MS4 Sage Advice

Yours Truly, Med13

Table of Contents

• Scheduling 4th year – Summer, time off, required rotations – Switching rotations – Specific Info re: Rotations: Neuro, Peds II,

Surg II, ICU, Sub-I’s – Popular 4th Year Electives: Anesthesia, Path,

Rads, EM, Interdisciplinary Disease of the Breast and Multi D Pulmonary Disease

• Step 2 CK and CS – CK: Study time, resources, scores, re-

scheduling – CS: locations, prep, what to expect, end of

the day/getting home • Residency Applications

– Important research tools; FAQ’s; pearls • The Application

– Letters; CV; pearls • Personal Statement

– Writing it; suggestions; mistakes to avoid • Applications advice that is hard to find

elsewhere • The Interview

– Preparation – Questions to ask the residents,

faculty/interviewers, and general tips • Post Interview Etiquette and Rank Order List • Budgeting for the Interview Trail • Away Rotations

– Timeline – Scheduling notes

• Couples Matching – Advice

• General FAQ’s!!

Scheduling 4th Year Summer: - The part of MS4 year that you need to be most strategic about scheduling - You have about 3.5 rotations before your residency application is due - Try anything else you might be interested in that you were not able to rotate in as a third year to decide on your specialty choice. - Do rotations that you would expect to get a letter of recommendation from (ex- Sub-I’s, Subspecialties, Away Rotations…)

Time off: -You should have at least 3 rotations/3months off if you did an elective during MS3 year, and at least 2 rotations/2 months off if you did not. - Two of these “off” blocks tend to be used for taking Step 2 and interviewing. - The third month, if you have one, is great to use as a time for important social things (like getting married!) or for your last rotation of the year to have more time off before starting residency. Required Rotations: -Sub-i, ICU (you can do two sub-I’s or two ICUs and this will fulfill the requirement for a Sub-I and an ICU), a second surgical rotation, a second peds rotation, and neurology. - 4-5 elective blocks that can be used at your discretion. Try not to necessarily use them all just for the things you like and are going to specialize in (ex- if you are going into Peds don’t do all pediatric electives) because that is what residency is for! This is a great time to try something that you always were curious about or something that you wish you were better at or understood more.

Switching/Trading Rotations

It’s easy! - Just go in or email Kaitlin or Marcia (I always find that going in to the office to see them is easier/faster!). - Deadline to switch your rotation is about one month prior to it starting. Kaitlin is great about emailing you to remind you of this. - Keep in mind that it is not always possible to switch rotations- difficult ones can be neurology, Peds II, or other highly sought-after rotations. - Be sure not to switch out of a rotation before you are sure that you will be able to get it somewhere else in your schedule if it is required!

Required 4th Year Rotations NEUROLOGY: -2 weeks on an inpatient ward service- either OHSU, the VA or Pediatrics, 1 week on a critical care service- either stroke, neurosurg, or neuro ICU, and 1 week on ½ day clinics in a subspecialty- like neuromuscular disorders, movement disorders, epilepsy etc. - There are also sites for neuro in Bend and Eugene, which tend to be structured a bit differently than on the hill (more time with individual providers, less time on specific sub-specialty neuro services). -There is a paper due during the third week, essentially a case report - You will finish the rotation with taking the Neurology shelf exam. Good prep sources for this exam include Pre-Test and the Clinical Neurology book they let you borrow for the rotation. PEDS II: - Another 4 week rotation where your patients are under 18! - Rob Bogacz will email you a few weeks before the rotation with something like 20+ different options and you will email back with your top 12 choices - There is also the option to “create your own” rotation, for example if you would like to work with a community pediatrician that you know, or would like to work with a pediatric service at Doernbecher that doesn’t typically have Peds II rotators.

- Be sure to set this up EARLY if you want to “create your own.” - There is a “project” requirement, which is just as vague as it sounds. Almost anything counts for this- a case report, a PowerPoint, a pamphlet, etc… - Additionally, you will need to finish the CLIPP cases that you started during your pediatrics rotation during third year.

Required 4th Year Rotations SURGERY II: - It’s not just spending another 4 weeks on the Blue, Green or Gold service. - There are a lot of options that can count toward this requirement, including but not limited to: anesthesiology, ENT, urology, orthopedic surgery, nutritional management of surgical patients etc. - A great opportunity to try something you may find interesting or something that may enhance your future career plans (ex- if you want to be a pulmonary critical care doc, think anesthesia, or if you want to be a sports med family doc think ortho!) - Hours and the commitment required will be highly variable depending on the specialty you choose. ICU: - Don’t forget that if you are terrified of ICU medicine and know that it is not for you, that you can do two sub-i’s to fulfill your ICU requirement (and vice versa- if you know critical care is for you, do two of these rotations and skip spending 4 weeks on a medical ward as the sub-i) - The PICU and the NICU count toward this requirement if you are interested in pediatrics. - If you are more interested in surgery, the Surgical ICU and Trauma ICUs would be great options (generally even if you sign up for SICU or TICU you’ll spend 2 weeks on each). - The hours on any of these rotations will likely be grueling and often will require call. Expect to arrive most days at 5:30ish and stay until 5:30ish (totally depending on the service, but just a rough idea). - Several of the ICU rotations will have up to q4 28 hour call.

Required 4th Year Rotations SUB I: -An opportunity to really practice what being an intern is like without the same level of responsibility. It’s often a favorite rotation for 4th years! - Don’t forget that you can do to sub-i rotations in place of doing ICU (or vice versa) - Internal Medicine: OHSU only opens 10 spots for Sub-I’s on the hill (5 University Hospital/5 VA) AND they are only available during June and November. November is too late if you need a LOR out of your sub-I. However, you can apply for Sub-I’s at any of the community hospitals for any month of the year. You will need to make the best decision for you regarding location of your sub-I. - Pediatrics: Sub-I options include General Peds (Hood or Coast team), Heme/Onc, PICU or NICU. All only take 1 student per rotation, so you may need to be flexible about which sub-i you do, or timing of the rotation. - Subspecialties: some subspecialties have dedicated sub-i’s and some do not. For example, those with dedicated sub-i’s include Family, EM, Ortho, ENT etc. Some that do not have a dedicated sub-i include Anesthesia, Urology, Ophthamology… When you decided what you are going into, you will need to consider what is an appropriate sub-i for you

Popular 4th Year Electives ANESTHESIOLOGY: - Counts for your second surgical rotation (if you need more reason to take it!) - Hours are about 6:30-3:30 most days. - You will have the opportunity to learn a lot about airway management and the main principles of anesthesia. - This is a great rotation to practice procedures! You will often get first crack at intubating patients, placing IVs and setting the patient up for surgery. - During the actual surgery, when there is downtime, most of the anesthesia residents are great about teaching and you can learn about the main anesthetic drugs, how to manage mechanical ventilation (important for ICU rotations!), and remind yourself of important principles in physiology (especially pulmonary and circulatory!) - A tip on how to do well- look up your patients for the OR you are assigned to the night before and know a little about them for the next day, toward the end of the rotation it is reasonable to have an anesthetic plan in mind for these patients (only at a very basic level)

PATHOLOGY -Often taken for the reportedly easy hours, pathology is a great opportunity to remind yourself of the molecular/microscopic pathophysiologic basis of disease. - There is daily 2:00pm conference where the read-out attendings and residents will gather to work through any tough cases or questions on consult slides. - There are residents and Masters-level Pathology Assistants working through gross specimens and time-sensitive frozen sections daily, and a team of three or four residents and a student fellow assigned only to autopsy, and they’re all happy to have you around as much as you want. - You have time to attend a multitude of conference that you may find interesting, too - tumor boards, autopsy conference, pathology and radiology-pathology didactics, journal clubs…

Popular 4th Year Electives RADIOLOGY: - Most people who take just one radiology elective take the standard four-week rotating intro to radiology elective. - Structured by week-long blocks, one each in chest, musculoskeletal (MSK), body, which includes ultrasound, and neuro imaging. If you have a specific interest (IR, mammography, peds rads), you can often substitute up to a week of your days during the intro elective with those things, but you have to be proactive about arranging these days. - Mornings are spent in the reading rooms with the residents and attendings and observing procedures, and the afternoons are spent in didactics. - After afternoon lecture you can go back to the reading room or you can study on your own. - One thing that can certainly add value is to look up the clinical history of a patient on Epic as the resident is reading the study.

EMERGENCY MEDICINE: - A super fun way to spend an elective 4th year, and doubtlessly helpful for intern year in almost any field - Usually you will do about 12 shifts over the month, including a day of an ambulance ride-along and a day with the Poison Control service - There are all-day didactics every Wednesday - There is an exam, both written and oral, the last week, as well as a significant amount of paperwork and keeping track of your notes, patients seen, procedures done etc. - Counts as a sub-I

INTERDISCIPLINARY DISEASE OF THE BREAST AND MULTIDISCIPLINARY PULMONARY DISEASE: -Both courses created by Dr. Mark Kettler. You get to rotate through multiple specialists with the primary focus being on disease rather than specialty. You get awesome experience and perspective. He also allows you to miss up to 5 days for interviews without any make up time!

Step 2 CK info Study time:

Most students take 2-3weeks to study for the exam. Some options: • Take a full 4 week rotation off to study • Take a 2 week rotation, then use the remaining two weeks to study and take the exam • Study during a low requirement/low stress rotation • Participate in the GIE lab assistant rotation and study

Resources: -USMLE world question bank -USMLE step 2 CK first aid -Any step 1 study material you found helpful is nice to have on hand for review, but remember, this

exam is more focused on clinical scenarios to tie in your third year knowledge Scores: If you take the exam BEFORE September 1 – it is automatically included in your application to

residency programs. Taken AFTER September 1, you have the option to include it later or not at all. *be in contact with your mentor/faculty advisor regarding your particular desired career path and what they want to see from you.

– Dr O recommendation: take it before September 1 if your score is less than what you want to be competitive. Take it after September 1 if you are pleased with Step 1 score. * programs are interested in your score trend if Step 1 is on the lower side. Regardless, take the exam BEFORE December so that the results will be available to the program director prior to ranking.

Rescheduling: This happens all the time – something comes up and you need to postpone your exam. Work with

Marcia on your schedule and you will succeed!

Step 2 CS info Locations: info on where to stay, how to get to testing centers (http://www.usmle.org/step-2-cs/#testcenters) Hotel info: https://www.aamc.org/meetings/153904/clinicalskills_mtgs_homepage_teaser.html

– LA; Houston; Philadelphia; Chicago; Atlanta Most locations have hotel shuttle from the airport. You can ask your hotel if they provide shuttle

service to the testing center, some do. Preparation:

-Budgeting: Registering for the exam is approximately $1300.00. Plane tickets and hotel accommodations are approximately $300.00 more.

-Materials: read through a copy of First Aid Step 2 CK – anywhere between 1 week before exam to the plane ride to the location.

-Find out if your desired speciality requires a score before they will send you an interview as this will determine when you should sign up for the exam. *Scores are returned approximately 4-6 weeks after taking the exam.

What to expect: -13 standardized patients, 12 of which count toward your overall score. Use the first one to settle in,

get a feel for the timing and then take the remaining in stride! -Dress professionally -Speak in coherent English sentences, wash your hands, connect with your patient, and type up a

coherent H & P and you’ll be fine! *Remember: unlike our OHSU OSCEs, this exam doesn’t require you to take the whole 15 min with the

patient. In fact, the time you don’t spend with the patient can be used to typing up your brief H & P and consider diagnostic testing which you must defend.

End of the day/getting home: -schedule a late flight home the evening of the your test day. You will likely be done between 2:30 and

3:30p. They run a tight ship, so timing is crucial during testing. You are then finished late in the afternoon with plenty of time to get back to the airport and possibly take an earlier flight home if there is room on stand by or ticket change. Or, make a vacation out of it and stay a while!

Residency Applications Important Research tools for Residency Programs •Program’s Residency web page •FREIDA online: https://freida.ama-assn.org/Freida/user/viewProgramSearch.do •Board passing rates- google “[specialty name] board passing rate” which will bring you to the American Board of that specialty and passing rates of individuals programs. E.g Internal Medicine- American Board of Internal Medicine: www.abim.org/about/examInfo/data-pass-rates.aspx •www.acgme.org for accreditation status •Fellowship placements: match lists usually provided on the program’s webpage, or handed out on interview day

Frequently Asked Questions Q: When can I register for myERAS? A: July 1 Q: When will I get my token from the Dean’s office so that I can start working on myERAS? A: Tokens are emailed out the first week of July. Q: When can I register for NRMP (and what is this?) A: August 15, this allows you to rank programs and participate in the match. September 1 you can select programs to apply to on ERAS September 15 you can submit your ERAS application to designated programs. Q: When is my Dean’s letter released? A: October 1- this is completely taken care of by the Dean’s Office!

Pearls •Update your CV as soon as possible (Spring of third year). If your CV is pristine, it’s only a matter of copying this data onto your ERAS application •Look sharp in your photo. Programs use them as a visual reminder of who you are when they are composing their Rank List. Photo dimensions should be 2.5”x3.5”, color, full view of head and shoulders with a light background. Professional photos are a nice touch if you don’t mind spending the $$. •Don’t forget to register for NRMP!!

The Application Letters •You MUST check each program you apply to for their specific letter requests. If a program specifies 3 and you send 4, this may be interpreted that you did not follow the directions. Also, Some will specify letters from within versus outside of the department. The earlier you check, the more time you have to get the right letters! •Ask your writers to give them to Marcia DeCaro via email as PDF. It should be on the writer’s work letterhead and signed. The writer can also directly upload it to ERAS. If they choose campus mail, address to: Marcia DeCaro Director of Student Records Education and Student Affairs, L102 School of Medicine Oregon Health and Science University

CV •ERAS will have designated sections for: Education, Membership and Honorary/Professional Societies, Medical School Honors/Awards, Work Experience, Volunteer Experience, Research Experience, Publications, Hobbies & Interests, Language Fluency, and Other Awards/Accomplishments •Make sure to use active voice in descriptions, eliminate all passive verbs (is, was, were, will be etc) •Cut clutter •ERAS allows you to “view your CV” and print as a PDF. Print this and have someone else proofread it for you to ensure there are no errors.

Pearls •Most letter writers don’t write them until July or August despite when you approached them with the request. Be patient, but you can always send an email if you are a Nervous Nelly. If a letter has been submitted, the Dean’s office will upload it to your ERAS within a day or two (you must finalize your letter writers in order for them to upload). •You no longer have to inform your letter writer that you “waive the right to view your letter” because ERAS now has a check-box for this, but it can’t hurt to tell them anyway. •Write thoughtful Thank You’s to your letter writers •Submit your application on September 15. It most likely doesn’t matter what time you submit it, but since you’ve finished, why not set your alarm and send it ASAP?

Personal Statement- Ask yourself, “does this portray me?” The following is taken from AMA, Written by Jeff Gonzalez, MD Resident, Department of Medicine, Hospital of the University of Pennsylvania; AMA-MAS Governing Council,

Resident and Fellow Section Representative Writing Your Personal Statement Why is the personal statement so important? It is important because it is the only part of your application that is not based on test scores or other people’s perceptions of

you. For this reason committees place a heavy emphasis on the personal statement. It is the one part of your application that you have complete control of and allows you to make a personal case for yourself. Because of these reasons, however, it is so very difficult to write.

There are some basic questions that you need to address in your personal statement. These are usually divided into three paragraphs that address: 1) what got you interested in the field that you have chosen; 2) what are you looking for in a residency program; and 3) what are your expected goals in the field you have chosen. You are always free to add other commentary that is relevant to the above topics. But, make sure you discuss these 3 topics in your essay.

Your personal statement should fit onto one page when it is printed from the ERAS system. You can test this prior to submitting your statement to residency programs. Some helpful suggestions in getting started: 1.Go back to your medical school application essay. Some students find it useful to look at that as a basis for their residency statement. Specifically the introductory and final

paragraphs. 2. Find out if your school has a writing office, which can help you with your statement. 3. Use a theme to structure your essay. This helps unite all aspects of your statement. 4. Provide concrete examples that pertain to your life, goals and experiences. 5. Be concise. Refrain from using a lot of unnecessary words. 6. Begin your essay with an attention grabber: a quote, a story, an anecdote, or a riddle. 7. Finish your essay with a conclusion that refers back to the beginning of your statement and restates the theme. 8. Have your departmental program director evaluate/critique your statement. Remember they have probably seen thousands of essays and is most likely the best authority

at your institution to evaluate your work. 9. Don’t be afraid to start from scratch if your essay is not working. 10. Do write about what interests you, excites you. Your reader wants to hear a positive essay not a negative one about the profession. Mistakes to avoid in a personal statement:

1. Underestimating the importance of the personal statement. 2. Underestimating the time and difficulty involved in developing the personal statement. 3. Lack of “flow”. You read the essay and have no idea what the applicant is trying to say. They jump from one tangent to another. When reading a statement like this I would

rather not read the essay at all. To prevent this error you need not one, not two, but at least three people to read your essay and give you feedback. You need to revise your essay several times. Therefore, you cannot start working on the essay one week before it is due. I recommend starting to work on your personal statement in July. Remember that most attendings will ask for a copy of your personal statement in order to write a letter of recommendation. You therefore need to start early.

4. Spelling and Grammar mistakes. These can kill you. It says a lot about an applicant if they have not taken the time to carefully proof read their essay. Is this someone who pays attention to detail and will spend time taking care of patients in my hospital? No!

5. Avoid clichés. 6. Making the writing process a group effort. This does not work. 7. Being too cute. This is not an essay for college admissions where originality/strangeness is applauded. Keep it simple to the point and address the issues I have brought up

before. 8. Procrastinating until the very end to begin your statement. You need to start months in advance. 9. Failing to let yourself come through. This goes back to trying to make your statement too cute. You do not want to show up to an interview and have the interviewer

thinking: Am I speaking to the same person that wrote this statement? 10. Including topics in the statement that if asked to discuss you would not be able to answer, such as particular research points, volunteer activities, etc…

Application Advice that is Hard to Find How many should programs should I apply to? *This totally depends! Please ask your advisors/program director/students a year ahead of you etc When will I start hearing back? • Don’t be surprised if you get interview invitations the following day after submitting your application on

September 15th, even though programs don’t have your Dean’s Letter. There may be a flurry of activity in that first week of submission. However, different specialties hear back at different times, and even programs within a specialty can have drastically different timelines. For example, it is not uncommon to hear from a smattering of programs in that first week after submission, and then hear from the majority of programs 2-3 weeks AFTER the dean’s letter is released. The majority of programs will send out their first wave of invitations by the end of the first week of November. Also, do not be discouraged if you get early rejections. Swallow your pride and ride it through, you will get more offers after these rejections. Also, you may even get offers after you start interviewing. You may also not hear back from a program until you’re finished with your scheduled interviews. It is highly variable. Bottom line, it’s stressful for every applicant. Accept it.

When do I need to reply to an offer? • Immediately. Keep your smart phones on vibrate in your pocket. More interviews are offered than most

programs have slots available, so you want to reply as soon as you can. This can be difficult if you are trying to cluster interviews geographically, so you’ll have to artfully juggle this dilemma.

Does it matter when I schedule interviews? • The interview season starts as early as late October through January. There is no evidence to suggest

any interview time is better than another. However, you will have a lot of energy/anxiety while getting interview offers which may be alleviated by starting the actual interviews earlier rather than waiting until after Christmas. Though let me emphasize, timing of your interview does not affect your rank! (evidence based)

The Interview Preparation •Research the program, know name of the Program Director and other VIPs •Review your application, personal statement, and CV and prepare yourself to discuss anything you’ve mentioned including research. •Prepare a list of questions that you want answered by the PD or faculty and another list for the residents. Examples on following slides** •Dress smart. Women often bring purses, men often bring a nice folder. You should bring a copy of your transcript, a copy of any of your published research, your CV, and paper for note taking. •Prepare your own answers to the following frequently asked questions:

1.Why this specialty? 2.Why are you interested in this program? 3.Where do you see yourself in 10 years? 4.Tell me about yourself? 5.What are your strengths/weaknesses? 6.Are you interested in research? 7.Talk about a difficult time in medical school and how you overcame it? 8.What was the most interesting case that you have been involved in? 9.How will you deal with the rigors of residency? 10.What questions do you have?

Questions to ask on the Interview trail Examples of questions to ask residents: • Are you happy here? • Do you feel supported by the program when problems come up? • Why did you choose this program over another? • Would you come here again? • Do you and the other residents hang out outside of the hospital? • Do you feel your third year residents are competent and ready to be attendings? • What would you like to change about the program? • Do you feel like you get enough autonomy? Procedures? • (surgery specific) how much do you operate? To what degree are you pushed or kept from

progressing in the OR? • What kinds of things do people do outside of the hospital? What’s the area like? • What’s the call schedule? • Do you feel like you have enough backup (while on call; in ICU; overnight)? • What are the didactics like? • Is there time to do research? • Do you feel like you have a voice? Can implement change if you see something that could be

improved? • Is there a “type” of person who chooses to do residency here? • How is the relationship between the residency program and the nurses? social workers? other

programs here? With the faculty? • What’s the cost of living around here? Average 1 month rent for apartment? • Where do most residents live?

Questions to ask on the Interview trail Example questions to ask faculty/interviewers: • How did you end up at this program? What keeps you here? (interesting to hear what people have

to say, plus everyone likes talking about themselves!!) • What is the case mix like (medical or surgical)? • What international opportunities are available? • What research opportunities/requirements are there? • Is there any training regarding the larger healthcare system? • Ethics training? • Is there any room for individualized path? (i.e.. if I have a special interest in something, can I

emphasize that in my training?) • Do you feel like your third year residents are capable and ready to be attendings? • What’s the patient population? • Are attendings teaching faculty or hospitalists? • Are there any systems or processes by which residents can be involved in affecting change? • What happens if a colleague has a baby? How is that absorbed (ie. is it a happy and accepted time?

do other residents have to pick up tons of extra work? etc.) • What do graduates go on to do? (academic vs private) • What areas of the program have room for improvement? Are those being addressed?

Questions to ask on the Interview trail

Some general tips/thoughts... • Don’t ask “factual” questions that can be easily found on the program’s website... • When an interviewer asks why you are interested in their program, know some specifics about the

program itself (not just location!!) • Use the tours and lunches as times to ask residents questions you really want to know, but may

not ask faculty. Most of the time they’re pretty honest and willing to share both bad and good. That being said, they can and do inform faculty or program directors if you do or say something crazy...

• Try to explore the area a bit while you’re there to see whether or not you could imagine yourself (and family) living there. Go to coffee shops, run, walk around, do whatever you normally do to get a feel for the place

• Pay attention to your own feelings while you’re there, whether you feel happy and comfortable there, or if you’re on edge and just want to get out.

• Pay attention to how you’re treated at the interview day (a nice breakfast and welcome, lots of residents coming to lunch to chat and share their excitement for the program, a well-thought-out day, a nice folder of information, free dinner, etc.) - though we all know it’s a wining-and-dining game, it also says something about how they may treat you after you’re a resident there...

Post Interview Etiquette and Rank Order List • After the interview, a letter of thanks and intent may be sent to the residency director and those with

whom you interviewed. These may be either hand-written or emailed depending on your own preference. Keep it brief, tell them what you thought and let them know of your desires.

• A multi-institutional study of communication during the resident matching process revealed these results:

– More than 85% of students reported some type of communication with the program, the majority occurred with the program director. Competitive specialties such as derm were less likely to communicate with applicants.

– During these communications, programs told applicants they’d “fit in well with the program,” “be ranked highly” or be “ranked to match” About a quarter of all students surv3dyed changed their rank order list based on these communications

– Further, about 20% of all students surveyed reported feeling they would match at a program based on these communications, so ranked that program first, but ultimately failed to match to that program.

– The study didn’t specifically address whether applicants should inform their top program of their ranking intention

• No one knows whether programs rank applicants lower if they never hear they were the applicant’s No.1.

• It’s dishonest to tell more than one program they are you’re top choice. Do not commit and do not fall into the trap of restricting your match list based on any promises that may have been made. Remember, the medical education community is small, and students are often remembered for poor behavior.

• So, accept complimentary communication as a compliment, but don’t base any decision on it. • Bottom line: make your rank order based on where YOU want to go!

Budget How much money should I budget for this Interview Process? **(to be surveyed to class, but I’ve heard an approximate range between $4,000-8,000) Pearls for keeping to your budget: • Cluster interviews geographically if possible • Keep in mind it might be cheaper to fly into the closest large city and rent a car to drive to the program • Generally, you usually find better deals online for hotels and rental cars than in person • Check with your own car insurance for their coverage on rental cars, you might be able to opt-out of

extra rental car insurance Take advantage of OHSU’s HOST program! -a program to connect you to OHSU alum in cities all over the

country! This may be anywhere from friendly advice about the city or program to letting you crash! Miscellaneous Costs: NRMP registration: $50 Program application costs Professional photo cost Additional- suit, dry cleaning etc

Number of Programs Per Specialty

ERAS Fees

Up to 10 $92

11-20 $9 each

21-30 $15 each

31 or more $25 each

Away Rotations • Purpose:

– Allows you to get a feel for a program in which you’re interested and lets them get to know you – This is useful to confirm you like a place and increase your chances of matching, but also useful to

discover you don’t like a place – Obtain letters of recommendation from leaders in your field

• Who:

– Away rotations are typically most useful to, and done by, people going into competitive specialties, i.e. neurosurgery, ENT, derm, plastics, etc OR people wanting to go to competitive programs i.e. UCSF, Stanford, Harvard, etc

• Caveat: – They may not like you; you can hurt your chances of matching somewhere by screwing up or

offending the wrong people while on an away rotation – Be sure to talk to your specialty residency program director to get their advice

• Arrange your MS3 year so you can do your home sub-I in June (1st MS4 rotation)

• Do aways as soon as possible to allow you to get letters of recommendation from away Chairman or

Program Director before it is time to submit your ERAS

• VSAS (Visiting Student Application Service) is like AMCAS—a common application system used by some programs to apply for away rotations, but not by all programs; some have individual universities and departments have location specific applications

• Away sub-I’s can be demanding, so if you’re doing multiple aways, consider scheduling a month of down time (aka radiology, etc) in between your rotations; for example, Home sub-I in June, Away 1 in July, Radiology/ERAS prep in August, Away 2 in Sept.

Away Rotations: Timeline • Dec-Jan of MS3 year:

– Brainstorm, research, and talk with mentors to identify potential programs at which you might want to rotate

• Feb-Mar: – Apply to programs either via VSAS or individual applications – Do your due diligence because programs have different deadlines for when you need to

apply and have all the stuff into them; SPOTS will fill FAST – Complete immunization requirements

• Apr-May:

– Confirm programs and arrange housing, travel etc.

• June-Oct: – Complete away rotations; the earlier the better

• Sept:

– Submit ERAS application WITH letters from away Chairman and/or PD

Away Rotations: Other Notes • Most programs require crazy proof of immunizations like multiple TB tests or Quantiferon gold and

VZV/Hep B titers, so give yourself time to get all this nonsense taken care of early

• Away rotations are a pain in the ass, but really are the only way to get a true feel for what a place is like—it is way better than interviewing. Comparing multiple programs helps you formulate what you’re looking for in a residency program and see how things are done differently at different institutions and regions of the country, which helps you pick a program during the interview season

• Overall, I think they are very valuable to the competitive applicant and an essential component of your training

• Many people will end up matching at one of the places you did an away, so put some time and thought into choosing where to go—it’s a difficult decision you have to make with minimal information and with big ramifications for your career and life

• Geographic considerations: If you want to stay in a particular region of the country, then do your aways there, but if you want to apply broadly, its worth doing your aways in separate parts of the country as this provides evidence that you’re willing to go anywhere, otherwise program directors may pigeon-hole you as a “west coast” or “Midwest” guy/girl and not consider your application or invite you for an interview

• If possible, take advantage of OHSU alums who are residents at your program of interest or in your specialty of interest—contact them and stay in touch throughout the whole away rotation and residency interview process. They can be a very valuable resource and provide helpful advice and information during the application process and can help look out during the away rotation.

The Couples Match • PLAN!

– Get a map and start talking. You really need to have an idea of where each of you are willing to move and how far away from each other you are willing to be. Every dollar you spend visiting a place that you are not really interested in could otherwise been better spent on a vacation somewhere you really want to be for the weekend!

– You also need to have a great sense of geography. Many programs are closer to (or further from)

each other than you would think (even between states), or have terrible traffic in between. – Meet with your own advisor and then meet with your advisors together to come up with a list.

Your partner’s advisor might know something about your specialty – but it also makes it easier for them to advocate for you as a couple if they’ve met you together.

– Be realistic about your competitiveness – and each other’s. Don’t know? Ask each other and your

advisors. It is expensive to interview somewhere where your partner won’t and expensive to interview at more places than you really need to. (Then times that by 2)

• Apply Broadly – (Then narrow for interview acceptances.) You might have all overlapping invitations. You might get

fewer overlapping than you would think. It may also be a while until you know. Schedule everything that comes in at first (and quickly) – you can always cancel if you give enough notice after you have a better idea of how many interviews you two will have. Think of how many programs you would apply to if you were single. Then do more.

– The strengths of individual programs can differ so greatly within one institution. It may take

applying to quite a few programs in order to get a couple of programs that are strong in both of your specialties.

The Couples Match

• Advocate for Each Other – You absolutely can get your partner an interview somewhere you did. Don’t be afraid to tell your

program your situation. Likely, if they wanted to interview you, they’ll nudge your partner’s program in order to get you both there. This can work even after “rejections”. It is amazing what can come through at the very end of the interview season.

– Accept when this doesn’t work. In some institutions the programs will communicate with each

other. Others just won’t. • Have a strategy

– If you get an interview at a program and your partner hasn’t yet heard, you may want to schedule that interview later in the season. You want to avoid interviewing places where your partner won’t – you likely won’t rank those places at all. Having said that…..

• Talk about each other

– ….interviewing somewhere that you are really interested in, even if your partner hasn’t yet heard, can get your partner an interview if you make a good impression.

– Email your program after your partner gets an offer and tell them how excited your partner is to go, and how much you would like the opportunity as well.

– Also, couples matching is a strength. It gives you another reason to choose that program: You can say your partner loves their program there. (Why else would you be in North Dakota?) It gives you a built in support system during your residency. And it gives you a reason (hopefully) not to leave.

– Most programs like the idea of a liaison to another program.

– It sets you apart. And anything (positive) that makes you memorable is a good thing on the interview trail.

The Couples Match • Try to visit together

– You can pool resources, its easier to do fun things in a new town when you’re with someone, and the programs will invite your partner to the dinners the night before. This is great if your partner tells a good joke. Plus, they’ll remind you later if the residents at that dinner were cool – you might be too busy impressing them to notice if they seemed happy.

– Ask for a specific date if your partner already has an interview or ask to re-schedule when your partner gets a different date.

• Communicate with Each Other

– Your perception of each program, what you’re looking for, and your ideas about residency in general, will change throughout this process. What are you most excited about? What gave you the “warm fuzzies” or the “sparkle factor” for each program? And, as the process evolves, ask your partner where they are finding themselves visualizing their life in the next few years.

• Communicate to Your Programs – Update them after you or your partner visits. Tell your program how much your partner liked their

visit to their respective program.

• Be Gracious and Patient – Realize that this process, and likely where you will end up, will look very different as a couple than if

you had done this alone because you needed to compromise. There will inevitably be a program that you loved that your partner didn’t. This will be a sad day but remember, it is more important to be with this person.

– Remember that the experience you will have in residency has more to do with you, your attitude, and your happiness than the name of the institution where you match.

– Remember that you can ultimately only go to ONE PROGRAM. You don’t need to have 7 programs

that you completely agree on.

General FAQ’s Q: When is Graduation? A: Check on your MSPE. It is always on the final draft. Q: When is Match Day? A: Always the third Friday in March Q: When does MSPE go out? A: October 1. Q: Can I add grades or comments to the MSPE after October 1? A: No. Q: How do I get a copy of my transcript? A: from the Registrar’s Office. Q: How do I know which letters of rec have come in? A: You are welcome to come up to the Dean’s office and check anytime. We have a special file drawer all

set up for students to look into their file to see what is here. Do not call and ask the staff to open up your file and check for you.

Q: My letters are not all in, can I still apply? A: Applications do not have to be 100% complete in ERAS. The Common Application Form and Personal

Statement should be in before applying, but letters of recommendation, transcript, and photo can all follow.

Q: How do I upload my photo? A: It needs to be emailed to Marcia as a jpg. It must be (to quote ERAS) “It must show a full front view of

the person’s head and shoulders, with full face centered in middle of the photograph. It must have a plain white or light colored background.”

Best of Luck!! Yours truly, Med13