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Posts Tagged ‘school’

Scramble Update and Advice

I discussed some of this in previous posts, but here’s an update:

I was operating under the advice of many when planning the match.  I was told several times that there are always EM spots available in the scramble, as long as you are willing to go to some podunk town in BFE for residency.  My desire to stay on the west coast was strong, both for myself and my wife’s career.  I decided to apply to and rank only west coast programs, and if I didn’t match – I didn’t care where I went. 

After the Osteopathic match – programs were calling and emailing me for days to get me to interview.  I told them all that I was waiting for the allopathic match.  Most responded that they would not wait to fill their spots.  I decided to take my chances.

Despite good grades, scores, and audition rotations – I didn’t match.

On Tuesday, I scrambled from home because I live in SoCal.  I scanned my CAF, board scores, and LORs in PDF format so that I could email them to program directors.  At 9 AM, I emailed everyone.  I made phone calls from my cell phone and used my land line to fax my app.  I submitted ERAS apps to everyone that had an open spot.  I GOT NOTHING BUT BUSY SIGNALS from 9AM to noon.  I tried, but even the Osteopathic programs that had been courting me earlier had filled.

When I re-checked the NRMP site, every program had filled except Puerto Rico.  I quickly switched gears and started applying to IM and Traditional Internships.  I got one interview, and although they loved me, they questioned my dedication to IM because my personal statement and LORs all said EM. 

Luckily, a program director heard that I was scrambling and saved me a spot at a Traditional Internship.  I have a job for next year.  My current plan is to work my ass off and pray that I can fall into a PGY-II spot somewhere.  If not, I have no qualms about repeating my intern year.  The difference between an intern salary and an emergency physician salary is roughly $150,000.  That means that my match strategy was a $150,000 mistake.  Please don’t make the same mistake.

Some advice:

• Schedule audition rotations toward the end of the interview season at your top picks so that you will be fresh in their minds when making their rank list.  Schedule a “Practice” rotation before then, so that you can learn the ropes.  I did an audition rotation first thing fourth year.  By the time they made the rank list, I was a distant memory.  I was also very green early in my fourth year, so I didn’t have the knowledge and experience that showed in later auditions.
• Don’t count on the scramble.  I heard from many people that even traditionally non-competitive programs like OB-GYN and PEDS filled quickly.  Apply to a lot of programs, interview at a lot of places, and rank at least 10.
• Don’t count on the NRMP match.  If you do the allopathic match – set up a contingency plan.  Rank a few spots in another specialty or at Transitional/Internship years at the end of your rank list just in case. 
• Plan to scramble early.  Even some people at the top of our class had to scramble.  When you get letters of recommendation, ask the writers if they can write two copies – one geared toward your specialty, and a generic one.  Write a generic personal statement and upload it to ERAS just in case you need to scramble into another specialty.  Continue collecting letters of recommendation even after interview season – you might get a great letter in ERAS that can be used in the scramble.
• TAKE BOARDS EARLY.  The COMLEX-II is much easier than step I.  If you did poorly or even mediocre, you can easily look good by scoring better on step II.  If you do have to scramble, many programs will ask if you have passed your boards and are on track for graduation.  If you fail an exam and have to re-take it, that may look bad at the last minute.

Good luck everyone!

Bri

Scramble

I spent all day yesterday scrambling for a spot. When I started making plans for the match, I was operating under the advice I had heard many times: “You can always get a spot in EM, as long as you’re willing to train anywhere.”  Well, after the match there were only 5 categorical EM programs that went unfilled in the NRMP match.  All the advanced programs filled.  All the combined IM/EM and FP/EM programs filled, too.  I spent all morning calling, emailing, and faxing stuff.  All I got were busy signals.

Right now I’m working on an IM spot at Arrowhead.  While I’ve always wanted EM, my passion for medical puzzles and complicated patients has never been truly fulfilled in the ER.  I always had the idea of doing critical care in the back of my mind, especially after doing a MICU rotation at Arrowhead.

Cross your fingers for me!

COMLEX II Percentile Table

The three-digit COMLEX score is often difficult to interpret.  This table converts your score to a percentile so you can gauge your performance against that of your peers. This table is based upon the 1995 to present three-digit score with a  mean of 500 and a standard deviation of 83.  Passing score is 400. Read more »

Callbacks

It was kind of surreal being back in the classroom again.  I really had a hard time being there at first.  You see, none of the testing or anything we did counts toward a grade.  I felt really unmotivated, but then I remembered how stressed out Western students always are over their shelf exams, and I felt a little better.  

Of course, we also got to see where all our tuition was going.  300k went into upgrades in the OMM lab.  It’s really impressive.  They have HD video with three cameras and about twenty monitors.

Tonight we got to play a little euchre with Collin and Brian.  I caught them both “in the barn”.

COMLEX I percentile table

Here’s another percentile table – this time for the COMLEX I. They list the mean as 500, the SD as 79, and the SEM as 18-25.

USMLE Percentile Table

Here’s a little table to help you interpret your USMLE scores. The scores reported are hard to decipher, and it sometimes helps to think of your score in terms of percentiles to see how you performed relative to your peers. This table is based on the most recent administration of the test in which the mean was 218 and the standard deviation was 23 for first-time test takers in the US and Canada. A score of 185 is passing. Keep in mind that the SEM for this measure was 6 points, so you should think of your percentile as a range. For example, someone who scored a 210 should add 6 and subtract 6 to look at the percentiles between 204 and 216. This gives us a range of 27th to 45th percentile.

Hair[cut]

It sucks, but I was kind of expecting it. After the first day, I thought I was free and clear because nobody had said anything to me. The second day of rotations, the chief resident pulled me aside and informed me that the program director was not OK with my hair. I think he was a little surprised when I didn’t get defensive or put up a fight about it. I cut it the same day. It turns out that it was a “no publicity is bad publicity” type situation, because now everybody knows who I am, and I totally came across as a team player. Hilarious.

The bottom line is – hair grows back, and job opportunities don’t.

White Coat Ceremony

Here’s a little video from my recent white coat ceremony. The ceremony marks my transition from academic education to clinical education. I was able to trim it down from 2 hours of mind-numbing boredom to a 3 minute highlight reel. Enjoy.

Thoughts from class…

So we’re in the GI unit right now, and we keep covering my favorite disease: megacolon! Doesn’t it sound great? I always think of a superhero when I hear megacolon. Just imagine: MEGACOLON MAN – fighting for truth, justice, and gigantic bowel movements!

One thing megacolon man can’t stand is retarded lecturers. The other day we had a pediatrics lecture, and we were discussing umbilical hernia. The teacher used this photo. One of the students was curious about the breast buds, and the professor looked up at the screen and said “She has premature thelarche.” Really, is the penis not obvious? Most of us just looked at each other and laughed. He kept on lecturing…

[In case you were wondering - thelarche is the medical term for "first boob". Even if this was a girl baby, that isn't what is happening here. Many babies - girls and boys - have breast buds as a result of estrogen from mom. They go away with time.]

The meat and cheese belong together club

It’s been a while since I’ve written an opinion piece – so here goes. What follows is an e-mail from a student at school, and below it is my opinion. We’re just about to go into blocks, so I didn’t post it to everyone because I just don’t trust that my classmates are open-minded, and I know that my inbox would overflow with hate-mail.

First, some background for those not familiar with the school: Touro is a private Jewish school. In the past, Jews attending other schools would have to miss a lot of class time to observe holidays – usually to the detriment of their education. Touro was created to help orthodox jews pursue higher education, while still being able to observe holidays. In addition – all food served on campus must be kosher. Read more »