Game Plan for Competitive Residency

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OasisFTW

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I am a rising M2 who underachieved in undergrad. I think the best strategy is to assume that I want to go into something competitive and plan accordingly, instead of finding out late in the game when you don't have time to do significant research. This summer, therefore, I have been working on 2 projects: A first author health economics paper with an MD/MBA from Case Western (I majored in econ during undergrad) and a dermato-economic project with a Mass General dermatologist. Even if the health econ paper does not get published, I will be giving an oral/poster presentation on it during the fall. Since I spent most of my summer on this project, I will finish the derm project during the fall, which will result in 2 publications (a review article and a cost-benefit article). Apart from doing well on Step 1, 3rd year grades, and finding a mentor who can write me a strong LOR, any other advice to put me in the best shape for residency?

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Best bet at this point is to determine which competitive specialty you want. Throwing the next two years towards one specialty will build on your good base.

Howd M1 grades go? Are you on track to get AOA?
 
I am a rising M2 who underachieved in undergrad. I think the best strategy is to assume that I want to go into something competitive and plan accordingly, instead of finding out late in the game when you don't have time to do significant research. This summer, therefore, I have been working on 2 projects: A first author health economics paper with an MD/MBA from Case Western (I majored in econ during undergrad) and a dermato-economic project with a Mass General dermatologist. Even if the health econ paper does not get published, I will be giving an oral/poster presentation on it during the fall. Since I spent most of my summer on this project, I will finish the derm project during the fall, which will result in 2 publications (a review article and a cost-benefit article). Apart from doing well on Step 1, 3rd year grades, and finding a mentor who can write me a strong LOR, any other advice to put me in the best shape for residency?

In my first year of medical school a Urologist came and gave us a talk about how to get into Urology (presumably how to get into any competitive residency) and gave this advice, and in this order:

1. Step 1 score: 230 minimum. 240 preferred. 250+ is all the same
2. AOA / Class Rank: Be AOA
3. Research: Pubs > Posters > Bull****; High-Impact > Low-Impact > Nothing
4. Letters of Rec: Chair of the Department
5a. Auditions: Do aways. They are critical. Your best shot of getting a residency is either the home school or the place you do an away.
5b. Auditions can be your Personal Statement if going into something less difficult.
 
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In my first year of medical school a Urologist came and gave us a talk about how to get into Urology (presumably how to get into any competitive residency) and gave this advice, and in this order:

1. Step 1 score: 230 minimum. 240 preferred. 250+ is all the same
2. AOA / Class Rank: Be AOA
3. Research: Pubs > Posters > Bull****; High-Impact > Low-Impact > Nothing
4. Letters of Rec: Chair of the Department
5a. Auditions: Do aways. They are critical. Your best shot of getting a residency is either the home school or the place you do an away.
5b. Auditions can be your Personal Statement if going into something less difficult.

Yes, this sounds pretty right to me, although auditions can be more important or less depending on the specialty. To the OP, it sounds like you are considering derm. That's not just a competitive specialty, it is arguably the most competitive. You probably will need more research, and you need to blast step 1. Grades must be outstanding.
 
In my first year of medical school a Urologist came and gave us a talk about how to get into Urology (presumably how to get into any competitive residency) and gave this advice, and in this order:

1. Step 1 score: 230 minimum. 240 preferred. 250+ is all the same
2. AOA / Class Rank: Be AOA
3. Research: Pubs > Posters > Bull****; High-Impact > Low-Impact > Nothing
4. Letters of Rec: Chair of the Department
5a. Auditions: Do aways. They are critical. Your best shot of getting a residency is either the home school or the place you do an away.
5b. Auditions can be your Personal Statement if going into something less difficult.

Agree with this. Would add two caveats:
1. AOA. Not essential, just helps you. Some schools have some really wonky standards for choosing AOA. Don't kill yourself to get it. Kill yourself to do the things in your control.

2. Research. Better to be the frontman for a poster presentation than a bench monkey 5th author on a publication. The purpose of research on your application is to demonstrate you are going to be a productive publisher as a resident (which reflects well on the chair and program). The more responsibility you have over a research study and the more intelligently you can talk about it, the better it reflects on you, even if it doesnt make it to publication.
 
I am applying for residency this year and from my conversations with program directors and interviewers, I have gathered that these are the only things that matter...

Step 1 score (250+ ideal)
Junior AOA / Class rank (top quartile)
Honors in Medicine and Surgery clerkships (other clerkships meaningless)
LORs from an internist and a surgeon
Meaningful research

I have never once been asked about clerkship grades besides medicine/surgery, volunteer work, or leadership activities.
 
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I am applying for residency this year and from my conversations with program directors and interviewers, I have gathered that these are the only things that matter...

Step 1 score
Junior AOA / Class rank (top quartile)
Honors in Medicine and Surgery clerkships (other clerkships meaningless)
LORs from an internist and a surgeon
Meaningful research

I have never once been asked about clerkship grades besides medicine/surgery, volunteer work, or leadership activities.

...What specialty are you applying to?
 
Radiology. Btw, ME rocks!

I have yet to meet a single radiology resident (at 2 different hospitals so far i've rotated at) who was AOA. These are also good residency programs. Radiology is also largely a lot of anatomy and basic sciences so their emphasis on clinical training is probably less but I've never heard a radiology *resident* say that clinical grades are worth LESS than preclinical grades. I suppose it depends on the current crop of program directors.

Point is (for others reading this thread) you don't need AOA to match radiology, urology, ophthalmology, etc. It helps a little bit but it won't make or break your application if you're strong in every other respect.

Agreed with most of the above. Step 1 score 240+ (250+ is good too i suppose), research, letters of recommendation, and auditions.
 
Step 1 score is really the major door opener. If you can rock Step 1, you will be on every residency program's narrow list. When I was on my residency program's applicant selection committee, we had to filter through thousands of good applicants. It's nearly impossible to do this by hand; so as you imagined, each applicant's hard scores were input into a software program and each applicant was given a total score. Interview invites were given to those scores at the top, and then we spent more time reviewing the middle tier scores. The lower tier scores were neglected unless sometime came up (a phone call from applicant or faculty sponsor). Keep in mind, the total score was weighed on different criteria, but the most weight was given to Step 1 score.

Once you were invited for an interview, then the we re-scored each applicant based on the interview, recommendations, etc, etc. Once you reach this point, the Step 1 score doesnt manner much anymore.
 
I may be in the minority to say this, but...Research is only helpful in the field to which you are applying, if it is a competitive specialty.

What I mean by that is that IM or Peds programs will be happy you did research in radiology or brain tumors or whatever. But Derm programs aren't going to give a **** about research you did outside of derm. Same is true for ortho, ENT, nsurg, rad-onc.

Aways are very specialty-specific as someone mentioned. My understanding is that for ENT, they quickly pigeonhole you and many people don't do them. Whereas, for my specialty, everyone did at least two...

Moreso than step 1 / research / grades, you need to know how to represent yourself as a normal human being at interviews. This is what kills otherwise good applicants on paper. Talk extensively with residents in your field of choice, and the PD/chair of that department, to see exactly what you should be / shouldn't be doing on interviews.
 
What I mean by that is that IM or Peds programs will be happy you did research in radiology or brain tumors or whatever. But Derm programs aren't going to give a **** about research you did outside of derm. Same is true for ortho, ENT, nsurg, rad-onc.


I've only personal spoken with one PD about this, but this was most certainly not the case, according to him. He is more than happy to see research of any type on a student's resume, particularly if it's led to publications or other meaningful endeavors.
 
I've only personal spoken with one PD about this, but this was most certainly not the case, according to him. He is more than happy to see research of any type on a student's resume, particularly if it's led to publications or other meaningful endeavors.

This is the same problem seen with the poll given out to PDs and published by NRMP...where pretty much everything on the ERAS application is listed as "important". It costs them nothing to say this. But when it really comes down to it, of course research within the field is way, way, way more important than research done elsewhere.
 
This is the same problem seen with the poll given out to PDs and published by NRMP...where pretty much everything on the ERAS application is listed as "important". It costs them nothing to say this. But when it really comes down to it, of course research within the field is way, way, way more important than research done elsewhere.

I wouldn't say its more "important"... but research within their field is generally more interesting to them than research out - though there are exceptions. And being interesting in competitive specialties, where the applicants are amazingly homogeneous on paper, can mean quite a bit.
 
That advice I gave was just the optimal stats that would most likely guarantee you an interview. Class rank is probably about as good as junior AOA. Once you get an interview at a program, I suspect these raw data are less important and all bets are off. In other words, personality and sincerity of interest will determine your matching.
 
What about research in a "related" field. For example, right now I'm working in the Ortho department at my school, but I'm actually interested in just doing general surgery. I was also thinking sports medicine or PM&R. Would my current research project help boost my resume if I get into one of these fields? Or does it not count as research in that field?
 
What about research in a "related" field. For example, right now I'm working in the Ortho department at my school, but I'm actually interested in just doing general surgery. I was also thinking sports medicine or PM&R. Would my current research project help boost my resume if I get into one of these fields? Or does it not count as research in that field?

I would assume it would obviously be a plus but I also dont think research is really necessary to match gen surg.
 
Looking at all the lifestyle residencies (derm, optho, anes, rads), derm is far and away the hardest to get into (70 percent match rate) compared to the other 3, which have match rates in the 90 percent range. As a result, I decided it would be best to do research in derm, as even a stellar Step 1 score is no guarantee of getting a derm match compared to the other ones. Also, I think my health economics research will prove to be extremely important, as it is one of my passions that will hopefully distinguish me from other applicants. Furthermore, given the uncertainty of health care reform and Medicare reimbursement cuts is likely to impact all specialties, such research might even have more impact than any research I do in a specialty.


This is the same problem seen with the poll given out to PDs and published by NRMP...where pretty much everything on the ERAS application is listed as "important". It costs them nothing to say this. But when it really comes down to it, of course research within the field is way, way, way more important than research done elsewhere.
 
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