This edition first published 2015 © John Wiley & Sons Ltd
Registered Office
John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
Editorial Offices
350 Main Street, Malden, MA 02148-5020, USA
9600 Garsington Road, Oxford, OX4 2DQ, UK
The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
For details of our global editorial offices, for customer services, and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell.
The right of Justin W. Kung, Pauline M. Bishop, Priscilla J. Slanetz and Ronald L. Eisenberg to be identified as the authors of the editorial material in this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.
Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book.
Limit of Liability/Disclaimer of Warranty: While the publisher and author(s) have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. It is sold on the understanding that the publisher is not engaged in rendering professional services and neither the publisher nor the author shall be liable for damages arising herefrom. If professional advice or other expert assistance is required, the services of a competent professional should be sought.
Library of Congress Cataloging-in-Publication Data
Tips for the residency match : what residency directors are really looking for / edited by Justin W. Kung, Pauline M. Bishop, Priscilla J. Slanetz, Ronald L. Eisenberg.
p. ; cm.
Includes bibliographic references and index.
ISBN 978-1-118-86093-9 (pbk.)
I. Kung, Justin W., editor. II. Bishop, Pauline M., editor. III. Slanetz, Priscilla J., editor. IV. Eisenberg, Ronald L., editor.
[DNLM: 1. Internship and Residency–United States. 2. Career Choice–United States. 3. Professional Competence–United States. 4. Students, Medical–United States. 5. Vocational Guidance–United States. W 20]
R840
610.71’55–dc23
2014037411
A catalogue record for this book is available from the British Library.
Set in 10.5/14 Adobe Garamond Pro by Aptara, Inc., New Delhi, India
This book is dedicated to our families for their understanding and support:
To the three girls in my life: Adrienne, Evelyn, and Ava J.W.K.
For my daughter, Kaylie, and my husband, Kristoffer P.M.B.
To Raja, Robert, Natalie, and Helen P.J.S.
To Zina, Avlana, and Cherina R.L.E.
Faculty
Rina Bloch, MD
Associate Professor
Program Director, Physical Medicine and Rehabilitation
Tufts University School of Medicine
Boston, MA, USA
Robert P. Bonacci, MD
Assistant Professor
Program Director, Family Medicine
The Mayo Clinic
Rochester, MN, USA
Anthony Chang, MD
Associate Professor
Associate Program Director, Pathology
Pritzker School of Medicine
University of Chicago
Chicago, IL, USA
David Chong, MD
Assistant Professor
Associate Program Director, Internal Medicine
Columbia University College of Physicians and Surgeons
New York, NY, USA
Kenneth B. Christopher, MD
Instructor in Medicine
Assistant Program Director, Internal Medicine
Brigham and Women’s Hospital
Harvard Medical School
Boston, MA, USA
George S. M. Dyer, MD
Assistant Professor
Program Director, Orthopedic Surgery
Harvard Combined Orthopaedic Residency Program
Harvard Medical School
Boston, MA, USA
Benjamin L. Judson, MD
Assistant Professor
Associate Program Director, Otolaryngology
Yale School of Medicine
New Haven, CT, USA
William Krauss, MD
Professor
Program Director, Neurosurgery
The Mayo Clinic
Rochester, MN, USA
Jennifer L. Kurth, DO
Assistant Professor
Northwestern University Feinberg School of Medicine
Chicago, IL, USA
Former Program Director, Psychiatry
Loyola University Medical Center
Chicago, IL, USA
Yvette LaCoursiere, MD
Associate Clinical Professor
Program Director, Obstetrics and Gynecology
UCSD School of Medicine
San Diego, CA, USA
James N. Lau, MD
Clinical Associate Professor
Associate Program Director, Surgery
Stanford University School of Medicine
Stanford, CA, USA
Zachary N. London, MD
Associate Professor
Program Director, Neurology
University of Michigan Medical School
Ann Arbor, MI, USA
Suzanne Long, MD
Assistant Professor
Program Director, Radiology
Thomas Jefferson University Hospital
Jefferson Medical College
Philadelphia, PA, USA
Elias M. Michaelides, MD
Assistant Professor
Program Director, Otolaryngology
Yale School of Medicine
New Haven, CT, USA
Heather McPhillips, MD, MPH
Professor
Program Director, Pediatrics
University of Washington School of Medicine and Seattle Children’s Hospital
Seattle, WA, USA
Qi Cui Ott, MD
Instructor
Associate Program Director, Anesthesia
Beth Israel Deaconess Medical Center
Harvard Medical School
Boston, MA, USA
Andrew C. Peterson, MD, FACS
Associate Professor
Program Director, Urology
Duke University Medical Center
Durham, NC, USA
Rachel Reynolds, MD
Assistant Professor
Program Director, Dermatology
Harvard Combined Dermatology Residency Training Program
Harvard Medical School
Boston, MA, USA
Carlo L. Rosen, MD
Associate Professor
Program Director, Emergency Medicine
Associate Director, Graduate Medical Education
Beth Israel Deaconess Medical Center
Harvard Medical School
Boston, MA, USA
Pierre Saadeh, MD
Assistant Professor
Program Director, Plastic Surgery
New York University School of Medicine
New York, NY, USA
Paul Tapino, MD
Associate Professor
Program Director, Ophthalmology
Scheie Eye Institute
Perelman School of Medicine
University of Pennsylvania Medical School
Philadelphia, PA, USA
Stephanie Terezakis, MD
Assistant Professor
Program Director, Radiation Oncology
John Hopkins University School of Medicine
Baltimore, MD, USA
Carrie D. Tibbles, MD
Assistant Professor
Director Graduate Medical Education
Beth Israel Deaconess Medical Center
Harvard Medical School
Boston, MA, USA
Jim S. Wu, MD
Assistant Professor
Former Program Director, Radiology
Beth Israel Deaconess Medical Center
Harvard Medical School
Boston, MA, USA
Residents
Shushmita M. Ahmed, MD
Resident, General Surgery
Stanford University School of Medicine
Stanford, CA, USA
Sara Alcorn, MD, MPH
Resident, Radiation Oncology
John Hopkins University School of Medicine
Baltimore, MD, USA
Jason S. Barr, MD
Resident, Plastic Surgery
New York University School of Medicine
New York, NY, USA
Laura Chen, MD
Resident, Pediatrics
University of Washington School of Medicine and Seattle Children’s Hospital
Seattle, WA, USA
Steven T. Chen, MD, MPH
Resident, Dermatology
Harvard Combined Dermatology Residency Training Program
Harvard Medical School
Boston, MA, USA
Bonnie Choy, MD
Resident, Pathology
Pritzker School of Medicine
University of Chicago
Chicago, IL, USA
Amy Downing, MD
Resident, Pediatrics
University of Washington School of Medicine and Seattle Children’s Hospital
Seattle, WA, USA
Kathleen Dunn, MD
Resident, Obstetrics and Gynecology
UCSD School of Medicine
San Diego, CA, USA
Kian Eftekhari, MD
Resident, Ophthalmology
Scheie Eye Institute
Perelman School of Medicine
University of Pennsylvania Medical School
Philadelphia, PA, USA
Jacob Erickson, DO
Instructor
Resident, Family Medicine
The Mayo Clinic
Rochester, MN, USA
Shannon Fitzgerald, MD
Medical Student
Harvard Medical School
Boston, MA, USA
Michael Granieri, MD
Resident, Urology
Duke University Medical Center
Durham, NC, USA
Elena B. Hawryluk, MD, PhD
Resident, Dermatology
Harvard Combined Dermatology Residency Training Program
Harvard Medical School
Boston, MA, USA
Joseph Kapurch, MD
Resident, Neurosurgery
The Mayo Clinic
Rochester, MN, USA
Mary Lally, BMBCh
Resident, Family Medicine
The Mayo Clinic
Rochester, MN, USA
Christine Miller, MD
Resident, Obstetrics and Gynecology
UCSD School of Medicine
San Diego, CA, USA
Vinod E. Nambudiri, MD, MBA
Resident, Dermatology
Harvard Combined Dermatology Residency Training Program
Harvard Medical School
Boston, MA, USA
Boris Paskhover, MD
Resident, Otolaryngology
Yale School of Medicine
New Haven CT, USA
Michaela Restivo, MD
Resident, Internal Medicine
Columbia University College of Physicians and Surgeons
New York, NY, USA
Samir Shah, MD
Resident, Radiology
Beth Israel Deaconess Medical Center
Harvard Medical School
Boston, MA, USA
Amanda Trotter, MD
Resident, Radiology
Beth Israel Deaconess Medical Center
Harvard Medical School
Boston, MA, USA
Natalie Wheeler, MD, JD
Resident, Neurology
University of Michigan Medical School
Ann Arbor, MI, USA
The Mayo Clinic
Rochester, MN, USA
Every year, thousands of medical students from the United States and abroad apply for residency positions through the Match. The application process can be chaotic, as students struggle to choose a future career path based upon limited exposure while at the same time trying to juggle their clinical responsibilities. In this book, we attempt to simplify and summarize the Match process. In Chapter 1: The Match Alphabet Soup, we break down the Match, giving readers insight into the history behind it, the technical intricacies of the match process, and the strategy behind the match algorithm. There are multiple organizations and acronyms associated with the Match, including the NRMP, ERAS, ECFMG, and SOAP, and we explain how they all have a role in the Match process.
Preparation is key. In reality, students are preparing for the Match from the first day they enter medical school and are wrestling with the very important decision of specialty selection. Students need to be aware of specific steps that they must take in medical school in order to position themselves for a great match. We highlight those steps which should be taken, beginning in the first year of medical school right up to the Match. We also discuss the very difficult choice of specialty selection, which is a complicated interplay of student preference and realistic expectations. A match in Dermatology and Plastic Surgery may not be attainable by every applicant. However, through a process of Self-assessment, Exploration, Likelihood, and Fallback (SELF), every student can select a specialty best suited towards his/her individual talents.
What exactly is a Program Director looking for in your application? How important are pre-interview dinners? There are multiple Insider Tips offered throughout this book based upon years of experience in the residency selection process. We offer a unique look into the Match through the eyes of a Program Director. What is the selection process really like? We detail this in Chapter 5: The Selection Process – Theirs. We also offer a detailed look at every specialty, including the information you always wanted to know but were afraid to ask, such as salary and lifestyle. These individual specialty-specific chapters are written by some of the nation's top Program Directors and their residents from institutions including Harvard, Yale, John Hopkins, Duke, Columbia, Stanford, UCSD, Mayo Clinic, and many more. Specialty specific insights are provided by leaders in fields ranging from Neurosurgery to Psychiatry.
Finally, International Medical Graduates (IMGs) play a crucial role in providing healthcare in the United States, but the path to the Match can be more arduous. We offer specific advice important to IMGs in areas including USLME preparation, research fellowships, and specialty selection.
We hope that you enjoy and profit from this book.
This book would not have been possible without the support of many people, and we wish to express our thanks and appreciation to all of them.
The information contained in this book is strictly for informational purposes. The editors and authors of this book have used their best efforts in preparing this book, but make no representations or warranties with respect to the accuracy, applicability, fitness, or completeness of the information contained in this book. The information in this book is provided “as-is” and without warranty. The editors and authors shall not be liable to any party (including, without limitation, the reader) for any direct, indirect, special, punitive, consequential, or other damages arising out of or relating to, in both cases directly or indirectly, from the use of the information in this book. Names and specific facts used in examples and anecdotes have been altered to protect the identity of individuals. Information regarding the subject matter of this book may change rapidly and readers are solely responsible for checking program application deadlines, fees, dates, or any other requirements.
Justin W. Kung is an Assistant Professor of Radiology at Harvard Medical School and a radiologist at the Beth Israel Deaconess Medical Center in Boston. He serves as an Associate Residency Director and has specific interests in medical student education.
Pauline M. Bishop is an Interventional Radiology Fellow and former Radiology resident at Beth Israel Deaconess Medical Center in Boston.
Priscilla J. Slanetz is an Associate Professor of Radiology at Harvard Medical School and a radiologist at the Beth Israel Deaconess Medical Center in Boston, where she is the Residency Director. A Fellow of the American College of Radiology, she holds an MPH in Health Policy and Management from the Harvard School of Public Health.
Ronald L. Eisenberg is Professor of Radiology at Harvard Medical School and a radiologist at the Beth Israel Deaconess Medical Center in Boston. An Associate Residency Director, he is the author of more than 20 books in radiology. A Fellow of the American College of Radiology, Dr. Eisenberg is also a non-practising lawyer and author of Radiology and the Law: Malpractice and Other Issues (Springer).
Congratulations! If you are purchasing this book, you are either nearing the end of medical school and crossing a major hurdle in your training, or you are in your preclinical years and planning ahead for residency application. Both possibilities deserve praise.
Besides passing your medical school classes and boards (a feat unto itself), you have two incredibly important decisions to make: choosing a specialty and then a residency. These decisions are extremely nerve-racking for a medical student. You are only just starting to feel comfortable in your book-based knowledge and now, with very little information about actual clinical practice, you are compelled to choose a career path and the training program that will get you started on it. It is a decision that requires truthful introspection about both your professional and equally important personal goals. No doubt, your energies have been so fixated on short-term objectives, such as getting good grades on exams, that you have had little time to consider the bigger picture. What sort of life do you actually want? A specialty choice will play a large role in achieving that life. Once you have narrowed down the field to one or two potential specialties, it is time to take another honest look at your academic performance. Can you actually get a residency position in your desired specialty?
The 2013 National Residency Matching Program® (NRMP®) results revealed that it was the most competitive year to date, with a total of 40 335 registrants and 34 355 active applicants submitting applications for 29 171 positions, 26 392 of which were available at the first postgraduate year (PGY-1) level (Figure I.1). This represents a sharp increase compared with the 38 377 registrants in 2012, an upsurge due largely to several new US allopathic medical schools graduating their first classes, adding up to nearly 1000 new registrants. The increase was also largely affected by approximately 800 more US citizens studying abroad (US International Medical Graduate (IMGs)) and hoping to return to the United States for their residency education, not to mention 740 more non-US citizen IMG applicants in 2013 compared with 2012 [1]. Even after discounting those initial registrants who eventually withdrew from consideration, or, as the NRMP would put it, were no longer “active”, there were only 0.77 available PGY-1 residency positions per active applicant! Not only has the Match become increasingly competitive as a whole, but as the cost of medical education rises, more and more graduating medical students are forced to consider future income as a major factor in specialty selection. This causes certain subspecialty residency programs to be disproportionately competitive.
As competition for residency increases without a relative increase in residency positions, now more than ever it is important to understand what a Program Director is looking for in an applicant. The primary and contributing authors of this book represent several combined decades of Program Director experience, which has demonstrated that graduating medical students undervalue their worth by emphasizing the wrong facets of their applications. We will aim to bridge the gap between medical students’ perceptions of a solid application and the perceptions of residency Program Directors.
We will teach you how to build a strong application from the moment you start medical school right up to Match Day, while at the same time investigating the specialties so you can find the right fit for you. Specialty selection is a daunting process; we will walk you through the steps involved and factors to consider. In addition, in Chapter 3: The Specialties – Program Directors’ Perspectives, we provide more detailed specialty-specific information, provided by Program Directors of some of the top residency programs in the country, ranging from competitiveness of the application process to a frank discussion of salary and lifestyle expectations after residency.
Once you have decided on a specialty, it is time to dive into the residency Match. We will discuss the particulars of the application process, including a clear explanation of the complex matching algorithm as well as recent updates in the “All In Policy” and the Supplemental Offer and Acceptance Program® (SOAP®), and explain how these may affect your rank order list (ROL). Furthermore, we will teach you how to highlight key components of your curriculum vitae and personal statement in order to increase your chances of being invited for an interview and how to excel on interview day once it arrives. Many programs meet shortly, if not immediately, after each applicant interview session to plan their ROL. We reveal how these decisions are made; you may be surprised by how subjective the evaluations are. However, with the help of this book, you can use those idiosyncrasies to your advantage.
Insider Tips from highly regarded residency Program Directors are peppered throughout this book. Here are just a sample of tips that are generally true across all subspecialties. Each will be discussed in more detail in their dedicated chapters.
Our goal is that by the end of this book, you will be able to make an educated decision about a career choice, and then work towards that choice with a thorough understanding of the match process and a realistic appreciation of your residency competitiveness.