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:
Dr. Shah asks: What is more important for IMGs - research work, or electives and observerships?
Dr. Shah asks: What are the common mistakes made by IMGs when applying to residency programs?
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
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.
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.
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.
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.
AMA has good resources
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