matching question

[entprospect]

So, its end of the 3rd year. I have a strong interest in ENT; however the response from the dept and the folks at my school has been semi discouraging. They seem to constantly remind ever "its a tough match." etc. etc. Which might be a great service they are doing to us, but than i'm not really sure what I should do. I really like ENT and that would be my #1 choice, but if its that hard to where i have a 50/50 chance of not matching than i also like other fields (nerosurg: where i've had a great response from the dept). My stats: 240 and i'm in the upper 1/2 of my class at a top 50 school but not AOA currently working on my first research project (no pubs). I am shooting for any program not necessarily the top ones. Please be honest and tell me what my chances are. I would appreciate all your help.

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[chirurgino]

Your step I score is definitely good enough. The research will help you also--it'll be important to get at least a small pub if you're working on a clinical research project--with a basic science project, it may be more difficult to get a publication before you interview, and that would be OK.

My impression is that AOA is not a make-or-break thing (obviously it does help), but I think you really need to get honors in surgery and of course your ENT sub-I. While on the interview trail this year, I didn't get a great sense of what % of applicants were AOA or what percentile they were in their class (there are people on this forum who have sat on interview committees and they will have a better sense of this). Make sure you get multiple letters from ENT faculty.

The ENT match is definitely competitive, make no mistake about it, but it sounds like you have a shot. Get some good advice from an advisor at your home program who you trust--they will have a better sense of how people from your institution have done in recent matches.

 

[resxn]

I'd say that with those numbers you'd be in the top 50% of those applying to ENT, so go for it. I'm not sure what the current numbers are but I think they are holding pretty steady in that at worst 2/3 applicants match. It's probably slightly higher than that many years. Still with a 30% non-match rate that can be pretty scary.

I'd agree with the above in that you really want to try to get some publications out there if possible, but even without one, being able to describe the research in detail is worth points on the interview.

Here is what our committee looked for at the 2 schools where I've been involved with matching residents:

Paperwork Criteria, when deciding who to invite for an interview:
#1 - Step I
#2 - Class rank
#3 - Letters of Recommendation
#4 - Research (some schools rank this higher, but I was at 2 clinical programs)
#5 - Rotation Grades
#6 - AOA
#7 - Bonus stuff - extracurricular activities (some pheonomenal sports thing, or working as a museum curator, or having artwork published, or whatever)
#8 - Quality of the med school

Each bullet outranked the next one in importance, so if there were 2 candidates who looked similar, the chairman would keep looking to see if the next bullet broke the tie. If #7 is really special it could trump a lot of the above bullets. For example, there was a guy who played NCAA Div I ball for a team that went to the Final Four. He played all 4 years in college and then played a year of European ball before going to med school. His extracurricular stuff earned him an interview even though his numbers weren't as great.

In the Interview, at least at my program, the criteria were
#1 - Personality
#2 - Personality
#3 - Personality

In other words, once you made the interview, your academics were good enough to match. The question was whether you'd be a good fit for the personailty of the program. Every department has a different one and the better the chemistry among residents and between faculty members, the better the department is overall. Anyone who has been on a team with a great chief and good residents or who has been with a terrible chief and bitter residents knows this. I think that is particularly true in ENT when most of the ENT teams are small groups.

 

[chirurgino]

entprospect--the other thing I forgot to mention is that you'll get great advice from guys like rsxn and The Throat on this board (as you can see above). You'll probably stumble onto otomatch.com at some point--this is very helpful in stressing you out while you're waiting for your interview invites (and can see when everyone else is getting them), but take all the general advice on that board with a big chunk of salt.

 

[aggernodi]

The one thing I would add is doing a sub-I at a program you are interested in and work your butt off and be personable. This can either really help you or hurt you bad. No middle ground.

If they like you, you will (almost) be a shoe in.

If they dislike you, well, you most definitely won't match there.

 

[resxn]

The one thing I would add is doing a sub-I at a program you are interested in and work your butt off and be personable. This can either really help you or hurt you bad. No middle ground.

If they like you, you will (almost) be a shoe in.

If they dislike you, well, you most definitely won't match there.

Yes, SubI's are a double-edged sword. I usually recommend against them (at your top program--I'm all for them at one of your mid-tier choices) because at least when SFmatch was doing our stuff they showed that SubI's usually did not match at their SubI school. My chairman felt that SubI's hurt themselves more often than helped themselves and I think pretty much the same thing, but I've said that before.

 

[dynx]

Hold on here. You're saying that playing basketball (granted at a very high level) played into your PDs determination that he was a worthy candidate for a ENT interview? What the F*ck is the thought process there?

 

[entprospect]

thank you for the info. I appreciate all the advice.

 

[TheThroat]

My program was research heavy, so we put an emphasis on having some research in candidates that we interviewed. The one thing that separated candidates was their interest in research and commitment to being active in a research environment.

This is where the interview comes in. I had no publications going into interviews and had only worked on a basic science prject. I would say that at least 1-2 interviewers at at program asked me about my research. Having "slides" of your research on color paper and being able to "present" the research that you did in fives minutes, in my opinion, can be very helpful in showing your interest in the project that you completed.

 

[TheThroat]

Yes, SubI's are a double-edged sword. I usually recommend against them (at your top program--I'm all for them at one of your mid-tier choices) because at least when SFmatch was doing our stuff they showed that SubI's usually did not match at their SubI school. My chairman felt that SubI's hurt themselves more often than helped themselves and I think pretty much the same thing, but I've said that before.

Completely agree. I did not do an away sub-I, but candidates from schools that don't have an Oto dept should definitely do one. IF you do an away sub-I, be prepared to eat/drink/sleep oto for a month. Get up at 3 am, round on every patient, memorize every detail of their history and be ready to present them on rounds. Ask to be a scut monkey (get films, call consults, fill out reqs for rads/labs, etc). Then go home and read up on your patients' problems. Don't blab about how you know this or that, but let the residents kow what you are reading. Ask one or two questions per case in the OR (again, don't blab, just a question here or there). This will remind the staff that you are thinking about the case.

We had some sub-I's who were awesome, but most just acted like they were there to be a regular med student. I can stilll remember the good ones, though.

 

[TheThroat]

Hold on here. You're saying that playing basketball (granted at a very high level) played into your PDs determination that he was a worthy candidate for a ENT interview? What the F*ck is the thought process there?

Honestly, this is rarely the case, but it does play a part in the overall picture. Doctors are not and should not be robots. Looking at hundreds of applications makes one think, "Is every one of these guys the same person?" Obviously, the Div 1 bballer also has to have the other qualifications as well. That said, having a great talent can definitely separate a candidate from the "crowd".

 

[MattMKL]

.

 

[aggernodi]

Lets say you do an away sub-i and neither impress nor disappoint the staff, sort of the regular med students you mentioned above. Does that actually count as a negative against you since the program has already had the opportunity to assess you and were relatively unimpressed?

I would say it would count as a negative... If you plan to do an away sub-I with the intention of matching there, you really have to go to impress. Do not think of going as a regular medical student, but a super duper workaholic medical student.

 

[TheThroat]

I would say it would count as a negative... If you plan to do an away sub-I with the intention of matching there, you really have to go to impress. Do not think of going as a regular medical student, but a super duper workaholic medical student.

Agree completely. This is the reason my chair told me NOT to do an away elective...mainly bc/ he new that once people got to know me, there would be no way that I would match anywhere.

 

[msl2007]

bc/ he new that once people got to know me, there would be no way that I would match anywhere.

LOL.

 

[AMedStud]

So should I do research in the institution where I want to go for residency?

 

[drfunktacular]

Agree completely. This is the reason my chair told me NOT to do an away elective...mainly bc/ he new that once people got to know me, there would be no way that I would match anywhere.

Ha. I hope they don't say the same thing about me... although I expect they might.

The Oto department at my school is undergoing some flux, so there is a good chance I won't have a chairman letter from my institution (I am on an oto rotation now sans-chairman, and may not be able to do one again until after applications are due). This leads to two questions: 1) will PD's know that about my school's dept and cut me some slack w/r/t the chair's letter? 2) Does that make an away sub-I more advantageous in trying to get a chair's letter elsewhere (even bearing in mind all the foregoing comments about away sub-I's)?

 

[resxn]

Ha. I hope they don't say the same thing about me... although I expect they might.

The Oto department at my school is undergoing some flux, so there is a good chance I won't have a chairman letter from my institution (I am on an oto rotation now sans-chairman, and may not be able to do one again until after applications are due). This leads to two questions: 1) will PD's know that about my school's dept and cut me some slack w/r/t the chair's letter? 2) Does that make an away sub-I more advantageous in trying to get a chair's letter elsewhere (even bearing in mind all the foregoing comments about away sub-I's)?

overall, that situation sucks.

Yes, every chair pretty much has an idea when a chair at another department leaves. With only a handful of programs, the world of ENT is small and word travels fast. Lightning fast.

Most places will cut you slack for that.

A letter from the chair at an outside school is better than no letter at all, but just use common sense. First, every school to which you apply will know that you got that letter after being around for only a month. How much can that really mean? Second, when you think about it why would a chair from another school write a glowing letter for you? If he loves you, a glowing letter would make other programs want you making it less likely that he gets you. Other programs would see a glowing letter from the opposite side (they think: if he--the chair--wrote such a great letter after knowing this kid--you--for only a month, he doesn't want him (you) as much as he wants him (you) to match somewhere else).

Nevertheless, it does show some good initiative if you're able to get a chair from another school to write you a letter--it just has that double entendre.

tough situation. good luck.

 

[TheThroat]

"So should I do research in the institution where I want to go for residency?"

In a word, no.

"Agree completely. This is the reason my chair told me NOT to do an away elective...mainly bc/ he new that once people got to know me, there would be no way that I would match anywhere."

Did I really misspell "knew"? Wow, people must think that I am a total Texas bumpkin...oh...wait, nevermind.

 

[drfunktacular]

overall, that situation sucks.
when you think about it why would a chair from another school write a glowing letter for you? If he loves you, a glowing letter would make other programs want you making it less likely that he gets you. Other programs would see a glowing letter from the opposite side (they think: if he--the chair--wrote such a great letter after knowing this kid--you--for only a month, he doesn't want him (you) as much as he wants him (you) to match somewhere else).

I can certainly see your point, but isn't some of that inherent in a letter of rec even from the chair of your own dept? As in, "if this is kid is really so great, why isn't the chairman at X school of medicine trying to keep him at that institution?"

Any other tips for dealing with this state of affairs?

 

[resxn]

I can certainly see your point, but isn't some of that inherent in a letter of rec even from the chair of your own dept? As in, "if this is kid is really so great, why isn't the chairman at X school of medicine trying to keep him at that institution?"

Any other tips for dealing with this state of affairs?

No, not entirely. Your chair's job is to get you matched IF and only IF you're a quality student. When your own chair writes a letter on your behalf the language they use is very specific indicating what they think of you. If it's glowing, they're sticking their neck out for you. Also, most programs don't want to take students from their own school too often--it creates a reputation of being a homer which can hurt a national reputation. If Hopkins only took Hopkins students, it reflects poorly on them nationally with the other chairs.

Other advice? No, not really. I'd get the SubI letter because like I said, some letter is better than none. And programs will likely know why you don't have a letter from your own chair. It just isn't the ideal and that's what sucks and that was my point. In the grand scheme I doubt it will make much difference at all and I wouldn't sweat it. It would be a bigger deal if you were below average applicant (and by that I mean bottom 20% of the applicants) and you really needed a good chair going to bat for you.