What's it like applying to residencies?

Gaurdian,

I don't think it's too early to start thinking about residency application. I wish I had.

Applying to residency is a lot less stressful than med school apps because you will get a residency in some area no matter what. That being said, it is still stressful, especially if you want to enter a competitive field like radiology, ENT, ortho, ER, etc. Anywhere from 10-25% of people applying to these fields from US Med Schools do not get them and must do something else or try again. If you want internal medicine, peds, surgery, and most other fields, you will find a spot. The only stress is finding a good one and one that is right for you. This is academic for some and community for others. Although it is extremely variable, the general rule seems to be that people who want to do general private practice choose community programs (most of which are easier to get into than academic) and those who are thinking of academic medicine, research, and subspecialty enter university programs. Again, this doesn't mean the opposite doesn't happen.

As for what programs look for, grades (especially 3rd year), USMLE (mostly Step I but some want Step II), letters of recommendation, research (if you want academic programs), and the interview are the factors. Each specialty and program has different emphasis, but many competitive programs use USMLE I as a screening tool so study your ass off for it.

That's about it from me. I'm a fourth year medical student planning on going into radiology and am bitter because it all of the sudden got really competitive in the past 3 years. Anyway, if you have other specific questions, post them and I'll try to answer.

 

So Guardian....do you think you are hot stuff now just because you moved from posting on pre-allopathic to posting on allopathic???? I think not. You ain't no Dr. Horwath!!!!

PS: I still haven't gotten my thesis from her!!!!

PPS: So how was your first week as a med student guardian??

 

Guardian,

You can get letters of rec from attending physicians in your third and early fourth year. A letter from a resident is useless, even though they work with you much more closely than attendings. Usually, you want a letter from a attending who has seen what kind of work you can do and agrees to write a 'strong' letter on your behalf. Some people and some specialties recommend a letter from the chair of the departement, even if you didn't work with them. They usually just interview you prior to writing on your behalf. If you do research at any time, your preceptor may be another good letter writer. Another tip, medicine and surgery letters are good for any specialty!

I was initially thinking of internal medicine and going on to cardiology. I really enjoyed my third year rotations in medicine. I analyzed what I liked about it and found that it was the interesting cases and figuring out the diagnosis from imaging, labs, EKGs, and Echos. Radiology is a great field because you see pathology relating to every field of medicine and are often the one that clinches or narrows down the diagnosis. Plus, you get to do lots of cool procedures (not only in interventional, but also GI, Body imaging, ultrasound and others). Its not sitting in front of a box all day like everyone imagines. You interact with physicians from all specialties and there is immense variety.

I will have to admit that the better hours (especially compared to cards) and the awesome money right now (new residency grads getting offered 250-350 K for general rads) helped clinch my decision. I must emphasize that these factors cannot make you happy if you don't like what your doing.

Good luck. And I repeat: Study your ass off for Step 1!!

 

Thats interesting, whats the difference with an academic program v. a regular one? Would this be something along the lines of if you want to be a clinical professor or something?

That being said this is what i've observed with applying to residency's. Apparently its....less stressful but then again you're applying for less spots than you did when you applied to med school. If i recall, talking to the chief resident, she was interviewing ....people for 5 spots in the peds dept.

My only....info that i have really is to not write a personal statement longer than a page and a half. Thats all i heard about..hehe. "You better have something good to say if its more than 1.5 pages long!" Thats just what i've been told by them.

 

nullIs it like applying to medical schools or better? Do the majority of people apply for positions at teaching hospitals? Also what comes into play other than board scores and grades/class rank? I don't know why I ask, I'm just starting my first year

Applying to residencies are as competetive when compared to app's to medical school in highly sought specialties: ENT, Ophthalmology, Ortho, Derm. Other specialities wax and wane with various changes in the healthcare industry. Boards and Class Rank are important - prepare for the boards the first time .

Another thing to consider is location and prestige of the hospital that you're considering. Highly sought programs like Hopkins, Harvard, Duke will focus on research in addition to the hard numbers. Consider your living conditions when searching for a program


Consider the different programs - Community, University Based, Private practice or other hybrids. Each has it's strengths and weaknesses.

Look at the presence of fellows and determine how they can affect your training. Who does the majority of teaching?

Get recommendations from faculty that are published or well known in their field. Resident recommendations will carry little weight. Most importantly, make sure that the person writing your recommendation knows your abilities, strengths, etc in addition to your saintly personality. Get involved in research during medical school. Even if you don't have any desire to do research, it will give you better reasons why to pursue it or not(rather than it takes too much time). Basic science prof's will only carry weight if you worked closely on a research project with them or if the area is close to your specialty of interest (eg Pathology Prof-> Pathology Res.)

Clerkships are important in your 3rd year for preparing for the boards. Enter each rotation with an open mind (Would I like to do THIS for the rest of my life?). Choose electives wisely - do not concentrate on doing all electives in the specialty of choice. Definitely do a sub-i in a program that you're interested in pursuing. Play the part, walk the walk, and talk the talk....

 

An attending is the term used in most hospital based rotations to denote a staff physician (faculty member). This includes surgeons, medicine docs, psychiatrists, everyone. It seems to me preceptor may refer more to some one you work with occasionally and helps you out, but I'm not really sure about if it is used in other circumstances or not.

As for the letters from heads of departments you hardly know, many people do it. Opinion seems to be divided on whether it is a good idea or not since the only info they have on you is from what you give them and not how you actually work on the wards. I know at our school, the head of surgery writes letters for pretty much everyone who is applying to general surg. Our chair of medicine also writes letters for many students he barely knows.

Of course, the best letter would be from a head of a department who you worked with on the wards and impressed. That's hard to come by.

Anesthesia is a great field for relatively benign residency schedule and income after you get out. Its getting harder as more and more med students discover this, but its still relatively easy to get into great programs.

 

After talking with many residency directors, it is not only important that your recommendation comes from someone well known in the field but that the writer knows who you are and can write about your talents, aptitude and interactions.

One letter of rec that I had came from a surgeon that I worked with closely for an entire year.

 

I was enjoying this informative discussion until reading platinumdoc's comments about choosing a residency based on avoiding driving thru "the hood" into "gangland crossfire". It is clear that radiology suits you better than a field where you might have to interact with such riff raff and actually pretend you care about their health.
I live in New Orleans where we all drive thru areas you'd probably be too good for. The real fact of life is most people live in "the hood" b/c they are poor, not b/c they like to shoot random strangers.
Sadly, I think many of the privelged med students out there share your feelings, so I warn you all - If you hold onto these snobby, judgmental attitudes of yours, you will never be able to deal well with the varieties of patients that most specialties encounter.

 

After reading platinumdoc's post again, I think this statement from tulanestudent would be be more suitable to his/herself than to platinum's.

Talk about jumping the gun tulanestudent...
don't be so sensitive.

 

I didn't mean to offend tulanestudent or others by using terminology like the 'hood' or 'driving through gunfire'.