Blog Archives

Try a Residency Bootcamp

I was recently speaking to a medical student with excellent foresight, who was asking me what he could do to prepare himself for residency. I suggested reviewing the basics – perhaps by perusing a favorite clinic handbook – of how to work up common chief complaints like chest pain, shortness of breath, abdominal pain, back pain, among others. It was timely, then, that I read an article about Transition to Residency classes offered at the majority of medical schools. These intensive courses help medical students refresh their knowledge about clinical approaches, so they can hit the ground running when internship starts. 

If a Transition to Residency class is robust and offered at your institution, I would recommend taking it.

Also, when thinking about preparing for residency, I advised the student to consider ways to make life as smooth as possible: When I was in training, I splurged to pay for a laundry service. I never missed the money; instead of spending my downtime at a laundromat or an apartment complex laundry room, I was able to sleep a little more. 

Of course, I had to be frugal during residency, as many others do, but doing one or two things that can make your life better can pay dividends.

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Medical School and Residency Admissions: It’s Not Personal

When I was in my second year of medical school, a third-year student (who later also went into emergency medicine, as I did) came to speak to our class about being on the wards. He gave an animated talk about how important it was to recognize that when residents, attendings, or nurses hollered at us on our clinical rotations, 99% of the time, it wasn’t personal. He likened the situation to Boston traffic – how drivers lean on their horns for little cause because they are simply frustrated about their days.

It’s not personal, he said.

I say the same to those I mentor. Candidates get an interview at one highly ranked institution but rejected at what is considered a lesser one with no clear cause. Faculty interviewers mix applicants up with one another; some turn up wholly unprepared – reading students’ applications for the first time during the interview itself. Remember: It’s not personal. This process is arduous and cruel, and most candidates, faculty, and program coordinators are tired and doing their best in a dysfunctional system.

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Five ERAS Platform Quirks to Heed

On September 7th, ERAS will open for submission, so it’s time to get moving on your written materials. Let’s briefly cover five quirks of the ERAS platform to help you get through the drafting process. The ERAS platform…

1) Does not support italics. While journal articles and some phrases (e.g. “summa cum laude”) should be italicized, don’t be surprised when you can’t.
2) Prompts you for a supervisor for each activity. In some cases, you simply may not have one, but whenever you can, name someone. A name validates the experience.
3) Prompts you for average hours per week for each activity. It can be difficult to calculate this number for certain experiences, especially those that are intermittent, but it’s worth making your best estimate rather than leaving the question blank.
4) Offers space to include a “reason for leaving” for each activity. Don’t skip this section, but keep your answers brief.
5) Limits you to 1020 characters for experiences, 510 for the interruption in the medical training section, and 510 for each of the awards sections. Be aware of these limits as you write, so you are not furiously cutting later.  

For tips on how to craft your ERAS, check out these 15 ERAS tips.

Contact me for help with this weird, wild process.

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Responses from Program Directors are as Valuable as the Email They’re Written On

A residency candidate asked me to review an email a program director (PD) had sent him after interview day. The candidate wanted to know if I had any insights into the PD’s intent: Was the PD sending a generic note or was he really interested in the applicant?

I told the applicant honestly: Who knows and who cares?

I wasn’t trying to be dismissive. The point is that it’s impossible to know what a PD is thinking. Unfortunately, I’ve seen applicants heartbroken by false hope they read into a PD’s comments. More importantly, what a PD says should not affect your rank list anyway. The algorithm requires you to put your first choice first and your second second, etc. (More on that in an upcoming January blog post.)

As they say, kisses aren’t contracts and presents aren’t promises. Don’t put deep thought into those PD notes because they don’t guarantee a thing and, as we say in clinical medicine, they don’t change management.

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Something You Probably Haven’t Considered Could Have a Huge Impact on Your Professional Happiness

A recent article in Emergency Medicine News caught my eye. Emergency physician Dr. Tom Belanger conducted a small study (n=573) in which he crafted a nine-question Likert scale survey and then attempted to predict emergency physicians’ employment structures based on respondents’ answers. He used statements like “I am paid fairly,” “I am secure in my career,” and “Emergency medicine is a good career” in his survey.

In medical school and residency, I thought little about employment structure, which can include democratic, hospital employee, contract management, independent or locums, academic, resident, or government systems. As a student, I was so focused on what specialty I would choose and was so influenced by the academicians I worked with that I didn’t even consider that I could choose a field in which I might be happy in one employment structure and discontent in another. 

Belanger found that employees of contract management groups (CMGs) tended to be the most negative respondents, and owners of CMGs were not far behind. On the other hand, owners of democratic groups were the most positive in almost every aspect. 

In this study, all respondents were in the same specialty and yet, employment structure divided respondents with regard to their career satisfaction. Belanger’s graphs are worth viewing in his piece, but the take-home point for medical students and residents is the importance of the employment structure in which you ultimately work, a topic that may not have even crossed your mind until now. 

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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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