So….You are going to be an MS-4

….light at the end of the tunnel or an oncoming train?

1ST THINGS FIRST

What do you want to do with your life? RULE #1 – Don’t freak if you don’t know,

work hard

RULE #2 – If you do know, still work hard

RULE #3 – Work on developing the knowledge and skills you’ll need to be a great doc

RULE #4 – BE HONEST WITH YOURSELF

Things to consider

Are you interested in the common patient complaints?

Are there patients you really don’t like dealing with?

Are there patients you would be miserable not seeing?

Lifestyle choices? Practice choices? Your colleagues Geography Try to see as many patients as you can third year If you are really unsure – talk to some fourth years

and talk to faculty

Scheduling for MS-4

Back to RULE #1 – Do NOT freak out. Fourth year will be different for EVERY

single person Four parts:

The Tests Things required for MUSOM Things required for your residency goals Things required by/for you (aka FUN)

The Tests

By July 1, 2011 ACLS: Two sessions offered by MUSOM

By December 31, 2011 Step 2 CK: Essentially just like Step 1, only generally

considered “easier” and 1 block of questions longer Step 2 CS: 12 patient OSCE that you have to travel

for, pay lots of $$ for, but not study much for

By April 1, 2012 MUSOM Radiology Exam: On-line 100 question

exam

MUSOM Requirements

4 weeks of IM at the VA

4 weeks of Emergency Med at CHH

4 weeks of Surgery (1 wk anesthesia + 3 wks of subspecialty)

Plus…22 weeks of electives/away rotations/rural if you need it

Electives

The things for your residency goals & for FUN Away rotations Extra rotations in your field or subspecialties Stuff you may never see again International or Wilderness electives Time off for interviews/vacation/having babies

http://musom.marshall.edu/students/senior-handbook/ Listing, description & contact info for all the fourth

year electives Check them out BEFORE the scheduling meeting so

you have an idea what is out there

The Big TWO ?s of MS4 scheduling

What do you want to do?▪ Do we have an academic department?▪ Is it a highly competitive specialty?▪ Do you want to go to a highly competitive

area/specific program?How strong of a candidate are

you?▪ Do you need to take Step 2 early?▪ Do you need to apply to more than one

specialty?▪ Will you need to do a lot of interviews?

As for the answers…

The Fountain of Residency Data

http://www.nrmp.org/ - then go to the “Data & Reports” section, then entire 281 page PDF is there for all specialties

Mentors

Help you honestly gage your chances as an applicant in your chosen field

Guide for away rotations, where to apply, personal statement

Letter of recommendation (you’ll need at least 3). If you don’t have one – find one! Join the American College of Whatever Specialty,

some have virtual mentors Current MS-4s Access to faculty is a MUSOM strength – use it!

Iserson’s Getting into a Residency (library or purchase)

The big scheduling conundrums

When to take Step 2 CK?

When to take Step 2 CS?

Away Rotations: Yes or No?

Interview Season Scheduling?

Step 2 CK – what to consider Your Residency Candidacy

If step 1 low: need a boost, take early If step 1 high: maybe consider late, but earlier usually

better

Preparation Have you struggled on mini-boards? Do you know you need extra study time?

Timing Have to sit by end of December – but fit around away

rotations, required rotations, interviews, etc. Takes 3-wks to score, if going for the “boost” try to take

by the end of Sept at the latest so score will be in by Nov 1st

Step 2 CK Prep

Time & Resources MUCH more varied than Step 1 (1-6 wks) Kaplan/USMLE World QBANK (Both are pretty good) Step 2 Review Course – Pretty Good, 2 weeks, mostly half days First Aid Step 2 – unlike Step 1 this is only ok not the best Step Up to Medicine – Great, but long and detailed Secrets – Very popular – detailed Crush Step 2 – Very Popular – very general

Main Focus of test: Internal Medicine – As pathology was to Step 1 OB/GYN & Pediatrics – MUSOM typically perform well here Surgery (subspecialties) – Use Qbank for review *Neurology/Biostats – Fill in your knowledge gaps, biostats VERY

high yield Psychiatry – First Aid for Psychiatry is great

Step 2 CS

Travel: Houston, Chicago, Philly, Atlanta or Los Angeles (Philly hardest to schedule)

Does NOT require a lot of preparation, no advantage to waiting

Realize it is administered directly by the USMLE not Prometric

First Aid for CS is all you’ll need. Review it the couple of days before your test

Squish it in whenever is it convenient given the travel.

Schedule ASAP (you can change it relatively easily if you have enough advance notice)

Away Rotations

You should definitely consider if: MUSOM does not have an academic department You want to go to a…

specific program specific city extremely competitive residency or place

Everyone: just to see a different way of doing things

Visiting Student Application Service (VSAS) http://www.aamc.org/programs/vsas/

Other Institutions – check their websites

Most are 4 weeks

Away Rotations – what to consider

Rotations are usually subspecialties Highest yield for resident exposure Define what’s most important: what

or when Apply to 2-3 for the same month Personal contact/connections Frustrating how slow schools are with

getting back to you Respond promptly

Program considerations (for away rotations & applications)

Programs/schools are grouped into somewhat arbitrary tiers – there is no “10-best” list

Ask Faculty in the field Expect some Bias See Linda Holmes for list of graduates in a specialty

Ask MS-4s going into that specialty Freida (on the AMA site)

Specialty Training Statistics StudentDoctor.net

http://forums.studentdoctor.net/ US News Best Hospitals

http://health.usnews.com/sections/health/best-hospitals

Interview Season

Cannot miss any days of your anesthesia week

Check with away rotations on interview policy BEFORE committing

“Flexible” electives (academic medicine, medical spanish, readings in international/rural health, medical education)

October November December January

Anesthesia ------------------

-------+++++++

+++++++++

+++++++++++

Derm ------------------

------------------

++++++++++

++++++++++

ER ------------------

-------+++++++

+++++++++

+++++++++++

Family -------------++

+++++++

++++++++

++++

+++++----------

Gen Surg ------------------

++++++++

+++++++++

++++------------

Internal -------------+++

++++++++

+++++++++

++++------------

Neuro Surg ------------------

+++++++

++++++++

++++++

+---------

ObGyn -------------+++

++++++++

+++++++++

++++------------

Ortho ------------------

------------------

+++++++++++

++++++++

Peds -------------++

+++++++++

+++++++++

+++++----------

Rads ------------------

+++++++

++++++++

++++++++

+++

Interviews – how to make it work

Required rotations: July/August if that is your field Christmas and NYE if live nearby Strategically schedule interviews

Away rotations: Earlier than later, be wary of interview

season Interviews:

Clump together geographically

So how does this all work out?

Preference will be given to the first three months of your schedule Required/away/elective/step 2 Required/sub-I/away Away/away/step 2/elective Away/away/away, etc

You can trade required times with your classmates

$$ is a issue for interviews & aways – you do NOT get much school loan money Credit cards, parents, residency & relocation

loans

The Take HOME Messages Start planning/thinking about things NOW (but not to

the detriment of your rotations!) You should start working on your application in LATE

spring – it will take WEEKS to finish it (due Sept 1st) Personal Statement Letters of Recommendation (Ask early!) Compiling all of your extracurricular activities

Research Community service Leadership/Awards Hobbies (be VERY honest here – you will get a lot

of interview questions!) Things more complicated if you do Ophtho, Peds

Neuro, Urology, Military

We’ll be back….…in mid-march (shortly after Match Day)

The dirty details of the Applications (ERAS)

Interviewing 101 The Matches & Ranking (NRMP) Small-group discussions with

freshly matched MS-4s and current residents

Useful Links

http://musom.marshall.edu/students/senior-handbook/

http://www.nrmp.org/

http://www.aamc.org/programs/vsas/

http://forums.studentdoctor.net/

http://health.usnews.com/sections/health/best-hospitals