S TROLLING T HROUGH THE M ATCH The Beginning of the End … or the end of the beginning Presented by Owen P. Phillips, M.D. and Debbey Hester

T HE A PPLICATION T EAM Letter Writers ● Owen Phillips, M.D. ● Gerald Presbury, M.D. ● Renate Rosenthal, Ph.D. ● David Stockton, M.D. (Knoxville) ● Robert C. Fore, M.D. (Chattanooga) ● The Faculty (excluding the MSPE) Application Coordinator ● Debbey Hester

910 Madison Avenue, Suite 1043 Memphis, TN Tel: | Fax: O UR C ONTACT I NFORMATION

● Medical Student Performance Evaluation ● Letters of Recommendation ● Preparing your Curriculum Vitae ● Writing your Personal Statement ● Applying for Residency  Nat’l Resident Matching Program (NRMP)  Electronic Residency Application Service (ERAS) STTM O VERVIEW

Designed Programs ● AAMC Careers in Medicine (CiM)  Appraising The Challenge  Self Assessment  Surveying Alternatives  Evaluating Alternatives  Achieving Commitment ● Career Day (January) ● Strolling Through the Match (STTM) P REPARING FOR YOUR F UTURE

The Process ● experiences prior to medical school ● summer preceptorship ● research experiences ● clerkship experiences ● specialty interest groups ● senior electives ● attending Alumni panel ● seeking out private practice experiences ● speaking to specialty counselors ● remembering family & significant other P REPARING FOR YOUR F UTURE

Curriculum Vitae & Personal Statement Strolling Through the MatchMay 2011

Preparation for Success ● Be certain about career choice  Narrowed it down - or come see me ● Talk with Clerkship Director (and others) to answer nagging worries about career choice ● Once certain about career choice, talk with department chair  competitiveness of specialty, where to apply, outside rotations, etc. ● Get CV together Getting Ready for the Match

Preparation for Success ● Write your personal statement ● Consider who should write you letters of recommendation  contacting his/her secretary to schedule an appointment ● Debbey Hester schedules ALL MSPE appointments  Scheduling begins July 11, 2011  Instructions for scheduling MSPE appointments will be sent via late June Getting Ready for the Match

Strolling Through the Match May 2011

A ‘CV’ is… ● Your life course ● The course of your life ● An organized document of how you have spent your professional life  not intended to be a philosophical statement, but rather a fact sheet with order and content ● On paper, it’s who you are professionally C URRICULUM V ITAE

Format ● One page ● Good quality paper ● White or near white ● Ordered and structured C URRICULUM V ITAE

Do NOT need to put your… Age Marital status Names of children SS # or NRMP # Place of Birth Courses taken Career plan C URRICULUM V ITAE

The Header (top of page) ● Identifying Information  Full name  Address  Telephone number  Address C URRICULUM V ITAE (CV)

The Body Education  college, NOT high school  School, years of attendance, major, degree  Add GPA, class standing ONLY if it’s impressive C URRICULUM V ITAE

Honors Alpha Omega Alpha, 2011 Presidential Scholarship, UTK, 2005 – 2009 Summer Honors Research Scholar, 2007 Activities Vice President of Academic Affairs, 2010-present President of Class Notes, C URRICULUM V ITAE TIP: Do NOT list all; limit your society memberships unless an officer.

Employment Electrocardiogram technician, Methodist Hospital, Summer, 2002 Chemistry lab assistant, UT, Knoxville, Research UT, Knoxville Investigated cardiac output of rats under the influence of nitrous oxide. Under supervision of Dr. Thomas Mitras TIP: List chronologically. TIP: Be prepared to discuss your research. List reverse chorological order. C URRICULUM V ITAE

Publications & Presentations Presented National Association of Rat Biologists, “ Effects of Nitrous Oxide on Cardiac Output of Rats ” Personal Interests Painting, hiking, photography Special Abilities Capable in sign language, fluent in Spanish C URRICULUM V ITAE

Summary Try to keep to one page  Exception: Research and publications Ask friends, family, faculty to proofread and comment Be prepared to discuss any research documented Explain any awards C URRICULUM V ITAE

● One page ● Good quality paper ● White or near white ● Ordered and structured TIP: Don’t include GPA, Class Rank

Strolling Through the Match May 2011

A Personal Statement is… ● In contrast to CV, personal statement may be philosophical ● A narrative ● About the past that is relevant and as importantly, what the future dream is ● Who you are that is not revealed in your transcript or your CV ● Doesn’t describe your life chronologically ● An introductory sentence to capture interest P ERSONAL S TATEMENT

A Personal Statement tells… ● Why I chose medicine ● How I chose this specialty ● Where I see myself ● Insight into family and very special interests P ERSONAL S TATEMENT

Format ● One page long ● Have others proofread: spelling, proper English, flow & appropriateness of content ● Use good paper & a font that is easy to read ● Use humor ● Talk about fears, poignant events in life if they are relevant ● Be positive about the traits you possess that will help make you a good resident P ERSONAL S TATEMENT

Suggestions  This is your own statement; individualize  Make an attempt to reveal who you are on paper Pitfalls  Be careful talking about religion practices  Too long or too short  One long paragraph  Make it reader friendly P ERSONAL S TATEMENT

Don’t use it to explain bad grades Or explain step score failures? And what about future plans?  Optional More issues with personal statements

Summary ● CV & PS quality will not make or break you ● May induce a great deal of interest and augment ‘the numbers and grades’ ● Poor grammar or sloppiness may hurt ● Bring a good copy of CV and personal statement with you when you meet with faculty about writing a reference letter CV & P ERSONAL S TATEMENT

Quote from Hillel the Elder, Jewish Philosopher “If I am not for myself, who will be for me?”

“… And, if not now, when?”

“At this point in time, I see myself pursuing a fellowship in sports medicine… In the future, I see myself practicing in a medium sized community working with the local high sc h ool and college teams while at the same time serving the various members of the community…” What do you think… Plus or Pitfall?

“From summer camp to teenage youth director, I have always loved being around kids – shy, screaming, laughing, unreserved, honest kids… The pediatric ward reinforced my feelings in real time… An equally rewarding aspect of pediatrics is preventive medicine…” What do you think… Plus or Pitfall?

“In his essay on the profession of medicine, Sir William Osler writes that the medical field strives for a time, ‘when there should be no more unnecessary death, when sorrow and crying should be no more, and there should not be any more pain.’…” “Though I intend to first and foremost become a clinical physician, I also plan to participate in investigation and education throughout my career… The balance for which I search in my career will unite direct and honest patient care with practical discovery and education. A residency in internal medicine will provide the ideal foundation for this pursuit… I see myself not only as a future leader in providing health care to my community, but also as a leader outside of medicine as a respected citizen, neighborhood advocate, author, and role model…” What do you think… Plus or Pitfall?

“In my journey through medical school, I have realized that pursuing a career in family medicine will allow me to address several of my special interests while also allowing me to serve me community effectively… My interest in adolescent populations is one of the main reasons I am opting for a career in family medicine… I also hope to address the needs of the special populations…” “I have learned that people with substance abuse issues present a special set of challenges, and I plan to use what I have learned in a prevention effort in my community… I had some academic difficulties in the basic sciences as a result of my difficulties with test taking. I was able to address these difficulties in a decelerated curriculum that allowed me to spread out the traditional preclinical courses and focus on each course in more depth… Returning to a full-time curriculum for my clinical clerkships… Though it was personally difficult for me to accept a change in the course I had planned, I am grateful for the additional enriching opportunities…” What do you think… Plus or Pitfall?

Medical Student Performance Evaluation (MSPE) Strolling Through the MatchMay 2011

The MSPE is a comprehensive assessment regarding comparative performance. ● It should describe, in sequential manner, the student’s performance, as compared to peers, through 4 full years of school. ● It should be an assessment of both academic performance and professional attributes. ● It should be 2-3 pages in length and appropriately formatted with appendices. T HE MSPE…

Is neither a letter of recommendation nor a prediction of future performance in residency T HE MSPE…

Format ● Identifying Information  Identifies you as a fourth year medical student at the University of Tennessee Health Science Center ● Personal Comments / Noteworthy Achievements  demonstrated leadership  research abilities  community service  significant challenges/hardships T HE MSPE…

Format ● Academic History  graduation and matriculation dates  breaks, gaps, LOA  Transfer school and dual degreed program information  explanation of remediated coursework  explanation of adverse actions T HE MSPE…

Format ● Academic Progress  basic sciences & introduction to clinical medicine (PCC/DRS)  required clinical core clerkships and electives reported thru mid-October T HE MSPE…

Format ● Summary  summative assessment of comparative performance relative to peers  reference to unique characteristics / accomplishments  overall performance in basic medical sciences & clinical clerkships with emphasis on professional attributes T HE MSPE…

Format ● Overall Medical Student Performance Rating  GPAs taken from GPA/Class Rank report (available early September) T HE MSPE… Indicates percentage of class in each category; not an indication of class rank. OVERALL MEDICAL SCHOOL PERFORMANCE Outstanding ( ) Excellent ( ) Very Good ( ) Satisfactory ( ) 15%25%50%10%

Format ● Appendices  A – bar graph of performance relative to peers in each preclinical course  B – bar graph of performance relative to peers in each core clinical clerkship  C – assessment of professional attributes relative to peers **  D – bar graph showing overall performances relative to peers  E – medical school information page T HE MSPE… ** Not currently included in the MSPE

Letters of Recommendations Strolling Through the MatchMay 2011 Download ERAS LOR Coversheet for US Graduates from Student Affairs Website

Generally are required; 4 recommended ● ERAS will allow a maximum of 4 letters per program ● department chair of your chosen specialty ● senior faculty member usually in specialty of choice (i.e., faculty with whom you did JI) ● other faculty member(s), not necessarily in specialty, who knows you well ● make appointment EARLY to review your professional goals and answer questions ● provide a CV, personal statement, transcript, and list of programs; attach ERAS LOR Cover Sheet ● don’t be shy about discussing your strengths or extenuating circumstances L ETTERS OF R ECOMMENDATION

Chair’s letter Call to set up an appointment- do not The chair is expecting you- even if you have never met The interview as well as your performance on the rotation will be enough for him to write you a letter Bring with you a list of programs you are applying to Ask about your competitiveness for programs and listen to the feedback

The Electronic Residency Application Service (ERAS) ~ the electronic application delivery system

ERAS What is ERAS ? Electronic “ application delivery service ” used to transmit applications, letters of recommendation, MSPEs, transcripts, and other supporting credentials from applicants and medical schools to residency program directors using the Internet. Tokens will be distributed via UT to applicants in late June MyERAS available (but not live) for applicants mid July ERAS Post Office opens September 1 st ; available for transmission of documents to programs Required for NRMP and some early matching services

ERAS  ERAS is comprised of four main components:  MyERAS is the Web site where applicants complete their ERAS Application  select programs to apply to, and assign documents to be received by programs.  DWS is the software used by the designated dean's office.  scan and attach supporting documents to the application, such as photographs, medical school transcripts, MSPE, and LoRs.  PDWS is the ERAS software used by program staff to receive, sort, review, evaluate, and rank applications.  ERAS Post Office is the central bank of computers that transfer the application materials from applicants and their designated dean's office to residency programs.

 Students should NOT wait on a complete file before submitting application  No supporting documents can be transmitted through ERAS UNTIL THE STUDENT SUBMITS HIS/HER APPLICATION!

ERAS How Does ERAS work? Applicants receive electronic token in late June to register with MyERAS; begin completing online ERAS application. – Worksheet from ERAS applicant resource page – Copy of AMCAS application from Registrar’s Office Applicants certify/submit ERAS application to programs beginning in September. – USMLE receives and process requests to upload USMLE scores Transcript includes scores posted at time applicant submits School begins uploading support documents in September Programs begin downloading applications in September; make interview offers Applicants & School can track ERAS applications using ADTS!!!

ERAS ERAS is NOT the same as NRMP… You must register for ERAS separately from NRMP ERAS – July NRMP - August ERAS is required for applicants enrolled in the NRMP and the Urology matches as well as for some branches within the military match.

ERAS How much does ERAS cost? ● ERAS processing fees are based on the number of programs to which you apply per specialty ● Check ERAS website for pricing Is there a deadline for submitting ERAS applications to Student Affairs? ● No. However, SA recommends all ERAS applications be completed no later than October 20 th  Programs set their own deadlines  Some specialties/programs have early deadlines and therefore, should take priority over our October 20 th deadline recommendation

A PPLYING FOR R ESIDENCY ~ the mechanics of the application process Strolling Through the Match May 2011

A PPLYING FOR R ESIDENCY PATHS of Residency Applicati on Advanced specialties with own Match US Armed Forces National Resident Matching Program (NRMP)

A PPLYING FOR R ESIDENCY Advanced specialties with own Match  Early Match | Results faxed to our office o San Francisco Matching Program   Neurology, ophthalmology, and plastic surgery  Must register for the NRMP for preliminary year  Uses ERAS for prelim year only; does not require a different set of letters or PS o American Urological Association Residency Matching Program   May or may not require NRMP for prelim year  Uses ERAS

A PPLYING FOR R ESIDENCY US Armed Forces (Military Match)  Should also enroll in the NRMP  Automatically withdrawn by NRMP if matched by military  Results faxed to our office

The National Resident Matching Program (NRMP) ~ a coordinated matching service Strolling Through the Match May 2011

A PPLYING FOR R ESIDENCY National Resident Matching Program (NRMP)   The Match - service for matching applicants to programs  Provides uniform date of MSPE o Absolutely NO MSPE will be released prior to 1 November  Registration for NRMP begins August 15 th

T HE NRMP Categories/Tracks of Internships ● Preliminary (P)  Serves as prerequisite for additional post graduate medical education in other disciplines o Ex. Prelim medicine, Prelim Surgery ● Transitional Year (P)  May/ may not serve as preliminary year  Undecided about specialty ● Advanced (A)  Begins PGY 2 and requires 1-2 years of preliminary training o Ex. Radiology (A), Anesthesiology (A), Dermatology (A) ● Categorical (C)  Offer positions for PGY1 with no preliminary training required o Ex. Family Medicine, Surgery, Internal Medicine, Medicine- Pediatrics, Ob/Gyn, Pediatrics, Psychiatry

T HE NRMP - M ATCHING AS A C OUPLE Participating as a Couple When two individuals are registered for the same specialties matching service (e.g., NRMP), they may participate in that Match as a couple. Couple’s match is not a separate match from the NRMP! Each partner of a couple enrolls individually in the match. The NRMP allows couples to form pairs of choices on their rank order lists, which then are considered in rank order in the Match. Partners can be matched into positions in the same institution or in different institutions. Couples are encouraged to talk to us for assistance with preparing their rank order lists for the Match

M ATCHING AS A C OUPLE IMPORTANT! Partners listed as a couple are treated by the Match solely as a couple. If one partner does not match, neither partner will matched. If one partner wishes to withdraw, both partners must uncouple before either can withdraw.

How important is ? ● EXTREMELY IMPORTANT! Check daily! ● Programs accepting applications via communicate using , including announcements, questions about one’s application and interview offers ● Student Affairs uses to notify you of important developments and/or alerts as it relates to ERAS or other issues involving the application process or Student Affairs  Student Affairs uses UT accounts only!  Avoid using HOTMAIL with ERAS due to incompatibility issues with the ERAS software

Stay on top of your application and pay attention to your programs’ deadlines! SUMMARY

Avoid waiting until the last minute to ask for letters of support. Submit your application and other required materials on time! SUMMARY

Rumors cause problems… Contact our office when you have questions or have concerns about your application!

We have a lot more information to help you! Office of Student Affairs 910 Plaza, Suite 1043 Tel: C LICK, C ALL OR C OME B Y ! Online chat Available!

The Bottom Line… Dr. Phillips wraps it up with the latest Match Trends

MATCH TRENDS ~ Total positions vs. Total Applicants (includes IMGs, previous grads, osteopathic, etc.) Over the past several years, the competition for residency positions has heightened.

Unmatched Applicants, Unfilled Positions ~ 2001 – 2010; Includes IMGs, previous grads, osteopathic, etc.)

Unmatched US Seniors, Unfilled Positions ~

Available Scramble Positions ~

Specialty Preferences of 2010 Unmatched Seniors & Available Scramble Positions

Unfilled Positions: First Two Days

NRMP IMPLEMENTS CHANGE IN 2012 S.O.A.P. The NRMP Board of Directors will proceed with changes to Match Week 2012 with a new Supplemental Offer and Acceptance Program to be implemented for unmatched applicants and unfilled programs.

S.O.A.P. So they say!

S.O.A.P. - Applicant Eligibility

S.O.A.P. - Program Participation

Previous Match Week Schedule

Revised Match Week Schedule

Begin working on CV/personal statementNOW! Review your student evaluations (910 Plaza #1043)NOW! Begin familiarizing yourself with NRMP and ERAS via their websites: NOW! Register and begin entering ERAS application onlineJuly 1 Begin scheduling appointment for MSPE Appointments begin July 20 th ; end October 19 th* July 11 Registration online for the NRMPAugust 15 Begin transmitting ERAS applications to programsSeptember 1 MSPE released to all programsNovember 1 NRMP Online notification of “matched” or “unmatched”March 12 Match Day Class of 2012March 16 * tentative dates; subject to change R EMINDER OF T IMELINE

Wrapping it up…

Everyone should match. You should take our advice If you hear a rumor, confirm with us There are some realities to this process The Heartburn: Will I match?

Number of medical school graduates going up Number of graduates of osteopathy schools entering match going up Number of residency spots NOT going up Where are graduates going?  PRIMARY CARE ! AAMC reported trends

Match Applicants

PGY-1 Matches–

Percent Matched–

Family Medicine:1169, up 98 Internal Medicine: 2722, up 90 Ob/Gyn: 915, up 36 Pediatrics: 1711, up 29 Total increase in these primary care matches 253 Total U.S. senior increase 432 (59%) 2010 Match vs. 2009

Sent to all 126 student affairs deans on 3/29/ replied by 4/19/10 how many seniors in match? how many unmatched on 3/15/10? how many unmatched on 3/29/10? of those, how many are ready/qualified to start 7/1/10? reason for failing to find a position. how many post-graduates in this year’s match? number successful Match-Scramble Survey

111 (of 126) schools responded 14,623 seniors represented (NRMP = 16,070) 871 unmatched on Monday 3/15/10 (6.0%) 194 without a PGY-1 position on 3/29/10 (1.3%) 179 “ready to start” according to their student affairs deans (1.2%) 2010 Match-Scramble Survey

Of those 179  81- not competitive for chosen field  49- USMLE issues  28- Rank order issues  18- Difficulty with the process  16- Geography  13- Overly Aggressive  11- Poor interviewing skills  6- Professionalism issues  2- Poor Letters of Recommendation  1- Poor advice 2010 Match-Scramble Survey

Post-graduates in the match  921 total  512 matched (56%) 2010 Match-Scramble Survey

Conclusions: 1.The percent of successful matches for U.S. seniors remains 93-94% 2.The number of successful matches this year for U.S. seniors was greatly helped by 253 more seniors going into the four primary care fields. 3.There are approximately 200 “ready/qualified to start” U.S. seniors without PGY-1 positions at this time for July Match-Scramble Survey

From students went unmatched 20089/1496% 20095/1363.7% 20107/1435.6% 20116/1405% T HEN UT HEARTBURN EXPERIENCE

Otolaryngology1EM2 Ob-Gyn2Plast surg1 Anesthesia1Peds1 Urology1Derm1 Internal Med3 Radiology2 General Surgery4 Orthopedic surg.6 Step1 failures:4 T HE UT H EARTBURN

We don’t want to scramble anyone Come in early to see me I believe in a ‘parallel’ plan Or a decision about ‘what’s the worst thing that could happen to you’ We are here to help Let us help

Questions? More to follow Come see me or another advisor