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eric: General Impression about This Year's Applications
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发信人: ericusa (eric), 信区: MedicalCareer
标 题: General Impression about This Year's Applications
发信站: BBS 未名空间站 (Mon Nov 16 20:17:15 2009, 美东)

With the heated debate on healthcare reform and uncertainty surrounding many
medical specialties' future, what's the situation regarding this year's
residency application for AMGs? No official statistical data is out yet, but
one certainty is that we will feel more pressure because more than 500
additional AMGs entered the race this year. Here is a general impression
about applications in preliminary medicine, transitional year, general
surgery and radiology, based on the limited experiences from my classmates
and myself.

In terms of competitiveness,
Radiology >> Transitional Year > General Surgery > Preliminary Medicine.

Preliminary Medicine:
It's still relatively easy to get interview invites. Many programs try to
recruit more AMGs. Scoring 210 and above on USMLE Step1 puts someone in the
“comfort zone”. The kind of candidates is all mixed. Of course, top
programs are still very competitive.

General Surgery:
Moderately competitive. The kind of successful candidates are not
necessarily top students, but hard-working people who can get along with
surgeons very well. Getting into top programs or good programs at desirable
locations can be tough, as some of those programs received 200+ applications
for each categorical position.

Transitional Year:
Very competitive. The majority of the TY candidates are the same people
trying for hot specialties such as Rads and Derm. On the extreme case, one
program only interviewed people scoring 250+ on Step 1 and with AOA status.
But many TY programs will interview “above average” students. Since the
transitional year training is only for one year, clinical performance and
personality are programs' main focus.

Extremely competitive. The number of radiology applicants kept increasing in
the past several years and it's peaked in 2009. Several programs indicated
about a 10% decrease in the number of applicants this year, most likely due
to the proposed reimbursement cut. This won't make radiology applications
any easier however, because the quality of the applicant pool this year is
very high. For radiology, a very good, well-rounded application package is
essential to get any interview invites (even for the “worst” Rads program,
or the programs on probation). There are just too many 99ers/top dogs that
are competing for radiology. In 2009, the successful AMG radiology
applicants had these characteristics:

Mean USMLE Step 1 score: 238
Mean USMLE Step 2 score: 242
Mean number of research experiences: 2.7
Mean number of abstracts, presentations, and publications: 3.5
Mean number of work experiences: 2.6
Mean number of volunteer experiences: 5.3

Many top students applied for 50 or more radiology programs so little chance
was left for average students (181 programs participate in NRMP match this
year). Even high USMLE scores were no guarantee as many 99ers only got less
than 10 invites. Stories about people going for more than 10 interviews but
still not matching last year caused great fear and insecurity among
applicants. Many top students planned to attend as many interviews as they
can get, thus there are only very few cancellations. In contrast, Internal
medicine applicants only need about 4-8 interviews to match.

1) Is location a factor for competitiveness?
Absolutely. A so-so program at a desire location can be very competitive,
because many AMGs treat location as one of their top priorities. For example
, there is stiff competition for programs in DC, Boston, Chicago, Seattle,
and CA. One east coast student (Step 1 > 250, AOA, honored most clinical
rotations) said that he didn't get any radiology invites from Chicago and
Seattle, even community programs. Big cities are single candidates' top

2) Is there a regional basis?
Yes in a great degree. Some programs especially community hospitals give
preference to local candidates (or those come from neighboring states).
Several programs asked me about how seriously I'll attend a residency
outside of my region. Many programs on the east coast are more “open minded
”, while it's most difficult for outsiders to get into CA programs. There
are just too many qualified candidates in California (thanks for those
highly intelligent and hard-working Asian students there).

3) What are the program's selection criteria for AMGs?
It appeared “random” for the selection process, because selection
committees at different programs have their own ideas about an ideal
candidate. For example, one program I know doesn't rank any DO students, but
another one likes to pick up good DO candidates. In general the total
package counts. The initial screening is usually based on third-year
clinical grades, USMLE step 1 score, and recommendation letters. After that
the rest of the application will be evaluated. Strong research and clinical
experiences can carry a lot of weight.

4) How important USMLE Step 1 score is?
Very important, especially for competitive specialties like radiology. A
high score can open some doors for you. Of course this is only one of the
selection criteria, and the “total package” really counts. Some people
with both Steps > 240 got zero radiology invites, while others with Step 1
in 220s got a fortune because something in their applications caught PD's
eyes (graduates from top medical schools, research and volunteer experiences
, strong LoRs, connections, etc.) Some top academic programs will value more
on research experiences (this is good for CMGs. With strong research
background you'll have an advantage even with so-so USMLE scores). On the
other hand some community/lower-tier university programs may reject high-
scorers based on the likelihood those people will end up somewhere else, or
the past bad experiences of dealing with a few annoying high-scorers.

5) How important USMLE Step 2 score is?
In general it's less important for AMGs, but it's important for FMGs. AMGs
don't have to submit a Step 2 CK score at the time of the application. One
of the surgery programs I applied for requires a minimum score of 220 on
Step 2 CK before interview. Some programs required Step 2 CK score before

6) Is MSPE (Dean's letter) important?
Some programs may wait for MSPE before making any decisions. For many
programs MSPE is unimportant for strong candidates. It's used for evaluating
middle-tier and marginal applications.

7) Does an application need to be “complete” to be reviewed?
The answer is “Yes” but programs may have different definitions about what
constitutes as a “complete application”. Program A for example, may set
the filter as “CAF, Step 1 score, at least one LoR”. Program B, could be
more serious and may set the filter as “CAF, Step 1 score, Step 2 CK score,
transcript, 3 LoRs”. Our school uploaded transcripts on September 30, and
some programs already reviewed our applications and gave out offers before
that date.

8) Is October too late for application?
Most preliminary medicine and transitional year offers came in September, so
it's a good idea to apply early. I did another general surgery rotation in
September-October time frame and got a strong LoR from the surgeon. I sent
out my second-wave surgery applications in October 15 and received invites
from most of them. Most radiology programs sent out invites in October and

9) Are there any “big waves” for invites?
The invites came in every week since early September. The busiest weeks were
October 19-23 (14 invites arrived) and October 26-30 (8 invites). In post-
MSPE we see lot activities from programs with a bunch of invites and

10) May I use a connection?
Giving out a favor through a “back door” is considered as an unethical
behavior. The best “connection” is letting people to know you well, for
example, through observership/externship, research collaboration, and away
clinical rotations. It's difficult to evaluate a candidate only from a short
interview. Away rotations are very popular among AMGs because the students
can work closely with attendings/residents in that program for several weeks
. I did one radiology away rotation close to home and that program offered
me an interview.

11) For each position a program will interview how many people?
Anywhere from 8 to 20. FREIDA lists the number of residency positions for
each program and the number of people the program interviewed last year.

12) Should I respond to an interview invite ASAP?
Please do. Some programs send out more invites than the available interview
slots. If you respond several hours later you may end up in their wait list.


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