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Final Guide to residency

By Brandon Tucker,2014-11-04 07:33
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Final Guide to residency

    Underground Guide

    to Residency Application

    Harvard Medical School Graduating Class 2002

    Spring 2002

    Credit where Credit is due

General Editing and Writing: Ana-Claire Meyer, Rachel Van Sambeek, Kate Grossman

    Other Contributors: Sara Zeff, Anthony Powell, anonymous contributions mixed in at random

    collected by Bridget Fey

Specialties:

    Anesthesia- Angeline Chong Family Practice Debra Stulberg

    Emergency Medicine Mark Bisanzo

    General Surgery Kristofer Charleton-Ouw, David Kuwayama

    Internal Medicine Patrick Yachimski Neurology Ana-Claire Meyer

    Obstetrics and Gynecology Larissa Meyer Ophthalmology Kevin Cranmer

    Orthopaedic Surgery George Dyer

    Otolaryngology Chris Prichard

    Pathology Patrick Wagner

    Pediatrics Jen Kim

    Plastic Surgery- Helena Taylor Psychiatry Sara Auerbach

    Radiation Oncology Tracy Timms

    Radiology Bruce Stewart

Not received…Sorry!

    Dermatology

    Urology

    Table of Contents

INTRODUCTION .....................................................................................................................4

    GETTING STARTED ..............................................................................................................5

    REGULAR MATCH.................................................................................................................8

    GENERAL INFORMATION FOR THE MATCH .................................................................................8 REGULAR MATCH CHECKLIST ................................................................................................ 11 TIMELINE FOR REGULAR MATCH ............................................................................................ 12 EARLY MATCH .................................................................................................................... 13

    GENERAL INFORMATION ABOUT EARLY MATCH ..................................................................... 13

    GENERIC EARLY MATCH CHECKLIST ...................................................................................... 15 TIMELINE FOR EARLY MATCH ................................................................................................ 16 INTERVIEWING TIPS .......................................................................................................... 17

    COUPLES MATCHING ........................................................................................................ 17

    APPLYING TO MORE THAN ONE SPECIALTY .............................................................. 19

    THE UNTHINKABLE: WHAT IF I DON’T MATCH? ....................................................... 20

    FREQUENTLY ASKED QUESTIONS: ................................................................................ 23

    SPECIALTIES ........................................................................................................................ 27

    ANESTHESIOLOGY .................................................................................................................. 27 DERMATOLOGY...................................................................................................................... 28 EMERGENCY MEDICINE .......................................................................................................... 28 FAMILY PRACTICE.................................................................................................................. 31 GENERAL SURGERY ............................................................................................................... 33 INTERNAL MEDICINE .............................................................................................................. 35 NEUROLOGY .......................................................................................................................... 37 OBSTETRICS AND GYNECOLOGY ............................................................................................. 39 OPHTHALMOLOGY ................................................................................................................. 40 ORTHOPAEDIC SURGERY ........................................................................................................ 43 OTOLARYNGOLOGY-HEAD AND NECK SURGERY (ENT) .......................................................... 45

    PATHOLOGY........................................................................................................................... 48 PEDIATRICS ............................................................................................................................ 48

    PLASTIC SURGERY ................................................................................................................. 49 PSYCHIATRY .......................................................................................................................... 50 RADIATION ONCOLOGY .......................................................................................................... 52 RADIOLOGY ........................................................................................................................... 54

    UROLOGY .............................................................................................................................. 55

    PRELIMINARY AND TRANSITIONAL YEARS................................................................ 56

Introduction

Why are we doing this?

    Applying to residency can be a frustrating process. The process changes from year to year so that traditional information sources are often outdated. Also, there are so many specialties, each with its own idiosyncrasies, that the information available is often not specific enough.

    Advisors can be helpful but they often are not acquainted with the nitty gritty details about ERAS or SFMatch (don‘t worry- you will soon know what these stand for). A great source of

    information is the prior year‘s graduating class, but they can be hard to track down as they are busy surviving their internships across the country.

Hopefully, this will help a little...

You can do this!

    Although this seems like a daunting process, it can be done. And even if third year took a toll on your ego, don‘t forget: you are intelligent, compassionate, will be a great physician and wonderful addition to any residency program!!!

What can you expect to find in this guide?

Please do not use this guide as a substitute for doing your own research.

    1. There are many books written about applying to residency- please get one! They give valuable information about each of the specialties, what they are looking for in your application materials, suggestions on personal statements, interviewing tips, etc.

2. Talk to as many people as possible!! Don‘t be shy!! Most of the people you will talk to

    have had to go through this process, and almost everyone is eager to help. Talk to your interns, residents, fellows, attendings, other medical students, the staff of your society, your society master or associate master. Each of these folks will bring a different perspective (and will be more or less helpful).

    We are trying to put together the information that is often not available easily and that we have found through trial and error (many errors), along with helpful hints we wish someone would have told us. This guide is specific to HMS and will hopefully include information about the vast and occasionally impenetrable resources that HMS has to offer.

    Please keep in mind that this guide is highly subjective. We are writing about our own experiences during our application year; it may change by next year. So please check up on our information, and check up on it early!!

    Finally, if you found this helpful, consider updating it for the year that follows you!!!

Getting Started

    Ana-Claire Meyer, Rachel Van Sambeek, Kate Grossman

    Start as early as you possibly can. If you can, start during the second half of your third year. But, be reasonable. If you are doing your inpatient month in Surgery, there is no need to start thinking about residency. On the other hand, if you are getting out of the hospital at noon every day and have weekends off, definitely start working on your C.V. and doing research on various residency programs.

    1. Think about what you would like to specialize in. Ideally you will figure this out by

    May or June of your third year for Early Match specialties, and by July or August for

    Regular Match specialties. Realistically, most people do not know by then and some are

    even waffling between two specialties as they send in their rank list. Start getting ready

    even if you do not know exactly what specialty interests you! There are many things you

    can do beforehand.

    2. Do Research! There are a dazzling array of resources out there once you start looking.

    Here are just a few examples:

    ; Go to the Coop (or other bookstore of your choice). Buy a book on applying to

    residency. There are several decent books available, including the First Aid Series.

    Take your pick.

    ; Talk to lots of people - interns, residents, attendings, HMS administrators, staff in

    your Society, Society Masters.

    ; Contact programs for information. Many programs no longer send out information on

    their programs as almost all have their own websites which will give you a general

    idea of what they are about.

    ; Check FREIDA (a residency program database- see ―Important Websites‖) for

    residency program website listings. These are searchable by location and specialty

    but have limited information. The deadlines listed here are bunk, ignore them.

    ; Many of the professional associations sponsor websites that include valuable career

    and training information.

    ; The NRMP (National Residency Matching Program; see "Important Websites") also

    provides basic program information which is more limited but more up to date. Go to

    the NRMP site, log into the "Match Site" and look on the sidebar to the left for the

    word "Directory." The information is searchable by specialty and location.

    3. Update or Create a C.V. You can do this early and it will save you time later. Think

    hard about what you have been doing, and feel free to dip into your past (include college,

    volunteer, and work experiences prior to medical school) especially if you have taken

    several years off. Format is not as important as content as most applications require you

    to change it to their format. However, it is a good idea to have one in decent shape and

    printed up on nice paper to give to your letter writers, to submit for the Dean‘s letter, or

    to give to programs during interview season.

    4. Work on your personal statement. You do not need to know what you want to apply in

    to start writing this. There are as many theories on how to write an effective personal statement as there are people to give advice. Most of these ―theorists‖ agree that the

    personal statement should include why you are interested in the specialty and highlight pertinent accomplishments that are listed on your resume. It should be professional, concise, and factual. Contrary to medical school essays, you should avoid little stories or touching moments unless you are a very skillful writer and can do this without sounding trite. Most of us were advised to make our personal statements as bland as possible. Think of it as a very long cover letter for a real-life job. It helps to have an advisor or other faculty member read and critique your personal statement.

    5. Letters of Recommendation. It is never too early to think about whom you would like

    to write your letter of recommendation. During your third year, if you work with an attending and develop a relationship with them, ask them if they would be willing to write you a letter of recommendation. This works much better when you are standing there in person and the attending can see your face and remember who you are. It does not work as well when you ask them six to nine months later when they can barely remember who you are, much less what you did while you were on service.

A good way to ask someone for a recommendation is, ―Do you feel you know me well

    enough to write me a strong letter of recommendation?‖ or ―Can you write me a letter of recommendation?‖ When you ask for a letter, you are not committing yourself to using that particular letter, but at least you have established the relationship. Core clerkship directors expect to be asked for letters and recognize that it is part of their job; they do, however, appreciate being given plenty of time in which to write them.

    Figuring out whom to ask for a letter is a challenging process. Please see the specialty-specific information as this varies considerably.

    6. College transcripts: Believe it or not, for some Early Match specialties you need to include official copies of your college transcripts.

    7. USMLE: Dig up that copy of the score Sample score report: report for Step 1. You will need it not

    National Board of Medical Examiners only to enter your board scores, but also First class mail 3750 Market Street US Postage Paid Philadelphia, PA 19104-3190 for your USMLE number. It is Philadelphia, PA exceedingly difficult to figure out which Forwarding Service Requested is your USMLE number. It is the 8 digit number to the left of your name 0-000-000-0 Your Name 0-000-000-0 Your Address and address on the outside cover of your Boston, MA 00000 score report. If for some reason you

    can‘t find your old score report, you can

    get your number by calling (215) 590-

    9600. Ignore the voicemail menu and

    hit "0" to get a person who will be able

    to help you.

    8. Picture: Have a picture of yourself taken. Do not put this off until the last minute. Do not use a picture from 5 years ago on your backpacking trip through Nepal. Do take a current picture of yourself dressed up much as you would be for an interview. You can use a professional service or not depending on your budget and your photography skills.

    9. Check your attitude: A few things to remember...

    ; be flexible...this can be a trying process for everyone involved

    ; be nice to people...especially the hardworking staff here at HMS and at those

    residency programs you are applying to. First, being nice to people is just a good idea.

    Second, it is a highly effective way of getting what you want (oh- is it possible to

    change my interview date?) And third, staff people do many important things. For

    example, HMS staff play an important role in generating your Dean's letters (like

    writing them). Also, if you do match at that highly desired program you will be

    seeing that staff person for many years to come and they will be helping you do many

    things (get meal tickets, fixing your schedule, giving you batteries for your pager,

    helping you get a medical license). Making a good first impression is a good idea.

    ; be humble...just because you go to Harvard Medical School does not mean that you

    will get anything you want (i.e. you will be ranked at the top of the list for every

    program you apply to). Going to Harvard helps, but you can't rest on your laurels

    folks! There are a lot of talented people out there and you will be competing with

    them for residency. So, work hard on your personal essay, your CV, and do research

    on residency programs, and ask around to find out what a good candidate looks like.

    Then make yourself look GOOD!

Regular Match

    Ana-Claire Meyer, Rachel Van Sambeek, Kate Grossman

General information for the Match

    The ―Regular Match‖ or the ―Match.‖ This is how you apply and match to most specialties. There are a few specialties that do not participate in this Match and use a different process coordinated by the San Francisco Match, or ―Early Match‖ (see section later in guide).

Application

    The application process is coordinated by ERAS (Electronic Residency Application Service) and is now completely online and relatively convenient. You fill out a profile (contact info and board scores), C.V., and personal statement online. You also submit letters of recommendation and a photograph electronically. Last year, the Office of Student Affairs hired a person whose sole job was to make sure everything actually got online at crunch time. I am not sure if she will come back next year, but she was great at making sure things did get online and sent out a bijillion reminder emails and helpful hints. However, she was not at all involved in the Early Match, so if you are participating in that match, you are on your own.

The numbers: You need the following three numbers for your application:

    ; The first is an ERAS identification number. At the beginning of this process the Dean of

    Students sends you a sheet of paper with your ERAS token. This enables you to register

    on the ERAS site.

    ; The second is your USMLE identification number. This can be found on your score

    report as described previously (see ―Getting Ready‖).

    ; The third is your AAMC/NRMP (American Association of Medical Colleges/National

    Residency Matching Program) identification number. You need to log on to their website

    (see ―Important Websites‖), click on NRMP, then click on Register for Match. Fill out

    their form, pay them $40, and then they give you a number. Make sure you save your

    number and password because you will need this when you want to send in your rank list.

    C.V.: You need to make your C.V. conform to their format, which includes separate sections for medical education, undergraduate education, medical school honors/awards, work experience, volunteer experience, research experience, publications, language fluency, hobbies and interests, and other awards/accomplishments.

    Personal Statement: You can enter several different personal statements if you desire. This is helpful as you may want or need different personal statements for different programs: for example, for Primary Care Medicine vs. Categorical Internal Medicine; for preliminary programs; or if you are applying in more than one specialty.

    Photograph: Give one (hard copy or electronic) to Office of Student Affairs, and they certify it and then submit it to ERAS. Electronic submissions should be in jpeg format. They cannot just use your ISIS picture, so save yourself some time and just send a new one. If you absolutely must use your ISIS photo, you must figure out how to download it and send it in jpeg.

Transcript: This is sent to ERAS for you, but you need to go to the Registrar‘s Office to fill out a

    form to give them permission to send it on your behalf. Course directors can take a long time to submit your grades to the Registrar. Sometimes you want these grades (e.g. your September Sub-I that was a HH) to be sent out with your transcript. It is possible to request that the Registrar wait until a grade comes before sending the transcript. Just make sure you tell the Registrar that your deadline is 7-10 days before your actual first deadline so that your transcript will be in on time. Also, overworked course directors sometimes need a gentle reminder to send in your grade; the Office of Student Affairs can help with this in a tactful manner.

Payment: You pay when you actually send out your programs. This can also be done

    electronically with your credit card.

    Letters of Recommendation: You can also submit as many letters of recommendation as you like to ERAS. You are only allowed to send a certain number of letters (usually 3, but sometimes 4) to any particular program, but you can choose which letters go to which programs. Again, this helps you tailor your application to a particular program.

    To submit a letter of recommendation, you must print up a form on the ERAS website and give it to the person you are asking for a letter of recommendation. They are then responsible for submitting those letters to the Office of Student Affairs, who scans it onto the site. This sounds like it is fraught with difficulty, and it is. Most people happily agree to write you a letter and then never actually get around to doing it. Give your letter writers plenty of time (4-6 weeks). Feel free to lie liberally about your first deadline to speed up the process; we recommend a deadline that is at least a week or two before the real first deadline. Give your letter writer gentle reminders that the deadline is coming up. Email is usually an effective way of doing this, as it is certain to get to the right person, but not overly pushy. The Office of the Dean of Students can be a real asset in extracting letters of recommendation from the writers and usually will politely harass your letter writer for you as the deadline approaches.

    Dean’s Letter: A ―Dean‘s Letter‖ must accompany all applications. You need to submit a C.V. and usually your personal statement to your Society in September. Your Society Masters will prepare a Dean‘s Letter for you. You have one opportunity to proofread this for errors. Do read your letter VERY CAREFULLY as there are always errors, sometimes large ones. However, do not ask for changes to the content of the letter, as there is a strict policy against making those kinds of changes. So don‘t even try it. You will only annoy the hardworking society staff.

    These letters are formulaic. They come from your med school application, any info you submit to your society master, and verbatim from course evaluations. They are universally positive. They quote from your med school application/CV and from evaluations from Years 1 and 2. They quote from your clerkships. You do not get to choose the quotes. (However, if you are crazy and applying in more than one specialty, they will sometimes ask which clerkships to include). Then there is a summary. Because Harvard does not rank us, and we do not have AOA, there are no "code words" to imply your rank. So don't obsess about your "adjective."

    USMLE scores: You fill out a little form online as part of the application, authorizing USMLE to release your board scores.

Automatic Retransmission of USMLE scores: This is a weird and incomprehensible option for

    your application. Basically, if you check the box, USMLE will automatically send out your scores for Step 2 as soon as they are available. Somehow, the programs seem to get the scores even before you do when this box is checked. If you choose not to, your Step 2 scores will not be sent out to any programs unless you log in to ERAS and ask them to send your scores. To my knowledge, most programs do not require your Step 2 scores for your application. Be sure to check with your programs!

Choose programs and transmit application: You can transmit your application as soon as your

    profile and C.V. are complete. You can send in your personal statement later if you are not quite finished (keep in mind that it still has to arrive before the deadline). Your Letters of Recommendation and Dean‘s Letter will be automatically sent by the Office of Student Affairs once you have transmitted your application.

    To ensure that your application (and supporting documents) has been transmitted to residency programs, you need to check ADTS (Applicant Document Tracking System- see "Important Websites"). ADTS will show which documents have been sent to which residency programs and whether or not they have been received. Most programs will not offer you an interview until all your documents have been submitted, so watch carefully.

    Deadlines range from Oct 15 through Dec 15. However, the earlier you send in your application the better because interview spots fill up quickly. Some programs (particularly the larger specialties) will contact you exclusively by email with interview offers, so be sure to check regularly. (See "Interviewing Tips" later in the guide and check out the specialty specific information as well).

    The Match: The match process itself is coordinated by a different service called NRMP (National Residency Matching Program). This is the third number you needed in order to register with ERAS. When you are ready to submit your rank list you need to log onto this website (see ―Important Websites‖) to submit your Rank Order List. Make sure you ―Certify‖ your rank list or it does not get sent in. Once you certify a rank list, you are finished. NRMP will send you a short email confirming your list. You are permitted to change your certified list as many times as you would like before the deadline.

    Ranking programs is a tricky process. Definitely ask one of the Society Masters (or staff) or an advisor in your specialty. Please see the Frequently Asked Questions for more information.

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