The Successful Match: Introduction
Posted on May 9, 2007
Filed Under The Successful Match
By Samir P. Desai, M.D. and Rajani Katta, M.D.
Authors of The 250 Biggest Mistakes 3rd Year Medical Students Make And How to Avoid Them
“Where was the career guidance I needed for the past three years? No one sat me down in my first year and told me what it would take to get the career of my choice. Had I been handed a residency application form in my first year, I would have made many decisions differently. I cannot help thinking that my medical school has let me down. I am not going to shine on my residency application, as I had hoped.”
- S. Ellen Morch (Morch SE. Students unprepared for residency applications. CMAJ 1994; 151(9): 1237-8)
Thirteen years have passed since these words were written by a fourth-year medical student, and yet we continue to counsel students who find themselves in the same position. “If only I knew then what I know now” is sadly a common refrain among residency applicants.
As faculty advisors, we have had the opportunity to advise students through all facets of the residency application process. Unfortunately, misperceptions about the criteria involved in this process are shockingly common among students. Conversations with students confirm this fact. Conversations with faculty highlight this issue. Even a review of posted comments on message boards confirms the confusion among students as to what it takes to have a successful match.
This fact was highlighted several years ago when researchers surveyed medical students at the University of Colorado, University of Utah, and Vanderbilt University (Brandenburg S, Kruzick T, Lin CT, Robinson A, and Adams LJ. Residency selection criteria: what medical students perceive as important. Med Educ Online 2005; 10: 17). The aim of the survey was to discern which criteria students felt were important in the residency selection process. Students were asked to rate the importance of various criteria, including clerkship grades, USMLE scores, AOA membership, class rank, letters of recommendation, and published research.
- Although 55.9% of students considered grades in required 3rd year clerkships to be extremely important, 44% felt that these grades were moderately, mildly, or not important at all. In a recent survey of program directors representing the most competitive specialties, grades in required clerkships consistently received the top ranking (Wagoner NE, Suriano JR. Program directors’ responses to a survey on variables used to select residents in a time of change. Acad Med 1999; 74(1): 51-8).
- Only 14.7% of students rated the number of honors grades as extremely important. Program directors considered the total number of honors grades to be one of the three most important factors in considering a candidate.
- 49.3% of students felt that class rank was mildly important or not important at all. However, program directors rated class rank high in importance, following only clerkship grades and the total number of honors grades.
Clearly, there are significant differences in the degree of importance students and program directors attach to these different criteria. These misperceptions have the potential to affect a student’s chances of matching into a particular specialty or residency program.
From our own experiences as students, and in the process of counseling students, we know how difficult, anxiety-provoking, and mysterious the residency selection process is. Combining evidence-based advice from our review of the literature on medical education, along with our own years of experience and discussions with hundreds of students, residents, and faculty colleagues, we hope to clear up these misperceptions. Our goal is to make you a well-informed applicant. A better understanding of the residency selection process can help you develop an approach that maximizes your chances of a successful match into the specialty or residency program of your choice.
We invite you to join us regularly here at sdn for our column - The Successful Match. In our next column, we address the importance of the third year of medical school, specifically clerkship grades.
Samir P. Desai, M.D.
Dr. Samir Desai is a faculty member in the Department of Medicine at the Baylor College of Medicine. He has educated and mentored medical students and residents, work for which he has received teaching awards. As a member of several committees, including the internal medicine residency selection committee and the medical school admissions committee, he has gained considerable insight into the obstacles that prevent students from reaching their academic and professional goals.
His experience and insight led him to write a series of books to help students tackle the challenges of medical school. He is now the author and editor of ten books that together have sold over 80,000 copies worldwide. Most recently, he coauthored the 250 Biggest Mistakes 3rd Year Medical Students Make, a book developed to help students successfully transition into and excel during the third year. Among the other titles he has written are the popular The Residency Match: 101 Biggest Mistakes and the Clinician’s Guide to Laboratory Medicine.
In 2002, he founded md2b.net, a website committed to helping today’s medical student become tomorrow’s doctor. At the site, a variety of resources, including survival guides for each core clerkship, are available to help students tackle the challenges of these rotations.
After completing his residency training in internal medicine at Northwestern University in Chicago, Dr. Desai had the opportunity of serving as chief resident. He received his M.D. degree from Wayne State University School of Medicine in Detroit, graduating first in his class.
Rajani Katta, M.D.
Dr. Rajani Katta is an Associate Professor in the Department of Dermatology at Baylor College of Medicine. She has authored over thirty articles published in scientific journals, and lectured extensively both nationally and locally on dermatology and contact dermatitis to students, residents, and physicians.
She serves as the course director for dermatology in the basic science years, and has served as the clerkship director for the dermatology rotation. She has seen firsthand the difficulties of matching into a competitive specialty such as dermatology, and has witnessed over the past nine years the increasingly difficult match process for dermatology applicants. Most recently, she coauthored the 250 Biggest Mistakes 3rd Year Medical Students Make, a book developed to help students successfully transition into and excel during the third year.
After graduating with honors from Baylor College of Medicine and completing her internship in internal medicine, she completed her dermatology residency at the Northwestern University School of Medicine.
Authors of: 250 Biggest Mistakes 3rd Year Medical Students Make And How to Avoid Them
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6 Responses to “The Successful Match: Introduction”
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Reading the excerpt of the book on Amazon, it was interesting to see that faculty rated a video-taped performance of a resident much differently from faculty evaluator to faculty evaluator. This is not very surprisng to me however, having experience third year clerkships. It would be interesting to hear if there are any ideas about how to make third year clerkships more objective. Many medical students now know how powerful these third year evaluations can be, however subjectively based they are, and we have all heard stories about medical students with contacts with “big wigs” in a certain field, who get prestigious residencies that would not otherwise be meritted based on their grades in medical school. Often I, and several of my classmates, felt that faculty evaluators were often very biased towards certain students, i.e. those who hit it off socially with the attending, but did less work on the rotation and privately conceded that they hated the rotation, and those who had excellent fund of knowledge, but were sometimes disliked by faculty for a variety of personal reasons.
I think a large part of this is the fact that while in the past the best and brightest went into academic medicine, and therefore assigned grades based on who they felt demonstrated the qualities of the next generation of the best and brightest of physicians, this is no longer the case. Often present day clinical faculty instructors, especially those junior faculty on the wards, are less able to subjectively judge who is doing a better job. The most embarassing/frustrating aspect is having an arrogant faculty member pimp me, tell me I am wrong and then give me a wrong answer to one of his pimp questions! Medical schools need to change how third year clerks are evaluated, and make it more commensurate with grades, fund of knnowledge, and actual skill rather than un-standardized grading based on who an attending or resident gets along best with. Giving clinical faculty members the power to decide a grade based on their subjective perception of a student is flawed, and should be restricted to only approximately 25% of the total grade. Otherwise, clinical junior faculty have too much power to a decide a medical student’s future career options for them.
It will be interesting to see what things are shared in this column. I will have to admit that I am skeptical of information sites were the first text is a hyperlink to a site where you can purchase the authors’ book. I am hoping that it will prove to be a very useful and informative column.
3rd year objectivity? What for? Just learn your people skills and do your job.. You should get honors.. If you suck at people skills, don’t expect academics or robotic regurgitation of knowledge to keep you going.
You knew this going into the medical field. (Unless you were stupid enough not to read up on the field). Quit it with your Generation Entitlement, you sold your soul to medicine. It owns you now..
Well cool, looks like the hyperlink got moved. I regards to some above comments, I am sure that there are many things that are “common sense”, however, I think that there are many students without common sense and who do some crazy things in front of residents and attendings that I think they dont’ feel are crazy. Also, the debate about clerkship grades rages on, it will be interesting to see what the authors have to say and what insight they may have into this. Is it possible that they will share no new info? Sure! But it is also possible that they could reveal some tips that many people may not have considered fromt their personal perspectives. I hope its the latter.
This whole process has very little to do with personality or people skills or intelligence. I was rated a 5 on my interpersonal relationships and then given just a pass in medicine because I passed the shelf, then I got a high pass in surgery, and pediatrics shelf exams and was rated well for my interpersonal skills and just passed. I think a lot of it has to do with moxy. People who are able to maintain their cool in front of their esteemed professors and simultaneously hit it off well with their residents are the ones who get the best grades. Unfortunately, those same students that look so good in front of the professors are often the slackers that you would never want to work with. Then some of it is having the guts to ask for what you want–asking to be able to do something in the OR. That unfortunately is not a purchasable commodity. Some people are born into confidence and groomed to take their place at the height of society. Others like me have to take a leap of faith from what they were born to be to what they want to become. Kudos to all of you who are successful despite having to work your way up from the bottom of society. Kudos to all of you who actually work hard and are successful. Kudos to all of you who are not part of the 24% of Johns Hopkins students who cheat to get where they are. Hopefully, I will be working with some of you in the future.
Yes who says life is fair? Do best you can some are good at memorizing. some are naturally born wiht good people skills. what can you say. you just have to again BALANCE things out make best of what you get. then again Like some says, Medicine is really for the people and will be always for the people. Clinicals grades are just that to balance what you think you now based on arrogance of book knowledge ultimately comes back to you haunt you, and remind you that treating a patient does not stop at reading medical books . foremost improtant you have to get along with people. THis goes for not only medicine but in all types of JOBS out there in business. this is why they put so much weight on CLINICAL years. Just as they put artificial scales on how much you know as in written exam clinical grades also has that scale. GOOD luck. be talkative, be friendly and PLease dont be arrogant of what you know. its only skin deep.