Professional Development Series:
Part 3
How to Choose and Apply for
a Residency Program
Chariny Herring, DO
February 21, 2011
When to make the big decision……
Unraveling the Mysteries of the Residency
Application Process
Allopathic vs. Osteopathic
• Allopathic spots are more plentiful, but can be more
competitive. Check the % of osteopaths at allopathic
residency programs
• States with both DO/MD schools have more “mixed”
residencies
• If going allopathic, check for osteopathic compatibility
o What are the internship requirements to meet AOA
guidelines?
o Not meeting AOA requirements means you won’t be able to
sit for osteopathic specialty boards and you will get no CME
credit for taking allopathic boards
o http://www.aacom.org/InfoFor/students/careeradvice/Pages
/default.aspx
ACGME vs OGME Boards:
Step 1, 2, 3
• 1) Both?
• 2) OGME usually sufficient unless applying for
a highly competitive allopathic residency
Narrowing the List of Options
Don’t waste time or money!!!
Self check for competitiveness
Selection Criteria for Residency: Results of a National
Program Director’s Survey
(1207 Program directors from 20 specialties responded)
1. Grades in required clerkships
2. Step 1 board scores
3. Grades in senior electives in specialty
4. Number of honors in clerkships
5. Step 2 board score
6. Step 2 CS pass
7. Class rank
Selection Criteria for Residency: continued
8. Membership in Alpha Omega Alpha
9. Medical school reputation
10. Medical school academic awards
11. Grades in other senior electives
12. Grades in pre-clinical courses
13. Published medical school research
14. Research experience while in medical school
Green, Thomas and Jones AAMC 2008
http://www.aamc.org/members/gsa/sessionnine621jones.pdf
Pre-Interview
1) Find a program where you can learn “happily”
2) You are interviewing the residency program
(not the other way around at this point)
3) Talk to residents directly ( and not just the
“pre-selected” residents)
4) Check off list/take inventory of how each
program measures up to YOUR criteria before
you even consider applying
Pre-Interview List
• 1. Accreditation data/ranking
– Probation? ACGME for MD or OGME for DO
• 2. # of Residents in the program/unfilled slots/drop
out rate
• 3. Compliance with “TOAD” regulations
• 4. # of affiliated hospitals
• 5. Sites for rotating internship
• 6. Hospital/Clinic financial information/ budget cuts
or closings
• 7. Elective time/flexibility
Pre-Interview
• 8. SUPERVISION!!!!
• 9. Forecast of upcoming changes
• 10. Available associated fellowships/ % of
residents going into fellowships
• 11. Specialty Board Support and Prep and Pass
Rates
• 12. Resident support/”well being” resources
• 13. Resident Satisfaction
• 14. %FMG
Pre-Interview
• 15. Resident representation at the faculty
level/Elected “chief”
• 16. Teaching commitment/availability of the
faculty/Quality of conferences
• 17. Availability of the Program Director
• 18. Pt load per resident
• 19. Call frequency
• 20. Support staff and facilities (including UTD
technological abilities)
Pre-Interview
• 21. Salary
• 22. Moonlighting Opportunities
• 23. Benefits: Insurance (health &
malpractice), pager, food, vacation,
educational leave
• 24. What is the official process for filing a
complaint or affecting change?
• 25. Program strengths and weaknesses
Introduction to Residency Application
Process
Application
• Standard Application vs. Specific Application:
Standard APP is via ERAS for both MD and DO
Specific will be generated by the individual residency program
• Typos/grammar
• Professional picture:
Can use the one from school or email one to Angela Bacon
Has to be in an electronic format
Photographs
Do I need a new photograph?
Photographs
First Year
Photographs
Before
After
Application
• Letters of Reference:
–
–
–
–
1 from department chair
3 from chosen specialty docs
Do not send letters from academic professors, friends, relatives, or ministers
Can waive or retain rights to see letters/all letters reviewed and screened and
uploaded by A. Bacon.
• MSPE/Medical School Performance Eval:
–
–
–
–
–
–
–
(formerly know as the Dean’s Letter)
Eval of yrs 1,2,3
Quotes from site evaluations
Class Rank
In April, you will get and email with instructions on what you need to do/Can
meet with Dr. Stewart if special circumstances
June is the deadline
Will be given the chance to review it
Uploaded to ERAS in October
MSPE
Excerpt:
Histories and physicals are considered average. Fund of knowledge is
considered below average. Clinical judgment is considered average. Case
presentations are considered below average. Personal interactions and
communication skills are considered below average. Professional attitudes
and behavior are considered average. Overall he is an average to slightly
below average student. Faculty comments include:
“Adequate performance. He was reliable and typically competent. Hard to assess
knowledge as his responses seem below the 3rd year. He appears to be okay
regarding clinical judgment. His case presentations were a little too concise.
His histories and physicals are typically complete and accurate. He needs
improvement in knowledge, presentation, communication skills. Good
attitude and tried hard but has many deficiencies. Would be better If he
shows more initiative and interest in learning about surgical patient. He was
punctual. Apathetic; did not show interest. His history taking was too
succinct, not well-organized.”
Bad Letter
Personal Reference Letter
Dear Program Director:
It is my pleasure to provide this letter of recommendation for Applicant A. She is currently a
senior medical student at the University of ____________ and is expected to receive her DO
degree in June 2005. I worked with Applicant A while she was serving as an acting intern in
my surgical service.
Applicant A entered medical school with a background in research and the pharmaceutical
industry. Her added maturity has served her well in developing the skills necessary to
become a physician. As such her academic performance is not reflective of her clinical
abilities. Her attention to detail and concern for her patients’ well being is notable. She is a
true team player who is well liked by peers, faculty, and patients.
As a senior, she successfully completed the departmental honors program in surgery. This
program is an intensive eight week experience in the fundamentals of surgical science
designed specifically for students who will be competing for surgical residencies. She
functioned as an acting intern in the surgical ICU and consistently provided compassionate
and thorough patient care. Her patient presentations were well-organized and concise. She
was a model of professionalism.
I believe that Applicant A is dedicated to a career in surgery, and will work diligently toward
this goal. I sincerely recommend her to you for consideration. Please feel free to contact me
should you need further information.
Associate Professor of Surgery
Chief, General Surgery
Associate Program Director
Good Letter
Personal Reference Letter
Dear Program Director:
I have known Applicant C since his fourth year rotation on my General
Surgery Service. During his rotation I found him to be an outstanding
student. He was always well read regarding the patients who were
under his care. He treated all individuals, both hospital personnel and
patients with the utmost respect. His work was always top notch
because of his rapport with the patients and his meticulous and
thorough examinations and notes. Applicant C’s previous experience
in the _________ University Student Senate has prepared him with
maturity and a solid foundation of teamwork.
It is without hesitation that I highly recommend Applicant C for a position
in your residence program. He is a solid candidate in all frontiers. He is
personable, intelligent, hardworking, conscience and dependable.
Associate Professor of Surgery
Director, General Surgery Residency
Good Letter
Personal Reference Letter
Dear Program Director:
I have been asked to write a letter in support for Applicant B. I met
Applicant B this year when he rotated on our family practice service
as a subintern.
Applicant B is a kind and caring student. While on the service he followed
several patients and participated adequately. I would categorize him
as a good student and given the right environment he will really shine.
As you can see from his personal statement, he is passionate about
medicine. He has had some unique experiences and his family is
proud of his accomplishments. I have had time to discuss his plans
and he is committed to a career in family practice.
In summary, I recommend Applicant B for your training program.
Associate Professor of Family Practice
Average Letter
Application
• Curriculum Vitae /CV
– Name
– Contact Info
– Education: Medical, Graduate, College, High
School (school name, yr of grad, GPA and rank)
– Honors/Awards
Application
• CV:
– Publications/research
– Employment/Military
– Organizations/Clubs
– Hobbies/Interests/Languages
– Personal data (marital status, children)
– References
– CV workshop given in May by A. Bacon
Personal Statement
• 1 page or less
• Provides a window into your personality
• Can also be used to rule out people who are
not well spoken or have no tact
• Balance between bragging and humility
– Talk about accomplishments and abilities
– Reference inspiration by a mentor
– Personal story that led you to a career in medicine
– Discuss future plans (keep in mind program type
to which you are applying)
How to
for the Red Flags in
Resident Applications
RED FLAGS
Reference Letters
•
•
•
•
No letter from the Chairman or PD.
Letters from physicians in other specialties.
Less than three letters of reference.
Very short reference letter – no real content, especially
from the chairman.
• Chairman’s letter states you should call for additional
information.
• Concerning comments: “Given the right environment,
this student will do well”
“I have been asked to write this letter of reference” vs.
“I am delighted to provide a reference”
RED FLAGS
Dean’s Letter
•
•
•
•
No explanation of gaps in medical school.
Failed clerkship’s or lots of B’s and C’s.
Failed Board Exams
Last paragraph for final Dean’s recommendation
is vague or weak or doesn’t match other
recommendations/comments.
RED FLAGS
CV
• Large list of volunteer activities, of which all or most
are self serving.
• Multiple research projects and no publications.
• Disconnect between board scores and clerkship
grades.
• Consistent spelling errors in the application.
• A parent calls regarding their child’s application.
RED FLAGS
Personal Statement
• “Strange” personal statement.
• The word “I” is used on almost every line.
• If the applicant had a leave of absence from
medical school and does not address it in any
way.
• Typos
Preparing for the Interviews
• Create a folder for each program for which you have
applied
• Photocopy EVERYTHING you send out!
• Send each program a self addressed, stamped
postcard which they can return upon receipt of your
materials
• Create a master list with deadlines, interview date, etc
• Collect data on the program and place it in the folder
• Review the folder prior to each interview
Use the Application Data tracking Service (ADTS) within the ERAS
program to confirm which programs have received your
documents
Program
Name
Deadline to
Submit App
Items Sent
Date Sent
Postcard
Received
Interview
Date
Tulane
Jan 1
App, letters:
1/3, cv, pic,
ps
Nov 23
Pending
pending
Harvard
Dec 1
App, letters:
2/4, cv, pic,
ps
Oct 1
Nov 20
Jan 15
Preparing for the Interviews
• Set up a mock interview
• Prepare to answer the following questions:
1. What will you do if you do not match at our
facility?
Don’t want to give up easily, but be prepared with a back
up plan
2. Where do you see yourself in 5-10 yrs?
Rural vs urban, large vs small, research, teaching, private
practice, interest in subspecialization, avoid rigidity!
Preparing for the Interviews
3. Why did you apply to our program?
Show that you have done your research: give
examples of what has impressed you about the
program such as program reputation, resident
satisfaction, faculty members, research projects you
have heard about, board pass rates, etc.
Preparing for the Interviews
4. What are your strengths and weaknesses?
Interviewer is looking for tact, confidence,
humility, optimism, or pessimism. Avoid
extremes, try to keep it positive, do not brag,
give specific examples of strengths. Important
strengths are: empathy, devotion, consistency,
being a team player
Pick an “acceptable” flaw:
“I am intense at times or I tend to strive for
perfection”
Preparing for the Interviews
5. Why did you choose this specialty?
A rotation experience, a mentor, a special skill,
be enthusiastic!
6. What is the most
interesting/outstanding/significant thing you
have done?
6.What do you do with your free time?
Preparing for the Interviews
8. Discuss a memorable patient.
9. Did you have any problems in one or more
areas?
Discuss short comings honestly. If extenuating
circumstances exist, state them concisely and then
move on without belaboring the point. End on an
“up” note. May try to offset academic problem
with better performance in other areas such as
patient care.
Preparing for the Interviews
10.Describe an instance in which you had to
work with someone who was considered
difficult.
11. What do you think about the future of
medicine?
– Good time to discuss altruistic motives
– Journal citations
12. How do you perform under pressure?
– Give a specific example
Preparing for the Interviews
13. Discuss your research.
14. Have you ever been terminated from a
position?
– They are looking for the why and how you
reacted.
15. Where else are you applying?
– Ok to list places and mention their strengths
briefly.
Preparing for the Interviews
Inappropriate Questions:
– What is your sexual orientation?
– Are you going to select this program if we rank you
high?
– Are you physically healthy?
– Do you have any psychiatric problems?
– Any plans for marriage/pregnancy?
Best answer: “ May I know why you ask that?”
Preparing for the Interviews
• Read a current book (can be thin, but meaningful) ie:
“Who Moved my Cheese?” Spencer Johnson
• Go to the medical library and scan the last few mos of
articles from the specialty journal or email the
professional organization and ask for the top 5 areas of
attn/interest in that subject in the last 6 mos
• Don’t forget to be courteous to support staff
• Beta Blockers
• Prep 2 -3 questions for the interviewer:
– What are the strengths and weaknesses of your program
– Are you aware of any upcoming major changes to the program?
Preparing for the Interviews
• Buy one nice, comfortable yet formal outfit. Newer
shoes (not blister new!), polish shoes, use conservative
accessories and make-up, clean nails, trimmed facial
hair
• Choose a brief case or executive bag
• Survivor Kit: program folder, list of questions, extra
copies of resume and app materials, Kleenex,
deodorant, disposable dental care, small mirror, snack,
small water bottle, breath mints, pens, notepad,
cash/change, ID, phone (set to silent), any necessary
personal items (female items or rx meds), prn meds
such as Tylenol, Tums, band aids
Interview Follow-Ups
• Send a thank you note
• Try to include something personal or
memorable about the interview, visit, tour
• Can include a picture as a reminder
Career Advisor
• Angela Bacon, MS
angela.bacon@okstate.edu
• Provide CA with CV, personal statement, transcript
• Review your permanent record
• Stay in touch with CA to discuss:
– choices of programs
– info on previous student’s experiences
– activities/suggestions to strengthen application
– number of applications/interviews
– interview etiquette
– ranking strategies
Credits:
Staying Human During Residency, 4th Ed
– Allan D. Peterkin, MD
The Residency Handbook
– Lyle D. Victor, MD