1. Preparing for 4 th Year and the Match  Danielle Maholtz, OMSIV

2. Summary  Licensing Exams: timing, preparation, to USMLE or not to USMLE?  Scheduling Electives and VSAS  Roadmap to 4 th year  ERAS: selection of programs and cost  Interviews, travel and budget  Preparing the ROL  Match Day and SOAP

3. Licensing Exams  COMLEX Level 1: Second year  COMLEX Level 2 CE: Third year  COMLEX Level 2 PE: In Conchahocken, PA  Register early (summer/fall of 3 rd year) for best dates  COMLEX Level 3: Intern year  COMLEX is accepted for Licensure in all 50 states  Board Certification is a separate process: Board exams are taken at the end of residency

4. To USMLE or not to USMLE?  If you plan to complete your residency and fellowship within an AOA program, USMLE is not required  ACGME Program Director Survey  94% of program directors selected USMLE/COMLEX Level 1 score as most important factor in selecting applicants to interview with an importance rating of 4.1/5  31% of programs state they use USMLE Step 1 score only to know if applicants PASSED  36% of program directors state they use COMLEX Level 1 score to know if applicants PASSED and an additional 41% of program directors state they use it to see if students hit a target score  Total of 77% USE COMLEX Level 1 (12% less than USMLE Step 1)  65% look at ethics and professionalism with an importance factor of 4.5/5  If you plan to apply for ACGME programs, check with each individual program to see if they require Step 1, Step 2 or both and what their minimum scores are  Check Freida (https://login.ama-assn.org/account/login)https://login.ama-assn.org/account/login

5. Preparing for Licensing Exams: Level 1  Study for your classes: Lots of pharmacology and pathology on Level 1/Step 1  First Aid +/-  Doctors in Training, Kaplan, PASS program, Pathoma, etc.  Question Banks: USMLE World, COMBANK, COMQuest  Make a schedule and allow yourself some time for exercise, sleep and family  Schedule Exams a few days apart if you choose to do both  COSGP Medical Education Research

6. COMLEX Level 2  Your COM will send you an email when you are eligible to register  Cognitive Evaluation (CE)  Similar format and study resources as for Level 1  Material tested is less basic science and more clinical  Performance Evaluation (PE): 12 standardized patients  6 hour clinical skills exam at the NBOME testing center in PA  14 min encounter + 9 min SOAP note  8-10 weeks for scores to be reported  Ideally, you want passing PE scores at the time that ERAS opens (September 15 th ) so try to schedule your COMLEX PE during summer of 3 rd year (May, June, July)

8. Licensure vs Board Certification  You apply for a license through the state in which you practice  Requires all 3 steps of COMLEX  Some residencies cover cost – different based on state  Board Certification is specialty specific and requires completion of residency training  AOA Board Certification  American Board of Medical Specialties (ABMS)  Dual Certification is available  CME will be based on which Board certification is obtained  http://osteopathic.org/inside-aoa/development/aoa-board- certification/Pages/default.aspx http://osteopathic.org/inside-aoa/development/aoa-board- certification/Pages/default.aspx  http://www.abms.org/About_ABMS/ http://www.abms.org/About_ABMS/

9. Scheduling

10. Electives and Core Rotations  Check to see what requirements your school has and make sure you schedule blocks to fulfill them  Electives: Some schools have max number of weeks in a single specialty (ex: 16 weeks max in Pediatrics)  If you can, schedule vacation weeks that allow sufficient time to study for Level 2 and travel to PA for Level 2 CE  You may need to schedule vacation time for interviews and/or COSGP meetings  Check your school policies and MAKE SURE you meet all requirements for graduation

11. Audition Rotations/Sub- Internships  Pros  “Mandatory” for some osteopathic programs: you are more likely to be ranked if you rotate there  Try out a program  Prove yourself  See an area of the country that you may want to train in  Some programs offer courtesy interviews to Sub-Interns  Adventure!  Cons  Not always necessary for allopathic programs  Expensive!!  Double rent vs living out of suitcases  People will see your shortcomings in addition to your strengths so you have to perform at your peak at all times  Learning a new system (EMR, hospital layout, etc) every month is a challenge

12. Away Electives  Call the medical student coordinator at the host site  Program specific application process  Check the website of the program you’re interested in rotating at  Visiting Student Application Service (VSAS) – vsas.aamc.org  Centralized application service: Upload required documents and assign them to specific programs ($15 per application)  Check application opening dates, required forms (specific immunization forms)  Earliest opening date for Applications is February 1 but many programs take applications beginning in March, April or May for Fall rotations

13. Helpful Resources & Ideas  Try to schedule in August, September and/or October (new interns in July  Interview season is October-January  Rental cars are MUCH cheaper if you go through Hotwire.com or a similar site  Now is a great time to apply for a credit card which gives you airline miles if you don’t already have one!

14. Housing  Check with the host site about visiting student housing  Websites - Rotatingroom.com, Airbnb.com, craigslist.com  Consider rotating in places where you have generous friends/family with an extra room

15. Preparing for ERAS and the Match

16. Registration for the Match  Registration for NMS and NRMP are separate from ERAS!  National Matching Service: Osteopathic Match  $60 Registration fee. Deadline: Nov 1, 2014 to avoid late fee.  https://www.natmatch.com/aoairp/applregister.html https://www.natmatch.com/aoairp/applregister.html  National Resident Matching Program: Allopathic Match  $65 registration fee. Deadline Nov 30, 2014 to avoid late fee.  http://www.nrmp.org http://www.nrmp.org  Match Prism tracking App for iPhone and Android

17. ERAS: Electronic Residency Application Service  Documents: COMLEX/USMLE transcripts, LORs, Personal Statement(s)- assign these to programs  Application:  General Info, Licenses (ACLS, etc.), Medical Education  Medical School Honors/Awards  Membership in Honorary/Professional Societies  Education and Prior Training  Experience: Research, work, volunteer  Publications: Peer Reviewed Articles/Abstracts, Other articles, Oral Presentations  Languages  Hobbies and Interests  Other Awards and Accomplishments

18. Programs  Search and Apply to MD and DO programs  Assign documents to the programs you apply to  You can have multiple personal statements  Most programs require 3 LORs but will take up to 4  EM may require a SLOE (standard letter of evaluation)  Some programs will require a LOR form the Department Chair  Applicant Document Tracking System (ADTS) allows you to see when your documents are downloaded  ERAS Application Fees:  Programs Up to 10 - $95 total  Programs 11-20 - $10 each  Programs 21-30 - $16 each  Programs 31 or more - $26 each  Requesting COMLEX Scores $75  Requesting USMLE Scores $75

19. Helpful Resources and Hints  Start ERAS early! It will take several hours to enter all of your amazing accomplishments.  The Personal Statement (PS) might be the hardest thing you write in med school. Revise, Revise Revise!  Have people proofread your application and Personal Statement.  Don’t embellish your CV just to fill space but be sure to include any presentations you’ve given for your SGA or COSGP. They count!  Check each program’s website for application requirements. Some want your PS to address a specific topic or have LOR specifications.  Number of programs you apply to will depend on your specialty and qualifications.

20. Researching Programs and Specialties  Opportunities.osteopathic.org  FREIDA: https://login.ama-assn.org/account/login  Osteopathic GME Match Report: http://data.aacom.org/aacomas/do_gme_match_report2012.asp http://data.aacom.org/aacomas/do_gme_match_report2012.asp  NRMP Charting Outcomes in the Match: http://b83c73bcf0e7ca356c80- e8560f466940e4ec38ed51af32994bc6.r6.cf1.rackcdn.com/wp- content/uploads/2013/08/resultsanddata2013.pdf  NRMP Charting Outcomes in the Match: Specialties Match http://b83c73bcf0e7ca356c80- e8560f466940e4ec38ed51af32994bc6.r6.cf1.rackcdn.com/wp- content/uploads/2013/06/NRMP-Charting-Outcomes-in-the-Match- Specialties-Matching-Service-1st-Edition-Published-May-2013.pdf

21. Interviews and Budgeting  Most people do between 6-12 interviews  Interview invitations will start being issued within days of ERAS opening and continue well into December. Respond ASAP to get your choice of dates. Check your spam folder!  Some programs will pay for your hotel  Event with residents the night before, Interview day usually ~8a-2p. Details in program email.  If you’re doing an elective at a site where you end up getting lots of interviews, try to schedule them so that you can drive.  Use a spreadsheet and/or Google Calendar to keep track of logistics and program details that are important to you.

22. Outline Options  Program title and location  Interview offered?  Interview date  Travel and lodging plans  Number of residents  Salary  University vs community based  Research opportunities  Moonlighting  International elective  Residency start date

23. Preparing the Rank Order List  ROL opens for Osteopathic Match Participants on Jan 7, 2015- due Jan 23, 2015  ROL opens for Allopathic Match Participants on Jan 15, 2015- due February 25, 2015  Must certify your ROL prior to deadline but can make changes up until the deadline  Rank programs in order of your training preferences, not how you think the programs will rank you.

24. Match Day and SOAP (Supplemental Offer and Acceptance Program)  Friday before Match week: email notification of SOAP eligibility-does not mean that you didn’t match!  Find out WHETHER you have matched on Monday of Match week  SOAP (the scramble): applicants apply for any unfilled spots through ERAS  Find out WHERE you matched on Friday of Match week  Osteopathic Match: February; Allopathic Match: March  If you Match in the Osteopathic match you MUST withdraw your application from the Allopathic Match!  To participate in the osteopathic scramble, you must have registered for the NMS Match (even if you don’t rank any programs) **If you do the Allopathic Match you cant scramble into Osteopathic programs until after the Allopathic scramble**

25. Side Note  Criteria for AOA Recognition of ACGME PGY1 Training  The applicant must be an AOA member in good standing  The applicant must complete the application for AOA training recognition  The ACGME must submit a letter listing PGY1 core rotations  Applicants must participate in an osteopathic educational activity  Attend 1 category 1-A CME sponsored educational conference for minimum of 8 CME credits  Osteopathic clinical presentation for peer residents  Develop an original research paper on a clinical or educational topic in osteopathic medicine  May present at a category 1-A CME sponsored conference in a specialty area that includes an osteopathic component if you have completed residency

26. Overall Timeline  Third Year  Fall – Register for COMLEX Level 2 CE and PE  January – Contact programs for possible rotations  February – VSAS opens  March/April – Submit VSAS applications  Fourth Year  July 15 – AOA ERAS Application Submission Begins  September 15 – MD ERAS Application Submission Begins  October-January – Interviewing  November 1 – NMS Match Registration Due  November 30 – NRMP Match Registration Due  January 15 – NMS ROL Due  February 25 – NRMP ROL Due  February – NMS Match Day  March – NRMP Match Day  May/June - Graduation

27. Questions?