Applying for and Getting a
Residency in General
Surgery.
(and probably any other specialty too)
THE UNENDORSED STUDENT-TO-STUDENT GUIDE
PREFACE
This guide was prepared by a fourth year medical student days prior to Match Day 2004.
Several third year students have approached me for advice regarding the residency
application process. This guide was prepared deep from within the valuable minutes wedged
between the frequent siestas and x-box time associated with my vacation, to help students
applying to general surgery. Although this guide will probably help just about any student
applying to just about any specialty, it is of course specific to surgery because that is how I
intend to spend the rest of my professional life. Surgery is of course the best profession,
which reminds me that this is editorial in nature, and my opinion runs rampant throughout
this text. I was fortunate to have matched to my first choice, and hope you do the same.
Lastly, be kind enough to ignore all spelling and grammatical errors.
This guide is of course free of charge, you are free to read it over and over, reference it many
times. Share it with your friends, family, psychotic patients. Photocopy it, burn it, sell it on
Ebay- I don’t care. What I DO ask is that you continue a history of students helping
students at the University at Buffalo School of Medicine. I was on several occasions
“helped” by my “elders” at UB who are now called doctors. If you read any part of this
book, consider yourself “helped;” it is therefore obligatory for you to shed your wisdom and
knowledge onto the generations of students below you. Feel free to add to this guide, as
change is inevitable, and pass this down so that UB’s history of students-helping-students is
passed down just like MRSA through a SICU.
I would like to thank, as will you, the students above me who have passed their knowledge,
Dr. Dayton, Dr. Hassett, Dr. Nielsen, Phillipa, and the internet.
"Never regard study as a duty, but as the enviable opportunity to learn to know the
liberating influence of beauty in the realm of the spirit for your own personal joy and
to the profit of the community to which your later work belongs."
-
Albert Einstein
2
TABLE OF CONTENTS
TERMS
PRECLINICAL YEARS
Introduction
Word on Step I
Grades & Class Rank
Summers & Research
What I should have done
THIRD YEAR
Timeline
Clerkships
Letters of Recommendation
What I did
What I should have done
FOURTH YEAR
Timeline
INTERVIEW SEASON
Where to apply
How competitive am I?
What is the best residency?
How many programs to apply to
How many interviews to go on
Word on Step II
Interviews
Correspondence
Electives
Out of town electives
Letters of Recommendation
Personal Statement
Rank order list
TOP TEN LIST
LIST OF RESOURCES
3
TERMS
AOA: Honor society of medicine. The golden key to the residency of your choice, as long
as you are not, in addition to being AOA, and idiot.
ERAS: Website service that you will use to apply to residency. This is a great service that
will compile your application, LORs, etc. This is not the same things as NRMP.
FREIDA: AMA’s computerized list of residency programs.
LORs: Letters of recommendation
MBH: Man’s Best Hospital, a not-so-real-but-we-all-know-what-we-are-talking-aboutanyway hospital used frequently throughout this text to imply the best possible residency on
Earth I stole this from the book House of God, by Samuel Shem.
NRMP: Match program, with a website to submit your match list.
PD: Residency program Program Director
Residency: Surgical residency. 80 hour workweek nationwide has made this more attractive,
and therefore more competitive.
ROL: Rank order list.
4
PRECLINICAL YEARS
INTRODUCTION
First and second year of medical school went by fast. I really enjoyed my time in the
classroom, but I was ready for 3rd year. Study hard, try to do your best at all times. Gross
anatomy is important for surgery, and you should work hard in this class. Don’t be misled
by students who say “P=M.D.,” although the equation is probably accurate, starting with
this mindset will not help you do your best. Surgery is becoming more and more
competitive as the 80-hour workweek significantly eases the demands of residency.
Although your last two years are radically more important for a solid match, do not
underestimate the power of your first two.
WORD ON STEP I
Never underestimate the importance of Step I- this grade may very well be the first thing
looked at in your residency application- some program directors will use your score as a
screening tool. Your Step I score will roughly estimate what type of residency you will get.
Don’t get too worried, you certainly do not need top scores to get into a good surgical
residency. USMLE failure may not even prevent you from securing a good residency
position. If you do fail, be sure to meet with Dr. Nielsen, and try to boost your
competitiveness in other areas. Elite programs may use +1SD as floor. Majority of
university programs use -1SD as floor.
GRADES & CLASS RANK
Grades are important. Several interviewers had a sheet of paper with my “number of
honors” points. One interviewer said “so, you have X number of total honors points...” UB
does not use a numerical rank system; however the class IS broken down into 5 categories
labeled something like ‘superior’, ‘excellent,’ ‘good’, etc. Your total number of honors points
will determine your class rank. Since only the first or second rotations during your fourth
year will be reported on your residency application, the first two years make up about 2/3 of
your class rank!! It is important to do well! AOA is also heavily based on total number of
honors points. AOA is probably essential for residency at MBH (Man’s Best Hospital, a
not-so-real-but-we-all-know-what-we-are-talking-about hospital used frequently throughout
this text to imply the best possible residency on Earth. Stolen from The House of God, by
Samuel Shem, a book which should definitely be read by all medical students).
SUMMERS & RESEARCH
Research will NOT “make or break” you for residency, but having good research WILL
raise you a notch in terms of competitiveness. Publications are important, if possible. Your
residency application will include a section for research – you can include presentations or
publications. Surgical research with an internationally known academic surgeon is of course
preferable, but interviewers were impressed with my cardiology research done at UB.
Although UB has solid ongoing surgical research, you may have to do an away rotation to
secure a paper with an internationally known academic surgeon – see the section below on
5
away rotations. Look for this to change though, as I am sure the arrival of Dr. Dayton will
spawn a surge of academic power into UB. Research is probably necessary to assure
competitiveness for MBH. Note that it is very important for your research to be “real,” not
just “CV padding.” For example, I received two competitive summer research fellowships in
cardiology, and I am in the position to detail the research I did with great biochemical,
physiological, and clinical relevance. Interviewers can tell the difference if they ask you,
which they will.
WHAT I SHOULD HAVE DONE
I should have slept well before Step I. I was having trouble with insomnia during my 2nd
year, and the night before was NO EXCEPTION! I would HIGHLY recommend getting a
prescription for a sleeping drug a month or so before the exam. Take it a few times well in
advance of the exam to see how your body handles it, and to test how you feel in the
morning. You don’t have to take it, but you will regret not having it if you end up needing
it. I feel very strongly about this, and really implore you to consider this.
TIMELINE
THIRD YEAR
WHOLE YEAR
- Get LORs while you have the chance
- Get as many Honors points as possible... they really matter now!
JANUARY
- Apply for Step 2
MARCH
- Talk to 4th years- they have just finished the match, and all of this information is
fresh
APRIL
- Again, get contacts from 4th years- email, etc.
JUNE
- Step 2 application deadline
- Submit CV to Dr. Nielsen
- Dean’s letter appointment begin June/July.
CLERKSHIPS:
Do as well as possible! These grades REALLY do matter, especially in surgery, OB/GYN,
and medicine. I was on an interview, when the interviewer looked for, and circled these
grades. Some programs will not interview you unless you have received honors in surgery.
(Cornell is one of them- they say so on their website). Shelf exams are generally important.
Doing well in medicine WILL help you do well in surgery, especially for the shelf. Charge
into your surgical clerkship. Take as much call as possible with your team. You must be
6
interested and relatively aggressive. Ask to do procedures whenever possible. DO NOT
FAIL surgery!! Be a gunner, but never hurt your fellow students.
LETTERS OF RECOMMENDATION:
These are a pain in the ass, but absolutely essential! You must ask (politely, and respectfully)
for a LOR. Most programs require 3 LORs. You should get one from the Chair (Dr.
Dayton), one from the clerkship director (Dr. Hassett), and one from a senior faculty
member (full professor preferable) in the Department of Surgery.
LORs are written by faculty and sent to the OME, AKA the “ERAS Post Office.” The
“post office” must be “open” for you to have a LOR sent, this occurs in August. When the
LOR arrives in the OME, it will be scanned into the computer and attached to your ERAS
application. When you transmit your application, your LORs will be sent along too. You of
course can’t see them unless you fail to check a box waiving your right to read your LOR.
(DO NOT DO THIS!) If your LORs are not yet in, you can still transmit your application.
As your LORs arrive, they will be transmitted to the programs. Be sure to thank all of your
LOR writers! See the sections below for specifics.
This will all become very clear when you have to do this. Instructions will be abundant from
the OME as the time comes, but pay attention to the following. You cannot have a LOR
sent to the OME without the “ERAS Post Office” being open, which occurs in August. If
you identify a potential letter writer earlier in the year, you can (and should) ask that person
for a LOR during the rotation while they know you well. He/She should write it, and save it
to their computer. Later, when the “post office” opens, it can be sent to the OME. So, for
example you impress the hell out of a surgery attending in November (good for you). Ask
him to write you a LOR then, and save it until August. Explain that LORs cannot be sent to
the OME until August, and remind him when the time comes.
LORs are notoriously late and the source of frustration at application time. You may need
to remind an attending about your letter, but be sure to do it respectfully. If you become a
pain in the ass to them, anticipate this to impact your LOR.
WHAT I DID:
I did well in the 3rd year. I got mostly honors, but an HS in surgery. This did not kill me,
but may have prevented me from getting an interview at Cornell (their website says you need
an honors in surgery to be interviewed). Surgery was my last rotation, and I had LORs from
Drs. Dayton, and Hassett, a trauma attending, and an ENT surgeon. My ERAS will allow
you to print out a cover sheet/request sheet for LORs. After I asked for a LOR verbally, I
gave them a large envelope containing the following, and suggest you do the same.
1. Type-written formal letter thanking them for agreeing to write a LOR, including basic
instructions.
2. The My ERAS cover sheet
3. Stamped envelope addressed to the OME for the LOR
4. Postcard, stamped and addressed to me- to be dropped in the mail when they mailed the
LOR. This way I knew that the LOR had arrived in the OME. Other than this, no real
good way to tell.
WHAT I SHOULD HAVE DONE:
7
Posted honors in surgery. I should have taken surgery 3rd or 4th, (expect to be at your peak
in your 3rd or 4th rotation- too early and you will not know enough, too late and expect to be
a little burned out). When I was planning my third year I was intending to go into medicineI actually didn’t decide on surgery until the beginning of 4th year! I think I may have been a
bit burned out at the end, and didn’t take as much call as I could have. I think this
contributed (along with the fact I told my attending I intended to be a cardiologist) to my
HS in surgery.
FOURTH YEAR
TIMELINE
JULY
- Meet with Drs. Dayton and Hassett. Tell them you want to be a surgeon! They will
help you!
- Write your personal statement – give a copy to Dr. Hassett.
- Get info about different programs
- Register and start working on “My ERAS”
AUGUST
- Finalize all request for LORs
- Register for NRMP
- Complete ERAS
- You may begin transmitting your application around 8/15
SEPTEMBER
- Complete My ERAS if not already done!!!!! DO NOT DELAY!
OCTOBER
- You are in trouble if no ERAS transmission by 10/1
- My first interview was 10/30
- Be sure to have thanked LOR writers
NOVEMBER
- Dean’s Letter is sent 11/1
- Most interviews begin
- Talk to Dr. Nielsen if no invitations to interview
DECEMBER
- Interviews
JANUARY
- Interviews continue
- Start thinking about ROL
FEBRUARY
- My last interview was 2/2
8
-
Certify ROL
MARCH
- Match day around 3/18!!!!!
INTERVIEW SEASON
WHERE TO APPLY
1. Geography.
- The first question you have to ask is where. Where do I want to spend the
next 5-7 years? I looked at some great programs in poor locations. I looked
at some terrible programs in great locations. Where you will be happy is of
course up to you. Make a list of all the programs in areas interesting to you.
FREIDA is very helpful with this. California, Colorado, New York City are
generally competitive. May or may not be due to the quality of the programs,
but quality of the location. Location was actually very important to me
personally.
2. University, Community/University, Community
- University programs are generally regarded as the most competitive places
to train. They offer superior didactics, faculty, and research experience. The
goals are for fellowship placement and to produce academic surgeons. You
may be required, or certainly encouraged to take 1-2 years off for research.
These hospitals are of course associated with a university, but should also
include experience in community-based hospitals. Fellowship placements are
good, and you are prepared to go into academic surgery after residency.
-
Community/University programs are associated with a university, but you
train in a community hospital. Faculty may be associated with the university.
Research is generally poor, but the university affiliation will open doors.
Research is generally not mandatory or encouraged. Fellowship placements
are fair.
-
Community programs are not associated with a university. These programs
are found both in cities and in the woods. You will generally receive a
superb clinical training, but these programs have little to no research. The
goal is to produce clinical, not academic surgeons. Taking time off for
research is generally discouraged, as they usually have few residents. You will
have trouble attending a top academic fellowship afterwards.
-
My sincere recommendation is to apply to, and interview at all 3. You may
be surprised at what you find. You should know that it may be hard to
secure a good fellowship or position in academic surgery after a community
residency. It shouldn’t be a problem, however to go into private practice after a
university residency. In terms of applications, you may also want to apply to
some “nice climate” programs too. Let us not forget that Buffalo is COLD
during interview season- it may be nice to stay in Florida for a night or two in
9
January! Take a few extra days- take a pseudo-vacation, you will need it!
Who knows, you may end up loving the program and matching there!
-
Dr. Hassett will help you with this endeavor! He has seen many medical
students come and go- he may be the best resource for help in this matter,
especially for programs in the northeast.
HOW COMPETITIVE AM I?
For this I will refer to the American College of Surgeon’s “So, you want to be a surgeon”
website.
1. Lower half of class/scored below mean on USMLE:
a. It is unlikely that you will be competitive for any of the more well known
programs throughout the country.
2. Second quarter of the class/mean on the USMLE:
a. Competitive for good community-based programs, and some university
programs.
3. Top quarter of class/above mean on USMLE/honors in clerkships:
a. You will be competitive for most university programs.
4. AOA/honors in majority of clerkships:
a. You should be competitive for any program in the country.
The American College of Surgeon’s “So, you want to be a surgeon” website offers a
database which will indicate the quality of incoming residents over the past few years. I am
not sure how accurate this is.
WHAT IS THE BEST RESIDENCY?
No formal ranking system exists to assess program quality. Most of the big name university
programs are very good. One way to assess the quality of the residency is to check the
program websites for fellowship placements. Surgical oncology and pediatric surgery
fellowships are extremely difficult to obtain, and almost always require 1-2 years of research
in addition to residency training in a good university program. If the program you are
looking at has sent graduates MD Anderson for surgical oncology, and Pediatric surgery at
Boston Children’s (personal happiness and a good fit aside), it is a superb residency.
Personal happiness and a good fit cannot be overemphasized. Resident profiles may help
too- if the residents came from Columbia and Harvard, it is probably a competitive
residency. If the program has D.O.s, and a lot of foreign medical grads, it is probably not as
competitive. The program website may publish the resident profiles.
HOW MANY PROGRAMS TO APPLY TO
Apply to as many programs as you like! The cost increases after a certain number of
programs have been reached. Dr. Dayton offers the “3-6-3” rule. Apply to 3 excellent
programs that may be a “reach,” 6 solid programs where you would be competitive, and 3
“backup” programs. He says that in his experience, for most students it will be unlikely to
go unmatched using this formula.
I would use Dr. Dayton’s rule at the minimum. This is an exciting time in your life, and you
should use the time and opportunity to visit as many programs as you can. I applied to 33
programs in total, mostly university but some community-university, and a couple of
10
community programs. As I mentioned, it is COLD in Buffalo during interview season. It is
very possible that you may end up missing interviews due to poor weather!!
Be sure to apply to Buffalo. After all, it is your home school! I know people in applying to
other specialties that did not apply to UB for residency. UB has an EXCELLENT surgical
residency. I heard a story (not sure if it is true) about 4th year who was a particularly strong
surgical applicant (but also very arrogant). He did not apply to Buffalo because he
apparently thought he was a MBH applicant, and had no need to apply for anything else. He
also apparently conveyed his arrogance during his interviews and didn’t match at all! That
year Buffalo had an open position in the scramble, and they didn’t accept his application.
Sucks for him, but he deserved it. The Buffalo program has a lot of outstanding faculty
members, ranging from the wise, seasoned surgeon to new, younger surgeons. Dr. Dayton
is relatively new to Buffalo, and his impact has been extraordinarily strong. I met quite a few
chairmen along the interview trail, and I have to say that Dr. Dayton is perhaps the best. In
addition, I will quote Dr. Hassett when I say “it never snows in the OR.”
HOW MANY INTERVIEWS TO GO ON
It is nice to see “new messages” in your ERAS inbox inviting you to interviews (or not so
nice if rejected). I was rejected 3 times from MBH. They generally offer 3-4 dates- you can
choose. Don’t wait too long to reply as spots may fill up quickly. Go on as many interviews
as possible, so long as your wallet and sanity hold up. You should probably do no more
than 15 or so. Try to narrow your list down as you do more research on them. You may
cancel interviews – just do it respectfully, with plenty of time so the program has a chance to
offer the interview to somebody else. You may also try to reschedule interviews to different
dates.
I applied to 33 programs, and received an invitation to interview at most of them. I went on
17 interviews and cancelled the rest. I cancelled some prior to scheduling an interview date,
and some after. I had trouble remembering some details about programs (which will be a
problem unless you write down the details). I may have gone on too many, but was glad to
have a lot of options come the ROL deadline.
Most interviews are on Thursdays, Fridays, and Saturdays. Try to schedule them together,
with a geographical basis. I interviewed mostly in New York City, where I have friends and
family. I had several Thursday-Friday-Saturday interviews chained together, and was
therefore able to avoid hotels and multiple flights.
Don’t drive yourself poor, but it is probably not a good time to save money. Spend the
cash- it will be well worth it to secure a great residency spot when your 5-7 is breathing
down your neck. Make sure you have a nice suit.
WORD ON STEP II
Step II can be a double-edged sword, as it can help or hurt you. Some programs require
Step II, but not many in my experience, but I was asked about Step II by a couple of
programs on the interview. My advice is that if you did excellent on Step I, don’t take the
chance of potentially bombing Step II. If you did poorly on Step I, you may bring up your
grade with Step II, and subsequently increase your competitiveness. You must have an
honest, objective appraisal of your potential on Step II. Because I didn’t sleep well (actually,
11
didn’t really sleep at all) before Step I, I thought I could significantly pull up my grade on
Step II. I took Step II in mid-November, studied hard, and raised my grade by 20 points.
My grade wasn’t back in time for my initial application, but certainly helped on interviews
and almost certainly for the match.
You have the option with My ERAS to either automatically send your Step II grade when it
comes in, or manually release it at any time. You can decide to manually release it AFTER
match day if you did poorly or before match day if you did well. This is what I did… when I
discovered that I had raised my grade by 20 points I immediately released it, and then I got
drunk.
CAUTION: I am not sure, nor do I know anyone who knows for sure, if programs can tell
from your application that you decided to manually release your grade, or if the grade is in
but the release is pending. I didn’t hear of this being an issue for anybody, and it wasn’t for
me. My application seemed to be scrutinized on only 1-2 occasions. Most interviewers were
flipping through my application seemingly for the first time right in front of me during the
interview. Although it will sometimes be to your benefit to lie to programs (see the section
on lying), it is NOT wise to mislead programs about things such as grades, scores, honors,
AOA status, etc.
INTERVIEWS
Interviews were very “benign” in my experience. Be sure to read the “top ten” list about
interviews several times before you actually do it for the first time. If you have been invited
to interview, the program director (PD) has decided that on paper, you would be a good
resident at their program. Just be yourself and relax! It is my theory that the PDs have a
few goals:
1- They want the very best/brightest candidates. Best is defined by the program… it may be
a Step I > 230, all honors, blah, blah, blah… or it may be what they deem to be a “good
personal fit,” but most probably both- so you need to be this person.
2- They want to avoid going “deep” into their rank list, just as we want our number one
choice. I think they will rank applicants higher if they think the applicant will rank the
program high.
3- Likewise, it is important for you to have a reason for interviewing there. For example, at
Einstein when they asked me why I choose to apply to Einstein I of course didn’t say
something like “why not,” or “because.” I told them I bought my first medical textbook
across the street as an undergrad, and it was nice to be back (true story). “It is really nice to
be here interviewing here for residency… just a few years ago I was in the ER doing research
as an undergrad, thinking ‘one day.’” I bet this certainly helped. On the other hand, I had
no obvious reason to apply to UVM, so I had to explain why. Think of a good reason, and
try to be genuine.
It is also important to ask questions. Some interviewers brought me into the room, and just
wanted to know what questions I had for them. Be sure to have a list memorized, as I am
sure this will happen to you! Ask the same questions over and over at each place, even if
you already know the answer- make sure to have enough questions to avoid a 30 second
12
interview and to reduce the number of “awkward silence” moments because you didn’t have
anything to ask, and they didn’t want to ask you anything. Also know when to stop asking
questions to avoid being obnoxious.
Be sure to wear the right suit and not be an idiot! Relax, you will be a surgeon and surgeons
are cool people. Go out the night before if the programs offer a “booze” event (if you are
not a social fool). Drink if you want, but don’t get stinking drunk. I can’t tell you how to be
a social grace, but don’t be afraid to relax! The residents in your presence may have some
sort of input to the PD, so be careful. I suspect that their input will not have anything to do
with the amount of research you did, or what you honored, but more along the lines of you
personality.
The interviews are as much for you as they are for the program. You are interviewing the
program too. Get a close look at the residents. Can I get along with these people? You will
have a feeling about the place, some sort of reaction. Write down everything! I was shocked
to discover exactly how much I forgot by the time the ROL was due. Details are importantcall schedule, conferences, etc. Force yourself to sit down and write down the details as
soon as you are finished. Grab a beer across the street, or coffee- I don’t care, just WRITE
DOWN THE DETAILS!
Be sure to know your “favorite case…” you know- the one that made you sure that you
wanted to be a surgeon. I was asked about this one defining moment at almost every
interview. Be sure to KNOW this case well- read up on the case before you start your first
interview. Know details, they may pimp you about this.
I was pimped on occasion- usually simple stuff. I was however asked which thoracotomy
approach I would use for a victim of a gunshot wound. I of course had no idea, and laughed
politely. I told him that I really had no idea… he eased up, laughed himself, and replied that
his residents would probably not know either. I am not sure if he was assessing my ability to
react to stress or not, but I apparently ended up doing very well because I received a very
nice recruitment “we would like you to seriously consider training here” type letter before
the ROL deadline from the program. Be yourself.
Although nothing like this happened to me, I head a story about someone being asked to
display a one-handed and two-handed knot, both right and left-handed. He was also asked
to draw a diagram of the blood supply, anastamosis, and drainage for a pancreatic surgery
that the candidate had seen. This is exceedingly rare, and the applicant was probably an
asshole to begin with in order to have deserved this.
Finally, it may be intimidating to look around the room at interviews and read name tags that
read Harvard, Columbia, Penn, etc. Just remember that you have received an excellent
medical education, and you are at the same interview together! If you have been invited, you
are good enough for the position. Don’t ever “apologize” for coming from a state school,
or you board score, or lack of honors, etc. Be proud of your school, your work, your record,
and if they ask of UB’s department or medical school speak highly of it. Have only good
things to say about your rotations, etc. Nobody likes a perpetually negative person. If you
are negative during a 20 minute interview, imagine what they think you will be like over 5-7
years!!
13
CORRESPONDENCE
Thank you letters are in order after every interview! Email may be more appropriate
depending on your impression, but I usually sent a quick, typed letter to each person that
interviewed me. If the program secretary was helpful about rescheduling, etc, I sent a letter
to her too (I did this twice). If I really liked a program, but did not get to meet the PD or
chair, I sent a letter to them too, in addition to the interviewers. Finally, I sent emails to the
PDs at my top 3 programs in early February telling them that I ranked the program very
highly. I told my #1 that I had ranked them #1. These were very quick emails. Second
looks may be helpful. Mandatory second looks are NRMP violations. They may be
“encouraged,” though, and you should probably go if you get a feeling that you should and it
is your number 1 or 2 program.
LYING
OK, by this time you should know if you are a good at fibbing or not. You should NEVER
lie about things like grades, AOA status, and your ability to speak a different language. That
being said, you are totally free to say stretch the truth a bit about certain things (provided
you can do it well, and your paperwork doesn’t contradict yourself). For example, when I
was asked about why I applied to NYU I said “because I really want to train in a large
program in a big academic center with lots of research… NYU is one of the few in the City,
so it was perfectly logical to apply here.” When I was asked the same about applying to
Cabrini (a really small community hospital) I said “because I really want to train in a small
hospital with a community feel. From what I gather, the clinical training is superb here, and
I want to be a superb clinical surgeon. I really don’t have much interest in doing a lot of
research.” See how easy it is? If you tell the people at Cabrini that you want to train at an
academic powerhouse, or your personal statement says it, you are at risk of not being ranked
by Cabrini. You can figure out what is right for you once you have seen enough to make the
decision based on experience. For example, I thought I wanted an academic powerhouse,
but in the end I decided that a smaller university program would be best for me.
Don’t tell them that you didn’t get an interview at the other program across town if you
don’t have to. Never volunteer the fact that MBH didn’t want to interview you. For
example, when I was interviewing at BU I said something like “How does Boston U fit into
the Boston surgery niche?” I asked a good question, burned some time, and never let on
that I was rejected from MBH 3 times, potentially leading the interviewer to question my
competitiveness. They don’t want the “guy who couldn’t get MBH,” they want the guy who
“could get MBH, but wants BU.”
ELECTIVES
I would recommend radiology and the TICU. I didn’t do either, and deeply regret it.
Electives will be your last chance to formally learn things about cardiology, nephrology, ID,
etc., so you may want to take advantage. I took ID, cardiology, ER, vascular surgery,
forensic path, and a research module. Rotations are resident and location dependent, but I
loved vascular surgery at MFG. I have heard that people love the surgical oncology rotation
at Gates, and the CT rotation at BGH.
We didn’t have an opportunity to take electives during the third year, but I would
recommend taking electives that are learning opportunities that will help you do better in
14
your clerkships. Save the easy stuff for fourth year! From what I hear easy electives include
forensic path, radiology, allergy/immunology, radiation oncology, nuclear medicine, and
probably a few more that I cannot recall. Speak to the course coordinator if you can’t get a
spot- they may make an exception.
Regarding electives during interview season, avoid medicine. Neurology is a good one, since
you will have weekends are off, and in addition they will give you (no more than) 3 days off
to interview. Forensic path is a great rotation during interviews. Research may be a good
one too.
OUT OF TOWN ELECTIVES
I didn’t do any. They do not automatically assure an interview, but may help. My
philosophy on this is that if you look good enough on paper, doing an elective there will
only open up the possibility of doing something stupid in front of the wrong person. These
electives are, however crucial if you would like to have letters of recommendation by the
elite, internationally known “textbook writer” surgeons. Do not underestimate the power of
these elite LORs, as they can be the key to MBH. Take an away elective during your 1st or
2nd module of 4th year if you want the LOR, or later during the 4th year if you want a
vacation! I heard somebody did a transplant surgery rotation in California, riding on
helicopters with organs!
LETTERS OF RECOMMENDATION
These are very important, and their power cannot be underestimated if they come from
“giants.” To get a LOR from a “giant” it will probably be necessary to do an out-of-town
elective.
See the above section on LORs for more information.
PERSONAL STATEMENT
Should be direct and to the point, with no adverbs per Dr. Hassett! Dr. Hassett will help
you with this. You are allowed to submit more that one statement to My ERAS. I would
suggest writing one letter for the university programs and another for the community
programs. You can decide which one to send to each program. They should be about the
same as to avoid any problems with contradictions, but the career plans and objectives
should be changed in order to fit the program. See the section on lying.
RANK ORDER LIST
Go with your heart, you impressions. You will be glad to have written down a lot of details.
Rank you list in order of your true preference. Dr. Hassett and Dr. Dayton may help you
with this. Some chairs around the country will call your number 1 program to reiterate your
interest.
TOP TEN LIST
1. APPLY EARLY- as soon as you are able to. I applied in late August, and did not get
any of the interviews that I “added on” to my first round of applications in late
October- it was already too late.
2. ASK QUESTIONS- come to the interview armed with a few good questions!
15
3.
4.
5.
6.
7.
8.
9.
10.
KNOW WHEN TO LIE- and when not to.
BE CONFIDENT
SEE NUMBER 1
DON’T BE OVERCONFIDENT- if you have stellar scores, grades and all the bling
bling, you may be at risk for overconfidence. You must still work hard to present
yourself well.
KNOW “YOUR CASE”- be sure to know one surgical case cold, just in case they
ask you.
BE NICE TO EVERYONE- especially the program secretary. They may have
more input than you expect.
WRITE IT DOWN- make sure you remember the details!!!
APPLY TO BUFFALO- and get to know Drs. Hassett, Dayton, & Nielsen.
RESOURCES
FREIDA- http://www.ama-assn.org/ama/pub/category/2997.html
NRMP- www.nrmp.org
FACS- www.facs.org
SO YOU WANT TO BE A SURGEON- http://www.facs.org/residencysearch/index.html
STUDENT DOCTOR FORUMS (Excellent!!)- www.studentdoctor.net
ERAS- www.aamc.org/eras
SCUTWORK- www.scutwork.com
16