Understanding How the Match Works is Critical for Succeeding in the Process

Improving written materials and interview skills is important, but all of that work can go to waste if applicants do not understand basic strategies for the Match. In November of last year the NRMP published an article called, "Understanding the Interview and Ranking Behaviors of Unmatched International Medical Students and Graduates in the 2013 Main Residency Match" in the Journal of Graduate Medical Education. The data is especially important for IMGs who represented the majority of unmatched candidates.

Sadly, the authors found that some applicants made strategic errors including the below:

- Not attending all interviews, thus failing to capitalize on every opportunity to market themselves.

- Declining to rank all programs at which they interviewed or not ranking all programs they would be willing to attend.

- Misunderstanding the Match and ranking programs at which applicants did not interview.

- Failing to rank programs based on true preferences or ranking programs based on the perceived likelihood of matching.

It kills me to read about these mistakes :(. Here is a simple explanation of the Match algorithm. If you do not understand how the Match works, it is absolutely critical that you learn about it to avoid destructive errors.

A Great Opportunity: American Association for the Advancement of Science (AAAS) Science News Writer Internship

Looking for something different to do this spring and summer? The American Association for the Advancement of Science (AAAS) is offering a paid six-month internship (April through September) with Science Magazine in Washington, D.C.

As some of you know, I was an AAAS Mass Media Fellow in 1995. The program was truly fantastic and life-altering.

In terms of qualifications for the Science News Writer Internship, applicants need to have completed their undergraduate education or be in their senior year of college. They should have interest (and preferably experience) in writing about science for lay people. According to the AAAS, preference will be given to candidates who have published science journalism articles, worked at other science news publications, and/or completed a journalism or science writing program.

The AAAS suggests you visit their job information website to get more information. Applications are due by January 2nd, so get moving!

Your Residency Application: What Do Program Directors Really Want?

If you were a program director (PD), you'd be trying to avoid two big headaches as you assessed a residency candidate:

1) Will this person be competent and collegial? A PD does not want to get complaints from patients, faculty, or other services about his/her residents.

2) Will this person leave the program prematurely? A PD does not want to scurry around to fill an open call schedule/ residency slot.

As you approach your interviews, consider how you can demonstrate your competence and collegiality, as well as your commitment to the field and the residency program. For the former, ensure you showcase academic successes, extra curricular activities that demonstrate teamwork, and - if asked - hobbies and reading materials that demonstrate your personality. For the latter, highlight research projects in the specialty, sub-internships, and knowledge about the program and city.

Making sure the PD knows you are not going to cause him/her headaches is half the battle.

The Residency and Medical School Application: Moving Past Impostor Syndrome

First described by psychologists Drs. Suzanne Imes and Pauline Rose Clance in the 1970s, impostor phenomenon occurs among high achievers who cannot easily internalize their successes. They often externally attribute their accomplishments to luck and worry that others will eventually realize they are frauds.

Recognize this phenomenon of self-doubt?

You are not alone. Although many people suffer in silence (as they do not want to be revealed for what they perceive to be major deficiencies), the syndrome is quite common, especially in medical school. According to one 2016 study, almost a quarter of male medical students and nearly half of female students surveyed suffered with impostor syndrome. The phenomenon can be associated with depression, burn out, and anxiety.

The American Psychological Association offers a few tips for overcoming impostor syndrome including speaking to mentors, recognizing what you excel at, and talking to a professional if necessary. Here is a piece in Grad Psych for more information.

Finding Balance

This time of year, when the residency and medical school interview processes are in full swing, many of us feel overwhelmed. Here's a brief but thoughtful piece regarding balance. As you consider your future career, it's worth thinking about issues the author covers like clarifying what makes you happy and defining balance. In this day and age, one can choose a traditionally tough specialty but work in a practice setting that allows for some autonomy and flexibility. But you need to know what you want to guide yourself in the right direction.

Your Medical School or Residency Application: What is a Letter of Interest/Intent?

A letter of interest or intent (LOI) is a supplemental note applicants write to medical schools, residencies, and other medical programs to let faculty know of their enthusiasm for an institution and the distinctiveness of their candidacies. LOIs can be written early in an effort to obtain an interview, after the interview to show enthusiasm and to remind the faculty of the candidate's worthiness, or after a wait list notification (for medical and dental students who don't participate in the Match).

The letter should be written in a timely fashion. In other words, there's no reason for a residency applicant to write a letter of intent in late February. The letter should avoid restating the strengths of the institution. Instead the applicant should express his/her interest and then move onto his/her strengths. An LOI should be a page or less.

Please note that some schools and residency programs do not allow post-interview contact, in which case an LOI is not recommended.

For help writing a professional, expert LOI, hire me here.

Your Residency or Medical School Application: More on the Squeaky Wheel

Please see my previous blog entry about contacting institutions regarding your status. When you call you can gently say, "I'm attempting to make some travel arrangements and was wondering if you could give me an update on my status." As long as you are polite, you won't hurt your candidacy. (Of course, if an institution specifically requests on their website or brochures that you not call, I would advise against it.)

Your Residency or Medical School Application: Be 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 that 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 residency or medical school application 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. If you haven't received an interview invitation, now is the time to make a phone call.

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

Residency and Medical School Applications: Don't Make It Urgent

I'm writing this blog entry from the Compton, California Jurors' Waiting Room, having been called for duty today. We were to arrive at 7:45am. After hearing a long introduction from the orientation coordinator here, I noted a woman arriving at 8:50. She sat next to me and asked me to repeat everything the orientation coordinator had said for the last hour.

Her lack of judgment prompted this entry. When approaching your interviews, try to anticipate problem issues and ensure you complete tasks early:

Responding to interview invitations immediately helps you target a time frame you prefer. Also, since some programs do not have enough slots for all of the invitations they issue, it also assures you a slot.

Arriving at your interview early decreases stress, which allows you to perform optimally. At times it also gives you the opportunity to better acquaint yourself with the coordinator or even the residency director. (Several years ago a residency candidate told me he had a fifteen-minute one-on-one conversation with the residency director because the applicant had arrived early. He felt confident that the individualized time furthered his candidacy.)

Sending your thank you notes immediately increases the likelihood they could make a positive impact on your candidacy since faculty may speak about your candidacy earlier rather than later.

So, don't make it urgent. Plan in advance. If nothing else, the perception of control will help reduce anxiety and improve your interview days.

If You Think Your Medical School Application is Expensive...

According to an article in this month's Annals of Emergency Medicine, the median educational debt for surveyed emergency medicine residents was $212,000, a substantial amount that altered life and career priorities and caused significant stress.

Medical school is not only tough mentally and emotionally, but also it's a huge financial burden. And the low salary that residents take home only compounds the issue because of the opportunity costs of not having invested starting at a young age.

Although sobering, it's worth looking at the study and the conclusions drawn.

Residency and Medical School Interview Questions: How to Answer that Icky Decade One

"Where do you see yourself in 10 years?" the interviewer asks you, and you squirm...

An influential physician-administrator once complained to me that whenever he asked potential new faculty hires where they saw themselves in a decade they always said they were interested in global health or teaching. "They just say that because it's sexy," he remarked. "Many of them have nothing in their C.V.s to bolster their interest in either pursuit."

When asked where you see yourself in ten years, consider what your accomplishments thus far support to show a clear evolution. This doesn't mean you're stuck with what you've done even if you didn't like it. You could point out that having tried myocardial bench research, you realize that your real interest is in clinical investigations of new cardiac markers. Throwing out activities just because they sound appealing doesn't make you look professional or your candidacy seem well-synthesized. The idea is to have a trajectory that you can back up, defend, and easily justify.

Many medical school applicants say they don't know what field they want to go into. Of course not! And many residency applicants don't know if they want to do a fellowship. That's okay. Again, the point is to focus on your previous strengths and achievements and leverage them.

One more thing: If you are planning to seek mock interview help from me, please do it now. I am booking several weeks in advance.

Using Psychology to Further Your Residency or Medical School Application

In my last post, I spoke about the importance of knowing about a school or program in detail in order to show enthusiasm. This entry is a follow-up piece. Being genuinely complimentary (there's no need to sell yourself down the river being disingenuous) can readily further your candidacy:

There is a psychological principle that asserts that if someone likes you, you tend to like him/her more. So, if I say, "I was just talking to Mike, and he always says the nicest things about you," you now like Mike more (even though he's not a real person in this case).

Use this strategy to your advantage. It's hard to say, "I like you!" in an interview setting. But when speaking about a school or program during interview day, showcase what the institution's strengths are and specifically, how they apply to you. If the program has a focus on public policy, mention your work with AMSA's lobbying efforts. If the school is in Utah, note how much you like skiing. Demonstrating interest and zeal can go a long way to leverage simple psychology. 

Your Residency Application: Know Before You Go

I distinctly remember a very strong candidate whom we considered as a potential emergency medicine resident many years ago. Although multiple faculty members raved about the medical student, one of my colleagues pointed out that the applicant made it clear he did not want to move to Boston. "He wants to stay in California. If he's not interested in us, why are we interested in him?"

Mathematically speaking, this strategy doesn't make a lot of sense. Programs should rank strong applicants highly no matter what they believe the candidates' desires are. (After all, the program may be wrong, and there is little disincentive to go for the gold.) But the point is that it's critical that you don't give off signals that you are not interested in the program at which you are interviewing. (If you would rather not Match than be at that residency, you shouldn't be interviewing there - not a tactic I would generally recommend, however.)

Know the program well and be enthusiastic about its strengths. Every program has something to offer, and you'll need to learn details of those positive qualities if you want to stay in the running for a spot.

Residency and Medical School Interviews: Don't Be the "Guy with the Tie"

Check out this brand-new Insider Medical Admissions Guru on the Go© under-one-minute, stop-motion video called, "Spiffy Tie for the Dull Guy." If you're heading to residency or medical school interviews this season, you'll want to learn about this effective way to protect your candidacy while you evade the fashion police.

Medical School Interviews: Preparing for your MMI

Although the majority of medical school interviews are traditional, an increasing number of medical schools (as well as dental schools) are using the MMI platform. The MMI (multiple mini interview) is a format that uses several timed stations to assess applicants' interpersonal skills and judgment.

A few things to note about MMI interview questions:

1) They are not always medically-related. You may be asked to manage an everyday problem (e.g. a disagreement at the supermarket).

2) They are not always situational. You need to be prepared for conventional questions too (e.g. what are your three greatest strengths?).

3) Schools are trying to assess whether you can skillfully employ important techniques and demonstrate professionalism. Underlying topics might include your ability to offer effective counseling, your understanding of patient-doctor confidentiality, your ability to diffuse a heated situation, your capacity to admit wrongdoing, etc.

It is important that you practice MMI questions before you go to your medical school interview. Even if you have excellent social skills, there are techniques you should hone to expertly manage the challenging MMI format. Please consider hiring me for a mock interview or two as soon as you get your first interview invitation, as my slots go fast.

Medical School Interview Tips: What Do Admissions Officers Really Want?

Congrats to those who have already been invited for medical school interviews. It's early in the season, so if you are an applicant who has not been invited yet, do not dismay.

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

1. 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 with their pre-professional achievements.

2. 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.

3. 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. Being professional during the interview day and having strong letters are important.

4. 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 medical school interviews without preparing. If you are interested in working with me, please hire me with at least two weeks' advance, as I'm booking up quickly.

The Medical School Interview: Creating your Elevator Pitch

You may have heard the term "elevator pitch," a streamlined summary a person uses to describe and hopefully, sell her product, service, screenplay, or book. In preparing for medical school interviews, you, too, should create an elevator pitch to sell...you.

Create a 2 to 3 minute "summary statement" that recaps your candidacy, specifically your pre-professional accomplishments and other skills that make you distinctive. (Perhaps you are multilingual, for example.) I'd recommend conceiving of the elevator pitch in chronological order and presenting it that way as well. Doing so makes it easy for you to remember and for the listener to absorb.

Content should include accomplishments in these categories: academic, clinical, leadership, volunteerism, research, teaching, writing, and international work.

If you have this elevator pitch at the tip of your tongue, you'll be at a great advantage at your medical school interview, ready to nail questions like "Tell me about yourself" and prepared to showcase your accomplishments in other open-ended questions throughout the interview session.

Residency Personal Statement: Honors Won't Make it Write

Several years after writing my own residency personal statement, I found myself reading essays and making admissions decisions as a medical school faculty member. In assessing application essays, I learned firsthand that certain personal statement techniques fly and others don’t. A candidate’s approach can mean the difference between acceptance and rejection at his/her dream institution.

The below are some of the most common and easily-avoidable errors applicants make in crafting their personal statements:

1)      Unlike mom, an admissions essay reader doesn’t offer unconditional support for an applicant’s endeavors. Candidates who write a paragraph (or two) about their childhood surgeon Halloween costume have made two fatal flaws: First, the tactic is overused. Second, these stories do not engage the admissions reader nor further an applicant’s candidacy because they are not built on evidence of any distinctive accomplishments.

2)      The rule applicants should remember is this: All stuff, no fluff. (No Miss America clichés!) The residency personal statement should be a persuasive document that convinces programs that a candidate is worthy of a spot at their institutions, which means it should include facts about what makes an applicant special – her achievements.

Just like a lawyer does when s/he is trying a case in front of a judge, the residency applicant must persuade with evidence. Saying he is a caring person or wants to make the world a better place is not compelling, and those claims do not distinguish the candidate from the scores of other applicants competing with him. The candidate needs to prove his value and distinctiveness with academic, clinical, research, community service, leadership, international, and teaching achievements. To the admissions reader, applicants are what they do – not what they say.

Every part of the personal statement should be distinctive, highlighting unique qualities through accomplishments. If there is even a phrase in the essay that could have been written by someone else, it should be omitted.

3)      I remember a talented residency applicant I advised a few years ago who showcased an award she had won. She listed the name, but didn’t explain what it was. When I asked her, she told me the award was an academic honor given to only the top 1% of students out of several thousand. Had she not rewritten the section, her admissions readers wouldn’t have given her an ounce of credit for that extraordinary accomplishment. What a candidate fails to adequately explain counts against her.

Bottom line: Candidates must ensure their residency personal statements can stand alone and don’t rely on the remainder of the application for clarification.

I hope this year’s applicants will leverage the knowledge I’ve offered above to anticipate a future reader’s objections so that they can strengthen their personal statements and reach their career goals.

Residency Application: ERAS Tips

I've been editing a whole heck of a lot of ERAS applications recently, so I thought I'd create a list of tips for those embarking on their descriptors:

1. Include relevant pre-professional accomplishments from college. If you conducted research, for example, list and describe it. Do not include high school achievements unless they were truly unique (worked at the White House, sang on Broadway ;)).

2. While you want to include many strong achievements, you do not want your ERAS to be so long that your reader is tempted to skim it. Be selective.

3. Keep your descriptors to approximately three to seven sentences. Fewer can look lazy and more can look self-indulgent.

4. Use full sentences. It’s a formal application, and you want to make your written materials as readable as possible.

5. Avoid abbreviations. Again, you want to be formal, and abbreviations you think are common might not be familiar to the reader.

6. Make sure you spell out your accomplishments clearly. If your reader doesn’t understand an activity, you will not get “full credit” for what you’ve done. Make no assumptions.

7. Write about yourself and your role – not an organization. For example, don’t use the space to discuss Physicians without Borders. Use it to discuss the specifics of your role at Physicians without Borders.

8. Use numbers to be persuasive. Saying that the conference you organized had 300 participants says it all.

9. Unless your PI won the Nobel, avoid using supervisors' and/or doctors' names in your descriptors as they will be meaningless to the majority of your readers.

10. Get help. Do not submit your residency application without having it reviewed. Don’t submit suboptimal materials for a process that is this important and competitive.

Nailing the Residency or Medical School Interview

Google had a problem.

As a New York Times article describes it, Google executives were growing increasingly aware that they were not hiring enough women. Worse still, they were attracting negative attention about it. So, Google did what Google does best: They amassed data and mined it.

In their analysis, among other findings, Google concluded that the company was overlooking women who tended to be more modest than comparable male applicants during interviews. The interviewers inappropriately perceived the women applicants to be less accomplished, and the female candidates were not offered jobs. (Once they understood the problem, Google altered their internal hiring policies accordingly.) 

This story is instructive in understanding the importance of your residency or medical school interview.

Let’s start with your overarching strategy, one that can be gleaned from the Google story: The residency and medical school interview processes are persuasive ones. Your role is to convince faculty that you deserve a slot at their institutions. The best way to persuade is with facts, just like a lawyer does when s/he is trying a case in front of a judge. Saying you are compassionate or hardworking is not convincing, and it doesn’t distinguish you from the scores of other people the interviewer is meeting. You need to prove your worth by highlighting your academic, clinical, research, community service, leadership, international, and/or teaching achievements.

When mentoring applicants, I hear them ask: Michelle, if I showcase my accomplishments in my residency/ medical school interview, doesn’t that mean I’m being redundant? My answer: Absolutely! Think of the medical admissions process like building a house. Your ERAS®/AMCAS® and letters serve as one layer of that house – like scaffolding. 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 (plumbing, pipes, electrical). Finally, the interview is your chance to add on the thickest peel (exterior, roof). Discussing your accomplishments in detail can seal the interviewer’s positive impression of you. 

If you still feel shy about drawing attention to your achievements, I can assure you that occasionally residency and medical school interviewers do not leave adequate time to review materials for the candidates they will ultimately judge, or they are asked to interview such a large number of applicants that they might understandably get candidates confused. If you treat every residency and medical school interview as though it were a “blind” one, you address these obstacles. Determine in advance how you want your interviewers to remember you when they represent you to the committee, and tailor your interview to leave that impression. At the end of the week, when your interviewer asks what others thought of the "young woman who volunteered with Mother Teresa while doing malaria research and competitive hammer-throwing,” all the other admissions officers know immediately she is referring to you.

Medical School Interview Questions: How to Handle the Illegal Ones

In the United States, a professional interview is subject to basic legal rules. Specifically, admissions officers should refrain from asking medical school interview questions that are not relevant to the position the interviewee is seeking. Questions about race, religion, sexual orientation, and marital or family status fall into this category.

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. ("I think you're asking if my home life will affect my ability to carry out my medical school studies or my clinical duties. I can assure you it won't, and I’ll complete my full tenure here at your school.")

If you have the opportunity to give feedback to the institution about your medical school interview questions or experience, you can consider doing so after the interview. When I was interviewing for residency, I was asked by a faculty member if I had a boyfriend. After the interview day, I talked to a faculty mentor at my school who reported the situation to the other institution. The faculty member who asked me the illegal question was no longer permitted to interview.

Residency Personal Statement: Should you be a Creative Non-Conformist?

There is no question that being different is an asset in medicine. Those who think outside the box consider diagnoses that others miss, craft approaches to tough patients that others don’t conceive of, and come up with solutions to systemic problems that can positively change medicine as a whole. However, being different does not mean being unprofessional.

Yes, you want to distinguish yourself in your residency personal statement, but you want to do that by showcasing your unique and impressive pre-professional accomplishments, not by submitting a zany essay. Think of it this way: It would be a shame to annihilate your career goal because you’ve made a reader cringe when you were simply trying to write imaginatively.

This is not to say your residency personal statement should be boring! By using good writing techniques – crafting a catchy intro, using robust language, even choosing a compelling sequence – you can write an outstanding essay while still showcasing your accomplishments.

For the skeptic who insists, “Michelle, I’m special. I can do something wild and not scare off the reader,” I will tell you the following anecdote: In all of the time I read essays at Harvard, I remember only one applicant who submitted a truly wacky essay who still received rave reviews. (There was a lively discussion about his weird personal statement, however, before he got the thumbs up.) This person was a true superstar applicant. He came to our program, was loved by patients and staff alike, and eventually became an emergency medicine chief resident. The point of this story? I remember him because he was an outlier - the only applicant in years of assessing candidates whose strange essay did NOT kill his candidacy. Much like CPR, the vast majority of eccentric essay writers don't respond to heroic efforts to save their candidacy.

Take home point: You get one bullet. Don’t use it to shoot yourself in the foot.

How to Explain Inconsistencies in Your Medical School Application

You put your heart and soul into your compelling, charismatic medical school personal statement; you showcased your accomplishments and drive to succeed in your activities section; and you demonstrated the endorsement of respected faculty allies in your letters of recommendation. Now your hard work has paid off and helped you get a foot in the door: You’ve been invited to interview at your dream medical school.

But how do you manage the medical school interview when you have a gap in your resume? Let’s say, for argument’s sake, that you took a year off after college and moved to Barcelona to pursue an exciting romantic relationship, only to find yourself dumped two months later. You moped the rest of the year and had neither research nor volunteer experiences to show for your time off. Your interviewer asks you that dreaded medical school interview question: What exactly did you do, anyway, during the gap year?

A prepared candidate can see this interview question as an opportunity to turn a skeptic into an ally. Responding with a calm demeanor – without making excuses or delving into the intricacies of your personal life – will make you look professional. This is a great time to explain that, although you graduated college with a minimum of life experiences, your year off helped you consider alternative professional paths and strengthened your resolve to enter medicine. Consequently, you will pursue your medical career with greater maturity and commitment and a broader perspective than those who went straight through.

The medical school interview requires preparation and an optimistic attitude. Support your candidacy with practice and enthusiasm.

Managing Difficult Medical School Interview Questions: Rehearse Your Elevator Pitch Now

An important key to preparing for tough medical school interview questions is realizing that a) interviewing is a skill and b) practice improves performance. Every year too many medical school (and residency, fellowship, and dental school) candidates expend tremendous energy assembling fantastic applications, only to undermine their chances by approaching the interview with twisted laws of entropy and enthalpy: They prepare for it with maximum randomness and minimum energy.

Once you’ve done adequate groundwork, the medical school interview represents your opportunity to distinguish yourself and impress your interviewers as the type of candidate they’d love to have at their institution.

That’s not to say every interview will be full of hugs and puppy kisses. Like the story of the interviewer whose window was nailed shut, there may be uncomfortable moments and even illegal questions. With a bit of preparation, you can learn to hit these curveball questions out of the park. Let’s explore an example that has come up in the not-so-distant past.

Rehearse Your Elevator Pitch

While most interviewers take the time to read your application materials in advance, don’t be offended by the faculty member who did not prepare, is blankly flipping through your application right there in front of you, and who asks open-ended (and dreaded) medical school interview questions, such as “Tell me about yourself” to be brought up to speed. View it this way: These faculty members are offering you the opportunity to define how you’d like to be remembered.

Your goal should be twofold: 1) to persuade them how much you’d add to their institution and 2) to make their job easier by giving them the bullet points they’ll need to persuade their peers about your candidacy’s worthiness. When your interviewer sits around a table advocating on your behalf, steer her to use terms that will be germane to your candidacy. Are you the, “global health advocate who volunteered with Mother Teresa and ran his school’s homeless food program?” Or perhaps you are the “first generation college graduate who held premier leadership positions in medical school?” Help your interviewer help you.

In the end, difficult interview questions are less intimidating if you both prepare well and have an attitude that they are an opportunity to clarify and further your candidacy.

Residency Personal Statement: What's Your Best Strategy and How Do You Execute It?

I've had several applicants recently ask me if they need to showcase their accomplishments in their residency personal statements if they have already drafted a strong ERAS activities section. The simple answer is yes.

First, remember that you don't know at what part of your application the readers will be starting. If some start with your personal statement, and it's pale, you will have lost those readers from the beginning.

Also, note that the faculty members seeing your application are reading many more ERASes than just yours. If you only mention an important achievement once in your application, the program director might simply forget your accomplishment. After all, s/he is reading scores or even hundreds of similar applications. Your readers have to be reminded several times of your candidacy's strengths. (You'll mention those accomplishments in your interviews as well.)

To a program director who hasn't yet met you, you are what you've done. You need to use substantive examples of your achievements to demonstrate your worthiness for a potential residency position. Evidence is persuasive; use it!

How to Design Your Life

I just watched a great video called, "Designing Your life: What Do you Want to Be (When You Grow Up)?" The mini-workshop is part of the Stanford (University) Connects program and showcases design professors Bill Burnett and Dave Evans, who run a course about life design at Stanford. For those who want to make considered choices about their professional and personal future (and who doesn't?) I recommend the video workshop. You'll be taken through exercises about how to craft different versions of yourself and how to explore options through prototype conversations.

Medical School Interview Questions - Discerning or Disturbing?

This fun piece from the Harvard Medical School (HMS) alumni magazine is worth a read. The article, "Stress Fractures" by Dr. Jules Dienstag, a member of the HMS Admissions Committee, briefly chronicles a history of the "stress" interview at HMS, specifically whether a well-known professor Dr. Daniel H. Funkenstein used the dubious tactic. The famous nailed-shut window story is explored.

ERAS Help and Scheduling

Just a reminder that U.S. medical students can already register for MyERAS and can start inputting their application materials. IMGs must wait until June 21 for their tokens and then they, too, can register. Both groups can "assign" their documents early September, which means that at that time they can start sending their completed applications to ACGME-accredited residencies.

DO candidates for AOA-accredited residencies have a somewhat accelerated cycle; please check it out here.

No matter what camp you are in, please start working on your materials early. Good writing takes a lot of time, and that mad rush at the end is never strategic.

How to Navigate the Residency Personal Statement when You're Applying for a Preliminary Year

Candidates who apply to certain fields - dermatology, ophthalmology, etc. - need a preliminary or transitional year of residency before initiating their specialty training. So does that mean those applicants need to toil over two personal statements?

No, thankfully. It's very appropriate (and strategic) to use the same essay with modifications. Ensure you explicitly address why a prelim year will advance the rest of your career and how you will contribute to the training program as a future specialist.

When you use a very similar essay, you can be honest about what your professional goals are. After all, the reader knows you're applying for a one-year position anyway.

Remember that many preliminary/transitional year programs are eager to match residents who are moving onto competitive fields. In general, those applicants will have strong USMLE scores, evaluations, and clinical skills.

Medical School Help: What are the Next Steps Once the AMCAS is In?

Once you've submitted your AMCAS, what can you do next to best prepare for what's to come in the medical school admissions process?

Here are a few tips:

1. Start to draft secondary essays. Even if you haven't yet received the prompts, you can begin to craft responses to common themes like "how would you add diversity to our school?" and "describe an extracurricular activity that might be of interest to the committee." Good writing takes time, but if you wait for the onslaught of secondary applications, you won't be able to impart your essays with your highest quality effort.

2. Get a head start on preparing for the medical school interview. Practice, practice, practice. Start mocking up answers to interview questions so that you distinguish yourself.

3. Consider what you want. Do some soul searching to determine what you are really seeking geographically, philosophically, and educationally. You want to make considered decisions when the time comes.

AMCAS tips

On June 7, you can submit your AMCAS. In preparation for that rapidly upcoming date, here are a few quick tips for writing your AMCAS activities:

1. Use full sentences. It's a formal application, and you want to make your written materials as readable as possible.

2. Avoid abbreviations. Again, you want to be formal, and abbreviations you think are common might not be familiar to the reader.

3. Make sure you spell out your accomplishments clearly. If your reader doesn't understand an activity, you will not get "full credit" for what you've done.

4. Choose "most meaningful" activities that show a breadth of experience, e.g. one that is related to research, another that is clinical, and a final that is volunteer.

5. Write about yourself and your role - not an organization. For example, don't use the space to discuss Habitat for Humanity. Use it to discuss the specifics of your role at Habitat for Humanity.

6. Use numbers to be persuasive. Saying that the conference you organized had 300 participants says it all.

7. Get help. Do not submit your application without having it reviewed. Don't submit suboptimal materials for a process that is this important and competitive.

Medical Students: How Do you Select Your Specialty?

'Tis the season: Yes, it's time to make those final decisions about your future specialty. However, the way the medical education system is set up, it's a very difficult and stressful choice to make. Here's my Student Doctor Network article on how to choose your future career.

Get a Better Letter

After over a decade of reading medical school and residency letters of recommendation (LOR), I can tell you that the biggest error I see in the LOR process occurs when applicants settle for mediocre letters. In other words, they know that a supervisor/faculty member/attending isn't going to write them a strong letter, but they fill the LOR slot with the middling endorsement anyway.

Please take a look at my most recent Student Doctor Network article, "Get a Better Letter" for concrete ideas on how to approach the letter of recommendation process.

Personal Statement Errors You Can Easily Avoid

As AMCAS® and ERAS® openings approach, I wanted to remind candidates about a few personal statement errors to avoid. First, take a look at my piece Tales from an Insider on Student Doctor Network about how to write a persuasive (not narrative) personal statement. Second, spend under two minutes (literally) checking out two Guru on the Go® Videos on my YouTube channel: Personal Statement Russian Roulette #1 and #2.

Contact me for personalized help on your documents.

AMCAS Opens this Week

Just a reminder that AMCAS opens on May 3, and you can submit your AMCAS as early as June 7. This application cycle's AMCAS Processing Fee is $160 (which includes one medical school designation). Additional medical school designations are $38 each.

AMCAS has fantastic resources, including a FAQ sheet and pre-med calendar for applicants. Take a look here to get started.

International Medical Graduate (IMG) 2016 Match Statistics Are Out

The ECFMG® recently published 2016 Match statistics for International Medical Graduates (IMGs). In the 2016 Match, only 53.9% of U.S. citizen IMG participants were matched to first-year positions, and of those IMG participants who were not U.S. citizens, only 50.5% obtained first-year positions. While the actual number of IMGs matching was slightly better than last year (with more residency positions on the whole available), IMGs still face large challenges in the residency application process.

For Pre-Meds, What IS Solid Clinical Experience Anyway?

Getting into medical school has gotten so competitive that it's increasingly important to have a strong candidacy with excellent grades and robust extracurricular activities starting early in your college career. As I've mentioned in previous blog entries, one mistake I see pre-meds make is that they are so focused on leadership and research they forget a critical component - clinical experience. To prove you want to be a doctor, it's essential you obtain clinical experience for a significant period of time - not just a health fair or two. Good grades will not make up for a lack of clinical experience.

Working as an EMT, in a good clinical care extender program, or in a low-income clinic are just some ideas for obtaining excellent clinical exposure. (Although you might think free clinics would be thrilled to have a pre-med volunteer, many understandably require one-year commitments.) Shadowing is a mixed bag: Medical schools don't know whether you're second-assisting in the operating room or just standing in a corner being ignored. If you choose to shadow, make sure you strategically highlight your clinical experiences in your written materials. Other popular options include international clinical work (although it is usually short-lived) and working as a volunteer in a hospital (although it might be more clerical than clinical, depending on the position).

Do your research before accepting a "clinical" job so you ensure you'll really get the experience you need to confirm to yourself that you've made the right career choice (very important) and to show admissions committees that you can handle the heat.

Don't Just Do It

Many medical school applicants ask me if they have to do things they don't want - like bench research - to get into med school. While having reasonable academic numbers and some clinical experience is critical, candidates can succeed while lacking traditional aspects of the application, like research.

Now, having a strong research project (especially a publication) under one's belt will almost invariably help propel an applicant's candidacy forward, but finding very strong alternatives is a reasonable option.

Graduate Medical Education Bill Introduced

Here’s some interesting information from the Association of American Medical Colleges on the recently proposed Graduate Medical Education (GME) Bill. The legislation’s intent is to increase the number of residency training slots in an effort to improve the U.S. physician shortage problem.

Writing a Compelling Personal Statement

It's that time of year... Check out my Student Doctor Network® article on how to craft a persuasive personal statement. Remember the goal is to convince the reader of your worthiness – not simply tell a story.

How to Be Happy in Residency

I'm sending a big congratulations to all of those residency candidates who successfully matched last week! Next year will be the start of something wonderful and challenging. Here are my tips for being happy (or at least as happy as possible) during residency:

1. Physician heal thyself. You will be working a ton, but eating healthfully and getting exercise will make everything a little better.

2. You've got a friend. You may be working 80-hour weeks, but plan to spend at least half an hour every week catching up with someone who makes you laugh.

3. Vacation - all I ever wanted. Figure out somewhere fun you want to travel when you are not working, and then happily anticipate the trip.

4. Date night. Take time out for your spouse or partner. Although I was not yet married when I trained, I remember being upset by seeing several marriages and relationships split up. You can never get that back. (This advice goes for children too, if you have them. You have an even greater challenge ahead of you than most if you are a parent in residency.)

5. Dance dance party party. Knitting, hiking, dancing, watching movies, kayaking, reading - whatever it is , do not let yourself become unidimensional.

6. Realize that the honking drivers have simply had a bad day. When I was in medical school, a brilliant upper classman came to speak to us about being on the wards. He told us that when someone aggressively honks at you on the road, it's often because s/he in a bad mood - not because you are about to cause an accident. The same is true in the hospital. Tired, burned out professionals can make you feel bad. Don't let them.

Won't Hire a Chef Who Hasn't Been in the Kitchen

Pre-meds, as you prepare your candidacy - either for this year's application cycle or one in the future - please recall that it is absolutely critical that you have clinical experience to be a competitive applicant. Even excellent grades and MCAT scores rarely overcome the limitations of a lack of patient contact. See my less-than-one-minute Guru on the Go® video below "Med Schools, No Patience for No Patients" for a quick review of this topic.

An Offer You Can't Refuse

I speak to a few lucky medical school and residency applicants who are asked to write their own letters of recommendation. If you have this opportunity, first, realize that it is not unethical to write your own letter if you're asked. If you'd like to explore the scruples of this issue, take a look at this New York Times ethicist column about this exact topic.

The mistake I see candidates make in these situations is that they feel awkward about showcasing their accomplishments fully in their letters. If you have this opportunity, write a glowing letter. Be effusive and full-throated in your compliments to yourself. After all, the letter writer can always tone it down if s/he doesn't agree. But if s/he does, you have bolstered your candidacy tremendously.

The Fresh-Faced Physician’s Fade

Here’s a piece that is not for the faint of heart: Dr. Sandra Scott Simons is a nocturnist emergency physician who describes how disappointed her earlier-self would have been in what medical care giving has become.

Medicine's Diversity Problem

Here's a recent article from Emergency Medicine News about Dr. Alden Landry who started the Tour for Diversity in Medicine, a project to encourage minority students to become health care providers.

It's worth exploring the AAMC's Practice Specialty by Race and Ethnicity table to better understand the lack of diversity in each and all medical fields.

Yes, Doctors in Training Should Work Fewer Hours

Here's a NYT piece by Dr. Dhruv Khullar, a current resident in training, regarding duty hours. His points in the last few paragraphs are his best. I remember doing - and I am not exaggerating - a 138-hour work week once during residency. I can assure you that I was not the best doctor I could be.

Physician Heal Thyself By Getting Help

I wrote recently about burnout, which affects 37.9% of doctors, as compared to 27.8% of the general population, according to an Archives of Internal Medicine study.

Beyond burnout, suicidality is a major problem for doctors. Physicians have much higher suicide rates than the general population with male doctors at 70% higher and female physicians at 250-400% higher, according to a JAMA piece.

For the younger cohort in the profession, things are also rough: Fifteen to 30% of medical students and residents screen positively for depression, according to Medscape, and suicide is the number one cause of death among medical residents.

Excessive work burdens and expectations, lack of a perceived internal locus of control, and isolation from friends and family can all lead to clinical depression among medical students and trainees. It’s critical to take note if you see symptoms in yourself or colleagues, including hopelessness, withdrawal, anger, recklessness, anxiety, substance abuse, excessive feelings of guilt, and inability to concentrate. Realizing that many others are in the same boat and that most institutions have psychological counseling options can be a relief. Additionally, a national resource is the National Suicide Prevention Lifeline at 1 800 273 TALK.

SOAP®

Just a reminder that if you have received few or no residency interviews, it's time to start getting ready for SOAP.

On March 14 SOAP begins, but you need to understand how it works and be prepared for its brisk schedule prior to that.

Here is the main residency Match calendar. Here is an article on the history and basics of SOAP. And finally here are NRMP® video tutorials on SOAP.

Choosing a Specialty and a Life

During the winter season, I spend time talking to a lot of residency applicants about their future specialty choices: Want the majority of your time to be in the operating room or in the clinic? Like procedures?

But another fair and reasonable approach is to consider lifestyle. A recent New York Times piece noted that 50% of physicians are burned out. Burnout is particularly severe among emergency physicians and critical care doctors.

As you go through your third-year clinical rotations ask yourself if you can find a role model who fits - not just your professional goals - but your personal ones. Ask to meet individually with faculty members for their opinions on their fields' pros and cons.

Considering the growth in patient volume and the continued dearth of physicians, it's critical to determine whether you can see yourself happy in a busy, lifelong career in a particular field.

Match Ranking is (Strategically, but Not Emotionally) Easy Peasy

Getting into residency is hard. Understanding how to rank programs for the Match is easy. Thanks to a Nobel Prize winning economist and his colleagues, the current Match algorithm ensures that your desires are the priority over the residency programs'. What this means practically is that you should rank your first choice first, your second second, etc. There is no need to try to play the system.

I've had applicants tell me that they plan to rank a less preferred institution higher because that program has more residency slots. That's a huge no-no. The applicant will actually be harming him/herself with that strategy!

Please see my Guru on the Go® video "NRMP Ranking to Avoid a Spanking" below for a fun summary and the NRMP® website here for more details about how the algorithm works.

Improve Your Medical School Candidacy: Prove you can Handle the Heat

Getting into medical school has gotten so competitive that it's important to have a strong candidacy with excellent grades and robust extracurricular activities starting early in your college career.

One mistake I see pre-meds make is that they are so focused on leadership and research that they forget a critical component - clinical experience. No one wants to hire a cook who hasn't worked in the kitchen. If you want to prove that you want to be a doctor, it's essential that you obtain clinical experience for a significant period of time - not just a health fair or two. Good grades will not make up for a lack of clinical experience.

Working as an EMT, in a good clinical care extender program, or in a low-income clinic are just some ideas for obtaining excellent clinical exposure. Although you might think free clinics would be thrilled to have a pre-med volunteer, many understandably require one-year commitments.

To create a plan for your medical school candidacy, secure a Strategy Session with me here.

How Do I Evaluate My Score from the New MCAT?

Assessing your score on the new MCAT is not easy. The AAMC has no plans to release an MCAT conversation table from old to new scores, as their position is that the tests are not comparable.

With the old test, the conventional wisdom was that getting a 30 or 31 (approximately the 85th percentile) was the threshold to aim for, as it represented the allopathic medical school new matriculant average. Until we see who gets into medical school this year and what their corresponding scores are, it's hard to know what the "new 30" is.

Having said all of that, using last year's MSAR should still help you decide whether you need to re-test. An option for those committed to medicine who don't score at or above the "new 30" is osteopathic medical school, an institution that shows a great commitment to primary and holistic care and a (limited) leniency with MCAT scores. (Students entering osteopathic medical schools in 2013 had an MCAT score of 27. Their average GPA was 3.5 compared to 3.69 for incoming allopathic students.) Here is a great New York Times piece about DO schools.)

We have to take a wait and see approach to assess scores from the new MCAT, but it is key that you ensure you give yourself enough time to study and that you prepare effectively.