Medical School Applicants: Avoid Missteps in the Admissions Process

Check out my recent, featured interview on the Varsity Tutor blog. Note some of the biggest mistakes candidates make in applying to medical school, the single most important thing medical school applicants should focus on, and why mediocre letters of recommendation are actually bad ones.



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Check Out My Latest Piece in PreMedLife Magazine

Please take a look at my recent, featured piece "Shhh...Interview Tips from a Medical School Insider" in PreMedLife Magazine.

Check me out at www.insidermedicaladmissions.com.

Medical School and Residency Interview Social Events: Dine but Don't Whine

In an effort to attract desirable applicants, some medical schools and residency programs invite candidates to social events immediately before or during the interview day. The events usually include dinner, lunch, or even drinks with the students or residents.

It's in your interest to attend these events: They show institutions that you are serious about their programs, afford you the opportunity to score social points, and allow you to gain valuable information about the students' or residents' satisfaction.

One insider piece of advice, however: Ensure you act professionally even if you are told that what you say will not affect your candidacy or get back to admissions. Even if everyone has good intentions, information garnered from these events can make its way to decision-makers. If you had a bad experience at the interview day, have a significant other who doesn't want to move, or know your first choice is a different program, these social events are not the time to reveal that information.

For insider help with medical school or residency interviews, contact me.

Check me out at www.insidermedicaladmissions.com

Medical Interview Questions: Is that Kosher?

The medical interview - whether for med school, residency, or fellowship - is subject to basic legal rules. Admissions officers should refrain from asking questions that are irrelevant to the position the interviewee is seeking. Questions about race, religion, and marital/family status are no-nos.

When I was interviewing for residency, I was asked about my dating status. Very awkward.

If you are asked these types of questions, you can simply answer (if it's not distasteful to you) or respond by addressing the intent of the question without revealing personal information. You can also refuse to answer the question; of course, this last tactic might cost you the position you are seeking.

For help responding to sticky medical interview questions, contact me.

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Think Before You Post

Before you tweet that racy comment or post a picture of yourself partying on Facebook, I recommend you pause. A recent study "Social Network Activity May Affect Medical School Acceptance" from the Postgraduate Medical Journal indicates that social networking is affecting medical school and residency admissions.  Nine percent of the medical school and residency program survey participants acknowledged routine use of social networking sites as part of the selection process.

The American Medical Association has advised doctors that social network content can adversely affect physicians' reputations. That advice seems straightforward. However, what troubles me is that admissions officers can intentionally or subconsciously form negatively judgments about applicants based on the candidates' family situations (e.g. a woman applicant with a new baby), political leanings, or romantic relationships.

Contact me for help with your residency application and medical school candidacy.

Check me out at www.insidermedicaladmissions.com

Residency Application Help: AMSA National Convention

I have been asked to be a featured speaker at the American Medical Student Association (AMSA) Annual Convention for the fourth year in a row. I'm grateful for the opportunity to interact with AMSA members again. 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" on Friday, March 13 at 3pm in Washington, DC. Last year, we had a standing-room only crowd. More on the talk as we approach the date.

In the meantime, for those applying to residency programs this year or next, contact me for help with your residency application, the residency interview, and personal statement writing.

Check me out at www.insidermedicaladmissions.com

Power Positioning

I have gotten such good feedback about my blog "How Amy Cuddy Can Help You" that I thought I would post the TED talk that Professor Cuddy gave: "Your Body Language Shapes Who You Are." I've forwarded this link to a few of my clients to help them prepare - physically - for their medical school and residency interviews. The talk is both entertaining and moving. Enjoy!

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Doctorectomy

One of my former emergency medicine residents Christine Tsien Silvers wrote this provocative piece, "Doctorectomy: Why One EP Stopped Practicing Medicine." The article is charming and insightful, and it provides useful perspective on how your current career choices might clash with your future priorities. 

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Create an Elevator Pitch to Help You Stand Out

Many of you have heard the term "elevator pitch," the short summary a business person might use to describe and - hopefully - sell her product or service. In preparing for interviews, you, too, should create an elevator pitch to sell - you!

Create a 1-2 minute "summary statement" that recaps your resume. If you have this elevator pitch at the tip of your tongue, you'll be at a great advantage, ready to answer questions like "Why do you think we chose to interview you?" and prepared to showcase your accomplishment in other answers throughout the session.

For personalized help with interviews, contact me.

Check me out at www.insidermedicaladmissions.com

The Nobel Prize and the Match

Some of you may have heard about last week's economics Nobel Prize announcements, but you may not know that one of the Nobel winners created the current Match algorithm. Previously, residency applicants would try to game the Match because of an algorithm flaw, but now the system is much fairer. See this interesting NYT article for details.

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How Amy Cuddy Can Help You

I recently discovered the work of Dr. Amy Cuddy, a social psychologist who teaches at Harvard Business School. Her research is really fascinating, including evidence that body language can directly affect interviewers' perceptions of candidates. For those of you who are not yet familiar with her work, it is worth examining.

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Specialty Blues?

For residency applicants, picking a specialty can be a very stressful process. I remember feeling the weight of my future career on my shoulders before I selected emergency medicine.

This "most-emailed" New York Times article "Follow a Career Passion? Let it Follow You" should make residency applicants feel better about the decision-making process.

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MSPE Releases Today

Just a reminder that the ERAS Medical School Performance Evaluation (MSPE) release is scheduled for today - October 1st  - instead of November 1st, as in years past. Likely this will lead to earlier interview invitations at many residency programs.

If you are interested in mock interview assistance, please consider contacting me early, so you are not caught with a surprisingly early interview without professionally-guided practice.

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What do Residency Directors Really Want?

The 2012 NRMP Program Director Survey results are out, and they are very instructive. The NRMP sends questionnaires every two years to residency directors who have participated in the previous Match in an attempt to determine what factors program directors use to decide whom to interview and then whom to Match.

The overall response rate this year was 44.8% - down from 2010's survey - but the results are as useful as ever. Of note, the personal statement is one of the top factors in deciding whom to interview - more than Step 2 scores! (See page 3 for details.) Furthermore, interactions with faculty and house staff and interpersonal skills are more important than Step 1 scores and honors in clinical clerkships in ranking applicants. (See page 5 for details.)

What this means: Your personal statement and your interview skills are critical for success in the application process! Some candidates spend months studying for the Boards, yet they rush through their application written materials and don't practice before their interviews. Don't be one of those misguided people! Contact me for assistance.

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Important ERAS Date

This is just a quick reminder that residency applicants can begin applying to Accreditation Council for Graduate Medical Education (ACGME) residency programs tomorrow, September 15.

NRMP Data Worth Viewing

The National Residency Matching Program (NRMP) does an excellent job of collecting and publishing Match statistics. One of their latest publications is "Results and Data: 2012 Main Residency Match," which includes valuable information like how many positions were matched in each specialty in 2012. Here is the report.

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Take a Lesson from Google

I recently read this article in the New York Times regarding recruiting and keeping women at Google. Toward the bottom of the piece is something that is relevant to those applying to medical school, residency, fellowship, and dental school. Here’s the excerpt:

Google’s spreadsheets, for example, showed that some women who applied for jobs did not make it past the phone interview. The reason was that the women did not flaunt their achievements, so interviewers judged them unaccomplished.

My Mock Interview clients know that I reinforce that applicants must showcase their accomplishments fully. In the almost ten years I’ve conducted real and practice interviews, I’ve noticed that women and non-U.S. born candidates are more likely to be “overly modest” in interviews. Although modesty is an excellent trait, one doesn’t want to be overlooked because s/he is not highlighting important achievements. If you feel that it’s rude to “brag,” consider that you are really just stating facts when you speak to an interviewer about what you’ve done. Remember, too, that by understating your achievements you may be overlooked when others are skillfully showcasing successes.

For Mock Interview help, contact me. Please note: I am currently booking 2 to 3 weeks in advance.

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Quick Tip: Be Too Proud to Beg

In writing their personal statements, some candidates end their essays
with a plea like "I hope your residency program will see me as a
valuable candidate who is eager to learn and work."

Remember that if you are writing an effective, persuasive document
with explicit examples of what makes you a distinctive applicant, you
won't need to make a second person appeal because your accomplishments
will make your case for you.

Imagine that you are a lawyer in front of a judge. How can you best
argue the case that you will be an excellent resident? With examples!
Keeping that idea in mind will help you show – not tell.

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Medical School Secondary Essay Tip

I receive a lot of questions about the "why-our-school" secondary essay prompt. Although it's a lot of work, the goal here is to research each school and then link your qualities or interests with the school's.

The mistake I see made is that applicants tend to use generalities, e.g. "XX University is an excellent match for me because I am seeking a medical school with an outstanding faculty and a focus on research." That sentence does not afford the admissions committee members a sense that the applicant is interested in their institution. On the contrary, it sounds like something anyone could have written about any school.

Say your interests and accomplishments are linked to the underserved. Look into the school's commitment to that community - a free clinic at which the medical students volunteer, a medical student program to teach sex education in a struggling public high school, etc. Then, in your essay, specifically mention your achievements and the school's associated opportunities.

Remember: Schools want to see that you like them!

For those who need some guidance, here's information about my secondary essay service.

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The AMCAS Verification Process - Longer than Expected

I'm getting feedback from some medical school applicants that this year's AMCAS verification process is taking longer than many candidates had hoped. According to the American Association of Medical Colleges (AAMC), applicants should expect a wait of up to six weeks from the initial "Ready to Review" status post-submission to complete processing. To check on your AMCAS status, you can go to the Main screen of the application and click on the "Status" link on the left hand side. 

You can send questions to AMCAS@aamc.org. I've found the response time to be quite fast.

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MyERAS Residency User Guide

For those of you feeling lost in the logistics of ERAS, the Association of American Medical Colleges (AAMC) offers the 2013 MyERAS Residency User Guide in PDF format. It's 32 pages of detailed, step-by-step instructions to help navigate the application process. Here it is.


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Earlier Release Date for Medical School Performance Evaluations (MSPEs)

This year the MyERAS PostOffice will release MSPEs to U.S. residency
programs on October 1, one month earlier than last year. (Remember:
The MSPE is a close equivalent to a dean's letter.)

U.S. medical students' designated deans' offices will attach the MSPE
(and the medical school transcript) to applicants' electronic files;
the documents are then automatically sent to all the programs to which
a candidate applies.

International applicants must ensure that their MSPEs are submitted to
ERAS Support Services at ECFMG. The documents are then processed and
transmitted to the ERAS PostOffice. (For more information on
submitting documents - including the MSPE - see the ERAS Support
Services for Applicants section of the ECFMG website at
http://www.ecfmg.org/eras/applicants-index.html.)

As always, please ensure your supporting documents are ready early in
order to avoid harmful delays in your application.


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Keeping Your Contact Information Up-To-Date

Quick tip: Ensure that the email and mailing addresses you provide to the Association of American Medical Colleges (AAMC) are up-to-date, and once the interview season starts, check your spam box regularly. Many medical schools and residencies contact applicants through email, and you would not want to miss an important notification or invitation because of a simple oversight.


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MyERAS Opens Two Weeks Later This Year

The MyERAS Post Office opens September 15 this year, two weeks later than last year. On the 15th, residency applicants can officially begin applying to residency programs, and the programs can begin downloading ERAS applications and supporting documents. 

Here is a link to the  ERAS 2013 Timeline.


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Sadly, Medicine is Not an Exception

For those of us who have worked in academic medicine, the findings of Gender Differences in the Salaries of Physician Researchers, a recent JAMA publication, was not a surprise. Still, it's worth reading the commentary at the end of the article, especially for those who will be choosing specialties in the not so distant future.

Every Emergency Medicine Spot Filled in the 2012 Match

In the 2012 NRMP Match, all 1668 of the available Match positions in Emergency Medicine were filled. The fierce competition likely stems from a variety of factors - popularity of the field and the fact that currently, medical students apply to more residency spots than they had in years past.  Either way medical students need to understand that matching into EM is not easy. Having an early strategy, submitting optimal written materials, and interviewing well are critical. 

Here's is an article in the Annals of Emergency Medicine regarding last year's Emergency match.


Please check me out at www.insidermedicaladmissions.com.

The Craft of Writing

Two weeks ago I blogged about the importance of using your personal statement to showcase your accomplishments, while ensuring your essay does not become a resume in prose. In the "The Sound of a Sentence," Constance Hale reviews techniques a writer can use to invigorate his or her compositions. 


During my medical school admissions process, I introduced myself to my Duke interviewer who said, "Ever since reading your secondary essay, I've been looking forward to meeting you!" I had made a favorable impression and distinguished myself through my writing - the goal of my essay. I find some applicants are simply slogging through the process of writing their personal statements. Remember that you only have a small piece of geography to catch the admission reader's attention. Use the personal statement space to your advantage, and don't lose a great opportunity to make a positive impression!


Contact me for help with your written materials - AMCAS, ERAS, personal statements, secondary essays, CVs, letters of intent, etc.


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Happy Customers

“Your turnaround speed is amazing!”

“I hope that all is well, and that your clients are all as happy as I am!”

“Your edits really helped me think deeper about this process.”

The above are comments I’ve received from clients this month. If you are hitting a wall with your AMCAS, consider hiring me.

Please check me out at www.insidermedicaladmissions.com.

Showcasing your Accomplishments without Creating a Resume in Prose

Recently, an applicant asked me how to write a personal statement that distinguished him without regurgitating his resume. 

Although highlighting your achievements is critical to make you stand out as a distinctive applicant, you can avoid simply repeating your curriculum vitae by giving a sense of your motivation, dedication, and personality with your choice of words and details. You can also express yourself through the weight you place on your varied accomplishments.

Writing a persuasive - yet personal and nuanced - essay is not easy. It takes a lot of work and multiple drafts and edits. Contact me for expert help.

Please check me out at InsiderMedicalAdmissions.com.

Expert (Goofy) Writing Tips

This entertaining list of writing don'ts offers a comic break for applicants who are working feverishly on their medical school personal statements. The rules are based on the wit and wisdom of the late New York Times' William Safire and the copywriter Frank LaPosta Visco. Enjoy!

1. A writer must not shift your point of view.
2. Always pick on the correct idiom.
3. Analogies in writing are like feathers on a snake.
4. Always be sure to finish what
5. Avoid alliteration. Always.
6. Avoid archaeic spellings.
7. Avoid clichés like the plague. (They're old hat.)
8. Avoid trendy locutions that sound flaky.
9. Be more or less specific.
10. Comparisons are as bad as clichés.
11. Contractions aren't necessary.
12. Do not use hyperbole; not one in a million can do it effectively.
13. Don't indulge in sesquipedalian lexicological constructions.
14. Don't never use no double negatives.
15. Don't overuse exclamation marks!!
16. Don't repeat yourself, or say again what you have said before.
17. Don't use commas, that, are not, necessary.
18. Don't be redundant; don't use more words than necessary; it's highly superfluous.
19. Eliminate quotations. As Ralph Waldo Emerson once said, "I hate quotations. Tell me what you know."
20. Employ the vernacular.
21. Eschew ampersands & abbreviations, etc.
22. Eschew obfuscation.
23. Even if a mixed metaphor sings, it should be derailed.
24. Everyone should be careful to use a singular pronoun with singular nouns in their writing.
25. Exaggeration is a billion times worse than understatement.
26. Foreign words and phrases are not apropos.
27. Go around the barn at high noon to avoid colloquialisms.
28. Hopefully, you will use words correctly, irregardless of how others use them.
29. If any word is improper at the end of a sentence, a linking verb is.
30. If you reread your work, you can find on rereading a great deal of repetition can be avoided by rereading and editing.
31. It behooves you to avoid archaic expressions.
32. It is wrong to ever split an infinitive.
33. Never use a big word when a diminutive alternative would suffice.
34. No sentence fragments.
35. One should never generalize.
36. One-word sentences? Eliminate.
37. Parenthetical remarks (however relevant) are unnecessary.
38. Parenthetical words however must be enclosed in commas.
39. Place pronouns as close as possible, especially in long sentences, as of ten or more words, to their antecedents.
40. Placing a comma between subject and predicate, is not correct.
41. Proofread carefully to see if you any words out.
42. Prepositions are not words to end sentences with.
43. Profanity sucks.
44. Subject and verb always has to agree.
45. Take the bull by the hand and avoid mixing metaphors.
46. The adverb always follows the verb.
47. The passive voice is to be avoided.
48. Understatement is always best.
49. Use the apostrophe in it's proper place and omit it when its not needed.
50. Use youre spell chekker to avoid mispeling and to catch typograhpical errers.
51. Who needs rhetorical questions?
52. Writing carefully, dangling participles must be avoided.

Please check me out at InsiderMedicalAdmissions.com.

Start with a Clincher…

Advisees routinely tell me how they struggle with crafting their personal statement introductions. My advice: Start with a clincher (and end with a zinger). But how can you avoid writing about accompanying your grandmother to the emergency department/ realizing your calling? (FYI: If you are considering this tactic, it’s worth noting that I’ve seen it scores of times.)

Here is a great piece from my alma mater’s The Stanford Magazine. I originally read this short article way back in 2008, but it stuck with me.

Let the examples you read open your eyes to the opportunity you have to distinguish yourself in the eyes of medical school admissions committees and residency directors.

If you are interested in my editing assistance, please consider hiring me soon. My volume is already increasing tremendously as the summer approaches.

Please check me out at InsiderMedicalAdmissions.com.

Insider’s New Approach to Helping Applicants

Most of you have probably already noticed that I’ve just rolled out a new format here on my blogspot blog, which includes improved searchability and a video bar. 

The “search this blog” option (on the right, midscreen) can be especially helpful for applicants who are about to starting their personal statements, ERAS or AMCAS, and thus, need strategic application writing tips ASAP.

Please be sure to check out my website at InsiderMedicalAdmissions.com.

Waiting and Waiting and Waiting on the Wait List…

Good news for wait list candidates: May 15 has traditionally been that “turning-point” date that medical school wait lists start to show movement. At many U.S. medical schools, the fifteenth is the deadline on which accepted applicants must commit to matriculate. (The registration deposit makes the decision firmer.)

Although not ideal, some wait listed students even get acceptances into the summer. So, don’t give up yet.

Please check out InsiderMedicalAdmissions.com.

Wall Street versus Medical School?

This NYT article regarding college students' recruitment to Wall Street is compelling. The author highlights the financial incentives that direct students to financial careers  - and away from graduate degrees like medicine.

AMCAS

Here’s a reminder that the 2013 AMCAS application is scheduled to open tomorrow, Tuesday, May 1; you will be able to submit your application as early as June 5.

The first day that AMCAS will begin transmitting application data to medical schools is June 29, which means an applicant who is really on top of things could receive secondary applications as early as the 29th!

I recommend watching the AAMC’s video for details about dates and changes to this year’s AMCAS.

Please contact me early for assistance. Last year some of my most organized clients were admitted to medical school as early as October.

Changing Medical School Curriculum

Here's a NYT piece by Pauline Chen, MD regarding changes in medical school training at Harvard, Columbia, and the University of Minnesota, among other institutions. I'll also add to Dr. Chen's point: Not only does the current system of third-year rotation blocks reinforce fragmented care, but it also does not allow students adequate time to make informed decisions about their future specialties.

Friendly Reminder...

Just a tip: If you are applying to residency or medical school (especially the latter) during the upcoming cycle, now is the time to get working on your personal statement. Good writing takes a long time.

Also, although my editing turn around time is always very fast (see my testimonials page regarding this topic), sending me your draft now will help you (and me :)) avoid the summer rush.

Open Emergency Medicine Positions

I recently heard about two open EM positions – one PGY-2 and one PGY-3 – at the University of Michigan and Harbor-UCLA, respectively, starting July. (The positions were open at the time or this writing, but I cannot guarantee how long they will be available, of course.) The information I have is public, but I suspect some candidates might have trouble accessing it.

For Michigan, the administration will consider both EM trainees who have completed a year of residency or trainees from other disciplines at ACGME accredited residencies. Contact is bkulp@med.umich.edu.

For UCLA-Harbor, candidates must have completed their PGY2 year in a 1-3 program or their third year in a 1-4 program or 2-4 program before July 1. Contact is fernandez@emedharbor.edu.

Insider's Evidence-Based Advising Strategy

As those of you who have worked with me or have heard me lecture know, I use Evidence-Based Advising in mentoring my clients. Just like we use data to drive good clinical practice, I have developed the concept of Evidence-Based Advising to use facts to drive strong application decisions.

In previous blog entries, I've discussed the utility of the NRMP Program Director Survey and the NRMP's Charting Outcomes in the Match in helping to make solid, informed application decisions.

The Educational Commission for Foreign Medical Graduates' (ECFMG) data on Match results is another piece of information that can be helpful. For those contemplating applying to an international medical school or for those International Medical Graduates (IMGs) approaching this year's application cycle, understanding IMGs' performance in the Match is important. The current data just came out and is available here.

Of course, basing your decisions only on numbers is not adequate. When we provide excellent clinical care, we use experience, as well as the literature, to make our decisions. (This necessary combination is what makes managing patients during medical school and residency so hard.) For those of you interested in strategy based on years of admissions experience, coupled with Evidence-Based Advising, please contact me for one-on-one help.

I'll continue to publicize useful sources of data for applicants.

Cool Things Med Students Do

I wanted to put in a plug for a charity that does great work in the battle against the spread of HIV. Little Travellers, an organization started by a Canadian medical student, sells beaded dolls and necklaces made by South African women infected with or affected by HIV in a community with a 45% HIV rate.

Not only does the project help with hospice care, education and medical facilities, but it also employs the bead artists who make the dolls and jewelry. If you'd like more information or you'd like to get involved, please contact Erin at erin@littletravellers.net.

The Match

Congratulations to my residency applicant clients on your great success in the Match! Special kudos goes to those who applied successfully in very competitive fields.

I was also thrilled that even those with significant weaknesses in their candidacies presented themselves effectively in their written materials and interviews such that they matched well.

Now, go out and celebrate!

AMSA Success

Thanks to everyone who attended my AMSA lecture. We had a standing-room only crowd. Your support is appreciated!

Letters of Intent

Medical school letters of intent (or what some applicants jokingly call "love letters") can be used for several types of applicants:

1) Those who have been wait listed
2) Those who have been interviewed but have not yet been accepted or rejected
3) Those who have not yet been invited to interview

When writing your letters of intent (LOIs), you should have the following principal goals:

1) Restating your interest in the institution
2) Positioning yourself as a distinctive candidate

The biggest error I see in LOIs is too much content about a specific institution's advantages. There is no reason to spend a paragraph or more telling medical school admissions members what makes their institution special. They already know! Using your precious space this way is an opportunity cost, keeping you from fully showcasing what makes you a compelling applicant.

For those of you interested in LOI assistance, please contact me. I do offer a popular LOI editing service.

AMSA Conference Update

Just an update that last week the American Medical Student Association (AMSA) secured the Honorable Kathleen Sebelius, the twenty-first Secretary of Health and Human Services, to give the AMSA National Conference's keynote address on Friday, March 9th from 1:00pm-1:50pm. Her speech will bump my talk - previously at 2:30pm - to 3pm.

I look forward to seeing many of you there.

NRMP Rank Order List Certification Deadline

Just a reminder that applicants and programs must certify their rank order lists before February 22 at 9pm EST.

Please see my previous blog entry on creating a rank list. Don't make the error of changing your rank order last minute based on panic! Your list should be a considered decision.

It Gets Better

In honor of the Dan Savage's "It Gets Better" campaign, I thought I would dedicate this blog entry to those who are in medical training and are struggling. (And who isn't?!)

Despite the relatively warm winter many of us are experiencing, this time of year can be particularly rough for medical students and residents trying to get through classes and rotations. As a practicing MD, I want to let you know that it gets better! For every medical student, resident or fellow who has heard an attending physician say, "If you think training is hard, wait until you're done," I say, "Don't believe that silly doctor!" Once you get through this tough time, you can look forward to more autonomy and a happier lifestyle.

I wish someone had told me all of this when I was going through training. It really gets better!

Making Your Match List

That time of year is quickly approaching, and I've already been asked how to optimally create a Match list. The algorithm for the Match is relatively simple; you can look at the details on this NRMP page.

The bottom line:

1. Rank programs so that they represent your true preferences. Your first choice should be first. Your second should be second and so on. Do not try to "outthink" the system, as it will only be to your disadvantage.

2. If you would rather not match than be at a specific program, then that program should not be on your Match list. Do think carefully, however, about the prospect of not matching, trying to scramble, and possibly having to reapply next year :(.

3. If you are applying to a competitive field, consider having many programs on your rank list to increase your chances of success. How many is many? See this excellent document for evidence-based assistance in how many programs you need, depending on your specialty choice.

Promises, Promises

As we approach the Match, I want to remind applicants that - although residency directors (RDs) are permitted to express strong interest in candidates - RDs' comments should not be interpreted as promises regarding rank.

Here is the NRMP's Statement of Professionalism that reviews violations and "misleading communications." The document is clearly written with examples of problematic interactions between RDs and applicants.

Pre-Match Offers

I received an urgent request from an applicant last week. He wanted to discuss a pre-match offer he had received that had a Friday deadline. The pre-match program was an academic institution, which was appealing, but the interview day had left the applicant underwhelmed for a number of reasons.

On the one hand, this offer was a sure thing. On the other, the applicant had noted what he considered to be red flags. He asked me what to do.

As usual, in life there is no right answer :). But here are a few suggestions if offered a pre-match:

1. Ask for more time. In the worst case scenario, the program director says no. Nothing lost.
2. Try to move up any interviews you have not yet attended.
3. Contact the other program directors and let them know you have a pre-match offer and give them the deadline date. They may offer you a pre-match in return. Or - on the contrary - they may let you know they are not interested. Either would be helpful in making your decision.
4. Speak to residents who are at the pre-match program. Trainees will often readily tell you the weaknesses of their institution :). This information will help you make an informed decision.
5. Assess a) your risk-taking comfort zone and b) the strength of your candidacy. This step is probably the hardest, yet most important.

In the end, the applicant did not accept the pre-match offer and is crossing his fingers he'll end up at another program he likes better. He is so relieved that - with the information he has now - the decision seems to have been the right one for him.

Outside of the Box

Now that the new year is here, many pre-meds, medical students and residents will be asked to finalize their schedules for the next year or more. Although it's easy to get wrapped up in it all, I wanted to put in a plug for something a bit unconventional - time away from the field entirely.

When I was in medical school, I took almost a year away to travel and explore journalism, a career that had always interested me. I obtained a small grant to conduct research in Mexico and then backpacked with some friends through Mexico and Guatemala. I also spent a month in Thailand. Additionally, I was awarded an American Association for the Advancement of Science Mass Media Fellowship in Science Writing, so I worked in Portland at the Oregonian writing articles for the paper.

Taking time away from medicine is not an option for everyone: Some institutions do not encourage it, and there is usually a financial opportunity cost. I will say, though, that being away from medicine made me appreciate it more and helped me improve several useful skills, including foreign language and writing.

If taking a scheduled break from the norm is a viable choice for you, I would strongly encourage it. The experiences I had have long-reaching effects that continue to help me as a physician today.

Step 2 CS Changes

In 2004, a team was created to initiate a multi-year, comprehensive review of the USMLE program. This team, called the Composite Committee, is comprised of the Federation of State Medical Boards (FSMB), the National Board of Medical Examiners (NBME), the Educational Commission for Foreign Medical Graduates (ECFMG) and the American public.

Last month this team announced some "enhancements" to Step 2 CS that are scheduled to start the middle of this year. Here is a summary of those changes. Updated practice materials for Step 2 CS will be posted to the USMLE website in March 2012.