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The Myers Hurt Method Podcast

Countdown to the MATCH - the official podcast of the Dr Myers Hurt AKA the Match Gurus is the only podcast dedicated to helping residency applicants shine on interview day. Dr. Myers Hurt discusses specifics involving the NRMP and ERAS, and dissects common (and uncommon) residency interview questions for The Match.
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Oct 24, 2016

Illegal questions are always a hot topic surrounding interviews. As you all know, the NRMP sets very strict communication rules surrounding the Match process, and have very specific requirements of what constitutes “legal” communication. 

From the proverbial horse’s mouth, the NRMP Code of Conduct reads:

“To promote the highest ethical standards during the interview, ranking, and matching processes, program directors participating in a Match shall commit to:

Refraining from asking illegal or coercive questions Program directors shall recognize the negative consequences that can result from questions about age, gender, religion, sexual orientation, and family status, and shall ensure that communication with applicants remains focused on the applicant’s goodness of fit within their programs”.

Furthermore, federal law prohibits most of these questions for any job, not just residency, and it is illegal to make hiring and firing decisions based on this information. 

SDN, reddit, ValueMD, the usual forums people frequent usually have some version of “is this an illegal question” threads with arguments for and against.

My personal and professional thought are that they will happen. Overall - it will happen - these things come up in casual conversation all the time, and usually work their way into conversations that are comfortable during an interview session. Sometimes it is not the interviewer, but the applicant who brings it up, and the conversation flows from there.

Just a quick PubMed search has a 2016 study from Academic Medicine with a sample size of 11,000 applicants - Two-thirds of applicants reported being asked potentially illegal questions. Their data revealed that more women than men reported receiving questions about marital status or family planning in that study.  Similar results were reported in the initial study in 2013 in the same journal - about two-thirds report an illegal questions, and questions about marriage and childhood were a large majority of those questions.

There is no red light, no button, no siren that goes off, and no red phone you pick up to report the incident when these topics slip out, and my recommendation is to just keep rolling and try to redirect to more topical issues.

The rules are there to protect YOU, so you can offer the information, hospitals are just not allowed to ask you. Conspiracy theorists will say that you will give too much away by asking these loaded questions - and that may be true, but I’d say you are reading too much into it.

Often these are not brought up in a malicious way. Some examples of how they can work their way into conversation:

The real Catch-22 in my opinion is that they are important issues to you as an individual - if you have kids childcare is important - if you are a specific religion, perhaps being close to a specific house of worship is important - lots of decisions can hinge on these so called “illegal” topics and could help you pick one program over another, or at least give you some comfort about your overall “fit” with a program. . 

If you feel you have been targeted - discuss first with the PD, then the NRMP / ACGME.

Thanks for listening, hope you enjoyed the content and find it useful.

Please subscribe to catch each new episode as they are uploaded, and if you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

Remember to send your questions to us through our website at www.matchgurus.com, or twitter @theMatchGurus - I personally answer every email and twitter DM we get.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

 Our book is also available on Amazon in paperback and eBook - less that 10 bucks - it is a quick read you can easily knock out on the flight to your next interview. If you find it helpful, please take some time to leave a review for that on Amazon as well - it means a lot. And of course, any of you looking for in-depth specialty-specific preparation for your interviews drop me a line and we can discuss our coaching packages. Take care.

Oct 24, 2016

I recently had the opportunity to chat with Dr. Megan Tresenriter, one of the creators of Swap and Snooze - a free service you can use right now when scheduling interview travel.  They help arrange medical student hosts for interview candidates to not only help you save some money on the interview trail, but also get an authentic experience and see how the students or residents at that hospital live, their surrounding city, and a look at life outside the hospital.

I take full responsibility for a patchy internet connection the day we talked, but we managed to edit together a good bit of our conversation - so without further ado - Dr. Tresnwriter:

Thanks for listening, hope you enjoyed the content and find Swap and Snooze useful on the interview trail. With all of the money you’ll save on hotels, you can pick up a copy of our book, or contact us for personalized coaching services and mock interviews. 

Please subscribe to catch each new episode as they are uploaded, and if you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

Thanks again, remember to send you questions to us through our website at www.matchgurus.com, or twitter @theMatchGurus. Take care.

Oct 10, 2016

While I’m sure you all hang on my every word, just in case any of you skip to the next track at the at the end of every show, I want to lead off this episode with a reminder that my partners and I are primarily a boutique coaching and mock-interview service. Too many times we’ve seen very strong applicants either sound average or even absolutely tank their interviews, and conversely weaker candidates outshine their peers and end up high on rank order lists. Interview day means a lot, you only have a handful of hours with a handful of people to impress, and there are things we can teach you that help you put your best foot forward when it matters the most. Our calendar is filling up quickly, but we offer a free 15 minute trial to show you what we can do, and our most popular package is now discounted for the remainder of this 2017 season to just $499 for three 30 minute interviews.  After the first interview, you’ll end up with explicit feedback on your verbal and nonverbal communication style, specific diction to use when answering questions that will help you stand out, and how to work the strongest points of both your personality and CV into the questions you are sure to be asked. We do the same homework I ask you to do and we role-play specific programs in specific cities to best simulate your actual interview day. The remaining two interviews give you a chance to put that feedback into action, and approach questions with a new angle that highlights what program directors want to see.  It is not too late to any of you who are listening to this in the middle of or even towards the end of your interview trail - if you were just blindsided by questions you didn’t prepare for, or had confidence walking into your first few interviews but now want to polish some rough edges before you talk with your dream program - drop us a line as well and we can look at our schedule.

Allright - for today’s topic, to cap off the questions you should be asking programs, I want to simply read an article I wrote for Student Doctor Network entitled The Million Dollar Question.  Link is in the shownotes, and it is based on advice I’ve given countless times, and still think holds true. I want to read it only so that the content isn’t diluted by one of my usual ramblings, and so that you can reflect on why you think it is important, and how it can help you ultimately  decide on the program that is right for you.

The Million Dollar Question

 

Interview season. The time of year that roads and skies swarm with the best and brightest medical students to all corners of the country taking aim at the next step in their training – residency. Believe it or not, behind the shiny brochures, extravagant dinners and polished powerpoint slides, residency programs are just as nervous about attracting top talent as you are about getting your top choice.

The interview trail is usually a blur of dry cleaning bills, rental cars, and the smell of breath mints masking cheap coffee mixed with nervous sweat. The broken record of the obligatory “strengths and weaknesses” question loops in your head. One of the more terrifying moments in the day comes when an interviewer asks: “What questions do you have for me?” Regardless of who asks it–the intern only four months above you in training or the gatekeeping program director–you know you have to ask something. So why not make it count?

Things like call schedule, orientation timelines, research requirements, away rotations, moonlighting, and meal plans may look important to you on paper, but should not be foundations of choosing one program over another. In fact, the best questions regarding most of these details can not truly be asked until you are in fact already a resident. The proverbial hindsight being of course 20/20. Is a meal plan a perk if the food is terrible? Moonlighting opportunities? Moot point if your paperwork and 45-minute commute are already pushing duty hour restrictions. It is simply not possible to ask an informed question on the specifics of most logistical things before setting foot in the hospital.

The best bang for your buck in this golden opportunity to ask them anything boils down to one “Million-Dollar” question:

Where do the graduates go?

Most programs are proud to tell you, and will have specific data on hand for at least the last 3 to 5 years. Fellowship, small group practice, academic center, private practice, rural areas, urban centers, with program alumni, unemployed, mom’s basement–the nuance in these specifics will speak volumes.

From this data you can easily glean:

  • board passing rate
  • research requirements
  • the reputation of the program over geographic regions
  • the reputation of the program in competitive fellowships
  • a network of alumni to help with future job placement
  • faculty strengths
  • procedure exposure
  • much, much more

If all graduates of the plastic surgery program you are looking at go into a maxillofacial fellowship at an Ivy League university hospital, and that aligns with your goals, great! You can assume the program has a good reputation, skilled specialty faculty, sound research, strong professional conference participation, and that residents see a heavy maxillofacial caseload. If this is not in tune with your dream of becoming a burn specialist however, you may want to look at programs with a different focus.

You may feel like a specific family medicine program trains the most well-rounded doctors by exposing them to a rural patient population and teaching procedures like colonoscopies and cesarean sections. If on the other hand, you were planning on practicing in an urban area after graduation, those procedures will be lost to specialist. A residency program at a larger training institution might be better suited to your future goals of working as a primary care physician in an urban, specialist-heavy environment.

Variety is paramount here. Private practice, fellowship, rural, urban, hospital setting, outpatient setting, in-state, out of state, etc. A diverse mix of jobs tells us that the graduates leave the program prepared for anything and are competitive in any marketplace.

Free white coats each year? That will run the department a few dollars annually. Free food? Maybe a few thousand dollars over the course of a residency. Daycare? I’ll admit that might be hard to pass up in certain instances. Upon graduation, however, the stakes go up exponentially. Consider the above scenarios: a plastic surgery program can graduate three to four residents annually with average starting salaries in the $300,000 range. A family medicine program can churn out six to eight graduates with starting salaries of about $150,000. Crunch those numbers, and you guessed it: $1,000,000 worth of contracts signed by each graduating class.

Follow all of the usual advice: put your best foot forward, have fun, be yourself, and get ready to talk about the summer research poster you submitted at least 30 times. When the time comes–and it will–remember the “Million Dollar” question, and pay attention to how it either expands or limits the scope of your future practice. Most importantly, envision yourself and your level of future happiness in the scenarios that unfold.

Closing:

Short and sweet today - thanks for listening, as usual I hope you enjoyed the content and find it useful.

Please subscribe to catch each new episode as they are uploaded, and if you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

Remember to send your questions to us through our website at www.thematchgurus.com, or twitter @theMatchGurus - I personally answer every email and twitter DM we get.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

 Our book is also available on Amazon in paperback and eBook - less that 10 bucks - it is a quick read you can easily knock out on the flight to your next interview. If you find it helpful, please take some time to leave a review for that on Amazon as well - it means a lot. And of course, any of you looking for in-depth specialty-specific preparation for your interviews drop me a line and we can discuss our coaching packages in more detail. Take care.

Oct 10, 2016

Today I’ll continue the series of questions you need to ask programs with three more areas of focus. Remember that each and every program will have some time for you to ask THEM questions. Not asking anything makes you come across as uninterested, asking something you can look up online makes you look like you didn’t do your homework, and asking good questions can show that you know what you are talking about.  

I’ll follow the AAMC document introduced last episode, link in the shownotes, and and cover three new topics. My goal is to explain the logic behind them, and let you know what to expect in an answer.

Employment Issues

  • What are the basic resident benefits?
  • Is parking a concern for residents at your program?
  • Are meals paid for when on call?
  • What is your family leave policy?
  • Is there reimbursement for educational supplies and books?
  • Are moonlighting opportunities available?
  • What are the rules for moonlighting?
  • How are residents represented at the institution level?

How is the resident member of GMEC selected?

  • Is there a union? Is membership mandatory? Are there dues?
  • Is there a House Officers Association?

Questions to specifically ask other Residents

  • What are the strengths and weaknesses of the program?
  • Would you consider the same program if applying again?
  • Is there an appropriate balance between service obligations and the educational program?
  • Is there enough ancillary support to minimize "scut?"
  • What has changed since you came to the program?
  • Is the program responsive to suggestions for change?
  • How accessible is the faculty?
  • Is the relationship with faculty collegial?
  • Do the residents get along with one another?
  • How do your residents get along with residents in other programs?
  • In what activities are you involved outside of the program?
  • How does your spouse/significant other like the city/area?

Questions to ask Yourself

Finally, you will likely find yourself facing a decision between one of several programs which are all extremely similar from academic and patient-care standpoints. At this

time, it is very important to consider factors relating to your personal happiness and comfort for the duration of your residency.

  • Can I be happy working in this program and with these people?
  • Am I confident in the program and the sponsoring institution?
  • Are there factors that make this place (city/town/rural area) an attrac

tive place for me to live during my residency? (Factors that you may include are prox

imity to immediate and extended family, happiness of spouse/significant other, housing, cost of living, quality of secondary school system, community opportunities,

and recreational activities.)

Closing:

Unfortunately that’s all the time we have for today’s show. Thanks for listening, hope you enjoyed the content and find it useful.

Please subscribe to catch each new episode as they are uploaded, and if you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

Remember to send your questions to us through our website at www.thematchgurus.com, or twitter @theMatchGurus - I personally answer every email and twitter DM we get.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

 Our book is also available on Amazon in paperback and eBook - less than 10 bucks - it is a quick read you can easily knock out on the flight to your next interview. If you find it helpful, please take some time to leave a review for that on Amazon as well - it means a lot. And of course, any of you looking for in-depth specialty-specific preparation for your interviews drop me a line and we can discuss our coaching packages. Take care.

Oct 10, 2016

Today I’ll continue the series of questions you need to ask programs with three more areas of focus. Remember that each and every program will have some time for you to ask THEM questions. Not asking anything makes you come across as uninterested, asking something you can look up online makes you look like you didn’t do your homework, and asking good questins can show taht you know what you are talking about.  

I’ll follow the AAMC document introduced last episode, link in the shownotes, and and cover three new topics. My goal is to explain the logic behind them, and let you know what to expect in an answer.

Clinical Duties

  • What is the general call schedule?
  • What provisions are made for back-up call or sick-call coverage?
  • What type of structure for supervision is in place?
  • Do your residents express that there is an appropriate balance between independence and supervision?
  • How does the resident’s autonomy change as he/she progresses through the program?
  • What type of ancillary support is available (phlebotomy, respiratory therapy, social workers, etc.)?
  • Does the general volume of clinical responsibility support a balance between service and education?
  • Do your residents express they are involved in too much non-educational activity (i.e., “scut work”)?

Resident Performance

  • How often are residents evaluated?
  • What is the structure of the evaluation (forms, face-to-face, etc.)?
  • What other forms of feedback does the resident receive ( in-training exam, etc.)?
  • What support structures are in place for residents in academic need?

Program Performance

  • What is the status of the program’s accreditation?
  • If there were any citations at the last review, what has been done to correct them?
  • When is the next Residency Review Committee (RRC) review?
  • Are there any plans for changing the program size or structure?
  • What is the status of the last Accreditation Council for Graduate Medical Education (ACGME) Institutional Review?
  • How solid is the financial status of the sponsoring institution?
  • How committed is your institution to resident education and graduate medical education in general? How isthis evidenced?
  • What percent of your residents complete your program?
  • What percent of your graduates pass the specialty boards on their first attempt?
  • Where do your graduates go (e.g., fellowship, academics, private practice)?

Closing:

Unfortunately that’s all the time we have for today’s show. Thanks for listening, hope you enjoyed the content and find it useful.

Please subscribe to catch each new episode as they are uploaded, and if you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

Remember to send your questions to us through our website at www.thematchgurus.com, or twitter @theMatchGurus - I personally answer every email and twitter DM we get.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

 Our book is also available on Amazon in paperback and eBook - less than 10 bucks - it is a quick read you can easily knock out on the flight to your next interview. If you find it helpful, please take some time to leave a review for that on Amazon as well - it means a lot. And of course, any of you looking for in-depth specialty-specific preparation for your interviews drop me a line and we can discuss our coaching packages and mock interview services. Take care.

Oct 10, 2016

Over the next four episodes, I’ll cover the questions you need to ask programs. Don’t forget - during the interview process, they ask you plenty of questions, but each and every program will have some time for you to ask THEM questions. First of all, always have a question. Not asking anything makes you come across as uninterested.  

Instead of reinventing the wheel, there exists a PDF file online that has been floating around for many years put out but the AAMC that does a great job of breaking down the types of questions that will help you determine if a program is right for you. In the next few episodes, I’ll break those down for you, and let you know what to expect, why they are important questions, and what to look for in answers.

As always, there is a link to the document in the shownotes, or you can just google AAMC “Don’t Forget to Ask.”   

The document starts:

Don't Forget to Ask:

Advice from Residents on

What to Ask During the Residency Interview

The process of applying and interviewing for a residency position is complicated and can be stressful. This process involves both “selling” yourself to a program, as well as collecting the information that you will need in deciding how to rank the various programs you visit. Programs that you consider will all have unique strengths and weaknesses—some of which may not immediately apparent. The following list of questions was created by residents and students from various backgrounds as a guide to assist you in identifying and assessing those strengths and weaknesses. Use this guide in constructing your own more specific questions, and in exploring your own expectations and preferences. Your residency training is an important experience. Identifying the program that is best suited to meet your educational and professional expectations is paramount. Some questions are best answered by other residents in the program, and some questions you will need to ask yourself. Ask the program administrators and residents for specific examples that give a true understanding of the program.

Be honest with yourself about how you want your residency experience to be structured. Good luck! And remember, always be yourself.

Education

  • Is there an orientation program for incoming residents?
  • Is there a formal didactic curriculum, and what is its structure?
  • What are the informal learning opportunities (i.e., bedside rounds, etc.)?
  • What programs exist for resident education (e.g. , lectures, journal clubs, grand rounds, board review courses,)?
  • Is there a feedback structure that allows for the resident to evaluate the program’s curriculum?
  • Is attendance at regional and national conferences encouraged? Is it funded, and, if so, to what degree?
  • What are the required rotations for the first year? Subsequent years?
  • Are then any required rotations that take place outside of the city?
  • Are there opportunities to do “away” rotations?
  • Is there a formal mentoring program for new residents, and do faculty serve as mentors?

Research Opportunities

  • Are research opportunities provided to residents? Is this a required experience?
  • Is there a possibility of "protected" time for research?
  • How are fellowships handled?

Teaching Responsibilities

  • What teaching responsibilities for medical students are expected of residents?
  • If residents have teaching responsibilities, how much time per week is spent with students? Is it "protected"?
  • Is there any formal training for residents on how to teach students and other learners effectively, and how to

provide feedback?

Closing:

Unfortunately that’s all the time we have for today’s show. Thanks for listening, hope you enjoyed the content and find it useful.

Please subscribe to catch each new episode as they are uploaded, and if you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

Remember to send your questions to us through our website at www.thematchgurus.com, or twitter @theMatchGurus - I personally answer every email and twitter DM we get.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

 Our book is also available on Amazon in both paperback and eBook format - less than 10 bucks - it is a quick read you can easily knock out on the flight to your next interview. If you find it helpful, please take some time to leave a review for that on Amazon as well - it would means a lot. And of course, any of you looking for in-depth specialty-specific preparation for your interviews drop me a line and we can discuss our coaching packages and mock interview services. Allright, take care.

Sep 17, 2016

Let’s continue breaking down some common questions you will experience on the interview trail. Dr. Mike Olson and I will discuss what we think the “question behind the question” is, and what programs are looking for in an answer.

Questions about your behavior. For example:

 

  • Tell me about a stressful patient encounter you had in medical school and how you handled it.
  • Tell me about a time you disagreed with an attending physician and how you handled the situation.
  • Tell me about a time you had to work with someone you didn’t like - what was the outcome?
  • Tell me about the last time you failed at something.

 

 

Questions about your personality. For example:

 

  • Tell me a joke.
  • If you were a plant, what type of plant would you be?
  • Draw a picture of me as a character in your favorite movie.

 

 

Unfortunately that’s all the time we have for today’s show. If today’s topic struck a cord with you and you would like to practice your interviewing skills, drop us a line over at the MatchGurus.com and we will set up a speciality-specific coaching package and mock-interviews designed specifically for you. We still have a few slots open, and interview season is just around the corner. 

Please subscribe to catch each new episode as they are uploaded each week.  If you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse


Thank you to everyone for listening, remember to send you questions to us through our website at www.thematchgurus.com, or twitter @theMatchGurus.  Our book is also available on Amazon - please leave a review there as well. Take care.

Sep 17, 2016

Let’s continue breaking down some common questions you will experience on the interview trail. Dr. Mike Olson and I will discuss what we think the “question behind the question” is, and what programs are looking for in an answer.

Questions about previous patient cases. For example:

 

  • What was the most interesting surgical procedure you scrubbed on and why?
  • Tell me about your most memorable patient experience.

 

Questions based on ACGME Core Competencies. For example:

 

  • What does professionalism mean to you?
  • Tell me about a time you were able to work in an interdisciplinary team successfully.
  • How familiar are you with evidence-based medicine in decision making?

 

Questions about clinical decision making. For example:

 

  • Are you familiar with the new hypertension guidelines?
  • Tell me what you know about the treatment of COPD exacerbations.
  • If you are paged to the ICU and find an unresponsive patient, what is your first instinct?

 

Unfortunately that’s all the time we have for today’s show. If today’s topic struck a cord with you and you would like to practice your intervieweing skills, drop us a line over at the MatchGurus.com and we will set up a speciality-specific coaching package and mock-interviews designed specifically for you. We still have a few slots open, and interview season is just around the corner.  

 

Please subscribe to catch each new episode as they are uploaded each week.  If you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

Thank you to everyone for listening, remember to send you questions to us through our website at www.thematchgurus.com, or twitter @theMatchGurus.  Our book is also available on Amazon - please leave a review there as well. Take care.

Sep 16, 2016

In the next three episodes I want to help break down some of the most common questions you will experience on the interview trail, as well as some uncommon and even illegal ones. Dr. Mike Olson and I will discuss what we think the “question behind the question” is, and what programs are looking for in an answer.

In this episode, we will discuss questions about you, questions about your future goals, and questions about the field you are applying to.

Questions about you. For example:

 

  • Tell me a little bit about yourself.
  • Who would you say “you” are?
  • How would your friends describe you?
  • How do you spend your free time?

 

 

Questions about your future goals. For example:

 

  • Why do you want to be an emergency physician?
  • Where do you see yourself in five years?
  • What does the ideal residency look like to you?
  • What are your post graduation plans?

 

 

Questions about your chosen profession. For example:

 

  • Which personality traits do you have that will make you a successful surgeon?
  • Who inspired your interest in Urology?
  • Where do you see the field of pediatrics in 10 years?

 

 

If today’s topic struck a cord with you and you would like to practice your intervieweing skills, drop us a line over at the MatchGurus.com and we will set up a speciality-specific coaching package and mock-interviews designed specifically for you. We still have a few slots open, and interview season is just around the corner. 

Please subscribe to catch each new episode as they are uploaded each week.  If you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

Thank you to everyone for listening, remember to send you questions to us through our website at www.thematchgurus.com, or twitter @theMatchGurus.  Our book is also available on Amazon - please leave a review there as well. Take care.

Aug 30, 2016

Questions on today’s podcast come to us from Dr. Sagar Shah via twitter - you can follow him @thisissagarshah In a short exchange he asked questions a lot of our IMG clients ask, and I thought the answers would be valuable to a wider audience, so I’ll answer them here. There is a lot of good information available online from different sources like the ECFMG, ERAS, etc.  so I won’t regurgitate a lot of that stuff and will instead give more personal advice.

Any US student who wants to get a bit of understanding may also gain some insight from today’s topics. As you may remember from earlier episodes, only about 50% of any given match year over the last 10 years has been US allopathic MDs, IMGs made up about 40% of the pool or may not know, IMGs currently make up about 25% of the physician workforce. Most of those in Internal medicine, psych, pedi - more primary specialties. Regionally, New Jersey, New York, Florida, and Illinois had the highest concentration of IMGs when last polled in 2009 - could have shifted a bit since. The country supplying the most IMGs is India, the Caribbean schools collectively make up a huge chunk - Dominica, Grenada, Netherlands Antilles, then Pakistan, China, Philippines, Mexico - overall 127 different countries granting ECFMG certificates in this 2009 paper. So, a bit of perspective - as a US student you will absolutely work with an FMG in the near future, and as an FMG, you will not be alone when you match into a US residency program. Let's get into the questions:

Dr. Shah asks: Can you give a good strategy for IMGs?

This is a very loaded question with about 50 questions encapsulated into this one - so I think I know what you are asking and I’ll try and outline a “good strategy” for any IMG.  When we work with clients, each individual candidate is unique - geography, speciality, graduation year, family concerns, US experience, visa status, etc - so it is hard to point a whole group of people in one direction with advice, but there are some highlights:

  • Do as well as you possibly can on the USMLE. I can not emphasize this enough.  Some foreign schools already have credibility in certain states or in certain programs so that PDs and state licensing boards are familiar with the caliber of graduates that come out of them. Lots don’t - so doing well on a standardized test makes you look good comparing apples to apples. Be prepared to do whatever it takes - multiple review courses, thousands of dollars, multiple months off for individual study.  SImply put, the higher your score, the better your chances.
  • Know your priorities - as an FMG, getting a US residency spot is already a hard process, for you and your family, and it is a hard choice both personally and professionally when deciding what you are going to prioritize. Ultimately you may find yourself needing to choose between practicing any type of medicine in the US vs practicing a specific specialty anywhere on earth. You will often see IM or FM residents in US programs who were Orthopedic Surgeons or Ophthalmologists in their home countries, but they choose to change specialty to practice medicine in the US. On the flip side you see US citizens who go out of the country for medical education, fall in love with Dermatology or Otolaryngology to the point that they remain in their training country to practice that passion instead of trying to get into the hyper competitive US options. Think about these options when deciding what would benefit you and your loved ones the most.  
  • Be flexible - the saying “beggars can't be choosers” absolutely applies here - apply to a huge number of programs, and absolutely apply to multiple specialties. Consider multiple geographic regions.  If finances are a strain, you can focus your efforts, but the reality is that extra 12/16/26 dollar fee to tack on one more program is a drop in a bucket and can get your foot in the door to a six figure salary for the rest of your career - now is not the time to pinch pennies.
  • Be realistic - short term - knowing where to apply and how to go about it, and long term as well. Some IMGs end up compromise too much and get stuck in patterns of multiple prelim years, malignant programs, grad school, and other endeavors to try and become more competitive for the match and can paradoxically become less competitive, and really mount up debt. Some test prep courses can be these endless loops of multiple time test takers, who can ace qbanks but not get residencies - end up a tutors, advisors, lab assistants, phlebotomists, foreign MDs are definately not guaranteed anything in the US. Know how competitive you are and focus your efforts accordingly.
  • Use your connections - anyone you know - and I mean anyone, previous alumni, any friends or relatives, anyone you rotated with on AI or observership.
  • Play to your strengths - whenever the opportunity arises - PS, LORs, interview, make sure you let them know you speak multiple languages, talk about your hands-on experience, paint a picture of IMGs as a group that is hungrier, harder working, more resilient, more flexible - willing and able to move countries to train.  As any US students listening may not realize that different countries have regulatory bodies and medical training outside of the US can be drastically different - US students have curriculum that can be evidence based, problem based, well researched, validated tools, etc. learn from an online module, and get excited when an attending lets them throw a few simple interrupted sutures during closing - when students in Mexico for example don’t have the luxury of having a note taking service, or even professors who know what is covered on Step 1, but they were first assist in transplant cases with a resident in charge  - no fellow, resident, other students fighting for the case.
  • Be optimistic - don’t believe everything you read on SDN or valueMD or other forums. Plenty of IMGs have jobs. In fact, IMGs make up about 25% of the current physician workforce.  This is a subject that hits close to home as personally, I am an IMG, and it is the reason I wrote my book and the reason I started this business was to help IMGs - I think they are a vital portion of the medical workforce and bring elements to US medicine that will continue to drive it forward. “Millennial” generation with note taking services, angry when a professor didn’t tell them what question was going to be on a test, upset over anything less than perfect on an evaluation form - nauseating and not indicative of patient care. IMGs traditionally flying blind, fighting tooth and nail for any position available often taking USMLE on their own, with bootleg study review materials, fighting for any leg up, fighting to find material relevant to the USMLE vs deciding between 4-5 books to see which is best. A handful of common US student complaints are about not getting enough away rotations, or the lack of financial support or housing, or getting an evaluation from a resident that an attending signs, or even an attending you didn’t really spend time with. Meanwhile IMGs may have clinical rotations in 7 different cities with a loose word-of mouth network of where to live, and shared subway cards, IM in Chicago, then OB in NYC, Psych in LA - and they are grateful for a LRO in English from ANYONE, much less the person who will give them the best letter.  Long list of intangibles that IMGs deal with often that departments may or may not know - you have been through a lot, you will get through this too.

Dr. Shah asks: What is more important for IMGs - research work, or electives and observerships?

  • Clinical, clinical, clinical. Research is important, but to frankly answer this question, I have to emphasize clinical patient care. You are looking to get into a program to take care of patients, so show them you can take care of patients - the more involved the better. Get an LOR out of the experience, and if possible get it at a hospital you want to train at.

Dr. Shah asks: What are the common mistakes made by IMGs when applying to residency programs?

  • Prior to applying - Not doing your homework - not using connections, not looking at the specifics of visa paperwork, how to get one, which ones you need, if a program will sponsor it. State specific in some cases, program specific.
  • Commonly overestimate their value - look at your scores, look at your application, you will not get ortho - there is a difference in being optimistic and being delusional - miracles may happen elsewhere, but don’t bank on it in the Match.
  • Commonly underestimate their value - in the current landscape, there are still not enough US grads to fill all of the available spots - your life, happiness and career are not worth too much compromise. Bad program, on probation, abusing residents, poor education, poor employment opportunities - that will be a bigger stain on your record than your foreign school - at the next level you are always judged by the most recent level - you are no longer a *** grad, you are a *** resident.
  • Common mistakes during the interview I have seen - focusing too much on justifying academic performance - many foreign schools work on strictly objective, merit-based rewards - highest score gets the highest spot. I encourage all of our IMG clients to remember the social component - telling families they lost a loved one, discussing cancer diagnoses, end of life care, navigating health system beliefs.
  • Nuances of the english language lost in translation - miscarriage vs abortion, obesity vs fat, spanish culture.    
  • Forgetting that this is a job to learn - when coaching US clients we usually work on US lifelong student changing a mindset from student to employee - need to work on projecting leadership / confidence / reliability / autonomy that go with patient care, and dampen the submissive, passive traits. IMGs I see a lot of the opposite - well established physicians that may carry respect / klout to a degree that need to change mindset to a more traditional learner. Programs don’t want to but heads with someone for multiple years who is coming in and telling them how to do things or how they used to do things back home - you are there to learn from these people, learning pt care, learning communication, learning procedures - even if you have performed 200 knee replacements back home, you are interviewing to be an intern  next year - wound vac changes, bowel disimpaction, perhaps someone half your age being your superior, etc - show THAT aspect of your personality.

For our last question today, Dr. Shah asks: Looking at the current scenario can an IMG with a green card get into Radiology residency?

Yes - do your homework, be flexible, be realistic, know yourself - all of the above apply. Know that they are not going to hand it to you, and you are going to have to work for it, but be optimistic. FIrst I would make sure I was a competitive applicant - are my scores well above average? Would my application as a US student be competitive? Look at “Charting outcomes in the Match” - diagnostic radiology - step 1 235, step 2 240 - Data shows while most applicants matched at 240 and above, 14 of these “independent applicants” matched with 200 or less.

If you were a client, I would polish your application - make sure your strengths come across as strengths, and any red / yellow flags are addressed. CV polished, appropriate experiences highlighted, perfect multiple PS, LORs appropriately uploaded. Etc.

Create a spreadsheet, look at every website to determine if they are “IMG friendly”, or call them all - or even outsource that.  When I was applying freelancing was taking off, I hired a virtual assistant call every program coordinator I was interested in and ask bluntly about cutoffs and multiple attempts, IMGs - whatever your specific situation. If you were my client, that is something we can arrange for you.

Once you have your list, polish your application - would tweaks in your PS add to your application? - geography specific or school specific - are you familiar with a professor’s works, research,etc. Mention these specifics so they stand out once you clear the initial hurdles.

Then, apply to every single one you can afford.

That would then generate a handful of interview invitations, I would walk you through how to communicate with programs, how to best schedule, and we would practice radiology-specific mock interviews with explicit feedback on body language, diction and word choice, confidence, how to tell your story given different interviewer styles or different question types to make sure you are your best self to these handful of people in a handful of hours. We would help you create your rank list, and sit back and wait patiently. There are some other pre and post communication nuances we could coach you through if they arise.

As a backup plan, take that same list of programs, and apply across the board to preliminary medicine (or surgery) programs with radiology departments you want to train at - if you don’t match in radiology, you will at least have a US residency spot as a foothold. I would show you how to structure your rank list to set you up to rank at any radiology program first, then fall to your top choice IM program. During that year, spend every free moment with the radiologists and let them know your interest. Radiology reading rooms - trauma call in the ED - hang out with the residents, and talk with faculty if available - let them know your interest bluntly and that you will be applying next year. To a US residency program, a year spent in US clinical medicine is better than 5 years at the best hospital in any other country, research, perfect step scores, etc. You would now be Dr. Shah, intern at *** IM program. Keep up with radiology CME websites / trending news - be able to discuss specifics of scans - really impress these people.  They will be doing the interviews, can pass the word up the ladder, and the more senior resident will be the chief residents.

In addition, there are rare opportunities to jump into available spots mid-year - so we would be looking for any available spot that opens mid-year - funding is attached to resident slots, so if people leave secondary to illness or family crisis, or disciplinary action,etc. , there are opportunities to move laterally into programs.

Not foolproof, and no guarantees, but a solid plan to set you up to be that approximately 30% of the entering PGY 2 class that comes from outside of US allopathic seniors.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

Aug 21, 2016

Hey everybody this is Myers Hurt with another edition of “Countdown to Match Day,” the official podcast of the Match Gurus, and the only podcast aimed at helping applicants shine on interview day. Remember to follow us on twitter @theMatchGurus and send any questions you want answered on the show. If you like the content please take some time to leave a review on iTunes, or review the book on Amazon.

In true countdown style, this season we’ll release one podcast each week for the 40 weeks leading up to Match Day.  This is season 1 episode 9 - now 32 weeks to go until #MatchDay2017. Let’s get started:

What to expect - usually the resident dinner is a collection of applicants and residents, set up as an informal environment to get some questions answered from the resident point of view. There is no set question time / eating time, it just flows naturally.

Who will be there: residents and their significant others - specifically to answer the most amount of questions for the most amount of people. Consider the scheduling from the other side. Residents already feel overworked and underpaid - even with free food as an incentive - it says a lot to volunteer time to go out after a 12-16 hr day only to talk about how much you love that 12 or 16 hour day. Consider the timeline as well - as chief I could always get people fighting over the first few free steaks, then late in the season it could be pulling teeth.

Who to bring: spouses are ok, children, parents, friends - even girlfriends/boyfriends are not. No need to bring anything to take notes, anything to try and impress people - just an opportunity to be yourself.

What to wear: not a suit, not jeans and a t-shirt - something in between - a business lunch or business dinner. Collared shirt with or without blazer, good rule of thumb is it is always easier to dress down instead of dressing up.

What to order: If you have any preferences as far as vegetarianism, vegan, kosher, food allergies, etc - feel free to mention to the program coordinator - feel free to communicate without being judged.

Alcohol - borderline issue - never be the first to order alcohol, tea, water, soda are safe bets - if the most senior person at the table orders a beer or some wine, feel like the ice is broken, and go for it. Always ok to abstain without fear of being judged, just don’t order bottle service, not Jersey Shore. Remember that you are always being interviewed. I understand both arguments - in a stressful environment, one glass of wine takes the edge off, however, if alcohol makes you anything less than your best self, best to abstain.

Nothing new - allergies, don’t like the taste.  Nothing sloppy or saucy - think first date - want to enjoy a civilized meal in a nice setting, no need to wear most of your dinner, or embarrass yourself.

What questions to ask: “front line” questions - parking, housing, child care, - things that are important to you.  As well as how they feel - do they get along with faculty, do they get along with each other, do they feel like they are learning, good balance of learning and autonomy to learn by doing

Pearls: remember the resident’s names - it always comes up the next day - who did you go out with? Multiple people ask, and simply by remembering the names of your future colleagues shows an incredible amount of interest. Forgetting people or forgetting what you talked about is a red flag.

You are being watched - how you interact with the waitstaff, hostess, etc all reflects on how you will work in a team. In the hospital, you have nurses, students, PT, OT, maintenance, dietary, mid levels, attendings, etc - I’m Texan, so yes ma’am, no ma’am and holding doors open for people is second nature, but anyone rude to the waiter or waitress is absolutely going to hear about it. Would always be suspect of a candidate who was rude.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

Thank you to everyone for listening, remember to send you questions to us through our website at www.thematchgurus.com, twitter @theMatchGurus, or snapchat.  Our book is now available on Amazon - please leave a review there as well. Take care.

Aug 21, 2016

Hey everybody this is Myers Hurt with another edition of “Countdown to Match Day,” the official podcast of the Match Gurus, and the only podcast aimed at helping applicants shine on interview day. Remember to follow us on twitter @theMatchGurus and send any questions you want answered on the show. If you like the content please take some time to leave a review on iTunes, or review the book on Amazon.

In true countdown style, this season we’ll release one podcast each week for the 40 weeks leading up to Match Day.  This is season 1 episode 8- now 33 weeks to go until #MatchDay2017. Let’s get started:

In this episode, I talk with Dr. Mike McInnis - we talk about Internal Medicine, how to identify a good Internal Medicine program, introverted personalities, and social medic during the interview season.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

Thank you to everyone for listening, remember to send you questions to us through our website at www.thematchgurus.com, twitter @theMatchGurus, or snapchat.  Our book is now available on Amazon - please leave a review there as well. Take care.

Aug 4, 2016

I want to break format today and talk exclusively about the personal statement this episode. I know a lot of you already have one, or have at least a draft of one, but with enough time between now and September 15th (and even after that) I will help you make it better.  

I think there is a sort of comfort level and confidence that med students approach the PS with and that is fair - because all of your previous personal statements up until now worked. Lots of positive reinforcement - positive thing - however those were personal statements for you to convince people you are good at reading, studying, and taking tests.

Residency is a job. Literally the first “real” job you will have as a physician. This is a personal statement to convince programs you deserve a job.  Lean away from telling them you have objective skills, and towards subjective skills. Demonstrate professionalism, communication skills, teamwork, goal setting, and understand the challenges and demands of the road ahead, and still want to make a living at it.

Almost breeds an inherent difficulty as the typical med student had curriculum focused on math and science, or at least prioritize them over language and arts, now asked to produce a written piece that we are not necessarily that comfortable with. To add to the discomfort this a rare moment that you are both the salesperson and the product.

NRMP data from the 2014 program director’s survey ranks it as the fifth factor used when deciding who to extend interview invitations to (Step 1, LORs in the speciality, MSE (Deans letter), step 2 CK, then personal statement) and about halfway down when deciding who to rank - so it is up there to get your foot in the door.

I would consider it one of the only subjective methods to tell your story before the interview - CVs and transcripts, USMLE scores all fit into boxes well, LORs and dean’s letter are what others say about you - PS is the only chance you have to tell you story - talk about yourself.

 

  • More important to a program that does not know you - no rotations, no sub-Is, no away rotations - how are they going to get to know you and your work ethic?

 

  • Opportunity to briefly explain any gaps in your record - if done carefully and cast in a positive light

 

  • Proficiency in english language - for IMGs from unknown schools

 

  • Behavior patterns: Writing styles that can identify positive or negative behavior traits - I,I,I,I - narcissism, whereas too much self-depreciation or responsibility sloughing may shine through

 

If you haven’t looked at MyERAS yet - there is no specific prompt - extremely open ended - what should you write about?

 

Personal statements need to be:

 

Written by you

 

A study performed by the Brigham and Women's Hospital In Boston, Massachusetts published in MedScape article ''Level of Plagiarism in Residency Application Essays Worrisome'' revealed that 13.7% of Personal Statements submitted by IMGs to IM, Anesthesiology, and Surgery programs at the hospital were plagiarized.

 

Plagerism http://www.ncbi.nlm.nih.gov/pubmed/26462161 - plagerism scanning software in anesthesiology applications 4% of US grads, 13% of IMGS 8 words or more of unoriginal content - as much as 58% percent of the statemetn unoriginal.

 

Polished of all spelling errors - spell check, multiple edits, multiple proofreaders.

 

Friends and family are ok, but they already like you - i recommend involving a third party for an unbiased approach

 

Reddit / SDN “PS swaps” are a decent choice - although the opinion of other 4th years is not necessarily the best

 

Does benefit you to get it read by someone who has done it before - even last year’s MS4s / current interns.

 

Read it out loud - clear / concise wording

 

Polished of all grammatical errors

 

I love Grammarly /

 

Consider using a professional service / scribindi / fivver / odesk / Match Gurus

 

Formatted appropriately for MyERAS - one page, 600-700 words - ASCI formatting - so no bolds, italics, or underlining shows up - no emojis - you need to make your points pop with actual english words.

 

The MyERAS application can be viewed as a PDF version of the information entered in MyERAS by selecting View/Print MyERAS Application located on the Application section on the Dashboard and top-right area of every page under the Application section. This allows you to see how the contents of the MyERAS application will be displayed to programs.



Steps to take:

Start now - sometimes attendings ask for PS and CV for writing your LORs

 

Brainstorm - entertaining stories, even and maybe especially even inappropriate ones - what elements of your personality can you draw out of those moments?

 

Structure - opening, closing, know what you want to say and how you want to say it

 

Aim for a balance of past, present, and future in the speciality

 

Familiarize yourself with the ERAS requirements - length and formatting

 

Don’t be afraid to start over - if you hit on something that really resonates with you - start again

 

Answer the obvious questions - why this speciality, why do you think you will excel?

http://www.ncbi.nlm.nih.gov/pubmed/25342950 - 2012 resident class of UC Davis Derm residents matched vs unmatched - surprisingly those that specifically why they liked derm were higher in the matched, much higher trait were those who mentioned their desire to contribute to the medical literature.

 

Know your audience - all interviewers, not just PD, will look at to ask questions.

 

Know that if you are applying to different specialties, can use different statements, you can upload specific versions to specific programs if they have specifics in geography and school name - just make sure to send the correct one.

 

Things to avoid:

Lies / exaggeration

 

Plagiarism

 

Dashes / slashes, short abbreviations

 

“I knew i wanted to be a doctor when”

 

The opening impact statement / the opening quote “webster's defines” - overdone, may come back like fashion waves. I am personally guilty of this in a previous personal statement

 

Anything too outrageous - no ZDogg raps here - works well for him now, but don’t forget that he is still an internist from Stanford. I would actually love to have him on the show and find out his advice - I’ll reach out to him.

 

Too long = too boring

 

Don't talk shop - avoid medical jargon - these people already know more than you

 

Do not restate your CV in narrative or prose form

 

Don't rehash your medical school PS - you are already “in medicine” this is a statement of why this specialty - why specifically pathology or why specifically dermatology

 

Dont talk about personal illness - boring and an illegal question if they ask it another way - may even add some unconscious bias - just avoid it

 

No mention of religion, politics, or any other controversial issue. NOt a soapbox

 

Pearls and resources:

Knowing what I know now, if i were reapplying to family medicine, I would talk about my newfound passion for growing food, how I arrived at that passion through personal weight loss journey, then see health benefits in individual patients in published medical literature in Mediterranean diet, anti-inflammatory diet on cardiovascular risk, community health as far as community gardens, how these real live social networks help educate and promote health, simple upstream interventions that benefit pubic health. That can demonstrate an understanding of preventative health, community outreach, knowledge of health literature, goal setting and achievement, it is relevant to the specialty, personal reflection, long term involvement.

 

Medfools

 

AMA has good resources

 

UNC

 

ECFMG

 

MCW sample personal statements

 

Really knock it out of the park, talks about various sentence structure, diction and word choice, crisp and elegant writing, “The Elements of Style” by Strunk

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

Jul 27, 2016

Milestone:

We crossed 100 downloads! Combined total of the first 5 episodes, still, an exciting milestone, and I hope you guys continue to find some value in this format.  If you have a free second please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.

We are ramping up our website over at the Match Gurus, so check the website soon to add your e-mail to our mailing list. We are primarily a consulting group, and work with individual clients to identify strengths and weaknesses in your application and hone your interview skills - so check out our website for the specific services we offer.

Any of you looking for a consolidated guide on how to approach to interview season - my book is titled “Getting In” - available on Amazon in both kindle and paperback format - currently the lowest price book on the market for residency interviews - I know how books add up in med school and am making a conscious effort to keep that product at a reasonable price point so you get more bank for your buck.

Residency timeline update: Hope you are all working on your personal statements, and working hard in those rotations and Sub-Is to get glowing LORs - remember if you are struggling with your PS we can help - drop us a line over at theMatchGurus or DM us on twitter

I want to get into our first topic today, and that is knowing who will actually be interviewing you.

Who will be interviewing you:

Short answer - everybody. THIs is not a figurative expression either. Literally everyone you encounter from the second you receive an interview invitation has a say in your future. As we mentioned previously in our who’s who sement - most if not all of your pre-interview communication will be through a program coordinator. Treating them with respect goes a long way. No need to go overboard and send them gifts or anything, they won’t help position of candidates on a ROL directly, but they can absolutely turn any candidate into a DNR with any evidence of disrespect or poor communication skills.

More formally, you will generally be interviews by two groups of people - residents and faculty.  Traditionally, 2-3 junior residents and interns attend a social event, or pre-interview dinner the evening before your actual interview. These are people who have just now made the transition you are about to - great opportunity to ask them about their process in choosing the program, how they are experiencing their first few months, things they wish they had asked, or things they thought were important that turned out were not, etc.

Very informal, very social, your chance to ask practical questions in a relaxed atmosphere.  Good examples would be typical cases they see, typical hours, curriculum for interns for didactics. Even things like parking, day care, housing, transportation - more day to day practical questions are good for the residents and especially these dinners, and less so for the faculty.

Essentially a “Getting to know you” or “meet and greet” session that is less formal Q&A interview, and more “can we work with this person. This is of course, part of the whole interview package, and don’t confuse “informal” with “unprofessional.” You are very much on display and these people have an incredible say in who gets ranked and ultimately hired.

Interview day is typically reserved for senior level or chief residents and faculty. Faculty can include MDs, DOs, NP and PA involved in resident education, PhDs, educators or behaviorist. Programs are starting to integrate people who can evaluate the more “soft skills” required to train in medicine.

These are the people with the best info about fellowship placement, careers of recent graduates, current faculty strengths, future department goals (as a lot can change in 7 years - while an outgoing chief is thinking about next 6 months) Building new hospitals, clinic, getting new equipment either specifically for resident training, or treatment.

Do your homework and look into the interests of those who will be interviewing you. A little will go a long way, and you’ll be able to make conversation outside of the expected, obvious questions.

The second topic of the day involves our question of the day - and this weeks question comes to us from Travis:

Question of the day:

Does it look better to get a letter from the program director or a department chair?

Classic question, thanks for asking Travis. This comes up all the time - and the reddit medschool forum, SDN forums, ValueMD forums all have versions of the same answer - the best letter comes from the person who knows you best.

We all know these pillars of medicine in our own institutions - big names with hundreds of articles, book chapters, grant dollars, caseloads, etc - anything that is seen as god-like in medicine, and hope that by getting a letter with your name at the top, and their name at the bottom is a golden ticket.

That can absolutely be true. However, you would have to spend a significant amount of time with that attending, and they would have to be a good letter writer.

Ask the recent graduates now in their intern year (your ex-upper levels) who was open to writing a letter, and who seemed to have good letters.

Ask the secretaries / administrative assistants who writes good letters - they usually dictate them and upload them to ERAS - they will have unique insight into who writes quick one-liners vs who tells personal stories of strong recommendation.

No need to feel intimidated, you are not the first person to ask for an LOR - in academic medicine, faculty expect to write these things monthly. They can always say no - and don’t confuse that with the worst thing that can happen - it isn’t.  The worst thing that can happen is they say yes, then write you a sub-par letter.  Impersonal, generic, cookie-cutter letters absolutely scar an application.

Best way to approach it is to lead off with your intentions.  Usually during AIs and away rotations, the implied understanding is that you are there to impress and are at least interested in the field, as well as that specific program.  There is nothing wrong with stating your intentions once you arrive that you would like to work hard for the time you are there in order to produce a strong LOR. Let your upper levels on the team know, let your admin assistant contact know, and let the attending know. Volunteer yourself up front for anything above and beyond.  Show up early, stay late, do the grunt work, there to learn and there to impress.

Towards the end of your month, not 6:30pm on the Friday your rotation ends, touch base with your letter writer and phrase your question in a way that gives them an out. “Dr. soandso, as you know I’m looking to go into Radiology and really enjoyed my time here. Do you think you know enough about me and my work ethic to write a strong letter of recommendation?”

I love it - as a faculty member on the receiving end of questions like “Can you write me a letter” I would always say yes, and generate a good letter, but sometimes had to struggle to find good aspects I would want to highlight.  

Often times, faculty will offer to write letters for outstandingly strong students - never say no, as those will likely be some of your strongest.

Waive your right? I understand some of the bias, but I know plenty of people who give samples to the students as well. My personal policy was you waived your right, but I want you to also be praised and proud of the work you put in, at the very least send it home and make your parents proud.

Longest possible answer to your question, Travis - and I could go on - but to summarize - letters are often used after certain objective benchmarks are met, cutoffs are passed, and departments are teasing out who would be a better fit with a team. I read hundreds of letters, and personally written dozens - there are PDs who have reads tens of thousands. Bad ones are usually outstandingly bad - no matter whose name is at the bottom - “Jimmy is a great students, he was on time every day and always read his assigned articles. Patients really liked him.” tells us nothing.  Stories about a specific patient interaction, well thought out research, outstanding clinical and critical thought - these things speak volumes, regardless of who they are from - and the content is what you should be primarily concerned about. Get as many as you want, ERAS lets you pick and choose which letters you send where, no harm in collecting an excess. Better to have the problem of which to choose vs scrambling at the end to piece one together from an old preceptor.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

Jul 13, 2016

This is now season 1 episode 5 - 36 weeks to go until Match Day 2017 - let’s get into it:

First of all thanks to all of you for being patient - I know listening to me alone can get a bit monotonous, so I have arranged for a few interviews with program directors, program coordinators, and residents of different specialties to highlight specifics they recommend. I want to use this as a platform to share more specific, practical value with our listeners. Just like your questions - please feel free to send any suggestions you would like to hear on the show to me via twitter, snapchat, or our website.

Types of residency interviews:

Traditional - 1 on 1, interviewer has access to all of you application and can pull questions from all information

Blinded - typically also 1 on 1, however interviewer is blinded from some objective information (usually school name and USMLE scores) to help eliminate bias against higher scores or school

Panel - group of interviewers (residents and faculty) interview single applicant at a time

Group - “mix and mingle” format where faculty, residents, and applicants all interact - good look into group dynamics, see who functions well in team environments, who is a good listener, etc.

Multiple Mini Interviews (MMI) - originally Canadian, great at observing “soft skills” and EQ, format similar to USMLE Step 2 CS - 5 to 10 rooms, applicant moves around, questions rage from traditional to very abstract.  

Telephone - falling out of favor, typically reserved for IMGs during the SOAP

Video - starting to emerge as an option to help keep costs down, recent studies show more programs offering it as an option, California Anesthesia program showed similar match rate for video applicants.

Question of the Day:

What specifics made applicants stand out for the right reasons, and what specifics made applicants stand out for the wrong reasons?

Dr. Olson’s: answer: Poorly coordinated and poorly communicated interview process was a strong negative. Applicants that were engaging, timely, and sincerely interested in program goals are strong positives. Knowing something about the program helps convey genuine interest.

Dr. Hurt’s answer: Emphasis on the disrespect for office staff / program coordinator.  The legend of Puff Daddy. Positive standouts I personally remember involve travel stories, and interests outside of medicine.

Closing:

    Unfortunately that’s all the time we have for today’s show. Please subscribe to catch each new episode as they are uploaded each week.  If you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

Thank you to everyone for listening, remember to send you questions to us through our website at www.thematchgurus.com, twitter @theMatchGurus, or snapchat.  Our book is also now available on Amazon - please take the time to leave a review if you enjoy the material.  Take care.

Jul 13, 2016

In true countdown style, this season we’ll release one podcast each week for the 40 weeks leading up to Match Day.  This is season 1 episode 4 - now 37 weeks to go until Match Day 2017. Let’s get started:

We got some feedback about poor audio quality in the first few episodes, so I upgraded the microphone and added a pop filter - hopefully it is a bit more crisp now for all of our listeners.

Residency timeline update: now is the time that all of our DO listeners can start submitting applications for AOA residencies - for all MD candidates - you won't start until September so hang tight. If you wanted to start working on anything, you can start exploring MyERAS by using your token to register, complete your profile, and researching programs.

NRMP Numbers

  • NRMP - the numbers episode - who is applying, understand what you are up against
  • Data for 2016
  • Infographic
  • Applicant pool is made up of allopathic US seniors, allopathic US grads from previous years, DOs, Canadian grads, Fifth Pathway, US born IMGs and foreign-born IMGs
  • 42,370 total applicants in 2016
  • How to interpret the data
  • US seniors - the odds are not only that you will match, but that you will match at one of your top three choices. Relax a bit, and really tease out which program will be right for you, and focus on standing out among people exactly like you. Even if you are an all-star at your school, you will be interviewing alongside other all-stars for a limited number of spots. Also realize that you are only about 50% of the application pool, and don’t get cocky. Even if you think you are overqualified and extremely competitive for certain spots, take the process seriously. Every year since 2012 at least 5% of US seniors go unmatched.
  • Foreign grads - rejoice! We are still in a position that the number of US residency spots outnumber US allopathic senior graduates. While the odds are nowhere near as comforting as those for US grads, getting a US residency slot is far from impossible. When you do match, you are just as likely as a US grad to get one of your top 3 choices, as a total of 403 programs (over 1,000 spots) didn’t fill last year - apply correctly and you can stack the odds in your favor and avoid the SOAP.

The ACGME and their role:

  • The Accreditation Council for Graduate Medical Education is the body responsible for accrediting the majority of graduate medical training programs for physicians in the United States. They conduct audits / site visits of each program ratings from every 1 to 10 years to evaluate each residency program.
  • Duty hours, duty hour restrictions, elements of program funding, surgical and some speciality case logs, and how you will be evaluated during your residency
  • Knowing this now - before you start residency - will give you a leg up during your interviews.  The faculty conducting your interviews are already well-versed in this ACGME core competency system, so you can construct your answers to fit the molds already in place. You will come across as very informed, and have a leg up.
  • You may have heard the adage: to stand out during your fourth year work and act like an intern, to be a good intern work like a second year, etc.
  • Stanford site - throughout your residency, you will get feedback on the 6 core competencies  of: patient care, medical knowledge, practice-based learning and improvement, systems based practice, professionalism, interpersonal skills and communication.
  • Why is this important - accreditation - does indeed impact your career both in residency and after graduation.  Stripped Hopkins Internal Medicine for violating 80 hour work weeks in 2003, Yale General Surgery in 2002
  • Link to search programs

Question of the Day:

How important is undergraduate, medical school geography in my application?

Dr. Olson’s: answer: communicate how each location has influenced you, and how it will reflect in your training, also communicate clearly why this geographic region fits with your goals.

Dr. Hurt’s answer: You need to make it very clear that you would do well in any geographic region you want to train in. Residency is very difficult - having friends or family nearby communicates to programs that you have a sort of built-in support system, and can be seen as a strength. In your specific situation, if you are far from friends and family - mentioning that you were able to live far from home in the past and adjust well, and achieve success can be seen as a strength - it’s all how you present it.

I would also mention future goals when geography comes up - where you want to practice when you graduate, as even a subconscious bias exists trying to recruit top talent to the region, or even stay on as faculty where you trained. (Exactly what I did - family medicine in Texas while training in New York) Also consider what you would learn being in a certain region you couldn’t get elsewhere - training near a coal mine in West Virginia exposes you to lung pathology not seen other places in the country, Emergency medicine programs in Chicago are likely to have higher percentage of gunshot wounds than others, and coastal regions may have more fish hook trauma and jellyfish stings. Make sure to highlight exactly why the region is right for your situation now, and will benefit you moving forward.

Closing:

    Unfortunately that’s all the time we have for today’s show. Please subscribe to catch each new episode as they are uploaded each week.  If you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

Thank you to everyone for listening, remember to send you questions to us through our website at www.thematchgurus.com, twitter @theMatchGurus, or snapchat.  Our book is now available on Amazon - please leave a review there as well. Take care.

Jul 12, 2016

Intro Music:

Ryan Little “Get Up”

Hey everybody this is Myers Hurt with another edition of “Countdown to Match Day,” the official podcast of the Match Gurus, and the only podcast aimed at helping applicants shine on interview day. Remember to send any questions you want answered on the show via twitter @theMatchGurus or snapchat thematchgurus and we will get your questions answered.

In true countdown style, this season we’ll release one podcast each week for the 40 weeks leading up to Match Day 2017.  This is season 1 episode 3 - 38 weeks to go until Match Day 2017. Let’s jump into today’s topics of discussion:

The 5 Simple rules of Residency Interviews:

Rule #1: The program coordinator is your best friend

Rule #2: Know your goal

Rule #3: Do your homework

Rule #4: You are always being interviewed

Rule #5: Be yourself

Question of the Day:

What are your thoughts on taking an extra loan out for interview season?

Please subscribe to catch each new episode as they are uploaded each week.  If you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on. Check out our book on Amazon titled "Getting In" and please leave a review on Amazon if you find it helpful.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

Thank you to everyone for listening, remember to send you questions to us through our website at www.thematchgurus.com, twitter @theMatchGurus, or snapchat.  Take care.

 

Jul 12, 2016

Intro music:

Ryan Little “Get Up”

Hey everybody this is Myers Hurt with another edition of “Countdown to Match Day,” the official podcast of the Match Gurus, and the only podcast aimed at helping applicants shine on interview day. Remember to send any questions you want answered on the show via twitter @theMatchGurus or snapchat thematchgurus and we will get your questions answered.

In true countdown style, this season we’ll release one podcast each week for the 40 weeks leading up to Match Day 2017.  This is season 1 episode 2 - 39 weeks to go until Match Day 2017. Let’s jump into today’s topics of discussion.

Why focus on the interview?

Where and when the interview comes into play. Anecdotally, umbers get your foot in the door, interview gets you a job. To prove that, this is the Program Director Survey. This is 2014 data, but is the most recent they have available, and I’m hoping for a new document soon. If you read the introduction the response rate is just over 50% from program directors, but I would say it is still a good resource. The full doc is 148 pages, and divided into speciality-specific data sets, we can dissect those later in the season, but now I would invite you to look at Figure 1 on page 3 and Figure 2 on page 4.

Figure 1: Percentage of programs citing each factor in selecting applicants to interview.

THIS is why USMLE step 1 is so important. The USMLE is primarilty a test for state medical licencing borads (NBME / FSMB), desigend to see if students pass or fail, not necessarily a ranking system to see which students are best - residency programs adopted it as an objective comparrison tool. DoctorsInTraining, Kaplan, Pass Program, MedQuest, USMLEWorld, Pathoma, SketchyMedical - the list goes on  - these are such successful entities for this reason.

FIgure 2: Percentage of progarms citing each factor in ranking applicants.

I'm guilty of speaking in hyperbole - but this is any area I think deserves it. No exageration, these are the two figures that I think are life changing - they show how students with 99%ile scores don’t match, and how mediocre IMGs can get their first choice.  They answer almost every question on the ValueMD and SDN message boards. 

Is Step 3 important? Look at the chart.

Should I do an away rotation? Look at the chart.

How important are letters of recommendation? Look at the chart.

If you look through the entire document at the speciality you are applying to, you will be able to tease out nuances that your speciality values, and wht program directors in that speciality have explicitly stated they are interested in.

AAFP Strolling through the MATCH

The 2016 AAFP booklet. Admittedly, as a family practice doc I am mostly exposed to AAFP materials, but this is a document that serves all medical students, not just thoise interested in primary care.

My previous institution has a family medicine interest group that hosts an annual event that highlights this document.

General residency application timeline and checklist, listing the Table of Contents:  

Section 1 - Choosing a Specialty

Section 2 - IMG resources

Section 3 - Preparing your Credentials - CV, personal statement tips, LoR tips

Section 4 - Selecting a Program

Section 5 - The interview Process - etiquette, question types, etc

Section 6 - The Match: What is it and How it Works

Section 7 - The SOAP - Supplemental Offer and Acceptance Program

Section 8 - Resources

As you can see, a fairly robust document that is beneficial to all applicants, and a good place to look for up to date answers.

Question of the Day:

Alistair asks: Is research I did in undergrad signifignat enough to “count” for my ERAS application?

Closing:

    Unfortunately that’s all the time we have for today’s show. Please subscribe to catch each new episode as they are uploaded each week.  If you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on. Check out our book on Amazon titled "Getting In"

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

Thank you to everyone for listening, remember to send you questions to us through our website at www.thematchgurus.com, twitter @theMatchGurus, or snapchat.  Take care.

Jun 18, 2016

Intro Music:

Ryan Little “Get Up”

Hey everybody this is Myers Hurt with another edition of “Countdown to Match Day,” the official podcast of the Match Gurus, and the only podcast aimed at helping applicants shine on interview day. Remember to send any questions you want answered on the show via twitter @theMatchGurus or snapchat thematchgurus and we will get your questions answered.

In true countdown style, this season we’ll release one podcast each week for the 40 weeks leading up to Match Day 2017.  This is season 1 episode 1 - 40 weeks to go until Match Day 2017. Let’s jump into today’s topics of discussion.

The Alphabet Soup of Residency Applications:

ERAS - Electronic Residency Application Service - this is your application portal, and a service provided by the AAMC. You will be issued a token to register. Here is a good example of a YouTube tutorial for how to do that. For timeline, deadlines, and other reminders, follow ERAS on twitter @ERASinfo

NRMP - National Resident Matching Program - this is a third party organization that conducts the actual matching process. The R3 system - register, rank, results. Here is their calendar. Here is their checklist. Follow them on twitter @TheNRMP

FREIDA - Fellowship and Residency Electronic Interactive Database - list of all fellowship and residency programs published by the AMA, number of available spots, contact information, and other

ECFMG - Educational Commission of Foreign Medical Graduates - for international and foreign medical students applying to the US NRMP Match - you will go through them to get your token and upload documents. OASIS - Online Applicant Status and Information System

AAFP Strolling through the Match 2016 PDF

Who’s Who in the residency application process?

Chairperson: Head of an entire department - oversees medical student education, residency education, research, patient care, surgical simulation, finance, hiring and firing, and all other department-wide logistics.

Program Director: Head of the residency education slice of a department. This is who will be overseeing residency interviews, applications, and submitting the final rank list.

Program Coordinator: Administrative assistant to the residency department. Deals with new applicant communication, interview scheduling, current resident licensing, and even logistics for residency alumni.

Question of the Day:

Can you elaborate on the specific systems that residency programs use to evaluate residents?

Dr. Michael Olson’s: The academic aspect of evaluation will never go away, but more departments are interested in a holistic approach. Make sure your Step scores are competitive, be open, honest, and clear about gaps in education. Other evaluation method is social - from first email to relaxed moments with residents, to how you interact with the other applicants.  

Dr. Myers Hurt’s answer: Agree with the social and “EQ” components of evaluation. There is no standardized evaluation form, but there is often a form that your interviewers will complete with Likert scale (1-5) of certain qualities to help “objectify” subjective data, along with a “comment” section.

Please subscribe to catch each new episode as they are uploaded each week.  If you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on. Check out our book on Amazon, and leave a review if you find it helpful.

Thank you to everyone for listening, remember to send you questions to us through our website at www.thematchgurus.com, twitter @theMatchGurus, or snapchat.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

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