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Residency Workshop Summer 2013 July 12 & August 2 Bondurant Hall G100 Dr. Georgette Dent Dr. Robert Gwyther. Office of Student Affairs. The goal is a successful match How do we get there?. 1) Choose your specialty Do electives/ selectives Meet with College Advisor
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Residency Workshop Summer 2013July 12 &August 2Bondurant Hall G100Dr. Georgette DentDr. Robert Gwyther Office of Student Affairs
The goal is a successful matchHow do we get there? 1) Choose your specialty • Do electives/ selectives • Meet with College Advisor • Careers in Medicine website 2) Prepare application • Meet with Ashley Olsson for MSPE • Meet with Career goal advisor(s)/College advisors • Sign up for ERAS (and/or CAS) • Fill out & submit application (Big 3) • Solicit LORs • Write personal statement • Decide on program list 3) Wait for interviews to roll in! 4) Register for NRMP (and SF, Military, or AUA) & submit ROL
Choosing a specialty: When to decide? • Take electives/selectives in July, August & September to help with specialty choice • Ideally, need to decide on specialty and apply by September 15th • May decide as late as October 1st (Dean’s Letter release date) • Can apply in more than one specialty if truly can’t decide • July grade will be last grade on Transcript
Selection Criteria for Residency: Results of a National Program Directors Survey Green, Marianne MD; Jones, Paul MD; Thomas, John X. Jr PhDAcademic Medicine: March 2009 - Volume 84 - Issue 3 - pp 362-367 (Link at end of presentation)
40,335 Applicants 29,171 Residency Positions 17,487 US Allopathic seniors Almost 400 more US senior students chose primary care (5.5% increase) Approximately 1,000 unfilled positions and approximately 1,000 unmatched students Number of US seniors unmatched after Match and SOAP doubled 2013 NRMP Data AMA Website
Highly Competitive Specialties: Ratio of Positions to US Seniors Median Step 1 Scores for Matched Students Ratio Step 1 • Orthopedic Surgery 0.8 240 • Radiation Oncology 0.8 240 • Plastic Surgery0.9 249 • Otolaryngology 0.9 243 • Dermatology 1.0 244 • Radiology 1.3 240 Match Outcomes Data, August 2011
Moderately Competitive Specialties: Ratio of Positions to US SeniorsMedian Step 1 Scores for Matched Students Ratio Step 1 • Emergency Medicine 1.0 223 • General Surgery 1.1 227 • Obstetrics/Gynecology 1.3 220 • Anesthesiology 1.3 226 • Med/Peds 1.3 230 • Pediatrics 1.4 221 Match Outcomes Data, August 2011
Less Competitive Specialties: Ratio of Positions to US SeniorsMedian Step 1 Scores for Matched Students Ratio Step 1 • PM & R 1.7 214 • Psychiatry 1.8 214 • Neurology 1.8 225 • Internal Medicine 1.8 226 • Pathology 1.9 226 • Family Medicine 2.1 213 Match Outcomes Data, August 2011
Percent US Seniors In Honor Society (AOA) who Matched in 2011 Source: NRMP Charting Outcomes in the Match – Characteristics of Applicants Who Matched to their Preferred Specialty in the 2011 NRMP Main Residency Match
Can your credentials be enhanced? • Step 2 • Research • Audition electives • Joint degree • Spanish If your credentials cannot be enhanced, then you may need a back up or parallel plan if you are applying to a competitive specialty.
Graduation requirements: USMLE Step 2 CK • Take Step 2 Clinical Knowledge by November 15, 2013 • Show passing score of Step 2 CK by December 31, 2013 • Lack of a passing score by December 31 means eligibility for the Match and graduation is in question
Graduation requirements: USMLE Step 2 CS • Show proof of registrationby February to participate in the NRMP • Take Step 2 Clinical Skills by April 25 to graduate in May 2014 • Exam taken after March will not be graded until June/July • Some program directors like to see a passing score to interview or rank students! • Should have gotten financial aid for registration • Can take time off from electives/selectives for exam
Step 2 CS 5 Test centers • Philadelphia • Atlanta • Los Angeles • Chicago • Houston
Choosing a specialty: What if I can’t decide? • Talk to your Advisory College Advisor • Talk to Career Goal Advisors in the specialties you are interested in • Consider matching in a transitional or preliminary year • Apply to more than one specialty • Delay residency • Graduate studies • Research year
How do we get there? 1) Choose your specialty • Do electives/selectives • Meet with College Advisor • Careers in Medicine website 2) Prepare application • Meet with Ashley Olsson for MSPE • Meet with Career goal advisor(s) • Sign up for ERAS (and/or CAS) • Fill out & submit application (Big 3) • Solicit LORs • Write personal statement • Decide on program list 3) Wait for interviews to roll in! 4) Register for NRMP (and SF, Military, or AUA) & submit ROL
Medical Student Performance Evaluation (MSPE) Update • July 26 – last date to meet with staff writer to review draft letter • August 1 – Any CV updates due so that letter can be completed. Remember to send anything you may have promised to send, especially MPH details. • September – review final letter prior to release. Wait for notification that your letter is ready. • October 1 – MSPEs released
College Advisor Meeting • Discuss your career choice • Discuss your ability to match in that specialty • Ways to enhance your application • Discuss personal statement and letters of recommendation
Career Goal Advisor(s) • Discuss with your CGA: • Your reasons for choosing the field • Your realistic ability to match • Ways to strengthen your application • Whether to do away electives • Program choices and priorities • Number of applications and interviews • Ranking strategies • Listing: http://www.med.unc.edu/md/fourthyear/career-goal-advisors
Electronic Residency Application Service (ERAS) • The application for the “regular match” • Important dates: • 07/01/2013 Access to “MyERAs” • 09/15/2013 Submit application/ Transcript released • 10/01/2013 MSPE • 05/31/2014 Application info purged • Check individual program dates • After application is submitted, only Profile section can be changed • https://www.aamc.org/students/medstudents/eras/
The MyERAS Program • Enter CV information in MyERAS • After certification, information cannot be changed • except profile (name, email, address, AOA, phone#, ID#, USMLE#) • Enter names of letter of recommendation writers • Select programs • Import personal statement(s) • Assign letters and personal statements for each program • Supply 3x4 color (ERAS) and 2x2 black & white (SOM file) photos to SA
Anesthesiology Dermatology Diagnostic Radiology Emergency Medicine Emergency/Internal Medicine Family Practice Internal Medicine Internal Med/Family Med Internal Med/Pediatrics Internal Med/Preventive med Internal Medicine/PM & R Internal Med/Psychiatry Nuclear Medicine Neurology & Child Neurology Neurodevelopmental Disabilities Neurosurgery https://www.aamc.org/services/eras/ Obstetrics/Gynecology Otolaryngology Orthopedic Surgery Pathology Pediatrics (all tracks) Pediatrics/Emergency Medicine Pediatrics/PM & R Physical Medicine & Rehabilitation (PM & R) Plastic Surgery Preventative Medicine Psychiatry Psychiatry/Family Medicine Radiation Oncology Surgery Transitional Year Urology (AUA match) ARMY & NAVY PGY-1 ERAS Residency Specialties
Surgical Specialty Matches • Ophthalmology • Central Application Service (CAS) & San Francisco (SF) Match • Opens in June • Target dates to submit application: 9/4/13 • SF Match • ROL certification: 1/7/14 • Match results released to schools: 1/14/14 • Unfilled vacancies announced: 1/16/14 • www.sfmatch.org • help@sfmatch.org • Urology • ERAS and AUA Match • Important dates • Registration opens: Summer 2013 • ROL Certification: 1/3/14 • Match Day: 1/22/14 • http://www.auanet.org/education/urology-and-specialty-matches.cfm
Letters of Recommendation • Waive your right to read the letter • Ask faculty if they feel that they know you well enough to write letter • Give writer your CV, personal statement • Give writer ERAS cover sheet • Most programs want 3-4 letters • At least 1-2 from chosen specialty • Letters from graduate work or research mentors make great 4th letters • MSPE is not a LOR
Letters of Recommendation • Deadline for letters is a month earlier than past years • Ideally need letters by September 15 or October 1 at the latest • Faculty have 3 ways to submit letter • Email to Student Affairs at ERAS@med.unc.edu • Mail paper copy to Student Affairs at CB# 9535, 1001 Bondurant Hall • Load letter directly into ERAS
Personal statement • Aim for 600-650 words (one page max) • Questions to consider • Why am I interested in this field? • What do I want in a residency program? • What are my professional goals? • Why should a residency choose me? • What accomplishments should I highlight? • What contributions can I make to the specialty? • What contributions can I make to the residency program? • What outside interests do I have?
Personal statement • Do • Write a statement that someone who knows you well can pick out of a stack • Provide insight into who you are and what you have achieved • Write about something you would like to discuss in an interview • Address a problem in your application if you can put a positive spin on it • Don’t • Restate your CV/application • Be too cute or out there unless you have vetted it with several people • Use the entire statement to address problems in your application—try to keep it positive
How many programs should I apply to? • Applying to programs is not the expensive part of the application—interviewing is. • Err on the side of applying to too many programs and have the good fortune to decline interviews • If you are a less competitive candidate for a specialty, you should apply to more than the average number of programs
Average number of applications and target #programs on ROL for Highly Competitive Specialties • Dermatology 55 09 • Orthopedics 47 12 • Urology 43 10-12 • Radiology 41 13 • Plastic Surgery 29 11 • Radiation Oncology 34 11 Match Outcomes Data, August 2011 Apps ROL
Average number of applications and target # programs on ROL Moderately Competitive Specialties • Emergency Medicine 27 11 • Anesthesiology 25 13 • General Surgery 22 11 • Obstetrics/Gynecology 23 11 • Pediatrics 17 10 Match Outcomes Data, August 2011 Apps ROL
Average number of applications and target # programs on ROL Less Competitive Specialties • Internal Medicine 16 10 • Physical Medicine & Rehabilitation 19 11 • Psychiatry 16 9 • Pathology 16 9 • Family Medicine 12 8 Match Outcomes Data, August 2011 Apps ROL
The goal is a successful matchHow do we get there? 1) Choose your specialty • Do electives/ selectives • Meet with College Advisor • Careers in Medicine website 2) Prepare application • Meet with Ashley Olsson for MSPE • Meet with Career goal advisor(s) • Sign up for ERAS (and/or CAS) • Fill out & submit application (Big 3) • Solicit LORs • Write personal statement • Decide on program list 3) Wait for interviews to roll in! 4) Register for NRMP (and SF, Military, or AUA) & submit ROL
Interviews • The most important component to program directors in selection of residents • How many should you do? • Check “Charting the Outcomes of the match” for specialty specific data • There is a limit to what you can do… • 20 interviews is about max • 25 would be Herculean • 30 would be lethal! • Interview workshop to be held:October 18
National Residency Matching Program (NRMP) • The NRMP provides a uniform date of appointment for residency and fellowship positions • Everyoneneeds to register • Registering with NRMP does not register you with ERAS and vice versa • NRMP is a binding agreement • Web address: http://nrmp.org
NRMP Dates to Remember • 09/15/2013 Registration opens ($60.00) • 11/30/2013 Application deadline • ($50.00 late fee after this date) • 1/15/2014 Rank order listing opens • 2/26/2014 Final rank order certification (Before 9pm EST!) • 3/17/2014 Matched/Unmatched info posted online • 3/18/2014 Re-Match (SOAP) • 3/21/2014 MATCH DAY!
Costs • ERAS Number of applications in same specialty up to 10 $92 11-20 $9 each 21-30 $15 each 31 or more $26 each • NRMP 20 ranks $60* 21 or more $30 each * for couples $75/each for 30 ranks
Costs • SF Match/CAS $100 registration plus: 1-10 apps $60 each 11-20 $10 each 21-30 $15 each 31-40 $20 each > 41 $35 each • AUA Match $75 no limit • NBME $70 unlimited copies
Predictors of Matching • Number of programs ranked!!!!!! • Applying to more programs, means more interviews, means more programs you can rank! • Step 1 • Step 2 • Graduate of top 40 NIH ranked school • AOA (medical honor society) Match Outcomes Data, August 2009
Matching Strategies for Couples • Target large cities • Sign up in NRMP as individual, but indicate matching as a couple • Enter partner’s NRMP code (partner enters your code) • Couple ranks the same number of programs • Computer treats couple as a linked pair only • Can mix types of programs, institutions, specialties, geographic locations in each pair of ranks • Rank acceptable programs
He – Internal Medicine 1.UNC-CH 2.Duke 3. Duke 4. UNC-CH 5. Mass General 6. Brigham & Women’s 7. Boston University 8. No match She – Pediatrics UNC-CH Duke UNC-CH Duke Boston Children's Boston Children's Boston Children's Boston Children’s Matching Strategies for Couples
Review of Residency Application Process Spring– Update CV, schedule appointments Spring/Summer– MSPE (Dean’s Letter) appointments , have photo taken, attend summer ERAS & ranking strategies workshop, take CPX Summer/Fall– Sign up with NRMP, request LORs, write personal statement, research & apply to programs Fall/Winter– Take Step 2 CK and at least register for Step 2 CS, Interview Winter– Submit rank order list
What puts you at risk for not matching? • Competitiveness issues: academic/professionalism problems (e.g. USMLE, grades, no research) • Apply to more programs • Apply to back up specialty • Well crafted personal statement to provide context to record • Try to enhance credentials (e.g. early Step 2, research year, do well 4th year) • Away electives • Attitudinal/interpersonal issues: poor interviewer; ambivalent about medicine or specialty • Take electives to better define specialty choice • Do practice interviews • Geographical issues: • Apply to more than one specialty • Do elective and/or research in targeted location • Couples need to apply to at least one big cold city
Wisdom • Be honest and forthright about your own profile • Don’t leave out information—it will be found • Be truthful with yourself • Listen to advice • Hear what is said • Give yourself enough options
On-line Resources • Careers in Medicine: https://www.aamc.org/students/medstudents/cim/ • Personal Career Assessment • Medical Specialties ApitudeTest • http://www.med-ed.virginia.edu/specialties/ • Temperament Sorter • http://www.advisorteam.com/temperament_sorter/register.asp?partid=1 • Match • Charting outcomes of the match: http://www.aamc.org/programs/cim/chartingoutcomes.pdf • ERAS: http://www.aamc.org/students/eras/ • VSAS: https://www.aamc.org/students/medstudents/vsas/ • NRMP: http://www.nrmp.org/ • Selection Criteria for Residency: Results of a National Program Director’s Survey: http://journals.lww.com/academicmedicine/Fulltext/2009/03000/Selection_Criteria_for_Residency__Results_of_a.24.aspx • FREIDA: http://www.ama-assn.org/ama/pub/education-careers/graduate-medical-education/freida-online.shtml • AAMC Roadmap to Residency: From Application to the Match and Beyond www.aamc.org/publications Click “Student Affairs”