VOL. 24 NO. 1 â€˘ $5.00
New York University School of Medicine
University of Illinois at Chicago School of Medicine
Baylor Medical College
Q&A with Nisha Branch,
SNMA's new Chicago Medical School
Columbia College of Physicians and Surgeons
Rush Medical College
UC Irvine School of Medicine
The Residency Match Guide
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速 F O R
M I N O R I T Y
M E D I C A L
S T U D E N T S
Charter Members 2012
Michigan State University Kalamazoo Center for Medical Studies
These special friends of the Journal for Minority Medical Students have demonstrated their commitment to reach out to minority medical students by placing their recruitment messages in each quarterly issue. We salute them and encourage our readers to consider these programs as they continue their medical education.
HOFSTRA NORTH SHORE-LIJ SCHOOL OF MEDICINE GRADUATE MEDICAL EDUCATION PROGRAMS DEDICATED TO PATIENT CARE, TEACHING AND RESEARCH IN THE NEW YORK METRO AREA n
Second largest secular, non-proft health system in the United States. 15 hospitals with 10 teaching facilities. The Feinstein Institute for Medical Research is among the top six percent of research institutions receiving National Institutes of Health funding. Over 115 graduate education programs responsible for more than 1,400 residents and fellows.
State-of-the-art simulation and bioskills education center. Home to Hofstra North Shore-LIJ School of Medicine and its innovative curriculum. Affiliated with Albert Einstein College of Medicine, NYU School of Medicine, SUNY Downstate Medical Center, SUNY Stony Brook University Hospital and New York College of Osteopathic Medicine.
Residency Programs Diagnostic Radiology Emergency Medicine Emergency Medicine/ Internal Medicine • Family Practice Medicine • General Surgery • Internal Medicine • Neurology • Neurosurgery • • •
• • • • • • • •
Obstetrics & Gynecology Opthalmology Orthopeadic Surgery Pathology Pediatrics Plastic Surgery Psychiatry Physical Medicine & Rehabilitation
Dental • General Practice Dentistry • Oral Maxillofacial Surgery • Oral Pathology • Pediatric Dental Medicine Podiatry • Podiatric Medicine & Surgery
Fellowship Programs Cardiology • Cardiothoracic Surgery Emergency Medicine • EM/IM/CC • Toxicology • Sports Medicine Internal Medicine • Cardiovascular Diseases • Gastroenterology • Geriatric Medicine • Endocrinology • Hematology/Oncology • Infectious Diseases • Interventional Cardiology • Nephrology • Palliative Care • Pulmonary/Critical Care • Rheumatology • Sleep Medicine Neurology • Clinical Neurophysiology • Movement Disorders • Vascular Neurology
Obstetrics & Gynecology • Maternal Fetal Medicine • Female Pelvic Medicine & Reconstructive Surgery Pathology • Cytopathology • Hematology Pediatrics • Adolescent Medicine • Allergy & Immunology • Cardiology • Child Neurology • Critical Care • Developmental Behavioral • Emergency Medicine • Endocrinology • Gastroenterology • Hematology/Oncology • Infectious Disease • Neonatal/Perinatal • Rheumatology
Psychiatry • Addiction • Child & Adolescent • Geriatric • Psychosomatic Medicine Radiology • Body Imaging • Neuroradiology • Pediatric • Vascular/Interventional Urology • Endourology • Pediatric Urology • Neurourology • Urologic Oncology Surgery • Colon & Rectal • Critical Care • Laproscopy • Pediatric • Vascular
For additional information visit us at northshorelij.com or call the North Shore-LIJ Office of Academic Affairs (516) 465-3192.
Hope lives here.
THE RESIDENCY MATCH GUIDE Vol. 24, No. 1 VOL. 24 NO. 1 • $5.00
Features 31 The Match Guide Intro 32 Highest Match Rate in 30 Years New York University School of Medicine
34 Match Day 2012 Success Story: Thomas Cudjoe
University of Illinois at Chicago School of Medicine
Baylor Medical College
Q&A with Nisha Branch,
36 Get cleaned up for SOAP
37 Changes to the 2013 Match
SNMA's new Chicago Medical School
Rush Medical College
35 Tips for Match season
38 The Residents Speak: Dr. Greggy Laroche Columbia College of Physicians and Surgeons
UC Irvine School of Medicine
The Residency Match Guide
on the cover: Match Day 2012! A look Match Day activities around the country.
39 2013 Match Timeline 40 Learn, Be, and Smile: Advice for New Interns by Mary Brandt, MD 42 The Residents Speak: Dr. Jordan Bowling 44 Making the most of your residency interview by Phyllis Kopriva 47 Residency Director Q&A: Dr. Daniel I. Steinberg 49 Residency Director Q&A: Dr. Earl Norman 50 Residency Director Q&A: Dr. Evan Bass 51 Match Day 2012 Success Story: Owoicho Adogwa, MD, MPH 53 Getting in gear for the USMLE by Benjamin van Loon 56 Match Day 2012 Success Story: Louis Frazier 58 A peek inside The Royal Hotels of Mexico
Perspectives 6 Publisher’s Page 9 AAMC Perspective 13 AMA Perspective 19 NMA Perspective 21 NHMA Perspective 24 SNMA Perspective 25 LMSA Perspective 27 The Surgeon General’s Report 63 A Second Opinion, Please
PASSION: global health
family medicin e
My family medicine training gave me the skills I need to create sustainable solutions where they are needed most.
BE THE DOCTOR
you always wanted to be.
jOURNAL FOR MINORITY MEDICAL STUDENTS PUBLISHER Bill Bowers EDITOR-in-chief Laura L. Scholes firstname.lastname@example.org SENIOR ACCOUNT EXECUTIVE Gail Davis Campus Rep Liaison Nisha Branch, Howard University College of Medicine ART Director Jeff Garrett CONTRIBUTING WRITER Benjamin Van Loon copy editor Robert Wilder Blue PUBLISHER’S ADVISOR Michelle Perkins, MD EXECUTIVE ASSISTANT to the PUBLISHER Sara Huff
MYTH: ItÊisÊnearlyÊimpossibleÊtoÊgetÊintoÊ anÊorthopaedicÊresidency. FACT: YouÊcanÊaccomplishÊtheÊ goalÊwithÊvisionÊandÊ determination. The truth is, entering any residency program is tough and competitive. However, recent ﬁgures show over 80% of senior medical students who apply for an orthopaedic residency position successfully match. So, if youÕre driven to help restore patients to a higher quality of life, you can make it happen. ChooseÊaÊcareerÊinÊOrthopaedicsÑourÊ uniqueÊmentoringÊprogramsÊofferÊ personalizedÊguidanceÊandÊsupportÊtoÊhelpÊ pushÊyouÊahead.ÊForÊmoreÊinformationÊ visitÊaaos.org/diversity.
SPECTRUM HEALTHCARE DIVERSITY & INFORMATICS PRINCIPAL INVESTIGATOR Bill Bowers VICE PRESIDENT OF OPERATIONS Tamika Goins SENIOR DEVELOPER/DBA Naresh Kumar
Produced in collaboration with the Ruth Jackson Orthopaedic Society and the J. Robert Gladden Orthopaedic Society
The AAOS extends sincere appreciation to Zimmer for its charitable contribution.
Match Day 2012 Shows Physician Need Continues By Bill Bowers, Publisher, Journal for Minority Medical Students
ith the U.S. Supreme Court case pending, the President’s health care law may be in limbo, but what’s not in limbo is the need for physicians. Match Day 2012 proved just how deep the need is. At this year’s Match, 22,934 applicants were assigned first-year residency positions. At 95%, it was the highest Match rate for fourth-year U.S. allopathic medical school students in 30 years, according to the National Resident Matching Program. In fact, NRMP officials declared it their largest Match in history—and among the most successful. Though the numbers are certainly a positive sign of a healthy profession, officials such as AAMC PresiBill Bowers dent and CEO Darrell G. Kirch, MD, say that even more residency Match Day 2012: Brown University positions are needed to meet the Warren Alpert Medical School demand and avert a doctor shortage. “The AAMC is encouraged by the slight increase in the number of residency training positions in this year’s Match and by the new high in the total number of U.S. medical school graduates who matched to a residency training position this year,” he says. “While recent efforts have resulted in more residency positions, we remain very concerned that these increases are insufficient to meet the nation’s future health care needs and the looming doctor shortage.” And though we certainly don’t want to kick this particular can down the road for another day, we are happy to stop and recognize the hard work and many successes of our readers. So the Journal offers our most heartfelt congratulations to this year’s graduates—and good luck to Match Day 2012: those preparing for Match Day 2013! Medical College of Georgia
6 | Journal for Minority Medical Students
Auro ra: A Le ad e r i n He a lt h Ca re
Aurora Health Care’s residency programs, located at Milwaukee-based Aurora Sinai Medical Center and Aurora St. Luke’s Medical Center, are designed to help you make the most of your medical education. Our goal is to fill each residency program with academic and clinical challenges to best prepare you as a well-rounded, competent and caring physician. Aurora St. Luke’s and Aurora Sinai medical centers offer diverse opportunities to the physician in training. All residency programs share one commonality: as a resident, you will be fully involved in patient care – making decisions, offering opinions, honing skills, sharing and acquiring knowledge. You will practice medicine and learn in a wide variety of settings and across disciplines.
• Family Practice
• Internal Medicine
• Diagnostic Radiology • Transitional Year Residency
Cardiology • Geriatrics • Gastroenterology
Aurora Health Care is a not-for-profit health care provider and a national leader in efforts to improve the quality of health care.
For more information, call 414-649-6558 or visit www.Aurora.org/Residency
Medical Students: A Career In Pediatrics Can Open Up New Doors The American Academy of Pediatrics (AAP) has a membership opportunity for medical students. The AAP offers many benefits, both general and specific to medical students, including: Affiliate membership in the Section on Medical Students, Residents and Fellowship Trainees FREE admission to the AAP National Conference & Exhibition (NCE) Discounts on all AAP products and services Pediatrics 101—a resource guide from the AAP Online Resources - An e-newsletter for medical students, - Medical Student Listserv®, - Access to the YoungPeds Network AND the new networking site YPConnection!!! And much, much more!
For information please contact us at: email@example.com or call Julie Raymond at (800) 433-9016 ext. 7137 or visit www.aap.org/ypn
Scrambling to SOAP By Sarah A. Schoolcraft, MS, Senior Research Analyst, AAMC
atch Week in March has always been an exciting time for medical school seniors, beginning with notification of whether or not a student is matched and culminating with the Match Day ceremonies at the end of the week. This year, the National Resident Matching Program® (NRMP®) unveiled a rather significant change from years past. Instead of the Scramble—literally a day where students scrambled to find positions—the process transitioned this year to the “Supplemental Offer and Acceptance ProgramSM,” or SOAPSM. Like the Scramble, SOAP provides an additional opportunity for students who have not initially matched to find a program before the end of Match Week; but unlike the chaos assumed in the name Scramble, SOAP provides a more fair, organized means of linking unmatched applicants with unfilled programs. At the beginning of Match Week (Monday), students receive notification as to whether or not they matched. Ideally, a match was made and students merely have to
wait in eager anticipation until the end of the week when they learn where they begin their residency training. However, not all students match initially. Until this year, unmatched students have had the ability to be placed in unfilled programs via the Scramble. Anybody who has participated in the Scramble knows it was just that—a mad dash to find a position, regardless of desired specialty or location. If a student finds out on Monday he or she did not match, s/he could begin to scramble” for remaining available positions on Tuesday at noon. There was little order to this process, and this scramble resulted in overloaded phone lines, busy fax machines, and abundant emails. Students had only 48 hours to secure one of these few positions, as the process officially closed on Thursday of Match Week, when schools hosted their Match Day ceremonies. The Scramble was becoming increasingly chaotic and students were having an increasingly difficult time securing a match before the process closed. To address
Sarah A. Schoolcraft, MS
these issues and identify ways of improvement, the NRMP and the Association of American Colleges (AAMC) co-convened a workgroup in 2008 to identify means for improvement. In addition to representation from both the NRMP and the AAMC, the workgroup included numerous stakeholders, such as program directors, medical students, and resident physicians. This workgroup identified the primary areas of concern, such as the lack of trust and transparency; the fact that there was no separation between application, interview
Journal for Minority Medical Students | 9
Medical Student Programs at Harvard Medical School Boston, Massachusetts
VISITING RESEARCH INTERNSHIP PROGRAM (VRIP)
VISITING CLERKSHIP PROGRAM (VCP)
Sponsored by the Harvard Catalyst Program for Faculty Development and Diversity, VRIP is an 8-week mentored summer research program open to 1st and 2nd year U.S. medical students, particularly underrepresented minority and/or disadvantaged individuals from accredited U.S. medical schools. VRIP is designed to enrich medical studentsâ€™ interest in research and health-related careers, particularly clinical/translational research careers. VRIP offers students housing as well as a salary and transportation reimbursement for travel to and from Boston. Applicants must be U.S. Citizens or U.S. Noncitizen Nationals or Permanent Residents of U.S.
Sponsored by the Harvard Medical School Minority Faculty Development Program, VCP is open to 4th-year and last quarter 3rd-year minority medical students in good standing at U.S. accredited medical schools who wish to participate in a clerkship in any discipline at Harvard Medical School (HMS) affiliated hospitals. Housing and financial assistance towards transportation expenses to and from Boston are available. Students are assigned a faculty advisor, provided the potential to network with HMS residency training programs and have access to the medical school library, seminars and workshops. Clerkships are offered year-round. Applications must be submitted 3-6 months in advance of the desired rotation.
For more information on Harvard Catalyst programs please contact: Vera Yanovsky, Program Coordinator Phone: 617-432-1892 E-mail: firstname.lastname@example.org Web Site: www.mfdp.med.harvard.edu/catalyst
For more information please contact: Jo Cole, Program Coordinator Phone: 617-432-4422 E-mail: email@example.com Web Site: www.mfdp.med.harvard.edu
Program Director: Joan Y. Reede, MD, MPH, MBA Dean for Diversity and Community Partnership Associate Professor of Medicine Harvard Medical School
and appointment, meaning that programs did not have the ability to read all applications and rank candidates based on who would be the best fit, nor did students have the ability to compare and rank programs based on specialty or location; and the disorder that resulted from an inconsistent process for applying to programs and accepting offers. To address these issues, SOAP
was created and launched during this year’s Match Week. There are a few primary changes between SOAP and the Scramble. Instead of finding out one day they did not match and having to wait an additional day to see which programs remained open, unmatched applicants and unfilled programs are now posted on the same day. In lieu of frenzied emails and phone calls, applicants and programs send and receive applications through the centralized Electronic Residency Applicant Service (ERAS®.) Applicants must accept or reject the offer within two hours; however, unlike the Scramble, students may have more than one offer in any round. In addition to transitioning from a hectic, chaotic process to an orderly, controlled one, the SOAP offers tangible Match Day 2012: University of Wisconsin benefits for both stuSchool of Medicine dents and programs. For
students, residency is an essential building block and even a turning point in one’s career, and the Scramble forced unmatched students to hastily make a big career decision. SOAP affords students the opportunity to look at all available positions to find and apply for a position in the specialty of their choice, and the fact that they may receive more than one offer in any round gives an even greater level of choice. Similarly, SOAP allows programs to have a preference list. They have the ability to review applicants and make informed decisions. Based on numbers alone, positions are still harder to obtain in SOAP than in the Main Residency Match, and SOAP therefore should not be used as an “alternative” to the Match. However, if a student does not match initially, SOAP opens up more possibilities and provides a much calmer process than the Scramble did.
Journal for Minority Medical Students | 11
Make The Commitment To Medical School, And We’ll Make The Commitment To You. The University of Alabama School of Medicine offers you more than a world-renowned medical curriculum. We also provide you with opportunities to succeed. Our Office of Diversity and Multicultural Affairs was created specifically to assist students like you to make the most of your education and enjoy all of the advantages of medical school. Phone us at 1-800-707-3579, ex. 6 and find out more about our: • •
• • • •
Combined M.D., Ph.D. and M.D., M.P.H. degrees and the Early Decision Plan Newly sponsored programs through HCOP º The Summer Health Enrichment Program (SHEP) for undergraduate students º The Summit Scholars Program for high school and middle school students º Pre-matriculation program for entering medical school students º Post-baccalaureate program on the campus of the University of Alabama in Tuscaloosa Financial assistance and scholarships Assistance in securing research and clinical opportunities Counseling and support for academic and personal concerns Liaison activities among the School of Medicine’s, diverse students and medical organizations
MSII Brittney Anderson (sitting) and MSII Charis Chambers
Visit our website: https://www.uab.edu/medicine/home UAB is an equal education opportunity institution
Did SOAP help clean up Match Week Problems? By Tim Hotze, Sr. Research Assistant, Medical Education, American Medical Association
rom the apprehension of orientation through two years of classes and exams through initial clinical contacts, no one has ever claimed that the four years of medical school does not have tense moments. However, for many students, the tensest moment may not occur in front of students or professors, or even in front of a patient. Instead, the most stressful time for a great number of students comes, perhaps unsurprisingly, as they prepare for their future during Match Week. The National Residency Matching Program uses a series of algorithms (described on the program’s website1 for those curious) to try to make sure that medical students and residency slots find mutual “best fits.” Unfortunately, not all students find matches through this program, and not all residency slots are filled. That has left students without matches going through a second, less-organized process known only as the Scramble, where unmatched students and residency slots try to match with each other. Unlike the (relatively) orderly process of the
Match, the aptly-named Scramble worked much like it sounded, with the unmatched students trying to contact a residency program in a largely uncoordinated process. Some programs accepted applications through the official ERAS system; others accepted submissions through phone calls, emails or faxes (or both), creating headaches for students, leaving many unsure whether their application was successfully sent to the right person at the right time. In 2010, the National Residency Matching Program, working with the Association of American Medical Colleges, recognized that this process often did a much poorer job of creating good matches than
might be possible, and created the Supplemental Offer and Acceptance Program, or SOAP, which finally came into effect for Match week this year. On paper, SOAP looked like a major step forward on a number of levels. It released unmatched applicant and residency information at the same time, eliminating the need to send hundreds of messages to residency programs the next day to try to get a toe in the door. It also required all residency programs to use the system and was covered by the Match Participation Agreement, which created a binding commitment between programs and applicants. There were questions, however, as to whether the system would actually perform as hoped. Based on the experience over this March’s Match Week, we can say that the program seems to work. The NRMP reported only a few complaints, and a record number of US medical students were matched, the highest match percentage in 30 years. Of the 1,131 positions placed in SOAP,
Journal for Minority Medical Students | 13
AMA perspective 1,033 were filled, and many U.S. medical student seniors received multiple offers through the SOAP program. As you prepare for Match Week either next year or the coming years, the SOAP program should make finding a good fit a little bit easier—and less stressful—if you aren’t matched in the first step of the process. The program makes it easier to find and apply for programs that are a good fit for you, and it increases the chances that you’ll get multiple offers so you can start your professional life as a physician in a position of your choice. While the anxiety—and stress—of Match Week remain, hopefully SOAP will make it just a tiny bit less stressful.
Match Day 2012: Morehouse School of Medicine
1. National Residency Matching Program. http://www.nrmp.org/res_match/ about_res/algorithms.html
Match Day 2012: UC Davis School of Medicine
14 | Journal for Minority Medical Students
U C D AV I S S C H O O L O F M E D I C I N E
Visiting Clerkship Program The Visiting Clerkship Program provides support for fourth-year students from socially and economically disadvantaged backgrounds who have historically been underrepresented in medicine. This program is sponsored by the UC Davis School of Medicineâ€™s Office of Student and Resident Diversity, in collaboration with the departments of Family and Community Medicine, Internal Medicine and Pediatrics. The program is designed to: n
Expose students to both the academic medicine and community service opportunities offered through the above UC Davis Residency Programs
Allow students to care for a racially and ethnically diverse patient population from both rural and urban communities
Encourage students from diverse backgrounds to apply to the UC Davis Residency Programs
Eligible participants are: full-time, fourthyear medical students in good standing at accredited U.S. medical schools. Students remain registered at their own schools while participating in the externship at UC Davis; however, student must complete an application form through American Association of Medical Collegesâ€™ Visiting Student Application Service (VSAS): www.aamc.org/programs/vsas/start.htm. Length: Rotations are four weeks in duration and are subject to space availability. Mentoring and Networking opportunities: The students will meet Darin Latimore, assistant dean of the Office of Student and Resident Diversity. Students also will be introduced to members of the Latino Medical Student Association, the Student National Medical Association and the LGBT Students in Medicine group, if interested.
Office of Student and Resident Diversity
Acting Internship and Externships in Family and Community Medicine, Internal Medicine and Pediatrics. Visit www.ucdmc.ucdavis.edu/mdprogram/ registrar/visiting.html for more information.
Financial assistance: n
Reimburse up to $500 toward travel costs
Provide a $500 food allowance
Waive the application processing fee ($150)
The Visiting Clerkship Program provides housing for participating students at the Courtyard by Marriott, which is on the Sacramento campus of UC Davis, where the School of Medicine is located. Applications:
Please submit both the VSAS application, which has a link located on this page, and a UC Davis Office of Student and Resident Diversity Visiting Clerkship Program application, which can be found in the Quick Links section on this webpage: www. ucdmc.ucdavis.edu/mdprogram/registrar/visiting.html
For information about the Visiting Clerkship Program, please contact firstname.lastname@example.org. 11-0601 (3/12)
UCLA INTERCAMPUS MEDICAL GENETICS RESIDENCY PROGRAMS
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UCLA INTERCAMPUS MEDICAL GENETICS
A welcome from our residents Greetings,
Grace J. Noh, MD
As a recent graduate of the 2-year UCLA Intercampus Medical Genetics fellowship Program, as directed by Cedars-Sinai Medical Center, I was impressed by the diversity that this program offers its trainees. Our attendings and staff come from varied backgrounds, which contribute to the wealth of education that help ground a fundamental base in genetics. Coming from an internist background, I found myself surrounded by other internists and obstetrician-gynecologists in a traditionally pediatrics trained �ield. As part of our fellowship program, the basics of medical genetics are learned through a didactic course, with additional experiences drawn from our clinical patients. You’ll have the chance to thrive in a nurturing environment where differences are embraced; and based on your career plans, �lexibility and support help you succeed in your chosen path. As a proud product of this program, I am grateful for the chance to learn in such an enriching environment full of so many possibilities. The opportunity to see diverse cases is understated, as this is the site of the world renowned International Skeletal Dysplasia Registry; we attract patients from all over the world. Additionally, we rotate through several campuses including UCLA, CHOC, Harbor-UCLA and Cedars-Sinai Medical Center, each center with its unique patient population and distinctive faculty. Grace J Noh, MD Chief Fellow, Medical Genetics Institute Cedars-Sinai Medical Center Greetings Potential Applicants,
Natalie M. Gallant, MD
Currently in my 5th year of the UCLA-Intercampus Combined Residency in Pediatrics and Medical Genetics, I am amazed at the opportunities that have been afforded to me by this program. This program truly embraces diversity – in its faculty members, patient population, clinical experiences, research projects, and applicants. The faculty comes from diverse backgrounds with varied clinical and research interests. As a strong advocate for the advancement of women in medicine, I have been fortunate to have many female role models. Whether your interest is primarily clinical care, basic or clinical research, or advocacy, there are multiple potential mentors to inspire you and help you to thrive. Additionally, residents have access to the vast intellectual resources of the prestigious UCLA campus. Located in Southern California, we treat patients from all cultural and socioeconomic backgrounds. In addition to receiving robust experience in general pediatrics, residents see many patients with disorders so rare, most physicians will not see any such patient in their careers. The UCLA-Intercampus Combined Residency in Pediatrics and Medical Genetics seeks applicants with unique qualities and experiences who can further add to the rich diversity of this program. Natalie M. Gallant, MD, Chief Resident UCLA Intercampus Combined Residency
nma perspective NMA’s Project I.M.P.A.C.T. Celebrates a Milestone
ed by Principal Investigator Dr. James Powell, the National Medical Association’s (NMA) Project I.M.P.A.C.T. has provided various levels of education and intensive training to over 5,000 health professionals in the United States and the Caribbean. The program is the jewel in the crown of the NMA’s commitment to increasing diversity in all aspects of the clinical trial process, especially among clinical investigators and volunteer participants. Project I.M.P.A.C.T. (Increase Minority Participation and Awareness of Clinical Trials) was established in 1999 to coordinate its efforts to educate African Americans about research, develop physicians as effective clinical investigators, and facilitators of research in minority communities. “It is the National Medical Association’s position that African American patient and physician representation in clinical trials is generally inadequate, compromising the quality and validity of clinical trial findings used to treat African Americans,” says Dr. Cedric
Project I.M.P.A.C.T. works to educate African Americans about clinical trials.
M. Bright, President of the NMA. As such, the NMA is committed to increasing physician and consumer diversity and participation in all aspects of the clinical trial process. The NMA, in partnership with the Association of Black Cardiologists, conducted its signature Good Clinical Practices and Skills Building program in December, 2011. Good Clinical Practices training ensures compliance with specific regulations and guidelines that govern human medical research. “We have learned that it is not enough to educate and increase awareness,
place physicians into a database and think that they are now ready to participate in clinical trials,” said Yolanda Fleming, Project Director of I.M.P.A.C.T. The two-day Good Clinical Practices program featured clinical research experts from government, academic, industry, and private practice. It covered such topics as Investigator Responsibilities, Adverse Event Reporting, Food and Drug Administration Regulations, Informed Consent, Successful Clinical Trial, Cultural Competency, and Ethics.
Journal for Minority Medical Students | 19
nma perspective “My patients are better served by the knowledge and skills I gained from attending the I.M.P.A.C.T. training,” said Dr. John McAdory, an Internist in Miami, Florida, and graduate of the I.M.P.A.C.T. program. “As a clinical investigator, I contributed to the evidence in evidence-based medicine and as a result both my patients and I have benefited from the experience.” There are numerous other success stories from NMA physicians and patients who have participated in clinical trials. The NMA continues to move this groundbreaking project forward and plans additional workshops, training sessions, and other events for physicians and consumers throughout 2012. Project I.M.P.A.C.T seeks to assure that the NMA truly makes an impact in the area of clinical trial participation in minority populations. Building on a strong educational foundation, in conjunction with housing the largest minority physician database and a reputation of being an advocate for minority health, the NMA will continue to chip away
20 | Journal for Minority Medical Students
Match Day 2012: University of North Dakota School of Medicine
at health disparities and inequities while building an army of trained clinical investigators. “The NMA is dedicated to providing ongoing education and support for our trained physicians,” said Bright. “Further, we combine this with an aggressive campaign to educate the public and combat the history, myths, and distrust associated with clinical trials in the minority community. As one of the nation’s most trusted association of physicians, we are able to make the case to our community.”
Match Day 2012: Marshall University Medical Center
The Importance of Immigrant Children’s Health Research By Elena Rios, MD, MSPH, President, National Hispanic Medical Association
hen it comes to studying child health, there is an often-neglected segment of our society—immigrant children. The National Children’s Study has been created to examine the effects of the environment—air, water, diet, sound, family dynamics, community and cultural influences, and genetics—on the growth, development, and health of children across the United States, following them from before birth until age 21. The goal of the study is to improve the health and well-being of children and contribute to understanding the role various factors have on health and disease. Given the importance of specific influences on immigrant children’s health—family dynamics, community, culture—we need to go beyond politics and consider that 11 million immigrants live in the U.S. today and that this number will continue to rise. We must also acknowledge that many of these immigrants live in communities with poverty, low income jobs, low educational attainment, air pollution, toxic housing, crime, and stress, which increases the likelihood they will acquire infectious and chronic diseases. This will also increase the demand for health and behavioral health services. Who are immigrant children? According to the Urban Institute, in 2010, 8.7 million U.S. children had at least one immigrant parent, double the number from 1990. This represents
nearly one in four children. According to Pew Hispanic Center, four of every five immigrant children are U.S.-born and by 2050, one third of all U.S. children will be immigrant children. They will shape the labor force, the military, and demands for government health benefits, including Social Security. We want to encourage the leaders of the National Children’s Study to expand our knowledge of immigrant children in order to learn more about their health care and behavioral health care needs, so our health care system can be more responsive to immigrant children and families. Here are a few thoughts on this process: • Parent behavior change needs to be a focus of research. We need to build their trust and engagement in children’s health decision making with the health professionals and providers who care for them. • We must encourage partnerships between entities from across the spectrum—community leaders, agencies such as Head Start, schools, health professionals, clinics and children’s hospitals—that impact health services uptake and health education of immigrant children. • We must consider ways to develop
Elena Rios, MD cultural competence by working with the Office of Minority Health. There is a growing momentum to address health disparities under the HHS Secretary’s Disparities Plan and NIH and NICHD priorities for impact studies, dissemination, and adoption across partners, research, and community agencies. • We must recruit researchers who have immigrant backgrounds to be part of the team. Our National Hispanic Health Foundation, the foundation of the National Hispanic Medical Association, is interested in working with NCH on developing mentoring and research networks among our communities. We are committed to doing everything we can to support the mission of NCH and bring the health care needs of immigrant children to light. Journal for Minority Medical Students | 21
Fellowship Training Program in Pediatric Cardiology and Cardiovascular Research The Fellowship Training Program in Pediatric Cardiology and Cardiovascular Research at Children始s Hospital Boston and Harvard Medical School is actively recruiting under-represented minority candidates. Our innovative research and clinical programs have contributed to major advances in the understanding and treatment of congenital and acquired cardiovascular disease. We are committed to the training of the next generation of leaders in our field.
For more information about the Fellowship Training Program in Pediatric Cardiology and Cardiovascular Research please contact: David W. Brown, M.D. Director, Clinical Training Program Pediatric Cardiology Children始s Hospital 300 Longwood Avenue Boston, MA 02115 email@example.com
20 | The Career Issue
Advanced clinical care. State-of-the-art techniques. The Fellowship Program of the Department of Cardiology at Children’s Hospital Boston The Fellowship Program of the Department of Cardiology trains academically oriented leaders in the clinical care and laboratory and clinical investigation of pediatric cardiovascular disease. One of the department’s main goals is to teach state-of-the-art approaches and techniques to prepare trainees to work at the forefront of their ﬁeld. To build on the recent dramatic advances in pediatric cardiology, it is important for trainees to gain a better understanding of cardiovascular structure and function at the molecular, cellular and organ system levels with respect to development, morphogenesis, physiology, pathology and pharmacology. These approaches are expected to have a signiﬁcant impact on the most pressing issues in pediatric cardiology including: • •
the “natural history” of surgically corrected complex cardiac malformations antenatal diagnosis and therapy of congenital defects
the cellular basis of cardiac development and the cellular response to abnormal physiology the eﬀective prevention of both congenital and degenerative cardiovascular disease
With these expectations, the Children’s Cardiology Department maintains that thorough training in basic research is essential for all future leaders in pediatric cardiology. The program at Children’s graduates exceptionally trained, clinically oriented fellows with expertise in areas that match their interests and aptitude. The training program combines the resources of Children’s Cardiovascular Program with the clinical and research opportunities of Children’s Hospital Boston, Harvard Medical School and Boston’s Longwood Medical Area community to oﬀer an unparalleled opportunity for fellows to explore virtually any area of clinical or basic research. With well-developed divisions of interventional cardiology, cardiac imaging, electrophysiology, preventive cardiology, prospective clinical research, intensive care cardiology, transplant cardiology and adult congenital heart disease, along with the unparalleled resource of the Cardiac Registry, the program at Children’s oﬀers a range of approaches within each clinical subspecialty to introduce trainees to the core problems and frontiers of clinical pediatric cardiology.
For more information, go to: http://www.childrenshospital.org/carecenter/Site2902/mainpageS2902P10.html or contact:
snma perspective An interview with Nisha Branch, the new—and energetic—president of SNMA
isha Branch, who is finishing up her fourth year at Howard University College of Medicine, recently took the reins as president of the Student National Medical Association (SNMA). She’s already had a very active year as president-elect, and we wanted to find out what she’s got planned for the upcoming year. What are you planning to focus on during your tenure as president? Branch: My goal is build and inspire our membership by creating initiatives in which they’re truly interested. Right now, my program is unofficially called Upgrade 2.0 and we’re really focusing on engaging with our members in all the social media outlets—Facebook, Twitter, our updated website. Since all of our members are in different programs, we don’t often have a way to communicate effectively with each other. We want to create a place where members can help members. We’re considering having a themed topic each month about which members can share their personal experiences: recovering from a bad exam, balancing personal life
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with med school, etc. You obviously have great passion for your position; what are you most excited about for the upcoming year? Branch: We’re doing a competition based on that television show, The Biggest Loser. A lot of medical students gain weight in school because of the crazy schedules, stress, and lack of access to healthy meals. So we’re doing a six-month competition to inspire people to take off pounds and get to a healthy weight. We’re trying to get one or two physicians to support the program by being our mentors on our website to answer nonspecific health questions. We know that sometimes it’s easier to lose weight when you have other people around you doing it, not to mention an additional motivation—cash prize— behind it. Has anything surprised you about making the transition into a leadership position with SNMA? Branch: I think the whole process has been surprising, mainly because I don’t really see myself as a leader so much as I just see myself as one of the other medical students with a passion for SNMA’s mission. That’s pretty
much how I went into it, and that’s what my election platform focused on. Because for me, the strength of our organization comes from our members. If you don’t think of yourself as a leader, what made you pursue the position? Branch: I’ve been involved in SNMA since my first year of med school, and I was president of our chapter, which was one of the founding chapters of SNMA. We have the largest chapter in the country, but there hadn’t been an SNMA president from Howard since the late 70s. So I felt we really needed to have a strong presence at the national level, especially as we are approaching our 50th anniversary. I wanted to be a part of that.
LMSA National celebrated its 7th Annual Conference in conjunction with the 39th Annual Northeast Regional Conference. The conference took place at Harvard Medical School in Boston, MA. The keynote speaker was Dr. Pedro José Greer, Assistant Dean of Academic Affairs and Chair of the Department of Humanities, Health and Society at Florida International University School of Medicine. Other medical leaders came from across the country to speak to the conference’s 280 participants. Students also got to take part in several workshops sponsored by Brigham and Women’s Hospital, Beth-Israel Deaconess Medical Center, Massachusetts General Hospital, Dana-Farber Cancer Institute and Partners Healthcare. During the conference, five students received the first-ever
ALL PHOTOS BY CONSTANCE WILLIAMS
The Latino Medical Student Association Celebrates 7th Annual National Conference
Students gather to register for the 7th Annual LMSA National Conference
LMSA Scholarship for U.S. Medical Students. This scholarship was developed in 2009 to assist medical students with the financial burden of accredited U.S.
medical school tuition. Personal qualities, financial need, academic and extracurricular achievement were considered in the selection process.
Journal for Minority Medical Students | 25
LMSA perspective At the conference, the National Board also welcomed new national officers: • National Coordinator: Emma Olivera • National Coordinator-Elect: Alvaro Galvis • Treasurer: Kenny Perez • Secretary: Monica Ruiz • Parlimentarian: Nicole DeJesus-Brugman • National Conference Coordinator: Miguel Gonzalbes • Membership Co-Chairs: Stacey Pereira & Claudia Ruiz • AMA Liaison: Nicolás E. Barceló • Policy Co-Chairs: Orlando Sola & Ann Santa Ines • Fundraising Chair: Jose Cruz • Pre-Med Liasion: Lizbeeth Lopez • Latino Healthcare Day Coordinator: Amanda Hernandez
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The Surgeon General’s
The Importance of Stopping Youth from Smoking By Regina M. Benjamin, MD, MBA, VADM, USPHS Surgeon General Regina Benjamin
ach day across the United States over 3,800 youth under 18 years of age start smoking. In fact, nearly all tobacco use begins during youth and young adulthood, and these young individuals progress from smoking occasionally to smoking every day. Although much progress has been made to reduce the prevalence of smoking since the first Surgeon General’s report in 1964, today nearly one in four high school seniors and one in three young adults under age 26 smoke. Of every three young smokers, only one will quit, and one of those remaining smokers will die from tobacco-related causes. Most of these young people never considered the long-term health consequences associated with tobacco use when they started smoking; and nicotine, a highly addictive drug, causes many to continue smoking well into adulthood, often with deadly consequences.
My office recently issued a Surgeon General’s Report on this topic that details the epidemiology, health effects, and causes of tobacco use among youth ages 12 through 17 and young adults ages 18 through 25. For the first time, tobacco data on young adults as a discrete population has been explored. This is because nearly all tobacco use begins in youth and young adulthood, and because young adults are a prime target for tobacco advertising and marketing activities. This report also highlights the efficacy of strategies to prevent young people from using tobacco. After years of steady decrease following the Tobacco Master Settlement Agreement of 1998, declines in youth tobacco use have slowed for cigarette smoking and stalled for use of smokeless tobacco. The latest research shows that concurrent use of multiple tobacco products is common
among young people, and suggests that smokeless tobacco use is increasing among White males. An important element of this Surgeon General’s report is the review of the health consequences of tobacco use by young people. Cigarette smoking by youth and young adults is proven to cause serious and potentially deadly health effects immediately and into adulthood. One of the most significant health effects is addiction to nicotine that keeps young people smoking longer, causing increased physical damage. Early abdominal aortic atherosclerosis has been found in young smokers which affects the flow of blood to vital organs such as the lungs. This leads to reduced lung growth that can increase the risk of chronic obstructive pulmonary disease later in life, and reduced lung function. This new report examines the social, environmental, advertising, and marketing influences that enJournal for Minority Medical Students | 27
Match Day Brings Long-Awaited Answers
Morehouse School of Medicine Facts: • Class of 2012 - Primary Care and Core Specialty Disciplines - 24 out of 52 = 46% (Including Family Medicine, Internal Medicine, Pediatrics, Obstetrics/ Gynecology, and General Surgery)
• Percentage of seniors who matched to their first specialty of choice: 47 students = 90%
• Morehouse School of Medicine Alumni 67% practice in primary care
• Ranked top 10 of least expensive medical schools – US News Report
• Ranked # 1 in Social Mission – Annals of Internal Medicine
Morehouse School of Medicine’s 52 medical education seniors added to the nearly 16,000 medical graduates around the country to make up the largest match rate in 30 years. Match Day, the culmination of a yearlong process that connects students with medical centers and hospitals across the country through the National Residency Match Program (NRMP), is a longstanding tradition filled with joy, excitement, accomplishment, occasional dejection and lots of nerves. It is the culmination of four challenging and arduous years, and, in some ways, is the most exciting day of the Medical School experience. There were some icebreakers along the way, thanks to some creative dance moves from excited students, proud parents, and a few children who tried to steal the show. “We are so very proud of these doctors,” remarked Dean and Executive Vice President, Dr. Valerie Montgomery Rice. “This day is really the first day of the rest of their lives.” By MSM tradition, the students revealed where they will train for the next three to six years. The 2012 class produced outstanding results with another 100% match and 90% of the class matched to their first specialty of choice. According to the According to the National Residency Matching Program (NRMP), the 2012 Main Residency Match is the highest rate in 30 years with more than 95 percent of U.S. medical school seniors matching in residency positions. These individuals make up the nearly 16,000 U.S. medical students. NRMP is a private, not-for-profit corporation established in 1952 to provide a uniform date of appointment to positions in graduate medical education.
Dates to remember: Class Day ~ May 18th – National Center for Primary Care, Ginger E. Sullivan Atrium Commencement ~ May 19st – Martin Luther King Jr. Chapel, Morehouse College
720 Westview Drive SW Atlanta, Georgia 30310-1495 www.msm.edu
are on a mission ”
“Many influences help attract youth to tobacco use and reinforce the perception that smoking and various forms of tobacco use are a social norm—a particularly strong message during adolescence and young adulthood.”
courage youth and young adults to initiate and sustain tobacco use. Tobacco products are among the most heavily marketed consumer goods in the U.S. Much of the nearly $10 billion spent on marketing cigarettes each year goes to programs that reduce prices and make cigarettes more affordable; smokeless tobacco products are similarly promoted. Peer influences; imagery and messages that portray tobacco use as a desirable activity; and environmental cues, including those in both traditional and emerging media platforms, all encourage young people to use tobacco. These influences help attract youth to tobacco use and reinforce the perception that smoking and various forms of tobacco use are a social norm—
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a particularly strong message during adolescence and young adulthood. Many initiatives have been put into place to help counter the influences that encourage young people to begin tobacco use. The Tobacco Master Settlement Agreement in 1998 curtailed much of the advertising that was particularly appealing to young people. With the passage of the 2009 legislation giving the U.S. Food and Drug Administration the authority to regulate tobacco products and tobacco advertising, we now have another important means of helping decrease the appeal of tobacco use to this population. Coordinated, multicomponent interventions that include mass media campaigns, comprehensive community pro-
grams, comprehensive statewide tobacco control programs, price increases, and school-based policies have also proven effective in preventing onset and use of tobacco among youth and young adults. We know what works to prevent tobacco use among young people. The science contained in this and other Surgeon General’s reports provides us with the information we need to prevent the needless suffering of premature disease caused by tobacco use, as well as save millions of lives. By strengthening and continuing to build upon effective policies and programs, we can help make our next generation tobacco free.
A D Y H 2 C 0 T 1 2! A M Forget basketball fever—the real March Madness took place at med schools across the country when fourth-year students found out where they’d be spending the first few years of their new careers as MDs. From the looks on the faces we feature throughout this year’s guide, it’s obvious that Match Day 2012 was a smashing success. Read on to find inspiring personal Match stories, residency director advice, tips from current residents, and more. Congratulations to all who got the match of their
Louisiana State University
dreams—and good luck to those already preparing for next year’s big day!
Columbia University Albert Einstein College of Medicine Journal for Minority Medical Students | 31
Highest Match Rate for U.S. Medical School Seniors in 30 Years; Family Medicine Match Rate Slows
ore than 95 percent of U.S. medical school seniors—the highest rate in 30 years—matched to residency positions. The 16,000 students for 26,772 positions, an increase of 614 over 2011, including 146 positions in child neurology, which joined the Match this year. Internal medicine, anesthesiology, and emergency medicine saw the largest increases in 2012, and emergency medicine filled every available position. The number of family medicine positions increased only slightly (1.1 percent) following notable increases over the last two years. The number of matched U.S. citizens who attended international medical schools continued to rise, increasing by 218 over 2011 and by more than 500 over five years. After declining for two years in a row, the number of non-U.S. citizens matched to positions rose by nearly 2 percent. For individuals who were not matched to a residency position, the NRMP debuted the Supplemental Offer and Acceptance Program (SOAP), a new process developed in partnership with the Association of American Medical Colleges (AAMC) and in consultation with student affairs deans, residency program directors, resident physicians, and medical students. Designed to help streamline, equalize, and automate the process for students who are not matched initially, SOAP replaces the Scramble, the unofficial name for the period of time during Match Week when unmatched applicants contacted programs with unfilled positions. Under SOAP, the NRMP makes available the locations of unfilled
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Northwestern Feinberg positions, so that unmatched students can submit applications for these positions through the AAMC’s Electronic Residency Application Service (ERAS). After receiving applications through ERAS, residency program directors create a list of candidates in order of preference and the NRMP offers positions in that order in a series of up to eight rounds. Applicants are able to receive multiple offers in a single round; if an offer is accepted, it is binding. This year, 1,246 residency positions were available after applicants who matched were notified. During SOAP, programs offered 1,131 of those positions and only 152 remained available at the conclusion of three offer rounds. “The 2012 Match has been overwhelmingly successful due to strong participation by applicants and teaching hospitals and the launch of the Supplemental Offer and Acceptance Program. The development of SOAP exhibits the dedication of
the medical education community to improving the Match process for all applicants, program directors, and medical school advisers. There is great cause for celebration across the nation’s medical schools today,” said Mona M. Signer, executive director of the NRMP.
• Emergency medicine programs offered 61 more positions and filled all 1,668 available positions. • Anesthesiology programs offered 78 more positions, and U.S. seniors filled 725 of the 919 positions offered.
Couples in the Match
Of the applicants who matched, 81.6 percent of U.S. seniors and 81.5 percent of independent applicants matched to one of their top three choices. More than 56 percent of U.S. seniors and approximately 49 percent of independent applicants matched to their first choice.
This year, the Match included 878 couples, an all-time high. Participants who enter the Match as a couple agree to have their rank order lists of preferred residency programs linked to each other to ensure that they match to programs within the same geographic area, for instance. This year, 804 couples matched to their respective residency program preferences. A couple is any two applicants— regardless of the nature of their relationship—who participate in the Match as partners.
Specialty Trends Match results can be an indicator of career interests among U.S. medical school seniors. Among the notable trends this year: • Dermatology, orthopaedic surgery, otolaryngology, plastic surgery, radiation oncology, thoracic surgery, and vascular surgery were the most competitive fields for applicants.
Washington University School of Medicine
Journal for Minority Medical Students | 33
MATCH DAY 2012
SUCCESS STORY Thomas Cudjoe
4th year student at UMDNJ-Robert Wood Johnson Medical School Residency Match: Internal Medicine at Howard University Hospital, Washington, DC
homas Cudjoe graduated summa cum laude from the Honors College at Hampton University with a bachelor of sciences in biological sciences concentrating on cellular and molecular biology. Through his participation in the 4-year ROTC scholarship program, he was commissioned as a 2nd Lieutenant and was identified as a cadet in the top 10% of those in the nation. Based on his excellence as a scholar, leader, and athlete, Thomas earned the Distinguished Military Graduate commendation. In addition to receiving various academic honors, including a National Science Foundation Academic Excellence Award, Thomas was also recognized for service on campus and in the community. While continuing his record of academic success at Robert Wood Johnson Medical School, Thomas also maintained his passion for research and his desire to play a meaningful role in the community. Thomas spent the summer following his first year of medical school at the Mayo Clinic, where he studied factors that lead to the mortality of elderly individuals with congestive heart failure. Thomas presented the findings of this project at the Harvard Medical School New England Science Symposium and the American College of Cardiology Annual Meeting. Most recently, his work has been presented at the
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European Society of Cardiology International Meeting. Early in his training at RWJMS, Thomas began to better understand the parallels between his interest in community advocacy and the field of medicine. With this growing understanding and with encouragement from our school, Thomas decided to take advantage of our Student Scholar Program by pursuing a masterâ€™s degree in public health in health policy and management at the Harvard School of Public Health. During this one-year program, Thomas joined students from around the world in studying health economics, quality improvement strategies, and negotiation and conflict resolution. Moreover, he assisted the Massachusetts Legislature Committee on Public Health in understanding best practices for management of patients with chronic disease. While making his own contributions to society, Thomas has placed special emphasis on mentoring younger generations through advising students in pipeline programs. Even while in Massachusetts for just a one-year program, Thomas sought to establish a collaboration between Harvard School of Public Health and the Tobin Community Center as a vehicle for academic and mentoring relationships among the students at both institutions. In recognition of his performance at RWJMS, Thomas was elected for the Gold Humanism Honor Society (GHHS).
Coming out on top:
Tips to make the most of a very competitive Match season
It will come as no surprise to hear that Match is more competitive than ever. New medical schools and bigger classes mean there are more students vying for the same number of residency slots. In fact, AAMC predicts that the number of graduates will surpass the number of residency slots available by the year 2021. So while the people in charge struggle to figure out how to head off this problem— the first step is this year’s inaugural SOAP (Supplemental Offer and Acceptance Program), what used to be called the Scramble—you’ll want to make sure you do whatever you can to optimize your chances of getting the program you want.
from Vineet Aurora, MD, of Futuredocsblog.com 1. Think twice before leaving off a program where you interviewed. Consider whether you would rather enter the Scramble (aka SOAP) or go to the program. The length of the rank list is the strongest predictor of matching. This means you should not “suicide” match, or just list one place due to false assumption that you are definitely “promised a spot” there. 2. Consider where you want to live and other non-program factors when constructing your list. When faced with programs that look very similar, think of locations where you would be happy. Many people settle in the city that they do their residency training in. It may be especially difficult to distinguish between programs the further you go down your list, so definitely consider location at that point. 3. Don’t worry about where the program ranks you. Remember: the Match algorithm works in your favor, so it is to your benefit to rank programs in the order you want to go to them and not try to guess where they will rank you to reorder your list. 4. Avoid 11th hour changes. These will likely be motivated by faulty reasoning. Instead, talk over your decisions with your friends and family well before the deadline so you can relax (as much as you can, anyway). 5. Don’t forget to press “certify!” The last thing you want to do is be undone by failure to press this button when you’re finally sending off your choices.
Journal for Minority Medical Students | 35
Get cleaned up
for SOAP! This is the first year the NRMP is using the Supplemental Offer and Acceptance Program (SOAP) in place of the old Scramble for unfilled positions. "Our goal is to make the Match Week Scramble less chaotic," said Mona Signer, MPH, executive director of the NRMP. "There are many more unmatched applicants than there are unfilled positions." So what has SOAP got to do with you? It really means your application matters twice because it will be used to consider you both for the main Match, and, if you don’t match anywhere, it will be used again for SOAP. There are no second chances on first impressions, so make your application count, because it counts twice. If you’ve got an application dotted with grammatical errors or a lackluster personal statement that doesn’t get you where you want to be for the main Match, chances are it’s not going to help you with SOAP either. Make sure everything you submit is clean, clear, and compelling. It will go a long way to getting you where you want to go.
University of Kansas School of Medicine
Weill Cornell Medical College
Emory University School of Medicine
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Ch-ch-ch-changes to the 2013 Match Recently, the National Residency Matching Program (NRMP) voted to require programs participating in the Main Residency Match to place all positions in the Match. The so-called "All-In" Policy will become effective for the 2013 Match that opens for registration on September 1, 2012. The policy will affect all PGY-1 positions and PGY-2 positions in advanced programs.
University of Iowa Carver College of Medicine
University Texas Medical School at Houston
Meharry Medical College Journal for Minority Medical Students | 37
The Residents Speak
Dr. Greggy Laroche Third-Year, Pediatrics at Wake Forest Health System Medical School: SUNY Upstate
Tell us a little bit about the Match process for you. Was it easy? Challenging? Nerve-wracking? Greggy Laroche: It was all of the above. I had no idea where I wanted to go. I’m from Long Island, New York, and went to school in upstate New York, but I was tired of the cold. My parents had moved down to Florida a couple of years ago and though I didn’t want to be there, I wanted to be somewhere in between. I went on sixteen or seventeen interviews. Wow. That’s a lot! Laroche: Yeah. I love traveling, so I wanted to see different places and see what every program had to offer. If you had to do it over, would you go on that many interviews again? Laroche: Yes, I would. Some people burn out, but I didn’t. I just enjoyed seeing different people and places and hospitals. What made you choose Wake Forest?
Laroche: The night before the interview, most programs host a
dinner. It’s a great time to talk to the residents and see what everyone is like. I’m really social, but there were some places where I thought, I’m not interacting well with these people; how is it going to be for the next couple of years of residency? But when I came to Wake, the people were so much fun. I chatted with a couple of people for two or three hours straight, and I felt really comfortable. They had great ideas and great opinions of the program. The next day, my interviews went really well. Everyone I saw was so down-to-earth, and that’s what I was looking for: people who know when to work and when to relax.
Now that you’re coming to the end of your residency, are you happy that’s the path you’ve chosen? Laroche: Definitely. There are definitely sad moments, and you just can’t let that hit you too hard. Tragedy hits sometimes, but then, the next patient could be a five-year-old who just loves the exam and interacts with you and giggles and laughs. That’s what keeps me going. Do you have any idea what you’re going to do next?
Laroche: I’m doing a pediatric gastroenterology fellowship. I’m
starting in July at Johns Hopkins.
And what got you interested in that program?
Laroche: I did two weeks of gastroenterology during medical school
and I just fell in love with it. You have time to actually sit down and talk to the family, instead of just seeing them for five minutes, and then onto the next person and the next person. I really like the idea of focusing on one thing and being really good at it.
What advice would you give to someone starting this Match process now? Is there anything you’ve learned that you would want to share? Laroche: Just take it day by day, month by month, because a lot of things fly by fast. These three years definitely flew by. I would also recommend for people to travel. Do international trips. My parents are from Haiti, and during the first year of residency, I went to Haiti for a week just to volunteer. It was amazing. And then, this year, I did an international elective for a month in Mexico, and that was just amazing as well. Get passports and go on international trips. It’s definitely worth doing.
What’s been the hardest thing about residency for you?
Laroche: Keeping up with reading. And sometimes you’re not as
social as you want to be, because you’re thinking, should I sleep? Or go out? And you almost always think, “I’m just going to sleep.” What’s been the most unexpected thing about residency?
Laroche: Even though I was just talking about lack of sleep, the
most unexpected thing was having more free time than I thought I would, though maybe I’m saying this because I’m a third year (second year was really tough). But I like that I’m able to have evenings off in different rotations, and I have more elective time. Why did you pick pediatrics?
Laroche: I actually went into medical school thinking I wanted to
do pediatrics. I’ve always had a good time with kids; I think I’m just a big kid myself. There was a time during medical school where I was thinking about family medicine because you get trained in everything. But I decided adults have way too many things going on! Kids are more innocent. The negative part can be the parents. When a kid comes in with a viral illness, and you know they don’t need antibiotics, and the parents insist they do, it’s hard.
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Southern Illinois University School of Medicine
h c T t i a m M e l 3 i 1 ne 0 2 July 2012 • Both USMLE Step 1 and USMLE Step 2 CK should be taken BEFORE the end of July 2012. • Estimate four months of Prep time EACH for Step 1 and Step 2 CK. • It will take around four weeks for Step 1 and Step 2 CK results to be electronically reported. • Register for the Step 2 CS as early as you can. • Try your best to take the Step 2 CS before August 2012. • Purchase ERAS Token online by July 1st to get AAMC ID. • Documents for Match must reach ERASECFMG for scanning by end of July or else the big waiting line will delay your scanning making delaying your application.
August 2012 • Collect information on residency program eligibility criteria. • Start drafting your personal statements (also called SOP) for the application. • Complete your online application called Completed Application Format (CAF) on the online ERAS system. • By end of August at the latest, you should have passing scores on Both USMLE Step 1 and Step 2 CK reported.
September 2012 to January 2013 • Interview season! Most invitations arrive between September and December. • Keep trying to get clinical or research experiences and update programs via email.
January to February 2013 • In almost all cases, arrival of interview offers will end by January. • Start entering your Rank Order List online for NRMP Match.
March 2013 • Match Day—March 15, 2013!
April to June 2013 • Sign contract with your residency program. • Graduate and prepare to begin residency. Woohoo! • Prepare to move.
June to July 2013 • Residency begins.
September 2012 • Apply via ERAS on September 1, 2012. • Register for Step 3 before first week of September if you wish to take the Step 3 in 2012.
Wright Boonshoft School of Medicine
Journal for Minority Medical Students | 39
Learn, Be, and Smile Advice for New Interns
by Mary Brandt, MD, Baylor College of Medicine
ach year, roughly 16,000 new doctors in the United States will start their residency training as interns. For those at this point on their journey, you are a doctor, even if it may not feel like it yet! The first year of medical school gave you the “vocabulary” you needed for this new language. The second year gave you the “grammar.” Your rotations in the clinics taught you the “language.” Now you get to actually use it every day. In talking to other physicians and thinking about my own experiences, here are a few words of advice for you as you start your internship this week.
University of Washington School of Medicine
University of Louisville School of Medicine
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Learn from every patient As an intern, you will need to know a lot of detailed information on your patients. You’ll need to use a system to keep track of all this information so that when you are asked, you know the last potassium level, which antibiotics were ordered and what the ID consultant said. If you have a system you developed as a 4th year medical student, great! If not, start with 3×5 cards. Keep one card per patient, clipped together or held together with a metal ring. There are electronic systems available like iScut and My scut list. I haven’t found one that I think is adequate, but I’d love to hear from anyone who has found good software that works! Also (very important), if you are going to have any patient information stored electronically, please make sure it is HIPAA-compliant. That covers the information, but not the learning. Learning is something that should be actively integrated into your day, not something you do at night when you are falling asleep. Work on a system that lets you record what you are learning during your daily tasks in a way you can review later. I suggest 3×5 cards because they are a simple, cheap and a very effective system for studying medicine. Make a separate card (or use the back of your rounding card) to list something you learn from every patient you see. But don’t confuse gathering information with studying information. Taking notes is a critical part of learning. Don’t just make files of chapters and articles; summarize them to review later by taking notes. Be a caregiver for your patients This may sound obvious, but in the everyday world of the hospital, it is really easy as an intern to get lost in the details of patient care and forget about actually caring for the patient. Stop every once in a while and remember that you really are their doctor. Take a few deep breaths and put yourself in their shoes for a minute to ask something about their family, hold their hand, or just sit with them for a minute.
It’s very easy to get swept away by the velocity of the work most interns experience and lose the “big picture.” When you are confronted with something you haven’t seen before, push yourself to make a plan before you call your upper-level resident or the attending. What if you really were the only doctor around? What would you do? Spend two minutes on UpToDate if you have to, but don’t just be a clerical worker – be their doctor. That said, part of being a good doctor to your patients is to recognize your own limitations. You should never feel bad about calling someone with more experience, no matter how “dumb” you think the question is. It’s the right thing to do for the patient. Be deliberate about learning your field From day one, commit to an organized plan of study to cover everything you need to learn in your field. Your goal should be to learn (not just read) everything in the primary textbook for your field. Make a plan to read (and then study to learn) a textbook every year. Make notes that are easy to review, so you don’t have to go back to the textbook to review the material. Whatever system you use, make it easy to integrate the notes you are making in the hospital (i.e., the 3×5 card on each patient) with your organized study system. Adding articles into the mix is fine – but only after you have mastered the basics. Don’t let reading the latest research take the place of really learning the material in the textbook. Be kind and be part of the team Hard work is made easier when it’s done with your friends. You will all be tired. You will all be stressed. But be kind to each other. Staying five minutes late to help out a fellow intern is an investment that will
Oregon Health & Sciences University benefit both of you. Look for ways to apply the golden rule of internship: “Help others the way you would liked to be helped.” Make your bed Do this simple act every morning to remind yourself to take care of yourself. Find time to consciously take care of your emotional, physical and spiritual health. Take good food to the hospital for your nights on call. Find ways to get stressreducing exercise into your weekly schedule, or at least find ways to increase your activity while you are at work. Watch your weight. If you are losing or gaining, it’s a sign that you need to focus on your own wellbeing by improving your nutrition and working on your fitness. Nurture your relationships. Make your family and friends a priority. Take care of your spiritual needs in whatever way is best for you, but don’t ignore this important aspect of self-care.
The intern year will be one of the most profound transitions you will ever make. It will be a year of intense and fabulous memories. Take some time to write down the stories, or take some photos (but not of patients unless you have their permission). These notes and images will be precious memories in the future. Congratulations to you for all you’ve accomplished thus far. Enjoy this incredible journey! Dr. Mary Brandt is Professor of Surgery, Pediatrics and Medical Ethics, Vice Chair of Education in Surgery and Associate Dean of Student Affairs at Baylor College of Medicine. Please visit her blog www.wellnessrounds.org.
Smile! You have the enormous privilege of caring for other people and learning the art of medicine. Take a little time every day to notice the moments of joy in this work and, if you can, write them down to look at on the days you are tired.
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The Residents Speak
Dr. Jordan Bowling Intern, General Surgery at Mount Sinai Medical School: Howard
Where did you go to medical school? Bowling: I went to Howard, but I’m kind of a weird guy: I didn’t major in science, and I didn’t go straight med school after undergrad at Amherst College in Massachusetts. I took time off iin between and relaxed. What did you major in? And how did you go from there to where you are now? Bowling: I majored in religion and I did all the premed requirements at the same time because though I was pretty sure I wanted to do medicine, I needed a break to recharge my batteries and assess my future. I wanted to to make sure I was really ready to jump into a medical career because I don’t like doing anything halfway. What did you do in between college and medical school? Bowling: I lived in Hawaii for a year. I worked in construction and landscaping, and I volunteered in the emergency room. Then I had to move back home to Nebraska to help my mom, and I actually worked as a garbage man while I did that. The shift starts at 4:30 in the morning, and I was done by noon, so I had the rest of the day to work on my mom’s house or study for the MCAT. It was a fun job.
You’re now on the other side of the Match. What can you tell our readers about how you approached the process? Bowling: The Match wasn’t easy, but I don’t tend to get too stressed about stuff like that. The interview process is definitely draining because you get asked the same questions everywhere you go, and you’ve got to ask the same questions over and over. How many interviews did you have? Bowling: I did 12 or 13. I had more scheduled, but as I got further along I knew more of what I wanted so I ended up canceling some. I see people approach the interview process in two ways. Some people have a spreadsheet they fill out with every little detail about the place: ancillary staff, work hours, how do they feel about the program director? I’m on the other side. I just went with my gut—with what I liked—and I was fortunate to get matched with the program I wanted. You sound like a pretty laid-back guy, but surgery is competitive! Bowling: General surgery is not as competitive as the specialties— orthopedic surgery or plastic surgery—but it is getting more so. A lot of people who aren’t sure they’ll absolutely match in general surgery, applied to other types of specialties as well. A Plan B. Did you have a Plan B? Bowling: No. I wanted to do surgery. So that’s what I did. I was fortunate enough to be a halfway-decent candidate, so I was able to Match. I got lucky. Was Mount Sinai your first choice? Bowling: It was. The thing I loved about Sinai is that it was a nonmalignant place. By that I mean the attendings and residents are very down-to-earth. It’s also a very diverse program, which I really loved. There are only two males in the intern class this year; I’m one of the two. There are no white males in the intern class, and that’s kind of unheard of in surgery. Our program director is a Filipina physician, Dr. Celia Divino. She’s absolutely awesome. She doesn’t care what school you’re from or what your race or gender is, as long as you’re a good candidate. Have your expectations been met at Mount Sinai? Bowling: You know, it’s like any job. Some days, you wake up and you think, “Why did I do this?” But as a whole, I love it here and I’m really happy with my choice. I think I might have been happy pretty much anywhere, because I try to make the best of things. But I’m very pleased with the outcome. Very pleased.
University of Pennsylvania Perelman
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What has been the hardest thing about this transition from medical school to residency? Has anything surprised you? Bowling: You still have to study when you’re in residency, and you have to find time to fit that in, even though the work hours are
so much greater. Then, of course you also want to make some time for yourself. That’s hard to do. There are a lot of times I’m just too tired to study, or I’m not able to meet up with friends, because I have to clean my house or I haven’t done laundry in two weeks. But med school does prepare you for residency. When you start doing your clinical years, you realize, oh my gosh, look at all that free time I had in my first couple of years and I didn’t even know it. In residency, you don’t have all day to study. Now you’ve got to study after work. Also, the level of responsibility goes up. That’s something you have to get comfortable with. Has it been hard to make the transition from student to doctor? Bowling: It’s hard not just in terms of responsibility. There are so many variables, and you feel like you’re walking a tightrope sometimes. And there are days you’re just so stressed out. But there are also days you help that one patient and you make that connection, and then it’s all worth it. In those moments you realize why you went into the field. So it’s hard, but it’s not unmanageable. Some days you just have to put the pager away for five minutes, take a deep breath, look out the window, grab a coffee and just regroup. That’s a big thing I had to learn how to do. If I’m super stressed, I have to take five minutes to myself and regroup. What’s your schedule like?
Bowling: It varies. With most services, you’re on call that day. With
the work-hour regulations, you can’t go overnight. But during that day, you’re running that service. On some services, you even hold the pager while you’re still in the OR, so you have to figure out a way to be the ER consult between cases. It’s just something you learn. There is a learning curve, and you start on the bottom of it.
East Carolina-Brody School of Medicine
absolute right or wrong way to do it. You’ve just got to figure out what works for you. Don’t be afraid to divvy out jobs among the other interns to get work done, because when you all work as a team, it works a lot better, and everybody’s a lot less stressed. I know that sometimes you want to be the superman who solves all problems, but that’s just not how it works. It’s a team effort: doctors, nurses, social workers, nutritionists. Speaking of nurses, above all, be nice to them. A lot of those nurses know how to manage patients better than you do.
Do you feel like you’re treated like a doctor or a student?
Bowling: It varies. On some rotations, the attendings micromanage
their patients, so you feel like you’re a secretary putting in orders. But on other rotations, the attending says, “I want you to work up the plan. If I think it should be changed, we’ll talk about it.” Being an intern means you’re still kind of in that limbo phase, but it’s good, because while you’re in that limbo phase, you have the opportunity to learn and build up your repertoire of skills. You make critical decisions when they come about, and you learn from your senior residents. That’s how I like to do it. I often ask a senior resident, “What was your thought process?” How does it feel to actually be taking care of patients? Bowling: I love it! I wake up in the mornings, and a lot of times I just lie there with a smile. It’s rewarding to be a physician and especially to be a surgeon. You have the opportunity to cure a patient through a surgical procedure and see them walk out of the hospital. There’s no greater feeling.
Dr. Bowling’s Tips •
“If you make a mistake, you can’t get down on yourself. You fall down, and you’ve just got to get back up, admit your mistake, and learn from it.” “Get ready for those pagers for intern year—they almost drive you up the wall!” “Relax all you can before going into residency. Some people say, “Read.” But you’re not going to remember half of the stuff you read. You will, however, remember those times you hung out with your friends and family. I guarantee it.”
Do you have any tips for someone who’s following in your footsteps next year? Anything you wish you had known when you were starting your internship year? Bowling: You’re going to have bad days, but don’t get discouraged. Try to learn your hospital system; learn how to page people and be efficient. Everybody has their own unique way, and there’s no
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Making the most of your residency interview
Phyllis Kopriva Former Director, American Medical Association Women and Minority Services
Step 1: Set Up Your Interviews
Make arrangements for your interviews as early as possible without scheduling them so early as to look pushy or over-anxious. Certain programs interview by invitation only. In those cases you must send in your application and hope for the best. If you are extremely interested in a program, consider doing a visiting elective there before your fourth year. It is a good idea, however, to get a few interviews under your belt before you go to the ones that you regard as the most important. And it is reasonable to expect that after a dozen interviews you will be battle-weary. Therefore, scheduling your most prized interviews in the middle might promote the best results.
Step 2: Research the Program
Research the program as much as possible before you go so that you will be able to target your questions for that program, rather than doing a generic interview. You might check to see if any graduates of your medical school are there, and if so, consider getting in touch with them. Do some research on the latest developments in the specialty that you’re interested in, including what types of people they’re looking for. Different specialty programs may have different priorities - leadership, community involvement, research, or clinical abilities. Review your application, personal statement and curriculum vitae, and prepare yourself to discuss anything that you’ve mentioned on them, including any research that you’ve done. Prepare a list of questions that you want to have answered during your
Good to know
As a rule of thumb, program directors would like to be finished with their interviews by January so they can attend to the administrative details in order to meet the National Resident Matching Program (NRMP) deadlines.
Northeast Ohio Medical University stay. And remember, you don’t have to memorize your questions; you can take your notes into the interview.
Step 3: Plan Your Trip Well Housing Some students find it helpful to make prior arrangements for housing in residents’ quarters. At the same time, check to see if you can schedule an interview on a day when you can attend morning rounds or a teaching conference. If you have the time, stay an extra day to talk with residents. Time and again, respondents reported the value of information gained from this source. What to Pack A residency interview is a job interview, and the propriety of your dress reflects a sense of being in touch with the world. Your
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choice of a residency, and their choice of a candidate to whom they can entrust patients, is serious business. For men and for women, suits are serious clothes and are appropriate for interviews. Failure to wear professional-looking clothes might not cost you a placement, but it can distract the interviewer. Sweaters and slacks are okay when you’re on call in certain programs, but your safest bet when you interview is to dress for success. Business schools impart lots of information to their graduates about how to dress for job interviews; medical schools do not. Don’t be fooled. Although you may not be going for job in banking, you are interviewing for a professional position. In addition to carefully planning what clothes to bring, run through the other possibilities that may arise while you’re away. You may go for a meal with one of the residents. It could rain, so take an umbrella. It is easy to spill something on a shirt, spot a tie, or rip a seam. Pack accordingly.
Step 4: Go on the Interview The First Impression Students often go into the interview room very nervous. Most adjust quickly, but wish they could avoid the early jitters. If this applies to you, and it probably does, follow these helpful hints: • Be on time. • Get the names, including spellings, of the interviewers from the departmental secretary so you know who you’re seeing. • Look your interviewers in the eye, greet them by name, and offer your hand for a firm handshake. • Smile. • Let everyone else sit down first (old fashioned manners). • If you’re offered coffee or tea, but you’re pretty shaky, refuse it. • Take a deep breath and proceed. During the Interview Selecting your residency program is a major decision a decision that you will have to make after very brief contact with people who may be your associates for a long time. Value the impressions that you make of the program and the people, and keep track of those feelings about the interview to assess how suitable the fit is between you and the program. Direct each question to the appropriate interviewer (i.e., program funding to the director and call schedules to the residents). Consider which questions are appropriate for the interview, and which are for a less formal setting. Think about your real priorities and make sure you express them. And, ask your questions at the appropriate times. The beginning of the interview is not the best moment to ask about salary, benefits, and call schedules. Although they are legitimate questions, bad timing or asking the wrong people could make your interviewers uncomfortable about your values. In addition, ques-
tions that challenge or confront interviewers can be alienating; nuances such as tone and word choice are important. “What is wrong with your program?” is more difficult to answer than “What are some of the challenges that I might face here?” Investigate each year of residency; students often direct their focus only on the first year. And don’t try to buddy up with faculty by telling each of them that you want to go into their specialty—they might compare notes later. Beyond the Questions In answering questions about what kind of person you are, why you went to medical school, and what you want to accomplish, you will want to distinguish yourself from the other interviewees. However, that is often difficult to do. Many have reported that the most common questions were sometimes the hardest to answer, for example, “Why to you want to be a doctor?” Most of us become physicians for the same reasons—to “save lives,” “improve health care in America,” “help people,” “make a contribution to society,” and so forth. That is not to say that you should not say those things; by all means do so. After all, that probably is what you hope that you will be contributing. In addition to your heartfelt answers to those questions, you can distinguish yourself by showing that you have spent time in introspection and that you understand how your experiences have shaped you and influenced your decisions about becoming a physician and choosing your residency. One experienced interviewer told us, “Everyone has a story, but many of the students we see don’t seem as if they know their own particular stories. Many have not really thought through their lives and what they want.” Spend some time with yourself before the interview. Ask yourself these questions: •
What are your expectations of what your life will be like after residency? What’s your visual image of your life as a doctor? What have you done in your life that shows that you are a hard working and dedicated? (Remember, it doesn’t have to be restricted to medicine.) What besides medicine do you have in your life that you feel passionate about? What About “Lifestyle?”
The medical profession continues to debate the advantages and disadvantages of the intensity of the residency demands and schedules. Long resident work hours, sleep deprivation, high stress levels, relationship interruptions—these are somewhat par for the course in a typical residency program, but of legitimate concern nonetheless,particularly as you may think about your now or future spouse or children. It’s appropriate to ask about call schedules such as, “How often will I be taking call?” or “What are the expectations for a new resident?” But too many questions about time off will make you look like you’re picking your residency on that basis, which does not speak well to the program. It’s a fine balance.
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University of Nebraska School of Medicine Commonly Asked Questions Some of the most common, open-ended questions cause the most anxiety: “Tell me about yourself,” or “What do you want to know about the program?” Another common question was about personal weaknesses. As one respondent said: “You should pick something that doesn’t expose some horrible shortcoming—something that could actually be seen as a strength. For example, you may feel that, “I’m a perfectionist, I trust people too much.” Or “I’m too organized.” You certainly can’t respond, “I’m insensitive, cruel, and lazy!” If you are prepared to answer the following list, you should be ready for many of the questions you will face: • Why did you choose this specialty? • Why are you interested in this program? • What are your goals? • Tell me about yourself? • What did you do before medicine? (to an older student) • Why should we pick you? • What are your strengths? • What are your weaknesses? • Where else have you applied? • Are you interested in academic or in clinical medicine? • Do you want to do research? • Where will you rank us? • What was the most interesting case that you have been involved in? • Present a case that you handled during medical school. • Do you plan to do a fellowship? • What could you offer this program? • How do you rank in your class? • Do you see any problems managing a professional and a personal life? • Are you prepared for the rigors of residency? • Where do you see yourself in 5 years? • What questions do you have? Uncommonly Asked Questions Beyond the routine questions, there are others that are more difficult, unusual, or even strange inquiries that may not seem
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to pertain to your future as a doctor. You cannot prepare for all the questions you hear about through the grapevine. Nor can you prepare for all the remote possibilities that you conjure up in your head. If you are asked something that seems pretty off-beat, it is probably best to assume that you are being judged on your grace under pressure as much as on the substance of your answer. Some program directors think that the way to test your smarts in the face of medical emergency is to put you into a crisis in your interview. Remember, not all interviewers are equally skilled. You can correct some of the problems you encounter by keeping the interview focused. When questions are asked that don’t seem germane to the interview, you may tend to over-answer hoping to hit on something your interviewer wants. But don’t go on and on. If you’re asked a question about whether there are any physicians in your family, you needn’t give a monosyllabic yes or no, but don’t do your family tree, either. Rambling in an interview robs you and the interviewer of the opportunity to exchange the information you both need.
Step 5. After the Interview
Go back to your housing and immediately write down your impressions of the interview. After a few interviews, you will tend to start forgetting what happened where. Write a description or make a list of what you liked and didn’t like, and do it right after the interview because you won’t remember later. Don’t rank a program you will feel uncomfortable working for. If you’re going to interview at many programs, it’s a good idea to prepare a checklist in advance of the factors that are particularly important to you that you can use for all your interviews. At the end of the process you can then use a consistent rating system to help sort out your decision. Follow up your interview with a note of thanks—but not one that sounds like a form letter. Make sure that you sound genuinely interested. Questions to Ask During Interviews It’s important to develop your own set of questions for the programs you’re interviewing with. First, it is imperative that you glean the information that you need to assess the program; as one respondent to our questionnaire said, “You’re interviewing them just as much as they’re interviewing you.” Second, it is a handy emergency procedure in the event that you run into an interviewer who wants you to direct the interview. One note of caution: Be careful not to ask a question that is already covered in the literature on that program.
Residency Director Q&A: Daniel I. Steinberg, MD
Residency Director, Internal Medicine Beth Israel Medical Center
What is the most important factor for a student applying to your program? Dr. Steinberg: The first and most important thing is to be honest on the application. You must never misrepresent yourself in any way. Highlight your strengths, but never exaggerate. I’ll give you an example of how a student got into trouble. The student said they were fluent in Spanish on their application. But an interviewer tried to engage the student in a conversation in Spanish with no luck. Turns out the applicant spoke a little Spanish, but wasn’t really fluent. The interviewer contacted the National Resident Matching Program (NRMP), and the NRMP launched an investigation. They sent a letter to every program director in the country. These types of things can be tempting to do—they seem like small details at the time—but they represent intellectual dishonesty. This is a serious issue, and it’s not taken lightly by the Match or by program directors. It’s like applying for any job: you either have the skill or you don’t have the skill. And because many students have never actually been in a professional setting, they don’t realize you can’t fudge things.
What about when people have something they’re anxious about noting on the application (bad grade or other lapse). How do you advise them to handle that? Dr. Steinberg: A lot of people run into speed bumps in medical school. Those are obviously best avoided, but sometimes they can’t be. The best thing to do is address them in some way in their application. For example, if a student failed a class and had to retake it, or had to take a leave of absence in medical school, they should either address that outright in their application or be prepared to speak to it in an interview. I’m interested of course in someone’s record, but I’m just as interested in how they may have overcome or dealt with challenges, as this can say a lot about their character. How such issues are presented in an application is also a reflection of their honesty and professionalism. My best advice for students addressing speed bumps in their application is to work with their dean’s office. The dean’s office is a very important resource and is there to advise them on just these types of situations.
How important are test scores? Dr. Steinberg: Students need to do as well as they possibly can on the USMLE Step 1. It’s critical because by application time, everybody has taken it. And having a Step 1 score cutoff is a very common “filter” programs use to screen applications; it’s really one of the only common denominators among applications. There’s great variability in how deans’ letters are written, the letters of recommendation, and class rank. One of the few objective comparators is the Step 1 score, so students really need to do their very best on that. Many students wonder if there are cutoff scores below which interviews aren’t granted. My best answer is that some probably do and many probably don’t. Another reason Step 1 is important is that program directors are very risk-averse when it comes to ranking applicants; we don’t want to take a chance on ranking someone who might fail Step 2 and not graduate and start our program on time. If someone has failed Step 1 or has a very weak Step 1 score, I’m wondering if they’re going to also have problems
Applications received: Around 4,750 Total class size: 52
with the other exams they have to pass along the way. Some institutions have policies that residents cannot be promoted to the senior years of training without passing Step 3, and this is a situation program directors want to avoid.
Do you have any advice about writing personal statements? Dr. Steinberg: The main thing you want to avoid in a personal statement is making mistakes. There is of course nothing wrong with voicing your opinion on the world or your experiencees, but avoid political, religious, or otherwise potentially divisive statements. Also, don’t repeat things that occur elsewhere in your application. Use the personal statement as a platform to highlight things you want to draw particular attention to—an outstanding achievement that you’re proud of or a hardship you overcame either in medical school or in life that led to a disruption in your training.
What about recommendations? How important are they to your process? Dr. Steinberg: Candidates should definitely have at least two letters in the specialty to which they’re applying. In internal medicine, for example, if someone has three letters of recommendation and only one is from internal medicine or a subspecialty, it can be a red flag. So if an internal medicine candidate has, in addition to a letter from a cardiologist, letters from a radiologist and an anesthesiologist, that makes me wonder why didn’t he or she form relationships to get at least one more letter from an internal medicine faculty member. Further, you don’t want to give off mixed signals and have programs wonder if you might also be applying to another specialty, as this can cause question of your commitment.
How important is the interview at your school? Dr. Steinberg: The interview day and the period after the interview are both very important. The standard advice applies: be on time, dress appropriately, read about the particular institution. If you know who’s going to be interviewing you beforehand, it’s wise to Google them and find out a little bit about them. One important piece of advice is to make sure you have a good set of questions ready. A candidate is going to be asked many times throughout the day, “Do you have any questions?” The answer should never be “No.” You need to always have a question prepared for two reasons: 1) having questions ready is the sign of a prepared applicant; and 2) it’s actually a useful technique to ask different people the same question. Consistent answers are a good sign that you’re getting “true picture,” while inconsistent answers might indicate otherwise. On the interview day, it’s important to do well in the interviews, of course. But it’s critical that candidates be polite and respectful to everyone: program office staff, residency manager, and administrative staff. Program directors may take people out of the rank pool if they’re rude to the office staff. Most students don’t realize that all residency programs require that residents be regularly evaluated by nonphysician staff— nurses, administrative staff, or similar. How a resident interacts with nonphysician staff is a key marker of their professionalism. The most important thing is to spend as much time talking to the house staff as possible. They’ll be your best source of information and give you the clearest picture of what life is like as a resident in that program.
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What should students do in terms of follow-up after the interview? Dr. Steinberg: Students should be mindful of the post-interview communication protocol and preferences at individual programs. It’s certainly appropriate to send a thank-you follow-up email, but be careful: because email is so easy to send, you need to be mindful that you’re not sending too many. All your thank you emails to those you met at a program may be forwarded ultimately to the program director, so avoid “form letter” type thank you emails. Also, before you ask further questions after the interview, first check to see whether the information you’re seeking was provided on the interview day or is available on the program website. It can work against you if you call and ask about something we went over on the interview day.
You’ve mentioned honesty quite a bit, and you’ve mentioned another trait, professionalism. Can you think of any other top traits that you’re looking for in a candidate? Dr. Steinberg: Yes. It’s what we call interpersonal and communication skills. Do you make eye contact? Are you friendly? Are you polite? Are you respectful? Are you paying attention? I always ask my residents to let me know of any applicants they felt were rude or boastful or otherwise inappropriate--how my residents feel about an applicant’s interpersonal skills holds great weight with me. Also, in this age of social media, very common pitfalls we see are texting or updating your Facebook page on your iPhone when you’re sitting in the interview day orientation session. Sometimes I’ll look out at the applicants I’m speaking to, and there are inevitably a couple of them who are on their phones. It doesn’t necessarily disqualify them, but I do take note and wonder why they’re not paying attention. Along similar lines, one thing that applicants really should not do is approach program directors or faculty members they’ve interviewed with on Facebook. Some program directors may be okay with it. My sense is that most aren’t, so why take the chance?
University of Maryland School of Medicine
The opinions expressed by Dr. Steinberg are his own and do not represent those of Continuum Health Partners.
Jefferson Medical College
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Residency Director Q&A: Earl Norman, MD
Residency Program Director, General Surgery Michigan State University Kalamazoo Center for Medical Studies
What are the most common mistakes you see from candidates applying to your program? Earl Norman: I think the most common mistake is not being prepared for interview questions. When you ask a candidate why they want to go into surgery and they don’t have a good answer, that’s a concern. I asked one candidate this year, “What will you do if you don’t match?” She said, “Well, I don’t know. I’ll go into family medicine, I guess.” It showed a lack of commitment to general surgery. Another mistake is not being able to discuss what’s in their records. Candidates have an ERAS application, which is basically a CV on steroids. It contains every bit of information about them. So if you ask them something and they really can’t elaborate or speak intelligently about, say, research they’ve done, that’s not good. Most people’s records have something that needs explanation. Maybe you took some time off, or failed a clerkship, or you have a negative evaluation that happened to make it into your final application. Obviously those are things an applicant should know about and be prepared to answer for. Another thing to remember is that even informal encounters should be considered a part of the interview. There’s always an informal session in the interview process. It might be a dinner, it might be a lunch, it might be just sitting in a conference room waiting for your interview. There are always going to be residents from the program around, wanting to talk up the program and answer your questions. What candidates need to realize is that they’re being evaluated during those informal times. Nothing is off the record. For instance, we have a dinner the night before the interview. They come in on a Friday, and they go to a hotel, and we put them up. They go to dinner at one of our resident’s homes. It’s a very nice atmosphere: there’s no faculty around. It’s informal. But sometimes we’ll hear back from the residents that one of the candidates was acting weird, or got drunk.
Surgery is a highly sought-after field, and it’s a very specific field. How important are recommendations for you, overall? Do you want recommendation letters to come only from professionals in your specialty? Norman: Primarily. Let’s say I get five letters of recommendation. I want most of them to be from surgeons. If a candidate has a family medicine doctor who really knew them well and was really in their corner, or someone with whom they did research, that person would be a good recommender as well. But the most powerful letter is going to be from somebody in the field that I know, either personally or by reputation.
Residency directors in internal medicine or family medicine talk about the fit being very important. Do you consider how a candidate fits into your program? Norman: Yes. Fit is very important, and that’s part of what we try to ascertain during our interview process. Because we’re a small program, somebody who doesn’t fit can really hurt the program.
Can a student assume if they’ve been invited to an interview that they are desired by that program? Have they passed a significant bar? Norman: Oh, yes. Consider that we start the year with about four hundred applications on the ERAS system, and we try to interview fifty people for two positions.
Applications received: Around 400 Total class size: 2
Those numbers are very different from internal medicine. Do you feel different factors are important for your specialty because you have so many applicants and take so few? Norman: We’re looking for people who want to work very hard and understand the commitment. We’re looking for people who like anatomy. They tell you, “I used to take things apart and put them back together when I was a kid.” We get a lot of people who like to build things, people who have rehabbed houses or cars. People who like to do things with their hands. We also like to see leadership skills. I’d rather see somebody who started an organization on their campus than somebody who was a member of fifty clubs. Somebody who has organized a minority organization—like the Hispanic Women’s Surgery Group or something—that takes a lot of effort. A candidate like that is obviously a leader. Surgeons are considered leaders in the medical community; we like to think so, anyway.
What about experience beyond leadership, but outside of clinical rotations? Is it important for a candidate to have surgery experience in their file? Norman: We want to see somebody who has had experience with research at some level. I’m not looking for somebody to have a hundred publications, but to have been through the process, have their name on a couple of papers, or have worked in a lab for a few months. But I’m also looking for outside activities as well, as I mentioned before. Ask orthopedic surgeons or general surgeons: we love Eagle Scouts—you can get an interview just based on that.
What about board scores and class rank? Do you have any filters on your application? Norman: Everybody wants to downplay the importance of board scores, but in fact they’re vitally important. And we have filters, but our filters are probably lower than filters at Mass General or in an orthopedic surgery program. But everyone has filters. Let’s say your initial filtering is at 220, and you scored a 210. I don’t even see your application. And there are other things you might put in as a filter, such as receiving an honors in a surgery rotation, or making AOA.
How important is the personal statement in your selection criteria? Norman: I have interviewed people based largely on their personal statements. The rest of their application may have been a little weak, but I really loved what they said, or I loved what their history was, and it was so compelling, I felt I just had to meet this person.
You’ve already mentioned leadership. What are some other traits you’re looking for in a good candidate? Norman: I like to see somebody who’s dedicated to something. It might be their family. It might be their church. I like to see somebody who has followed through on something, who is committed to something, is passionate about something. There are some things that transcend place and gender and everything else. We had somebody who took care of her mother when she was sick with cancer. She continued medical school and worked at the same time. You have people who do these incredible things that make you feel like you wouldn’t be able to polish their shoes. These people have already done such wonderful things in their lives. I want to see something that shows that kind of dedication, intensity, focus, and follow-through.
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Residency Director Q&A: Evan S. Bass, MD
Assistant Chief of Service, Department of Family Medicine, Kaiser Permanente South Bay Medical Center Founder and Associate Director, Harbor-UCLA/Team to Win/Kaiser Permanente Sports Medicine Fellowship
What is the biggest mistake people make when they’re applying to your fellowship program? Evan Bass: Probably the biggest mistake we see is candidates not showing an attempt to do some sports medicine during their primary care residency program. We like candidates who have shown an interest in sports medicine throughout their residency. Sports medicine should not be something they decided to pursue at the last minute.
How would a candidate demonstrate that interest? Bass: There are a lot of family medicine residency programs that do quite a bit of sports med. Candidates can cover sporting events, football games, or work with people at the program who do sports med. Also, a lot of residencies have elective time, which allows the candidate to spend some time pursuing options outside of the residency. We like to see applicants who have used that elective time to obtain experience in the sports med area.
What are the top traits you look for in a candidate? Bass: We look for someone who really fits well into the curriculum that we offer. Sports med fellowships are not all the same. They offer quite a variety of experience to the candidate, depending on where the program is located. If, for example, a program is on the campus of a major university, fellows get more experience in that arena. Our program is more community-based; we have a lot more experience with local junior colleges and high schools. Ultimately, what we look for is somebody whose vision of their career seems to fit with the training that we provide.
Applications received: 30 Total class size: 2
we were founded. Other programs don’t have that focus, so we’re really looking for somebody who wants to get out there in the community and help out this group of athletes.
Can you tell me about the interview process? Bass: The people we invite will interview both with the major faculty of the program as well as the current fellows. I actually think the applicants listen more to the fellows than they do to the faculty sometimes! The interview generally lasts about four hours, but we feel it’s very hard to get to know our program that way because our fellowship takes place on three different sites, since we’re a collaborative fellowship between Harbor-UCLA, and Kaiser Permanente. We’re also affiliated with an outside program called The Team to Win, which serves the underserved athletic population of Los Angeles. We have a very open door policy to our fellowship. Every applicant is invited to come back on any day they wish to see our program. We don’t feel the need to put on a show or anything special. We actually tell candidates, “Please dress down. Relax. Come as you are.” We’re not as nationally known as some programs are; we’re not interested in a big bowl game somewhere. But we are kind of local heroes. For that reason, we often get a lot of local people interested in us, people that have come and spent time and said, “This is what I hope to do,” practice in the community doing sports med for the local Joe.
So not somebody who’s got their heart set on being a Chicago Bears team coach? Bass: That’s a good way of putting it. We do tell candidates who are interested in working at a Division 1 university that they should probably look for a program based out of a Division 1 university—like UCLA, for example.
What qualities do you look for in an applicant, in terms of skills or character? Bass: Hopefully candidates have developed some orthopedic exam skills in their residency, but it’s not entirely necessary. We start out our program by focusing on that and giving every candidate some additional training in that aspect of our specialty. We really are looking for somebody who’s fairly resilient and can deal with a lot of different personalities, but I think that’s characteristic of physicians in general.
Can you speak about the importance of board scores and class rank? Bass: We’re not necessarily focused on top board scores. We just want to be sure that the scores are solid. Once somebody gets past the initial screening of applications, usually the scores become less important, and we’re focusing more on the fit of the individual. We’re always trying to find somebody who would be happy with what we provide.
How important is the personal statement in your selection process? Bass: I’d say it’s very important, because it helps us to gauge what this person is looking for. The programs in our area are all very different. Our mission is to serve the underserved athletic population in LA; that’s the premise on which
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Texas Tech School of Medicine
MATCH DAY 2012
SUCCESS STORY Owoicho Adogwa, MD, MPH Vanderbilt School of Medicine Matched at Duke University in Neurosurgery
hen Owoicho Adogwa heads back to his undergraduate alma mater, Duke, there had better be a soccer team close by. Adogwa is a native of Nigeria, who almost became a professional soccer player after his family settled in Trinidad and Tobago. However, at his mother’s urging he decided to accept a scholarship to pursue both academics and soccer at Duke. “She said I at least needed to entertain the idea of having a career, and my father was a professor of neuroanatomy, so I decided to explore this further,” Adogwa said. While serving as a star player on the Blue Devils’ soccer team, his mentor, Dr. Henry Friedman, a neurooncologist at Duke University Medical Center, sparked his interest in neurology and neuroscience. Adogwa acknowledges that it was the sage advice of others that led him to a profession not far from his father’s own. Although now, Adogwa says there is an opportunity to give back through education and mentorship. He hopes to do just that as he pursues neurosurgery at Duke. “I would like to begin by returning to Nigeria about 30 percent of my professional time. I plan to launch an educational foundation aimed at providing financial support, mentoring, and encouraging young men and women to pursue their dreams. I also hope to work with the health ministry to improve the health systems in Nigeria,” Adogwa said.
Adogwa (right) helps classmate Chukwudi Chiaghana (center) celebrate his match in anesthesiology at the University of Florida with a preliminary year at University of Alabama. Their friend, Stephen Tourjee (left) matched in orthopedic surgery at University of Missouri, Columbia.
Duke School of Medicine
Indiana University School of Medicine
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MATCH DAY 2012 Match Photos
University of Hawaii School of Medicine
Creighton School of Medicine
Virginia Commonwealth University
Michigan State University College of Human Medicine
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University of Pittsburgh School of Medicine
University of Texas Medical Branch
Getting in Gear For USMLE
Step 1 and Step 2
By Benjamin van Loon
here’s no fast track on the road to becoming a medical professional. Though daunting, Step 1 and Step 2 of the United States Medical Licensing Examination (USMLE) are necessary bridges for you to cross on the way to full medical licensure. In the tortoise-and-hare world of medical school, the tortoise is the one who has the philosophy for long-term success. Robert Meekins, the Executive Director of Med School Tutors (www.medschooltutors.com), says that, above and beyond everything else, the key for testing well is, “operating in a strategic and structured fashion, utilizing the right resources, staying focused, and using those resources in a carefully scheduled fashion.”
Step 1: USMLE Step 1 is waiting for you at the end of your second year of medical school and is one of the most important tests you’ll have at the beginning of your student career. Combined with letters of recommendation from your years on rotation, USMLE Step 1 score will determine your residency and, as a result, your future career path. Brian Herst, a third year medical student at University of Illinois-Chicago, recently completed USMLE Step 1. He said, “What made me most nervous about going into Step 1 was finding time to study. During the weeks before the test, I was in the books for 12 hours a day.”
When to start According to Meekins, while it is okay to start thinking about Step 1 during your first year at medical school, you don’t need to give it serious thought until your second year. “Students should talk to people who have done well – other students, instructors—and pay attention to what they did to hit the ground running,” says Meekins. You will be taking the test toward the end of your second year and will have between five and ten weeks to dedicate full-time study to the exam. By structuring and regimenting your study schedule prior to this time, and securing access to supplemental study resources, your study will be both fruitful and productive. Meekins suggests, “If you can prep during your winter break [of your second year], then you can gradually do some work throughout most of the second semester, integrating the best Step 1 materials into what you’re already learning.”
Use outside help When asked what he did to bolster his studies for Step 1, Herst said the program “Doctors in Training” was invaluable (www.doctorsintraining.com). It is a two-week digital course with lectures, practice tests, and other supplemental materials. The Northwestern Medical Review (www.northwesternmedicalreview.com) and the Princeton Review (www.princetonreview.com) are also popular test resources. In addition to regimented individual or group-study sessions, utilizing the services of a tutor can be indispensable. Services such as Med School Tutors and USMLE Tutors (www. usmletutors.com) make it their business to match individual students with experienced tutors. According to Meekins, “Anyone who works with a good tutor is going to improve. As long as the student wants the help, then it is going to be a benefit.”
Practice tests and study guides Taking practice tests and examinations by utilizing materials offered directly from the USMLE website (www.usmle.org) or user-based Internet forums is also a way to get you used to the language and prepare you for the unpredictability of test day. Many students often cite the importance of study guides. First Aid for the USMLE Step 1 is a popular guide and is a navigable resource for all things Step 1. There is also the USMLEWorld Q-bank (http://www.usmleworld.com/step1/ step1_qbank.aspx), which is a fee-based USMLE “questions bank” featuring interactive, comprehensive Step 1 Q&A material.
Step 2: Though some of the challenges of USMLE Step 2 are similar to Step 1, the test itself is intended to assess your Clinical Knowledge (Step 2 CK) and Clinical Skills (Step 2 CS). In short, Step 2 is concerned with how you’re applying everything you’ve learned. Dr. L. Somas, Director of the New York Clinical Skills Prep program (www.nycsprep.com), says that the best way to study for Step 2 is practice. “If you want to run 100 meters, you need to run 100 meters. If you want to learn clinical skills, you need to work with patients.” Step 2 is generally taken during your final year of medical
Journal for Minority Medical Students | 53
school. As soon as you’re done with Step 1, you need to start thinking about Step 2.
Stay on schedule Though some of the rules will be different, the study practices you established in taking Step 1 will still apply just the same to Step 2. Though you are being entrusted with more practical experience, you are still a student, and you should treat every encounter—whether it is with a doctor, teacher, classmate, or patient—as an opportunity to learn. While textbooks can teach you knowledge and procedure, bedside manner is what you learn during your day-to-day experience. According to Somas, the best time to start a serious study and pursuit of Step 2 is immediately after the completion of your third year. “Much of what it takes to excel on the Clinical Skills portion is learning to deal with patients,” says Somas. “It’s not about your English skills, it’s about your people skills.”
More outside prep resources PASS Program www.passprogram.net Falcon Reviews www.falconreviews.com Doctors In Training www.doctorsintraining.com USMLE World www.usmleworld.com National Board of Medical Examiners www.nbme.org
Use outside resources There are a wide variety of virtual Step 2 CS and CK preparatory services. Step 2 Clinical Skills Review (www.step2cs.net), Med School Tutors (http://medschooltutors.com/) and a wide host of one-on-one tutors are excellent resources for specialized knowledge and skill test prep. Practice exams offered by resources such as New York Clinical Skills Prep (www.nycsprep.com) and Ximedus (www. ximedus.com) also offer specialized, hands-on walk-throughs that have you shadow or simulate patient encounters. This preparatory experience bolsters your confidence with patients and gets you used to physical encounters with real people.
Step Up Though USMLE Step 1 and Step 2 are different exams, they both require the same fundamental approach. Both should be considered long before you set the test date, both call for strict schedules of regimented study, and both can strain your nerves. However, the stress of these tests can be abated by a conscientious, open-minded approach to study. Preparatory clinical experience, practice exams, study guides, and tutoring from skilled peers and professionals are available for both Step 1 and Step 2. Don’t hesitate to consult with instructors or senior students to learn what they did to prepare. Pace yourself like the tortoise. Build good study habits and understand the importance of small steps early on so you’re ready for when it’s time to make the big moves. This way, you won’t need to sweat the small stuff—or the big stuff.
54 | Journal for Minority Medical Students
Medical College of Wisconsin
#1 USMLE and COMLEX Prep Program Offering: • USMLE Steps 1, 2 & 3 prep • COMLEX prep • One-to-one physician tutoring • M1 Pre-matriculation program • On-line video lecture
Dr. Francis Ihejirika
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Click and move...
MATCH DAY 2012
SUCCESS STORY Louis Frazier Wake Forest School of Medicine Matched in Emergency Medicine at Vanderbilt
ouis Frazier, a fourth-year student who went through the Match this year, has always dreamed big. When his fifth-grade teacher asked Frazier to draw a picture of himself as Time magazine’s “Person of the Year,” he knew he wanted to become a doctor. “My aunt had a history of breast cancer,” he said. “So I drew myself as a doctor of the future, finding a cure for cancer.” But realizing that childhood dream would not be easy. His biological father died of alcoholism before Frazier reached high
school. He saw family members use illegal drugs. Gang activity was common in his neighborhood; a cousin was shot and killed. Despite his circumstances, Frazier was focused on building a positive future. “Something inside me said that wasn’t the path I should take.” In 2003, Frazier was accepted at Wake Forest University on a full athletic scholarship to play left tackle on the football team. He majored in biology with double minors in chemistry and sociology. He faced a major setback, however, when he suffered a knee injury in the 2005 season. David Martin, MD, professor of Orthopaedic Surgery at Wake Forest School of Medicine and director of Sports Medicine for Wake Forest University, examined Frazier and found his anterior cruciate ligament (ACL) was torn. Although treatment for the ACL injury required surgery Match Day 2012, Frazier’s dream of becoming a doctor came true: he matched and six months of rehabilitaat Vanderbilt in Emergency Medicine. tion, Frazier wasn’t one to
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give up easily. A typical day included class, practice, treatment for his knee, and finally, time for study, said Frazier. “I definitely put the hours in.” And his hard work paid off. The next year, Frazier became the first Deacon football player to be named to the ESPN The Magazine Academic All-America first team since 1959. To be nominated for the Academic All-America team, a student athlete must be a sophomore starter or significant reserve on their team with a 3.20 cumulative grade point average; Frazier had a 3.76 GPA. He was a member of the Dean’s List as well as several honor societies, including Phi Beta Kappa (the nation’s oldest academic honor society). Frazier had accomplished so much athletically and academically that he had to make a choice: try out for the NFL or continue his pursuit of a medical degree. He turned to his adoptive family for guidance. Mark Matson, his wife, Angela, and their two sons and daughter had been part of Frazier’s family since he was in the 10th grade. “Angela said, ‘You need to study medicine.’” Match Day 2012, Frazier’s dream of becoming a doctor came true: he matched at Vanderbilt in Emergency Medicine. “People told me I couldn’t play Division I football and go to medical school,” he said. “Every step, I had to prove myself.” —by Michelle Porter Tiernan
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This is the Life:
A Peek Inside The Royal Hotels of Mexico By Leea Joseph
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esigned for the most discerning guests, THE ROYAL in Cancun and THE ROYAL Playa del Carmen are luxury-gourmet, allinclusive, all suite, adult only resorts. Each resort boasts the best location in its destination with wide expansive beaches, yet adjacent to the shops and exciting nightlife of Cancun and Playa del Carmen. Created for romance, these resorts offer ambience, gracious service, lavish amenities and sumptuous dining.
The Royal in Cancun THE ROYAL in Cancun is the flagship hotel for Real Resorts. It is a luxury-gourmet, allinclusive, all-suite resort located beachfront in the heart of Cancun’s famous Hotel Zone. It is the only hotel in Cancun with an ocean view spa (SPAzul) and is conveniently located next to its sister property, the Gran Caribe Real Cancun. All of its 288 ocean view suites have views of the Caribbean and feature large balconies with hammocks for relaxation. In addition to magnificent views of the turquoise blue Caribbean waters and a large white sand beach, guests will enjoy outstanding facilities with exceptional amenities and a wide selection of gourmet dining including the resort’s signature restaurant, Chef’s Plate, where a unique chef selected nouvelle cuisine menu is served private club style each evening. THE ROYAL in Cancun is the first Cancun resort to be recognized with the American Academy of Hospitality Sciences’ International Star Diamond Award. It has received the award for two consecutive years in 2009 and 2010.
The Royal Playa del Carmen Guests will discover an explosion of luxury around every corner at the gourmet-luxury, all-inclusive, adult only ROYAL Playa del Carmen. This casually elegant beachfront resort is the jewel of the Rivera Maya with breathtaking views of the turquoise Caribbean. Yet its beachfront location is only steps from Playa del Carmen’s famed Fifth Avenue. Discover hip night spots, trendy cafes, colorful shops and the local color of this fishing village while experiencing THE ROYAL’s flawless hospitality. The resort’s interior is as impressive as its palatial exterior, where the use of textures, fabrics and natural materials reflect sophisticated seaside grace. Each of the resort’s 508 guest suites is richly appointed and most enjoy an ocean view or are oceanfront. The exquisite furniture is handcrafted by local artisans and guests will enjoy an array of unique and exceptional amenities designed to make their experience perfect. In addition, the recently completed new wing of the resort includes super luxury two story Presidential Suites that feature a private splash pool with a 360 degree view of the beach and Playa del Carmen.
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Sustainability Real Resorts has recently joined efforts with MARTI, an organization that merges government and private capital in an important tourist project focusing on the Meso-American Reef preservation, one of the most sensitive areas of the Mexican Caribbean. In keeping with its environmental commitment, Real Resorts recently announced a new sustainability program ‘Real Green,’ at all four of its resorts.
Other unique features of both hotels • Adult only, minimum guest age is 16 years old. • All suites feature an in-suite double spa tub and 24 hour complimentary room service • A choice of suite accommodations including the unique Beachfront Swim-up Master Suites with private swimming pools. • Gourmet dining in a selection of restaurants offering international a la carte cuisine, as well as buffet service. • The signature SPAzul which offers a wide variety of eco-holistic and Mayan influenced treatments including the Temazcal ancient ritual. • A Life Fitness® Center with a Stott Pilates® program • A selection of wedding services including an ancient Mayan influenced celebration • A Beach Butler offering complimentary suntan lotions, books, magazines and fresh fruit throughout the day
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Location The Royal Playa del Carmen is steps from the town’s famous Fifth Avenue shopping and entertainment district. The Royal in Cancun is minutes from downtown bars, clubs and Cancun Plaza for high-end shopping like Louis Vuitton. Both locations have an endless number of amenities and personal butler service that would make anyone feel like royalty. There’s a restaurant to satisfy a wide range of preferences, plenty of nearby night-life, and plenty concierge to direct guests to every sort of excursion possible. The Royal Resorts can simply be regarded as “Heaven with a beach-front.” For more information and reservations visit: www.RealResorts.com.
Thinking about a Psychiatry Residency?
We can help! MUSC has a world-class department of psychiatry with a strongly embedded, vibrant and progressive residency training program. We have a large general program, combined med/psych and neuro/psych programs, plus numerous opportunities for research, community work--as well as fellowships in addictions, child, forensics and geriatrics.
Join us on the web to learn more... www.musc.edu/psychresidency Department of Psychiatry & Behavioral Sciences
Charleston, South Carolina
firstname.lastname@example.org 62 | Journal for Minority Medical Students
A SECOND OPINION, PLEASE
The Case of the Sinister Sinus Pain By John Dunn, MD
Anthony: No, seriously, Maria! Watch this one! (Anthony spins and leaps into the air, knocking over a desk).
Yvonne: Yeah, the show is brand new. But there’s no shortage of contestants, in this very room!
Maria: Uh huh…
Holmes: I see. Well, perhaps I can catch it some time. For the moment, however, I’m hoping one of you will regale me with something a bit more…academic.
Anthony: Yeah, well, there will be lots more room on the set. Maria: Uh huh…. Anthony: Seriously! And J Lo, she’s like, she’s so smooth, girl...I’ll just spin her to the... (slips and falls flat on his back as Yvonne enters the room). Maria: Floor. I see. Yvonne: You do? All I see is some fool destroying the room. Anthony: Oh yeah? You’ll be talking out of the other side of your mouth when I nail down the title. Yvonne: I wish you’d just nail down your head for a change. What in the “h” are you doing? Maria: He’s practicing for “Dancing with the Stars.” (Holmes enters briskly.) Yvonne: Don’t you mean “Dancing with the Morons?” Holmes: I don’t believe I’ve seen that program, Yvonne. Something new?
Yvonne: Sure, Doctor Holmes. Let me tell you about a new patient of mine. Holmes: By all means, please proceed. Yvonne: MW is a 28-year old woman who presented to the Ambulatory Care Clinic yesterday with a three-day history of coughing up blood. About two weeks ago she developed a cold, which exacerbated her asthma, so she saw her primary care doctor who put her on prednisone. She also complained of low-grade fever and mild nausea for a couple of weeks, plus an itchy rash on her right lower leg. She denied chest pain, diarrhea, joint pains or neurological symptoms. Holmes: A most unusual constellation of symptoms, Maria. Please continue. Yvonne: Other than mild asthma and mononucleosis she’s been pretty healthy. She’s on no medications and has had no major surgeries. Socially, she’s single with a steady boyfriend, and works for an international aid organization called “Seeds for Self Reliance,” which helps poor farmers in Haiti and the Dominican Republic. Maria: Has she been on any trips there recently? Holmes: Excellent question, Maria! Yvonne: Well, she said she goes there every six weeks or so, so I guess so. Oh, and she doesn’t smoke, has a rare glass of wine, and denies recreational drugs. Maria: Does she have any family history of hemoptysis or bleeding disorders? Yvonne: I don’t think so. Her mother had breast cancer and her father has hypertension. Holmes: Very good, Yvonne. Does anyone have any comments? Anthony: Yeah. I do! Yvonne: And?
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A SECOND OPINION Anthony: I think the Lakers will take it this year. Yvonne: Oh yeah? And I think your head is so far up... Holmes: Ahem! Yvonne: Sorry, Doctor Holmes. Let’s just say he won’t have to worry about sunscreen this summer. Holmes: I am happy to see you express such concern for your classmate, Yvonne. Could you please tell us what you found upon examining your patient? Yvonne: Sure. She’s a thin, somewhat nervous-appearing 28year old woman. Her temperature was 37.5 degrees Celsius, BP 95/60, respirations 24 and heart rate 110. Her HEENT was unremarkable, with no scleral icterus, and no signs of bleeding or masses. Her neck was supple, without adenopathy. Her lungs had bibasilar crackles and scattered wheezes, and her heart sounds were normal. Her abdomen was soft and nontender, with no organomegaly or masses. Her skin was pretty interesting, though. Holmes: Indeed? Anthony: Yes, indeed! Yvonne: Must be an echo in here. Did Anthony open his mouth? Sounded sort of like the Grand Canyon… Maria: Or Canyonlands. What was the rash like? Yvonne: Kind of like a track of some sort. You know, a raised, red track that kind of meanders up her leg. Holmes: Fascinating! Maria: I hate when he says that. Hey, how were her labs? Anthony: My grandmother had a lab once. Yvonne: Huh? Anthony: Yeah, a chocolate one. His name was Piper… Wait a minute, did I say “chocolate?” Yvonne: The only “chocolate” around here is stuck between your...
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Holmes: Yvonne. Yvonne: Oops! Sorry about that, Doctor H. On laboratory examination her hematocrit was normal, and her white blood cell count was 12,500, with 15% eosinophils. Holmes: Really! How extraordinary! Pray do continue, Yvonne. Anthony: Pray? Here? Yvonne: Her electrolytes and other blood chemistries were normal, and her chest x-ray showed ground glass opacities of both lower lobes, consistent with infiltrates, interstitial lung disease or hemorrhage. Holmes: My goodness! This is a fascinating foundation of findings! I hope you like my alliteration. Anthony: Hey, somebody called me “alliterate” once, too… Yvonne: What a surprise… Holmes: Allow me to summarize the case for our readers. We have a generally healthy 28-year old tropical traveler who developed an acute lower respiratory process with hemoptysis following treatment for asthma with steroids. She has an unusual serpentine rash and a striking eosinophilia. Let’s ponder the differential diagnoses for both hemoptysis and eosinophilia and seek something that fits.
A SECOND OPINION: THE ANSWER Holmes: So, who would like to take a try at eosinophilia?
Maria: Anthony! That was great! Way to go!
Holmes: Ah yes, the time-honored mnemonic!
Anthony: Yeah, well, tell that to “she of little faith” over there.
Anthony: Pneumonia? Maria: No, Anthony: mnemonic. You know, where each letter... Yvonne: Give it up, Maria. Just lay it on us. Maria: OK. N is for “Neoplasm,” the first A is for “Allergy,” the second A is for “Asthma,” the C is for “Collagen Vascular Diseases,” and the P is for “Parasites.” Or Protozoans. I forget which. Holmes: Either one is fine, Maria. Very good. The three most common causes of elevated blood eosinophils are allergic, infectious and neoplastic. Included under the neoplasm heading would be some of the acute and chronic leukemias, myelodysplastic disorders, Hodgkin’s and non-Hodgkins lymphomas, and the so-called “hypereosinophilic syndrome.” Under the allergic heading one might add reactions to medications, which is a common cause of eosinophilia, and various toxins. Collagen vascular diseases associated with eosinophilia include SLE and other forms of vasculitis, and there are many infectious processes that can result in elevated eosinophil levels. The most common infectious causes include, as you said, Maria, parasitic infections and, in particular, worms of the helminthic variety, as well as fungal diseases such as aspergillosis and coccidiomycosis, and retroviral infections such as HIV. Yvonne: Wow…that’s quite a list, Doctor Holmes. Holmes: Yes, and that’s only a partial one. As you see, hypereosinophilia is a common finding in myriad illnesses. Anthony: Yeah. What’s a “myriad illness?” Holmes: Hmm. Anthony, why don’t you tackle the causes of hemoptysis? Anthony: Sure, Doc. No problema. Well, there’s…there’s… coughing up blood. Yvonne: Coughing up blood is hemoptysis, you hamburger head! Anthony: Be cool, Jules! I’m just warming up. Well, first you got your airways diseases, like bronchitis, tumors, foreign bodies and such. Then you got your lung parenchymal diseases, like infectious pneumonias, or inflammatory diseases like Wegener’s, Lupus and Goodpasture’s. And finally you got your vascular causes, like PE’s, AVM’s and other vascular anomalies.
Yvonne: Maria’s right, Anthony. I am impressed. I don’t know how you did it, but I am impressed. Kind of like a magic trick, I guess… Holmes: Yes, excellent work, Anthony. So, if we cross-reference the two lists we’ve created, it seems to me there are two major areas where they intersect: the infectious etiologies, or the inflammatory ones. Under infection we would need to consider acute bacterial, fungal or parasitic infections, and under inflammatory we must needs consider connective tissue diseases like Lupus or other forms of vasculitis. Maria: That makes sense to me, but what’s the next step? Holmes: Ah! We must look for additional clues to steer us in one or the other direction. Remember, sometimes the answer is staring us right in the face. Anthony: Yvonne? Yvonne: No, you micro-mental mush mind! It’s her skin! That’s what’s staring us right in the face! It’s that rash, Doctor Holmes, isn’t it? Holmes: Indeed, I believe you are right, Yvonne. There is a pathognomonic raised red track, caused by the migrations of parasitic larva, known as “larva currens,” or “running larvae.” Anthony: Curried larva? No, I’ll pass on that one, Doc. Holmes: And so you should. Larva currens is caused by the helminthic parasite Strongyloides stercoralis. Yvonne: Like Anthony on a motorcycle? Oops! That’s a “helmeted parasite.” My bad! Holmes: Ahem. Strongyloides is a parasitic worm generally found in tropical or subtropical regions, including the southeastern United States. Filariform larvae, living in soil, penetrate the feet of their hosts, enter their bloodstream, and thence to the lungs. From here they migrate up the tracheobronchial tree, are swallowed into the esophagus and wind up in the duodenum or jejeunum, where they may reside for several years. Maria: It’s amazing that a worm like that can live for so long! Yvonne (glancing coolly at Anthony): Not really. Holmes: Clinically, symptoms of “strongyloidiasis” may persist for years, and typically include gastrointestinal,
Journal for Minority Medical Students | 65
PHYSICAL MEDICINE AND REHABILITATOIN
REHABILITATION INSTITUTE OF CHICAGO/NORTHWESTERN UNIVERSITY MEDICAL SCHOOL Chicago, IL
CINCINNATI CHILDREN’S HOSPITAL MEDICAL CENTER Cincinnati, OH
Providing medical care to this nation’s estimated 40 million physically disabled citizens is a responsibility that often falls to the physiatrist—the physician specializing in the field of physical medicine and rehabilitation. Patients commonly seen by a physiatrists include children and adults who have disabilities such as hemiplegia; paraplegia; quadriplegia; amputations; arthritis; fractures; pulmonary, vascular, and neuromuscular diseases; and other less disabling conditions. The Department of Physical Medicine and Rehabilitation at Northwestern University Medical School offers a program of interdisciplinary studies centered at the Rehabilitation Institute of Chicago (RIC), with associations at Veterans Administration Westside Medical Center, Northwestern Memorial, Children’s Memorial, Illinois Masonic Medical Center and Alexian Brothers Hospitals. With more than three decades of experience in the field, RIC is dedicated to excellence in research, education and providing comprehensive care programs to the physically disabled. A 176-bed private, nonprofit freestanding facility, RIC was named top rehabilitation hospital in the country by US News & World Report for 21 years in a row.
Cincinnati Children’s is a national leader in pediatrics. As a major academic pediatric medical center, we attract patients from all over the world, conduct pioneering medical research and offer outstanding teaching programs. We work closely with community based caregivers. Our vision is to be the leader in improving child health and in preparing tomorrow’s pediatricians. We are proud to be ranked third in National Institutes of Health funding to children’s hospitals and pediatric departments nationwide. In addition, US News and World Report consistently ranks Cincinnati Children’s Department of Pediatrics as one of the top three departments in the country.
Information: Office of GME Northwestern University Medical School Address: 420 E. Superior Street Rubloff Building, 12th Floor Chicago, IL 60611 Contact: James Sliwa, DO Residency Program Director Rehabilitation Institute of Chicago 345 E. Superior St. Chicago, IL 60611 www.northwestern.edu/pmr email@example.com Applications: Electronic Residency Applicatoin System (ERAS) firstname.lastname@example.org www.aamc.org/cras 202-828-0413 202-828-1125
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Running the Numbers Number of beds: 475 Annual admissions, including short stays: 27,392 Radiologic procedures: 150,000+ Outpatient visits (includes satellites): 790,949 Emergency department visits: 93,456 Surgical procedures (inpatient and outpatient): 29,168 Critical care admissions (cardiac, ICU, NICU): 3,287 Interactive Team Care Each ward team is made up of four PL-1’s, with primary responsibility for patients on their ward and two PL-2 or PL-3 supervisors. Each team also includes a faculty member who makes rounds and plays an integral role in teaching. The teams cover wards that admit primary pediatric and subspecialty patients of all ages. Please contact us or visit our website: Pediatric Residency Training Program Cincinnati Children’s Hospital Medical Center 3333 Burnet Avenue, ML 5018 Cincinnati, Ohio 45229 (513) 636-4315 www.cincinnatichildrens.org
A SECOND OPINION: THE ANSWER dermatological and pulmonary manifestations. In the GI tract, duodenitis with nausea and vomiting are common. There are several skin findings, including a nonspecific erythematous dermatitis known as “ground itch,” periumbilical purpura and this larva currens pattern we see in Yvonne’s patient. Yvonne: Wow…all that from a worm? Maria: Yes, and hemoptysis, too? Holmes: Although uncommon, hemoptysis does occur with strongyloidiasis, particularly in patients who are being treated with immunosuppressive drugs, as was Yvonne’s patient when she received steroids for her asthma flare-up. In some cases a cycle of autoinfection can lead to a massive parasite burden and the so-called “hyperinfection syndrome.” This massive dissemination of larvae results in severe inflammation of the lungs, liver, heart, central nervous system and endocrine glands, which can progress to septic shock and death.
optimal therapy in patients with severe disease is not clear, although the antihelminthic agents ivermectin and albendaozole have both been used with success, sometimes in combination. Maria: But first we have to prove that’s what it is, don’t we? How do we do that? Stool samples? Holmes: Yes, stool samples are certainly one traditional way of detecting the parasite, as is an aspirate of duodenal fluid, but Strongyloides can also be detected serologically, by ELISA or PCR testing. Yvonne: All right! Let’s do this thing, then! I’ll order the PCR, Maria can you order the ELISA, and Anthony... Anthony: I’ll order the pizza, OK? Yvonne: No, actually, Anthony, that just leaves one thing for you to do. Anthony: Oh, really? And what is that, O Mighty One?
Yvonne: That is one nasty parasite, Doctor Holmes. How can we get rid of it? You know, some parasites are notoriously hard to get rid of.
Yvonne: YOU start collecting…the stool samples!
Holmes: True enough, Yvonne. Fortunately, Strongyloides tends to be fairly susceptible to antibiotic therapy, although cases of disseminated disease can be more resistant. The
Yvonne: I can see it now, Anthony: “Fools Dancing with Stools.” Has a nice ring to it, huh?
Anthony: Why am I not surprised?
BRIGHAM & WOMEN’S HOSPITAL Boston, MA The Internal Medicine program at Brigham & Women’s Hospital is a national leader in clinical training and research. As a major academic center, we are at the forefront of medical research and innovative curricular development. We draw patients from a large international referral base as well as our large local diverse population, and we are one of the largest providers of free medical care in the state of Massachusetts. Our vision is to promote healthcare and health equality throughout the region, and we are dedicated to recruiting, training and retaining a housestaff and faculty that reflect the diversity of our patient population. We will be accepting applicants to our categorical medicine, primary care medicine, combined medicine/pediatrics and preliminary medicine programs. Key Hospital Information: Number of beds: 777 Inpatient Admissions: Over 45,600/annually Ambulatory Visits: 773,000/annually Emergency Department Visits: Approximately 58,000/annually Contact: Nora Y. Osman, MD Assistant Program Director Office of Minority Affairs email@example.com (617) 732-5775 www.brighamandwomens.org/residency
Match Day 2012: University of Alabama at Birmingham School of Medicine
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FACULTY POSITION The Sidney Kimmel Comprehensive Cancer Center (SKCCC) at Johns Hopkins Leukemia Clinical Investigator
A dvertiser ’ s I nde x
American Academy of Family Physicians . . . . . . . . . 4 American Academy of Orthopaedic Surgeons . . . . . 5 American Academy of Pediatrics . . . . . . . . . . . . . . 8 Aurura Health Care . . . . . . . . . . . . . . . . . . . . . . . 7 Children’s Hospital of Boston . . . . . . . . . . . . . . 22-23 Cincinnati Children’s Hospital . . . . . . . . . . . . . . . 12 Harvard Medical School . . . . . . . . . . . . . . . . . . . 10 Johns Hopkins Medicine . . . . . . . . . . . . . . . . . . . 68
The Johns Hopkins SKCCC is recruiting a clinical investigator with expertise in leukemia/myelodysplasia/ myeloproliferative disorders. This individual will participate in an active clinical and research program in leukemia, should be board certified/eligible in medical oncology or hematology, and eligible for licensure in the State of Maryland. Responsibilities will include: attending on inpatient leukemia service, attending and supervising fellows in outpatient clinic, and developing and supervising research protocols. The academic appointment will be commensurate with the individual’s experience. The Johns Hopkins University, an EEO/AA employer, is committed to increasing the representation of women and members of underrepresented groups on our faculty and encourages applications from such candidates. Applicants should provide a letter of interest, curriculum vitae/ bibliography and the names of three references to:
Kaiser Permanente . . . . . . . . . . . . . . . . . . . . . . CV2 Medical University of South Carolina . . . . . . . . . . 62 Michigan State University Kalamazoo . . . . . . . . . . . 8 Morehouse School of Medicine . . . . . . . . . . . . 28-29 North Shore Long Island Jewish Health System . . . . . 2 PASS Program . . . . . . . . . . . . . . . . . . . . . . . . . . 55 U.S. Navy . . . . . . . . . . . . . . . . . . . . . . . . . . . . CV4 University of Alabama at Birmingham . . . . . . . . . . 12 University of California at Davis School of Medicine 15 UCLA Intercampus Medical Genetics Residency Programs . . . . . . . . . . . . . . . . . . . . 16-17 Vanderbilt University . . . . . . . . . . . . . . . . . . . . . CV3 Western Connecticut Health Network . . . . . . . . . . 18 R E S I D E N C Y I nde x
PHYSICAL MEDICINE & REHABILITATION Rehabilitation Institute of Chicago . . . . . . . . . . . . . 66 Pediatrics Cincinnati Children’s Hospital . . . . . . . . . . . . . . . . 66 internal medicine Brigham & Women’s Hospital . . . . . . . . . . . . . . . . 67
Richard J. Jones, M.D. Co-Director, Hematological Malignancy Program The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins 1650 Orleans Street-Room 244 Baltimore, MD 21231 firstname.lastname@example.org
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Major strength lies in the quality of our faculty, residents and students
OFFiCE FOR DiVERSiTy HOUSE STAFF AND FACUlTy AFFAiRS
Vanderbilt School of Medicine is seeking to bring the best residents, fellows and faculty from all ethnic, racial and gender groups into this great Medical Center. As we broaden our reach, you will enrich our environment and make Vanderbilt a leader in promoting people of diverse backgrounds. We invite you to visit Vanderbilt and learn more regarding our training programs or visit our website at www.mc.vanderbilt.edu/gmediversity. U.S. News & World Report listed Vanderbilt Medical Center 16th on its 2009 “Honor Roll” of hospitals, a tribute reserved for a select group of institutions labeled the “best of the best.” Vanderbilt is the third fastest growing health sciences center in the country in research funding
The Monroe Carell Jr. Children’s Hospital at Vanderbilt has been ranked No. 15 on a listing of best children’s hospitals in the U.S. by Parents magazine, the third national accolade earned by the hospital this year. Our office supports the Minority House Staff for Academic and Medical Advancement (MHAMA), an organization of Vanderbilt house staff and advisors www.mc.vanderbilt.edu/mhama. Contact us by e-mail at email@example.com. or call 615-343-7958 André L. Churchwell, MD Associate Professor of Medicine (Cardiology) Associate Dean for Diversity in Graduate Medical Education and Faculty Affairs Vanderbilt University School of Medicine