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Road to residency

Getting into residency is just like applying to medical school.  When your doing it, it seems overwhelming, complex, and full of pointless essays.  But after matching, you gain perspective and it seems simple.  So here are few tips that I have gained from my match experience.  I would say I was a rather average applicant, but I matched to both my #1 choices in ophtho (SF match) and prelim Internal Medicine in regular match.

Getting Started:
The first step is picking your path.  It is important to settle on one career choice.  Each program wants to think your only interested in that program and will go into that specialty.  If you’re applying to several specialties, they will lose interest fast.  This is not an issue for most, but if you are the fence, cancel your next rotation and start doing Sub-Is until you find what you love.

Getting Your Stuff Done:
You can NEVER have your application done soon enough and never count on anything done.  I would recommend asking for letters of recommendation at the end of each rotation; especially if you think you did well.  It is always better to have too many letters, and when your application is due you do not want to waiting on that last letter.  Even if you asked for a letter of recommendation 6 months ago, do not count on it being done.  I recommend two months before the opening of that match you contact each person you have asked, and politely inquire if they have written the letter.  If they haven’t, do not lose touch with.  Contact them weekly until it is done.  The same is true for every other aspect of the application.  Never assume something will be done because someone has reassured you; this is your future not theirs.

You will be surprised in the delays that you will face.  I had 100% of my applications done prior to SF Match (early match) opening, and because of clerical delays I missed deadlines for schools for ERAS programs, despite having 100% of my letters, pictures, essays, etc done.  You need to check your application status constantly and contact your Dean’s office daily.  Be a bother!!!  I checked every other day and as a result, I missed deadlines, and by the time I complained to the Dean it was too late.  Don’t let this happen to you.

In addition to getting it done, programs see early applications as interest.  They will only pick a limited amount of applicants to interview.  So have your application on top.

Doing Aways:

Think of your aways as interviews.  Towards the end of third year, you should make a list of programs that you will appear at the top of your match list.  These are the schools were you should do aways.   Aways are a great way to get to know a program and the best way from residencies to get to know you.  Programs care more about how you fit in than your grades, your step 1, or anything else in writing.  The program has to work with you for years, so “Fit” is extremely important to residency.  As a result the residencies where you are most likely to match are 1) Your home program 2) programs in the same region 3) programs where you have done aways.

When you do aways, it is needless to say you need to know interest above and beyond the typical student and be nice to everyone.  The sectary that keeps losing your paper work, is already part of the department and her musings mean more than your application, so be graceful!

If you did not do an away, all hope is not lost, keep reading.

Communicate Early and Often:
Most of the programs that you are applying to have no idea who you are or why you are applying.  This leads to predictable results.  When you make the list of programs you are applying for, you should write a letter/email to every program director and tell them briefly why you want to interview at their program, list your personal ties to the area, and another information that you think is remotely relevant.  This will open doors to programs that you would not haven been asked to interview at.

When invites begin rolling out, do not wait for invites, contact programs you have not heard from.  Reiterate your interest.  This will get your application looked at again and will demonstrate your sustained interest, this can move your application up in the ‘pile.’  If you did an away, this is a great time to contact professors, which you developed a relationship with.

Finally, ‘no’ does not mean ‘no.’ If a program you really want to go to turns you down.  Do not take it lying down!  Decisions can be over turned.  Call the sectaries, relate to them (let’s face it, nurses run the hospital and assistant directors run the admissions office).  Talk with the program director; ask why your application fell short.  Your interest is something that < 1.0% of applicants show.  Hopefully you did an away, this is a good time to contact professors to talk with the chair and program director on your behalf.

Types of Letters:

There are 3 types of letters of recommendation
1)    Personal Letters:  These are typically written by young enthusiastic attendings.  These demonstrate your character and you should have at least one
2)    Famous Letters: These are written by the famous/well-known attendings.  The more well known the letter-writer the less personal these letters are.  These letters are often standard forms fill out by secretaries.  These letters, while not glowing, carry a lot of weight.  The letter states that Dr. X endorses you.  You should have 2 of these letters.

  1. There are various degrees of fame.  Any program director’s letter will carry weight and will be well received by other program directors.
  2. A legend in the field, Dr Wiese, Dr Sabiston, or Dr Kaniski, their letters are worth more than their weight in gold.

3)    The Elusive Famous + Personal Letter:  The best of both worlds, there are a few of these floating around each match.  They are golden tickets for interviews.  Don’t hold your breath for one, but use it if you got it!

How to Get into the Program You Want:
1) Aways away away
2) Communicate
3) Letters of recommendation
4) Never let anyone tell you what you cannot do.  Your grades, your step 3

Remember, that there is nothing magical to the match.  You pick programs that appeal to you and programs pick applicants that appeal to them.  Programs want people that want to go to the program and will fit in.  Their best bet is picking from regional programs.  They have so many suitors that they don’t need to pursue every applicant.  Most pick the people they will interview based off of med school, did they do an away, letters of recommendation, and a few facts from their cover sheet.  Most do not read essays until the day-of-interview and only to tease out a few talking points.  This means that the majority of responsibility for getting an interview lies with the applicant and how they court the program.

I can unequivocally say that my prospective works and feel free to contact me for any help 😆