1. No category

Obtaining the Residency of Your Choice
Residency & Match Must Knows
FRIEDA
ERAS
Letters of Recommendation
MSPE (Dean’s Letter)
Personal Statements
CV
Interviewing
NRMP
SF Match
Military Match
Supplemental Offer & Acceptance
Program (SOAP)
Office of Student & Affairs and Admissions
May 2014
Housekeeping announcements
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2- step PPD now required
• Recommend you have the 2-step even if your most recent PPD is less
than 12 months old. If required by a site and you don’t have it, you will
miss clinical time.
• Provide documentation to Student Affairs for upload to New Innovations
Absence requests
 Same policies as MS-3. These are NOT “personal days” to take
 Request 30 days in advance of rotation
 Max two (2) excused absences in 4 wks to get credit.
 Max one (1) day excused absence in 2 wks to get credit.
May 18-21, 2015
 Be available! Not vacation time.
 Briefings about transition to residency, program-specific and general.
Some Student Affairs activities.
Year 4 Schedule Requirements
# of
Blocks
Requirements
2
RIB
Notes
1
EMD Clerkship
1
NRL Clerkship
1
Sub-I Elective
Within the 6 core MSIII departments
1
Surgical Elective
Required Sub-I does not fulfill this
1
Non-Surgical Elective
4
11
Other Electives
Minimum 2 must be clinically oriented
(direct patient contact is not required) e.g.
Radiology, Anatomic Pathology
Non-clinical electives include: GHI, bench
research, medical education, or class room
based academic electives
Total Blocks
Elective Parameters:
a)
b)
c)
d)
e)
Max of 3 blocks of extramural electives
Max of 4 blocks Student Initiated Electives (SIEs)
Max of 4 blocks out of town electives
Max of 6 two-week blocks
Max of 1 block Longitudinal elective (requires a corresponding block on the
schedule)
f) Max of 1 two-block (8 week) elective – Must be taken consecutively
g) Max of 2 identical electives – 1 at BSOM; and 1 away
Year 4 schedule
SIE requirements:
• Include grid with work week hours
• Note Block # and calendar dates
Faculty aren’t yet thinking Blocks; use dates
XML requirements:
•Approval from away site
•Approval from advisor, department, & Student
Affairs
Your Task/Challenge
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Research programs through ACGME or FREIDA websites
Complete ERAS
Develop CV and Personal Statement
Request letters of recommendation (LoRs)
Review Medical Student Performance Evaluation (Dean’s letter)
Interview
Register for match(es)
Submit rank list(s)
Avoid SOAP at all costs
Step 2 CK & CS to Pass…
YIKES!!!
I NEED HELP!!
•
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It’s normal to feel stressed
Applying to med school you had 135 choices; for residency you have
3,000 plus…that’s how many specialty programs there are
Seem daunting? choices, choices, choices!
You’ve not been there before…it’s OK to be overwhelmed…today you’ll
learn what, when, and how to do it
Timeline
 Apr… start ERAS; start FREIDA, register for SF match, complete CV
meet with advisor (CV, Letters of recommendation (LoR), type of
residency, etc), request LoR’s
 Aug…finish ERAS; go to website for your MSPE, list activities, review it in
Student Affairs; submit military rank list
Will not be sent
unless viewed
by you
 Sep…certify (send) ERAS application; don’t wait for
LoR; begin interviewing
 Oct 1st…MSPE is sent
 Dec…submit SF & Urology Match rank order lists, Joint Services GME
Selection Board (military) releases results
 Jan…SF & Urology match results released; submit NRMP rank order list
 Mar…SOAP (Supplemental Offer & Acceptance Program) & Match Day
USMLE Step 2
Clinical Knowledge (CK) & Clinical Skills (CS)
 Must Pass Step 2 CK & CS to graduate & receive diploma
 You may not begin residency without your diploma
 CS slots fill quickly & scores take longer than CK scores to be
reported; therefore…
 register by Mid Sep
 prepare for exam. Students have failed; it will be similar to your OSCE
 schedule/take it by Nov 30th so your score is available to programs
prior to NRMP rank order list mid Feb deadline
 No passing score on Step 2 CS? Highly likely that programs will not rank you
 SA deadline for 2 CS is end of Nov; for 2 CK – end of Oct.
Careers in Medicine
 Helpful for students who have not picked a specialty
 AMCAS ID required to access CIM
 To avoid switching residencies after med school…
 put time & effort into exploring your choice
 be thoughtful
 understand self…likes, dislikes, preferences
 collect info on multiple specialties
 talk to others…advisors, faculty, students, family
 “try-out” specialties…shadow
Medicare Payments for Graduate Medical Education
Initial Residency Period (IRP)
What Every Student Needs to Know
The Feds want to pay for you to train in 1 specialty only, therefore, your Initial
Residency Period (IRP)…determines how much Medicare reimburses the hospital
on your behalf forever…
IRP in Years
Medicare Reimbursement
Peds, IM, FM
3
100% X 3 years
OB
4
100% X 4 years
Surg
5
100% X 5 years
Example…Let’s say after 1 year in Family Med, you switch to OB…(1yr + 4yrs=5yrs)
in the 2nd & 3rd years, the hospital will receive 100% reimbursement, in the 4th &
5th years, only 50%...OUCH☹☹☹☹
IRP… designed by the Feds to discourage hospitals from training you in >1 specialty
ACGME Accredited Programs
- searchable website 
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Go to: http://www.acgme.org/adspublic/
Has info on every accredited residency, fellowship program
Similar to FREIDA, can search by specialty & geographic area
An “apples to apples” comparison of program details
 Contact info for program director and coordinator
 Details about number of positions, how many filled, training sites
 Link to program’s own website
double WOW them by knowing what they don’t want you to
ACGME website
Search results for:
“Internal medicine”
“Wisconsin”
Yielded 5 programs:
Shows cities
“View details” for each
Sponsoring institution
If any fellowships there
When last accredited
Slots per year
Sites residents train at
FREIDA
Fellowship & Residency
Electronic Interactive Data Access
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Go to: www.ama-assn.org
Has comprehensive info on all 3000 plus training programs
Can search by specialty & geographic area
Has all the info you will need on each program, download it,
read it over the night before your interview…
you’ll WOW them by looking informed and prepared
ERAS…Electronic Residency Application Service
MyERAS…Your App
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Go to: www.aamc.org
Web-based, 1 application, user friendly
Your token ID has already been sent
For $92, students can apply to 10 programs under the same speciality. Additional fees for
additional programs. USMLE Transcript Fee: $70 assessed once per season.
MyERAS includes…
application
MSPE & letters of rec
BSOM transcript
AAMC ID number…provided by ERAS immediately upon registering token…needed
for couples match
color photo…we’ll use your official BSOM photo or you may provide your own (no
later than June 1st)…visit WSU’s Photography website:
http://www.wright.edu/office-of-marketing/services/photography-and-digitalimaging#tab=request-a-photographer
…they’ll charge $20 for 30 minutes…send digital copy to som_eras@wright.edu as
email attachment
Curriculum Vita & Personal Statement
see
examples
at Careers
in
Medicine
CV…same as resume
 used for requesting letters of recommendation
Personal Statement…important in helping programs to assess
your character, convictions, beliefs, compassion,
professionalism, if you’ll fit in as team member & what you’ll do
after residency
 may have up to 5 (for different specialties have different points)
 you’ll assign them to programs
 avoid saying how much you like the specialty, the reader
assumes this.
 DON’T just spell check. Read through it yourself and
ask others to review for you!
Letters of Recommendation
 Words to use when asking… “Dr. Smith, Do you feel you know me and my work
well enough to write a strong letter of recommendation for me?”
 Consider…
one from BSOM chair (expected) & two from preceptors
3 from preceptors is OK
 Some programs will accept or require a 4th
 In MyERAS, list author & print out request cover sheet, sign & waive right to see
letter, ask author to send letter to SAA for upload…
recommended
Getting LoRs to ERAS
 DIRECT UPLOAD!! Authors of LoRs may upload directly to ERAS
 Email: som_eras@wright.edu
recommended
 U.S. Mail: Wright State University, Boonshoft SOM, Student Affairs ERAS, 3640
Colonel Glenn Highway, Dayton, OH 45435
 Campus mail: ERAS, BSOM Student Affairs, 190 White Hall
 Faxing not recommended due to poor quality.
Medical Student Performance Evaluation
(Dean’s Letter) & Transcript
 Go to New Innovations/RMS…complete Request for Medical
Student Performance Evaluation…although not required by school,
virtually all programs require it
 Review MSPE for accuracy & approve…you’ll receive email from
Ms. Joyce Baver…you may not revise evaluative statements
 The MSPE (if approved by you) & transcript will be uploaded to
ERAS by School & transmitted on Sept 15th by AAMC
rule…requests received on or before Aug 25th will be ready by Sept
15th
 For non-ERAS programs, provide Ms. Baver with list of program
addresses for sending MSPE & transcript
When You Interview,
Be Able to Explain
Our Transcript
Quintiles
Transcript Legend
For each course/rotation, the class is rankordered by final Percent score, if available,
and divided into five quintiles. The first
quintile is the top one-fifth of students, and
the fifth quintile, the bottom one-fifth.
Letters of Rec ERAS Cover Sheet
Listing Authors
On the MyERAS letter of rec cover sheet…
 The author appears as listed by you
 You’ll print-out cover sheet & sign to waive right to see letter
(address information will already be filled in). Give cover sheet to
the author, she/he needs it to send with letter
 Two proper ways to list authors…
John Donnelly, MD or
Dr. John Donnelly
do not say Dr. John Donnelly, MD (redundant)
Letters of Recommendation Process
 Schedule appointment to make request early, give packet to author, it
serves as a reminder of what she/he will do…
ERAS cover sheet
CV
Packet
Personal Statement
List of programs you’ll apply to
 Generic letters work best if applying to multiple specialties (they do not
specify a specialty), otherwise request specialty-specific letters
 For SF & Urology Matches, send directly to them
 A thoughtful touch for voluntary faculty…provide preaddressed & stamped
envelopes to make it easier for those without campus mail
 3-4 weeks after request, send thank you note to author, it will serve as
gentle reminder…guilt is a powerful motivator
 We suggest having your letters submitted by September 1st
When it’s all said and done…don’t find yourself
saying…
 Apply to enough programs, 10-30
 Know the qualifications of matched & unmatched applicants
 …Which are you more like?
 Know if you’re at-risk of not matching
 NEED TO TALK with your faculty advisor / mentor if a potential
 Have safety (back-up) specialty if at-risk
 Certify (send) MyERAS early…Sep 1st
 If you don’t match at first, SOAP is your next option.
Applying Strategy
Be Aware…..
 many specialties have more applicants than positions…
 plastic surg
 Derm
 surg, neurosurg, psych & IM
 ortho, oto, path, & rad
 PM&R, OB-GYN, anesth
 consider…class rank, AOA, GPA (yours is %), USMLE scores, research,
publications, volunteer & work experiences
 check…Charting Outcomes in the Match…view at www.nrmp.org
Interviewing
Interviews are by invitation…
 the season begins September & ends January
 you’re expected to use RIB time
 time off should be requested well in advance…
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You are not entitled to miss time from a rotation
You must be granted permission by elective/course director & preceptor
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Limited to 2 days/4-week block…do not
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exceed (may lose credit ☹)
might receive email or phone invite
may or may not be given choice of day
It may be easier to be off in the last half of month after you’ve shown
preceptors how hard you work
Schedule interviews for your 1st choice program(s) in middle of the
interview season… that’s when you’ll make the best impression
Interviewing
Best advice…be yourself
Practice…
Research their program and have 4-5 questions ready
Be prepared to discuss…
 your favorite book/movie from last year
 your heroes & mentors
 an interesting patient
 your willingness to work & fit in
 what you believe in…your values, beliefs, convictions & passions
 what you’ll do after residency
Keep post interview notes & construct your rank list as you go
Ignore promises to rank you high…
 put zero trust in what they promise you
2nd visit might be possibility. Recently many have cut back, might be good strategy
if you have early interview & want to be remembered. Will be at own expense.
Stay in a Host Home @ No Cost☺
Apply on line & get more info…
1. the AMA Physician In-training Host program
http://www.amaalliance.org/site/epage/41976_625.htm
2. the BSOM Bed & Breakfast Program
http://www.med.wright.edu/alumni/bedboard.html
National Residency Matching Program
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Go to: www.aamc.org
Enrollment is web-based. Registration begins Sept 15th
You’ll submit rank list & get results via the web
Most students will enroll… the NRMP is a back-up for
 SF PGY-2 Match students
 Urology Match students
 Military Match students…IF released for civilian residency
 Enroll only if available to begin residency on July 1st…
by Match rule…off-cycle students may not go through Match☹
rather you’ll learn about mid-year vacancies thru FindAResident…
https://www.aamc.org/students/residents/findaresident
NRMP
Fee is $60 (Sept 15-Nov 30), pay by credit card or check. Late fee
of $50 added after Nov 30.
 individuals may rank 20 programs ($30/program for each
program over 20)
 couples may rank 30 programs (additional couples’ fee)
Use your AAMC ID and password for
Couples (married/unmarried) may go through as a pair…
 for students who need to match in same location
 You’ll provide your partner’s AAMC ID number when
registering & submitting your couples rank list
NRMP Couples Rank Order List
A rank is a pair of choices…
Student A
1. FP WSU Dayton
2. EM Mt. Carmel, Columbus
3. FP U. of MI, Ann Arbor
4. FP WSU Dayton
5. No selection (unmatched)
6. FP U of N Carolina
Student B
Ortho WSU Dayton
Ortho OSU, Columbus
Ortho, U. of MI, Ann Arbor
Ortho, U. of Cincinnati
Ortho U. of Chicago
Gen Surg, U of N Carolina
Note Safety Specialty
NRMP Timeline
Sept 15…registration opens
SOAP
Nov 30…registration deadline, avoid $50 late fee☹
Supplemental Offer &
Jan 15…rank order list entry begins
Acceptance Program
Feb 26…rank order list entry deadline
New for 2012
Mar 17-21…Match Week Schedule
 Monday…you’ll log in to the NRMP site at noon, it will say…
“you’re matched☺” or “you’re unmatched☹”
 12:00 PM…Unfilled positions on Web…ERAS begins sending apps
 Tuesday…Programs may begin entering their SOAP preference lists
 Wednesday…11:55 AM Programs finalize first round SOAP preference lists. SOAP
offers begin at 12 PM
 Thursday…SOAP offers conclude at 5 PM
 Friday at noon…Match Day Ceremony…families welcome…your location &
program are announced.
NRMP Strategy
3 Types of Positions Offered…
 Categorical (C) most students want this, a multiyear position, train
straight through and qualify for board certification
 Advanced (S) a Post Graduate Year-2 (PGY) position for entry in
2016, when entering NRMP rank list, the computer prompts you to pair
this up with a preceding PGY-1 2015 position
 Preliminary (P) 1-year positions…usually in medicine & surgery,
provide prerequisite training for Advanced (S) programs
To use NRMP to your advantage…rank programs in descending order
according preference & desirability
Only rank programs where you interviewed & are willing to go…
Once matched, you are contractually/legally obligated to go to that program
NRMP Strategy…the New Reality
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Reality in Match 2012 and years prior: On average, 3-6 students fail to match to a PGY-1
or PGY-2 position or both, rarely do they not get a position in the SOAP (Supplemental Offer &
Acceptance Program).
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Reality in Match 2013: 1097 seniors of U.S. Allopathic Medical Schools st did not match
(6.2% of active applicants). 93.7% of U.S. allopathic seniors were matched to PGY-1
positions in Match 2013, within the historical 92-95% matched rate.
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Reality in Match 2014: The match rate for U.S. seniors was 94.4 percent, 0.7 percentage
points higher than last year. Of the applicants who matched, 54 percent of U.S. seniors
and almost 50 percent of all other applicants matched to their first choice for training.
1,662 previous graduates of U.S. allopathic medical schools, an increase of 175 over last
year; their match rate of 48.0 percent rose 7.2 percentage points
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Note where students have matched in past…programs like to keep the BSOM pipeline
flowing…for match results of last 5 years see
http://www.med.wright.edu/admiss/match/index.html
Match Fill Rates
Specialties with at least 10 positions in Match 2014 and 100% fill rate:
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Dermatology
Medicine-Emergency Med
Neurological Surgery
Otolaryngology
Pediatrics-Primary
Physical Medicine & Rehab
Plastic Surgery (Integrated)
Psychiatry-Family Medicine
Radiation-Oncology
Thoracic Surgery
Specialties with at least 10 positions in Match 2014 and filled more than 90% by
U.S. Seniors:
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Dermatology
Neurological Surgery
Orthopedic Surgery
Otolaryngology
Plastic Surgery (Integrated)
Radiation Oncology
What does this mean???
1. Plan, don’t panic.
2. Talk to people who know how it works.
a. My Dad’s advice: Dream Big.
b. My Mom’s advice: Someone has to pay the bills.
c. My advice: Dream Big and Be Smart.
3. Have a back up plan if you are interested in a
competitive specialty/competitive program.
4. Take CK and CS early.
5. Register as soon as you can. Don’t delay on any
deadlines. You don’t want to play catch up.
San Francisco Advanced PGY-2
Specialty Match
 For second year positions beginning in July, 2016
 Go to: www.sfmatch.org
 For positions in
Neurotology
Ophthalmology
Plastic Surgery
 For Plastic Surg, there are PGY-1 and/or 2 spots offered through the
regular NRMP match as well…it’s confusing.
 Notify som_eras@wright.edu if participating so we can upload
transcript and MSPE. Letters must be mailed directly to SFMatch.
San Francisco PGY-2 Match…
the Low Tech Match
 Submit…
application
undergrad college transcripts
medical school transcript & MSPE (uploaded by BSOM)
USMLE scores (request/purchase from NBME)
3-4 letters of rec
your list of programs
 SF Match mails your application to programs
 Costs about from $50-$160 for up to 10 programs, additional
programs are extra
San Francisco PGY-2 Match
 Application deadlines based on the programs.
 Check their website for specifics.
 Jan… results released prior to regular NRMP rank order list deadline in
event you don’t get a spot
 If successful…
you’ll apply for a 2015 PGY-1 position through the regular NRMP
this will precede your PGY-2 spot for 2016
 If unsuccessful…
you’ll go through the regular NRMP
 Please feel free to see your Advisor, or Drs. LeRoy & Watt to
discuss strategy…It can be a little complicated, they’ve been there,
done that
Urology Match
 The only specialty with their own match
 Most Urology programs use ERAS
 An early match like the SF PGY-2 match
Go to www.urologymatch.com for info & to register on-line
Aug…register
Jan…get results
 If unsuccessful, you’ll go through NRMP, provided you
registered
 If successful, you may…
go through the NRMP as a formality for a PGY-1 Surgery-P spot at
same institution, or
go through the NRMP for a PGY-1 Surgery-P spot elsewhere
Military Scholarship Students
 Military branches have a selection/match process
see http://www.militarygme.org
handled by Joint Service Graduate Medical Education Selection Board
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Army & Navy programs use ERAS, Air Force has own system
MUST also apply through ERAS for possible deferment to NRMP
You’ll apply early (Summer) & find out in mid-December
Your MSPE will be sent on October 1st according to AAMC rule, sorry no
exceptions
 If given a deferment to do a civilian residency, you'll continue in NRMP for
the March match. Remember Nov 30th deadline
 Dr Tous says HPSP students should talk with him to review process
 Commissioning ceremony is the morning of graduation, 22 May 15!
Supplemental Offer & Acceptance Program (SOAP)
 Monday, March 16, at noon
 Something you can avoid with planning & smart work, it’s…
high pressure/stress…something you prefer to avoid
Typically, the profile of an unmatched student…
• there is a mismatch between program/specialty & the student’s
credentials/qualifications --or-• the student applied to only unrealistic dream programs/specialties -or—
• the student limited the geographic area.
 If applying to dream/competitive specialty and at-risk…
You must have a safety (back-up) specialty…be discreet.
programs do not get this from NRMP
Don’t apply to different specialties/programs at same hospital…
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program directors may find out via grapevine…to programs this looks like
specialty indecision…programs are looking for reasons to rank you low
Supplemental Offer & Acceptance Program (SOAP)
…the New Reality
 You can SOAP from Student Affairs or from your home
 Everything is computerized.
 The source of stress…
 The typical unmatched student will changes specialties between
12:00 Noon & 2:00 PM on Monday & typically, get a 1-year spot…
-- categorical spots in one’s preferred specialty will be more difficult to get
 Match Day, Friday, March 20 at noon
All students (including successful SOAPers) get an envelope.
SOAPers are treated the same as matched students.
No one knows you participated in SOAP unless you tell them.