How to make the big decision: gathering information as an M3?

1. How to make the big decision: gathering information as an M3? Owen Phillips, MD Associate Dean, Student Affairs

2. As M2s • You have had a preceptor experience • You have had personal experiences • You may have preconceived notions- some may be true, some may be false • You need information

3. CiM Four Year Timeline

4. Reviewing your Careers in Medicine Protocol? • Visit the Careers in Medicine website? • www.aamc.org/careersinmedicine • www.aamc.org/students/cim • Did you get to know yourself by completing the self-assessment sections on the site?

5. Discover your own CiM website • OLSEN on the UT COM page • Specialty Profiles • Departmental information- • Program director • Chair • Other faculty members willing to help • “If you want more information”

6. Autonomy Caring for Patients Continuity of Care Diversity Focus of Expertise Innovative thinking Intellectual Content Interacting with other Physicians Manual/Mechanical Activities Pressure Responsibility Security Sense of Accomplishment Status among Colleagues Patient Characteristics Types of Illnesses Think back to the Critical factors

7. Gathering Information • With that review, you know what you want in life and in medicine, it’s time to find what specialty will fit your needs • Go to the Specialty Profiles in the CiM website • This is a great place to start exploring your many choices.

8. AAMC CiM Specialty Profiles • Nature of the Work • Personality Characteristics • Residency Requirements- what is required to get in • Match Data • Workforce Statistics • Compensation

9. It’s a start • You think you really like Peds but you also like procedures as well. • The specialty profile shows that procedures are very low in Peds • But this profile doesn’t take into account neonatology, Peds cardiology, Peds ER and Peds GI which all are very high in procedures.

10. Expand • Don’t just evaluate one profile - do the same exercise with other similar profiles. • You may learn that you are a closer match to similar specialty than the one you first considered. • Also, make comparisons in specialties you never considered – you may be surprised.

11. Other Online Resources • AMA-Freida- AMA’s Fellowship and Residency Electronic Interactive Database Access • Provides statistical information about each specialty, information about GME programs, and institutional offerings by specialty and geographic location.

12. Be vigilant about your career choices • While an M3--- • Talk to clerkship directors, residents, physicians you come in contact with • Try it on- tell people you are considering *** • Ask questions • Electives- UT gives flexibility to do some electives early • Be realistic

15. Specialty Associations • Join the academies at reduced student rates • Visit specialty Web Sites – AAP, AAOS, etc. • This and other information on your UT CiM site

16. Personal Contact • Clerkships • Summer Experience • Faculty Mentors (see CiM website) • Private Practitioners • Residents • Friends • Be aware of the variable reliability of each source • There are many misconceptions out there!

17. Surveying the Alternatives • Canvas and wide range of alternatives • Be open to new alternatives as you have different experiences on clerkships • Talk to the residents: do you look like them; do you like what they do?

18. Try it on • Discuss your ideas with others • Just like trying on clothes • Don’t commit too soon- it could make it harder to change your mind

19. Inoculate yourself • After you’ve made your decision, review the negatives • This will inoculate you against overreaction and criticism to your decision • It will help you during negative experiences during residency

20. Consider Alternatives: Realities • Some specialties are hard to match into • Plastic surgery - Neurosurgery • Urology - Otolaryngology (ENT) • Dermatology • Orthopedics • AAMC- match information • Consult the program director, talk to me

26. If I know I want to go into a particular specialty, should I schedule that clerkship first or last? Two ways to look at it

27. First or near the beginning of the third year To see whether I do like it

28. Last or near the end In order to be experienced and excel And to be fresher on everyone’s mind and nearer to residency recruitment time

29. My experience • UT students are ‘ready’ from the first clerkship and the excellent, interested students shine in the first rotation • Faculty and residents have good memories- if you are a good student, the impression of you will last

30. I want to take as many third-year rotations in Knoxville or Chattanooga as I can Will this limit my ability to get into any residency programs

31. Third-year rotations away • Knoxville and Chattanooga programs give excellent experience • Your residency choices will not be limited • We encourage students to take rotations at our other campuses • If you do your rotations in KN or CH, you can always do an M4 elective back in Memphis

32. Any advantages to doing rotations at Chatt or Knox. • Course directors from there will speak to that • Ask M4s who have had experience there • Some clerkships are community-based and give an educational experience that is really ‘best’ for you

33. Advantages • Smaller residency programs- usually 2-4 residents/year • Faculty involvement may be private doctors who are affiliated with the residency • Patients may be private patients • May be more one on one with a faculty member

34. M4 Away Rotations • Some residency programs are very competitive and you will need to do a rotation there to even be considered • It is a good way to get an insider’s look at the program • The department chair should know the scoop on such programs and will be able to advise you.

35. How to schedule ‘away rotations’ • Talk to UT, Memphis chair or program director • Will need to get a signature on the UT form (available in the catalog) • Go to the websites of the outside colleges about procedure and contacts • Get this ball rolling in Jan. or Feb.

36. M4 Away rotations • Pitfalls • If you don’t ‘shine’ while away, you may have done yourself harm • By the time you learn the new system, you may not match up to the home boys (or girls) • “Got to get into Harvard”

37. What about fourth year electives here at UT • Again, discipline-dependent • For Ob, your best impression was as a third-year clerk. We would rather see you take dermatology or radiology than do an elective • For Orthopedics, you may need the visibility. • If you did your clerkship in Kn or Ch, you may wish to have ‘Memphis exposure’ • You should ask

38. Should I have research on my CV to be competitive Some programs are requiring research in the field to be competitive

39. Research • Difficult to do meaningful research during third-year • Programs where this an issue are the competitive fields: Otolaryngology, Urology, Neurosurgery • Find a professor-level faculty member and ask for advise (CiM website has research mentors listed)

40. Ask for advice • Thinking: “it is either Peds or Med-Peds” • Talk to the clerkship director or another faculty member • Will help you sort out your thinking process or suggest opportunities that will help (a shadowing experience in a private office)

41. Ask for advice • “Pretty sure it’s Med-Peds” • But have some questions about my competitiveness and need to stay in Memphis • Talk to the program director

42. Ask for advice • Once you have committed to a specialty, you should talk to the chair of the department: call the office and make an appointment. Email may not be best • You will need a chair’s letter for your ERAS application.

43. What about the residency interview process • May- Strolling through the Match- an orientation • We will talk about • When and how to schedule dean’s letters • Other letters of reference • Preparing a personal statement • Preparing your CV • The timeline

44. The Process • Early matches- neurology, ophthalmology, urology • August- Early match applications due, • interviews in Sept-Dec. • October-For the rest, applications due • interviews- Nov-Jan

45. M3 • Work hard • Pay attention • Have fun