Transcript How to make the big decision: gathering information as an M3? Owen Phillips, MD Associate Dean, Student Affairs.

How to make the big decision:
gathering information as an M3?
Owen Phillips, MD
Associate Dean, Student Affairs
As M2s
You have had a preceptor experience
You have had personal experiences
You may have preconceived notions- some may
be true, some may be false
You need information
CiM Four Year Timeline
M-1
August
CiM Intro
March
Phase I
Summer
M-2
February
M-3
Fall
M-4
Self Assessment
Shadowing
Research
Volunteer
Phase II
Getting ready for Career Exploration
Alumni Panel Discussion
Clerkships
Student AMA lunches
January
Phase III
Career Day
April
Phase IV
Strolling thru Match
Fall
ERAS
Dean’s Letter
Reviewing your Careers in Medicine
Protocol?
Visit the Careers in Medicine website?
www.aamc.org/careersinmedicine
www.aamc.org/students/cim
Did you get to know yourself by completing the
self-assessment sections on the site?
Discover your own CiM website
OLSEN on the UT COM page
Specialty Profiles
Departmental information– Program director
– Chair
– Other faculty members willing to help
“If you want more information”
Think back to the Critical factors
Autonomy
Caring for Patients
Continuity of Care
Diversity
Focus of Expertise
Innovative thinking
Intellectual Content
Interacting with other Physicians
Manual/Mechanical Activities
Pressure
Responsibility
Security
Sense of Accomplishment
Status among Colleagues
Patient Characteristics
Types of Illnesses
Gathering Information
With that review, you know what you want in life
and in medicine, it’s time to find what specialty
will fit your needs
Go to the Specialty Profiles in the CiM website
This is a great place to start exploring your many
choices.
AAMC CiM Specialty Profiles
Nature of the Work
Personality Characteristics
Residency Requirements- what is required to get
in
Match Data
Workforce Statistics
Compensation
It’s a start
You think you really like Peds but you also like
procedures as well.
The specialty profile shows that procedures are
very low in Peds
But this profile doesn’t take into account
neonatology, Peds cardiology, Peds ER and
Peds GI which all are very high in procedures.
Expand
Don’t just evaluate one profile - do the same
exercise with other similar profiles.
You may learn that you are a closer match to
similar specialty than the one you first
considered.
Also, make comparisons in specialties you never
considered – you may be surprised.
Other Online Resources
AMA-Freida- AMA’s Fellowship and Residency
Electronic Interactive Database Access
Provides statistical information about
each specialty, information about GME
programs, and institutional offerings by
specialty and geographic location.
Be vigilant about your career choices
While an M3--– Talk to clerkship directors, residents, physicians you
come in contact with
Try it on- tell people you are considering ***
Ask questions
Electives- UT gives flexibility to do some
electives early
Be realistic
Specialty Associations
Join the academies at reduced student rates
Visit specialty Web Sites – AAP, AAOS, etc.
This and other information on your UT CiM site
Personal Contact
Clerkships
Summer Experience
Faculty Mentors (see CiM website)
Private Practitioners
Residents
Friends
Be aware of the variable reliability of each source
There are many misconceptions out there!
Surveying the Alternatives
Canvas and wide range of alternatives
Be open to new alternatives as you have
different experiences on clerkships
Talk to the residents: do you look like them; do
you like what they do?
Try it on
Discuss your ideas with others
Just like trying on clothes
Don’t commit too soon- it could make it harder to
change your mind
Inoculate yourself
After you’ve made your decision, review the
negatives
This will inoculate you against overreaction and
criticism to your decision
It will help you during negative experiences
during residency
Consider Alternatives: Realities
Some specialties are hard to match into
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–
–
–
Plastic surgery
Urology
Dermatology
Orthopedics
- Neurosurgery
- Otolaryngology (ENT)
AAMC- match information
Consult the program director, talk to me
Charting Outcomes in the Match
Characteristics of Applicants who Matched to
their Preferred Specialty in the 2005 NRMP
Main Residency Match
A collaborative project of the National Resident Matching
Program and the Association of American Medical
Colleges
Paul Jolly, PhD
Division of Medical School Services and Studies
Association of American Medical Colleges
July 2006
Plastic Surgery
Dermatology
Radiation Oncology
Transitional Year
Orthopaedic
Surgery
Surgery-General
Physical Medicine
and Rehabilitation
Emergency
Medicine
Internal
Medicine/Pediatrics
Pathology-Anatomic
and Clinical
RadiologyDiagnostic
Anesthesiology
Psychiatry
Obstetrics and
Gynecology
Pediatrics
Internal Medicine
Family Practice
Percent Matched
Match Success of U. S. Seniors Ranking Each Specialty First
2005 Main Match
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Physical Medicine
and Rehabilitation
Psychiatry
Family Medicine
Obstetrics and
Gynecology
Pediatrics
Anesthesiology
Internal
Medicine/Pediatrics
Emergency
Medicine
Surgery-General
Internal Medicine
Pathology-Anatomic
and Clinical
Transitional Year
RadiologyDiagnostic
Radiation Oncology
Orthopaedic
Surgery
Dermatology
Plastic Surgery
Median USMLE Step 1 Score for Matched US Seniors
(vertical lines show interquartile range)
260
250
240
230
220
210
200
190
180
Family Medicine
Psychiatry
Pediatrics
Obstetrics and
Gynecology
Surgery-General
Physical Medicine
and Rehabilitation
Internal Medicine
Emergency
Medicine
Orthopaedic
Surgery
Pathology-Anatomic
and Clinical
Anesthesiology
Internal
Medicine/Pediatrics
RadiologyDiagnostic
Radiation Oncology
Transitional Year
Dermatology
Plastic Surgery
Step 1 Score
Median USMLE Step 1 Score for Matched All Others
(vertical lines show interquartile range)
260
250
240
230
220
210
200
190
180
Transitional Year
Family Practice
Plastic Surgery
Psychiatry
Pathology-Anatomic
and Clinical
Internal
Medicine/Pediatrics
Pediatrics
Obstetrics and
Gynecology
Internal Medicine
Physical Medicine
and Rehabilitation
Dermatology
Radiation Oncology
Emergency
Medicine
Anesthesiology
Surgery-General
RadiologyDiagnostic
Orthopaedic
Surgery
Mean Contiguous Ranks by Specialty Ranked First and Contiguously
U. S. Seniors 2005 NRMP Main Match
14
12
10
8
6
Matched
Not Matched
4
2
0
If I know I want to go into a particular
specialty, should I schedule that
clerkship first or last?
Two ways to look at it
First or near the beginning of the
third year
To see whether I do like it
Last or near the end
In order to be experienced and excel
And to be fresher on everyone’s mind and
nearer to residency recruitment time
My experience
UT students are ‘ready’ from the first clerkship
and the excellent, interested students shine in
the first rotation
Faculty and residents have good memories- if
you are a good student, the impression of you
will last
I want to take as many third-year
rotations in Knoxville or Chattanooga
as I can
Will this limit my ability to get into any
residency programs
Third-year rotations away
Knoxville and Chattanooga programs give
excellent experience
Your residency choices will not be limited
We encourage students to take rotations at our
other campuses
If you do your rotations in KN or CH, you can
always do an M4 elective back in Memphis
Any advantages to doing rotations at
Chatt or Knox.
Course directors from there will speak to that
Ask M4s who have had experience there
Some clerkships are community-based and give
an educational experience that is really ‘best’ for
you
Advantages
Smaller residency programs- usually 2-4
residents/year
Faculty involvement may be private doctors who
are affiliated with the residency
Patients may be private patients
May be more one on one with a faculty member
M4 Away Rotations
Some residency programs are very competitive
and you will need to do a rotation there to even
be considered
It is a good way to get an insider’s look at the
program
The department chair should know the scoop on
such programs and will be able to advise you.
How to schedule ‘away rotations’
Talk to UT, Memphis chair or program director
Will need to get a signature on the UT form
(available in the catalog)
Go to the websites of the outside colleges about
procedure and contacts
Get this ball rolling in Jan. or Feb.
M4 Away rotations
Pitfalls
If you don’t ‘shine’ while away, you may have
done yourself harm
By the time you learn the new system, you may
not match up to the home boys (or girls)
“Got to get into Harvard”
What about fourth year electives
here at UT
Again, discipline-dependent
For Ob, your best impression was as a third-year
clerk. We would rather see you take dermatology
or radiology than do an elective
For Orthopedics, you may need the visibility.
If you did your clerkship in Kn or Ch, you may
wish to have ‘Memphis exposure’
You should ask
Should I have research on my CV
to be competitive
Some programs are requiring research in
the field to be competitive
Research
Difficult to do meaningful research during thirdyear
Programs where this an issue are the
competitive fields: Otolaryngology, Urology,
Neurosurgery
Find a professor-level faculty member and ask
for advise (CiM website has research mentors
listed)
Ask for advice
Thinking: “it is either Peds or Med-Peds”
Talk to the clerkship director or another faculty
member
Will help you sort out your thinking process or
suggest opportunities that will help (a shadowing
experience in a private office)
Ask for advice
“Pretty sure it’s Med-Peds”
But have some questions about my
competitiveness and need to stay in Memphis
Talk to the program director
Ask for advice
Once you have committed to a specialty, you
should talk to the chair of the department: call
the office and make an appointment. Email may
not be best
You will need a chair’s letter for your ERAS
application.
What about the residency interview
process
May- Strolling through the Match- an orientation
We will talk about
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When and how to schedule dean’s letters
Other letters of reference
Preparing a personal statement
Preparing your CV
The timeline
The Process
Early matches- neurology, ophthalmology,
urology
August- Early match applications due,
– interviews in Sept-Dec.
October-For the rest, applications due
– interviews- Nov-Jan
M3
Work hard
Pay attention
Have fun