How to make the big decision: gathering information as an M3?

Owen Phillips, MDAssociate Dean, Student Affairs

As M2s

You have had a preceptor experienceYou have had personal experiencesYou may have preconceived notions- some may be true, some may be falseYou need information

CiM Four Year TimelineM-1 August CiM Intro

March Phase I Self Assessment

Summer Shadowing

Research

Volunteer

M-2 February Phase II Getting ready for Career Exploration

M-3 Fall Alumni Panel Discussion

Clerkships

Student AMA lunches

January Phase III Career Day

April Phase IV Strolling thru Match

M-4 Fall ERAS

Dean’s Letter

Reviewing your Careers in Medicine Protocol?

Visit the Careers in Medicine website?www.aamc.org/careersinmedicinewww.aamc.org/students/cimDid you get to know yourself by completing the self-assessment sections on the site?

Discover your own CiM website

OLSEN on the UT COM pageSpecialty ProfilesDepartmental information-– Program director– Chair– Other faculty members willing to help

“If you want more information”

Think back to the Critical factors

AutonomyCaring for PatientsContinuity of CareDiversity Focus of ExpertiseInnovative thinkingIntellectual ContentInteracting with other PhysiciansManual/Mechanical Activities

PressureResponsibilitySecuritySense of AccomplishmentStatus among ColleaguesPatient CharacteristicsTypes of Illnesses

Gathering Information

With that review, you know what you want in life and in medicine, it’s time to find what specialty will fit your needsGo to the Specialty Profiles in the CiM websiteThis is a great place to start exploring your many choices.

AAMC CiM Specialty Profiles

Nature of the WorkPersonality CharacteristicsResidency Requirements- what is required to get inMatch DataWorkforce StatisticsCompensation

It’s a start

You think you really like Peds but you also like procedures as well. The specialty profile shows that procedures are very low in PedsBut this profile doesn’t take into account neonatology, Peds cardiology, Peds ER and Peds GI which all are very high in procedures.

Expand

Don’t just evaluate one profile - do the same exercise with other similar profiles.You may learn that you are a closer match to similar specialty than the one you first considered.Also, make comparisons in specialties you never considered – you may be surprised.

Other Online Resources

AMA-Freida- AMA’s Fellowship and Residency Electronic Interactive Database Access Provides statistical information about each specialty, information about GME programs, and institutional offerings by specialty and geographic location.

Be vigilant about your career choices

While an M3---– Talk to clerkship directors, residents, physicians you

come in contact withTry it on- tell people you are considering ***Ask questionsElectives- UT gives flexibility to do some electives earlyBe realistic

Specialty Associations

Join the academies at reduced student rates

Visit specialty Web Sites – AAP, AAOS, etc.

This and other information on your UT CiM site

Personal Contact

ClerkshipsSummer ExperienceFaculty Mentors (see CiM website)Private PractitionersResidentsFriendsBe aware of the variable reliability of each sourceThere are many misconceptions out there!

Surveying the Alternatives

Canvas and wide range of alternatives

Be open to new alternatives as you have different experiences on clerkships

Talk to the residents: do you look like them; do you like what they do?

Try it on

Discuss your ideas with others

Just like trying on clothes

Don’t commit too soon- it could make it harder to change your mind

Inoculate yourself

After you’ve made your decision, review the negativesThis will inoculate you against overreaction and criticism to your decisionIt will help you during negative experiences during residency

Consider Alternatives: Realities

Some specialties are hard to match into– Plastic surgery - Neurosurgery– Urology - Otolaryngology (ENT)– Dermatology– Orthopedics

AAMC- match informationConsult the program director, talk to me

Charting Outcomes in the Match Characteristics of Applicants who Matched to their Preferred Specialty in the 2005 NRMP Main Residency Match A collaborative project of the National Resident Matching Program and the Association of American Medical Colleges

Paul Jolly, PhD Division of Medical School Services and Studies Association of American Medical Colleges July 2006

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Matched

Not Matched

If I know I want to go into a particular specialty, should I schedule that clerkship first or last?

Two ways to look at it

First or near the beginning of the third year

To see whether I do like it

Last or near the end

In order to be experienced and excelAnd to be fresher on everyone’s mind and nearer to residency recruitment time

My experience

UT students are ‘ready’ from the first clerkship and the excellent, interested students shine in the first rotation

Faculty and residents have good memories- if you are a good student, the impression of you will last

I want to take as many third-year rotations in Knoxville or Chattanooga as I can

Will this limit my ability to get into any residency programs

Third-year rotations away

Knoxville and Chattanooga programs give excellent experienceYour residency choices will not be limitedWe encourage students to take rotations at our other campusesIf you do your rotations in KN or CH, you can always do an M4 elective back in Memphis

Any advantages to doing rotations at Chatt or Knox.

Course directors from there will speak to thatAsk M4s who have had experience thereSome clerkships are community-based and give an educational experience that is really ‘best’ for you

Advantages

Smaller residency programs- usually 2-4 residents/yearFaculty involvement may be private doctors who are affiliated with the residencyPatients may be private patientsMay be more one on one with a faculty member

M4 Away Rotations

Some residency programs are very competitive and you will need to do a rotation there to even be consideredIt is a good way to get an insider’s look at the programThe department chair should know the scoop on such programs and will be able to advise you.

How to schedule ‘away rotations’

Talk to UT, Memphis chair or program directorWill need to get a signature on the UT form (available in the catalog)Go to the websites of the outside colleges about procedure and contactsGet this ball rolling in Jan. or Feb.

M4 Away rotations

PitfallsIf you don’t ‘shine’ while away, you may have done yourself harmBy the time you learn the new system, you may not match up to the home boys (or girls) “Got to get into Harvard”

What about fourth year electives here at UT

Again, discipline-dependentFor Ob, your best impression was as a third-year clerk. We would rather see you take dermatology or radiology than do an electiveFor Orthopedics, you may need the visibility.If you did your clerkship in Kn or Ch, you may wish to have ‘Memphis exposure’You should ask

Should I have research on my CV to be competitive

Some programs are requiring research in the field to be competitive

Research

Difficult to do meaningful research during third-yearPrograms where this an issue are the competitive fields: Otolaryngology, Urology, NeurosurgeryFind a professor-level faculty member and ask for advise (CiM website has research mentors listed)

Ask for advice

Thinking: “it is either Peds or Med-Peds”

Talk to the clerkship director or another faculty member

Will help you sort out your thinking process or suggest opportunities that will help (a shadowing experience in a private office)

Ask for advice

“Pretty sure it’s Med-Peds”

But have some questions about my competitiveness and need to stay in Memphis

Talk to the program director

Ask for advice

Once you have committed to a specialty, you should talk to the chair of the department: call the office and make an appointment. Email may not be best

You will need a chair’s letter for your ERAS application.

What about the residency interview process

May- Strolling through the Match- an orientationWe will talk about– When and how to schedule dean’s letters– Other letters of reference– Preparing a personal statement– Preparing your CV– The timeline

The Process

Early matches- neurology, ophthalmology, urologyAugust- Early match applications due,– interviews in Sept-Dec.

October-For the rest, applications due– interviews- Nov-Jan

M3

Work hard

Pay attention

Have fun