The recruitment cycle has officially kicked off and programs are in the thick of reviewing applications, selecting appropriate candidates, and sending out residency interview invitations. We are prepared for the season of welcoming potential candidates for the upcoming academic year.
Sifting and trying to reconcile the electronic picture with who I imagine the candidate is can be a difficult job, and requires reading between the lines. Program directors need to figure out who will fit in best with their program and who will ultimately be successful at the practice of medicine. And then there’s that statistic we’ve all been hearing about: by 2015, the number of graduates from US medical schools are likely to surpass the number of residency slots available. That statistic seems palpable this application season. Residency applications are up, and the quality of the candidates is outstanding. However, some of the mistakes I’ve seen in some applications break my heart, because there’s no longer any room for error.
This: a candidate who obviously graduated in enough time to have qualified for the match season last year. The USMLE® scores look great, and the medical school transcript is pristine. Importantly, the scores in both the pre-clinical years and the clinical years are in sync with his USMLE® scores. The letters of recommendation are fine. Not quite the letters that read like this, “we’re actively recruiting this student to our program” or “this student is in the top 10% of students I’ve taught over the years,” statements that indicate an authentic and genuine endorsement. But certainly not the lackluster “this was a nice student who came to work on time.” But there’s nothing in the application about why he didn’t either participate in the match, or match into a residency program. I look over everything again, and re-read the personal statement hoping to get some enlightenment. The personal statement just describes the journey to this ultimate moment of being on the brink of the desired residency. And so I’m left to wonder. Did he interview? Did he interview so poorly that no one wanted to rank him to match despite his stellar attributes? Or did he not apply widely enough? Perhaps in the past, I might have brought this candidate in to ask these questions. But not this year – there are so many qualified candidates.
Contrast that to another candidate with similar attributes; however, one of his letters of recommendation specifically comments on the difficult experience this student had not matching the prior year and speaks of being impressed by the candidate’s resilience and desire to regroup. The personal statement addresses the issue squarely by describing the process of self-reflection, humility and re-grouping that he had to engage in. These are ideal characteristics for a physician to possess. His application brings all of the pieces together in transparent fashion. I make the decision to bring this candidate in for an interview.
The lesson: anticipate, acknowledge and address the questions that programs will have about your candidacy. Don’t leave the committee to wonder and come up with the worse possible conclusions.
I’m not going to lie. It’s getting harder and harder to get a residency spot, and the trend is going to continue. The scores I’m seeing on USMLE®‘s are unprecedented, and are important in that first cut. However, I’m more impressed when I see a congruent association between the medical school transcript and those scores. It indicates a consonant journey toward the stated objective of being a physician. When I see repeated failures on the steps, failures on the classes taken in medical school, I have to wonder, does this person truly want to become a physician? Should this person become a physician?
Self reflection is so important to be successful as a physician and in everything we undertake. Ask yourself what you bring to the table. Do you have what it takes to be a physician? Ask yourself why you want to become a physician. Come up with honest and specific reasons. Is it because you want to engage in meaningful patient care? Save lives? Make a difference? Engage in clinical research? The prestige? The money? The promise of steady employment?
I find myself thinking of a recent conversation I had with a nurse practitioner colleague. Everyone always asks him why he didn’t go to medical school. He chose another route because he performed an honest assessment of what he wanted. He wanted to care for patients, and to have the appropriate amount of time to spend with them. He wanted to provide them with the best that preventive care had to offer. He realized that he could do that as an NP with less time and money invested. He went in that direction and never looked back, and he is incredibly successful, and his patients adore him. He achieved his stated objectives.
The key to success is careful planning, critical self-assessment, and sincere desire and dedicated commitment at the beginning of the journey. This has never been truer than now.
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All of the opinions expressed here are the author’s and hers alone, and do not represent necessarily those of Kaplan or its employees.
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