07-29-2008, 05:55 AM
I found this article on another website.. I wanted to share..
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We all heard of students with lower scores who have gotten into a better residency programs than those with higher scores. Although you can write this out as "Lucky", there is more to it than that meets the eye.
1. Preparing to Apply - Choosing a specialty is the most important professional decision that you would have to make. The factors affecting this choice are complex and include personal interests as well as practical lifestyle issues. To assist students the AAMC sponsors a structured four-phase career planning program, Careers in Medicine (CiM, www.aamc.org/students/cim).
For each specialty, it is helpful to determine the number of residency program positions available in the desired specialty and the number of applicants for that specialty in order to
assess the competitiveness of the application process for that specialty. The FREIDA Online® Web site, maintained by the American Medical Association (www.ama-assn.org/go/freida), provides aggregate information on ACGME programs, including the total number of residents per specialty, average program size, and average number of interviews provided per program, as well as information on the number of graduates and their career choices.
Five types of positions are offered through the NRMP Main Residency Match:
¢ Categorical © positions: PGY-1 positions in programs that provide the training required for board certification in a specialty
¢ Preliminary (P) positions: PGY-1 oneyear preliminary positions in transitional internal medicine or general surgery programs.
¢ Categorical (M) positions: PGY-1 primary care positions in combined programs in internal medicine and pediatrics
¢ Advanced (A) positions: PGY-2 positions in specialty programs that begin the year after the Match and subsequent to one or more years of preliminary training
¢ Physician ® positions: Positions in specialty programs that begin in the year of the Match for physicians with prior graduate medical education.
The NRMP uses a mathematical algorithm that employs the preferences expressed in the rank order lists submitted by applicants and programs. Although one feels that its getting tougher to get into a residency program, the matching rate for IMG/FMG has going up every year according to statistics provided by NRMP (http://www.nrmp.org/res_match/tables/table2_2003.pdf)
US IMGs Matched PGY-1
1997 43.5%
1998 45.5%
1999 47.4%
2000 51.4%
2001 52.4%
2002 53.8%
2003 54.6%
2004 57.6%
2005 59.6%
2006 61.6%
2007 63.5%
2008 65.5%
2009 67.4%
2010 69.4%
Although No published studies have systematically evaluated the fill rate of residency programs, There are certain programs termed IMG friendly. If you apply to them, there are higher chances of getting a seat. Plus assessing your own status and factors and being realistic in applying to right programs increases your chances.
2. USMLE scores: This is the single most important factor for an FMH at least. The higher the scores the better are the chances. Now there is a confusion over step 1 or 2 scores which are better. General perception is that Step 1 scores are more important. But I'd like to tell you about a study on this factor.
This study concluded that Step 2 scores had higher predictive value for getting good slots than step 1. The predictive value was not affected when step 1 and 2 combined scores were taken into account. This implies Step 2 scores have the maximum predictive value for getting residency, irrespective of step 1 scores. Few people might contradict this but this is what the study says. Here is an extract from that study
About a month after the completion of the 2004 Residency Match, Kaplan surveyed a set of students who had taken USMLE preparation courses with us over the past year. Students were asked whether or not they had secured a residency position, and for some information about themselves, such as USMLE scores, USMLE failures, the date on which each USMLE Step was passed, the number of programs to which they had applied, their year of graduation from medical school, and whether they were permanent residents of the U.S. or not.
By far, the best predictor of getting a residency position was the USMLE Step 2 score! Good Step 1 scores were also positively related to getting a residency, but STEP 2 scores mattered MORE!
When both Step 1 and Step 2 scores are placed in a stepwise regression analysis to predict the chance of getting into a residency, once Step 2 is entered into the model, there is no predictive capacity left for Step 1. This means that adding a Step 1 score to the model does not give a better prediction. A Step 2 score, by itself, gives the best prediction. Using just Step 2 scores as a predictor, we are able to derive a model that correctly classified 75% of those who did and did not get a residency position.
3. Research: "PUBLISH or PERISH". This qualification holds primarly as a rule but not the law. If you have published research papers, you definitely have an edge.
This matters more for University based programs than Community based programs.
4. US Clinical Experience: This is again a very important factor. Rather many programs shortlist only those candidates who have some USCE. It can be observership (where you only watch docs treating patients, not involved in any way in patient management), externships (You get hands-on experience). Plus if you are targeting a specific program, it™s better to do such externships at that hospital, because that would increase their chances of taking into their program. Another important reason for clinical experience is that during your time at a hospital, you may obtain a LOR from attending physicians. The more experience you have, the better for your application. If your experience is at a renowned hospital, it will booster your application even more. But they are usually a very expensive thing to do; not only housing, transportation, and food have to be considered, but at some hospitals a fee will be charged as part of your application. All expenses should be considered while planning your trip, and see if such investment is affordable to you.
5. LORs: Most programs require a minimum of three letters of recommendation from each applicant. In ERAS, the applicant may assign and send up to four letters to each program. The fourth slot is available for those documents required by programs that are considered legitimate ERAS documents. These include the socalled œCalifornia letter (the
Applicant Evaluation Status Letter from the Medical Board of California), which international medical graduates must submit when they apply for residency training in
the state of California.These count a lot specially if written by US doc (which is possible only if you do an externship under him). Still a well written Dean's letter and LORs by professor's from your medical school helps.
Many persons involved in the resident selection process wish to know whether or not an applicant has waived the right to see the content of a letter written on his or her behalf, since
some believe that letters to which the right of access has been waived provide more reliable, valid, and straightforward information than those to which access has not been waived. For this reason, most letter of recommendation forms (including those used by ERAS) document whether or not the applicant has waived his or her right of access to the letter.
The final decision about waiving the right to see a letter of recommendation is that of the applicant.
6. Visa status: The order of preference is obvious - US Citizens --> Green card holders --> H1/J1 ---> B1/B2. This is mainly because most residency program directors do not have a clue about visa issues. Do not make the mistake of mentioning about your visa status and what you need to go through to get it to a program director in a residency interview, even if the program directors asks, just be succinct about it. After all, he is not the one who will be involved with the process, it's the Human Resources Department. Bottom-line is they prefer a candidate with minimum visa hassles.
7. Contacts: It works everywhere.Contact all your Contacts, Contact everyone you ever know, You will be surprised how much "Connection" you have. Don't feel ashamed or embarassed because you never called that person in years so "what will they think after all this time I didn't keep in touch and now I call them for a Favor?" The worst thing that can happen is they'll be happy to hear your voice after a long time and say they don't know anyone, but keep in touch anyways and the best thing that can happen is they might know someone who knows someone who can get you an interview. Crush you Ego and you are almost gauranteed to match this year.
8. Interview itself: Never forget the importance of a good interview. Program Directors at US want an all round personality.. pleasant, confident, witty with good communication skills. Many guys get a seat over others with higher scores just because they can have an impact on their Program Director during interviews. General interview rules do apply to residency interviews. Start brushing up your communication skills from today itself.
9. Related Experiences: If you have other plus points like "Sport Star" or ther Exempliary records, they will help.
10. Others: Like Teaching experience, some audit experience, previous residency in your own country, MPH etc. may help you a bit.
There are number of factors that contribute to a successful residency match in U.S. These factors I've listed are just some of the factors which I got from various discusson forums and circles and also after talking to few program directors personally. Hope this helps you and I wish you all best of luck in the match.
Trishul Reddy M.D.
Step 2 CS Worksop
Manhattan, NY 10010
drtrishul
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We all heard of students with lower scores who have gotten into a better residency programs than those with higher scores. Although you can write this out as "Lucky", there is more to it than that meets the eye.
1. Preparing to Apply - Choosing a specialty is the most important professional decision that you would have to make. The factors affecting this choice are complex and include personal interests as well as practical lifestyle issues. To assist students the AAMC sponsors a structured four-phase career planning program, Careers in Medicine (CiM, www.aamc.org/students/cim).
For each specialty, it is helpful to determine the number of residency program positions available in the desired specialty and the number of applicants for that specialty in order to
assess the competitiveness of the application process for that specialty. The FREIDA Online® Web site, maintained by the American Medical Association (www.ama-assn.org/go/freida), provides aggregate information on ACGME programs, including the total number of residents per specialty, average program size, and average number of interviews provided per program, as well as information on the number of graduates and their career choices.
Five types of positions are offered through the NRMP Main Residency Match:
¢ Categorical © positions: PGY-1 positions in programs that provide the training required for board certification in a specialty
¢ Preliminary (P) positions: PGY-1 oneyear preliminary positions in transitional internal medicine or general surgery programs.
¢ Categorical (M) positions: PGY-1 primary care positions in combined programs in internal medicine and pediatrics
¢ Advanced (A) positions: PGY-2 positions in specialty programs that begin the year after the Match and subsequent to one or more years of preliminary training
¢ Physician ® positions: Positions in specialty programs that begin in the year of the Match for physicians with prior graduate medical education.
The NRMP uses a mathematical algorithm that employs the preferences expressed in the rank order lists submitted by applicants and programs. Although one feels that its getting tougher to get into a residency program, the matching rate for IMG/FMG has going up every year according to statistics provided by NRMP (http://www.nrmp.org/res_match/tables/table2_2003.pdf)
US IMGs Matched PGY-1
1997 43.5%
1998 45.5%
1999 47.4%
2000 51.4%
2001 52.4%
2002 53.8%
2003 54.6%
2004 57.6%
2005 59.6%
2006 61.6%
2007 63.5%
2008 65.5%
2009 67.4%
2010 69.4%
Although No published studies have systematically evaluated the fill rate of residency programs, There are certain programs termed IMG friendly. If you apply to them, there are higher chances of getting a seat. Plus assessing your own status and factors and being realistic in applying to right programs increases your chances.
2. USMLE scores: This is the single most important factor for an FMH at least. The higher the scores the better are the chances. Now there is a confusion over step 1 or 2 scores which are better. General perception is that Step 1 scores are more important. But I'd like to tell you about a study on this factor.
This study concluded that Step 2 scores had higher predictive value for getting good slots than step 1. The predictive value was not affected when step 1 and 2 combined scores were taken into account. This implies Step 2 scores have the maximum predictive value for getting residency, irrespective of step 1 scores. Few people might contradict this but this is what the study says. Here is an extract from that study
About a month after the completion of the 2004 Residency Match, Kaplan surveyed a set of students who had taken USMLE preparation courses with us over the past year. Students were asked whether or not they had secured a residency position, and for some information about themselves, such as USMLE scores, USMLE failures, the date on which each USMLE Step was passed, the number of programs to which they had applied, their year of graduation from medical school, and whether they were permanent residents of the U.S. or not.
By far, the best predictor of getting a residency position was the USMLE Step 2 score! Good Step 1 scores were also positively related to getting a residency, but STEP 2 scores mattered MORE!
When both Step 1 and Step 2 scores are placed in a stepwise regression analysis to predict the chance of getting into a residency, once Step 2 is entered into the model, there is no predictive capacity left for Step 1. This means that adding a Step 1 score to the model does not give a better prediction. A Step 2 score, by itself, gives the best prediction. Using just Step 2 scores as a predictor, we are able to derive a model that correctly classified 75% of those who did and did not get a residency position.
3. Research: "PUBLISH or PERISH". This qualification holds primarly as a rule but not the law. If you have published research papers, you definitely have an edge.
This matters more for University based programs than Community based programs.
4. US Clinical Experience: This is again a very important factor. Rather many programs shortlist only those candidates who have some USCE. It can be observership (where you only watch docs treating patients, not involved in any way in patient management), externships (You get hands-on experience). Plus if you are targeting a specific program, it™s better to do such externships at that hospital, because that would increase their chances of taking into their program. Another important reason for clinical experience is that during your time at a hospital, you may obtain a LOR from attending physicians. The more experience you have, the better for your application. If your experience is at a renowned hospital, it will booster your application even more. But they are usually a very expensive thing to do; not only housing, transportation, and food have to be considered, but at some hospitals a fee will be charged as part of your application. All expenses should be considered while planning your trip, and see if such investment is affordable to you.
5. LORs: Most programs require a minimum of three letters of recommendation from each applicant. In ERAS, the applicant may assign and send up to four letters to each program. The fourth slot is available for those documents required by programs that are considered legitimate ERAS documents. These include the socalled œCalifornia letter (the
Applicant Evaluation Status Letter from the Medical Board of California), which international medical graduates must submit when they apply for residency training in
the state of California.These count a lot specially if written by US doc (which is possible only if you do an externship under him). Still a well written Dean's letter and LORs by professor's from your medical school helps.
Many persons involved in the resident selection process wish to know whether or not an applicant has waived the right to see the content of a letter written on his or her behalf, since
some believe that letters to which the right of access has been waived provide more reliable, valid, and straightforward information than those to which access has not been waived. For this reason, most letter of recommendation forms (including those used by ERAS) document whether or not the applicant has waived his or her right of access to the letter.
The final decision about waiving the right to see a letter of recommendation is that of the applicant.
6. Visa status: The order of preference is obvious - US Citizens --> Green card holders --> H1/J1 ---> B1/B2. This is mainly because most residency program directors do not have a clue about visa issues. Do not make the mistake of mentioning about your visa status and what you need to go through to get it to a program director in a residency interview, even if the program directors asks, just be succinct about it. After all, he is not the one who will be involved with the process, it's the Human Resources Department. Bottom-line is they prefer a candidate with minimum visa hassles.
7. Contacts: It works everywhere.Contact all your Contacts, Contact everyone you ever know, You will be surprised how much "Connection" you have. Don't feel ashamed or embarassed because you never called that person in years so "what will they think after all this time I didn't keep in touch and now I call them for a Favor?" The worst thing that can happen is they'll be happy to hear your voice after a long time and say they don't know anyone, but keep in touch anyways and the best thing that can happen is they might know someone who knows someone who can get you an interview. Crush you Ego and you are almost gauranteed to match this year.
8. Interview itself: Never forget the importance of a good interview. Program Directors at US want an all round personality.. pleasant, confident, witty with good communication skills. Many guys get a seat over others with higher scores just because they can have an impact on their Program Director during interviews. General interview rules do apply to residency interviews. Start brushing up your communication skills from today itself.
9. Related Experiences: If you have other plus points like "Sport Star" or ther Exempliary records, they will help.
10. Others: Like Teaching experience, some audit experience, previous residency in your own country, MPH etc. may help you a bit.
There are number of factors that contribute to a successful residency match in U.S. These factors I've listed are just some of the factors which I got from various discusson forums and circles and also after talking to few program directors personally. Hope this helps you and I wish you all best of luck in the match.
Trishul Reddy M.D.
Step 2 CS Worksop
Manhattan, NY 10010
drtrishul
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