How to prepare for residency while in medical school

by winnell
How to prepare for residency while in medical school

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I’m sharing 9 of my very best tips for you to prepare for your road to residency. Buckle up !

Create a CV

Create a CV

From Day one you should create an excel spreadsheet or word document to keep track of every extracurricular activity you are a part of. This will come in handy when you are creating your ERAS residency application and showcasing the amazing leadership, community engagement you have been involved in. Every little thing counts. Trust me, I’ve been asked more about my extracurriculars than anything else during residency interviews. Every time you start or complete a new activity add, it to your CV. It is will make it much easier when it is time to input the information into the ERAS application. Here are some amazing templates to get started on your CV.

Practice questions from day one.

 Practice questions

If I could go back into time, I would’ve started doing practice questions much earlier. Practice questions help you integrate knowledge. I suggest starting USMLE Rx first round during your first year as it integrates concepts from first aid which will be heavily tested on Step 1. I also suggest doing practice questions alongside each basic science course. I highly recommend the Board Review Series (BRS) for Anatomy, Physiology, Biochemistry, Immunology, Cell Biology/Histology. Another Helpful recourse is Grays Anatomy for practice anatomy questions and Pretest series for Physiology and Neuroanatomy. Practice Questions help you recognize patterns and once you get to the real exam, you’ll feel that much more comfortable.

Think USMLE from Day one.

Think USMLE

Continuing on with the practice question theory, let’s dive into the importance of preparing for board exams from day one of medical school. The only research evidence that correlates to higher scores on USMLE board exams is the proportion of practice questions you do. Board exams generally speaking is the single most important factor in gaining residency interview invites. It is an easy objective measure to weed out applicants from certain programs and specialties. It is not the end all be all but it is very important in the application cycle and match success. Now that Step 1 is going pass/ fail, it is hard to tell how that will affect residency applications. Perhaps, programs may ask to release scores regardless of pass fail? We may never know. It is predicted that Step 2CK may become the the new Step 1 since it is clinical based. that brings me to the next question.

Research : Is it required for Residency ?

Residency

Everyone wants to do research in medical school! Is it necessary to match into residency?  Absolutely not. Is it a helpful addition to your application? It depends. Research is important as a physician because it shows that you are involved in scholarly activity and you have questions in healthcare that you plan to adresss. Research can mean different things. It can be actual bench research, writing literature reviews, publishing meta-anaylsyses, presenting posters and the list goes on. Depending on your specialty of interest and residency institution, research will be necessary.  Specialties that require an impressive research resume include dermatology, urology, ophthalmology, and neurosurgery. If you plan on applying to highly academic medical centers like Harvard, Johns Hopkins, Mayo clinic etc, research is definitely a must. In summary, do your research regarding academic research requirements for your speciality and residency program of choice!

Learn clinical foundations during your clerkships.

Learn clinical foundations

Your time spent on Hospital rotations is when you will finally have the chance to be a “baby” doctor. This is the time where you should absorb as much you can so that you feel the most confident during your first year of residency.  The things you should master during clinical rotations is taking a patient history, performing a thorough physical exam, writing a concise SOAP note and properly presenting a patient case. Finally, asa fourth year student, you will be expected to present your assessment and plan which includes creating possible differentials for your patient’s problem and ordering laboratory tests, imaging or consults to provide answers to rule in/out disease and treat accordingly.

Prepare for your shelf exams.

shelf exams

Shelf exams (or COMAT exams for DO medical students)  are monthly clinical based exams based on each clerkship. If you prepare well for these exams during your clinical years, you will be more than prepared to sit for Step 2CK. Once dedicated study time comes for Step 2CK/Level 2 you will need atleast 4 weeks and you’re good to go. The best way to study is doing  atleast 10-20 U-World questions per day. The Step 2 question bank is separated by medical specialty and shelf clerkship specialty. If you are studying for your surgery shelf, do as many surgery questions you can.  It’s okay if you do not finish the entire surgery question bank. The NBME has practice shelf exams that you can purchase for additional practice and you should definitely do those and carefully review your exams afterwards. Watch this video of this medical school student who honored her shelf exams and scores 250 + using the questions method. If you are a DO medical student, most schools will purchase the True learn COMBank program for you. It is vital that all DO medical students do COMAT practice exams in True learn as well as U world questions to practice for their shelf exams. Your aim is to score the highest possible on your board exams so you can confidently apply to programs of your choice. Uworld is the superior question bank for Shelfs and COMATs.

Choosing Electives and Away rotations

Electives

During your 4th year, you will have the opportunity to rotate at institutions outside of your required hospitals provided by your school. This is an amazing opportunity, because it will allow you to network with future residency programs that you may be interested in. You will also have the opportunity to explore your specialty of interest. There are a few ways to find electives during 4th year. This includes directly asking a physician you’ve met or worked with. you can also google a particular hospital institution you’re interested in and typing “ visiting elective or visiting medical student”. This will usually bring you to their elective application page where you can apply online or email contact for the coordinator to set up a rotation. Lastly, the easiest way to get elective rotations is using the Visiting Student Learning Opportunities (VSAS) portal (, which is powered by the American Association of Medical Colleges (AAMC) portal where thousands of hospitals list their current electives. It costs $15 for each application to a program and your school must grant you access permission to use VSAS which is usually is afforded by the end of third year. VSAS is great because you can filter by state, city, length of elective and it provides detailed descriptions of various electives from every specialty you can think of.

Choose a Specialty

Specialty

Everyone comes into the medical school with big dreams and hopes of being the next neurosurgeon or maybe living the cush life of a dermatologist. Then, reality sets in that board scores, favoritism ( a splash of nepotism) and finesse mostly determines your fate in terms of which residency programs will realistically invite you to interview based on your stats. The first step is to decide how you see your future. Being honest, most medical students come into medical school with one specialty in mind and will definitely change their mind once they get to their clinical rotations. I highly suggest looking at a list of specialities and experiencing them. If there is a specialty you are interested that you did not receive exposure to during rotations I.e (anesthesia, dermatology, P&MR, radiology, etc), ask to shadow or speak to a doctor to see if it is the right fit for you. Ask yourself these questions: Do you value lifestyle?  Do you have family?  Is age a factor?  Do you mind being in training for a long time? Next, decide if you like medicine or surgery. That is a big one. You need to decide if you like working with your hands and doing procedures or enjoy being in the operating room.  Perhaps, you are more cerebral, meaning you like deep thinking and mystery solving. If you’re someone who likes to help patients but not so much engaged in the social interaction or continuity aspect, you may enjoy radiology, pathology or anesthesiology. If you’re a fast thinker and love trauma, you may be intrigued with emergency medicine or Trauma surgery. If you’re someone who values continual care and long term patient relationships, primary care or outpatient practice may be your field. Find what works for you.

Research Residency Programs

This should come as a no brainer. Before applying to residency, you should know what programs you’re interested in. Perhaps geography isn’t a factor and you want to apply broadly, then that is an option. You should start using FREIDA which is free with an American Medical Association membership . It allows you to filter for residency programs based upon specialty, location, program type ( community vs community-university affiliated vs university based vs osteopathic recognition vs military based), visas offered for International Medical Graduates (IMGs) and percentage of MDs vs DOs and IMGs. Once you click a program, you will have information related to the official website, amount of residency positions, how many interviews they conduct, their minimum Step 1 and 2 score as well COMLEX scores (and if they accept). There is also information about call and work schedule, salary and benefits.

If you are interested in a free resource to research residency programs, you can sign up for a Doximity account. Doximity Residency Navigator allows you to filter for residency programs based upon specialty, location and popularity. You will be provided access to reviews from current and past residents, top feeder schools, amount of fellowships offered , alumni satisfaction rating of work hours, schedule flexibility, career guidance, culture, clinical diversity, program director  information and program coordinator contact.

Next resource is Scutwork. This is a website powered by the Student Doctor Network. Every medical student is an alumni of SDN. Warning, the Scutwork website is pretty outdated but does have some helpful reviews about the residency program as far as culture and training. Make sure to look at the dates of each review and take each with a grain of salt.

The last resource is Residency Explorer which can be used once you have input your CV data into ERAS. This is an amazing resource for you to see how you match up as a residency applicant as far as stats. First you will have to identify yourself as one of the following: US MD senior, US DO senior, US Citizen International Medical Graduate (US IMG or Non-US Citizen International Medical Graduate (IMG). You will have to enter the following from your ERAS application: work experiences, volunteer experiences, research experiences, peer reviewed publications, step 1/2 scores, Comlex 1/2 scores. Next, the system will generate a list of residency programs and show you how you stack up against current and past residents. This is helpful as it will help you assess your competitiveness for residency programs.

If you have any questions, feel free to send me a message or connect with me on Instagram @madamewinnell.

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