A D.O. Student��s Guide to Residency
Where
Does It End?
Draion
M Burch, DO
Council
of Interns and Residents
American
Osteopathic Association
1
Disclaimer!
- The goal
of this lecture is not to persuade any osteopathic medical student to
pursue any particular specialty, residency program or D.O./M.D. postgraduate
training. The purpose of this lecture is to help you make an informed
decision. The information in this lecture is subject to change!
Outline
- 2nd
year
- CV
- Portfolios
- Research
- Academic
File
Outline
- 3rd
year
- Unique
Rotations
- Evaluations
on Rotations
- Choosing
a specialty
- 4th
year
- Budgeting
- Scheduling
and Applying for Elective Rotations
- ��Audition
Rotations�� and Acting/Sub-Internships
4
Outline
- 4th
year (con��t)
- Boards-
(COMLEX Level 2/ USMLE Step 2)
- Tips for
selecting a residency programs (AOA vs. ACGME)
- Preparing
to Apply for Residency
- Electronic
Residency Application Service (AOA vs. ACGME)
- Residency
Interviewing Skills
- The Match
and Scrambling Processes (AOA vs. ACGME)
- Requirements
to Start Residency (AOA vs. ACGME)
5
Outline
- Post-doctoral
- Medical
Licensing/Board Certification (AOA vs. ACGME)
- Osteopathic
Approval of ACGME Postdoctoral Training Programs -Resolution 42
2nd
year
7
By
the end of your 2nd year
- Update
Curriculum Vitae
- Start Portfolio
- Conduct
Research
- Student
Researchers are more desirable to competitive residency programs!
- Review
Academic File
- Make copies
of items in your academic file for your portfolio!
Curriculum
Vitae Essentials
- Identification
Information
- Education
- Work Experience
- Leadership
- Research
- Publications,
Poster Competitions, Presentations
- Professional
Experience
- Professional
Affiliations
- Military
- Volunteer
Activities
- Honors
& Awards
- Special
Skills
- Hobbies
& Interests
- References
Portfolio
Essentials
- Title
Page with identification information, objective��
- Table
of Contents
- Curriculum
Vitae
- Personal
Statement
- Evaluations
- Clinical
evaluation summary, recommendation letters, etc��
- Honors
- Top 10%
letters, Scholarship Awards, Certificates, etc��
- Research
- Publications,
Posters, Protocols, Papers not published, etc��
- Lectures
- Public
Relations
3rd
year
11
Unique
Rotations To Consider
- International
Research Rotation
Do a research rotation
at a residency program of interest!
12
Evaluations
On Rotations
- During
your clinical years, you will receive grades per rotations.
- Try to
earn HONORS on all of your clinical rotations-
especially in your specialty of choice.
13
By
the end of 3rd year
Time to Choose a Specialty
- You should
have narrowed down your choices of specialties to 1-2 .
- You can
apply to more than one specialty via ERAS!
- If not,
don��t worry��yet! The earlier you decide, the easier this process
will be for you.
- Once you
have decided on a particular specialty, apply for out rotations/electives
in either this field or in one of its subspecialties.
14
4th
year
15
Budgeting
- Expenses
during 4th year include:
- Boards
USMLE Step 2 &/or COMLEX Level 2
- COMLEX
Level 2 Physical Examination/Clinical Skills + Travel expenses to testing
site
- Elective
Rotations
- Application
Fees, Travel expenses
- ERAS application
- The number
of programs you are applying to
- The number
of specialties you are applying to
- Transcripts
(COMLEX/USMLE and Medical School)
- Interviews
- Travel
expenses such as flights, hotels, rental cars, meals
- Costs
can range from ~$100-$5,000
16
Elective
Rotations
- Visit
potential residency programs by applying to do elective rotations or
acting internships (AI)/Sub-internships (Sub-I).
- Try to
rotate in these residency programs between July-Dec. Try to interview
while you are rotating there!
- Pursue
a well-rounded medical education��this is your last chance to truly
see anything and everything before you begin your residency or internship.
17
Elective
Rotations
- Elective
rotations are just what they say. You get to choose what you want to
do.
- Complete
rotations that will help you get a well-rounded education.
- Use this
time to see various residency programs.
- If a program
director is in a specific subspecialty, do an elective rotation in that
subspecialty!
18
Elective
Rotations
- Check
hospital websites for:
- Intern
and residency programs (Graduate Medical Education Links)
- Application
requirements and deadlines for elective rotations
- Student
(Extern) Rotation Application Form- may be an online application process.
19
Elective
Rotations
- Apply
for elective rotations 3-6
months in advance.
- Hospitals
will fill these rotations with their home medical school students before
they place students from outside schools.
- However, if you apply early
you will be on the top of the ��outside�� school pile.
- Some hospitals
charge an application fee
20
Elective
Rotations
- Some hospitals do not provide housing, travel expenses,
or meals.
- Apply
to 2-3 rotations for the same month.
- You may be rejected from an
elective rotation.
- Cancel
a rotation if you have another scheduled that you plan on completing
so other students can have the same opportunities as you.
21
Elective
Rotation Paperwork
- Hospital
Student Application Form
- Immunization
Records
- Letter
of Good Standing
- Professional
Liability Insurance Certificate
- Copy of
Transcript
- Copy of
USMLE Step 1/COMLEX Level 1
- CV or
resume
- Criminal
Background Check/Fingerprint Analysis
- Additional
paperwork specific to the hospital may be required.
22
Elective
Rotations
- Most students
will agree that you should try to schedule one or both of the following:
- ICU rotation
- Acting/Sub-internship
Elective
Rotations
- Most students
will agree that you should try to schedule one or both of the following:
- ICU rotation
- Acting/Sub-internship
Acting/Sub-internship
- You and
another student are paired up for the month. The two of you equal one
intern. You assume the responsibilities of an intern in terms of call,
admissions, and discharges.
- Glimpse
of intern year while still having someone looking over your shoulder.
- Chance
to shine and show a particular program what you are capable of.
- Great
way to get a good letter of recommendation, which
carries more weight.
25
��Audition��
Rotations
- Remember:
rotations at hospitals you will be applying to for residency should
be considered ��Audition�� rotations.
- Show the
program why they should take you. Get your face seen and known. This
way when they receive your application they will remember the impression
you left.
26
Boards
By now, you have completed
and passed USMLE
Step I and/or COMLEX
Level 1. Many students ask:
- Do I need
to take step 2/level 2 before I apply for residency?
- Do I need
to take the USMLE to apply to an allopathic program?
27
When
to take USMLE
Step 2/COMLEX Level 2?
- You should
take the your second set of boards
(including the PE)
by the late summer/early
fall!
28
Do
you need to take step 2/level 2 before residency applications?
- Most residency
programs would like to see step 2 before they make their official rank
order list.
- Therefore
you should take the boards (including the PE) by the late summer/early
fall.
- Some programs
may not rank you until you have completed both parts of step 2 (CK and
PE)!
- Make sure
to check with the programs you are interested in as these requirements
are program-dependent.
29
Do you need to take the USMLE to apply to an allopathic program?
Do you
need to take the USMLE to apply to an allopathic program?
- No program
can deny your application if you just submit your COMLEX scores; however,
they may choose to not consider you.
- This is
program dependent. At some programs, your chances may be increased if
you take the USMLE.
- Choosing
to take only COMLEX depends on how competitive an applicant is and how
competitive their specialty choice is!
30
Reasons Not to
Take the USMLE
- COMLEX
is based on the COMS curriculum while USMLE is based on the LCGME curriculum.
- A D.O.
must pass all 3 parts of the COMLEX only to be licensed as a D.O.
- If you
fail any exam and the state licensing board inquires, you must report
your results- which becomes part of your permanent record that your
state licensing board keeps!
- You double
the cost, preparation time, etc. by taking both exams.
- Some ACGME
programs will accept candidates with COMLEX only.
31
Board
Preparation
- Common
resources for Step 2/Level 2:
- First Aid
for Step 2
- Boards
and Wards- great resource for rotations
- Crush for
the Boards
- Usmleworld.com
or Kaplan Question Bank
- OMT Review
- Savarese
- W. Crowe
COMLEX Review
- http://www.md-do.org/NewOMMBoard%20Review02-REV.htm
32
Miscellaneous
Info about Boards
- You can
take the USMLE Step 2, without taking USMLE Step 1.
- There is
not a consensus if this is helpful, however, I would like to make you
aware of this option.
33
Residency
34
Allopathic
Positions you may apply to
- Categorical
- programs
that begin in the PGY-1 year and provide the training required for board
certification in medical specialties.
- Advanced
- programs
that begin in the PGY-2 year after a year of prerequisite training.
- Preliminary
- one-year
programs beginning in the PGY-1 year that provide prerequisite training
for advanced programs.
- Physician
- programs
that are reserved for physicians who have had prior graduate medical
education. Physician programs are not available to senior U.S. medical
students.
35
Osteopathic
Positions you may apply to
OPTION 1 (OGME-1 Resident)=
Specialty Track
- The first
postdoctoral year will be the first year of residency. This is the same
as the current specialty track model. All trainees will receive residency
credit for this 1st year of training. These positions will be known
as OGME-1 Resident.
36
Osteopathic
Positions you may apply to
OPTION 2 (OGME-1 Preliminary)=
Special Emphasis
- The first
postdoctoral year is not included in the residency, but is a specific
preliminary entrance requirement into the specialty to produce an enhanced
educational opportunity for that specialty. The trainee will have been
accepted into the OGME-2 specialty while a senior in osteopathic medical
school. These positions will be recorded by the AOA as Preliminary interns
and be known as OGME-1 Preliminary.
37
Osteopathic
Positions you may apply to
OPTION 3 (OGME- 1
Traditional)= Traditional
Rotating Internship
- This first
postdoctoral year is not included in the residency, but is available
in the format of a Traditional Rotating Internship. It may be utilized
by any osteopathic graduate uncertain of residency plans or those who
want a single year program. These positions will be recorded by the
AOA as OGME-1 Traditional.
38
39
40
Choosing
a Residency��Factors To Consider
- Location
and proximity to family
- Didactics
- Volume
(Surgeries, Deliveries, Procedures)
- Fellowship
opportunity
- Program
Reputation/Rankings
- Program
atmosphere (residents/attendings/facility)
- Research
opportunities
- Night
float vs. overnight call
- Amount
of scutwork
- Board
pass rates
- Amount
of autonomy
41
Information
about Residency Programs
- FREIDA
Online Website
- http://www.ama-assn.org/ama/pub/category/2997.html
- DO Online
Website ��Opportunities��
- Student
Doctor Network Website
- http://www.studentdoctor.net/
- SCUTWORK
Website
- Washington
University SOM Website
- http://residency.wustl.edu/
- Great website
with helpful information about residency
- MDsecrets
- http://mdsecrets.com
- List of
unfilled allopathic residencies
42
How
do you know if a
program is ��DO Friendly��?
- Look at
the programs websites and see what their specific requirements are-
also look to see if there are any DO��s in the program.
- Some programs
require passage of USMLE Step 1 to apply for their residency program!
- If they
list resident contact information (email address), contact the residents
especially if there are DOs.
- Don��t
hesitate to contact the program directors or program coordinators if
you have any questions!
43
What
if I choose not to do an Osteopathic Internship?
- There
are five states (PA,
OK, FL, WV, and MI)
which require completion of an osteopathic internship in order to be
licensed to practice in that state.
- Without
this internship or osteopathic approval you are unable to participate
in a residency, fellowship, or practice in these five states.
44
Documents
Needed for ERAS Application
- Regardless
of whether you are going to pursue osteopathic or allopathic postgraduate
training there are specific documents you must have.
- You will
need:
- 3-4 good
letters of recommendation
- (1 from
your specialty choice)
- Updated
CV
- Personal
statement
- Dean��s
Letter
- USMLE/COMLEX
Transcripts
- Medical
School Transcripts
- Photo
45
Letters
of Recommendation
- You will
need at least 3-4 good letters of recommendation.
- Don��t
get them all in one specialty. Programs want to see that you are a well-rounded
candidate (not only did you do well in Pediatrics, but also Surgery
and Psychiatry)
- Get an
early start- ask for letters during your 3rd year!
- Don��t
wait until a few weeks before you plan on applying on ERAS.
- Consider
completing an acting internship for a final letter of recommendation.
46
Letters
of Recommendation (LOR)
- Each LOR
will be accompanied by an ERAS coversheet, which includes your information,
the physicians information, and your option to waive your right to see
the LOR
- You may
want to waive your right on the cover sheet. This will allow the physician
to give you a fair and unbiased evaluation.
47
Packet
for Preceptors to help
them write your LOR
- Curriculum
Vitae
- Personal
Statement
- Their
evaluation of you during your rotation
- Thank
you letter
- ERAS coversheet
- Small
envelope- stamped, addressed to your address in case preceptor wants
to mail you a copy
- Large
envelope- stamped, addressed to Student Affairs for ERAS application
48
Personal
Statement (PS)
- Don��t
underestimate the importance of your personal statement!
- Don��t
procrastinate!
- Start writing
it as soon as you choose a specialty.
- Have several
individuals review your PS-your advisors, residents in your specialty,
the residency program director at your medical school!
49
Websites
to help you write
your Personal Statement
- http://u101.com/articles/med-school/residency-personal-statem.shtml
- http://www.rushu.rush.edu/studentlife/career/medpstate.html
- http://www.ama-assn.org/ama/pub/category/6700.html
- http://www.residencyandfellowship.com/page3.html
50
Medical
School Transcripts
- Request
copy of transcripts for yourself and for Student Affairs (for
ERAS).
51
COMLEX
&/or
USMLE Transcripts
- On MyERAS,
you must release your COMLEX transcripts!
- On the
other hand, you do not have to release your USMLE transcripts!
- May be
changing for future classes. Make sure you look into this if you took
the USMLE.
52
Dean��s
Letter
- Now known
as the Medical
Student Performance Evaluation (MSPE)
- Your Dean��s
letter is a formal institutional reflection of your academic background
and achievements.
- It is NOT
a personal letter of recommendation.
- Your medical
school��s student affairs uses your Personal & Academic File along
with your Curriculum Vitae to write your Dean��s Letter.
53
What
does your Dean��s Letter contain?
- Confirmation
of good academic standing
- Anticipated
Date for D.O. degree
- Your undergrad/grad
degree
- Degree,
year, where conferred
- Undergraduate
Activities Descriptions
- Volunteer
work, research activities, clubs, honors, teaching, etc.
What
does your Dean��s Letter contain?
- Explanation/Description
of curriculum
- Activities
Descriptions
- Volunteer
work, research, clubs, tutoring, professional associations, honors,
awards, fellowships
What
does your Dean��s Letter contain?
- Board
Exam Completion (percentile included if in top 30%)
- Rotations
to date, including:
- Positive
comments from each rotation
- Final assessment:
marginal to honors
- Closing
paragraph to summarize and recommend
Request
a copy of your Dean��s Letter
- Request
a copy in early Fall of Senior Year
57
Photo
- Use a
picture of you in your business attire- it looks more professional. Remember- you are interviewing
for a job!
58
ERAS
59
https://services.aamc.org/eras/myeras2009/
What
is ERAS?
- ERAS is
a service that transmits residency, fellowship and osteopathic internship
applications, letters of recommendations, MSPEs, medical school transcripts,
USMLE transcripts, COMLEX transcripts, and other supporting credentials
from you and your designated Dean's Office to program directors using
the Internet.
60
4
Components of ERAS
- MyERAS
Website
- This is
where you complete your application and personal statement, select programs
to apply to, and assign documents to be received by those programs.
- Dean��s
Office Workstation (Student Affairs)
- This is
ERAS software used by staff at your designated Dean's Office. From this
software they create the ERAS Token that applicants use to access MyERAS.
They also use this system to scan and attach supporting documents to
your application, such as photograph, medical school transcript, MSPE,
and letters of recommendation.
61
4
Components of ERAS
- Program
Director��s Workstation (Hospital Graduate Medical Education Office)
- This is
ERAS software used by program staff to receive, sort, review, evaluate,
and rank applications.
- ERAS
Post office
- This is
a central bank of computers which transfers the applications. You can
monitor the activity of your files in the ERAS Post Office on the Applicant
Data Tracking System (ADTS).
62
How
does ERAS work?
- Applicants
receive an electronic Token from their assigned Dean's office, and use
it to access the MyERAS Web site.
- Applicants
complete their ERAS application, select programs, assign supporting
documents, and transmit their application to programs.
- Schools
receive notification of completed application, and start transmitting
supporting documents: transcripts, letters of recommendation, photos,
MSPEs.
63
How
does ERAS work?
- Examining
boards receive and process requests for score reports.
- Programs
contact the ERAS Post Office on a daily basis to download application
materials
64
65
ERAS
Timeline
- Mid
June- Download
ERAS Applicant Manual will be available for PDF download by chapters
or in its entirety on the Web site.
- Late
June-
Schools may begin to generate and distribute MyERAS tokens to applicants.
66
ERAS
Timeline
- July
1st-
MyERAS website opens to applicants to begin work on applications.
- July
15-
Osteopathic applicants may begin selecting and applying to Osteopathic
Internship programs ONLY. Osteopathic Internship programs can begin
contacting the ERAS Post Office to download application files.
67
ERAS
Timeline
- September
1st-
Applicants may begin applying to ACGME accredited programs. ACGME accredited
programs may begin contacting the ERAS Post Office to download application
files.
- November
1st-
MSPEs (aka Dean��s Letters) are released.
68
ERAS
Timeline
- February- Osteopathic
Match
- March- NRMP Match results will be
available.
- May
31st- ERAS Post Office will close
to prepare for the next season.
69
Application
Process Guideline
- Step
1:Research/Contact programs of interest to find out their requirements
and deadlines.
- Step
2:Request your token from your designated Dean's Office and download
your applicant manual.
- Step
3:Register on MyERAS.
70
Application
Process Guideline
- Step
4:Register for your Match.
- Step
5:Obtain documents and send them to the designated Dean's Office
to be scanned and uploaded.
- Step
6:Create your Profile and MyERAS Application.
71
Application
Process Guideline
- Step
7:Create personal statements, create a list of recommendation writers,
and authorize transmission of your USMLE and/or COMLEX transcripts.
- Step
8:Search/Select programs of interest.
- Step
9:Assign documents to programs.
72
Application
Process Guideline
- Step
10:Certify and submit your MyERAS application then apply and pay
for programs.
- Step
11:Check the status of your applications.
- Step
12:Adding programs/Updating assignments and keep your Profile current.
73
Using
MyERAS- Overview
Account
- Profile
- Checklist
- Messages
- Password
Application
- Home
- Page One
- General Info
- Page Two
- Education
- Page Three
- Medical Education
- Page Four
- Previous Residency/Fellowship
- Page Five
- Experience
- Page Six
- Publications
- Page Seven
- Exams
- Page Eight
- Licensure Info
- Page Nine
- State Medical
Licenses
- Page Ten
- Race
- Page Eleven
- Ethnicity
- Page Twelve
- Misc Info
Using
MyERAS- Overview
Documents
- USMLE
Transcript
- COMLEX
Transcript
- Personal
Statements
- Letters
of Recommendation
Programs
- Search
Allopathic Programs
- Search
Osteopathic Programs (Visible to Osteopathic Applicants only)
- Programs
Selected
- Programs
Applied To
- Preview
Invoice
- Apply
to Programs
- Invoice
History
- Assignments
Report
ERAS
Application Fees
Number of Programs
Per Specialty AAMC Fees
- Up to
10 $60
- 11-20 $8
each
- 21-30 $15
each
- 31 or
more $25 each
ERAS
Application Fees
- Example
1: An applicant applies to 30 emergency medicine programs, AAMC
fees are $290. (60 + (10 x $8) + (10 x $15)).
- Example
2: An applicant applies to 20 OB/GYN programs, and 10 family practice
programs. The fees are $200. ($140 for OBGYN and $60 for family residency
programs).
ERAS
Application Fees
- Example
3: An applicant applies to 23 internal medicine programs, and 7
radiology programs. The fees are $245 ($185 for internal medicine programs
and $60 for radiology programs).
- Example
4: An applicant applies to 12 internal medicine programs, 10 emergency
medicine, and 8 family practice programs. AAMC fees are $196 ($76 for
internal medicine programs, $60 for emergency medicine programs, and
$60 also for family practice).
ERAS
Application Fees
- Example
5: A military applicant applies to 5 military family practice programs,
3 military internal medicine programs, 2 military surgery programs,
and 7 civilian pediatrics programs. The fees are $120 ($60 for the 10
programs consolidated under the military and $60 for the 7 civilian
programs).
ERAS
Application Fees
- Special
Instructions for Osteopathic Graduates:
Although the ERAS 2008 fee structure is the same for osteopathic and
allopathic programs, it is administered differently. For osteopathic
internships, the fee is applied based on the total number of programs
applied to, regardless
of the specialties
to which the applicant applies. Applicants applying to allopathic programs
are assessed based on the total number of programs applied to within a specialty.
80
Miscellaneous
Fees
- US
(Allopathic and Osteopathic) and Canadian Applicants
The National Board of Medical Examiners (NBME) charges a flat $50
fee to US and Canadian applicants who request transmission of USMLE
and/or NBME to programs, regardless of the number of transcripts requested.
The NBME fee is included on your invoice and collected by the AAMC.
81
Miscellaneous
Fees
- US
Osteopathic Applicants
Osteopathic applicants may request an unlimited number of COMLEX transcripts
to be sent via ERAS for $50. Applicants who request USMLE
transcripts via ERAS also pay a $50 fee to the NBME for an unlimited
number of electronic transcripts. Transcript fees are included on your
invoice and are collected by AAMC.
82
Payment
Method
- You may
use your VISA or MasterCard to pay for your ERAS fees online. This is
the safest and fastest way to process your application.
- You also
have the option to pay your ERAS fees by selecting the check/money order
option, printing out the invoice in the payment module, and sending
your fees by check (U.S. currency only) to the address on the invoice.
Your application(s) may be withdrawn if payment isn't received within
two weeks.
- All fees
are payable in U.S. funds on U.S. banks ONLY.
83
Payment
Method
- If your
check is returned for insufficient funds, you submit partial payment,
or there is a problem with your credit card payment, ERAS will endeavor
to collect fees owed and your application may be withdrawn.
- If ERAS
withdraws your application due to nonpayment, your application will
be withdrawn from each program to which you applied.
84
ERAS
Use During the M.D. Scrambling Process
- From 12
noon on the third Tuesday in March, until 12 noon on the third Thursday
in March each year, there is a "Scramble" period. This is
before the NRMP Match Day results are revealed.
- During
this period, applicants who did not match to a position attempt to fill
remaining positions. ERAS is available to applicants to apply to a maximum
of thirty (30) programs free of charge who meet the following criteria:
- The applicant
must have participated in ERAS during the regular season. This means
you must have applied to (and paid for) at least one program.
- The applicant's
account must be paid in full no less than two weeks prior to the Scramble
period.
85
Additional
��Scramble�� Information
- FindAResident is a company created by the
AAMC to help applicants find open residency positions.
- http://www.aamc.org/students/findaresident
- It is
an effective resource if you wish to:
- Change
specialties
- Change
location
- Switch
residency or fellowship programs
86
Osteopathic
Match Application
- The osteopathic
match occurs through the National Matching Services (NMS).
- You will
sign up in Sept. for this match after you are provided a pin number
from your medical school.
- The initial
fee is $60 to sign up for this match!
- http://www.natmatch.com/aoairp/
Always Register
for the OSTEOPATHIC Match!
87
Allopathic
Match Application
- The allopathic
match occurs through the National Residency Matching Program (NRMP).
- You will
sign up on Sept. 1 for this match after you receive your AAMC number.
- The initial
fee is $45 to sign up for this match!
88
Interview
Schedules
- Interviews
at osteopathic programs typically occur from Sept.-Dec.
- Interviews
at allopathic programs typically occur from Nov.-Jan.
- Make sure
to schedule rotations and vacation time accordingly.
89
Interviewing
Skills
- Before
you interview, try to go through a ��mock�� interview with a faculty
member.
- Review
the list of potential questions to ask during your interview.
90
Other
Interviewing Tips
- Schedule
rotations appropriately for interview season.
- Choose
rotations which have lighter schedules.
- Cluster
interviews-if within the same city
91
Other
Interviewing Tips
- Interact
with the residents during the interview day.
- They are
the best source for information. Keep in mind some residency programs
allow their residents to serve on the committee so act appropriately
with the residents.
- Schedule
interviews, even if its not at the top of your list.
- A program
can feel different in person. Don��t base your decision on their website
or literature provided.
92
After
Interviews
- You should
send a ��Thank You�� note in a timely manner.
- This can
be in the form of an email, phone call to the program director, or a
hand written thank you note.
93
After
Interviews
- You can
choose whomever you like to thank, but most applicants thank their interviewers
and the program director.
- Make sure
to get business cards from all of your interviewers. After each interview
write down some highlights from the interview that you can mention in
your thank you note. This will help you stand out and will not look
like a generic thank you.
94
Letter
of Intent
95
Letter
of Intent
- After
you have finished interviewing some suggest that you write a letter
of intent to your top one to three choices.
- State
why you want to be there are what this residency program offers that
makes you want to train there.
96
Letter
of Intent
- Do not
lie and say to all three programs that you are ranking them #1, just
say ��highly ranked�� to #2 & #3
- This is
a great way to keep in contact with a program
- Residency
programs typically rank applicants in late Jan/ early Feb.
- Some programs
rank applicants immediately after you interview!
97
After
Interviews
- After
you have completed the interview season, you are now challenged to create
a Rank Order List (ROL)
- When creating
a rank list remember to rank the programs that you want to go to in
the order YOU want them and not based on
your ��chance�� of matching there.
98
Rank
Order List (ROL)
- The Rank
Order List (ROL) is your preferred rankings for the residency you are
pursuing.
- For the
D.O. match, your ROL is created on the AOA Intern/Resident Registration
Program website
- For the
M.D. match, your ROL is created on the NRMP website
99
ROL
- You can
rank as many or as little programs as you like. The rankings are free
for programs 1-30, after which you will be charged a fee for additional
rankings.
- Applicants
will have a greater chance of matching if they rank more programs.
- You can
only rank programs you interviewed at.
100
Match
Algorithm
101
At first look it may
seem like a foreign language, but with careful observation the match
really gives the applicant the advantage.
Not
the real match algorithm!
The
Match Algorithm
- The match
favors the applicant!
- Here are
the websites explaining the algorithms:
- M.D.
- http://www.nrmp.org/res_match/about_res/algorithms.html
- D.O.
- http://www.natmatch.com/aoairp/ (click on ��match
process��)
102
Match
Algorithm Example
- If your
number one ranks you highly (ex. if they have 12 spots and you are within
the top 12) you will match at your number one.
- However,
what happens if you are number 16 and the first 12 applicants all have
this hospital ranked as their number one. Then you don��t match there
and you continue to your number 2.
103
Match
Algorithm Example
- If your
number 2 has you listed highly (again if there are 12 spots, and you
are listed within the top 12) you will match.
- Note:
Even if the 12 spots are filled by other candidates you can ��bump
off�� the last candidate if you are ranked higher.
104
The
Match Algorithm
- This is
why you should always rank your list based on where YOU want to go.
- You can
find another example involving several theoretical applicants at:
- http://www.nrmp.org/res_match/about_res/algorithms.html
105
Osteopathic
Match Timeline
JUNE
- Beginning
in June, students can download the Agreement form for participation
in the AOA Intern/Resident Registration Program (the "Match")
from this web site. To register for the Match, each student must return
a signed Agreement to National Matching Services Inc. accompanied by
the appropriate registration fee.
JULY - JANUARY
- Students
must apply to programs independently of the Match (via ERAS). Programs
receive applications and interview students independently of the Match.
Application deadlines for programs vary, therefore students should check
with programs regarding their deadline dates.
106
Osteopathic
Match Timeline
AUGUST - SEPTEMBER
- Each institution
offering osteopathic internship positions beginning in 2007 must provide
to National Matching Services Inc. information on the program(s) being
offered by the institution in the Match.
OCTOBER
- Recommended
date by which students should return their Agreements and registration
fees to National Matching Services Inc.
107
Osteopathic
Match Timeline
Early NOVEMBER
- By this
date, a Listing of Programs participating in the Match will be available
on this web site.
Late NOVEMBER
- By this
date, instructions for submitting Rank Order Lists and obtaining Match
results will be provided to registered students and programs.
108
Osteopathic
Match Timeline
Late JANUARY
- Final
date for submission of student and program Rank Order Lists. No Rank
Order Lists or Agreements can be accepted after this date.
Mid FEBRUARY
- Results
of the Match are released to all participants in the Match (students
and institutions), as well as to the colleges of osteopathic medicine.
109
Osteopathic
Match Timeline
- Institutions
must complete an institutional contract for each matched student, and
send it within 10 working days after receipt of the Match results to
the student for signature. Each matched student must sign and return
the contract to the institution within 30 days after receiving the contract
from the institution.
110
Allopathic
Match Timeline
Mid August
- Applicant
registration begins at 12:00 noon eastern time.
September 1
- Institution
/ program registration begins at 12:00 noon eastern time.
December 1
- Applicant
registration deadline (Note: Applicants may register after this deadline
by paying an additional late registration fee of $50.00 when registering
after 11:59 PM eastern time.)
111
Allopathic
Match Timeline
Mid January
- Rank order
list entry begins. Applicants and programs may start entering their
rank order lists at 12:00 noon eastern time.
Late January
- Quota
change deadline. Programs must submit final information on quotas and
withdrawals by 11:59 PM eastern time.
Late February
- Late registration
deadline.
112
Allopathic
Match Timeline
Late February
- Rank order
list certification deadline. Applicants and programs must certify their
rank order lists by 9:00 PM eastern time. CERTIFIED applicant and program
rank order lists and any other information pertinent to the Match must
be entered in the R3 System by this date and time.
Early March (3rd
Monday in March)
- Applicant
matched and unmatched information posted to the Web site at 12:00 noon
eastern time.
113
Allopathic
Match Timeline
Early March (3rd
Monday in March)
- Filled
and unfilled results for individual programs posted to the Web site
at 11:30 am eastern time.
Early March (3rd
Tuesday in March)
- Locations
of all unfilled positions are released at 12:00 noon eastern time. Unmatched
applicants may begin contacting unfilled programs at 12:00 noon eastern
time.
Mid March (3rd
Thursday in March)
- Match
Day! Match results for applicants are posted to Web site at 1:00 pm
eastern time.
114
Allopathic
Match Timeline
Mid March
- Hospitals
send letters of appointment to matched applicants after this date.
- Note:
Any contact between programs and unmatched applicants (or their designees)
prior to 12:00 noon eastern time Tuesday, March 13, 2007, is a violation
of the Match Participation Agreement. Contact between programs and matched
applicants prior to the general announcement of 2007 Match results at
1:00 pm eastern time Thursday, March 15, 2007, also is a violation of
the Match Participation Agreement.
115
Can you participate
in both matches?
- YES.
As a D.O. applicant you can choose to apply to both the D.O. and M.D.
match, the D.O match, or the M.D. match. The D.O. match occurs before
the M.D. match.
- If you
apply for both matches and you match into an osteopathic residency program
you will automatically be withdrawn from the match. This match is a
binding contract. Therefore you cannot break it to try to match in the
M.D. match.
- If you
don��t match at a D.O. spot, and you applied to both matches, you will
then be entered in the M.D. match.
116
Can
you participate in both matches?
- You can
match to a D.O. intern year and then match into an M.D. program if that
program requires a prelim year (i.e. anesthesia, PM&R, path). You
will apply to the M.D. match for a PGY-2 spot.
- If you
choose to pursue just the allopathic match you should withdraw from
the D.O. match on natmatch.com. There is an option for withdrawal that
states you will be competing in the M.D. match.
117
Can
you participate in both matches?
- There
is one exception in regards to residency requirements. If you want to
pursue an allopathic residency in ophthalmology, you MUST do
an allopathic transitional year.
- The Ophthalmologic
board does not recognize an AOA internship year and therefore you will
not be granted board certification because you failed to complete the
necessary requirements.
118
Pre-Match
Contractions?
- Prematches
are residency position offers outside of the match.
- Prematches
are available to D.O.s and FMGs applying to the allopathic match.
- As a D.O.,
you can accept a prematch from an allopathic residency program. However,
if you pursue this route, make sure you have a signed contract. Do not
skip the match based on a ��verbal agreement��.
Pre-Match
Contracts?
- Also you
may want to have an attorney look over the contract for any loopholes.
- If you
accept a prematch, you must withdraw from the match.
- Prematches
occur before Jan. 31, which is the last day programs have until they
have to notify the NRMP of the number of seats (quota) available for
the match
What
if you don��t match��
- If for
some reason you do not match you can always scramble.
- The ��scramble��
is a brief period of time that is set aside for those applicants who
did not match. The Scramble gives applicants an opportunity to contact
unfilled programs and possibly secure a position.
- Both matches
(D.O. and M.D.) have post-match scrambles for applicants who did not
match into a perspective residency program.
121
Osteopathic
Scramble
- Students
who fail to match initially are provided with information on programs
with available positions for them to contact.
- Likewise,
programs with available positions are provided with information regarding
unmatched students to contact. Thus, opportunities to obtain a position
may still exist after the Match.
- Unmatched
students may receive emails from programs that did not fill.
If you have to scramble,
go back to your medical school in order for them
to help you!
122
Allopathic
Scramble
- Unmatched
applicants who submitted a certified rank order list will be given access
to the Dynamic List of Unfilled Programs at 12:00 p.m. EST on Tuesday
of Match Week. Applicants may not contact unfilled programs prior to
12:00 p.m. EST that Tuesday. The list is updated by the NRMP every hour
to reflect the number of remaining unfilled positions.
123
Allopathic
Scramble
- If you
have already applied to a program, but that program still has unfilled
positions, you may contact the program and inform them that you wish
to be considered a Scramble applicant. That program will not count towards
your thirty (30) Scramble programs on MyERAS. Also, during Scramble,
you may NOT apply to more than thirty (30) programs using MyERAS, even
if you wish to pay for them.
124
Allopathic
Scramble
- During
this period, applicants who did not match to a position attempt to fill
remaining positions. ERAS is available for applicants to apply to a
maximum of thirty (30) programs free of charge who meet the following
criteria:
- The applicant
must have participated in ERAS during the regular season. This means
you must have applied to (and paid for) at least one program.
- The applicant's
account must be paid in full no less than two weeks prior to the Scramble
period.
125
Requirements
to Start Residency
- Each residency
has its own requirements. There are also state requirements that must
be completed for a training license.
- When applying
through ERAS, check with your residency program for the necessary requirements
prior to the start of residency.
126
Licensing
vs. Board Certification
��
127
(A.T. Still��s
original medical license)
Licensing/Board
Certification
- Do not
get these two terms confused.
- Your license
is state dependent.
- Your certification
is based on your residency training.
128
Licensing
- You will
be licensed by the state you are training in.
- At the
beginning of your residency you will be issued a ��training license��
- By the
end of your residency you will apply for a full practicing license.
129
Licensing
- When thinking
about licensure there is one special caveat all osteopathic students
need to consider.
- There
are 5 states that require an osteopathic internship or its equivalent
for licensure purposes. (PA, MI, WV, OK, FL)
- Without
this internship year, you can NOT train or practice because you will
be denied a license from the associated state osteopathic association.
- There
are options, which we will get to later.
130
Certification
- Your certification
is based on your residency training.
- If you
pursue osteopathic training you will be boarded by an affiliated osteopathic
board
- (i.e. IM will be boarded by
the American Board of Osteopathic Internists [ABOI])
- If you
pursue allopathic training you will be boarded by an affiliated allopathic
board
- (i.e. IM
will be boarded by the American Board of Internal Medicine [ABIM])
- States
have no regulation over your certification
131
Certification
- Should
you choose to train in an allopathic residency program or practice in
those 5 states and you are unable to complete an osteopathic internship
year, you can seek to get approval of your first year of residency.
132
Importance of AOA
Certification
- You
can't be a COM Dean, Program Director, or DME without AOA certification!
133
��Resolution
42��
- If you
decide to pursue an allopathic residency program there is a path you
can pursue to get AOA approval of your intern year.
134
What
is this ��Resolution��?
- Some students
who pursue allopathic training will mention Resolution 42.
- This is
a resolution created by the American Osteopathic Association to help
osteopathic physicians remain connected to the AOA.
- These
resolutions require certain criteria to be met during the intern year.
135
History
of these Resolutions
- These
resolutions began because the number of graduates of colleges of osteopathic
medicine out-numbered the available osteopathic residency positions.
- In 1986 Resolution 65 was developed. The AOA allowed
graduates from the classes of ��87-��89 AOA approval of their first
year of training as long as they participated in the AOA match, but
did not match and then pursued ACGME training.
- In 1996
the AOA replaced Resolution 65 with Resolution
22.
136
History
of these Resolutions
- Resolution
22 allowed AOA approval of the first year of ACGME training if there
were ��special circumstances�� and if the applicant completed the
rotational requirements of an osteopathic internship.
- In 1998, Resolution 19 replaced Resolution 22.
137
History
of these resolutions
- Resolution
19 did not require an osteopathic curricular component for approval.
- In March
of 1999, the AOA suspended Resolution 19.
- In July
of 2000, the AOA passed Resolution
42.
- Resolution
42 was designed to clarify the meaning of ��special circumstances��.
It also required a commitment to osteopathic principles and practice
and it allowed current and past trainees a route for AOA approval.
138
Resolution
42
- Resolution
42 is the latest idea created by the AOA for approval of the first year
of ACGME training.
- Resolution
42: "Approval of ACGME Training as an AOA-Approved Internship"
is a policy to grant AOA internship approval for appropriate ACGME training.
139
Resolution
42
- Like previous
training approval policies, the new "Approval of ACGME Training
as an AOA-Approved Internship" policy maintains a consistent theme.
That is, to be eligible for AOA internship approval of ACGME training
the osteopathic physician must complete all six of the traditional rotating
internship��s core rotations:
- 2 months
internal medicine, 1 month emergency medicine, 1 month family practice,
and two additional core rotations (internal medicine, surgery, OB/GYN,
pediatrics, family practice, or emergency medicine) so that a total
of 6 months in these core rotations are completed.
140
Resolution
42
- Unlike
previous policies, the new "Approval of ACGME Training as an AOA-Approved
Internship" policy responds to the needs of current and past trainees
who have completed their first year of training in an ACGME-accredited
program.
- Like the
superceded Resolution 19, special circumstances must be present to request
approval of ACGME training as equivalent to an AOA internship, as indicated
in Resolution 42.
141
Changes
in Resolution 42
Special circumstances
has been Eliminated!
Results
of Resolution 42
- Not everyone
that applies for Resolution 42 is approved.
- As of
November of 2005, a total of 937 applicants have applied under Resolution
42.
- 544 applicants
received approval (58%)
143
Resolution
42
- For more
information regarding Resolution 42, you can call the AOA Division of
Postdoctoral Training at
- (800) 621-1773,
extension 8276.
- Bulger,
J. ��Approval of ACGME Training as an AOA-Approved Internship: History
and Review of Current Data.�� JAOA. Vol. 106 (No. 12). Dec. 2006. 708-713.
- You can
also check out the AOA website :
- https://www.do-online.org/index.cfm?PageID
=sir_postdocabtres42
144
So
what does this mean?
- Resolution
42 will allow approval of an allopathic intern year to be counted as
an AOA-approved internship year.
- This
will allow students to pursue training or practice opportunities in
the states (PA, Fl, WV, Ok, MI) requiring the osteopathic internship.
145
Additional Requirements
for Resolution 42 Approval
- The trainee
must be a member in good standing of the AOA.
- Trainees
are responsible for negotiating rotational changes with their programs.
- A trainee
may attend an AOA annual meeting, state osteopathic annual meeting,
specialty college annual meeting or prepare and conduct an osteopathic
clinical presentation to satisfy the educational activity requirement.
- All osteopathic
clinical presentations are reviewed and subject to approval or disapproval
by a representative of the Program and Trainee Review Committee.
146
Miscellaneous Info
Can
an Osteopathic Trained Resident obtain an Allopathic Fellowship?
YES!
Can
an osteopathic physician who has ACGME Board Certification bill for
treating patients with OMT?
YES!
149
What
to do with this information?
- Although
it may seem overwhelming now, keep this PowerPoint presentation tucked
away in a safe place until you are beginning your 4th year, which is
when I hope it becomes a very valuable document.
Disclaimer!
- The goal
of this lecture is not to persuade any osteopathic medical student to
pursue any particular specialty, residency program or D.O./M.D. postgraduate
training. The purpose of this lecture is to help you make an informed
decision. The information in this lecture is subject to change!
For
more information��
- www.do-online.org
- Here you
can find the list of D.O. residency programs: go to For Students
then Opportunities
- http://www.ama-assn.org/ama/pub/category/2997.html
- Freida
online listing of M.D. residency programs:
- go to
Residency/Fellowship Training Program Search
152
For
more information��
- www.scutwork.com
- A peer
review of residency programs
- www.studentdoctor.net
- A students/resident
online forum
- Iserson,
K. ��Getting into a Residency: A guide for medical students��
- Desai,
S. ��The Residency Match: 101 Biggest Mistakes and How to Avoid Them��
153
QUESTIONS?
154
Contact Information
Draion M Burch,
DO
Region III Trustee
Council
of Interns and Residents
Vice Chair Intern-Resident
Committee
Michigan
Osteopathic Association
Resident Representative
Board of Trustees
American
College of Osteopathic Obstetricians and Gynecologists
Dept of Obstetrics
and Gynecology
Statewide Campus
System
Michigan State
University College of Osteopathic Medicine
St John Health
System Osteopathic Division
Macomb-Oakland
Hospital, Macomb Center
dr.draionmburch@gmail.com
155