Blog Archives

NRMP® Data Suggests Residency Applicants Should Apply Broadly

A few years back, the NRMP published a short document called the Impact of Length of Rank Order List on Main Residency Match Outcome:2002-2016. There, the NRMP reported that matched applicants consistently had longer rank order lists than unmatched applicants.

This data is a bit old, but it assesses over a decade of Matches, so I take it seriously. In my mind, what it 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, according to this data, starting out with more options usually will provide more opportunities to interview and thus, the ability to create a longer rank order list.

To create a plan for your residency candidacy, secure a Strategy Session with me here.

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Your Residency Application: Being Repetitive Again and Again

In writing their personal statements, many residency applicants ask me, “Isn’t it regurgitating my CV if I highlight my accomplishments?” After all, they say, their achievements have already been noted in the application, MSPE, and letters of recommendation. Think of the residency admissions process as an onion. Your ERAS and letters serve as one layer of that onion, albeit a thin one. In other words, your accomplishments are conveyed simply and succinctly there. The personal statement is your opportunity to apply a thicker layer, one in which you flesh out your achievements, thus persuading the reader of your distinctiveness. Finally, the interview is your chance to add on the thickest peel. Discussing your accomplishments in detail can seal the interviewer’s positive impression of you.

So yes, you are going to be redundant throughout the residency application process, but each part serves a different and additive purpose. If you do not include your achievements in your personal statement, how will you be viewed as distinctive? Remember: Who you are is what you’ve done… and what traits and skills you’ve gained accordingly.

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The Week I Spent 138 Hours in the Hospital and What it Means for your Residency Application

During my internship, on my surgical rotation, I once spent 138 hours in the hospital in one week. If you think this isn’t mathematically possible, I will tell you that I was on call from Monday morning to Tuesday evening, from Wednesday morning to Thursday evening, in-house on Friday, and then on call from Saturday morning until the next Monday morning. (I had to stay in-house that Monday until evening rounds were over too.) As you can imagine, I was barely human by the end. How this schedule was good for patient care is beyond me.

I thought of that ghastly time recently when reading this oldie-but-goodie article in the New York Times called “How Job Stress Can Age Us” written by Dr. Dhruv Khullar. The author reports on a study, “Physician-Training Stress and Accelerated Cellular Aging” that assessed the DNA of 250 first-year medical residents around the country. Researchers examined the saliva samples of these residents, focusing on their telomeres – the bumpers at chromosome ends that prevent DNA damage – before and after the first year of residency. Researchers found that the DNA of first-year residents aged six times faster than normal.

Six times faster.

I found this both shocking, upsetting, and validating. Residency training is as hard as we think it is. 

What I would strongly recommend is that you compare residency programs’ hours as you decide where to apply and before you create your Match list this coming winter. Strangely, many applicants don’t even consider this important issue when making decisions about their next three to five years. Also, many residencies support physician wellness programs and night coverage. Especially in the setting of severe burnout among doctors, your happiness should be a primary factor in your career choices. If you’re not sure, consider your shrinking telomeres. 

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Is Step 1 Still on Track to Go Pass/Fail?

Earlier this year, United States Medical Licensing Exam (USMLE) administrators announced that, after a long process of consideration, Step 1 would be scored as pass/fail going forward. With the global pandemic and many systems in disarray, some students had been concerned that the plans might be delayed, but according to the USMLE, the transition to Step 1 pass/fail score reporting is on track to be implemented in January 2022. The USMLE is also considering some changes to Step 2CS, although the details of those modifications are not yet available to the general public. 

Check out this piece about the details of the Step 1 scoring change.

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Post-ERAS, Pre-Interview Supplemental Questions

Several residency applicants have told me that since they submitted their ERASes, some programs have asked them to answer additional, written questions like “Why our program?” and “How will you bring diversity to our institution?” The additional workload seems burdensome, especially this year, but I suspect residency directors are concerned about interview hoarding – since sessions will be virtual and thus easier to accept and attend – and are trying to weed out applicants accordingly. 

Although originally written for medical school candidates, see my blog entry here to help with the “Why our program?” question and here to help with the diversity prompt. 

Remember: This is a marathon, not a sprint. 

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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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