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Apply Broadly. Nuff Said.

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In their publication Impact of Length of Rank Order List on Main Residency Match Outcome:2002-2018, the NRMP reports that matched applicants consistently have longer rank order lists than unmatched applicants.

What that means to those approaching the residency application process is that candidates should throw a wide net in choosing programs at which to apply. Of course, there is a financial cost to this strategy, and that expense needs to be balanced. However, if you can afford it, starting out with more options usually will provide more opportunities to interview and thus, the ability to create a longer rank order list.

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Preliminary Year: What do I do with my Personal Statement?

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Candidates who apply to certain fields – dermatology, ophthalmology, etc. – need a preliminary or transitional year of residency before initiating their specialty training. So does that mean those applicants need to toil over two personal statements?

No, thankfully. It’s very appropriate (and strategic) to use the same essay with minor modifications. Ensure you explicitly address why a prelim year will advance the rest of your career and how you will contribute to the prelim training program as a future specialist.

When you use a very similar essay, you can be honest about what your professional goals are. After all, the reader knows you’re applying for a one-year position.

Remember that many preliminary/transitional year programs are eager to match residents who are moving on to competitive fields. In general, those applicants will have strong USMLE scores, evaluations, and clinical skills.

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Applying in Two Specialties

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Here are some clarifications about what ERAS offers that will help you apply in two specialties:

1) Different personal statements can be assigned to different programs. This means you can assign your ob/gyn essay to ob/gyn programs and your internal medicine (IM) statement to IM residencies.
2) Different letters of recommendation (LORs) can be assigned to different residency programs as well. (A maximum of four letters may be assigned to each program.)
3) You will have only one MyEras application. It will go to all of your programs. Note that if you list your membership in multiple ob/gyn organizations, that will be viewed by your IM readers as well (and might make them question your commitment to IM).

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Happiness: Part 2

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Last week I posted about happiness. Unfortunately, I have recently spent a lot of time at an academic medical center with a sick family member. The hours I’ve spent there have made me think further about contentment in medical school and residency.

What I noticed about this highly academic hospital is that the care is outstanding, but the atmosphere is much more collegial than the setting in which I trained. The doctors and nurses are extremely bright and competent. They are also kind and approachable.

The institution at which I trained (and it may have changed in the 12 years since I left) did not have this culture. I experienced unchecked sexism, arrogance, and standoffishness. As I interacted with the physicians and nurses recently, I realized that I probably would have been much happier at an institution that better matched my personality. (Having said that, I met many of my dearest friends and my husband during medical school, residency, and as an attending, and I would not change any of that.)

Bottom line: Yes, reputation is a factor, but culture is really key. You can oftentimes train at an equally excellent place where you will happily fit in.

After all, we’re talking years of your life here.

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Choosing a Specialty and a Life

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During the winter season, I spend time talking to a lot of residency applicants about their future specialty choices: Want the majority of your time to be in the operating room or in the clinic? Like procedures?

But another fair and reasonable approach is to consider lifestyle. A recent New York Times piece noted that 50% of physicians are burned out. Burnout is particularly severe among emergency physicians and critical care doctors.

As you go through your third-year clinical rotations ask yourself if you can find a role model who fits – not just your professional goals – but your personal ones. Ask to meet individually with faculty members for their opinions on their fields’ pros and cons.

Considering the growth in patient volume and the continued dearth of physicians, it’s critical to determine whether you can see yourself happy in a busy, lifelong career in a particular field.

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About Dr. Michelle Finkel

Dr. Michelle Finkel

Dr. Finkel is a graduate of Stanford University and Harvard Medical School. On completing her residency at Harvard, she was asked to
stay on as faculty at Harvard Medical School and spent five years teaching at the world-renowned Massachusetts General Hospital.
She was appointed to the Assistant Residency Director position for the Harvard Affiliated
Emergency Medicine Residency where she reviewed countless applications, personal statements and resumes. Read more

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