Gotcha, I didn’t realize you thought non competitive specialties always have lots of open spots.
With regard to whether or not you can SOAP into specialties with <5 spots, these are the 2015 SOAP success rates for them (as in, the proportion of those <5 spots that were filled, not the success rate of applicants for them):
PGY-1
IM+EM: 1/1
IM+Peds: 1/1
IM primary care: 0/2
ENT: 1/1
Peds prelim year: 4/4
Plastic surgery: 3/4
Psych+Neuro: 1/1
Gen Surg: 2/2
And since you mentioned Derm, their 2014 results were 1/3
In other words, you absolutely can SOAP into those <5 spots, even in competitive specialties.
And just for the sake of correctness, psych was not on the list of filled specialties, peds/psych/child psych was. This is a different residency track where someone does a combined pediatrics, psychiatry and child psychiatry residency and ends up board certified in all 3 (they are often referred to as “triple board programs”)
Just wanted to chime in that residency so far has been great. I started off the year with a month of nights (which was really cool from a clinical and confidence-building perspective, but especially terrible from a life-outside-the-hospital perspective; only getting to see my fiance 1-2x/wk for 20min at a time was pretty brutal) and am now part of the way through two months of outpatient offices. It’s a pleasant change!
I KNOW I picked the right specialty and the right program, and I am so excited about my future here and the future of my program and hospital in general.
M4 year is awesome. It is so cool to have a little more knowledge about medicine and get to pick your rotations. It’s cool to see yourself and your friends choose their specialties and feel recruited by so many wonderful programs. And the time off is, of course, awesome.
But residency is a million times better. It’s great to finally feel like your decisions matter and you actually get to take care of your patients. I would say 95% of the time I’m thrilled to go to work that day, and the other 5% I’m tired because I’d just finished my 5th consecutive 14hr shift (or whatever).
To address a few points I saw in previous posts–
There is indeed a study going on about duty hours. The control group has 16hr maximums and 80hrs/wk averaged over 4 weeks. The experimental group has no such restrictions. My fiance’s program is in the control group. My buddy (same city as us!) is in the experimental group. He works 30+ hours at a time and he’s in a surg prelim program. (I may have “control” and “experimental” terms reversed but I think I’m correct.)
In my (peds) opinion, name of LOR writer seems to have regional effect more than anything. I interviewed across a pretty large geographic area. I had an LOR from a “big wig” in his (peds specialty) field. My prev dept chair is very charismatic and well-liked in our region. I had more than a few people say “Ohhhh Dr so and so was really impressed by your work–you must’ve done a great job!” and also “Is Dr so and so still your dept chair? He’s so awesome. Tell him hi for me!” So I agree with the rest of the advice here–your individual performance matters most, but if you can tie a meaningful name to it via LOR, might as well, and you’re probably more likely to find a big name doc at a big name med school (but not necessarily).
In regards to duty hours–I personally have never broken them, but abiding by duty hours is a big part of my program’s culture. I worked 70+ hrs/wk in July and 40-50 now. It seems like other specialties are finding clever workarounds for duty hour limits. My fiance’s part of an “X+Y” internal medicine residency (where you work in cycles of X weeks of inpatient (3) and Y week(s) of outpatient (1) and repeat that for the entire time) and during his first 2 sets of inpatient rotations he regularly worked >80hrs/wk, but then only worked about 35 during the outpatient portion so the average worked out with ACGME rules. (He suspects part of why he worked so much those first two rotations was that he was so new and inefficient).
Hope all is well with you guys! Sounds like the new residents are quite busy
Nice to hear from some long time CC Premed Topics members!
Whatever info you provide here will be valuable to me (a parent who know nothing about residencies.) Thanks.
DS has several friends who are PGY-1 now. He said they are extremely busy now (“pretty bad” is actually the words.) I think some of them are likely in a preliminary program, not in a transitional program. I guess the former is usually more challenging than the latter. Not sure how a PGY-1 in a category program fares as compared to a PGY-1 in one of those two 1-year-only programs.
I heard DS finally has a luck to publish a first-author paper. He did not have the chance to go to the conference to present though. I do not know if it will help him in his application or not, or the main benefit out of this effort is just that the professor/mentor will more likely write a “good” LOR now. (I do not know the kind/topic/weight of his paper. It seems to be a “short” paper rather than a very long and elaborate paper which is often published by those PhDs or MD/PhDs.
Kristin, nice to hear from you.
Maybe I will make you feel better about “There is indeed a study going on about duty hours” as my D’s program is also in a study. However, her program still has (I believe!) an 80 hrs restriction, as I know that the highest number of hours was 76 in one of D’s week, but schedule is crazy. She works 3 shifts of 12 hours (except, on the first week, there were 4 shifts of 12 hours), then she has a shift of 28 hours, she comes home around noon, sleeps for about 5 hours and if the next day is Fri / Sat / Sun, then she has it off, but if it is a weekday, then she still has a 12 hour shift next day. Also during the night of the 28 hour shift, she is in charge of her floor (22 patients or so). There are no other MD on a floor during night. Her chief resident is in charge of 2 floors, so D. still can call a chief in complicated cases. She can also call psych / legal or whoever else she feels needs to be involved and she is done it already for very complicated cases. Well, she said that there is no way to recover from 28 hours in this type of schedule. Technically, she is “allowed” to have an hour break. But she cannot nap for this hour, too much is on her brain. She is not complaining though, she is just stating the fact. But this week (her last) she will have 2 of 28 hours shifts, 2.5 days in between, one of which she is on 12 hour shift. They are allowed to call a taxi (will be paid by the hospital) if they do not feel like they can drive after the 28 hours shift. D. sounds very satisfied despite the fact that this job has little to do with her specialty. As her first year is Prelim (not categorical), she will not have this schedule for the next 6 weeks, she will be in rheumatology - one of her electives. In all of her Prelim year, she will have only 6 months of this crazy schedule. The other 6 months D.will have electives and then in second year she will start her specialty residency, with no hospital floor shifts.
Also in regard to duty hours, if one gets sick during shift, they can call quits. There are people in “jeopardy” - the substitutes, who are called in when the person gets sick during the shift. The reason that I know this is because my D. was called on her day off on Saturday (she was in “jeopardy”) when they went out and just ordered food. She had to get up and leave urgently. But since it was Saturday, the person owes my D. 2 days. So, it kind of worked out to my D’s benefit.
All in all, she is still working on the publishing of her big manuscript (first author, went to National yearly conference with the poster presentation, had positive review in some magazine while still a medical student). The manuscript did not get progressed for the reasons out of my D’s control. She has submitted it second time after review. Review resulted in big changes, she put in about 10 hours including working with the statistician. One of the requirements was to cut it 20% while including more information. The paper is huge, I forgot the original number of pages, it has been cut several times.
I am glad that she is young and do not have kids. I just talked to somebody, a mom of a first year resident, who is in her late 20s (still pretty young!), married with 2 kids - 4 y o and 4 months old. I do not know how she is doing it, but her mom, of course, is retired and is very busy with the kids.
I am still a very worried mom though…These challenges are not comparable to anything else in my life, and I have had my set of great obstacles.
On a bright side, she already bought the tickets for the vacation in Feb., 2016 in some very warm place.
I believe he has decided but I do not know exactly. (It is hard to believe but it is true that I do not know and do not care. Don’t tell and don’t ask here. His GF would know though. LOL.)
Yes. So they do not have a chance to do the couple match thing. (What may be worse is that she was in one of the top programs that DS may have a hard time to get matched into. These days, it seems that on the premed/medicine track, the female applicants are more competive than their male counterparts-- maybe some of the more competitive males could be in other career paths (CS, i-banking?) but the concentration of top female students on this track could be higher. But just like SAT, MCAT could be the very last affirmative action boost for these “lost boys.” I guess your D, MiamiDAP’s D, somemom’s D, GAmom’s D, curm’s D and WOWmom’s two daughters are all top guns. LOL. Really…DS said at one time he went to some lab sessions, he noticed all in that lab session were female – and from a PUBLIC high school. Those from a rich family, with their better than average connections, by and large do not have an interest in this “trade” career path. I may be biased though because of a small sample size. Also, maybe I am biased here again, I guess that female students tend to have more “endurance” in building up their resume on a long term basis, starting from freshman year in college all the way to the end of med school.)
mcat2,
I am sure your S. will be just fine. Guys tend not to share as much with parents, I know I have an older S.
Your gender observations may as well be somewhat true. The only person out of 9 who did not match in very selective specialty in D’s class happened to be a guy. I am still kind of sad about the fact, but when I asked D. what she think about the reasons that he did not match, she thought that it was his human/social skills. On the other hand, he happened to have only 6 interviews which is a red flag by itself. Hard to judge without knowing the person at all. But this specialty is considered a bit female dominated.
In regard to “endurance” in building up the resume, I am not sure if it is a gender oriented. Certain things that many considered to be important in applying to selective specialties, like AOA, publications, were omitted from many resumes in this specialty, where the name of the school itself and the connections that medical student has built that resulted in LOR from certain well known people seems to play a major role. Well, it makes sense that more social team players have an advantage in this area.
D. also pointed out that there are students who still “play the system” and choose rotations based on the probability of H. She mentioned that others know well who they are, and most medical students are not this way. At the end, even though such a person may achieve an AOA based on straight H’s, it really did not matter and did not influence the match. As I mentioned previously, only one out of 9 who applied to selective specialty had an AOA in D’s class, and she matched, but not as well as other 7. If this is considered a “gunner” type of behavior, at the end it really did not matter. The social aspect of personality become increasing more important as during interviews, the applicants are invited to pre-interview dinners (in many cases mandatory) and behavior at these dinners better not turn off others.
Again, these notes are very subjective because my D. tend to pay a lot of attention to social aspect in any setting and she absolutely has to feel comfortable with others around her. Not everybody is that sensitive, and guys tend to be less sensitive. I just share what I know from my D. Others may have a different prospective about things.
D. just finished her 4 week long floor shifts and her comments about it was positive. Guess, what was her first sentence? She said, “I love everybody that I worked with in the last 4 weeks and my attending was so nice and so bright”. She said she got positive comments from him also, he said that he trusted her with his patients. Overall great experience considering the fact that D. had 5 shift of 28 hours in the last 4 weeks. She said that it will take her at least a week to fully recover from this schedule, but she learned a lot.
mcat2, I wish your S. the best possible outcome of the match, he fully deserves it! Maybe he will even invite you to the ceremony, we waited to be invited and I am glad that we had a chance to participate!
Yeah…I also heard that at DS’s school, a male student really got into a big trouble because of his personality issue. I do not know the details but I heard he got into arguments with almost all superiors (attending, etc.) in almost all hospitals. This is really not the way to do things in this career path especially as a lowly trainee. Maybe eventually he went to academics and even forego the residency part of the training altogether. Some people really do not fit in this career.
At least DS once told me that he tends to get along with almost anyone. Whether or not he has the “chops” in the charisma is totally another story. Some really have this kind of talent. (Actually, even in my hi-tech world, I think more female employees tend to have this kind of talent. They could somehow get more coworkers to help them out when needed, while more male workers have a harder time or bigger ego to “ask other’s help” (i.e., they always want to figure everything out by themselves) even when it is apparently not their expertise and it is better to let others help to avoid potential mistakes in the process. This is sometimes true even for a new college graduate who is male also.)
Somehow my wife thinks we do not need to be present in DS’s match day. My reaction: what?! I think I would agree at this only when his GF could not be there (and there is a big chance she won’t be there unless she happens to have a break at that time. I heard her intern year is very tough also.) But if she is there, we may not need to be there.
"Somehow my wife thinks we do not need to be present in DS’s match day. My reaction: what?! I think I would agree at this only when his GF could not be there " - Well, this day was so special, I will never forget! D. had a crowd of 5 attending at her match day, including us. But we were waiting for her invitation. If she decided not to invite us, we would not come without any type of bad feelings about it. It was strictly her decision. The experience was very rewarding though. On Friday, there are people who matched, unmatched received notification on Monday. So, there are no low emotions, only various degree of high emotions, depending where they match. We are only 2 hours away from D., many parents did not come, there are many in her class who are from California. If your S. invites you, I would say, go!
If you’re invited to Match Day, I say go! It’s a really unique thing limited to only medical school. Everyone’s been to graduations and while the hoodings are “new” for most students, it’s not much different than any other commencement exercises.
Besides, Match Day has a completely different feel and much more elation/catharsis. The build up to it started as soon as step 1 scores came back and students suddenly had an idea of what they could get in to for a specialty. That progress through 3rd year of deciding is nervewracking and causes much soul-searching, leading to what is an undeniable onslaught through 4th year. As Kristin said, M4 year is a blast, but so much of it is spent with the greatest uncertainty. For those going into fields that they feel confident they’ll match into (for example pediatrics and me) it’s like looking through a key hole into a locked room - you have some sense of what’s on the other side, but can’t make out any of the finer details. For others going into competitive specialties, there are no clues, no concept of whats on the other side. Match Day is the release of that uncertainty and trepidation. Yes there may be some disappointed individuals but even they will agree the uncertainty was worse and just knowing which direction to go is a relief. Graduation in comparison is anti-climactic and assured (I wouldn’t let any student miss it, but it’s a display for Grandma more than the student).
Now, all that said, if you’re not invited, don’t pester your son or daughter. Where I did residency, the tradition for students was to throw an incredibly rowdy party complete with skits that were borderline in taste. This was a private party for the students as a class, and so it was not something they particularly wanted parents and grandparents to see. Again, that was just the tradition and had been that way for quite some time.
BRM, Thanks for coming back to CC. Many of us have read your insightful posts for many years (for me, it was in the middle of DS’s college years that I “found” this CC premed thread, but I was mostly a lurker and knew very little about premed and medicine back then.)
Agree with everything that BRM said. For my kid, M4 was more a torture of unknowns that the blast. Every interview invite was so precious, I had to watch when the invites for certain schools would come out (thank you, SDN, this was one time when I bow down to them). D. had so much travel (12 specialty + 14 prelim interviews) and sometime could not check her invites. I remember one invite from the very desirable location that I saw first and was trying ever so desperately to reach her and the sense of relief when she was actually on time to get a spot for an interview. She did not miss anything, except for one interview dinner. And she escaped all those bad snowstorms with all her (surprisingly good number!) of interviews in NE.
Anyway, watching their reactions at the Match Day was something that you will never see at any event.
Although we went to both Match Day and Graduation, we both felt that Match Day was when the students reached the light at the end. The 8+ years of work, sacrifice came to a head (mostly screams of joy and relief, some looks/tears of disappointment) upon opening their envelopes. You wont see a bigger smile on your kid’s face especially if the get first pick. The overall energy in the room was palpable. Gradation was nice but by then the kids were thinking about moving, orientation to residency. The vibe at graduation was much more laid back.
H and I were at Match Day and at D’s school it was a mixed bag of attendees. A handful of students had large extended families. I would guess that a quarter to a third of the students had parents. By that age many medical students have partners and if so, their partners were often in attendance without the parents. At the time our D did not have a partner so once she extended the invitation to us we wanted to be there. I can’t recall seeing anyone who was alone…but that doesn’t mean there weren’t some people who went up, grabbed their envelope and left.
I seem to be one of the few who is not a fan of Match Day rituals. My D was delighted with her result but there were a handful of people who were holding it together yet truly disappointed. I don’t care that they had perhaps overestimated their worth in the Match marketplace, had not strategized as well as they could have or should have been darn happy to have matched at all. It really bothered me that day. These are adults and the whole Match Day thing just seemed so contrived. There are plenty of times in life where we don’t get what we want but that being said, this is one of those instances where it would be very easy to save that handful the discomfort of their disappointment being viewed so publicly. Give medical students their envelopes some other way, allow them their privacy and have a party afterward for those who want to come. As I said, I am one of the very few who feels that way…so there you go. :-S
Elleneast, I do believe only a minority of schools still have rituals where everyone can/must clearly see each student opening their envelope (e.g. one school calls students up one by one in a random order so they don’t know when it’s coming to open their envelope in front of everyone on stage and has them put a push pin in a US map to signify where they are headed). At my school for example (and I know we’re not the only one that does it this way) they have all the envelopes out on a table that people can grab and open with as much or as little proximity to the table as they wish. You see the whole gamut of approaches:
Some don’t take one step away from the table before opening (which is annoying because you’re blocking other people from getting their letter)
Others open their letters still within plain view of friends and family
Others leave the room with or without family to open the letter somewhere more private, then return once they’ve processed the initial reaction
Others take the letter and leave, opening it with or without family, somewhere else with no intention to return to the main room
A handful plan vacations during that time and simply miss match day entirely since the results are emailed to you 1 hour after the schools are allowed to let you open the letter anyway.
A good 85+% of the class is probably encompassed by 2 and 3.
I don’t really have a problem with our system (I think if you object even to ours and its freedom, then yes, you’re in a small minority) and I wouldn’t be surprised if it’s the most common system among schools now a days. It’s especially nice because you see a lot of faculty, administrators, other students, residents, etc stop by to say congratulations and such.
Frankly, I believe that only those who did not match were disappointed. But they received this news privately on Monday. I did not see a single disappointed face at Match day. I believe that most were ready to go anywhere, including their last ranked place. I know that my D. was ready for any place that would take her.
Speaking from the experience of my friends and their friends, there are absolutely people who are disappointed by their match results on match day. Do they get over it? Of course they do - they are 26+ year old adults.
I’ve seen both people trying to hide disappointment (e.g. saying they’re excited/happy/relived when their body language and face clearly says otherwise) as well as explicitly stating their disappointment about not landing a spot somewhere above some threshold on the rank list.
No matter how quickly they get over it, they certainly weren’t over it during that initial moment while opening the letter (i’m talking about on the scale of <5 seconds after finding out) - and it can get awkward at schools where people have to do that one by one on stage in front of everyone (whether it’s simply the awkwardness of seeing someone’s disappointment on public display on what is supposed to be a joyous day or the awkwardness of seeing someone upset over an opportunity you would die to have). If they’re not being forced into this kind of ritual, you typically won’t see disappointed faces because they usually leave and don’t come back or leave and wait to return until they’ve gotten over the initial sting and can be happy/excited.
