The umpteenth 'Am I competitive?' thread: Otolaryngology

[cricfever]

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Good morning people,

I am an MS3 in a decent MD program hoping to match into ENT. I am going to give you all my stats and plans, and I would like to know if you think my chances of matching in this crazy competitive day and age are likely. Here goes:

Step 1: 246
Pre-Clinical grades: Honored Anatomy, passed everything else
Leadership: President of Otolaryngology and Dermatology interest groups, Clinical Clerkship Block Director
Research: Publications 7, Posters 5, Presentations 1 (total 13 research experiences)
Clinical Grades (so far): Honored General Surgery, honored OBGYN, honored Internal Medicine, honored Family Medicine.
Might not be relevant, but I speak Spanish as well.

I will be doing an away rotation somewhere on the east coast, and am doing a 4-week-elective in South America during my MS4 year with a facial plastics physician. I don't anticipate having problems with interviewing, and will get some strong letters from my program chair and my PI.

I am nervous because I did so poorly on my Step 1. I had been crushing practice tests to the tune of 265+ in the two weeks prior to my exam. Walking out of the testing center I felt like it was the worst test performance of my life (so I will be taking Step 2 early). Following my score results I worked hard on rotations and on research to compensate.

What do you guys think? Am I in the discussion? Are there areas I am weak that I could shore up? Thanks--

 

[Shipping News]

TIL a Step 1 score of 246 is "poor".

 

[Señor S]

Am I in the discussion?

No.

 

[Psai]

Clinical Clerkship Block Director ? A little early in your career for that?
I think you're a little above average for ent

 

[cricfever]

The block director position is an elected medical student position. In all reality we have essentially no influence on clinical rotation structure. @Shipping News--'poor' is relative to ENT step 1 match averages--246 is below the national mean. @senor S, excellent, thanks for your feedback.

 

[Shipping News]

The block director position is an elected medical student position. In all reality we have essentially no influence on clinical rotation structure. @Shipping News--'poor' is relative to ENT step 1 match averages--246 is below the national mean. @senor S, excellent, thanks for your feedback.

In Charting Outcomes 2014, the ENT average for matched US seniors was 248. So yeah, by neurotic standards, you are below the mean. But you have to take this in context. The rest of your application is clearly flawless: all honors in your clerkships, tons of research, fluent in another language...I mean come on. What advice do you want? Here you go: the obvious "do better on Step 2, don't crap the bed on your audition rotations, and apply to lots of programs". You will match.

 

[Psai]

Rock your away and get a strong letter from there.

 

[J ROD]

Yeah, you definitely have a shot.......no problem saying that.

I would work on getting a 20+ jump in Step 2 CK before Sep 15th. Set up several aways and beast mode those as you have been doing with honors. Nothing beats making an impression. Make sure you can interview well. Not just you thinking it but others as well. Nail down Strong LORs preferably in your area of interest and get them early so you know they are in if possible.

And of course apply broadly and rank enough places.

 

[Wordead]

Whats your relationship with your home program or other ENTs? One away is not enough to get 4 letters. What are your pubs in?

 

[member1000765]

Good morning people,

I am an MS3 in a decent MD program hoping to match into ENT. I am going to give you all my stats and plans, and I would like to know if you think my chances of matching in this crazy competitive day and age are likely. Here goes:

Step 1: 246
Pre-Clinical grades: Honored Anatomy, passed everything else
Leadership: President of Otolaryngology and Dermatology interest groups, Clinical Clerkship Block Director
Research: Publications 7, Posters 5, Presentations 1 (total 13 research experiences)
Clinical Grades (so far): Honored General Surgery, honored OBGYN, honored Internal Medicine, honored Family Medicine.
Might not be relevant, but I speak Spanish as well.

I will be doing an away rotation somewhere on the east coast, and am doing a 4-week-elective in South America during my MS4 year with a facial plastics physician. I don't anticipate having problems with interviewing, and will get some strong letters from my program chair and my PI.

I am nervous because I did so poorly on my Step 1. I had been crushing practice tests to the tune of 265+ in the two weeks prior to my exam. Walking out of the testing center I felt like it was the worst test performance of my life (so I will be taking Step 2 early). Following my score results I worked hard on rotations and on research to compensate.

What do you guys think? Am I in the discussion? Are there areas I am weak that I could shore up? Thanks--

More information necessary. Such as:
1. What was your research concerning? Are these publications from undergraduate or medical school? Were you first author, co-author, etc. What specialty are the posters/presentations in? Otolaryngology or another specialty?
2. It sounds like your medical school has an ENT program, correct? Have you made your interest known among the faculty?
3. What is your anticipated AOA status?
4. Is this FPRS surgeon private or is he/she a part of your academic program?

On the surface it sounds like you would be a strong applicant. If you rock STEP 2, and if all the research you listed is Otolaryngology-specific research, I think you'll be in a good position to apply. I would recommend going and monitoring the Otolaryngology applicant boards for more detailed and recent information

 

[cricfever]

These publications are all from medical school, 5/7 pubs were in ENT. I'm second author in 2 and first author in 3. Posters and presentations all in ENT (11/13 overall). I have met with each of the program directors and the chair to discuss my interest in the program. I have two PI's and they are both faculty. I'm not sure about AOA status--certainly not for preclinical grades but I'll likely honor everything clinically except psych and peds (and I'll high pass those). The FP surgeon is also faculty at our university.

Do you guys think I should do more than one away? I get mixed advice on that but I agree that it's gotta help (provided you dont do something terrible). I'm shooting for 10-12 interviews, not sure how you came up with the 'away=4 interviews' formula @Wordead.

More information necessary. Such as:
1. What was your research concerning? Are these publications from undergraduate or medical school? Were you first author, co-author, etc. What specialty are the posters/presentations in? Otolaryngology or another specialty?
2. It sounds like your medical school has an ENT program, correct? Have you made your interest known among the faculty?
3. What is your anticipated AOA status?
4. Is this FPRS surgeon private or is he/she a part of your academic program?

On the surface it sounds like you would be a strong applicant. If you rock STEP 2, and if all the research you listed is Otolaryngology-specific research, I think you'll be in a good position to apply. I would recommend going and monitoring the Otolaryngology applicant boards for more detailed and recent information

 

[tvelocity514]

These publications are all from medical school, 5/7 pubs were in ENT. I'm second author in 2 and first author in 3. Posters and presentations all in ENT (11/13 overall). I have met with each of the program directors and the chair to discuss my interest in the program. I have two PI's and they are both faculty. I'm not sure about AOA status--certainly not for preclinical grades but I'll likely honor everything clinically except psych and peds (and I'll high pass those). The FP surgeon is also faculty at our university.

Do you guys think I should do more than one away? I get mixed advice on that but I agree that it's gotta help (provided you dont do something terrible). I'm shooting for 10-12 interviews, not sure how you came up with the 'away=4 interviews' formula @Wordead.

You definitely need to do more than 1 away for competitive fields- and you need to do them well. You will (hopefully) get a great letter of rec and maybe even make them list you higher on their rank list. I would advise 2-3 (probably 3 imo)

 

[Wordead]

These publications are all from medical school, 5/7 pubs were in ENT. I'm second author in 2 and first author in 3. Posters and presentations all in ENT (11/13 overall). I have met with each of the program directors and the chair to discuss my interest in the program. I have two PI's and they are both faculty. I'm not sure about AOA status--certainly not for preclinical grades but I'll likely honor everything clinically except psych and peds (and I'll high pass those). The FP surgeon is also faculty at our university.

Do you guys think I should do more than one away? I get mixed advice on that but I agree that it's gotta help (provided you dont do something terrible). I'm shooting for 10-12 interviews, not sure how you came up with the 'away=4 interviews' formula @Wordead.

I said 4 letters of rec not 4 interviews. You only "need" to do aways if you dont have letters. Sounds like you already have LORs so you dont have to do more. Doing more is a matter of opinion - I think everyone should do 2, but plenty of attendings think 0 or 1 is enough.

You're likely fine and a bit above average though you should still apply broadly (60+). If some of those pubs are in high-end journals like laryngoscope and/or your PIs are bigwigs you could apply to less.

 

[J ROD]

I would advise to do a couple of aways...probably 2. Sounds like you got strong research. So, I would nail down LORs as I mentioned and network.

Apply to as many as you can afford and willing to attend. My advice. You never know which one might be the one.

 

[Pinkertinkle]

Top school or not top school? I would say you'll match if you apply broadly. Can't guarantee location.

 

[operaman]

Sounds like you've got a solid application and a reasonably good chance of matching assuming you aren't a psycho in person (unlikely given your clinical grades). I don't see any glaring weaknesses but will offer a few thoughts.

The Step 1 neither hurts nor helps and in the context of the rest of your application will be unlikely to hold you back anywhere. If you study enough and do well, you will likely boost your Step 2 score significantly. Remember that the 3 digit scores in step 1 and step 2 are as related as the 2 digit scores in the old MCAT and the ACT, but not many people understand this. If you score in the same percentile as your step 1, your step 2 score will be 15-20 points "higher" than your step 1 and thus likely to be viewed as a significant improvement by most.

Grades and research look good, especially if those pubs are in good journals. The spanish speaking is a nice bonus (do be sure to list your fluency accurately on ERAS as you will most certainly be challenged on it during interviews). If you are tenuously proficient and are expecting your time in south america to improve your speaking, be conservative in how you list it. There are many stories on the interview trail of people who inflated something on their app and were called out on it. If you say you're fluent, you better be fluent.

Biggest wild card in your written application are your LORs and are arguably one of the most important aspects - perhaps moreso than your grades and boards at this point. You want glowing letters from the biggest names you can get. It's a very small field and everyone knows everyone and the name at the bottom of a letter is just is (if not more) important than what's above it. Your chairman will obviously be a well known name; hopefully your faculty mentors are as well. If every letter but the chair's are from much younger and lesser known faculty, that's a weak point you may want to address.

As for aways, there are a finite number of reasons to do one. If none of these apply, don't bother. I didn't do one and it didn't hurt me at all, but most people do 1-2. It's true that you are equally likely to hurt your chances as help despite how good you are. Everyone has bad days and I met many awesome well-adjusted people on the trail who matched to elite programs but didn't get an interview from one of their aways. Reasons to do one:
1) You have no home program and need letters and an ENT sub-i.
2) You have a very small home program with no real bigwigs and need some letters from a big name
3) You have a perceived regional preference in your background and want to open up another part of the country
4) You have a specific program or city you really need to be in
5) You have some weaknesses on your application and need a superstar performance on an away to give you a leg up somewhere other than your home program
6) You really want to experience a different program and are willing to risk a potential interview to do it

That's basically it for aways. Your specific reasons will guide which ones (if any) you decide to do. If you do need letters, pay close attention to the structure of the sub-i. Some rotations you'll spend 4 weeks on a given service with the same attendings; others will give you shorter times but with more faculty. The former is arguably better for letters while the latter better for other things.

Definitely apply broadly when the time comes. It's definitely a crapshoot to some extent and you just don't know how the chips will fall until they do. 60 programs is a good number to start with. One of the issues with applying to 20-30 programs is that even if you get 10-15 invites, 5+ of those may all be on the same day; there are frequently very popular weekends where 15-20 programs interview on the same day. Always easier to apply first and sort things out later.

Ok this is getting too long. Good luck with your season! Get LOTS of advice before doing anything important!

 

[member1000765]

I think operaman nails it in terms of reasons to do an away rotation. In my own opinion, I think aways are a good thing to do because you learn that what you see at your home program is not the way things are done elsewhere and vice versa. It also bolsters your decision. In my case, after a 2 week elective as an MS3 I knew I wanted be an ENT. After one month with my home program and 2 months at other institutions as an MS4, I knew that I ONLY wanted to be an ENT, and I wouldn't be happy doing anything else. I think some people experience the opposite, as well; from what they saw of the specialty at their home program they felt they would be a good fit, but when they had the experience elsewhere they came to the reality that ENT wasn't what they imagined it to be.

I did 2 away rotations, both outside of my geographical region where I had gone to college and medical school. I do think that there are regional biases, and I definitely think I expanded my interview offers in these regions by rotating there and having letters written from those institutions. The two hospitals I rotated at were significantly different than my home program, and it helped me to decide more of what I was looking for in my ideal residency program. I also made lots of connections in those two months. I'm still in touch with different applicants I rotated with and interviewed with on the interview trail, and many of the residents I was under as a student are now staff at institutions where I'm applying for fellowships. It's fun to see how things come full circle.

You sound like a great applicant. My primary advice is to demonstrate to the faculty and residents that you are a hard worker, that you work and play well with others (you have no idea how important this becomes), and that you are motivated to be an Otolaryngologist. These are the types of comments that interviewers will be looking for in your letters of recommendation that will put you over the top of other applicants.

Good luck