Your Waiter Has A MD?

Residency Match Day can close a door for medical students. 

Read Anthony Youn MD's article on CNN here

I met Sam* in the OR a few years ago. A polite surgical technician in his early 30s, we’d often chat after work.

Sam obtained his medical degree from a school in Eastern Europe prior to immigrating to the United States. Now he spends his days cleaning surgical instruments and his nights working in a restaurant.

“Someday I’ll be a surgeon, just like you,” he says to me.

How did this happen? Sam had a bad Match Day.

Medical training in the U.S. involves four years of medical school followed by 3 to 6 years of residency training. International graduates must also attend residency in the U.S. if they wish to practice here.

On Match Day, graduating medical students learn which residency program they’ll be joining. Residency determines a physician’s field of medicine. For a young doctor to become a pediatrician, for example, he or she must complete a pediatric residency.

This year Match Day occurs today, March 16.

According to the NRMP, last year 971 graduates of U.S. medical schools were shut out, accounting for 5.9% of U.S. grads. Graduates of international medical schools fared even worse - less than 50% of them obtained a residency.

That means more than 7,000 doctors were left with a diploma that said “M.D.” but no guarantee they would be able to use it.

This situation is only going to worsen. Due to the pending doctor shortage, the Association of American Medical Colleges (AAMC) has called for a 30% increase in medical school enrollment, or 5,000 more doctors each year. College universities have responded to this demand, with 18 new medical schools currently in the process of opening.

The increase in the number of medical students would lead to an increase in residency positions as well, right?

Wrong.

Since 2001, the number of first year residency positions has increased by 3,000, compared to a whopping increase of 6,500 applicants. The slow growth in residency positions is likely due to a 15 year freeze in Medicare support. The current federal budget problems make lifting the freeze unlikely in the near future.

BTW: Dr. Youn was recently interviewed by Medical Spa MD.

Ultra Gunner Interview Tips: Medical School and Residency

This guy has the right idea, but the glasses just pushed it over the edge.I feel sorry for anyone who crosses paths with me on the interview trail

However, because Matt gave some nice thoughts on residency interviews, I thought I would add a few; some of his where just not my style. So to complete his post, here are a few from my personal repertoire. No need to thank me with gifts, just leave me a comment with your adoration and let me know how well they worked for you.

It’s important to Take Control of the interview

As soon as possible, you must establish your new place in the pecking order as a resident physician or college student turned med student. Showing them that you don’t put up with crap is a great attribute for a doctor. If you don’t like a question they ask just shoot back with,

“Not important, next question.”

It’s simple and direct, and they will respect you for it. I think.

Remember Medical Schools and Residency Programs Want What They Can’t Have

Be sure they understand you are doing them a favor by taking your time to interview with them. I even say, “Look, you guys are basically retarded if you don’t rank me #1.” I’ve executed this technique flawlessly at my last interview, and it worked like a charm. All they could do was shake their heads in amazement. What can I say, I’m a winner. I win.

Another free tip: cutting the interview short or coming a little late is a perfect way to set the tone and impart your importance.

Bring Every Conversation Back To Focus On You, Always

Though I cannot think of a time when this advice would not apply, it is especially true during interviews. Remember to implement this tip at all times during your interview visit. Eating out with the residents, during hospital tours, or even when conversing with other applicants. Remember, when they ask,

"Do you have any questions for us?"

The only reply is, “Yeah, what part of my resume do you like the best?”

Stand Out From The Crowd

Guys: Do not be afraid to rock the white suite! Trust me on this one! The white coat is a symbol of physicanhood and strutting into a residency or medical school interview with a sharp white suite just plants the seeds in everyone’s mind.

Girls: Don’t be scared to strut your stuff. Clothes with slits anywhere and everywhere are a must. This rule applies double if you are applying for Orthopedic surgery residency.

5 Uncommon Approachs to Residency Interviews

Thoughts from the interview trail

Finally the interview season is wrapping up. Here are 5 points to emphasize before embarking on the path to the rank list.

1) Interviews are more exhausting than you might originally think.

It takes a lot of work to put on your "game face" for 36 hours, to make sure you don't say anything inappropriate and to think of insightful questions to ask so you don't look disinterested. Be careful when planning your travel schedule to include time for rest, as a tired interviewee comes across as boring and unenergetic, traits which stellar board scores can never make up for.

2) If you don't enjoy the residents or attendings at an institution, perhaps it just isn't a good fit.

Don't be too hard on yourself. If you're miserable at work, you will not be academically productive and your patients will not get the care they deserve. The best team is a team with excellent work relationships, and though in your head a program might be your top choice, perhaps you will be better off in the long run somewhere else.

3) There's no reason to be nervous. 

Most interviewers these days just want to get to know you. Occasionally one will put you on the spot or ask tricky questions. You can prepare for the typical interview questions by pondering them ahead of time (things like "what was your biggest failure?"). The unexpected interview questions like, "what is the therapy for recurrent acute myeloid leukemia?" are likely questions other students would struggle with too, so just be humble and move on rather than letting one question destroy the whole conversation.

4) Some interviewers are quiet and difficult to talk to.

Perhaps this is the way they are typically or perhaps you just don't have much in common with the interviewer. A solid strategy at this point is to take control of the conversation by bringing up topics that augment your applications, either academic or personal. Perhaps if you've done a lot of travel, you might ask "are there opportunities for residents to do international electives?". Or if you're strong in research, perhaps you could ask, "what are the research opportunities like here?".

5) Be confident. You might think you don't deserve the interview or are concerned about matching, but they brought you in for a reason.

If you're at the interview, you're qualified to do the work. At this point they want to see if you will be a good fit for their program, a program which they have worked hard to build and which they have big dreams for the future. If you're a part of that future, they will be interested regardless of your board score.

One excellent and very detailed book to check out is, "The Successful Match: 200 Rules to Succed in the Residency Match" by Dr. Katta and Dr. Desai.

Best of luck to everyone going through the match. Please feel free to comment, as discussion makes us all better.