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Medical Residency Application Advice


Residency selection chairman reveals application missteps every med student should avoid.

September 1 is when the cap gun fires, and the race for a residency spot begins. On this date, medical students begin applying and transmitting their applications to accredited residency programs across the country, vying for coveted spots and hoping their application stands out from the pack. What’s that clicking noise? It is the sound of medical training programs everywhere contacting the ERAS PostOffice and downloading medical students’ applications.

Building up to this deadline for the residency Match process, StudentDoc consulted the Chairman of the Residency Selection Committee for Radiology at Thomas Jefferson University, Sandeep Deshmukh, M.D.

Read more: We also heard from Washington University School of Medicine's Assistant Dean for Career Counseling, Dr. Kathryn M. Diemer.

“Every specialty and even every program is different with regards to what they are looking for in a residency applicant,” notes Dr. Deshmukh, who is a Clinical Assistant Professor of Radiology. “Furthermore, each residency selection committee has a different makeup, which can affect what pieces of the application are stressed.”

With those caveats in mind, we plunge ahead to find out what prospective residents should pay attention to and what to avoid in applying to medical training programs.

StudentDoc: What is the most common pitfall you see medical students falling into as they prepare their residency applications?

Dr. Deshmukh: The biggest problem I see is poor judgment. This can be manifested in numerous ways, but generally when it comes to the ERAS application, it is obvious to selection committees who spent time and effort on their application, and who threw things together at the last minute in a slipshod fashion. This application is for a job that will affect the rest of your life. Put as much time and attention into it as it deserves. When I look through an applicant's folder with great board scores, fantastic grades, and outstanding letters, if everything else is poorly put together, I tell myself, this person may be smart but will also likely be lazy and sloppy. Why would I waste time interviewing that person if I know they have qualities I absolutely would not want in a resident.

The beauty of ERAS is that it helps medical students organize their achievements for their application. The problem with this is that applicants generally don't see any application other than their own. Selection committees sift through hundreds of these in a matter of days, subtle differences stand out quite glaringly.

StudentDoc: What are the key pieces of advice you offer medical students as they consider their applications and where they should apply?

Dr. Deshmukh: Radiology is a competitive specialty, therefore, I think it is advisable for applicants to meet with someone at their home institution who can provide guidance. I generally tell applicants to first determine where they want to be, like real estate, it is all about location, location, location! Consider whether or not you are willing to spend at least four years in a small town or whether you need a big city. If you have a spouse or significant other, they need to be part of this decision. If your personal life suffers because you don't have the appropriate support system in place, it will be reflected in your work life. After you decide where you want to be, then you need to figure out how wide a net to cast. For radiology applicants, I think everyone needs to start by applying to at least 35 programs. If your application is weaker, then this number should obviously be higher. I think the goal would be to interview at between 15 and 20 programs.  

Furthermore, I think that most applicants don't know too much about what different programs have to offer. Therefore, I think it is advisable to apply to equal numbers of university programs, community programs, and programs that are somewhere in between. Ideally at this stage of training most people should have a good idea about how they learn best and what type of academic environment they excel in. For example, if you are very good at retaining information you read, a program that places the burden on the resident to read would be suitable for you; however, if you learn by doing, then a smaller program may be a better fit. These are factors to consider when interviewing.

StudentDoc: The personal statement is crucial in helping med students stand out from the crowd. But how does one strike the right balance in tone and information shared?

Dr. Deshmukh: I may differ from many of my colleagues, but I feel that the personal statement is the most crucial part of the application. Everything the applicant enters into ERAS fits neatly into some box on the form, but really doesn't tell me too much about the applicant aside from the nuts and bolts. The personal statement is an opportunity for the applicant to tell the selection committee something about themselves we otherwise would not know. It is the one place in the application that the applicant can write about whatever they want while at the same time providing insight into who they are as a person. Radiology, unlike many other specialties, requires hours of interaction between attendings and residents every day. The selection committee wants to know everything about the applicant to help them determine if they can spend numerous hours working side by side with the applicant. 

It is extremely bad judgment not to put effort into this portion of the application. As I said earlier, radiology is a competitive specialty, likely most applicants will have top-notch board scores and grades, and many will have published research. But the personal statement is an opportunity to separate the wheat from the chaff.

StudentDoc: Strong letters of recommendation are crucial. What are the best ways of ensuring that letters are informative and compelling?

Dr. Deshmukh: Letters of recommendation are only useful if they are strong in their support. Asking someone who is famous is not helpful if they don't know you well or can't speak about your qualities in a meaningful way. I generally advise medical students to say something like, "Dr. X, would you be willing to write me a strong letter of recommendation?" I expect every letter of recommendation to be good; if there is anything negative or weak in the letter, it reflects poorly on the applicant (i.e., you had bad judgment in asking someone who wasn't going to write an awesome letter). As far as radiology goes, letters from radiologists tend to be weak, unless you have spent a significant amount of time working with the radiologist. One week of your four-week elective may seem significant, but in the grand scheme of things, it is not. I would much rather read a letter from a medicine, surgery, pediatrics, OB/GYN, or psychiatry attending who spent a significant amount of time with you during a clerkship and can comment on your fund of knowledge, work ethic, and logical reasoning skills, as well as your personality. Remember, if they are just going to write a generic letter which highlights achievements from your CV, I already have that information in the ERAS application.  

StudentDoc: Submitting a photo: Smile or no smile? Casual or business attire? Fun and big personality? Or studious and trust-worthy?

Dr. Deshmukh: Again, I think this is personal preference, but ultimately residency is a job. The picture should be what you think would be appropriate for a job interview. Letting some of your personality in is fine, but crazy hats and mismatched colors might be a little overboard.

More on medical residency applications

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