Mercer University School of Medicine
Organization of Student Representatives
Website: http://www.aamc.org/members/osr
Organization of Student Representatives – National AAMC Meeting
Seattle, Washington
October 26 – 29, 2006
Applying for Residency: finding a good match
Paul Jones, MD, Associate Provost Student Affairs Rush University, Director Pediatric Otolaryngology and Resident Education – Rush Medical College; Angela Nuzzarello, MD, MHPE, Associate Dean for Student Programs and Professional Development, Feinberg School of Medicine, Northwestern University
As many of you know and as many of us will soon find out, the match process is a daunting task that will determine what specialty of medicine we will practice. At Mercer we are fortunate to have the new clinical advisor program for our 3rd and 4th years to help us with this process; however, one must start preparing for the match as soon as possible. So what is important? What do you need to score on your Step tests? Do you need to do research? How important are away rotations and electives? What do you need to do to prepare for residency interviews? At the recent AAMC National Meeting, Drs. Jones and Nuzzarello addressed these questions.
Firstly, USMLE Step 1 scores are very important. Dr. Comeau emailed everyone the 2005 NRMP Match Data. See page 11 of this document for the overall results. Please keep in mind that the range lines above and below the means on this graph equal the 25% who matched had a Step 1 score above the mean and the line below the mean equals the 25% who matched with a score below the mean. This information gives you an idea of what you need to score on Step 1. Also, Dr. Jones states that many programs use Step 1 scores to screen applicants.
So, to all the 1st and 2nd years, study hard and do your best on Step 1.
How important is research? The answer to this question depends on what specialty of medicine you are applying whether it is dermatology or family medicine. For example, Dr. Jones used a table from “The Ultimate Guide to Choosing a Medical Specialty” by Brian Freeman, MD. This table lists every specialty along with the relevance of research. For example, research is “very important” for dermatology programs. Likewise, research is “important” for general surgery programs. Overall, research can not hurt you, and there seems to be a consensus that certain medical specialty programs expect it. Dr. Jones suggests that you make sure your CV reflects your role in the research you did and what skills were needed to perform that role. Furthermore, bring copies of any journal articles you authored.
Do away rotations and electives matter? The short answer is yes. Dr. Jones presented 2006 match data for Rush college of medicine. Overall, 44 of 121 (36%) students matched at programs where they did an away rotation. However, there was some variance depending on what specialty was matched. For example, of the two students who matched at an otolaryngology program, both had done a rotation at the program. Furthermore, 4 of the 7 (57%) students who matched in emergency medicine had done a rotation at the program. Please see the 
Powerpoint for the rest of the data. From this information it appears that doing an away rotation at programs you are interested in is definitely a good idea. It can only help you. Furthermore, Dr. Jones advises students to choose a variety of electives. Also, he states, “if all your electives are in a field different from the one in which you are applying, you likely will be asked about it when interviewing.”
Lastly, Dr. Jones feels that interviews can make or break you. First, he wants every student to know that everyone you meet when you are interviewing is evaluating you, even the secretary at some programs. He continued by saying that every interviewer ranks applicants based on different things. For example, he says that some of his faculty “ranks you differently if you wear a black suit with blue socks.” Dr. Jones suggests you do you homework about the program you are interviewing. Know what is unique about the program. Be aware of any recent changes in the program or department. Know something about the faculty/research in the department. Also, he states that you must be prepared to explain any “red flags” on you application like failure of Step 1 or unexplained leaves of absences. Furthermore, be prepared to answer the question, “what is your greatest weakness?” Dr. Jones also advises that applicants have questions prepared to ask either the program director or faculty interviewers. For example, ask program directors what percentage of their residency graduates have passed the specialty board exams on the first try.
For more information on these topics, please review the attached Powerpoint . Also, please keep in mind these are just recommendations.
The Role of Industry, Faculty, and Students in Pharmacology Training
Jerry Avorn, MD, Professor of Medicine, Harvard Medical School
The January 25th issue of JAMA included the publication of a landmark statement recommending sweeping changes designed to limit conflicts of interest between pharmaceutical companies and faculty at academic medical heath centers. Titled 'Health Industry Practices That Create Conflicts of Interest' the article included recommendations for policy changes to the distribution of pharmaceutical samples, the composition of drug formularies, financial support to continuing medical education, consulting and research contracts, and participation in speaker’s bureaus. The dramatic scope of the proposed changes highlights how pervasive potentially fraught arrangements have become at academic medical centers. Nonetheless, pharmaceutical companies in many ways represent the best that modern medicine has to offer, with astonishing developments over the past 20 years that have brought untold benefit to millions of individuals.
At the National Meeting, students discussed the AAMC and OSR’s role regarding recommendations for dealing with and educating students on the presence of pharmaceutical companies. Currently, very few medical schools have structured programs dedicated solely to the purpose of discussing pharmaceutical awareness. The OSR recognizes the lack of formal education with regard to ethical and other issues surrounding the presence of pharmaceutical companies in our schools and hospitals. The hope of the AAMC is to encourage structured educational programs at all US medical schools in the preclinical and clinical years with the intent of increasing student awareness to the presence of and ethical issues surrounding pharmaceutical companies.
Links:
USMLE – NBME Update
An administrator with the National Board of Medical Examiners, Dr. Gerard Dillon, was present to discuss with OSR members recent changes to the medical licensure exams and address any concerns regarding the examinations. Dr. Dillon also discussed new procedures and tools that are being introduced by the NBME. In particular, a new feature provided by the NBME is the Customized Assessment Service. This service is a basic science question bank of USMLE style questions available to schools to assess school performance and construct basic science exams. This question bank can be tailored to fit a school’s curriculum and meet the school’s needs regarding specific phases or lectures. The Customized Assessment Service would give students score reports with specific item-by-item student performance summaries to promote feedback and learning. Additional highlights of the presentation include:
Step I and II Clinical Knowledge
The USMLE is hoping to eliminate the 2 digit score
Hoping to establish electronic scheduling permits (similar to the ones currently used by CS)
Investigating the possibility of reporting scores electronically
No plans to change testing facility, Prometric, but are always monitoring for any problems that occur
Step 2 Clinical Skills
- US students have ~98% pass rate
- Performances are “on the rise” for both US students and IMG’s
- No plans to release student performance to residency programs
- No plans to reduce costs – considering possible cost increase for 2007
- No plans to give feedback to students on their performance because this might compromise the integrity of the exam
In addition, the NBME is currently undergoing a comprehensive review of the USMLE to ask the questions, “Does it all make sense” and “What is the value of the USMLE”. It was indicated that changes might be implemented to the USMLE within 3 to 5 years depending on the results of the comprehensive review.
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