Roadmap To Apply As A Pgy2?

[chicago13]

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So going along with some similar questions. what should i be doing next year as an intern to ensure that I can both apply and match in my 2nd year and not have to take a year off. i realize that being at a strong prog and research are the biggest factors. but more specifically:
1. Should I be going for a LOR during my CCU rotation?
2 Should I be going for a LOR during my cards consult month?
3. If I'm working on a real trial (unpublished) are "softer" things like case reports, and posters ok too?
4. This might be the dumbest question ever. Has anyone ever heard of interns taking one week of their very very precious vaca time to rotate at another institiution that they are very interested in? Lets say for instance your at Wash U or Michigan and then you really want to go to NYC for fellowship. Could you visit NYU or Mt. Sinai for instance in the hopes that it shows interest? or is this just crazy talk.
5. If my Step 1 is in the 230's and Step 2 is in the 250's when should I take Step 3? should i wait until after i start interviewing as a 2nd year?
6. when picking a researcher should i look for the biggest name guy thats nice or a guy who just publishes a lot? any specifics other than pick what I actually care about.
7. any other thoughts?

thanks!! really appreciate any help.

 

[P Diddy]

1. Should I be going for a LOR during my CCU rotation?

You need 3 letters minimum for your application: your residency director and two other letters (I seem to remember some programs asking for four; this may have changed). The letter from the residency director will probably be written by the secretary, so I suggest you get to know the secretary.

Your other two letters would ideally be from prominent cardiologists who know you well or have worked with you closely, either in a clinical or research capacity. The CCU is a great rotation to get a letter since your work is heavily scrutinized and you can really shine (or flop) as a resident. Even if you don't get a letter, a good performance bumps up your stock in the eyes of the local cardiology department. People do talk, and any good buzz (from fellows, nurses, attendings) is...good buzz.

2 Should I be going for a LOR during my cards consult month?

Cards consult month is another good month to obtain a letter since again you work closely with cardiology faculty who get a good feel for your fund of knowledge and clinical acumen. I would recommend that all your letters come from cardiologists; the exception would be if you're doing some amazing research with a prominent non-cardiologist who can speak about your research prowess.

3. If I'm working on a real trial (unpublished) are "softer" things like case reports, and posters ok too?

everything counts, and program directors realize how difficult it is to generate research during residency, especially when one is applying in their second year. case reports and posters show interest and while they don't carry the same weight as a published paper, they definitely carry more weight than blank space on a resume.

4. This might be the dumbest question ever. Has anyone ever heard of interns taking one week of their very very precious vaca time to rotate at another institiution that they are very interested in? Lets say for instance your at Wash U or Michigan and then you really want to go to NYC for fellowship. Could you visit NYU or Mt. Sinai for instance in the hopes that it shows interest? or is this just crazy talk.

visiting rotations for residents are possible, but I've never heard of anyone from my program (top 10) doing one, possibly because our program is strong and we match well in cardiology. if you were to do an away rotation you'd definitely want to get a letter for your file in that program to document the time and effort you put in. others may have more to say on this topic. I have heard of stranger thnigs than of using vacation time to do extra rotations. at my program, one of the clinical fellows spent half of her vacation in the cath lab. now that's crazy talk!

5. If my Step 1 is in the 230's and Step 2 is in the 250's when should I take Step 3? should i wait until after i start interviewing as a 2nd year?

I don't know that cardiology programs even look at Step 3 unless you fail. I applied third year so they could have looked at my depressing step 3 score. i think i read somewhere that some programs require Step 3 before applying, but I don't recall being required to enter my step 3 score at any time.

6. when picking a researcher should i look for the biggest name guy thats nice or a guy who just publishes a lot? any specifics other than pick what I actually care about.

pick someone who likes to work with residents and is productive. working with a big name is great if they write you a great letter, but the chances of that are relatively low if you have nothing to show for your efforts. the larger the lab (ie the greater the professor), the easier it is to get lost. that isn't always true, so I would say find someone who has ongoing projects that you can jump on and spin off of. keep in mind that when you are applying you likely won't have much to show, so you will be speaking largely of the _promise_ of whatever you are working on. do pick something you care about to research so that you can talk about it intelligently during an interview.


7. any other thoughts?

it can be a stressful process, but don't let it get to you. do whatever you can to make yourself a good candidate and then sleep easy. though cardiology is the most rewarding, fulfilling specialty in all of medicine and routinely attracts the most intelligent and physically striking applicants, I suppose even those who don't practice cardiology harbor the possibility of leading satisfied lives. keep things in perspective.

p diddy

 

[grendelsdragon]

I'll just add a few extra thoughts to P diddy's excellent post.

I've mentioned on a previous post that getting into a competitive cardiology program depends on first on solid clinical performance (reflected by statements in your chairman's/PD's letter) and on your research interests (past achievements and future direction). I say this because most of the top cardiology programs have taken an academic focus (for better or worse). With this in mind, let's address some of your questions:

1-2. LORs from CCU and consult month. Remember that you have only 3-4 reference leters (any more will be annoying). One-two will definitely be the chairman's and/or PD's letter. This letter is the principle letter people will be reading for your clinical perofrmance and your standing in your IM class (i.e. top, very best, amongst most favorite of all time, etc.).

So, your choice in LORs need to be strategic in light of this letter. If you perceive that this letter is very strong, there is little additional letters will add attesting to your clinical skills/personality/character. If, however, you perceive this letter is not as strong, then certainly you should bolster this with additional letters shedding light on your superior performance in the cardiology services. Otherwise, you are better off using your remaining letters rounding off the strengths of your application (like your research potential!).

4. Only for your personal edification if it will help you decide which place you like. Othwise, short aways won't help you. Better to use vacation time to relax and rally or catch up on backed up reading or research.

5. Although USMLE scores are important for getting into residency, cardiology fellowship applicants just need to have PASSED. In the interviews I have performed this year, the ERAS Common Application Form printout in my interviewer packet only listed the USMLE status as PASS/FAIL and the date of exam. This makes a lot of sense, because I don't much care whether an applicant is in the 99th percentile or 80th so long as they simply passed. I will look much more to the chairman's/PD's letter for the applicant's clinical skills and performance.

Good luck.

 

[chicago13]

thanks for all of the info. its been very helpful.
forgive my confusion, but I will need 3-4 LORs. So 1 will be my PD and 1 will be my Chair of IM or chief of cards? so then I only really need 1 more by my research mentor and then basically good to go. so the other months are not vital but good as backups i guess. is this correct? thanks for the advice.

 

[grendelsdragon]

thanks for all of the info. its been very helpful.
forgive my confusion, but I will need 3-4 LORs. So 1 will be my PD and 1 will be my Chair of IM or chief of cards? so then I only really need 1 more by my research mentor and then basically good to go. so the other months are not vital but good as backups i guess. is this correct? thanks for the advice.

Chicago,
Nobody should tell you what to do, and you certainly should not accept any line by line instruction/formula regarding these matters. Decide for yourself and be strategic about choosing the sources of your LORs. The makeup of these LORs depends entirely on your strengths and weaknesses and your judgment. I'll give you some very "common sense" pointers about LORs. Overall, I think ERAS accepts up to 4 LORs.

One of your primary letters will come from your residency program chair. Depending on your program, it may be a combined letter with the program director (for example, JHU IM letters have signatures from both Weisfeldt and Wiener). Sometimes, it's only the chairman, in which case you will have to decide whether the added weight of an extra PD letter will help you.

At least one of your letters should support your specific academic trajectory--that is to say what you have done and what you plan on pursuing for research.

It is not always advisable to ask the chief of cardiology at your institution to write you a letter unless he/she can write a strong letter (mostly only attainable if you do research for him/her).

ONLY ask for LORs from someone you know in advance will be a STRONG advocate. Nothing throws a wet towel on an application as badly as a luke-warm or mediocre LOR. Ask candidly (though with humility and sincerity) whether this person will write you a STRONG letter. If you get anything else but an enthusiastic response, say thank you then go to the next person on your list.

Good luck.

 

[bcheruvu]

Is there a specific step 3 score criteria for being competitive for cardiology?? i have passed on the first attempt. i scored 200 and 220 on steps 1 and steps 2 respectively, all on the first attempt. what else can i do to prepare to strengthen my application from day 1 during residency