Accomplished, Not Lovely

Pre-pandemic, I went to hear the author Nicole Krauss speak about her novel Forest Dark. I'm a big fan of Krauss' writing. The day I heard the author speak, she'd published an opinion piece in the NYT Sunday Magazine called "Do Women Get to Write with Authority?" In the article, Krauss highlights the lack of power women writers have compared to men, and specifically, how female artists' work is often characterized as "lovely," a word she describes as lacking in "independent power."

I must admit that I sometimes use the word "lovely" (both for women and men) when I like someone. But Krauss made me think about the word in the context of achievement - not personality - and her point is well-taken.

When you interview for medical school or residency, you want the faculty member you've met to leave the table saying you were "accomplished," not "lovely." Many applicants miss this point: You don't want to simply be liked; you want to be seen as worthy. It's critical that you focus on that important goal as you practice for interviews, crafting strategic responses to potential questions. 

As an aside, I would strongly recommend Krauss' History of Love, Great House, Forest Dark and To Be A Man.

I'm Worried about Emergency Medicine

While my career has been a good one until now, I'm increasingly worried about the field of emergency medicine. See my October 21 blog on the current dearth of emergency medicine jobs. The American College of Emergency Physicians (ACEP) recently published a report on the future of the field's workforce, concluding that there will be nearly 10,000 too many emergency physicians by 2030.

Dr. Thomas Cook published a piece recently called A Few Feasible Solutions to EM's Workforce Crisis. He demonstrates a healthy skepticism for the possible solutions that ACEP proposed. See his piece here.

In the meantime, corporate emergency medicine is depleting some physicians. A group has even considered unionizing.

In addition, burnout has been a big problem for the field - even before the pandemic. 

Medical students, as great as the specialty of emergency medicine is in many ways, I would be remiss if I didn't tell you to consider these issues seriously when making a decision about your future field.

AAMC Report on Residents 2021

 The AAMC recently published their Report on Residents 2021. Of note,

• The percentage of medical residents who identify as Black or African American and as Hispanic, Latino, or of Spanish origin has increased since last year.
• Women make up the vast majority in obstetrics and gynecology (85.2%) and pediatrics (72.7%).
• Only 27.0% of the 2020-21 graduates intended to train in the specialties they had listed as their preference when they began medical school.
• The majority of medical residents (57.1%) who completed residency training from 2011 through 2020 practice in the state where they completed their residencies.
• In a tip of the hat to my favorite state, physician retention after medical residency is highest in California (77.8%).

There are more goodies; the information is summed up in this table.

Medical School Interviews: Preparing for your Virtual MMI

While the majority of medical school interviews are traditional, an increasing number of institutions (including 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. Despite the virtual approach, a number of schools are still using MMI. 

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, or your capacity to admit wrongdoing, etc.

4) Make sure you know what structure the school is using and employ the right mindset: Working with an actor is different from executing a group project (especially remotely!), which is, in turn, different from answering questions about your opinions. 

5) Practice MMI questions before you "go" to your interview. Even if you have excellent social skills, there are techniques you should hone to expertly manage the challenging MMI format. 

Contact me for help. 

The Residency and Medical School Application Process: 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, burnout, 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's a fun article on imposter syndrome by Joelle Borhart MD, the Associate Program Director at Georgetown University. I also recommend Amy Cuddy's TED talk with over 63 million views. 

Perils of the Virtual Match

I've written before about the benefits of virtual interviews - both with regard to finances and equity. However, the ability to easily hoard residency interviews now has led to an unintended consequence of online access: An increase in qualified applicants who don't match. Thomas Cook MD, an emergency medicine program director in South Carolina, covers this topic in his piece "The Virtual Match is Like the Toilet Paper Rush." In it, he points out that when superior candidates accept a very large number of interviews, there are serious negative consequences for their peers. Cook has a suggestion for a potential remedy based on transparency. The piece is worth a read. 

Love Letters and Janet Jackson

Letters of interest (LOI) - or what some applicants jokingly call "love letters" - can be used in several types of situations:

1) Residency and medical school applicants who want to make an impression post-interview before decisions are made about their candidacies.

2) Medical school and residency applicants who have not yet been invited to interview.

3) Medical school applicants who have been waitlisted.

When writing your letters of interest, you should have the following goals:

1) Restating your strong interest in the institution
2) Positioning yourself as a distinctive candidate who can contribute fully to the institution

The biggest errors I see in LOIs are:

1) Too much content about a specific institution's advantages. There is no reason to spend a paragraph or more telling a PD or medical school admissions member what makes their institutions special. Using your precious space this way is an opportunity cost, keeping you from fully showcasing what makes you a compelling applicant.

2) Writing about how the program or school will help you. The focus should be on how you will be a contributor to their institution. (It's the "What have you done for me lately?" Janet Jackson principle.)

Finally, let me say that I find the term "letter of interest" to be better than "letter of intent" because, generally, I don't recommend you let institutions know what your intent is (since it might change). Note that with a letter of interest you can create one general letter that you modify and send to different institutions with different goals (i.e. requesting an interview or demonstrating your interest post-interview). You can also modify the letter and send it to your top choices because, if you are not making commitments, then you can honestly use it for multiple institutions. 

For those of you interested in LOI assistance for medical school or residency applicants, please contact me.

Happiness

As you interview now for medical school, dental school, residency, or fellowship, it's important to think about what will make you happy in the next phase of your career.

When I was a medical student applying for emergency medicine residency programs, a well-meaning dean gave me some bad advice. I was determining the order of my rank list and was particularly concerned about one program that had an excellent reputation but was in a city I didn’t like. The dean told me, “You’ll be so busy during residency it won’t matter where you live.” Luckily, the advice rubbed me the wrong way, and I wholeheartedly disregarded it. Where you live for your training is as important as the quality of your training program. The reasons are several-fold:

1. Training is time-consuming, and you want to be in a city you can enjoy fully when you’re able to blow off steam. 

2. Training is stressful, and you want to be in a city where you have social support.

3. Training is not completed in a vacuum. Your personal life continues. If you’re single, you may meet someone and end up staying in the city where you've trained for the rest of your life. If you’re in a long-term relationship, you may decide to have children (or already have them); down the road you might not want to relocate your family.

Not everyone gets the opportunity to train at an institution in a city s/he likes. But prioritizing your contentment will increase your opportunity for well-being and career longevity.

Haven't Heard Back from a Medical School or Residency Program? Here's What to Do.

One of the more frustrating aspects of the medical school and residency admissions processes is the lack of response from some institutions. There is no obligation for medical schools or residency programs to reply to a candidate, which leaves applicants in limbo.

If you have not heard back from medical schools or residency programs to which you've applied, I recommend that you contact (preferably call) the institutions to inquire about your status.

After I offered that advice to a residency applicant I was advising, she emailed me to say she obtained an interview in a competitive specialty with a phone call. Another said she received two preliminary interviews with simple emails. A third recently told me that, after calling in the morning, he was offered an interview by the afternoon. (Generally, I recommend calls over emails because it's hard to ignore someone on the other end of a phone line. Still, if you simply can't bring yourself to call, an email can be effective.)

I've seen this phone call strategy work for medical school interviews as well: 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. Shockingly, after the applicant's phone call, the school granted him an interview, reversing their original rejection. 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 in the application process. Now, if the school or program explicitly asks in written materials that you don't contact them about your status, then calling is not a good idea, of course.

An additional strong option is to send an effective update letter or letter of recommendation from an influential writer (alumnus, for example). I do edit letters of interest for medical school and residency applicants, but even if you choose not to use my services, I recommend sending a well-written, strategic note in addition to making a phone call.

This process is an uncertain one, but asserting some small bit of control can be useful (and comforting).

Medical School Admissions and Residency Applicant Rankings: It's Not Personal

When I was in my second year of medical school, a third-year student (who later also went into emergency medicine, as I did) came to speak to our class about being on the wards. He gave an animated talk about how important it was to recognize that when residents, attendings, or nurses hollered at us on our clinical rotations, 99% of the time, it wasn't personal. He likened the situation to Boston traffic - how drivers lean on their horns for little cause because they are simply frustrated about their days. 

It's not personal, he said.

I say the same to those I mentor. Candidates get an interview at one highly ranked institution but rejected at what is considered a lesser one with no clear cause. Faculty interviewers mix applicants up with one another. Some turn up wholly unprepared - reading students' applications for the first time during the interview itself. Remember: It's not personal. This process is arduous and long, and most candidates, faculty, and program coordinators are tired and doing their best. 

When things are rough, give others the benefit of the doubt. It will help you get through this stressful process with your sanity intact. 

Your Residency Application: Program Directors Don't Want Headaches

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

First, a PD doesn't want to field complaints from patients, faculty, or other services about his/her residents. Therefore, every far-seeing PD asks him/herself the simple question: Will this person be competent and collegial?

Second, a PD doesn't want to see the day when s/he's scurrying around to fill a residency slot and the consequent open call schedule. So, the oracular PD asks the simple question: Will this person leave the program prematurely?

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, extracurricular 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.

Just making sure the PD knows you are not going to cause him/her pain is half the battle.

Emergency Medicine: A Career That's Currently Taking a Lot of Hits

Having been in the field of emergency medicine since I started my residency in 1996, I can tell you that the discipline has had its ups and downs. Currently, the specialty is facing a lot of challenges: COVID has driven some physicians out (to utilization review, administration, research) and has adversely affected others emotionally. Additionally, there's a tremendous dearth of positions currently for emergency physicians. I've had friends and colleagues lose promised hours or their jobs entirely in the last 18 months. 

Here's a short piece on the job scarcity issue. Those choosing a specialty must consider the atmosphere of the job market (while recognizing it might improve in a few years).

You Don’t Have to Go to Every Party You’re Invited to, or Taking the Fifth

The goal of every medical school, dental school, residency, and fellowship interview is to distinguish yourself from everyone else to demonstrate you're worthy of a competitive spot.

So what happens when you get this (ugly) question:  

If there were one reason not to accept you, what would it be?

When a (salty) faculty member asks you this interview question, her motivation might be to determine whether there's a weakness in your application that she's missing. Or she may be assessing how you manage stressful situations by posing a question that is unpleasant.

While you need to be honest throughout the entire application process, you do not need to volunteer information that might harm you. So, for a charged question like this one that opposes your goal, you might answer, “While every candidacy has room to improve, I have a strong application." Then you can use the question as an opportunity to mention the strengths of your candidacy. Remember: You have a duty to further your candidacy, not damage it. 

Contact me for mock interview help. I still have some October slots open, as of this writing. 

Nailing the Residency or Medical School Interview (or "Just the Facts, Ma'am")

Google had a problem.

As an oldie but goodie New York Times article describes it, over a decade ago Google executives were growing increasingly aware they were not hiring enough women, and 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 asserts they 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. 

Applicants also ask me if showcasing their achievements is bragging. Not if you state "just the facts, ma'am," meaning you can be polite, confident, and accurate without being arrogant. When candidates still feel shy about drawing attention to their achievements, I remind them that occasionally residency and medical school interviewers don't 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 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 and Residency Interview Questions: How to Handle the Illegal Ones

In the United States, a professional interview is subject to basic legal rules. Specifically, admissions officers and residency directors should refrain from asking 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 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 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.

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. For help, secure your Mock Interview slot with me. I'm booking a few weeks in advance, so sooner is better than later.

Supplemental ERAS Application

A few clients have asked me about the new supplemental ERAS application for dermatology, internal medicine (categorical and preliminary), and general surgery (categorical) applicants. The application is more work for these candidates, but the AAMC says the supplemental app will foster a more holistic approach to the residency process. For more information, check out the PowerPoint presentation from a recent webinar the AAMC held on the topic. The supplemental application opened last week.

ERAS Announces Candidates Can Submit their ERASes without penalty through September 29 at 9am EST

Last week ERAS Communications sent out a notice to candidates that while applicants may certify and submit their MyERASes as early as Wednesday, September 1 at 9 am EST,  applications submitted on or before September 29 at 9 am EST will display an application date of “September 29” to programs. (Applications submitted after September 29 will display the actual application date.) This means that there is no penalty for candidates to wait to submit their applications until the 29th at 9 am EST. This date is considerably later than recent past years.

This is great news for applicants who are still working on their written materials. Use the time to make sure yours are in the best shape possible.

 

NRMP® Data Suggests Residency Applicants Should Apply Broadly

A few years back, the NRMP published a short document called the Impact of Length of Rank Order List on Main Residency Match Outcome:2002-2016. There, the NRMP reported that matched applicants consistently had longer rank order lists than unmatched applicants.

This data is a bit old, but it assesses over a decade of Matches, so I take it seriously. In my mind, what it means to those approaching the residency application process is that candidates should throw a wide net in choosing programs at which to apply. Of course, there is a financial cost to this strategy, and that expense needs to be balanced. However, according to this data, starting out with more options usually will provide more opportunities to interview and thus, the ability to create a longer rank order list.

Virtual Interviews Can Help Mitigate Systemic Sexism in Medical Interviews

Congratulations to a few applicants who have already received medical school interview invitations. For most, the season will start in the next month or so. Remote interviews are still with us, and my assertion is that the virtual interview process reduces discriminatory practices that have plagued the system for a while. See my Doximity article "How Virtual Interviews Might Mitigate Systemic Sexism in Medicine" for a personal story. 

Your Residency Application: Being Repetitive Again and Again

In writing their personal statements, many residency applicants ask me, "Isn't it regurgitating my CV if I highlight my accomplishments?" After all, they say, their achievements have already been noted in the application, MSPE, and letters of recommendation. Think of the residency admissions process as an onion. Your ERAS and letters serve as one layer of that onion, albeit a thin one. In other words, your accomplishments are conveyed simply and succinctly there. The personal statement is your opportunity to apply a thicker layer, one in which you flesh out your achievements, thus persuading the reader of your distinctiveness. Finally, the interview is your chance to add on the thickest peel. Discussing your accomplishments in detail can seal the interviewer’s positive impression of you.

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

Mom and Dad May Think You Have Good People Skills, But That's Not Enough When It Comes to Interviews

 Every year I am hired by re-applicants for medical school and residency who tell me that the year before they received multiple interview invitations, thought they performed well on interview day, but then were left with no offers in the spring. 

This is the truth: Interviews are hard. You need to strategically respond to criticisms of your candidacy, showcase the strengths of your application, be prepared for awkward or even - sometimes - illegal questions, all while seeming fresh and enthusiastic.

There are applicants who spend months studying for their MCAT or Boards, but don't spend even an hour practicing for their interviews. It's a naive disconnect. 

If you can mock interview with someone who has been on a medical school admissions committee for years or a faculty member who has strong experience with residency applications, go for it. If not, check out my mock interview services here. Don't rely on a friend or family member with no experience.

Here is a funny, less-than-one-minute, stop-motion video to guide you on this topic. 

The Week I Spent 138 Hours in the Hospital and What it Means for your Residency Application

During my internship, on my surgical rotation, I once spent 138 hours in the hospital in one week. If you think this isn't mathematically possible, I will tell you that I was on call from Monday morning to Tuesday evening, from Wednesday morning to Thursday evening, in-house on Friday, and then on call from Saturday morning until the next Monday morning. (I had to stay in-house that Monday until evening rounds were over too.) As you can imagine, I was barely human by the end. How this schedule was good for patient care is beyond me.

I thought of that ghastly time recently when reading this oldie-but-goodie article in the New York Times called "How Job Stress Can Age Us" written by Dr. Dhruv Khullar. The author reports on a study, "Physician-Training Stress and Accelerated Cellular Aging" that assessed the DNA of 250 first-year medical residents around the country. Researchers examined the saliva samples of these residents, focusing on their telomeres - the bumpers at chromosome ends that prevent DNA damage - before and after the first year of residency. Researchers found that the DNA of first-year residents aged six times faster than normal. 

Six times faster.

I found this both shocking, upsetting, and validating. Residency training is as hard as we think it is. 

What I would strongly recommend is that you compare residency programs' hours as you decide where to apply and before you create your Match list this coming winter. Strangely, many applicants don't even consider this important issue when making decisions about their next three to five years. Also, many residencies support physician wellness programs and night coverage. Especially in the setting of severe burnout among doctors, your happiness should be a primary factor in your career choices. If you're not sure, consider your shrinking telomeres. 

What Kind of Job Do Female Emergency Physicians Want and How Might that Affect Your Career Choices?

Recently Dr. Thomas Cook, a program director in South Carolina, wrote an article in Emergency Medicine News describing a study about my field - emergency medicine's - workforce. 

The data found interesting differences between male and female emergency physicians. For respondents, geographic locations was the only factor that was "very important" to more than half of the women (52%) but only 42% of the men. Interestingly, compensation was "very important" to 49% of the men and only 27% of the women. Proximity to family was "very important" to 38% of the women but only 27% of the men. 

Currently more than 50% of medical students are women and yet only one in three chooses emergency medicine for a career. Nationally, only 25% of emergency physicians are women. Using data to better understand what women emergency physicians are seeking might help the field improve the gender gap. 

Applying in Two Specialties

Occasionally I help residency applicants who are applying in two specialties. This tactic can be strategic in specific scenarios, but it also makes the process more complicated. Here are some quick clarifications to help:

1) Different personal statements can be assigned to different programs. This means you can assign your ob/gyn essay to ob/gyn programs and your internal medicine essay to internal medicine residencies. Of course, in this case, you need to have two versions of your statement in the first place.

2) Different letters of recommendation can be assigned to different residency programs as well. (A maximum of four letters may be assigned to each program.) You'll either need to have letter writers for different fields, letter writers who will craft two types of letters, generic letters (less compelling), or a mix of these approaches. 

3) You will have only one MyEras application. It will go to all of your programs. Note that if you list your membership in multiple ob/gyn organizations, for example, that will be viewed by your internal medicine readers as well - and might make them question your commitment to IM.

As always, contact me for help. 

Five ERAS Platform Quirks to Heed

On September 1, ERAS will open for submission, so it's time to get moving on your written materials. Let's briefly cover five quirks of the ERAS platform to help you get through the drafting process. The ERAS platform...

1) Does not support italics. While journal articles and some phrases (e.g. "summa cum laude") should be italicized, don't be surprised when you can't.
2) Prompts you for a supervisor for each activity. In some cases, you simply may not have one, but whenever you can, name someone. A name validates the experience.
3) Prompts you for average hours per week for each activity. It can be difficult to calculate this number for certain experiences, especially those that are intermittent, but it's worth making your best estimate rather than leaving the question blank.
4) Offers space to include a "reason for leaving" for each activity. Don't skip this section, but keep your answers brief.
5) Limits you to 1020 characters for experiences, 510 for the interruption in the medical training section, and 510 for each of the awards sections. Be aware of these limits as you write, so you are not furiously cutting later.  

For tips on how to craft your ERAS, check out these 15 ERAS tips.

Contact me for help with this weird, wild process.

Now That You've Gotten an Acceptance to Medical School...

Congratulations to all of my clients who will be starting medical school soon. This is a tremendous achievement. For those who hope to matriculate in the next year or two, I might recommend this Varsity Tutors piece that I wrote several years ago and the follow up article. The "medical school paradox" is a tough one to crack, but if you prepare in advance, you'll have an excellent head start and a professional advantage.

Something You Probably Haven't Considered Could Have a Huge Impact on Your Professional Happiness

A recent article in Emergency Medicine News caught my eye. Emergency physician Dr. Tom Belanger conducted a small study (n=573) in which he crafted a nine-question Likert scale survey and then attempted to predict emergency physicians' employment structures based on respondents' answers. He used statements like "I am paid fairly," "I am secure in my career," and "Emergency medicine is a good career" in his survey.

In medical school and residency, I thought little about employment structure, which can include democratic, hospital employee, contract management, independent or locums, academic, resident, or government systems. As a student, I was so focused on what specialty I would choose and was so influenced by the academicians I worked with that I didn't even consider that I could choose a field in which I might be happy in one employment structure and discontent in another. 

Belanger found that employees of contract management groups (CMGs) tended to be the most negative respondents, and owners of CMGs were not far behind. On the other hand, owners of democratic groups were the most positive in almost every aspect. 

In this study, all respondents were in the same specialty and yet, employment structure divided respondents with regard to their career satisfaction. Belanger's graphs are worth viewing in his piece, but the take-home point for medical students and residents is the importance of the employment structure in which you ultimately work, a topic that may not have even crossed your mind until now. 

Inaccuracies in Medical Student Grades Translate into a Residency Application Strategy

Here's an oldie-but-goodie New York Times piece by Dr. Pauline Chen on medical student grades. In reading the article, residency applicants should reflect on how important the content of their letters of recommendation is, especially in the setting of medical school grades that may be inflated or simply inaccurate. The 2020 NRMP Program Director Survey supports the importance of letters, as well, with statistics. Make sure your letters are very strong; remember that mediocre letters should not be a part of your residency package.

The Ins and Outs of Choosing a Specialty: The Generalist vs. The Early Committer

For many third-year medical students, this is a challenging time of year: Contemplating an ERAS application can be daunting, but it's even worse if you don't know what specialty you want to practice. Here's a short piece I wrote with my colleague David Presser, MD, MPH called "Choosing a Specialty: The Generalist vs. The Early Committer," and here's a complementary (non-medical) New York Times article called "You Don't Want a Child Prodigy" that's a great follow-up piece.

An Oversupply of Emergency Physicians?

When I applied in emergency medicine (EM), I had only two other classmates submitting applications to the field. EM wasn't a very popular specialty, although that would change as the show ER became hotter. Although enthusiasm for the field has generally increased over my career, medical students' interest in EM has waxed and waned.

Recently an eight-organization consortium of EM groups analyzed the field's workforce, demonstrating an oversupply of emergency physicians likely to appear over the next decade. There are a number of reasons proposed, including the proliferation of EM residencies and inappropriate use of physician extenders. Take a look at this piece in ACEP Now for detailed information, especially if you see EM in your future.

AMCAS Opens for Submission on Thursday

The AMCAS open-for-submission date is this Thursday, May 27. While submitting on Thursday is to your advantage because of rolling admissions, getting that application in at 9:30am EST on May 27 is not worth losing your mind over, so if you simply can't, please don't kick yourself.

If you're wrapping up your work and have your written materials in a superior state, just keep moving and get your application submitted promptly. If you're behind the eight ball and don't feel that you can craft outstanding written materials speedily, consider waiting a year to apply. Every season I encounter re-applicants who, during the previous cycle, submitted their AMCASes in August or September...thus making them re-applicants :(. 

Expert Writing Tips

With AMCAS' submission open date fast approaching (on May 27), I thought I might lower the boiling point a little by offering an amusing group of writing tips based on the wit of the late author William Safire and copywriter Frank LaPosta Visco. Enjoy!

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