Panda Bear said:
If you want to know what not to do if you want to match in a competative specialty, PM me. I'm still a little bitter about it (but not that much because I did manage to scramble into Family Medicine at Duke of all places) so I don't want to come across as petty and vindictive on such a public forum.
I got a few PMs so what the hell.
1. Get good grades. My grades weren't bad. Neither were my Step scores but higher grades mean more interviews.
2. Read your letters of recomendation. This sounds obvious but at my school they strictly enforce the ERAS rule that you can't see the letters. Just ask the letter writer for an unofficial copy. Apparently, one of my letters was pretty weak. Not bad
per se but so lukewarm that the writer damned me with faint praise.
This was certainly his perogative (although why write a letter for somebody if you're going to screw them over?) but it should also be your perogative to not use the letter.
3. On the same topic, make an effort on the pertinent rotations to work often with your potential letter writers. On my EM rotations I only worked a few times with every attending so they didn't have a solid knowledge of me.
4. Don't let geography dictate your applications. This is where I'm going to sound bitter and petty so I apologize.
My inlaws promised to relocate to the city where I matched. This was pretty important to my wife so naturally it was important to me. Unfortunantly, since they are elderly, they stipulated that that they didn't want to move anywhere with severe winters. This immediatly excluded almost two thirds of the EM programs including several which did not fill this year including Iowa and SUNY Upstate (if I remember correctly). Idiot me, I went along and only applied to 25 programs of which eight invited me to interviews. One (my own school) was obviously a courtesy interview so I was left with seven interviews with an only average application for a competative specialty.
In truth, I don't care about weather. And while you may be picky before you fail to match, I would have rather matched at the worst, most podunk, climatologically challenged EM program then been forced to scramble into a specialty which I had not seriously considered.
Oh, and my inlaws have decided
not to move to Durham with us. Ironic, huh?
5. Have a plan for not matching which I did not. Sure, I had a vague idea that I would do familiy medicine or internal medicine but this is not enough. You have to decide early if you want to do a preliminary year somewhere and try again in a year. The time between monday when you find out and Tuesday when you scramble is not the time to decide because if you don't have a plan you will be in a panic mode. (Which I was.)
6. On scramble day, look at the list of open programs in your specialty and immediatly (at 10 minutes to noon when it is legal) add them all to your ERAS "Applied to Programs." There is no charge for this on scramble day and almost every program you call, when you finally get through to them, will ask you to do this. (My school provides us with a designated "faxer" who faxes our CV and etc. to programs that want it all faxed.)
This way, they might even look at it before you call (or not) but at least you are ahead of the eight ball, not behind it. Things move quickly on scramble day.
7. But not that quickly. While the non-competative programs might be desperate to sign anybody, the competative programs know that they will get somebody so they might take a little more time to look at more than one applicant. Have several call out there. Keep calling if the line is busy. Have your wife, husband, significant other, or friends help you make calls.
I'm a little embarrassed to tell you all this because I did everything wrong on scramble day. Maybe I wouldn't have scrambled into one of the few open EM spots but I didn't really give it a good try. Instead I got sidetracked talking to Duke and when they offered me a spot I had the "any port in a storm" mentality. I could have said "can you give me thirty minutes?" or "I'll call you right back" and made a last minute appeal to one of the open EM programs.
I think Duke knew this because they didn't want me to hang up. (Which is flattering, actually).
Disclaimer: I have been up to Duke and met my new colleagues and I have talked to a lot of Family Medicine people here at LSU and (other than some lingering bitterness which anybody who is not used to failure will understand) I am really enthusiastic for the program and look forward to starting in July. Family Medicine is a great specialty, even if the pay is not as good as EM, and is versatile enough where I might actually end up working in an Emergency Room as it will be a long, long, time before there are enough board certified EM docs to staff every emergency room in the United States.
But in all seriousness, I would have to say it's the fear of the unknown. No matter how much shadowing, reading, working, volunteering, or introspecting you do, you won't really know how you feel about medical school and medicine until you actually get there. It's a huge risk to go to medical school as an older student, as opposed to staying with the "known" of your current career, because you actually have something to lose (and less ability to make up for lost time if you realize that you've made a mistake by going to medical school.) That's true even for those of you who absolutely hate your current careers, and even more so for those of us who actually like our current careers but are looking for something more. I fear the uncertain. That is the worst aspect of this whole process in my opinion.
