How to Survive your 4How to Survive your 4thth Year Year of Medical Schoolof Medical School

By Erik PaulsonBy Erik Paulson

ObstaclesObstacles

Selecting a SpecialtySelecting a Specialty Audition RotationsAudition Rotations Board ExamsBoard Exams ERASERAS InterviewsInterviews The MatchThe Match ExpensesExpenses

Waiver of LiabilityWaiver of Liability

All dates in this presentation are All dates in this presentation are for 2009. Since you will be for 2009. Since you will be applying for residencies in a applying for residencies in a different year, the dates may different year, the dates may change.change.

Selecting a SpecialtySelecting a Specialty

Interest, Lifestyle, Compensation, Interest, Lifestyle, Compensation, Personality, Competition.Personality, Competition.

ResourcesResources Iserson’s Guide to Getting a Iserson’s Guide to Getting a

ResidencyResidency Aptitude Test can be found at:Aptitude Test can be found at:

http://www.med-ed.virginia.edu/http://www.med-ed.virginia.edu/specialties/specialties/

Setting up Audition Setting up Audition RotationsRotations

What is an audition rotation?What is an audition rotation? A rotation in the specialty that you plan to A rotation in the specialty that you plan to

do a residency in, at a place where you do a residency in, at a place where you would like to do a residency.would like to do a residency.

How many audition rotations should I How many audition rotations should I do?do? As many as your school will let you!As many as your school will let you! As many as you can fit in before December As many as you can fit in before December

(that is when interviews normally begin)!(that is when interviews normally begin)! 24 weeks of core rotations24 weeks of core rotations 16 weeks of electives (4 months of audition 16 weeks of electives (4 months of audition

rotations)rotations)

Setting up Audition Setting up Audition RotationsRotations

When should I do audition rotations?When should I do audition rotations? Start of 4Start of 4thth year year

July, August, September, October, NovemberJuly, August, September, October, November

How do I schedule audition rotations?How do I schedule audition rotations? Find programs you may be interested inFind programs you may be interested in

http://opportunities.osteopathic.org/searchhttp://opportunities.osteopathic.org/search Call them Call them nownow and ask if you can and ask if you can

schedule a rotation. If they say it is too schedule a rotation. If they say it is too early, ask them when they begin early, ask them when they begin scheduling rotations.scheduling rotations.

If they are full, you can still rotate in If they are full, you can still rotate in another field at the same hospital and get another field at the same hospital and get to know people.to know people.

Setting up Audition Setting up Audition RotationsRotations

HousingHousing Ask the person that set up your rotation if Ask the person that set up your rotation if

they provide student housing or have they provide student housing or have resources for available student housing. resources for available student housing.

If not, go to www.Craigslist.org and click If not, go to www.Craigslist.org and click on the city and then temporary housing on the city and then temporary housing tab. tab.

Drive if possibleDrive if possible You will have transportation to and from You will have transportation to and from

the rotation and you can easily take a the rotation and you can easily take a months worth of supplies. Fly your months worth of supplies. Fly your significant other out for a long weekend significant other out for a long weekend after 2 weeks.after 2 weeks.

Audition RotationsAudition Rotations

Work hard, you are in a Work hard, you are in a competition!competition!

Be early for everything!Be early for everything! Better to over-dress than under-Better to over-dress than under-

dressdress Politics, Politics, Politics!Politics, Politics, Politics!

Board ExamsBoard Exams

When should I take the written When should I take the written portion of Step 2?portion of Step 2? If your step 1 scores are good-If your step 1 scores are good-

Take the written part of step 2 in Take the written part of step 2 in December or January (if your school December or January (if your school will let you) of your 4will let you) of your 4thth year. That way year. That way nobody will see them until your nobody will see them until your interviews are overinterviews are over

If your step 1 scores are bad-If your step 1 scores are bad- Take the written part of step 2 in Take the written part of step 2 in

August or September. This way, the August or September. This way, the people interviewing you will see them. people interviewing you will see them.

Board ExamsBoard Exams

How should I study for the written portion of Step How should I study for the written portion of Step 2?2? Crush USMLE for either COMLEX or USMLECrush USMLE for either COMLEX or USMLE First Aid for USMLE Step 2 CK for either COMLEX or First Aid for USMLE Step 2 CK for either COMLEX or

USMLEUSMLE Savarese for OMT questionsSavarese for OMT questions www.combank.comwww.combank.com for COMLEX for COMLEX

Promotion code for 15% off Promotion code for 15% off CRUSHCOMLEXCRUSHCOMLEX

www.usmleworld.comwww.usmleworld.com for USMLE for USMLE How long should I study for the written portion of How long should I study for the written portion of

Step 2?Step 2? 2 weeks2 weeks Email me if you want my 2 week study schedule for Email me if you want my 2 week study schedule for

COMLEX!COMLEX! 9am-5pm with an hour lunch break on weekdays9am-5pm with an hour lunch break on weekdays 9am-noon on the weekends9am-noon on the weekends

Board ExamsBoard Exams

When should I take the physical When should I take the physical exam portion of Step 2?exam portion of Step 2? Anytime before November.Anytime before November. That way, if you fail, you can retake That way, if you fail, you can retake

it and still graduate on time.it and still graduate on time.

Date COMBANK Crush Savarese First Aid Miscellaneo

us

Tuesday, 9/2 59   Chapters 1,2,3,4    

Wednesday, 9/3 69   Chapters 5,6,7    

Thursday, 9/4 42 1-20 Chapter 8    

Friday, 9/5 41 21-55 Chapters 9,10,11    

Saturday, 9/6 76 56-78 Chapters 12,13    

Sunday, 9/7 59 79-100 Chapters 14    

Monday, 9/8 65 101-140 Chapters 15,16,17    

Tuesday, 9/9 59 hangover hangover    

Wednesday, 9/10 56 141-180 Chapters 18    

Thursday, 9/11 69 181-219 Appendix A,B    

Friday, 9/12 60 220-268      

Saturday, 9/13 115 269-297      

Sunday, 9/14 162 Review charts Review autonomics &

Chapman points Rapid Review  

Monday, 9/15 82 Review charts Review autonomics &

Chapman points Rapid ReviewNBOME Practice

Exam

Tuesday, 9/16 EXAM DAY EXAM DAY EXAM DAY EXAM DAY EXAM DAY

Board ExamsBoard Exams

How should I study for the How should I study for the physical exam portion of Step 2?physical exam portion of Step 2? Fly to PhiladelphiaFly to Philadelphia Eat a cheese steak and drink a beerEat a cheese steak and drink a beer If you insist, First Aid for USMLE If you insist, First Aid for USMLE

Step 2 PEStep 2 PE How long should I study for the How long should I study for the

physical exam portion of Step 2?physical exam portion of Step 2? A couple of daysA couple of days

ERASERAS

What is ERAS?What is ERAS? Electronic Residency Application Electronic Residency Application

ServiceService This is how you send your application to This is how you send your application to

both D.O. and M.D. residency programs.both D.O. and M.D. residency programs. Cost of ERAS?Cost of ERAS?

$60 for up to 10 programs$60 for up to 10 programs $8 each for 11-20 programs$8 each for 11-20 programs $15 each for 21-30 programs$15 each for 21-30 programs $25 each for any additional programs $25 each for any additional programs

over 30over 30

ERASERAS

ERAS timelineERAS timeline In May, you will receive your “token” In May, you will receive your “token”

from your medical school. This allows from your medical school. This allows you to register.you to register.

In July, you can complete your In July, you can complete your application online and apply to application online and apply to Osteopathic programs.Osteopathic programs.

In September, you can apply to MD In September, you can apply to MD programs.programs.

In November, your school will upload In November, your school will upload your Dean’s Letter/ MSPE.your Dean’s Letter/ MSPE.

ERASERAS

What do I need to complete my What do I need to complete my application?application? You will enter information online such as You will enter information online such as

name, address, email, schools attended, name, address, email, schools attended, research experience etc.research experience etc.

You will select “release board scores” on the You will select “release board scores” on the ERAS website. Then the NBOME will upload ERAS website. Then the NBOME will upload them automatically.them automatically.

You will compose a personal statement You will compose a personal statement basically explaining why you want to go into basically explaining why you want to go into a certain field. a certain field.

If you are applying for multiple different specialties, If you are applying for multiple different specialties, you can compose multiple personal statements.you can compose multiple personal statements.

ERASERAS

What do I need to complete my What do I need to complete my application? Continued…application? Continued… Letters of recommendationLetters of recommendation

You will need 3+ letters of recommendation.You will need 3+ letters of recommendation. You can choose different letters for each program.You can choose different letters for each program. These should be sent to your school as you These should be sent to your school as you

receive them. receive them. Then, you will add the physician’s name and Then, you will add the physician’s name and

specialty on ERAS. Example Dr. Smith- Radiology. specialty on ERAS. Example Dr. Smith- Radiology.

Then you will certify it meaning it gets sent to Then you will certify it meaning it gets sent to your schoolyour school

Last, your school will upload them onto ERAS.Last, your school will upload them onto ERAS.

ERASERAS

What do I need to complete my What do I need to complete my application? Continued…application? Continued… Dean’s Letter/ MSRP will be uploaded Dean’s Letter/ MSRP will be uploaded

by your school in early November.by your school in early November. Transcripts will be uploaded by your Transcripts will be uploaded by your

school.school. Photograph will also be uploaded by Photograph will also be uploaded by

your school to the ERAS website. Your your school to the ERAS website. Your school may ask you to provide them school may ask you to provide them with a passport photo. Take a good with a passport photo. Take a good photo because this may be the first photo because this may be the first impression a program gets of you.impression a program gets of you.

ERASERAS

How to apply to programsHow to apply to programs Click on either search Osteopathic or search Click on either search Osteopathic or search

Allopathic programs on the ERAS website. Allopathic programs on the ERAS website. Select a programSelect a program

CategoricalCategorical Start PGY-1Start PGY-1

AdvancedAdvanced Start PGY-2 so you will need to apply separately for a Start PGY-2 so you will need to apply separately for a

preliminary year.preliminary year. Select which letters of recommendation & which Select which letters of recommendation & which

personal statement you would like sent to them.personal statement you would like sent to them. Select other miscellaneous things you would like Select other miscellaneous things you would like

sent such as photo etc.sent such as photo etc. Send that S#@%!Send that S#@%!

InterviewsInterviews

You will start getting rejection letters and interview You will start getting rejection letters and interview invites in October.invites in October. Hopefully more of the latterHopefully more of the latter

Book your flights & hotel early to save $$Book your flights & hotel early to save $$ Wear a nice suitWear a nice suit

Some say black but I went with beige. If you do Some say black but I went with beige. If you do everything else right, you can wear a pink suit and still everything else right, you can wear a pink suit and still get the position.get the position.

Fellas…Fellas… Cut your dang hair!Cut your dang hair! Have a clean shave!Have a clean shave!

Everyone…Everyone… Take out any piercings!Take out any piercings! Cover any tattoosCover any tattoos Whether it is fair or not, the majority of programs are Whether it is fair or not, the majority of programs are

run by older folks that are usually old fashion.run by older folks that are usually old fashion.

InterviewsInterviews

The night before your interviewThe night before your interview Don’t eat or drink anything crazy!Don’t eat or drink anything crazy!

The last thing you want is to have food The last thing you want is to have food poisoning!poisoning!

Go to bed earlyGo to bed early Wake up a few hours before you Wake up a few hours before you

interview to drink your coffee. This interview to drink your coffee. This way, you will be awake and won’t way, you will be awake and won’t be running to pee every 10 be running to pee every 10 minutes!minutes!

InterviewsInterviews

Common questions:Common questions: Tell me about yourself?Tell me about yourself? Why do you want to be a ________?Why do you want to be a ________? What are you strengths and What are you strengths and

weaknesses?weaknesses? Why do you want to do your Why do you want to do your

residency here?residency here? What do you do in your spare time?What do you do in your spare time? Why should we pick you?Why should we pick you?

For more questions, see Iserson’s For more questions, see Iserson’s Guide to Getting a Residency.Guide to Getting a Residency.

InterviewsInterviews

Thank them for inviting you for an Thank them for inviting you for an interview.interview.

Always pretend like they are your Always pretend like they are your top choice even if you don’t know.top choice even if you don’t know.

Send a thank you letter promptly. Send a thank you letter promptly. Not an email, an actual letter.Not an email, an actual letter. Don’t make it a freaking essay, one Don’t make it a freaking essay, one

paragraph will do!paragraph will do!

InterviewsInterviews

Often, they will invite you to Often, they will invite you to dinner or a party with the dinner or a party with the residents and/or program residents and/or program directors.directors. Tip #1- Go to it!Tip #1- Go to it! Tip #2- Don’t get too drunk and Tip #2- Don’t get too drunk and

have a dance off! Even if it was have a dance off! Even if it was their idea!their idea!

The MatchThe Match

You will need to apply separately for You will need to apply separately for the different matches. the different matches. M.D. MatchM.D. Match

National Residency Matching Program (NRMP)National Residency Matching Program (NRMP) www.nrmp.orgwww.nrmp.org

D.O. MatchD.O. Match National Matching Service (NMS)National Matching Service (NMS) www.natmatch.comwww.natmatch.com

Military MatchMilitary Match San Francisco Match (Plastic surgery, San Francisco Match (Plastic surgery,

Opthalmology, & Pediatric Neurology)Opthalmology, & Pediatric Neurology) American Urological Association American Urological Association

The MatchThe Match

D.O. Match TimelineD.O. Match Timeline October- Mail in registration form October- Mail in registration form

with $$.with $$. January 7January 7thth- Open to submit rank - Open to submit rank

order lists.order lists. January 23January 23rdrd- Deadline for - Deadline for

submitting rank order list.submitting rank order list. February 9February 9thth- Match Day & Scramble - Match Day & Scramble

Day.Day.

The MatchThe Match

M.D. Match TimelineM.D. Match Timeline August 15August 15thth- Register for NRMP online- Register for NRMP online November 30November 30thth- Last day to register for - Last day to register for

NRMP match without a $50 late fee.NRMP match without a $50 late fee. January 15January 15thth- Open to submit rank order - Open to submit rank order

list.list. February 25February 25thth- Deadline to submit rank - Deadline to submit rank

order list.order list. March 16March 16thth- Matched or Unmatched- Matched or Unmatched March 17March 17thth- Scramble if unmatched- Scramble if unmatched March 18March 18thth- Match Day- Match Day

The MatchThe Match

Military Match TimelineMilitary Match Timeline I guess it is classified because I I guess it is classified because I

can’t find much.can’t find much. Results are given in mid December.Results are given in mid December.

ExpensesExpenses

Away rotationsAway rotations Rent ($400-$800/ month)Rent ($400-$800/ month) Gas money or plane ticket ($300)Gas money or plane ticket ($300)

Board Exams (Approximately $2000)Board Exams (Approximately $2000) Step 2 written examStep 2 written exam

$550$550 Step 2 physical examStep 2 physical exam

$1000$1000 Plane ticket to Conshohocken, PA $350Plane ticket to Conshohocken, PA $350 Hotel $100Hotel $100 Rental Car $50Rental Car $50

ExpensesExpenses

ERAS (about $150)ERAS (about $150) The Match ($40 for M.D., $60 for D.O.) The Match ($40 for M.D., $60 for D.O.) Interviews (about $500 each)Interviews (about $500 each)

$300 plane ticket$300 plane ticket $50 rental car for 2 days$50 rental car for 2 days $150 for hotel$150 for hotel This means that if you do 5 interviews, This means that if you do 5 interviews,

you will spend around $2500!you will spend around $2500! Moving Expenses ($500- $5000)Moving Expenses ($500- $5000)

ExpensesExpenses

So how can I afford all of this if I have So how can I afford all of this if I have already maxed out on my student already maxed out on my student loans?loans? Medcap Xtra Loan from Wells FargoMedcap Xtra Loan from Wells Fargo

Will provide $5,000 for interviews and $10,000 Will provide $5,000 for interviews and $10,000 for residency relocation.for residency relocation.

8% interest8% interest Can be deferred until after your residency.Can be deferred until after your residency.

Credit Cards can help if used correctly.Credit Cards can help if used correctly. Apply for a credit card that has 12 months or Apply for a credit card that has 12 months or

more of no interest and use it.more of no interest and use it. Just make sure to pay it off before the 12 months Just make sure to pay it off before the 12 months

are over! Otherwise, you will be stuck with all of are over! Otherwise, you will be stuck with all of the interest from the previous 12 months!the interest from the previous 12 months!

Contact me if you have any Contact me if you have any questionsquestions

Email Email erik_paulson@yahoo.comerik_paulson@yahoo.com Phone 720-937-6863Phone 720-937-6863