The Fauci Effect

As I write this, I am listening in the background to an interview of Dr. Anthony Fauci by Dr. Sanjay Gupta through the Harvard School of Public Health. Dr. Fauci's leadership (along with that of other physicians and epidemiologists) has apparently prompted what news outlets are calling the Fauci Effect, an 18% increase in the number of applications to medical school this year. I find this encouraging. After all, one could envision people running for the hills with the physical threat that COVID has posed for physicians (and other critical medical staff and front line workers). See the interview (oriented for a medical and public health community) with Dr. Fauci here. 

The New York Times Ethicist

I field questions from clients about how to identify themselves racially and ethnically on their applications, and as diversity becomes a more prominent priority for many academic institutions, this issue will come up more often. The New York Times Ethicist answers an interesting moral dilemma posed by a medical school applicant in a recent column. Enjoy. 

Medical School Interviews: Preparing for your MMI

All bets are off this year when it comes to interviews, although I do think that virtual interviews will be more conventional and equitable than in past years. 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.

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. This year, because everything is virtual, I'm noticing that many schools are focusing on the latter type of problems for logistical reasons. 

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. 

Is Step 1 Still on Track to Go Pass/Fail?

Earlier this year, United States Medical Licensing Exam (USMLE) administrators announced that, after a long process of consideration, Step 1 would be scored as pass/fail going forward. With the global pandemic and many systems in disarray, some students had been concerned that the plans might be delayed, but according to the USMLE, the transition to Step 1 pass/fail score reporting is on track to be implemented in January 2022. The USMLE is also considering some changes to Step 2CS, although the details of those modifications are not yet available to the general public. 

Check out this piece about the details of the Step 1 scoring change.

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 and residency applicants who have not yet been invited to interview

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 Residency and Medical School Interview 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, burn out, and anxiety. The American Psychological Association offers a few tips for overcoming impostor syndrome including speaking to mentors, recognizing what you excel at, and talking to a professional if necessary.

Part of interviewing well is demonstrating confidence, according to Amy Cuddy, whose compelling TED talk has been viewed almost 60 million times. Practice a lot and then fake it until you make it, as she suggests. How you present yourself can make a big difference in the outcome of your interviews.

Post-ERAS, Pre-Interview Supplemental Questions

Several residency applicants have told me that since they submitted their ERASes, some programs have asked them to answer additional, written questions like "Why our program?" and "How will you bring diversity to our institution?" The additional workload seems burdensome, especially this year, but I suspect residency directors are concerned about interview hoarding - since sessions will be virtual and thus easier to accept and attend - and are trying to weed out applicants accordingly. 

Although originally written for medical school candidates, see my blog entry here to help with the "Why our program?" question and here to help with the diversity prompt. 

Remember: This is a marathon, not a sprint. 

 

Medical School Applicants: Here's How to Hit the Ground Running

For those applicants looking forward to starting their medical education next August and those who just started a few months ago, here's a piece called, "Setting the Right Goals During Medical School." How do you set yourself up for a successful residency Match while avoiding burnout? This short piece will give you some ideas to chew on.

Wednesday is Only Two Days Away, Which Means the ERAS Open Date is Fast Approaching

Residency applicants, this is a reminder that this Wednesday, October 21 at 9am EST is when programs can begin reviewing applications. ERASes submitted today through Wednesday will still display an application date of October 21 so ensure your ERAS experience section and personal statement are in tip top shape and then, simply submit by Wednesday. (Applications submitted after that day will be date-stamped in real-time.) For help, check out "15 ERAS Tips to Boost Your Residency Application" and "5 ERAS Platform Quirks to Heed." Then get your ERAS in and take a well-deserved break. 

How to Handle the Toughest Medical School and Residency Interview Questions

With medical school interviews in full gear and the start of the residency admissions cycle merely a few weeks away, it's past time to start practicing for your interviews. Personal experience and situational questions can be tough, but what happens when you have a serious gap in your candidacy or are faced with an awkward or even illegal question? Check out my two Student Doctor pieces:

Redemption Awaits: Let Your Medical School Interview Transform Liabilities into Assets
and 

Difficult Interview Questions: Learning To Hit A Curveball Out Of The Park

for clear and detailed guidance. 

You don't want to be caught with your pants down: As always, planning and robust practice are your friends.  

Awesome Paid Summer Opportunity

I was an American Association for the Advancement of Science (AAAS) Mass Media Science Fellow in 1995. 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 1, 2021. This cycle's fellowship dates are June 2 through August 17, 2021. Here's the link to application information. 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 opportunities journalists have. 

Residency Personal Statement Tips

I've received questions recently about the residency personal statement, so I'm including some articles and blog posts that might be useful:

• For an overall approach to the personal statement, check out this article.
• Is Your Personal Statement a Little Too Personal? is a fun, pointed piece by guest blogger David Presser MD, MPH.
• Should you be a creative nonconformist when writing your personal statement? Find out here. 
• Examples of outstanding essay intros (from Stanford undergraduate applicants) are here.

And as always, contact me for help.

Five ERAS Platform Quirks to Heed

I've been editing a lot of ERASes lately. 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 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 this short blog entry. 

Contact me for help with this weird and wild process. 

How to VITAlize your VITA interviews

 At the end of the spring, with the weightiness of COVID clearer, the AAMC (much to their credit) strongly recommended that medical schools and residencies conduct virtual interviews during the upcoming admissions season. Upending years of in-person sessions, the announcement has made a huge impact on this season's admissions process. Virtual interviews will likely diminish some of the bias that plagued the system previously and will save everyone a bundle of money. 

The AAMC did not urge the use of any particular platform, but it does provide its own, called the Video Interview Tool for Admissions (VITA), for interested medical schools. The AAMC describes VITA as a one-time, one-way recorded video interview to help medical schools assess applicants' pre-professional competencies that are important for success in medical school. 

The AAMC indicates that VITA questions will target the below capabilities:

• Social Skills
• Cultural Competence
• Teamwork
• Reliability and Dependability
• Resilience and Adaptability

An applicant's VITA session will include six questions presented in text form (no interviewer), and applicants record a video response after having one minute to read and reflect on each question. Candidates then have up to three minutes to record a response. If an applicant needs a break between questions, that's not a problem: All six questions can be completed in one sitting, or candidates can choose to have breaks of any desired length between questions. (Of course, the interview must be submitted by a medical school's deadline.)

According to the AAMC, questions can be related to personal experience (e.g. "Why did you choose medicine?"), past behavior ("Describe a time..."), or hypothetical situations ("Imagine you are... What would you do to resolve this issue?"). 

These types of questions can be tricky without practice, but are bread-and-butter for someone who is prepared. 

Remember the time you spent a week studying for the MCAT? No, you don't ;). That's because one week is not enough time to study for the MCAT! Along those lines, it's important to start early, preparing yourself fully for VITA and other virtual interview platforms. Much of interviewing is confidence, which can be developed. Please hire me now for help. 

How to Save a Bundle of Money

The big question of financing medical school and residency interviews is often swept under the rug, but this year things are - believe it or not - simpler: The virtual interview process is going to save everyone - applicants and institutions - a wad of cash. Please check out my Physician on Fire guest post The Virtual Interview for Medical School and Residency Will Save Everyone a Bundle of Money and feel free to share. 

Could Virtual Interviews Help Mitigate Systemic Sexism in Medicine?

Congrats to a few applicants who have already received very early medical school interview invitations. For most, the season will be starting in the next month or so. Virtual interviews through VITA or other platforms will be standard, and how that will affect the admissions process and next year's medical school classes is anyone's guess. My guess is that the virtual interview process will reduce discriminatory practices that have plagued the system for a while. See my Doximity article "How Virtual Interviews Might Mitigate Systemic Sexism in Medicine" and please pass it along. 

My Personal Experience with (What Appears to Have Been) "COVID Fingers"

I usually don’t use this blog to talk about personal issues, but I recently wrote this piece in KevinMD “Why Are COVID Antibodies of Questionable Relevance Being Marketed to the Public” regarding my experience with pseudo-chilblains (burning spots on my fingers – ouch) and my subsequent COVID antibody test. 

Even in the past week since the piece was published, there has been more in the news about the likelihood that T-cell modulated immunity may play an important role in COVID recovery. 

15 ERAS Tips to Boost your Residency Candidacy

 I've started editing ERASes this cycle and have developed this list for guidance:

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 your 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 300 participants says it all.

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.

No, I Can't Fix Your Computer

My husband spotted a man wearing a t-shirt with that saying on it, and we have ever since jokingly referred to it when someone in the house is having a tech problem. 

As we all probably know, there is usually someone in the extended family who is the "computer person." 

Well, we could use that individual now. While I am a big fan of the virtual interview for medical school and residency (see my upcoming Doximity article on the topic), I do worry about technical glitches. A client recently wrote me that her asynchronous, recorded virtual medical school interview had a problem, leaving her with one question unanswerable. (I counseled her to inform the school.) I'm crossing my fingers that this is an anomaly and not a reflection of what's to come this cycle.

As always, make sure to practice for your interviews; you wouldn't go into a standardized test without a lot of preparation, and the same should be true for interviews. 

Contact me here for help. 

The Virtual Medical School Interview: What to Expect when You're Expecting... An Unconventional Format

In the late spring, to its credit, the Association of American Medical Colleges® (AAMC) recommended that all medical school, residency, and fellowship interviews be done virtually this cycle. Formats may vary, but interviews should not be in-person.

One configuration that seems to be emerging for medical schools (at least) is a two-part model: asynchronous and synchronous. The former involves a recorded session in which a computer platform - without a live interviewer present - provides questions to applicants who then have a set time to record their answers. The synchronous session is a live, remote interview.

The advantage of virtual interviews - beyond obvious health benefits and cost containment - is a standardization of the process, but mastering the new, remote processes may be difficult and anxiety-producing. 

To get help with this new world of virtual interviews, contact me.