Guide to Residency Application and the Match

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• Guide to Residency Application and the Match
• Dwight Davis, M.D.

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Specialty Decision

• Final consideration of specialty choice
• Goal Identify something you love to do that
  utilizes innate and developed skills
• Review Careers in Medicine Components
• I - Self assessment (interests, skills, values,
  goals)
• II - Exploring specialty and career options
• III - Choosing a specialty
• IV - Getting into residency

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Senior Year Responsibilities

• Complete graduation requirements
• Review and track course requirements
• MSR submission and approval
• Pass USMLE Step 2 early
• Maintain good standing
• Do well in your remaining clinical rotations
• Make a planning calendar of important events and
  deadlines through Match Day

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Specialty and Residency Resources

• Careers in Medicine Program and specialty web
  sites
• Student specialty interest groups (faculty
  advisors)
• Library reserve references
• Clerkship attendings
• Residents
• Individual program information
• Graduating seniors match list
• College of Medicine specialty advisor

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Clinical Specialty Advisor

• All students should establish a relationship with
  a clinical specialty advisor to assist with the
  application process
• Procedure with specialty advisor
• Meet early to review specialty decision,
  background, and career goals
• Copy of transcript
• USMLE results
• Curriculum vitae
• Candid discussion about competitiveness for
  specialty selected, backup plan if appropriate
• Critique of personal statement when prepared

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Specialty Faculty Contacts

• Anesthesiology Leonard Pott, M.D.
• Dermatology Bryan Anderson, M.D.
• Jennie Clark
• Emergency Medicine Kimberly Scholfield, M.D.
• Family Medicine Dennis Gingrich, M.D.
• Medicine Philip Masters, M.D.
• Neurology Milind Kothari, M.D.
• Neurosurgery Robert Harbaugh, M.D.
• Ob Gyn John Repke, M.D.
• Ophthalmology David Quillen, M.D.
• Orthopaedic Surgery Edward Fox, M.D.
• Pathology Elizabeth Frauenhoffer, M.D.
• Pediatrics Deborah Kees-Folts, M.D.
• Psychiatry James Hegarty, M.D.
• Radiology Janet Neutze, M.D.
• Christine Peterson, M.D.
• Surgery Gordon Kauffman, M.D.
• Others Department Chair

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Residency Program Considerations

• Program evaluation examples
• Educational structure / clinical responsibilities
• Inpatient, outpatient, procedures, OR time
• Patient diversity and disease categories
• IT infrastructure in hospital and clinics
• Program size / type (acad, comm, clin setting)
• Opportunities for teaching and research
• Call schedule, rotations at affiliate hospitals
• Reputation of program chief and faculty
• Placement of graduates (practice / fellowships)
• Breath of subspecialty offerings
• Assessment of program quality (clinical advisor)

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Residency Program Considerations

• Personal Issues
• Region of country
• Size of city
• Housing
• Cost of living
• Spouse / partner needs and employment
• Family considerations

• Program Issues
• Stipend
• Vacation, illness procedure, professional support
• Benefits including dates of initial insurance
  coverage
• Parking
• Travel to affiliates
• Liability

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Curriculum Vitae (for ERAS)

• Succinct and accurate chronicle of past
  experiences (start w/ important college or work
  experiences)
• Typical sections
• Personal data
• Education
• Pertinent organizations (indicate leadership)
• Pertinent employment
• Significant extracurricular experiences
• Honors and awards
• Research, publications, and formal presentations
• See references for examples

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Personal Statement

• Motivation for medical career and specialty
• Process of specialty decision
• Relevant background experiences
• How you fit the specialty (interests, skills,
  etc.)
• Unique qualities or talents (modestly)
• Career goals if formulated
• Avoid quotes
• Good grammar and spelling
• Critique by clinical advisor
• Obviously avoid writing services, plagiarism

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Letters of Recommendation

• Usually three letters (four in file if
  manageable)
• Attendings in specialty area, clinical faculty
  who know you well, strong rotations, department
  chair
• Ask early if faculty can support your application
• Work closely with their administrative assistant
• Provide the following in advance
• Transcript, USMLE scores
• Curriculum vitae
• Personal statement
• Waive your right to see letters
• Program reassured about candid comments

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Medical Student Performance Evaluation

• Structured evaluation of medical school
  performance
• Not a document of recommendation
• Unique Characteristics
• Brief background, leadership, service, research,
  and special honors
• Significant challenges or hardships
• Academic history
• Matriculation date, LOA breaks
• Repeat or remediated coursework
• Adverse institutional action

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Medical Student Performance Evaluation

• Academic Progress and Performance
• Transcript and narrative summary of overall
  performance in basic science curriculum
• Grades and verbatim comments from all third year
  clerkships, early AI specialty grades
• Summary statement
• Summative assessment of comparative performance
  relative to peers
• Superior 5
• Outstanding 25
• Excellent 50
• Very Good 20

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Planning the Senior Year

• USMLE Step 2 CK and CS designed for early 4th
  year
• Must complete CK and CS exams by Jan. 1st
• Complete your MSR by early fall
• Decide on away specialty/hospital rotations now
  for July, August, or ? September
• Review vacation time
• Anticipate most travel mid Nov. to late Jan.
• Avoid high intensity rotations during travel
  months

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Rotations During the Senior Year

• Plan to use vacation for most of your travel
• Limit time away from rotations
• Discuss and request travel time well in advance
  (attending and senior residents)
• Offer extra time or patient evaluations to
  round-out experience
• Work hard to master medical knowledge and improve
  clinical skills
• Choose senior rotations wisely to prepare for
  residency

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2007 Match Summary
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Program Directors Academic Ranking
Green et.al., Acad. Med. 843, 2009
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Average Number of Programs to Consider

• Based on competitiveness of specialty
• Review information on 30 programs after you have
  a priority list
• Based on review, consider 25 programs
• Formal application to 20 25 programs
• Interview at 10 - 15 programs
• Rank most acceptable programs
• BUT, rank only programs that are true preferences
  (no surprises on Match Day)

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The Interview

• PREPARE
• Arrive early
• Business attire
• Well groomed and professional
• Dress comfortably, including shoes
• Know all aspects of your background
• Know the program well
• Mission, unique features
• Have appropriate answer for why you selected the
  program for interview
• Thoughtful answers to questions

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The Interview

• Understand the specialty and training process
• Think about your future plans
• Know your research (short abstract and detailed
  discussion if asked)
• Always have thoughtful questions about program
• Understand the rules about offers
• Leave impression that your decision about
  specialty was based on a thoughtful process
• Be accountable for blemishes in your record
• Be Honest

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Miscellaneous

• Obtain a professional appearing photograph
• Positive attitude and professional demeanor with
  all contacts during visits
• If plans change or travel delayed, contact
  program immediately
• Brief follow-up thank you note
• Complete your program assessment and rank after
  each visit
• Match results are binding
• Remember, you are a representative of the College
  of Medicine

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Issues for Unmatched Students

• You dont want to participate in the scramble
• Unrealistic assessment of competitiveness for
  specialty
• Limited geography for competitive specialties
• Professionalism issues
• Odd personal statement
• Rank small number of programs (3 4)
• Troubling personal qualities conveyed at
  interview
• Little rationale for specialty at interview
• Questionable graduation status (Step II)

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2009 Match Results
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Positions Available After Initial 2009 Match
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Useful References

• Roadmap to Residency (30 pages, a must read
  first, Student Affairs web site)
• Charting Outcomes of the Match (SA site)
• Isersons Getting Into A Residency, 7th edition
  (at least read the table of contents, library
  reserve)
• NRMP Results and Data Book (Google)
• Fellowship Residency Electronic Interactive
  Database (Freida online)
• Penn State specialty match list for last three
  years (SA site)
• MSPE Guide (SA site)

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Charting Outcomes of the Match

• Read carefully and note limitations
• Match success rate by specialty
• Range of USMLE Step 1 scores by specialty
• Programs ranked by matched and unmatched students
• Percent AOA students ranking specialty
• Percent participating in research
• Percent with one publication ranking specialty
• Graphs of individual specialties
• Missing data grades, Letters of support,
  personal statement, experiences, interview, etc.

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Christis Residency Match Chart