….light at the end of the tunnel or an oncoming train?

What do you want to do with your life?
 RULE #1 – Don’t freak if you don’t know, work hard
 RULE #2 – If you do know, still work hard
 RULE #3 – Work on developing the knowledge and
skills you’ll need to be a great doc
 RULE #4 – BE HONEST WITH YOURSELF

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Are you interested in the common patient complaints?
Are there patients you really don’t like dealing with?
Are there patients you would be miserable not seeing?
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Lifestyle choices?
Practice choices?
Your colleagues
Geography
Try to see as many patients as you can third year
If you are really unsure – talk to some fourth years and talk to
faculty

Back to RULE #1 – Do NOT freak out.
 Fourth year will be different for EVERY single
person

Four parts:
 The Tests
 Things required for MUSOM
 Things required for your residency goals
 Things required by/for you (aka FUN)

By July 1, 2011
 ACLS: Two sessions offered by MUSOM

By December 31, 2011
 Step 2 CK: Essentially just like Step 1, only generally considered
“easier” and 1 block of questions longer
 Step 2 CS: 12 patient OSCE that you have to travel for, pay lots of
$$ for, but not study much for

By April 1, 2012
 MUSOM Radiology Exam: On-line 100 question exam

4 weeks of IM at the VA

4 weeks of Emergency Med at CHH

4 weeks of Surgery (1 wk anesthesia + 3 wks of
subspecialty)

Plus…22 weeks of electives/away rotations/rural if you
need it
The things for your residency goals & for FUN
 Away rotations
 Extra rotations in your field or subspecialties
 Stuff you may never see again
 International or Wilderness electives
 Time off for interviews/vacation/having babies
 http://musom.marshall.edu/students/senior-handbook/

 Listing, description & contact info for all the fourth year electives
 Check them out BEFORE the scheduling meeting so you have an
idea what is out there

What do you want to do?
▪ Do we have an academic department?
▪ Is it a highly competitive specialty?
▪ Do you want to go to a highly competitive area/specific
program?

How strong of a candidate are you?
▪ Do you need to take Step 2 early?
▪ Do you need to apply to more than one specialty?
▪ Will you need to do a lot of interviews?

As for the answers…
http://www.nrmp.org/ - then go to the “Data & Reports”
section, then entire 281 page PDF is there for all specialties
Help you honestly gage your chances as an applicant in your
chosen field
 Guide for away rotations, where to apply, personal
statement
 Letter of recommendation (you’ll need at least 3).
 If you don’t have one – find one!
 Join the American College of Whatever Specialty, some
have virtual mentors
 Current MS-4s
 Access to faculty is a MUSOM strength – use it!
 Iserson’s Getting into a Residency (library or purchase)


When to take Step 2 CK?

When to take Step 2 CS?

Away Rotations: Yes or No?

Interview Season Scheduling?

Your Residency Candidacy
 If step 1 low: need a boost, take early
 If step 1 high: maybe consider late, but earlier usually better

Preparation
 Have you struggled on mini-boards?
 Do you know you need extra study time?

Timing
 Have to sit by end of December – but fit around away
rotations, required rotations, interviews, etc.
 Takes 3-wks to score, if going for the “boost” try to take by
the end of Sept at the latest so score will be in by Nov 1st

Time & Resources MUCH more varied than Step 1 (1-6 wks)
 Kaplan/USMLE World QBANK (Both are pretty good)
 Step 2 Review Course – Pretty Good, 2 weeks, mostly half days
 First Aid Step 2 – unlike Step 1 this is only ok not the best
 Step Up to Medicine – Great, but long and detailed
 Secrets – Very popular – detailed
 Crush Step 2 – Very Popular – very general

Main Focus of test:
 Internal Medicine – As pathology was to Step 1
 OB/GYN & Pediatrics – MUSOM typically perform well here
 Surgery (subspecialties) – Use Qbank for review
 *Neurology/Biostats – Fill in your knowledge gaps, biostats VERY
high yield
 Psychiatry – First Aid for Psychiatry is great
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Travel: Houston, Chicago, Philly, Atlanta or Los Angeles
(Philly hardest to schedule)
Does NOT require a lot of preparation, no advantage to
waiting
Realize it is administered directly by the USMLE not
Prometric
First Aid for CS is all you’ll need. Review it the couple of
days before your test
Squish it in whenever is it convenient given the travel.
Schedule ASAP (you can change it relatively easily if you
have enough advance notice)

You should definitely consider if:
 MUSOM does not have an academic department
 You want to go to a…
 specific program
 specific city
 extremely competitive residency or place
 Everyone: just to see a different way of doing things

Visiting Student Application Service (VSAS)
 http://www.aamc.org/programs/vsas/

Other Institutions – check their websites

Most are 4 weeks
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Rotations are usually subspecialties
Highest yield for resident exposure
Define what’s most important: what or when
Apply to 2-3 for the same month
Personal contact/connections
Frustrating how slow schools are with getting
back to you
Respond promptly
Programs/schools are grouped into somewhat arbitrary
tiers – there is no “10-best” list
 Ask Faculty in the field

 Expect some Bias
 See Linda Holmes for list of graduates in a specialty


Ask MS-4s going into that specialty
Freida (on the AMA site)
 Specialty Training Statistics

StudentDoctor.net
 http://forums.studentdoctor.net/

US News Best Hospitals
 http://health.usnews.com/sections/health/best-hospitals

Cannot miss any days of your anesthesia week

Check with away rotations on interview policy
BEFORE committing

“Flexible” electives (academic medicine, medical
spanish, readings in international/rural health,
medical education)
October
November
December
January
+++++++++++
Anesthesia
------------------ -------+++++++
+++++++++
Derm
------------------ ------------------
++++++++++ ++++++++++
ER
------------------ -------+++++++
+++++++++
+++++++++++
-------------++
++++++++++
+++++++++
+++++----------
Gen Surg
------------------
++++++++
+++++++++
++++------------
Internal
-------------+++
++++++++
+++++++++
++++------------
Neuro Surg
------------------
++++++++++
++++++++ ++++---------
ObGyn
-------------+++
++++++++
+++++++++
++++------------
Ortho
------------------ ------------------
+++++++++++
++++++++
Family
Peds
-------------++
+++++++++
+++++++++
+++++----------
Rads
------------------
++++++++++
++++++++
++++++++

Required rotations:
 July/August if that is your field
 Christmas and NYE if live nearby
 Strategically schedule interviews

Away rotations:
 Earlier than later, be wary of interview season

Interviews:
 Clump together geographically
Preference will be given to the first three months of
your schedule
 Required/away/elective/step 2
 Required/sub-I/away
 Away/away/step 2/elective
 Away/away/away, etc
 You can trade required times with your classmates
 $$ is a issue for interviews & aways – you do NOT get
much school loan money
 Credit cards, parents, residency & relocation loans

Start planning/thinking about things NOW (but not to the
detriment of your rotations!)
 You should start working on your application in LATE
spring – it will take WEEKS to finish it (due Sept 1st)
 Personal Statement
 Letters of Recommendation (Ask early!)
 Compiling all of your extracurricular activities
 Research
 Community service
 Leadership/Awards
 Hobbies (be VERY honest here – you will get a lot of
interview questions!)
 Things more complicated if you do Ophtho, Peds Neuro,
Urology, Military

…in mid-march (shortly after Match Day)
 The dirty details of the Applications (ERAS)
 Interviewing 101
 The Matches & Ranking (NRMP)
 Small-group discussions with freshly matched
MS-4s and current residents
http://musom.marshall.edu/students/senior-handbook/
http://www.nrmp.org/
http://www.aamc.org/programs/vsas/
http://forums.studentdoctor.net/
http://health.usnews.com/sections/health/best-hospitals