Sunday, February 27, 2011

Understanding How Residency Programs Will Evaluate You

Between board exams, clinical rotations and setting up residency interviews, this year promises to be busier than the last. All efforts up until this point have been paving the way for residency interviews and applications. 

Strengthening Your Application

I recently came across various data sets provided by the National Resident Matching Program (NRMP). It's not enough to present yourself well and make good with everyone you meet on the interview trail. To complement your in-person encounter, the chart above highlights the power-packed characteristics that program directors are looking for when they see you on paper. These are the 2010 NRMP program director mean importance ratings of factors in ranking applicants.

As reported, the strongest assets in your file will be letters of recommendation, grades and honors in your desired specialty. Step 1 scores, class rank, and strong performance on clerkships are close behind. It is worth noting that the personal statement, life experiences, and research have less of an impact on how we are evaluated, but play a small role nonetheless. In my opinion, if the evaluation criteria made its way onto this report it is in your best interest to consider developing that attribute on your application.

Interestingly, "other post-interview contact" was ranked rather low on this report, yet it has made its way onto the list. A well-placed phone call or hand-written card of appreciation would be an effective way to strengthen your candidacy. In fact it is probably one of the simplest, most inexpensive and least time consuming action we can take in our favor.

This is definitely an exciting and stressful time for all who are at this stage. Enjoy the challenge and make the most of your third and fourth years. Good luck to those preparing for the upcoming match and to everyone who will be on the interview trail in a matter of months.If you are interested in viewing information regarding a specific specialty or other reports, visit the NRMP website.

Question of the Week
A third year medical student is stressing out about upcoming exams, residency and career choices. He simultaneously blogs about his life as a medical student. Each week he writes or finds a question to pose at the end of his posts, yet wonders if these questions are of any benefit. What should be his next step?

A. Seek psychiatric counseling to address his stressors
B. Put an end to the "Question of the Week"
C. Accept reader submitted questions
D. Continue posing weekly questions
Answers & Explanations (post as a comment)

Sunday, February 20, 2011

Specialty Attire

Contrary to what I expected of a surgical rotation, I have not had the opportunity to wear scrubs all that frequently. I suppose being in an office based surgical sub-specialty merits wearing a tie and slacks more often than not. It's rather sad as I was looking forward to the change in wardrobe.

Dressed for Success

In urology I have seen a fair number of in-office procedures and considering the field, one would be correct in thinking they were occasionally messy. For a surgical specialty, we rarely see blood, but there are plenty of other fluids to be concerned about, though nothing a good lab coat couldn't handle. The urogenital organs, when combined, are no bigger than a volleyball and yet there is an entire profession dedicated to their treatment. Nonetheless, when these organs are not working properly, they can significantly decrease an individual's quality of life.

Much of what the physicians do in the office is geared towards keeping their patients out of the operating room. Apparently it is working well as there is little hospital time - at least in this particular practice. Many of the special cameras, ultrasound equipment and other instruments can easily be stored, making their office based practice feasible. Unfortunately, as a student I am not getting many of the skills commonly found in the operating room such as anatomical referencing, equipment handling and suturing. Overall, it has been an intriguing month and an eye-opener to a field I would not have otherwise considered. Whether wearing a shirt and tie combination or a relaxed scrub uniform, doctors can choose their work environment to fit their needs and their practice.

Question of the Week
A 22-year-old G2 P1 woman gives birth following an uncomplicated pregnancy to a term male infant weighing 2850 gm. On physical examination he has incomplete development of the dorsal aspect of the penile urethra, with the defect extending to the bladder, which is open on the lower abdominal wall. Which of the following is the most likely diagnosis?

A. Hypospadias
B. Bowen disease
C. Balanoposthitis
D. Epispadias
E. Paraphimosis

Answer & Explanation

Sunday, February 13, 2011

Making Use of the Library

I had no idea I would find myself in a library so soon. It feels as though I just finished preparing for board exams and now it's time to start all over again. After being in clinic so much, it was rather refreshing to visit the book vault again.

House of Books

Despite the clinic hours in third year, I still manage to find time to study at home. The library tends to change things up a little and re-engages the wayward dedication to endlessly cramming information into my head. Well, if for nothing else, at least it is a change in scenery. It was nice to see the tome-filled shelves in every direction. At Touro University Nevada, the majority of library resources are online and there is one shelving unit housing medical journals and old editions of various medical texts.

In this digital age, there is little need for printed editions of books. Almost everything can be found online, on compact disc, or on digital readers. It makes me wonder how medical school was years ago when the books in the library were the only source available. There were likely less distractions as Facebook, Twitter and YouTube were not yet evolved. If your library only had one book on the subject being researched, that was all you had to learn, instead of the plethora of Google results we have today that create an endless stream of knowledge.

The benefit of a digitized world is that the information is at our fingertips, whenever we need it and it doesn't require a body builder's physique to carry it around. We can get the information fast and from numerous sources. But those poor books at the library will just sit and go untouched for years because the sound of paper turning has been replaced by mouse clicking and key tapping. Being at the library was simulated going to a museum and experiencing first hand what black print on white smells and feels like. Perhaps one day I will be able to put screen culture aside and actual enjoy simpler things. With board exams approaching, I don't think that will be any time soon.

Question of the Week
A 24 year old male presents at the emergency department complaining of groin pain. On exam you find no testicular/scrotal swelling or discoloration, positive cremasteric reflex, and positive Prehn sign. What is the most likely diagnosis?

A. Torsion of the Appendix Testis
B. Spermatocele
C. Epididymitis
D. Testicular torsion
E. Testicular Cancer

Answer & Explanation

Sunday, February 6, 2011

Heart Health

The recency of my month on cardiology continues to nag at the inner beast that wants everything bad for the heart. Making wise decisions in diet and exercise has been one of the hardest challenges over the first years of medical school.

Fighting the Urge

Now working a specialty offering a little extra free time, I continue to be confronted with using my downtime effectively. I find that even with just a small amount of physical activity my days seem to be more productive. In addition to generally feeling better, that pesky voice of guilt is silenced more often. So I'm hoping that my yoga sessions and runs have put a little counterweight against the fries and pizza I couldn't resist.

Disappointingly, I've slowly watched my belly grow and my view of the ground become more limited. The belt has been loosened a notch to accommodate my horizontal expansion in an effort to breath more comfortably. This is not exactly what I had in mind when came to school. Now cursed with this food baby, I feel compelled to do something about it. Time is not more plentiful than before, but when productivity increases as a result of healthy living, there is a definite benefit to setting aside the time.

Question of the Week
A confused elderly man who was wandering around complaining of abdominal pain is taken by ambulance to the emergency department. He is unable to give a coherent history. Urine analysis shows ketones without glucosuria. Plasma glucose is 100 mg/dL. What is the most likely explanation for these findings?

A. Congestive Heart Failure
B. Emphysema
C. Alcoholism
D. Inflammatory Bowel Disease
E. Rheumatoid Arthritis

Answer & Explanation

Subscribe to Life as a Medical Student