Sunday, December 25, 2022

Medical School Interviews: Preparing for your MMI

Although the majority of medical school interviews are still traditional, many institutions (including dental schools) are using the MMI platform - even though interviews are now held in a virtual setting. 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. 

Monday, December 19, 2022

The Medical School Waitlist: Can Anything Be Done?

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

  1. Realize that getting into medical school has become increasingly competitive year by year. Being waitlisted is infinitely better than being rejected, and thus a positive, despite the anxiety it causes.
  2. Send a letter of interest. Let the school know of your continued enthusiasm and your new accomplishments. Ensure the letter is well written, streamlined, and brief. If the school is absolutely, positively your first choice, let the admissions committee know that. Feel free to send more than one letter if you are on a medical school wait list for months.
  3. Ask the school if you can set up a second look. A supplementary visit indicates to the institution that you are serious, and it offers you more data in making your decision if you're later offered a spot.
  4. Do not neglect your other options. Don’t focus all of your attention on this institution to the exclusion of others: Ensure you are well-prepared for any late interview invites at other medical schools.
  5. Ask a well-positioned faculty member who knows your work to make a call or send an email on your behalf. This tactic is especially helpful if the supervisor has a connection to the institution. (I do not recommend that a family friend who hasn't worked with you contacts the school.)
  6. Plan for last minute notice. At some institutions, applicants are offered slots off the medical school wait list throughout the summer. I’ve even heard of acceptances being offered the day before school was to begin. Would you be able to change your living situation, move your personal belongings, and uproot if this were to happen? Be prepared. 

Monday, December 12, 2022

Being Valued is Undervalued

I read an interesting JAMA study on burnout recently. We've all heard about the problem and its growth over the past few years. But I found the results of this study particularly interesting: The authors found that chaotic workplaces and lack of control of workload were associated with higher burnout (think emergency departments or a poorly run, overscheduled clinic), while efficient teamwork and feeling valued were associated with lower burnout. People sometimes pay lip service to the importance of being appreciated, but this study really proves its significance. 

It's worth considering this study's results when making decisions about what field to choose, where to train, and what position to take after residency. Here's the article.

Monday, December 5, 2022

Pared to the Bone

I heard a great Fresh Air interview of Siddhartha Mukherjee, who was a lovely acquaintance of mine at Harvard and who has since won the Pulitzer Prize for his book The Emperor of All Maladies. Sid is a hematologist/oncologist clinician/scientist who has a new book out called The Song of the Cell. 

Terry Gross asked Sid how he successfully writes for both the scientific community through his journal articles and for lay people through his books - two different skill sets. Sid responded by explaining the importance - for any genre - of crafting manuscripts that are "pared to the bone," meaning they avoid verbiage. His recommendation was excellent advice for any writer, even one who is crafting a personal statement. Take a listen to the full interview with Dr. Mukherjee here

Monday, November 28, 2022

Leaving the Medical Workforce

Beware: The article I'm about to recommend has a bitter tone, but it's important for those who are considering the medical field to hear all perspectives. Plus, many of the issues this anonymous writer brings up - understaffing, corporate medicine, twisted financial incentives,  lack of fulfillment - are on point. 

Here's the piece.

Monday, November 21, 2022

Surgery Without Anesthesia

As we look forward to Thanksgiving, I recommend this short NYT piece by AJ Jacobs on gratitude. It’s a few years old, but it's still relevant, fun, and reflective.

Monday, November 14, 2022

How to Evaluate an Institution: Consider Your Happiness and Trust Your Intuition

A few medical school and residency applicants have asked me how to evaluate institutions, especially since interviews are virtual. This is a huge topic, but here are some thoughts:

  • To me, geography is one of the most important factors – at least equal to the reputation of the institution. You want to make sure you are in a location that will make you happy – near community, family, friends and/ or the ability to enjoy your hobbies.
  • Cost is sometimes a deal breaker when it comes to medical school. There's not much more to say here except that most institutions are extremely expensive.
  • Of course, didactics and academic opportunities are critically important for both medical school and residency. However, many medical schools of similar caliber have equivalent curricula and programs. You likely could be happy at many different medical schools. With regard to residency, it's important to ensure you are getting a lot of hands-on experience and to look at what fellowships are available, with your interests in mind.
  • Faculty is hard to assess because – like anything – there are good and bad ones. Also, faculty come and go. Having said that, if you are applying to residency, the program director is very important (understanding that he or she could leave).
  • With regard to residency, call schedule and overall work hours are important to consider. Certain programs within the same specialty require a lot more hours and scut work than others.
  • One of your best bets is to talk to current students at medical school or current residents in a training program. Oftentimes they will be very honest about the pros and cons of their institution.
Once you've assessed all of the above - narrowing down your list by geography and quality - I would analyze the vibe you have. If this sounds too touchy-feely, remember that intuition is not a magical assessment; it's based on major and minor facts that you consciously and subconsciously analyze.

Remember: If you're a medical school applicant, consider yourself fortunate if you have more than one option to choose from. Earning admission to medical school is getting harder every year. It's a great problem if you need to struggle to decide among multiple schools!

Sunday, November 6, 2022

Your Residency Interview: What Do Program Directors Really Want?

Imagine you're a program director (PD) going through scores of ERASes and interviews. What questions would you ask yourself as you assess each residency candidate to avoid big headaches?

1) Can this person do the job? Is s/he competent?

2) Will this person "play well with others" and not create complaints from patients, faculty, or other services.

3) Will this person stick with the program and not leave 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, extracurricular activities that demonstrate teamwork, and - if asked - hobbies and reading materials that demonstrate your agreeable personality. For the latter, highlight research projects in the specialty, sub-internships, and knowledge about the program and city.

Simply making sure the PD knows you're not going to cause him/her trouble is at least half the battle.

Monday, October 31, 2022

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 enthusiasm for the institution
  2. Positioning yourself as a distinctive candidate who can contribute fully to the institution
Errors to avoid in LOIs are:
  1. Don't include generic 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 his/her institution special. ("Your faculty is strong and your trainees are collegial" or "You are a world-renowned institution.") Using your precious space this way is an opportunity cost, keeping you from fully showcasing what makes you a compelling applicant. Having said that, it is very reasonable to link a particular interest of yours with a specific opportunity at an institution. For example if you have done cancer research, make sure to mention how you will contribute to the renowned oncology program the institution is associated with.
  2. Don't write about how the program or school will help you. ("I know your residency will make me into a great doctor.") The focus should, instead, be on how you will be a contributor to their institution. For example, you can detail how a specific leadership experience of yours has given you the skills to make you a future leader at this 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.

Monday, October 24, 2022

Highly Recommended Paid Summer Opportunity

I was an American Association for the Advancement of Science (AAAS) Mass Media Science Fellow in 1995 (during medical school). The program was truly fantastic and life-altering.

Applications for this year's AAAS Mass Media Science and Engineering Fellowship just opened on October 1 and will remain available through January 2, 2023. The scholarship is a 10-week summer program that places science, engineering, and math undergraduate and graduate students at media organizations across the nation - outlets like NPR, the Los Angeles Times, and WIRED. I worked at the Oregonian in Portland and had a tremendous time, learning how to write effectively and edit. I also gained an appreciation for the amazing public health influence journalists can have. It's really an amazing program. 

Monday, October 17, 2022

Finding - and Redefining - Balance: It's Not about Better Multitasking

This time of year, when residency and medical school interview processes are revving up, many of us feel overwhelmed. Here's a brief but thoughtful piece I've saved over the years; it's about balance. As you consider your future career choices, it's worth thinking about issues the author covers like clarifying what brings you joy, considering your goals while understanding they will change, and defining balance for yourself.

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, and you need to give yourself the room to explore those goals in order to guide yourself in the right direction.

Monday, October 10, 2022

How to Turn Bad Advice on its Head

As you get to know different institutions during this interview season, I encourage you to take the opportunity to reflect and consider what will make you happy in the upcoming years.

When I was a medical student applying for emergency medicine residency programs, a well-meaning dean gave me some bad advice: After interviewing at several institutions, 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 medical training - medical school, residency, or fellowship - is as important as the quality of your training program! The reasons are several-fold:
  1. Medical training is time-consuming, and you want to be in a city you can enjoy fully when you have a few moments to blow off steam.
  2. Medical training is stressful, and you want to be in a city where you have social support.
  3. Medical 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 have trained for the rest of your life. If you’re in a long-term relationship you may decide to have children or may already have them. Down the road you may not want to relocate your family.
Not everyone gets the opportunity to go to medical school or train in residency and fellowship programs in a city s/he likes. But you can make choices that will increase your chances. Consider these options - and your happiness - as you make professional decisions this interview season and in the coming year. 

Monday, October 3, 2022

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...

A 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. "Most of them have nothing in their CVs to support their interest in international work or education," he remarked. "They just say it because it's sexy."

When asked where you see yourself in ten years, consider how you might demonstrate a clear trajectory. 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 path you can back up, defend, and easily justify. 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.

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.

Contact me for help with tough interview questions. (If you're planning to seek mock interview help from me, please do it now. I'm booking several weeks in advance.)

Monday, September 26, 2022

We Need to Decrease the Stress and Inefficiencies Associated with the Residency Application Process

Inefficiencies in the residency application system have been a problem for many years. While the AAMC and NRMP have made efforts to improve the process, including the move from the Scramble to SOAP a few years back, the lack of adequate slots for a large number of candidates leads to a tremendous amount of unnecessary stress and waste. With the introduction of virtual interviews, hoarding became a new problem.

To their credit, the AAMC is considering some reforms to the system. Allowing applicants to identify favored residency programs, called "preference signaling" through the supplemental ERAS, for example, has improved candidates' abilities to get interviews at chosen programs. Additionally, some specialties – with AAMC's support – have implemented a common interview invitation release date and a minimum response time for invitees. In the latter case, for example, most surgery programs provide candidates a minimum of 48 hours to accept or reject an invitation, such that applicants don't need to sleep with one eye open, jumping to respond to an invitation to avoid the wait list. There has even been a consideration of capping the number of interviews each applicant can have to avoid interview hoarding.

I recommend reading this piece on proposed reforms to the system. Having gone through the stressful process myself, I wholly support strategies that would increase transparency and decrease unnecessary anxiety. 

Monday, September 19, 2022

Medical and Dental School Interviews: Preparing for your MMI

While the majority of medical school interviews are traditional, some institutions (including dental schools) are using the MMI platform. The MMI (multiple mini interview) is a format that uses several timed stations (yes, even virtually) 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, 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, 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. 

Monday, September 12, 2022

How Do I Strategically Apply in Two Fields?

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, and you need to ensure you assign correctly. 

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.

Contact me for help.

Tuesday, September 6, 2022

Five ERAS Platform Quirks to Heed

On September 7th, 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.

Monday, August 29, 2022

Don't Let Other People Freak You Out

I started Insider Medical Admissions over 15 years ago, so I'm pretty good at spotting trends. Every year about now I start getting emails from premed clients saying they're worried about their lack of (or minimal number of) interview invitations. Yes, even as early as late August folks are concerned. They say they have a classmate who says he's gotten multiple interview invitations or they read online that others are being contacted with many invites.

Sure, it's possible some people are getting tons of early interview invitations. But, it's rare and should not affect your confidence. After all, according to Amy Cuddy, whom I've referenced before, confidence is the name of the game when it comes to interviews.

So, simply stop checking online and minimize conversations about interviews with others. If you are in the thick of the season and you still haven't gotten any interviews, then you'll need to reassess and act. But for now, put in ear plugs. This process is so very stressful; you certainly don't need to seek out more anxiety-provoking information (and who even knows if it's accurate anyway!).

Monday, August 22, 2022

The NRMP is Considering a Two-phase Residency Match

Recently the NRMP requested public comment on the concept of a two-phase residency Match. In part, the plan would mitigate weaknesses in the Supplemental Offer and Acceptance Program (SOAP), which provides the opportunity of unfilled positions to eligible unmatched residency candidates. SOAP replaced the Scramble, an inferior system from years ago. SOAP still has its weaknesses, however, including an expedited timeline for decision-making by candidates and programs.

See a full description of the proposed two-phase residency Match here. Of note, the first Match Day, which would be analogous to the current Match Day, would occur a month earlier in February. Accordingly, interview season would be shorter. 

The plan has many benefits, but it would require some adjustments in candidates' and residency directors' calendars and thinking.

Monday, August 15, 2022

Managing Difficult Interview Questions: Rehearse Your Elevator Pitch Now

An important key to preparing for tough medical school, residency, dental school, and fellowship interviews is realizing that a) interviewing is a skill and b) practice improves performance. Every year too many 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 interview represents an 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 faculty member whose 
window was nailed shut, there may be uncomfortable moments and even illegal questions (although I suspect the latter are rarer with virtual interviews). 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 questions, such as “Tell me about yourself” to be brought up to speed. (A now-attending I helped prepare for residency interviews several years ago recently told me that the best advice I gave him was not to be shocked when interviewers were completely ignorant when it came to his candidacy.) 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.

Monday, August 8, 2022

Charting Outcomes in the Match 2022 is Out

The NRMP recently published their Charting Outcomes information for 2022; data I keep bookmarked and which I would recommend applicants review. The reports (for MDs and DOs) separate results into specialties and include extremely helpful information, including what mean board scores, number of contiguous ranks, and number of research experiences were for those who successfully matched - and those who did not.

It's important to make sure you are in the range for your intended field and to compare the competitiveness of different specialties if you are seeking to apply in two fields.

Here is the MD report and the DO one.

Monday, August 1, 2022

Winning Strategies for Medical School Interviews

I've heard from several medical school applicant clients who've already been invited to interviews - in July! Congrats. If you're seeking my help with interview prep, please hire me at your earliest convenience; I'm scheduling 2 or 3 week in advance. 

Check out this piece on how to most effectively demonstrate your distinctiveness during your interview to show you are worthy of a competitive med school spot. And below are a couple of cute, under-one-minute Guru on the Go videos to reinforce the importance of practicing:





It's not luck; it's skill that will help you succeed!

Monday, July 25, 2022

Don't Accept Helicopter Parenting

Check out this bizarre (and sad) article from the New York Times about helicopter parenting, and note that two of the anecdotes are physician related. (Can you imagine interviewing for an attending position with your dad present?)

Along those lines, I'd recommend the New York Times best seller How to Raise an Adult by Julie Lythcott-Haimes for any parents who read this blog. (Disclaimer: Julie was one of my frosh resident assistants at Stanford.) Julie gave a great interview on Fresh Air last year. 

My policy at Insider is to work exclusively with applicants (not parents or spouses) to maintain confidentiality, avoid redundancy, and ensure candidates assume primary responsibility for their work. It's been a winning strategy. 

Monday, July 18, 2022

Optional Secondary Essays: Are They Really Optional?

I've recently received several questions about optional secondary essays and their necessity.

The beauty of an "additional comments" section is that it is intentionally vague. It's your chance to provide details, context, or qualifications that the structure of the application didn't allow you to present. For that reason, I lean toward using that space to both highlight who you are and any exceptional aspect of your candidacy that you'd want a reader to know before making an interview decision.

So, one good option for these essays is to pick something completely nonmedical that distinguishes you and is nowhere else to be found on your application. In this case, the essay can actually be fun to write.

Of note, sometimes people use this type of a prompt to explain one major deficiency in their candidacy. I only recommend that if there's a big elephant in the room: In other words, in general I tell applicants – throughout the process – to avoid highlighting weaknesses. The goal is to demonstrate distinctiveness and worthiness, so negatives are usually left out. But sometimes someone has a big problem like a low MCAT score that is an anomaly that's worth addressing head on.

Bottom line:  Since an interview isn't guaranteed, don't save your best material for an in-person meeting. Get your foot in the door. And as always, make sure that your essay is substantive and not fluffy.

Monday, July 11, 2022

15 ERAS Tips to Boost your Residency Candidacy

It's July, which means it's time for residency applicants to start thinking about their ERASes. Here are tips I've cultivated for crafting the best application:


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, published in Nature).

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, so avoid small activities (like an afternoon health fair). 

3. Keep your descriptors to approximately five 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. Ones you think are common might not be familiar to the reader.

6. Avoid contractions; they are too informal for an ERAS. 

7. Make sure you spell out your accomplishments clearly. If your reader doesn’t understand an activity, you won't get “full credit” for what you’ve done. Make no assumptions - not even that the reader has reviewed the experience's introductory information (location, name of activity). 

8. 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.

9. Use numbers to be persuasive. Saying that the conference you organized had 500 participants says a lot.

10. 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.

11. Do your best not to leave the "Medical School Awards" section blank. Even if you have to simply include clerkships in which you obtained honors (or high honors), fill that section out.

12. If you have not already, consider joining your specialty's national organization and listing it under the "Membership in Honorary/Professional Societies" section. If you are applying in two fields, take this advice, though. 

13. Try to end your entries with a sentence about how the experience you just described will help you as a future specialist. Making that connection for the reader furthers your candidacy. 

14. As with all good writing, avoid redundant language. Having the word "research" three times in two lines is distracting and demonstrates a lack of originality. 

15. Get help. Don't submit your residency application without having it reviewed by someone with a lot of experience. You do not want to put forward suboptimal materials for a process that is this important and competitive.

Tuesday, July 5, 2022

Understaffing is Affecting Patient Care

I am only middle aged, and yet, so many of my cohort, including myself, have recently left clinical medicine. There are layer upon layer upon layer of reasons: Even before the pandemic, burnout and discouragement about the current healthcare system were big problems amongst providers. Then, COVID facilitated more departures because of the need to stay home to care for children or even illness and death, sadly. Finally, the national workforce shortage and economic cuts have led to a real crisis in our medical system.

See this piece by Dr. George Hyde, a pediatric resident at Harbor UCLA, as he describes how understaffing is directly harming patient care.

Monday, June 27, 2022

"Why Our School" Secondary Essay: How to Get Started

Secondary essay prompts vary, but there are a few that are standard fare. See my recent blog entry for guidance on the familiar "diversity essay." "Why do you want to attend our school?" is also a common topic pre-meds will encounter.

Medical school admissions officers want to be assured that you know their institution, are seriously considering it, and will fit in well there. In approaching the "why-our-school" question, do your research on the institution and link something specific about you with the school's philosophy, curriculum, patient population, and/or extracurricular programs.

For instance, if you were a teaching assistant for chemistry in college, you might link your use of the Socratic method with a school's tutorial-based learning. In that way, you demonstrate knowledge of the school, show that you connect well with it, and showcase your accomplishment.  

The paradox here is that - although you are theoretically focusing your essay on one school - because so many institutions have overlapping philosophies, curricula, and objectives - you can oftentimes use the same essay framework for many different schools.

That's one strategic way to cut down the overwhelming workload that secondary applications present.

Monday, June 20, 2022

Secondary Essays: The Diversity Prompt

I’ve had several questions recently on how to approach secondary essays, so I'll address some common prompts over the next month or so in this blog.

In considering your strategy and content for the diversity prompt, I’d recommend you ask yourself the following question:

What ethnic, religious, racial, gender, language, socioeconomic, or sexual orientation aspects of me, my family, or my experience make me distinctive?

Please note that experience is part of the question I have posed. An applicant I mentored a few years back wrote to me concerned that she did not fit into a minority category and thus, could not answer the prompt effectively. I suggested she consider an experience that targeted the prompt’s theme, and she wrote a strong essay about her successful efforts to increase diversity during sorority rush. When I applied to medical school, I crafted one of my secondary essays on my experience hearing Spike Lee speak on my college campus. 

Don’t be afraid to think outside the box.

Monday, June 13, 2022

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 drafting 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.

Monday, June 6, 2022

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 grade inaccuracies. In reading the article, medical students should reflect on how important the quality and content of their letters of recommendation are for residency applications, especially in the setting of medical school grades that may be inflated or faulty. The 2020 NRMP Program Director Survey (which is the most current version) 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.

Monday, May 30, 2022

An Offer you Can't Refuse: Writing Your Own Letter of Recommendation

In the last few weeks, several medical school applicants have contacted me saying that potential letter of recommendation writers are asking the candidates to write their own letters.

If you have this opportunity for medical school, dental school, residency, or fellowship, first, realize that it is not unethical to write your own letter if you're asked to do so. If you'd like to explore the scruples of this issue, take a look at this New York Times Ethicist column about the topic.

The mistake I see candidates make in this situation is that applicants don't write strong enough letters for themselves because they feel awkward about showcasing their accomplishments fully. If you have the opportunity to write your own letter, craft a glowing one. Be effusive and full-throated in your remarks about yourself! Remember that the letter-writer can choose to tone down the recommendation if s/he doesn't agree. But if s/he does, you've utilized an opportunity fully and bolstered your candidacy tremendously.

Monday, May 23, 2022

Medical School Applications are at their Highest Level Ever

In 2021, medical school applications from first-time candidates increased a startling 18%. More than 62,000 students applied to medical school in 2021, compared to approximately 53,000 the year prior. It's unclear what caused such a large jump: It's possible the pandemic was not a factor and that many students had planned to apply prior to COVID-19's emergence. After all, it takes many years of planning to have a ready candidacy. Or perhaps individuals may have been inspired by healthcare workers' dedication during the beginning of the pandemic. Interestingly, there was a significant increase in applications from Black and Hispanic students, which is encouraging.

With increasing numbers of candidates, medical schools will be more selective about which applicants they accept. Perhaps some students will consider physician assistant training as an alternative, however, enrollment there is up as well.

Take a look at this short piece by Dr. Thomas Cook, the Program Director of the Emergency Medicine Residency at Prisma Health in Columbia, for more analysis.

Monday, May 16, 2022

Is There a Doctor on Board?

Those are words no physician wants to hear. Even as an emergency physician, I hated the few times I heard that phrase. Fortunately, the passengers I tended to were not terribly ill, but this story, written by a medical student who cared for a critically ill passenger, is well told and worth the read.

Monday, May 9, 2022

Choose the Right Category for your AMCAS Experiences

AMCAS provides 18 categories in which you can classify your experiences. They are:

Artistic Endeavors
Community Service/Volunteer – Not Medical/Clinical
Community Service/Volunteer – Medical/Clinical
Conferences Attended
Extracurricular Activities
Hobbies
Honors/Awards/Recognitions
Intercollegiate Athletics
Leadership – Not listed elsewhere
Military Service
Other
Paid Employment – Medical/Clinical
Paid Employment – Not Medical/Clinical
Physician Shadowing/Clinical Observation
Presentations/Posters
Publications
Research/Lab
Teaching/Tutoring/Teaching Assistant  

Sometimes an activity matches two categories. When that happens, lean on the clinical classificiation, if applicable. (For example, if your activity is both Leadership and Community Service - Medical/ Clinical, choose the latter.) If clinical is not relevant, then choose the category in which you have the fewest activities.

A client who came to me as a re-applicant a few years back told me that a school from which she was rejected indicated that they had not counted a clearly clinical activity as clinical because she had classified it differently. So be sure you consider the categories deliberately in crafting your AMCAS.  

Monday, May 2, 2022

Rolling Admissions: What's the Big Deal?

This year's AMCAS application opens on May 4 at 9:30 AM EST, and candidates will be able to submit their AMCAS applications beginning on May 28 at 9:30 AM EST. 

Because of rolling admissions, submitting a complete application early in the cycle has distinct advantages at many schools. That doesn't mean you should submit suboptimal written materials on the twenty-eighth; instead, you should start early enough that you're presenting your best work.

Rolling admissions means that a school takes applications in the order in which they are received and makes decisions about interviews and then acceptances, accordingly. So, as time goes by, there are fewer interview and admissions offers remaining to be made. Think of an auditorium whose doors open to allow guests in. Those in the front of the line get the seats, and those who come later may not have a chair to sit in. 

If your application is not complete, your candidacy may not be evaluated early when there are more opportunities for interviews and admissions. So, if you have not already, get started immediately. It could make a huge difference in your available opportunities. 

Monday, April 25, 2022

Study Shows Women Earn $2 Million Less Than Men in Their Careers as Doctors

A survey of 80,000+ physicians estimated that women make 25 percent less than their male counterparts over a 40-year career, according to a New York Times article. The troubling findings were published in a paper in Health Affairs. Of note, factors like specialty, type of practice, and patient volume were controlled for. Had they not been, one of the authors said, the discrepancy would have doubled. The salary gap starts at the beginning of women's careers and then only worsens.

According to the Times article, the pay gap is wider among healthcare practitioners than among those in computer and engineering jobs. Considering that, women pre-meds who are on the fence about a career as a doctor have every right to seriously consider another profession...

Monday, April 18, 2022

Positively Influence your Letters of Recommendation by Making the Job of Letter Writing Easy

When pre-meds, residents, nurses, and physician colleagues asked me to write them LORs when I was Assistant Residency Director, the first thing I requested was that they send me background information to make my letter robust…and my job easier. Accordingly, whether you are applying to medical school, dental school, residency, or fellowship, I strongly recommend you create a “LOR packet,” which can include the following:

1. A brief, well-written cover letter defining all of your important accomplishments
2. Your curriculum vitae (CV)
3. Your personal statement in its final form
4. Your transcripts.

With regard to the cover letter, keep it streamlined. No one will skip the beach or her two-year-old’s birthday party to read your exhaustive biography :), so you want to thank the writer and highlight your pre-professional achievements on one page. The point of the cover letter is to supplement a writer’s knowledge of your candidacy and offer flattering content for inclusion. A college professor may know that you made the only A in an organic chemistry class, but her LOR for medical school will be more complete, and she will demonstrate a more intimate familiarity with you if she knows enough to write that you volunteer regularly at a homeless shelter.

With regard to the CV and personal statement, these make useful supplements to the LOR packet only if they are in professional and final form. Don’t include rough drafts, as poorly organized background information leaves your writer the impression that you are a disorganized person. Also, only include the transcript if it bolsters your candidacy, demonstrating academic achievement. Don’t shoot yourself in the foot if you have some bad grades you’d rather not showcase.

Bottom line: An applicant who offered me a list of her accomplishments in a tidy, accessible package was more likely to get a strong, comprehensive letter that was submitted promptly. She also distinguished herself from the majority of candidates who requested letters without demonstrating a comparably sophisticated understanding of the demands this process made on my time. If you can make a letter writer's job easier, your forethought is likely to pay dividends in the letter you receive. The savvy applicant can take subtle advantage of her ability to "lead the witness."