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If you’ve found this thread looking for advice on how to match to a military residency, this is the wrong thread. The intent of this thread is to help military docs prepare for applications to the civilian match. A decent percentage of those who do HPSP decide to pay their time back as a GMO and get out for civilian residency. The problem is that there is VERY little help in regards to the planning that takes place to match. I am going to do my best to give a timetable for you to work with. I will also give valuable resources that you can use to make yourself the best civilian applicant you can be.
FIRST YEAR INTO GMO/FS/UMO TOUR
STEP 1. Determine the date of the end of your military commitment
-If you are signed up for a 4-year HPSP, like most people, it will be four years after the end of your internship.
STEP 2. Determine the competitiveness of your specialty, in context to your resume and degree type
-Not everyone was made for Dermatology, Neurosurgery, and ENT. You need to research the competitiveness of your specialty to determine the likelihood of you matching. I would go to the NRMP Charting Outcomes to get that information. http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf. Your degree type does matter. DOs are at a significant disadvantage when applying to particular residency types. IM, EM, FM, OB/GYN, Peds, Psych, Neuro, Path, Anesthesia, and PM&R tend to be more DO-friendly. Rads and Gen Surg are typically somewhere in the middle. Surgical subspecialties, Rad-Onc, and Derm tend to be DO-unfriendly. Also realize that many ACGME program types require USMLE. PM&R does NOT, but not having USMLE will hurt you while applying to most other specialties.
STEP 3. Educate yourself on the types of civilian residency programs
-The military match is very simple to understand. You match in December, and you show up the next Summer to start training. It’s not that simple for civilian programs. The reason is that there are multiple program types. Here is a brief overview on the residency types:
Transitional: PGY-1 only; starts the Summer after the match
Advanced: PGY-2 through completion of training; starts two summers after the match (assumes you will complete a transitional year prior year)
Categorical: PGY-1 through completion of training; starts summer after the match
Physician: PGY-2 through completion of training; starts summer after match (assumes you have completed PGY-1)
STEP 4. Determine the type of program you will apply
-I am going to assume that you have completed your internship, so that takes transitional programs off the table. That leaves advanced, categorical, and physician spots. There are advantages and disadvantages to each, but I personally believe that advanced programs have far less risk than other programs. Here’s the reason. You will later read that you have to get your resignation paperwork in about a year prior to separation. You match two years in advance for “advanced” programs, and therefore you will find out whether or not you have matched before you have to submit your resignation papers. You will not be able to do that with categorical and physician slots because you match only a few months prior to your resignation. So if you fail to match to an "advanced" program, oh well…you keep your military job and you don’t starve to death. You could try to reapply civilian the following your or apply military…life goes on. Not matching after you have submitted your resignation paperwork is a life altering event. It is NOT easy to pull back resignation paperwork. In my opinion, the only times you should apply categorical or physician is if your specialty doesn’t have advanced spots, if you get a military deferment or full-time out-service for the following year, if you are applying to a specialty that requires you to repeat an internship for lapses in training, or you are entering a completely different field than your internship (medicine to surgery, or instance). There is no one single resource available with that updated information, so you may need to do some legwork to better educate yourself about your desired specialty’s process. Obviously, going physician only would be preferable to categorical because you won’t have to repeat an internship (assuming you have a qualifying PGY-1 under your belt), but the problem with physician spots is that there are FAR fewer of them available each year. Have I sold you on applying to advanced programs yet? Good. Now let’s move on.
28 MONTHS PRIOR TO SEPARATION
STEP 1. Communicate with your clinical education department
-You know those awesome LORs you received in medical school? In all likelihood, your clinical education department got rid of them over the years. The LORs that were uploaded into ERAS years ago have disappeared into cyberspace. You will need to notify your clinical education department about your intent to apply to civilian residency for a particular match season and for them to expect to see LORs sent their way. They will be responsible for giving you your ERAS token (when ERAS opens), submitting your LORs, and submitting your Dean’s Letter (which will likely still be on file).
STEP 2. Collect Letters of Recommendation
- Understandably, you may not be able to get a new specialty LOR for an obscure specialty during your fleet tour. You can use medical school recommendations, but at the very least I would get your letter writers to update the dates on their letters. A program may have a tough time taking a recommendation seriously if it is 4-5 years old. I would encourage you to get “grown-up LORs”. A strong LOR from your internship program director and your senior medical officer will likely have more importance than a random non-specialty med school LOR.
STEP 3. Set your application season budget
-Figure out the cost of applications, lodging, and travel for the number of interviews you anticipate attending. KEEP TRACK OF ALL OF YOUR EXPENDITURES. YOU CAN ITEMIZE ABSOLUTELY EVERYTHING FOR TAX PURPOSES.
24 MONTHS PRIOR SEPARATION
STEP 1. Write personal statement
-I would recommend not using your internship PS. You can try to amend your prior PS to include more updated information, but you really run the risk of it not being a flowing prose. After a strong introduction, I prefer a chronological personal statement. When you get to your fleet experience, be sure to tie in how your fleet experience has prepared you to enter the residency you desire. An example could also be helpful in putting it over the top. Most medical school resumes look very similar. The personal statement of a GMO has a very good opportunity to stand apart. Do NOT underestimate the power of a strong personal statement.
STEP 2. Discuss residency plan with your commanding officer
-You must have your CO’s support to go on leave and/or TDY for the number of interviews you will need to attend to match. If you CO is concerned about giving you that many days off, I would recommend printing out the NRMP Charting Outcomes for your speciality to show how many programs you need to have a 90% probability of matching. I would request No-cost TDY, but if they are unwilling at bare minimum you should be able to land cost-TDY so you don’t have to eat into your leave.
STEP 3. Discuss coverage plan with other providers
-Self-explanatory. You need to have a general coverage plan.
MONTH OF MAY, YEAR PRIOR TO YOUR SEPARATION
STEP 1. Gain access to ERAS
-You may need to create a new ERAS account if you have forgotten your log-in information. At minimum, you will need your AAMC number, ACGME number, AOA number (if DO), and ERAS token. This can be acquired from your medical school’s clinical education department, and if they don’t have it you will need to contact AAMC/ACGME/AOA.
-ERAS opens in late May. Having access to ERAS is very helpful because you can very quickly search program information. For instance, you can look up advanced FP programs and it will spit out the entire list of them at you. This will allow you to focus your search on where you want to apply and how many applications you want to put out. The number of applications depends largely on the specialty you are applying and the competitiveness of your application. I would recommend applying to as many programs as your budget allows. You do NOT want the reason you didn’t match to be because you didn’t apply broadly enough.
MONTH OF JULY-SEPTEMBER, YEAR PRIOR TO YOUR SEPARATION
STEP 1. Submit applications.
-I would have EVERYTHING ready to go with ERAS weeks before invitations are sent out. ERAS will slow considerably in the days before the opening day for invites.
-Submit your application on opening day. Interviews are often issued on a first come, first served basis. For AOA, applicants can start applying in July. For ACGME, applicants can start to apply in September.
MONTH OF JANUARY-FEBRUARY PRIOR TO YOUR SEPARATION
STEP 1. Certify rank list on NRMP.
-Ensure you have selected the appropriate program type (as in advanced) and correct program.
-Try to cope with the longest 2 or so months of your life.
CONGRATS, YOU HAVE MATCHED! WHAT’S NEXT? WHILE THE OTHER FOLKS WHO MATCHED TO YOUR ADVANCED CLASS GO THROUGH INTERNSHIP, YOU CONTINUE YOUR DAY JOB, WHILE GETTING A FEW THINGS ACCOMPLISHED.
14 MONTHS PRIOR TO SEPARATION
STEP 1. Determine your GI Bill status
-Were you given incorrect counseling regarding your Montgomery GI Bill benefits? If you will be attending residency in a location with a low BAH, now is the time to contest your Montgomery GI Bill benefits. The appeals process can take a year, so you want to get started. Read my post here to see more details on how to do that: http://forums.studentdoctor.net/threads/important-info-for-new-accessions-gi-bill.485739/page-4
12 MONTHS PRIOR TO SEPARATION
STEP 1. Submit your resignation paperwork
-You will need to submit the following three documents on command letter head through your admin department to the appropriate authority (Navy is SECNAV): unqualified resignation from active duty, first endorsement for unqualified resignation from active duty, reason for submission of request. Speak to your detailer or admin department for more details. Ask someone who has gone through this before for a template. I’m Navy and I don’t mind sending anyone a template.
STEP 2. Talk to your command counselor
-They will give you information on TAPS (or the other branches equivalent transitions course) along with filling out paperwork you will need.
6-12 MONTHS PRIOR TO SEPARATION
STEP 1. Attend TAPS
-They will provide you more information on your GI Bill benefits, get you signed up for E-benefits, and talk about disability. You could be exempt from a portion of TAPS with your residency program letter of assignment.
6 MONTHS PRIOR TO SEPARATION
STEP 1. Have Separation physical
-This can’t be done until 6 months prior to separation. I would do it promptly at the 6-month mark, especially if you have any service connected disability
STEP 2. Request GI Bill benefits on E-benefits
-It will take time for the VA to mail you a letter saying that you are all set. At that time you will get instruction to contact a certifying official at the program you will be attending. This is usually handed by the medical school and NOT the residency program. Eventually you will need to get your certifying official a copy of your DD-214 which you receive at the time of getting your resignation orders.
STEP 3. Speak with your local AMVET representation
-If you have service connect disability, you will want someone to walk you through the process. There are lots of forms to fill out and stay on top of. You can’t afford to make a mistake on the forms and delay yourself lots of time. Get a representative. If you are married, you will need a copy of your marriage certificate. If you have children, you will need copies of their social security cards.
STEP 4. Contact resignation authority
-For the Navy it is PERS-834F to ensure that your request for resignation has been approved. They will unlikely write you your resignation orders right away due to budget constraints, but the key at this point is that they have been received and approved.
3-4 MONTHS BEFORE SEPARATION
STEP 1. Ensure that your residency program has contacted you
-They at the very least should give you instruction on filling out paperwork for your state medical licensure
-Also, look into the perks of the company that will employ you…you’ll be surprised. There are sometimes hospital specific classifieds where you can find a place to live. You can also look into medical, dental, insurances, etc. Get that stuff squared away to get an idea of your post-military budget
STEP 2. Get your resignation orders and DD-214
-They are your ticket to completing your disability claim, getting household goods scheduled, along with having the ability to separate.
-Waiting for order sucks. Assuming that they have been approved, you will get them. If you DO NOT receive your orders (very rare), they can be produced within a week by contacting your service's resignation authority (PERS-834F in the Navy)...so don't sweat it.
-After you receive your orders (you will likely get them from your personnel authority or command), you will need to notify your command career counselor. He/she will then organize a meeting with PSD (or your personnel support detachment "pay people" equivalent) who will go over your separation itinerary including travel and your DD-214.
-Your DD-214 may be required to apply for your medical licensure for civilian residency, and will be required for you to submit for disability. It is not essential to process your MGIB/P911GIB but your residency program will request a copy in case they get audited.
STEP 3. Start talking to your detailer and commanding officer to see if your replacement is in line.
-Who wants to be grinding up until the time you get into residency? It's also a nice thing to do for your command.
AFTER THAT YOU SHOULD HAVE COMPLETED EVERYTHING YOU NEEDED TO GET ACCOMPLISHED BEFORE RESIDENCY. SIT BACK AND DO YOUR BEST TO RELAX.
FIRST YEAR INTO GMO/FS/UMO TOUR
STEP 1. Determine the date of the end of your military commitment
-If you are signed up for a 4-year HPSP, like most people, it will be four years after the end of your internship.
STEP 2. Determine the competitiveness of your specialty, in context to your resume and degree type
-Not everyone was made for Dermatology, Neurosurgery, and ENT. You need to research the competitiveness of your specialty to determine the likelihood of you matching. I would go to the NRMP Charting Outcomes to get that information. http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf. Your degree type does matter. DOs are at a significant disadvantage when applying to particular residency types. IM, EM, FM, OB/GYN, Peds, Psych, Neuro, Path, Anesthesia, and PM&R tend to be more DO-friendly. Rads and Gen Surg are typically somewhere in the middle. Surgical subspecialties, Rad-Onc, and Derm tend to be DO-unfriendly. Also realize that many ACGME program types require USMLE. PM&R does NOT, but not having USMLE will hurt you while applying to most other specialties.
STEP 3. Educate yourself on the types of civilian residency programs
-The military match is very simple to understand. You match in December, and you show up the next Summer to start training. It’s not that simple for civilian programs. The reason is that there are multiple program types. Here is a brief overview on the residency types:
Transitional: PGY-1 only; starts the Summer after the match
Advanced: PGY-2 through completion of training; starts two summers after the match (assumes you will complete a transitional year prior year)
Categorical: PGY-1 through completion of training; starts summer after the match
Physician: PGY-2 through completion of training; starts summer after match (assumes you have completed PGY-1)
STEP 4. Determine the type of program you will apply
-I am going to assume that you have completed your internship, so that takes transitional programs off the table. That leaves advanced, categorical, and physician spots. There are advantages and disadvantages to each, but I personally believe that advanced programs have far less risk than other programs. Here’s the reason. You will later read that you have to get your resignation paperwork in about a year prior to separation. You match two years in advance for “advanced” programs, and therefore you will find out whether or not you have matched before you have to submit your resignation papers. You will not be able to do that with categorical and physician slots because you match only a few months prior to your resignation. So if you fail to match to an "advanced" program, oh well…you keep your military job and you don’t starve to death. You could try to reapply civilian the following your or apply military…life goes on. Not matching after you have submitted your resignation paperwork is a life altering event. It is NOT easy to pull back resignation paperwork. In my opinion, the only times you should apply categorical or physician is if your specialty doesn’t have advanced spots, if you get a military deferment or full-time out-service for the following year, if you are applying to a specialty that requires you to repeat an internship for lapses in training, or you are entering a completely different field than your internship (medicine to surgery, or instance). There is no one single resource available with that updated information, so you may need to do some legwork to better educate yourself about your desired specialty’s process. Obviously, going physician only would be preferable to categorical because you won’t have to repeat an internship (assuming you have a qualifying PGY-1 under your belt), but the problem with physician spots is that there are FAR fewer of them available each year. Have I sold you on applying to advanced programs yet? Good. Now let’s move on.
28 MONTHS PRIOR TO SEPARATION
STEP 1. Communicate with your clinical education department
-You know those awesome LORs you received in medical school? In all likelihood, your clinical education department got rid of them over the years. The LORs that were uploaded into ERAS years ago have disappeared into cyberspace. You will need to notify your clinical education department about your intent to apply to civilian residency for a particular match season and for them to expect to see LORs sent their way. They will be responsible for giving you your ERAS token (when ERAS opens), submitting your LORs, and submitting your Dean’s Letter (which will likely still be on file).
STEP 2. Collect Letters of Recommendation
- Understandably, you may not be able to get a new specialty LOR for an obscure specialty during your fleet tour. You can use medical school recommendations, but at the very least I would get your letter writers to update the dates on their letters. A program may have a tough time taking a recommendation seriously if it is 4-5 years old. I would encourage you to get “grown-up LORs”. A strong LOR from your internship program director and your senior medical officer will likely have more importance than a random non-specialty med school LOR.
STEP 3. Set your application season budget
-Figure out the cost of applications, lodging, and travel for the number of interviews you anticipate attending. KEEP TRACK OF ALL OF YOUR EXPENDITURES. YOU CAN ITEMIZE ABSOLUTELY EVERYTHING FOR TAX PURPOSES.
24 MONTHS PRIOR SEPARATION
STEP 1. Write personal statement
-I would recommend not using your internship PS. You can try to amend your prior PS to include more updated information, but you really run the risk of it not being a flowing prose. After a strong introduction, I prefer a chronological personal statement. When you get to your fleet experience, be sure to tie in how your fleet experience has prepared you to enter the residency you desire. An example could also be helpful in putting it over the top. Most medical school resumes look very similar. The personal statement of a GMO has a very good opportunity to stand apart. Do NOT underestimate the power of a strong personal statement.
STEP 2. Discuss residency plan with your commanding officer
-You must have your CO’s support to go on leave and/or TDY for the number of interviews you will need to attend to match. If you CO is concerned about giving you that many days off, I would recommend printing out the NRMP Charting Outcomes for your speciality to show how many programs you need to have a 90% probability of matching. I would request No-cost TDY, but if they are unwilling at bare minimum you should be able to land cost-TDY so you don’t have to eat into your leave.
STEP 3. Discuss coverage plan with other providers
-Self-explanatory. You need to have a general coverage plan.
MONTH OF MAY, YEAR PRIOR TO YOUR SEPARATION
STEP 1. Gain access to ERAS
-You may need to create a new ERAS account if you have forgotten your log-in information. At minimum, you will need your AAMC number, ACGME number, AOA number (if DO), and ERAS token. This can be acquired from your medical school’s clinical education department, and if they don’t have it you will need to contact AAMC/ACGME/AOA.
-ERAS opens in late May. Having access to ERAS is very helpful because you can very quickly search program information. For instance, you can look up advanced FP programs and it will spit out the entire list of them at you. This will allow you to focus your search on where you want to apply and how many applications you want to put out. The number of applications depends largely on the specialty you are applying and the competitiveness of your application. I would recommend applying to as many programs as your budget allows. You do NOT want the reason you didn’t match to be because you didn’t apply broadly enough.
MONTH OF JULY-SEPTEMBER, YEAR PRIOR TO YOUR SEPARATION
STEP 1. Submit applications.
-I would have EVERYTHING ready to go with ERAS weeks before invitations are sent out. ERAS will slow considerably in the days before the opening day for invites.
-Submit your application on opening day. Interviews are often issued on a first come, first served basis. For AOA, applicants can start applying in July. For ACGME, applicants can start to apply in September.
MONTH OF JANUARY-FEBRUARY PRIOR TO YOUR SEPARATION
STEP 1. Certify rank list on NRMP.
-Ensure you have selected the appropriate program type (as in advanced) and correct program.
-Try to cope with the longest 2 or so months of your life.
CONGRATS, YOU HAVE MATCHED! WHAT’S NEXT? WHILE THE OTHER FOLKS WHO MATCHED TO YOUR ADVANCED CLASS GO THROUGH INTERNSHIP, YOU CONTINUE YOUR DAY JOB, WHILE GETTING A FEW THINGS ACCOMPLISHED.
14 MONTHS PRIOR TO SEPARATION
STEP 1. Determine your GI Bill status
-Were you given incorrect counseling regarding your Montgomery GI Bill benefits? If you will be attending residency in a location with a low BAH, now is the time to contest your Montgomery GI Bill benefits. The appeals process can take a year, so you want to get started. Read my post here to see more details on how to do that: http://forums.studentdoctor.net/threads/important-info-for-new-accessions-gi-bill.485739/page-4
12 MONTHS PRIOR TO SEPARATION
STEP 1. Submit your resignation paperwork
-You will need to submit the following three documents on command letter head through your admin department to the appropriate authority (Navy is SECNAV): unqualified resignation from active duty, first endorsement for unqualified resignation from active duty, reason for submission of request. Speak to your detailer or admin department for more details. Ask someone who has gone through this before for a template. I’m Navy and I don’t mind sending anyone a template.
STEP 2. Talk to your command counselor
-They will give you information on TAPS (or the other branches equivalent transitions course) along with filling out paperwork you will need.
6-12 MONTHS PRIOR TO SEPARATION
STEP 1. Attend TAPS
-They will provide you more information on your GI Bill benefits, get you signed up for E-benefits, and talk about disability. You could be exempt from a portion of TAPS with your residency program letter of assignment.
6 MONTHS PRIOR TO SEPARATION
STEP 1. Have Separation physical
-This can’t be done until 6 months prior to separation. I would do it promptly at the 6-month mark, especially if you have any service connected disability
STEP 2. Request GI Bill benefits on E-benefits
-It will take time for the VA to mail you a letter saying that you are all set. At that time you will get instruction to contact a certifying official at the program you will be attending. This is usually handed by the medical school and NOT the residency program. Eventually you will need to get your certifying official a copy of your DD-214 which you receive at the time of getting your resignation orders.
STEP 3. Speak with your local AMVET representation
-If you have service connect disability, you will want someone to walk you through the process. There are lots of forms to fill out and stay on top of. You can’t afford to make a mistake on the forms and delay yourself lots of time. Get a representative. If you are married, you will need a copy of your marriage certificate. If you have children, you will need copies of their social security cards.
STEP 4. Contact resignation authority
-For the Navy it is PERS-834F to ensure that your request for resignation has been approved. They will unlikely write you your resignation orders right away due to budget constraints, but the key at this point is that they have been received and approved.
3-4 MONTHS BEFORE SEPARATION
STEP 1. Ensure that your residency program has contacted you
-They at the very least should give you instruction on filling out paperwork for your state medical licensure
-Also, look into the perks of the company that will employ you…you’ll be surprised. There are sometimes hospital specific classifieds where you can find a place to live. You can also look into medical, dental, insurances, etc. Get that stuff squared away to get an idea of your post-military budget
STEP 2. Get your resignation orders and DD-214
-They are your ticket to completing your disability claim, getting household goods scheduled, along with having the ability to separate.
-Waiting for order sucks. Assuming that they have been approved, you will get them. If you DO NOT receive your orders (very rare), they can be produced within a week by contacting your service's resignation authority (PERS-834F in the Navy)...so don't sweat it.
-After you receive your orders (you will likely get them from your personnel authority or command), you will need to notify your command career counselor. He/she will then organize a meeting with PSD (or your personnel support detachment "pay people" equivalent) who will go over your separation itinerary including travel and your DD-214.
-Your DD-214 may be required to apply for your medical licensure for civilian residency, and will be required for you to submit for disability. It is not essential to process your MGIB/P911GIB but your residency program will request a copy in case they get audited.
STEP 3. Start talking to your detailer and commanding officer to see if your replacement is in line.
-Who wants to be grinding up until the time you get into residency? It's also a nice thing to do for your command.
AFTER THAT YOU SHOULD HAVE COMPLETED EVERYTHING YOU NEEDED TO GET ACCOMPLISHED BEFORE RESIDENCY. SIT BACK AND DO YOUR BEST TO RELAX.
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