1. Overview of Residency Matching Program
Applicant’s Perspective
Warren Go, MD
Patricia Baile, MD
Michael Mendoza, MD

2. Agenda Why prepare well for the Match The Journey Ahead
2009 NRMP Match Outcome
The Journey Ahead
USMLE and ECFMG Certification
ERAS
Interview Trail
NRMP (Match)
The YADP Program

3. “Time is against you. If you want to train here get everything done now. The only asset you have is being recent grads. Do not waste time with activities that won’t attract program director’s attention”
Aldo Dumlao, MD. Class 2002
Utica, New York

5. The 2009 NRMP Match There were 22, 427 PGY-1 positions in 2009
There were 36, 972 applications received by NRMP in an increase of more than 1,016 compared to 2008

6. Why prepare well for the Match?

9. Fill rate of 2009 is 95.4
Increase of US medical seniors applicants
US IMGs and Non US IMGs registered the largest increase among all applicant groups

10. Specialties with highest matched rate among US medical Seniors
Internal Medicine
Pediatrics
Preliminary Medicine
Emergency Medicine
Anesthesiology
Family Medicine
Diagnostic Radiology
OB-Gynecology
Transitional Year
Surgery (Categorical)

11. Specialties with highest matched rate among US IMGs
Internal Medicine
Family Medicine
Pediatrics
Psychiatry
OB Gyne
Emergency Medicine
Preliminary Medicine
Preliminary Surgery

12. Specialties with highest matched rate among Non-US IMGs
Internal Medicine
Family Medicine
Pediatrics
Surgery Preliminary
Psychiatry
Neurology
Preliminary Medicine

13. Competitive Specialties
Dermatology
Neurological Surgery
Orthopaedic Surgery
Otolaryngology
Radiation Oncology

15. Successful applicants in the match
Rank more programs within their preferred specialty
Mostly US senior
Have higher USMLE step 1 and Step 2 Scores

16. The Journey Ahead

17. Educational Commission for Foreign Medical Graduates (ECFMG)
The “Dean’s Office” of International Medical Graduates (IMG)
IMG
MD or equivalent degree from medical school outside the US or Canada
US citizens graduating from medical school outside US or Canada
Non-US citizen who graduated in any US medical school is not considered IMG

18. Standard ECFMG Certificate
Required before starting ACGME accredited Residency Program
Not required for:
Applying for residency programs
Participating for the NRMP (provided you passed Step1, Step 2 CK and Step 2 CS)
ECFMG certification by September 1 (Advantage)

19. Requirements for ECFMG Certification
Medical school and Graduation year listed in International Medical Education Directory (IMED)
Examination requirements:
Pass Step 1
Pass Step 2 Clinical Knowledge (CK)
Step 2 Clinical Skills (CS)
Verified Medical Education Credential Requirements
Final Medical Diploma
Final Medical School Transcript
Standard ECFMG Certificate are sent approximately 2-6 weeks after all of the requirements have been met

20. I took USMLE step 1 after 2nd year. Step 2 ck during 3rd year
I took USMLE step 1 after 2nd year. Step 2 ck during 3rd year. Step 2cs after 3rd year. Step 3 shortly after graduation. I recommend doing observership or clinical rotations in US. Getting US doctors to write letters of recommendation The key to getting a good residency is proper planning and formulating a timeline which you can follow.
Francis Ryan Tan Class of 2004
Pittsburgh, Pennsylvania

21. The United States Medical Licensure Examination (USMLE)
USMLE Step 1
USMLE Step 2
Step 2 Clinical Knowledge (CK)
Step 2 Clinical Skills (CS)
USMLE Step 3

22. Matched US Applicant Score
USMLE
TOPICS
ITEMS
Blocks
Matched US Applicant Score
STEP 1
Basic Sciences
336 Multiple Choice test items
7 blocks (60 mins/block)
225
STEP 2 Clinical Knowledge
Clinical Sciences
352 Multiple Choice Test items
8 blocks (60 mins./block)
231
STEP 2 Clinical Skills
ICE, CIS and SEP
12 Patient Encounters
15 mins. Patient encounter and 10 mins. Clinical note
Pass
STEP 3
Emergency Dept. Inpatient, Outpatient, Office
480 Multiple Choice test items, 9 Computer based Case Simulations
DAY 1: 7 blocks
DAY 2: 4 blocks and 9 CCS case

23. Eligibility for Examination for Step 1, Step 2 CK and Step 2 CS
For Current Medical Students
Enrolled in a medical school outside the United States and Canada that is listed in IMED
Certification from Medical school indicating current enrolment status.
Completed at least 2 years of medical school.

24. For Medical School Graduates
Graduate of medical school located outside US and Canada listed in the IMED.
Medical School must certify your status as a graduate of the school.
Medical credential verification
Consider the postal/processing time lag for receipt of application in ECFMG (least 3 weeks processing)

25. Issues Scheduling Permit
Decides to Take Step 1 and Step 2 CK
Registration Information
Test Delivery Entity
IMG Applicant
ECFMG
NBME
Prometrics
Score Report for Step 1 and 2CK
Decides to take Step 2 CS
CSEC
US regional CSEC Centers
Score Report for Step 2 CS
Program Entities for Registering and scheduling for USMLE step 1, Step 2 CK and CS

26. Eligibility Period for Step 1 and Step 2 CK
Three month period of your choice
Limited Seat availability in Prometrics Test Center during peak seasons.
Busiest testing times in the US/ Canada
May – July
November - December

27. Eligibility and Scheduling for Step 2 CS
12 Month Eligibility
ONLY administered in the United States
Atlanta, Georgia
Chicago, Illinois
Houston, Texas
Los Angeles, California
Philadelphia, Pennsylvania
dates are available on a “first-come, first served basis.
Availability is not guaranteed
Peak time (Step 2 Calendar schedule)
May to July

28. Travel Status for CS IMGs are responsible for:
Travel and accommodation arrangements
Tourist VISA
Upon request ECFMG provides Step 2 CS applicants with a letter that may assist for getting Visa
(NOT A GUARANTEE)
If unable to get a US VISA- a full refund can be requested.

29. Reporting of Scores Step 1 and Step 2 CK Step 2 CS
3-4 weeks after your test date
6-8 weeks if taken during “Peak time”
Step 2 CS
Found on Schedule for reporting results
Typically 6 weeks.
Dependent on the volume of test takers “peak time”

30. Sequence and Retaking Exams
Steps can be taken in any order except Step 3
Are you prepared?
Step 1 and Step 2 CK
You may retake more than four times in any 12 month period
Step 2 CS
You may retake more than three times in any 12 month period

31. Tips in Scheduling for Exams
Application, registration and verification all online.
FEDEX or other courier services for sending documents .
Scores = extent of preparation
Don’t think one exam at a time when scheduling.
Schedule with a goal of being ECFMG certified before September 1
ONLY take exams when you are confident enough that you will get a HIGH score.

32. Tips when studying Set a HIGH GOAL (99 why not?) Commit
Choose one reviewer and master it.
Practice, Practice, Practice – MCQs
Take scheduled breaks
Review Materials:
Step 1: First AID, Goljan Notes, Kaplan Materials, Crash the boards, USMLE World
Step 2 CK: Kaplan notes, Crash the boards and USMLE World
Step 2 CS: First AID and Best friend to practice
Step 3: Step 2 CK study materials and USMLE World
Self study vs. Review centers – Discipline?
Pray hard

33. THE ERAS-INTERVIEW-NRMP CYCLE

35. US Graduate Medical Education for IMGs
Standard ECFMG Certificate.
Certain specialties and programs vary in their competitiveness.
The directors of residency programs decides on:
Selection of applicants for interview
Ranking the applicant
Whether a contract is actually offered.

36. Research your specialty and Programs early on.
Select a specialty
Selecting Programs within your specialty
Location of individual programs
Hospital affiliations
Accreditation
Performance of their graduates
INSIDER (Connections!!!!)
FRIEDA Online
ERAS Website
Contact Programs via

37. Programs for Applying to Graduate Medical Education programs
ECFMG (Secured Online program)
IMG’s designated Dean’s office
Provides access to ERAS Website (Token)
Applicant’s supporting documents (USMLE Transcript, ECFMG Status report, LORs, etc.) and transmits them to ERAS
Electronic Residency Application Service, ERAS (Secured Online program)
Applicant’s personalized website to contact, apply and transmit “credentials” to program directors.
Program Director’s website to screen, select, “filter” and communicate with applicants.
Generally, US programs accepts application through ERAS.

38. ERAS Documents Common Application Form (CAF)- “the resume”
Personal Statement
Medical Student Performance Evaluation (MSPE)
Letter(s) of Recommendation (LoR)
Medical School Transcript
USMLE Transcript
ECFMG Status Report
Postgraduate Training Authorization Letter – “California Letter)
2x2 Colored Photo

40. “Apply to many programs but concentrate on a few and make contact with them showing special interest. Research the programs prior to the interview. As I interview applicants especially IMGs they are too willing to admit that they apply to as many programs.....its a numbers game. That may be so but please never admit it.”
Todd M. Reiter, MD Class of 2004
Richmond, Virginia

41. Getting interview invitation
USMLE scores
Number of programs you applied in ERAS.
Insider-Network
Once called for an interview- the playing field is equal for all applicants

42. “Many Filipino applicants that I have encountered are very quiet and modest when they come in for their interviews...This does not help at all and can actually be a point against you...Do not be modest about your accomplishments”
Josefina Paderes, MD

43. The Interview Experience “TIPPING POINT”
Could be the most stressful, frustrating, challenging but enriching part of the cycle
Realizations:
Resourcefulness
How to travel and pack light
Forced to “shed” the Filipino “humble/mahiyain” culture.
Meet fellow applicants “Eye opener” how TRULY competitive the match.
How you feel spending 3-4 years of life in the hospital.

44. National Resident Matching Program (NRMP)
An online program that runs the “match algorithm” process
Applicants submit online a list of residency programs he/she has interviewed with in order of preference.
Program directors also submit a list of applicants “they prefer” for their programs –rank order lists

45. Program directors usually rank only applicants they have Interviewed.
There is no guarantee that the programs to which you have applied will interview you or include you on their rank order lists.
If you are ranked by programs, there is no guarantee that you will be matched to any of these programs.
TIP: rank only the programs you like and willing to attend.

46. FINANCIAL ASPECT of ENTERING A US RESIDENCY PROGRAM
EXAM
PREPARATION
COST
Step 1
3 months
$ 710 (+130)
Step 2 CK
2 months
$ 710 (+145)
Step 2 CS
1 month
$ 1,200
*Step 3
$ 690

47. FIXED EXPENSES Estimated Total Cost: 6000-10,000 USD VARIABLE EXPENSES
USMLE Steps 1-3: $ 3,585
ERAS Registration: $40
Application for Programs :
1st 10 programs: $60
11 – 20: $8 each
21 – 30: $15 each
31 onwards: $ 25 each
NRMP Registration: $40
Travel: $ 1,200 (MLA-USA-MLA)
Interview: variable
*Rent: $ 1,000 / month
Living expenses: $600/mo
Estimated Total Cost: ,000 USD
Estimate based on 6 month stay in US

48. The road to your residency begins now!
STUDY VERY VERY HARD and get HIGH SCORES in USMLE Steps
Start building your CVs-Document it.
Start writing down “memorable” clinical encounters.
Involve yourself in Clinical research, publication opportunities.
Moonlighting vs Concentrating on USMLEs
Start networking
Research your specialty and Programs
Get Medical volunteer experiences local or US
Pray and Work hard

49. Young Alumni Development Program (YADP)

50. Goals and Objectives Facilitate Transition to US health Care system
Mentor to UERMMMC Medical School graduates pursuing careers in Medicine in the US.
Provide Career advancement in Medicine in the US
Provide network of mentors in medicine
Establish a committee involving mentors, Dean and other faculty members of UERMMMC College of medicine, members of UERMMMC-MAAAA, Inc. And the UERMMARVADC Chapter

51. Eligibility Criteria for YADP
Graduate of UERMMMC who are seeking residency or fellowship training in the US.
Must have passed USMLE Step 1 or Step 2.
Must be responsible for obtaining appropriate VISA, living expenses, accommodation and health needs.

52. “So in closing, make good use of your time - even if you do not get in this cycle. Look for ways to enhance not only your experience but most importantly your academic track record - that is well documented and verifiable. A few abstracts or one peer reviewed publication (does not need to be 1st author) will surely beat one dozen observerships in some obscure clinic that carry no or very little academic impact or pedigree” Don't lose hope, continue to aim high but remain realistic - and best of luck!!
Romergryko G. Geocadin, MD, Class 91 Director, Neurosciences Critical Care Division Johns Hopkins Medical Institutions

54. Get more Information ECFMG (www.ecfmg.org)
Fellowship and Residency Electronic Interactive Database (FRIEDA) –
ERAS (
NRMP (
USMLE (
Prometrics ( Com)
YADP yahoo groups
SDN
USMLEtoMD
Prep for USMLE
Iserson, KV. Iserson’s Getting into a residency: A guide for Medical Students, 6th Edition