1. Guide to Residency Application and the Match Dwight Davis, M.D.

2. Specialty Decision Final consideration of specialty choice Goal: Identify something you love to do that utilizes innate and developed skills Review Careers in Medicine Components  I - Self assessment (interests, skills, values, goals)  II - Exploring specialty and career options  III - Choosing a specialty  IV - Getting into residency

3. Senior Year Responsibilities Complete graduation requirements  Review and track course requirements  MSR submission and approval  Pass USMLE Step 2 early  Maintain good standing Do well in your remaining clinical rotations Make a planning calendar of important events and deadlines through Match Day

4. Specialty and Residency Resources  Careers in Medicine Program and specialty web sites  Student specialty interest groups (faculty advisors)  Library reserve references  Clerkship attendings  Residents  Individual program information  Graduating seniors match list  College of Medicine specialty advisor

5. Clinical Specialty Advisor All students should establish a relationship with a clinical specialty advisor to assist with the application process Procedure with specialty advisor  Meet early to review specialty decision, background, and career goals  Copy of transcript  USMLE results  Curriculum vitae  Candid discussion about competitiveness for specialty selected, backup plan if appropriate  Critique of personal statement when prepared

6. Specialty Faculty Contacts AnesthesiologyLeonard Pott, M.D. Dermatology Bryan Anderson, M.D. Jennie Clark Emergency MedicineKimberly Scholfield, M.D. Family Medicine Dennis Gingrich, M.D. Medicine Philip Masters, M.D. Neurology Milind Kothari, M.D. Neurosurgery Robert Harbaugh, M.D. Ob & GynJohn Repke, M.D. OphthalmologyDavid Quillen, M.D. Orthopaedic SurgeryEdward Fox, M.D. PathologyElizabeth Frauenhoffer, M.D. PediatricsDeborah Kees-Folts, M.D. PsychiatryJames Hegarty, M.D. RadiologyJanet Neutze, M.D. Christine Peterson, M.D. SurgeryGordon Kauffman, M.D. OthersDepartment Chair

7. Residency Program Considerations Program evaluation examples  Educational structure / clinical responsibilities  Inpatient, outpatient, procedures, OR time  Patient diversity and disease categories  IT infrastructure in hospital and clinics  Program size / type (acad, comm, clin setting)  Opportunities for teaching and research  Call schedule, rotations at affiliate hospitals  Reputation of program chief and faculty  Placement of graduates (practice / fellowships)  Breath of subspecialty offerings  Assessment of program quality (clinical advisor)

8. Residency Program Considerations Personal Issues  Region of country  Size of city  Housing  Cost of living  Spouse / partner needs and employment  Family considerations Program Issues  Stipend  Vacation, illness procedure, professional support  Benefits including dates of initial insurance coverage  Parking  Travel to affiliates  Liability

9. Curriculum Vitae (for ERAS) Succinct and accurate chronicle of past experiences (start w/ important college or work experiences) Typical sections  Personal data  Education  Pertinent organizations (indicate leadership)  Pertinent employment  Significant extracurricular experiences  Honors and awards  Research, publications, and formal presentations See references for examples

10. Personal Statement  Motivation for medical career and specialty  Process of specialty decision  Relevant background experiences  How you fit the specialty (interests, skills, etc.)  Unique qualities or talents (modestly)  Career goals if formulated  Avoid quotes  Good grammar and spelling  Critique by clinical advisor  Obviously avoid writing services, plagiarism

11. Letters of Recommendation  Usually three letters (four in file if manageable)  Attendings in specialty area, clinical faculty who know you well, strong rotations, department chair  Ask early if faculty can support your application  Work closely with their administrative assistant  Provide the following in advance: Transcript, USMLE scores Curriculum vitae Personal statement  Waive your right to see letters Program reassured about candid comments

12. Medical Student Performance Evaluation Structured evaluation of medical school performance Not a document of recommendation Unique Characteristics  Brief background, leadership, service, research, and special honors  Significant challenges or hardships Academic history  Matriculation date, LOA breaks  Repeat or remediated coursework  Adverse institutional action

13. Medical Student Performance Evaluation Academic Progress and Performance  Transcript and narrative summary of overall performance in basic science curriculum  Grades and verbatim comments from all third year clerkships, early AI specialty grades Summary statement “Summative assessment of comparative performance relative to peers”  Superior 5%  Outstanding 25%  Excellent 50%  Very Good 20%

14. Planning the Senior Year  USMLE Step 2 CK and CS designed for early 4 th year  Must complete CK and CS exams by Jan. 1st  Complete your MSR by early fall  Decide on away specialty/hospital rotations now for July, August, or ? September  Review vacation time  Anticipate most travel mid Nov. to late Jan.  Avoid high intensity rotations during travel months

15. Rotations During the Senior Year  Plan to use vacation for most of your travel  Limit time away from rotations  Discuss and request travel time well in advance (attending and senior residents)  Offer extra time or patient evaluations to round-out experience  Work hard to master medical knowledge and improve clinical skills  Choose senior rotations wisely to prepare for residency

16. 2007 Match Summary

17. Program Directors Academic Ranking Green et.al., Acad. Med. 84:3, 2009

18. Average Number of Programs to Consider Based on competitiveness of specialty  Review information on 30 programs after you have a priority list  Based on review, consider 25 programs  Formal application to 20 – 25 programs  Interview at 10 - 15 programs  Rank most acceptable programs  BUT, rank only programs that are true preferences (no surprises on Match Day)

19. The Interview  PREPARE  Arrive early  Business attire  Well groomed and professional  Dress comfortably, including shoes  Know all aspects of your background  Know the program well  Mission, unique features  Have appropriate answer for why you selected the program for interview  Thoughtful answers to questions

20. The Interview  Understand the specialty and training process  Think about your future plans  Know your research (short abstract and detailed discussion if asked)  Always have thoughtful questions about program  Understand the rules about offers  Leave impression that your decision about specialty was based on a thoughtful process  Be accountable for blemishes in your record  Be Honest

21. Miscellaneous  Obtain a professional appearing photograph  Positive attitude and professional demeanor with all contacts during visits  If plans change or travel delayed, contact program immediately  Brief follow-up thank you note  Complete your program assessment and rank after each visit  Match results are binding  Remember, you are a representative of the College of Medicine

22. Issues for Unmatched Students You don’t want to participate in the scramble  Unrealistic assessment of competitiveness for specialty  Limited geography for competitive specialties  Professionalism issues  “Odd” personal statement  Rank small number of programs (3 – 4)  Troubling personal qualities conveyed at interview  Little rationale for specialty at interview  Questionable graduation status (Step II)

23. 2009 Match Results Data for the Scramble Positions offered22,427 U.S. Seniors participating15,638 Matched U.S. Seniors14,566 Unmatched U.S. Seniors 1,072 (7.3%) Positions to others in the Match 7,861 Initial unfiled positions left 359 F. Med, Medicine, and Peds positions~ 35% filled by non-U.S. Seniors

24. Positions Available After Initial 2009 Match

25. Useful References 1. Roadmap to Residency (30 pages, a must read first, Student Affairs web site) 2. Charting Outcomes of the Match (SA site) 3. Iserson’s Getting Into A Residency, 7 th edition (at least read the table of contents, library reserve) 4. NRMP Results and Data Book (Google) 5. Fellowship & Residency Electronic Interactive Database (Freida online) 6. Penn State specialty match list for last three years (SA site) 7. MSPE Guide (SA site)

26. Charting Outcomes of the Match Read carefully and note limitations  Match success rate by specialty  Range of USMLE Step 1 scores by specialty  Programs ranked by matched and unmatched students  Percent AOA students ranking specialty  Percent participating in research  Percent with one publication ranking specialty  Graphs of individual specialties  Missing data: grades, Letters of support, personal statement, experiences, interview, etc.

27. Christi’s Residency Match Chart 20072008PediatricsUniversity of Wisconsin Hospital and Clinics 2006 2008PediatricsUPMC Medical Education Program 2008PediatricsVanderbilt University Med 2007 PediatricsWalter Reed Army Medical Center 2008PediatricsYale-New Haven Hospital 2007 Peds/Psych/Child PsychBrown University/Rhode Island Hospital 2006 Physical Medicine/RehabNYP Hosp-Columbia Presbyterian 2007 Physical Medicine/RehabLSU SoM - New Orleans 2006 Physical Medicine/RehabNorthwestern McGaw/RIC 2007 Physical Medicine/RehabUPMC Medical Education Program 2006 Physical Medicine/RehabVirginia Commonwealth University Hlth Sys 20062007 Plastic SurgeryHershey Med. Ctr./Penn State 2007 Plastic SurgeryMt. Sinai Hospital 2007 Plastic SurgeryOhio State University Med Ctr 2008PsychiatryAlbert Einstein Medical Center 2006 PsychiatryBrown University Psych Res 2008PsychiatryHarvard Longwood Psych