From Medical School to Residency: How to Compete Successfully in the Residency Match Program

182 Pages·2000·3.985 MB·English

by  Roger P. Smith M.D. (auth.)

From Medical School
to Residency
Springer Science+Business Media, LLC
Roger P. Smith, M.D.
Professor and Program Director
Director of Ambulatory Care
Department of Obstetrics and Gynecology
University of Missouri at Kansas City—Truman Medical Center
Kansas City, Missouri, USA
From Medical School
to Residency
How to Compete Successfully
in the Residency Match Program
With 57 Illustrations
Springer
Roger R Smith, M.D.
Professor and Program Director
Director of Ambulatory Care
Department of Obstetrics and Gynecology
University of Missouri at Kansas City—Truman Medical Center
2301 Holmes Street
Kansas City, MO 64108
USA
Library of Congress Cataloging-in-Publication Data
Smith, Roger P. (Roger Perry), 1949-
From medical school to residency : how to compeet successfully in the residency match
program / Roger P. Smith,
p. cm. —
Includes bibliographical references and index.
ISBN 978-0-387-95003-7 ISBN 978-1-4612-1178-5 (eBook)
DOI 10.1007/978-1-4612-1178-5
1. Medical education. 2. Medicine—Study and teaching (Residency). I. Title: How to
compete successfully in the residency match program. II. Title.
[DNLM: 1. Education, Medical, Graduate—United States. 2. Internship and
Residency—United States. W20 S658f 2000]
R737.S5767 2000
610°.71°55—dc21 00-024951
Printed on acid-free paper.
© 2000 Springer Science+Business Media New York
Originally published by Springer-Verlag New York, Inc. in 2000
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ISBN 978-0-387-95003-7
Preface
Medical graduates seeking training in the United States get their residency
assignment through a matching process managed by the National Residency
Matching Program (NRMP). The process is intimidating for most; traumatic for
some. However, there are tips that can make the task easier and increase the
likelihood of success. Many of these tips are known to those of us who advise
students or are involved in the resident selection process, but this only helps if
students have access to a good advisor, and not everyone does. This text is
designed to fill that need for the student without access and to supplement the
advice received for those who do.
No text can provide final answers to questions that are inherently subjec
tive-only you, the student, can pose and answer those questions. The intent of
tlhis text is to help you frame those questions, develop strategies to assess them,
and, finally, feel comfortable with your final decision. This book provides a
glimpse into what residencies look for, how to choose the right program for
yourself, and the sequence of tasks you must accomplish to navigate the process.
It is easy to believe that everyone else is better, faster, bigger, and after exactly
the spot you want. This book gives you the tools you need to ensure that you can
be anybody's match.
Contents
Preface ...................................................................................................................... v
Chapter 1 Graduate Medical Education and "The Match" ..................................... 1
Anybody's Match ............................................................................................... 1
Postgraduate Education ...................................................................................... 2
The Application Process.................................................................................... 4
Types of Residencies....................... ............. ...................................................... 5
Fields of Study .................................................................................................... 6
The Match ........................................................................................................... 6
Chapter 2 Choosing Residencies............................................................................. 9
Styles and Contents................ ............ ................. ............................... ................ 9
After Residency................................................................................................ 10
Location, Location........................................................................................... 14
Competitiveness ............................................................................................... 15
Does Size Really Matter? ................................................................................ 16
The Myth of "The" Residency........... .............. ................................ ................ 17
How Many? ............. ............ ............ ... .............. ... ............................... .............. 18
Plan B. ............................................................................................................... 19
Chapter 3 Choosing Residents; Choosing You ...... ............................................... 23
Who Are They Looking For? ........................................................................... 23
What Do They Like? ........................................................................................ 24
Factors That Get You Noticed ......................................................................... 25
How They Carry Out the Process ........ .................................... ........................ 25
Chapter 4 The Master Timetable ................................ ........................................... 29
What Has to Be Done? ..................................................................................... 29
Milestones to Shoot for.................................................................................... 30
Chapter 5 Choosing an Advisor ............................................................................. 33
What to Look For ................ .................. ............ .................................. ............. 33
What You Don't Need ..................................................................................... 35
Using Them Wisely .......................................................................................... 35
viii Contents
Chapter 6 Tryouts and Electives ............................................................................ 37
Choosing Senior Electives.... ............ ................ ..... ........ .......... ........................ 37
Electives as "Wild Hairs" ................................................................................ 39
Electives as Interviews ............ .............. .............. ........... ............. ..................... 39
Chapter 7 Making the List-Your First Cut ....... .......... ...... ......... ... ......... .......... ... 41
Publications...... ........ ...... ........... .................. ................. .................................... 41
The Internet ...................................................................................................... 45
Brochures .......................................................................................................... 55
Experts .............................................................................................................. 56
Fellow Students... .............. ................. .......................... ............ ........................ 56
Chapter 8 Application Forms ................................................................................. 59
Paper or Plastic? ............................................................................................... 59
The ERAS System..... .................................... ....... ............... ..................... ........ 63
The Photo .......................................................................................................... 68
Chapter 9 The CV ... ........................ ............................. ... ..... ............................ ...... 69
What Is It? ........................................................................................................ 69
The Effective CV ............................................................................................. 70
Contents and Structure ................................................. '" .... ..... ........................ 70
Do's and Don'ts ............................................................................................... 80
Chapter 10 Effective Personal Statements ............................................................ 83
Why the Personal Statement? ....... ............... ........... ............. ................ ............ 83
The Painful Process.......................................................................................... 84
One or Many? ... ............. ............... ........... ............ ............. ................ ............. ... 88
Do's and Don'ts ............................................................................................... 88
Examples.. .......... .............. ............ .............. ............. ........... ............... ............... 92
Chapter 11 Recommendations ............. .............. ............. ........... ................ .......... 10 1
Who to Pick? .................................................................................................. 101
What to Ask Them For? ................................................................................ 103
The Dean's Letter........................................................................................... 105
Final Hints...................................................................................................... 105
Chapter 12 Making the List-Theirs (The Interview and After) ....................... 107
Getting the Slot. .............................................................................................. 107
Interview Timing ............................................................................................ 108
Travel Tips ...................................................................................................... 109
The Required Suit (Clothes and Grooming) ................................................. 110
Sparkling ......................................................................................................... 112
Fielding Questions ......................................................................................... 112
Getting Information ............................................................ , ...................... ..... 114
Contents ix
After the Interview ......................................................................................... 115
Secret Tips..... .... ............ ....... ........ ...................................... ............ .......... ...... 116
Chapter 13 After the Interview...... ............ ....... ............................. .......... ............ 119
What They Do After You Leave ................................................................... 119
Notes to Yourself ........................................................................................... 120
Notes to Them ................................................................................................ 122
After the Last Interview ................................................................................. 126
Chapter 14 Making the List-Your Match List................. ........... ...... ...... .......... 127
Which Ones? .................................................................................................. 127
How Many? .................................................................................................... 128
Who Goes First? ............................................................................................ 129
The Safety Net ................................................................................................ 131
Chapter 15 Special Circumstances ...................................................................... 133
Military Programs .......................................................................................... 133
Specialty Matches .......................................................................................... 134
Osteopathic Programs ................. ............. ... ................................. .................. 140
Canadian Programs................... .............................. ................... ............ ..... ... 142
International Graduates ............................... ................................ ................... 145
The Couple's Match ....................................................................................... 146
Shared Positions ............................................................................................. 152
Special Needs ................................................................................................. 152
Chapter 16 The Computer Match Process ........................................................... 155
Who Participates? .......................................................................................... 155
What Does the Match Do? ............................................................................. 156
Who Wins? ..................................................................................................... 164
Chapter 17 Match Day.. .... ................... ................. ............. ...... .............. .............. 165
What Happens?....... ...................... ................ .................................. .......... ..... 165
Getting Set...................................................................................................... 166
The Scramble .................................................................................................. 167
Chapter 18 Resources and References ................................................................ 171
Resources for Further Information....... ................... ................. ........... ...... .... 171
Medical Licensure .......................................................................................... 174
Internet Resources.......................................................................................... 174
References of Interest. .................................................................................... 176
Index ..................................................................................................................... 179
Chapter 1
Graduate Medical Education
and "The Match"
Anybody's Match
It won't be that long before you join the over 15,000 medical students who are
awarded the M.D. degree each year at one of 125 medical schools.
Unfortunately, this does not qualify you to practice medicine; you still have a
ways to go. Before you can hang out your shingle or put you name on the door,
you have to complete an additional three to seven years of residency training
(one to three years just to be licensed in most states). In a manner somewhat
akin to the process you went through getting in to college and medical school,
you now face choosing where this training will take place and in what field of
practice. Since 1952, this process has been simplified somewhat by the
institution of a national system designed to match candidates and programs. A
similar program is in place for graduates of schools of osteopathic medicine as
well. This system also provides for a uniform decision date; further reducing the
stress of the process. The system is designed to level the playing field, allowing
students to obtain the most desirable position available to them. (Over 80% get
their first, second, or third choice.) Almost all graduate medical trainees in the
United States go through the matching process to get their residency assignment.
There are some individual specialties and special circumstances that have their
own version of the matching process, and these will be discussed in Chapter 15.
This is not to say that the system is either simple or stress-free. It is not. The
process is intimidating for most, traumatic for some. There are, however, some
tips and guidelines that can be provided to make the task easier and that will
increase your chances of success. Many of these are well known to those who
advise students or who are involved in the resident selection process, but they
are only available to students if they have access to a good mentor. This text
should fill that need for students without access and supplement the advice
received by those who have an advisor.
Despite the National Resident Matching Program (NRMP, the match), there
are many decisions still to be made, forms to be filed, interviews to be arranged
and undergone, and lastly, the ranking of your choices and the match itself. How
2 1 Graduate Medical Education
can you make this process smoother, less intimidating, and successful in getting
you to your ideal residency? This book can provide you with a road map, battle
plan, time line, and helpful hints to ease the way. No text can provide final
answers to questions that are inherently subjective-only you can pose and
answer those questions. The intent of this text is to help you frame those
questions, develop strategies to assess them, and ultimately feel comfortable
with your final decision.
In the chapters that follow, we will explore the graduate medical education
system and the application process. We will look at ways to decide on your field
of study, and the type of residency you might want, and to assess your chances
of getting an appointment to the program of your choice. We will move through
the various steps that you will have to traverse on your journey to that ideal
position, providing hint, tricks, and the benefit of experience along the way.
While we will explore the options available if you do not match, the odds are
vastly in your favor that you will not need them. Let us begin by looking at the
process of postgraduate medical education.
Postgraduate Education
There is no single licensure to practice medicine throughout the United States;
however, there are broad standards that the individual states adhere to in
granting medical licensure. To provide patient care in the United States, a
physician must complete several years of postgraduate study in an approved
graduate medical education program. Programs are accredited by the
Accreditation Council for Graduate Medical Education (ACGME) and must
meet standards set by the certifying boards within each medical specialty. These
boards specify the formal training required, set the standards for certification,
administer the testing that determines that these standards have been met, and
oversee the work of the residency review committees (RRCs) for their specialty.
The duration of postgraduate medical education determined by the individual
specialty boards, but ranges from three to seven years (Figure 1-1).