August is that time of year when the new medical interns are acclimating to their programs. The summer is winding down and IM programs are starting to plan their interview season. ERAS opens in September and most programs don’t start interviewing until October or even November. Depending on program size, they will have, on average, screened thousands of applications after filters are applied and interview about 10% or less. I wrote another post on FAQs where I covered timing of ERAS see: Consolidated FAQs for IM Residency Applicants
Here are some tips to focus you during Interviewing and Residency Match season:
You’ve all heard the trite expression: “It’s not what you know but who you know.” Residency is no exception. If you read nothing else below, networking is the single biggest advantage you can achieve when all else is “similar.” However, this is particularly difficult for IMGs because of the limited time spent in the US. There are opportunities to meet people you just need to be willing to do the leg work. Observerships, volunteering, research and other electives allow you to meet people. This is your opportunity to connect and network, show your abilities and perhaps earn a recommendation (LOR). By being in front of those whom you will eventually interview with allows you more than the 5-10 minutes to show your stuff on interview day. You can become known as a solid worker who would fit the respective corporate culture. This is only achieved through “face time” (and no, not on your iPhone).
The USMLE score
There is more to a person than scores. If you have already made the interview then you’ve passed the score filter. However, if a decision needs to be made between two applicants and all else being equal, scores generally prevail. There are exceptions to everything so it’s best to put all efforts into it rather than regrettably saying later “why didn’t I say or do ----?” Also refer to my FAQs on scores: Consolidated FAQs for IM Residency Applicants
How important is your visa?
Visas are a concern for many programs and some have outright done away with accepting them. This was done largely because issues arise later on that necessitates a delayed start or worse, a break somewhere in the training. These programs don’t want that drama of uncertainty. However, good people don’t necessarily carry green cards nor are citizens of the US. It is important to have all visa issues resolved prior to the match. This gives programs some degree of comfort. I realize this is very challenging because you don’t know where you will end up. In my experience J-1 is better than H-1 but best to use an immigration lawyer to lay this out for you.
Do your Homework
Like any other industry, when interviewing, research the programs ahead of time. It demonstrates your interest and allows you to have dialogue during interview beyond the standard “I am a graduate and want to be a resident here.” A program’s minimum requirements are sometimes bypassed based on circumstances. So, don’t be discouraged if you’re on the cusp: There is still hope and opportunity particularly if you’ve networked.
During the intervals prior to and between interviews and the match, WORK! You need to keep in clinical mode so rust and barnacles don’t start to form. Believe it or not it will also help you when responding to the medical questions during your interviews. Program Directors want to know that you are working in the field during these down times. Observerships, electives and volunteer opportunities are good avenues.
Your interview was one of hundreds and it might be months before the match list is prepared. You’ve heard that thank you letters are standard but the timing of the thank you letter is equally important. In this case, if you were an early interview I would send a letter just after your interview and then a second letter at least to arrive a couple of weeks prior to the match lists being submitted. This ensures the arrival of the letter and that you are fresh on the Program Directors mind. So, show your appreciation with writing thank you letters. Be courteous but not overbearing. You want to stay in touch with the program but not to the point of being a nuisance.
While the personal statement is not the primary component of your application it is important to have a one page well-constructed document. This is different from your medical school statement, so change it. And please stay away from “I always wanted to be a doctor since I was…born”. This is trite and doesn’t speak to who you are. There is a journey you’ve taken to get to this point and I would share relevant pieces of it. Remember, people are collections of their experiences so share your story. Also, some programs focus on different things and therefore you can custom tailor your personal statement to suit.
You have learned or will become experts in how to present a patient’s case in 30 seconds. When it comes to “you” most folks can’t present themselves. I call this the 3 minute elevator pitch. Think of a seamless presentation of who you are and what you will be able to contribute to the respective program. Once you’ve done that practice it until it feels good and natural. You will be viewed as a person who presents well and with confidence, not chirpy or arrogant. Everyone you meet that day is involved in some respect with your interview and ultimately the rank order list. This means that everyone has influence in this process. A negative impression somewhere during the day can cause your ranking to suffer or be bumped entirely. There is a lot of pressure here so try and prepare and hopefully this will be alleviated to some extent.
NRMP has tips on their website. Please read them. A few key ones are being shared here.
- Rank programs in order of your TRUE PREFERENCE, not where you think you will match. Also, rank only those programs where you would be happy to train. Remember, the Match commitment is binding.
- Be realistic about your competitiveness and the competitiveness of your preferred specialty
- Go for your “reach” program but also include at least one “safety” program.
- Review the data. Make sure everything is entered correctly.
- Do not wait until the last minute to enter your rank order list.
For a complete list you can visit their website at NRMP.
You will be overwhelmed! This is to be expected. This is so because of the interview process and doing it in a foreign place. I am not certain about the rest of the country but NYC is a melting pot and regardless from where you are from you can find familiar things.
If you’ve taken your USMLE Step2 CS then you know the English language. However, be mindful of your accent as that can be offsetting to those you will interview with (and ultimately your patients). Different parts of the country also speak differently. I’m from NY and it will never be mistaken that I’m from NY, regardless of where I travel, because of my accent. Take a class or practice if you think it will help.
Chances are that you will also be meeting a lot of folks from other parts of the world coming for the same reason. Say hello and make friends. When time permits look around a bit. This country has many beautiful things to see in every State. This might come in handy on interview as you will have common ground with those who are interviewing you.
- Most of all – Be interesting!
- Murphy’s Law – What can go wrong will go wrong! So prepare and don’t underestimate anything!
As always, comments and suggestions are welcomed. If you have an idea for future topics please share and we can collaborate.
Michael Farca served as a residency program coordinator for the Department of Medicine at one of the largest training programs in the country. He became the Department Administrator with continued oversight of the residency program, 2 primary site fellowships and 3 rotating fellowships. Michael has dedicated over a decade to graduate medical education and is board certified in Teaching Administrators for Graduate Medical Education (C-TAGME).
Disclaimer: Michael Farca is an entrepreneur and is part owner and operator of Master the Wards, which provides Observership experiences for IMGs .