AMCAS Tips (and Particulars): How to Best Draft Your Work/Activity Experience Description Section

I've had a few clients recently who were confused about the AMCAS Work/Activity Experience Description character limits and how the Most Meaningful Experiences fit in. 

Please remember that AMCAS Experience Descriptions can have up to 700 characters (not words!), while the Most Meaningful Experiences max out at 1325 characters. (Note, then, that the Most Meaningful Experiences are separate from the Experience Descriptions.) 

Here's a short blog with AMCAS Work/Activity Experience Description writing tips and another with Most Meaningful Experiences guidance. Good luck!

How to Use the MSAR to Your Advantage

The Medical School Admission Requirements (MSAR) is an online database that allows users to search, sort and compare information about U.S. and Canadian medical schools. (I hate to date myself, but when I was applying to medical school and used the MSAR, it was a hard copy book.) The 2019 MSAR came out last month, and if you are applying to medical school, I'd recommend purchasing it ($28) because it provides so much information about schools and their admissions statistics. The MSAR allows you sort and compare schools by median MCAT scores, AMCAS GPAs, and other criteria. 

You should use the MSAR to help determine which schools are in your range and which are "reach" schools. While it's fine to have a lot of "reach" schools (if you can afford it), it's critical to ensure you are applying wisely to schools that match your numbers. The advantage of the MSAR is that you can make evidence-based decisions. I've found some applicants have eye-opening experiences when they thoroughly review schools' statistics and either realize that their numbers are low and that they should apply accordingly or, happily, that they have numbers that match with top schools. Either way, reviewing the data is critical to good decision making. 

Locum Tenens: A Nontraditional Path in Medicine

For those pre-meds, medical students, and residents interested in creative ways doctors practice medicine, here is a helpful review of a course on obtaining, maintaining, and effectively juggling locum tenens. For those unfamiliar, a medical locum tenens job allows a doctor to temporarily fill an empty slot (e.g. for someone who is on maternity leave). Locum tenens is an opportunity to do some traveling and make some income, but there are some complications you'll want to avoid. Take a peek at the article. 

TMDSAS: The Old and The New

For those applying to medical school through the Texas Medical and Dental Schools Application Service (TMDSAS), please note that your process is a little different from the AMCAS system: The TMDSAS allows for more expository writing, including the medical personal statement, the personal characteristics essay, and the optional essay. This year, too, the TMDSAS has added on a meaningful activities section, which can include up to three accomplishments, with a 500 character limit each.

The TMDSAS has a different timeline from AMCAS as well. Check it out here. For TMDSAS official application instructions, click this link.  

Yes, I do edit the TMDSAS! Contact me for help. 

Is Your Personal Statement a Little Too Personal?

As medical school applicants are crafting their essays and residency candidates are starting to think about theirs, I'm posting a short piece by a guest blogger today: Dr. David Presser graduated from UCSF Medical School, completed his emergency medicine residency at UCLA/Olive View and his MPH at Harvard. He wrote an excellent primer on getting into an emergency medicine residency. Here's today's blog written by him:

Picture, if you will, a residency admissions committee member beneath a halo of light reading applicant essays in her office at midnight. Caffeine on her breath, crumpled white coat next to her desk chair, she is making steady progress on the never-ending stack of applicant files until she picks up a residency personal statement that begins, “I first became interested in internal medicine when Grandma was diagnosed with cancer…” Pulling out her hair by the fistful, she tosses the file into the trash. That cancer may not have killed your grandma, but it just might have killed your application.

Many students devote a significant portion of their ERAS essays to describing a universal experience that may have piqued their initial interest in a specialty. A residency admissions committee member does look for evidence of how your fundamental connection to humanity will make you an empathetic and skilled physician. The problem comes when an applicant starts to make the reader feel like s/he is providing counseling to the applicant, that is, when the candidate uses language that could strike the wrong reader as inappropriate for a professional application. The admissions committee can handle empathetic writing; however, if they suspect you mistook your essay for the journal under your pillow, they may not be forgiving.

Think carefully about the topics you choose. With all due respect to each of us who has had a family medical catastrophe, you can estimate the prevalence of cancer among the elderly and conclude that starting an essay with the description of a grandparent’s battle with cancer is not going to catch the reader’s attention. Unfortunately, just because it is genuine, it may not be compelling reading or a useful means to distinguish you from the hundreds of residency applicants whose essays share similar themes.

There are exceptions. You can be forgiven for including a common topic if it directly ties into highlighting a unique personal accomplishment. Perhaps grandpa’s prostate cancer diagnosis led you to seek out a research position with a faculty member at your local university lab where you were directly involved in sequencing a promising new molecular marker for prostate cancer. Give the generic topic a brief mention and transition rapidly into how it demonstrated that you are a mover and shaker who took a universal experience and, by virtue of your work ethic and intellectual curiosity, turned it into a contribution to science.

You get a pass on writing about universal experiences if you can pull off a convincing reason to keep the midnight reader going; otherwise, keep your essay distinctive and befitting the professional you hope to become.

Make It Pop: Your Residency or Medical School Personal Statement

Many of you already know that I feel very strongly that the personal statement should be substantive and crafted in a persuasive essay format... Yet, the introduction is a place where you can let your hair down (to a point) and write in a narrative fashion. It helps to start your essay with a "clincher," something that will convince the reader your statement is worth reading: I found a short piece in an old Stanford Magazine to be an interesting reminder of what a dedicated writer can do with a personal statement intro. The author compiled a list of first lines from the application essays of Stanford's newest college class at the time.

Some of my favorites:

Unlike many mathematicians, I live in an irrational world; I feel that my life is defined by a certain amount of irrationalities that bloom too frequently, such as my brief foray in front of 400 people without my pants.

When I was 8 years old, I shocked my family and a local archaeologist by discovering artifacts dating back almost 3,500 years.

As an Indian-American, I am forever bound to the hyphen.

Note that these introductions catch the reader's attention, while also saying something about the writer's qualities and/or sense of self. For help with your personal statement, contact me. 

International Medical Graduate (IMG) 2019 Match Statistics Are Out

The ECFMG® recently published 2019 Match statistics for International Medical Graduates (IMGs). In the 2019 Match, only 59.0% of U.S. citizen IMG participants were matched to first-year positions. Of those IMG participants who were not U.S. citizens, only 58.6% obtained first-year positions (Source: ECFMG®) While the percentage of IMGs matching was slightly better than last year, IMGs still face large challenges in the residency application process despite the US physician shortage.

Start Your Engines...

The medical school cycle is revving up, and it's (past) time to get started on your application. Here's an article I wrote for Student Doctor Network called "Ten Ways to Improve your Medical School Application." The piece includes statistical truths, strategies for optimizing your approach, and philosophical guidance. 

Worth a Look: Medscape Female Physician Compensation Report 2018

Medscape's annual Female Physician Compensation Report is out, and it's thought-provoking on many levels. Among the findings from the 7600 female respondents:

The discrepancy in pay between the highest paid female physicians and the lowest is no small thing. Female plastic surgeons make $518K per year compared to Public Health and Preventive Medicine docs who make $180K. 

Also, to my surprise, 50% of plastic surgeons are now female. (Only 8% of orthopedists are.) My field of emergency medicine is low at 21%. 

Male primary care doctors make more than women in the same fields. Male specialists also earn more than their female counterparts. The disparity extends to several racial and ethnic groups as well. 

What I also found very interesting is that to answer the question "What is the Most Rewarding Part of Your Job?" more women than men felt knowing they are making the world a better place was most rewarding (27% versus 20%), and more men than women said that being very good at what they do was most rewarding (26% versus 21%).

There's more! Check it all out here. 

As Featured on WCI...

Looking for a podcast for your daily drive or work out? Check out the White Coat Investor (WCI) podcast, where I was recently interviewed. For those of you who aren't familiar with WCI, it's a website/blog/podcast founded by James Dahle MD, an emergency physician whose interest in personal finance and the FIRE (financial independence - retire early) movement has sparked a slew of physician devotees. My interview focused on how Insider Medical Admissions helped me create autonomy and flexibility while balancing a clinical career and a family. Check it out here or on your favorite podcast app. 

Why did ERAS crash during SOAP?

Congrats to all of those who Matched last week! And kudos for those of you who managed to make it through this year's difficult SOAP.

During SOAP (Supplemental Offer and Acceptance Program) last week, the server crashed, leaving many applicants and programs confused and scrambling (no pun intended). The 2019 Match Week and SOAP schedule was, therefore, revised such that all SOAP offer rounds were postponed and limited to Thursday, March 14.

At the time of this writing, it's unclear what happened. Rumors are that the volume of participants was greater than in past years, leaving ERAS/AAMC unprepared. This might be the case with the opening of many new medical schools and a continued, relative dearth in the number of residency spots available. Read this article for a controversial - but interesting - take on why. 

We'll probably have to wait for this year's Match numbers for any answers.

Race to the Bottom (In a Good Way)

Thanks to NYU's announcement that it will be eliminating tuition at its medical school, other institutions are reassessing their costs and graduates' educational debt, as some experts predicted. Recently, Kaiser followed suit with a free tuition plan for their new medical school in Pasadena. Now, Yale is making overtures as well, lowering the financial burden for needy students by covering more costs with scholarships, instead of loans. Keep your eye out for what will likely be a revolution as more and more medical schools note that to compete for strong applicants, they must offer robust financial support. 

Fee Assistance Program

As the 2019-20 medical school application process ramps up, I want to remind candidates about the Association of American Medical Colleges' (AAMC) Fee Assistance Program (FAP) and Insider Medical Admissions' available discount for those with a current FAP. The FAP is designed to offer help to individuals with financial limitations who cannot pay the MCAT registration or AMCAS application fees without financial support. 

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

For more information on the FAP, please click here. I offer reduced rates for applicants demonstrating financial hardship through a current AAMC FAP grant. After researching the issue, I believe Insider is the only medical consulting company who currently supports a discount for FAP grant recipients. (I apologize if I'm missing a company.) Once you have been granted the FAP and thus, can prove receipt, please feel free to contact me for more information.

Med Schools Have No Patience for No Patients

For those undergraduates who are starting to think about their medical school applications, I will tell you a secret: One of the biggest weaknesses I advise candidates on is their lack of clinical experience. I've seen students with outstanding MCAT scores who did not get into medical school on their first try. They had little or no patient experience.

So, ensure your application has robust clinical activities. Some suggestions:

Scribe
Clinical Care Extender
EMT
Low Income Clinic Volunteer
Hospice Volunteer
Veterinarian's Assistant (a great way to get hands-on procedural experience)
Phlebotomist

If you are not excited about getting clinical experience, it is time to question your interest in a career in medicine... which is exactly what admissions committees will do if they don't see that experience :).

Take a look below at my Guru on the Go© Video about this topic.

Flaunting our Failures?

The New York Times had a recent, thought-provoking article for perfectionists, overachievers, those with impostor syndrome, and any combination of the above. "Do you Keep a Failure Resume?" is a great reminder that chronicling our failures (something that isn't encouraged in medicine) can help us determine what the operational roadblocks were to our successes so that we avoid those obstacles in the future. (Perhaps the issue was lack of preparation or speeding through a project unnecessarily.) Reviewed in retrospect, an "anti-portfolio" is also a good reminder that a failure is sometimes the first step to a success in another realm.

Doctors are Crispy

The annual Medscape Burnout Survey is out and the news this year is  - again - somber. More than 15,000 physicians were surveyed in 29 specialties, and 44% of the respondents reported feeling burned out. Urologists made a jump up to the number one burnout specialty with a rate of 54% - with neurologists close behind at 53%. My field of emergency medicine was at 48%, compared to 45% last year. (Click here to see the 2018 Medscape Burnout Survey.) Women are more burned out than men at 50% versus 39%. 

For the brave of heart, take a look at all of the 2019 results here. 

Love Letters

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

1) Residency applicants who want to make an impression post-interview before program directors (PD) submit their rank lists

2) Medical school applicants who have been interviewed but have not yet been accepted or rejected
3) Medical school applicants who have not yet been invited to interview (It's a little late in the cycle now for residency applicants, but LOIs can be used in this way in October through December for residency.)

4) Medical school applicants who have been wait listed  

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?" principle.)

Finally, let me say that I am coming to think that the term "letter of interest" might 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 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.

The Rank Order List Deadline Is Approaching: Check Yourself Before You Wreck Yourself

This is an important reminder that Wednesday, February 20 at 9pm EST is the rank order list certification deadline. Start now to think about your priorities and specifically, where you will be happiest. Waiting until the last minute and making impulsive changes to your list is not a great idea.

Please make sure to avoid simple missteps in creating your rank order list. Improving written materials and interview skills is important, but all of that work can go down the drain if applicants do not understand basic strategies for the Match. In November of 2015 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.

Here is an 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.

Do No Harm

I recommend reading this piece in Emergency Medicine News by Dr. Graham Walker. He writes about a physician colleague who recently committed suicide. The article notes that anesthesiologists and surgeons are the most likely to die by suicide, and emergency physicians come next in the specialties. 

As a follow up, this NYT piece on physician suicide is also worth a read - old but still relevant. Sadly, it notes that pre-meds enter medical training with mental health profiles similar to those of their peers but end up experiencing depression at greater rates.

I've written about depression in doctors before and would like to reinforce the importance and urgency of seeking professional help for depressed clinicians.  

Evidence-Based Decision Making Regarding Your Planned Specialty

For those first-, second-, and third-year medical students who are trying to pick a specialty, remember to start with the facts: The NRMP published Charting Outcomes of the Match to give applicants an idea of what characteristics successful 2018 Main Residency Match candidates had. While sobering (the mean Step 2 score for successful radiology U.S. senior applicants was 249), the information is valuable as you approach the decision-making process.

If you're just starting medical school, you can strategically plan your candidacy for success. If you're more senior, you can decide whether you have the characteristics necessary to pursue a successful Match process.

The “No Contact” Rule After Interviews

Just a brief reminder about the “no contact” rule that some residency programs (and medical schools) follow. While thank you notes and letters of interest are often warranted, if the institution requests no contact, it is important that you follow that rule. First, you don’t want to be seen as someone who is trying to gain an advantage when others are holding back, and second, you would like to be viewed as a candidate and future practicing physician who notes and follows instructions.

Importantly, if you are contacted by residency programs after your interview and promised a ranking to Match, I’d suggest you take that information with a grain of salt. It is flattering, but it should not change your Match list in any way. If a medical school contacts you with a positive review but no acceptance (yet), I would suggest being gracious while you continue to move through the admissions process. In other words, don’t let compliments affect your good judgment.