST. You will be able to access the Live Chat service here. Starting September 1, you will find a link to the Live Chat service on every associated web page.

Decision Fatigue

This recent NYC article ("Do you Suffer from Decision Fatigue?") is really interesting, especially when you think how decision fatigue might affect your medical school or residency application. It's worth having the insight this article provides as you make decisions that will affect your future (where to apply, where to send secondaries, where to interview, how you make your match list or decide what school to accept).

Being Repetitive… Again and Again and Again

In writing their personal statements, many applicants ask me if it’s okay to include their accomplishments. After all, they say, their achievements have already been noted in the application, dean’s letter, and letters of recommendation.

Think of the medical admissions process as an onion. Your application (AMCAS, ERAS, post bacc CV, AADSAS) and letters serve as one layer of that onion, albeit a thin one. In other words, your accomplishments are conveyed simply and succinctly there. The personal statement is your opportunity to apply a thicker layer, one in which you flesh out your achievements, thus persuading the reader of your distinctiveness. Finally, the interview is your chance to add on the thickest peel. Discussing your accomplishments in detail can seal the interviewer’s positive impression of you.

So yes, you are going to be redundant throughout the application process, but each part serves a different and additive purpose. If you do not include your achievements in your personal statement, how will you be viewed as distinctive? Remember: Who you are is what you’ve done... and what traits and skills you’ve gained accordingly.

Applying in Two Specialties

Here are some clarifications about what ERAS offers that will help you apply in two specialties:

1) Different personal statements can be assigned to different programs. This means you can assign your ob/gyn essay to ob/gyn programs and your internal medicine statement to internal medicine residencies.
2) Different letters of recommendation (LORs) can be assigned to different residency programs as well. (A maximum of four letters may be assigned to each program.)
3) You will have only one MyEras application. It will go to all of your programs.

Thus, when you select a program to apply to, you will be able to choose which documents (personal statement, LORs) you would like send to that program. ERAS, in this way, allows you to keep your options open.

Ordering Your AMCAS Activities and ERAS Experiences

I've recently received a few questions about how best to order the AMCAS activities and the ERAS experiences. You do not have a choice in how you list your accomplishments. The computer will arrange them chronologically. This is one less thing to worry about!

Be a Minimalist

Just a reminder that AMCAS activities character limits are 700 (with up to 15 activities total) and ERAS experience character limits are 1020 (with a limitless number of activities). (The ERAS "reason for leaving" is 510.)

You do not need to write up to the character limit! In fact, brief, streamlined writing makes a much bigger impact. Your written materials are critical to your application; ensure you submit your best work.

Optional Secondary Essays: Are They Really Optional?

I've recently received several questions about optional secondary essays and their necessity. I would recommend completing these essays if you have something new or important to say. Writing these essays just to have more "stuff" on your application won't further your candidacy.

Another tip on secondaries: Start early. Although there is overlap among schools, you may have twenty to thirty of these to write, depending on the number of applications you send.

California Licensure for IMGs

Today I have a guest blogger. Daniel Louvet worked in my hospital's emergency department before he left to go to medical school. Daniel is super talented, smart and an all-around nice guy :).

Below is some very helpful and detailed information for IMGs interested in the requirements for California licensure.

As a native California resident and a recent IMG from Ross University
School of Medicine, I have often been asked by my fellow colleagues
about the process of becoming a licensed physician in the state of
California. The answer is as follows:

(A) First, the international medical school MUST be recognized by the
state of California and MUST be listed on their website PRIOR to starting medical school. NO EXCEPTIONS.

(B) Second, the student's United States clinical rotations MUST fulfill these requirements:

1) A total of 70 weeks of Accreditation Council for Graduate Medical Education (ACGME) clinical rotations MUST be completed by the time the application for licensure in California is submitted.

2) Of the 70 weeks of ACGME clinical rotations, 40 weeks of the 70 weeks MUST come from CORE rotations. The minimum number of weeks for each of the respective CORE rotations are as follows:

Internal medicine - 8 weeks
General surgery - 8 weeks
Ob/Gyn - 6 weeks
Pediatrics - 6 weeks
Family medicine - 4 weeks
Psychiatry - 4 weeks

While these CORE rotations only add up to a total of 36 weeks, an additional 4 weeks to complete the total of 40 weeks MUST come from any of the CORE rotations listed.

3) Of the 70 weeks of ACGME clinical rotations, 30 weeks of the 70 weeks MUST come from ELECTIVE rotations.

4) At the end of each ACGME clinical rotation, an L6 form must be completed PER clinical rotation as part of the application process for California licensure. The L6 form can be found here.

In the event that some of the requirements are not fulfilled by your medical school graduation date, it is highly recommended you complete these rotations after graduation and prior to starting residency, through your medical school.

If you happen to do a residency outside of California and have yet to fulfill all the requirements, it is possible to count the respective rotations done while in residency towards obtaining California licensure through a petition by contacting the California medical boards at (916) 263-2382. For instance, if you had a non-approved/non-ACGME Family Medicine rotation during medical school, and you matched into a Family Medicine residency, it is possible to count the Family Medicine rotation completed during residency to obtaining California licensure in the future.

IMGs: Your ERAS Tokens are Here

Just a quick note to International Medical Graduates: Residency Tokens for ERAS 2012 are now available. You can use the token to register with AAMC's MyERAS starting on July 1.

Visit the ECFMG ERAS Support Services website for instructions on how to get your token.

Formal Attire Required

In crafting your AMCAS or ERAS activity descriptors, make sure you write formally. By that I mean write in full sentences and avoid contractions and colloquialisms. The AMCAS and ERAS are important documents that deserve respect!

Also, ensure your descriptors - without going over the character limit - can stand alone from the activity title in case the reader skims through the latter. In other words, assume the reader has not read the organization and title before your prose.

Contact me for editing help.

Scribes

Here's a short Los Angeles Times article on scribes. The article points out what a good experience scribing is for pre-meds. (And it pays!)

Application Support for IMGs

Starting July 1 IMG residency applicants can reach ERAS Support Services through extended hours Monday through Thursday 8a-6p EST and Friday 8a-5p at 215-966-3520. Remember too that applicants can get some questions answered by e-mail at eras-support@ecfmg.org. I've emailed the ERAS Support Services before, and they respond relatively quickly. If they don't have your answers, they'll point you in the right direction.

That Foreigner Song

As soon as June 1 hits, I have a multitude of medical school candidates panicking about the urgency of their application submissions. Plan ahead! Good writing takes a long time.

Even if you have a super-fast editor like me on your side :), you should expect that you will revise your materials multiple times and that each revision will take you many days or weeks.

Residency applicants: Take note. Start working on your written materials now, as some of my organized clients have already done.

"You say it's urgent
Make it fast, make it urgent
Do it quick, do it urgent
Gotta rush, make it urgent
Want it quick
Urgent, urgent, emergency
Urgent, urgent, emergency
Urgent, urgent, emergency
Urgent, urgent, emergency
So urgent, emergency
Emer... emer... emer...
It's urgent" :)

New AMCAS Certification

I received an email recently from an applicant who was interested in hiring me and wanted to know my thoughts on AMCAS' new certification requirement. The phrasing is as follows:


“I certify that all written passages, such as the personal
statement, essays required from M.D./Ph.D. applicants, and
descriptions of work/activities, are my own and have not been written,
in part or in whole, by a third party. Quotations are permitted if the
source is cited.”


I want to remind applicants that I provide only editorial services; I do not generate content. This has been my policy since starting Insider, so the new certification is not a problem for me, my business or my clients.

Let me give you an example: In aggressively editing a personal statement, I will help with syntax, organization, etc., but I will not write any section for the applicant. I might make an explicit suggestion like "Another example of clinical work here that emphasizes your ability to communicate clearly will make this paragraph more robust. Can you think of something to add?" But I will not write a section for the applicant.

Throughout my website - home page, medical school applicant page, terms and conditions - I explicitly state that I do not generate content. I have turned down clients who have asked me to do so well before AMCAS required the new certification.

AMCAS 2012 Change

This year a significant new addition has appeared on the AMCAS. Applicants are being asked to identify their most significant extracurricular experiences (up to three) and support their choices.

Here's the prompt:

"This is your opportunity to summarize why you have selected this experience as one of your most meaningful. In your remarks, you might consider the transformative nature of the experience, the impact you made while engaging in the experience and the personal growth you experienced as a result of your participation. 1325 max characters."

This new section will add to the prose a candidate must craft, so if you are hoping to apply early (beginning of June), make sure to plan accordingly.

The Good News and The Bad News... and Then More Bad News

There is a clearly-written article by Jan Greene in the current issue of the Annals of Emergency Medicine about fifteen new, US medical schools that are currently being accredited and slated to open. The Association of American Medical Colleges (AAMC) estimates that this increase will lead to an additional seven thousand medical school graduates every year throughout the next decade.

Sounds great, right? More chances of getting into a US medical school!

Well, no so fast.

The idea behind opening these new schools was to preempt the impending doctor shortage, but, as Greene points out, the new medical school openings will not solve the scarcity because there are no plans to increase the number of residency spots. In fact, in fourteen years, the number of teaching hospital residency spots for which Medicare pays a share (about thirty percent) has not increased. With Medicare cuts in the works, it's unlikely residency positions will expand or that hospitals will have extra funds for unsupported spots.

Unfortunately, this means more competition for residency spots for everyone, especially International Medical Graduates. (The domestic graduates will likely be prioritized by residency directors.) And it means no solution to the doctor shortage. Unless funding for training programs increases, which seems unlikely, future doctors should expect a bottleneck at the post-graduate level. Bad news for doctors and the American medical system.

Featured Interview

I was recently featured on Medical MasterMind Community, a website for pre-medical professionals. Here's my twenty-minute interview with explicit essay-writing tips and techniques.

The Medical School Application Calendar

Don't forget that May 1 is the first day AMCAS 2012 is available on the AAMC website and that June 1 is the earliest date for submission of the AMCAS.

Submitting a strong application early is important for your candidacy, particularly with rolling-admissions schools. Your personal statement should be closing in on its final form now. For those of you who don't know where to start with your essay, consider my new Writer's Block Package.

Letters of Intent: Don't Forget Your Purpose

In editing letters of intent (LOI), I note that applicants often make the mistake of focusing on their desired institution's virtues. Remember that the goal of the LOI is twofold:

1) Affirm your strong interest in the institution.
2) Distinguish yourself with your accomplishments.

These programs already know their strengths; unfortunately, you won't further your candidacy by reiterating them.

See my editing pages for information on my LOI services.

Is It Kosher?

My advisees often have questions about the ethics of letters of recommendation (LOR).

First, some applicants tell me they feel guilty because - although they waived their right to see their LORs - their writers gave them their letters to read. If your letter writer crafts your LOR understanding that s/he has no obligation to let you read it yet chooses to offer you a copy, you have done nothing unethical. That decision is the letter writer's.

Furthermore, I've had applicants tell me they feel uncomfortable because faculty have told them to write their own recommendation letters after which the letter "writers" will edit and sign. Again, totally kosher. This topic was recently addressed here by the ethicist in the New York Times.

Remember to start early in asking faculty to write your recommendations. LORs almost always take longer than you think.

New "Getting Into Residency" CD-ROM Available

I don't usually refer readers of this blog to my other blog, but with the launch of my new "Getting Into Residency" CD-ROM, I thought that might be easier. Here is the information. The CD includes video, audio, printable slides and a transcript.

Getting to Know Faculty

When I conduct Strategy Sessions with medical and dental school applicants, I notice a recurring problem: It's hard to get very strong academic letters of recommendation, especially at colleges with large classes.

So I'm here to offer a piece of advice to those just starting their university studies: Get to know your profs. In addition to keeping your grades up from the beginning of your college career, acquainting yourself well with your teachers is one of the most important pieces of advice I can give to the new pre-med. Go to office hours, send an email invite for a lunch meeting or approach the faculty member about working in his or her laboratory.

In addition to being strategic, these relationships can fill a mentorship role that is invaluable.

Brevity is the Soul of Wit

Here's a NYT op-ed piece about learning to write concisely, an important skill in the admissions process.

Match!

Congratulations to so many clients who have written me about their Match successes. Here's a nice comment I received today:

"Hey Michelle, I wanted to thank you again for all of your advice in this year's Match, as I matched to my number one. I couldn't be happier and couldn't have been more prepared. You relieved a lot of the stress that accompanies such a demanding time. Thanks again!"

I would love to hear from all of you!

Being Classy

A client emailed me to say that after a recent interview, the medical school dean called her to say he was impressed with her candidacy and the hand-written thank you notes she had sent. The client thanked me for my help with her application and the thank you note tip. Needless to say, she was admitted.

Writing thank you notes is easy and goes a long way. Remember to hand-write the notes, keep them brief and send them immediately after your interview day.

AAMC Fee Assistance Program (FAP)

Just a reminder regarding the Association of American Medical Colleges' (AAMC) Fee Assistance Program (FAP). The FAP is designed to offer help to individuals with extreme financial limitations who cannot pay the MCAT registration or AMCAS application fees without financial support.

If you think you are eligible, it's worth applying for an FAP grant early: If an applicant submits his/her AMCAS prior to receiving a decision on his/her FAP application, that candidate will be ineligible to receive the FAP for the AMCAS. In other words, the candidate will not receive a refund.

For more information on the FAP, please click here. I offer reduced rates for applicants demonstrating financial hardship through the AAMC FAP grant. Once you have been granted the FAP, contact me for more information.

Learning to Doctor

Here's a NYT article about medical students at my alma mater. Frankly - as one of my friends and former classmates emailed me - it makes HMS students sound a bit socially inept. But this piece is written from a patient's perspective, and she should know best what does and does not make her feel comfortable.

It's a good lesson on doctoring well.

Getting Into Residency: An Insider's Tips

For those of you interested in my upcoming "Getting Into Residency" lecture who have written me saying you can't attend the AMSA national conference, I am currently working on an affordable CD-ROM with a version of the lecture, including video, audio, printable slides and a transcript.

I'll keep you posted as the project comes to fruition. Thanks for everyone's interest.

What Would your Mother Say?

I had a sweet client recently tell me that, although she will feel uncomfortable showcasing her accomplishments throughout her upcoming application process, she thinks her mom might be able to help her learn to speak about them fluidly.

If you have a supportive mother (father, grandparent), and you are having trouble highlighting your achievements in your personal statement, application, interview, even letter of intent, consider channeling your inner mother.

Remember: You must distinguish yourself from the other competitive candidates, and the best way to do that is with explicit examples of your accomplishments.

Ranking Schools

There’s an interesting Malcolm Gladwell article in the latest New Yorker on the pitfalls of U.S. News and World Report's college rankings. Gladwell's points regarding the deficiencies of a system that tries to be "comprehensive and heterogeneous" and the flimsiness of quality proxies can be applied to medical school rankings as well.

Despite their many shortcomings, however, I do use U.S. News and World Report's medical school rankings on my website because they are more descriptive than alphabetic order in listing where my clients have been accepted.

$105K Awards for Recently-Licensed California Physicians

The Medical Board of California recently sent me a notification about their Physician Corps Loan Repayment Program, a grant for California-licensed physicians who are willing to practice in underserved communities for three years. The goal of the program is to provide improved health care access to needy neighborhoods with the hope that doctors might remain where they are working after their three-year commitment.

The application deadline for this year is March 24, 2011. The application can be accessed here.

New International Medical School Options

Here's a short NYT article on three new Italian medical school programs that are being taught in English in part to attract foreigners. The advantages are lesser cost, nice geography and, apparently, lower admission requirements, although for at least one institution, the entrance exam includes questions on Italian current affairs.

As the supply of doctors continues to be a problem, while admission to US schools is increasingly difficult, more international schools will likely pop up.

Applying Evidence-Based Medicine to Applications

In medicine, we're taught not to do a test unless it is going to change outcome. (You have a very high suspicion for a PE? Why do the ddimer? You're going to have to do a definitive test anyway.)

The same is true for applications. Asking friends and colleagues about their progress in the application process won't change how you proceed; you'll do your best at interviews whether your neighbor tells you he's already been called by ten institutions or not.

I would recommend avoiding asking others about their progress or checking websites in which applicants make claims about their successes. It's likely to make you nervous and won't change your management.

AMSA Lecture: Saturday, March 12, 10am EST

As we approach the date, I'm sending this reminder regarding my AMSA National Convention lecture, "Getting Into Residency: An Insider's Tips." For the second year in a row, I have been invited to be a featured speaker at AMSA's conference, which will be held in Washington, DC. I'm speaking on Saturday, March 12 at 10am EST and will be available to answer questions after the talk. In the past, the American Medical Student Association's national meetings have been the largest annual gatherings of medical students in the United States.

Freshmen and Sophomores: Become an Outlaw

This blog post refers to an insightful article written by David Z. Presser, MD, MPH regarding the need for pre-med freshmen and sophomores to distinguish themselves early in their college careers. David's point, first made in the Chicano Medical Student Bulletin, is that pre-med underclassmen need to distinguish their "brand of leadership" as club officers. Here's an excerpt:

When you find an activity that you enjoy, a natural desire to explore your interests will lead you to want to get involved in a leadership capacity. Lots of people become officers in their organizations. An officer is someone who is elected to a position of leadership and fulfills the duties required of the job - nothing more, nothing less.

STORY BREAK: When I was a child, I used to love Billy the Kid. (This was at the age before I learned he was a sociopath.) The reason I put Billy on a pedestal was because he was an outlaw. He played the game by his own rules. He never accepted the limits imposed by society or dictated by convention.

The leaders who have the greatest impact on their groups and who revolutionize the way things are done are outlaws, not officers. It would be to your benefit to think like an outlaw and apply your innovative style to the different tasks you undertake. Among those tasks you can personalize are leadership duties in different groups. Don't stop at the list of duties specified by your position; rather, fulfill the needs of your group that no position is meeting.

David's point is well-taken. Anyone can be president of the health career interest club. But not anyone can organize a campus-wide conference on how physicians are being mis-incentivized, a controversial topic. Work toward originality and high impact to catch admissions committees' attention and enjoy your accomplishments more.

No One Wants to be your Second Choice for the Prom

Imagine you're back in high school, planning to ask out a fellow classmate to the prom. You approach your potential date, "Would you be interested in going with me to the dance? You're my second or third choice!"

Not very compelling...The same is true for letters of intent: I've had several applicants ask me if it's okay to say that an institution is their "second or third choice" or "one of my top" picks.

That does not sound very flattering! Instead you can say something like "I would be thrilled to be here" or " I’m confident I can make a positive contribution to this program." In other words, you don't need to lie (which I never recommend); but you don't have to shoot yourself in the foot either.

I do edit letters of intent, so let me know if you need assistance.

What to do about Medical School Wait Lists and Deferrals

I've had a few applicants ask me if there is anything to do after being wait listed for medical school. I do recommend streamlined letters of intent that include what makes you a distinctive candidate and updated information regarding your candidacy. I edit these if you want help.

I've also heard of applicants sending letters of intent AND making an appointment to tour the school. A visit demonstrates further interest.

Hang in there. Remember that some people get off the wait list as late as the summer. (Not ideal but better than not getting in.)