Sunday, July 24, 2016

Lessons from the 2016 Match

Image: Common Sense
Author: Mike Wilk, MS4
Medical Student Council President '15-'16 
Originally Published: Common Sense, May/June 2016

The 2016 match in emergency medicine continued the trend of rapid growth and a bright future for our great specialty. In comparing this year’s NRMP data to last year's, the number of EM programs increased from 171 to 174 and positions increased from 1,821 to 1,895. The number of applicants rose from 2,352 to 2,474 and USA senior medical student applicants rose from 1,613 to 1,693. Only one EM position in the entire country went unmatched. The match rate for American senior med students was nearly 88% (data on whether these students ranked other specialties above EM are not yet available, so the actual match rate may be higher). The number of American MD seniors filling these positions held steady at 78.4%, from 79% the previous year. Based on these data, it looks like the number of new programs and positions continues to balance consistently high demand for EM residency slots.

From sending applications to doing rotations away to Match Day, I want to share a few lessons I learned on the way to securing my own EM residency position.

Lesson 1: Applying for Away Rotations (January-March)
I planned to do my residency in the same city where I attended medical school, so when I began the process of applying for away rotations I applied only to programs in my area. I recommend doing your away rotations in the region you want to be in for residency, as this can affect whether or not you get an interview at certain programs in that region. It is not the end of the world if you don't do a rotation in a specific region though (more on that later). I ended up rotating at both a very strong community program and a very strong academic program in my area. I also recommend that you vary your experience by rotating at different types of programs — such as county, academic, and community hospitals — since they really do have different training environments and their faculties and house staffs will be populated by different kinds of personalities.

Lesson 2: Applying through ERAS (September-October)
Speak with an experienced EM adviser who can give you honest advice about the strength of your application, and tell you how many programs to apply for through ERAS. Many of my friends committed minor errors, such as not realizing interview invitations were going to the spam box and not assigning letters of recommendation to each individual program. Check and double check your ERAS applications, and please check your spam folder throughout the entire application process!

Lesson 3: Interviews (October-January)
I ultimately did fifteen interviews, which in retrospect was more than necessary. Of course this is easy to say after I have matched, but if I could go back I would do no more than 10-12 interviews. Keep in mind that your chance of matching with 12 interviews is greater than 95%. If you do not receive an interview invitation from a program you are strongly interested in by late October or November, I recommend sending a brief email to the program director to let him or her know you are particularly interested in that program. I emailed two programs outside my region and received invitations to both the following day. Many of my classmates had similar success with this strategy as the interview season progressed. It is no surprise that program directors would prefer to interview applicants who are truly interested in their programs, rather than even top applicants who are just checking another program off of their interview list.

I found nearly all interviews to be laid-back and conversational in nature. Remember, they are recruiting you to their program and want you to have a positive opinion of them. I found behavioral questions involving experiences with patients to be common, so have a few patient interaction stories from your EM rotations in the back of your mind and be prepared to discuss them.

Lesson 4: Rank List Time (February)

Making a rank list is highly personal and based on a variety of factors, including location, family and significant other preferences, training environment, prestige, cost of living, and “gut instinct.” This year 53% of U.S. senior medical students matched at their top-choice program, and nearly 80% matched in one of their top three choices, which demonstrates how truly personal rank lists really are.

I talked to a few of my mentors about whether or not to send “love letter” emails to the programs at the top of my list, and debated this issue with plenty of my classmates. Overwhelmingly, everyone agreed that emailing your top-choice program was advisable. Though you can email multiple programs and let them know you are ranking them highly, I decided to email only my top-choice program. Do not tell multiple programs they are your number one choice. I understand the temptation to do so, but EM is a small community and you will eventually run into the program director you lied to.

Lesson 5: Match (March)
Being surrounded by friends and family on Match Day made it one of the happiest days of my life. Congrats to all the fourth year medical students who matched, and good luck to those coming through the ranks! I wish you all the best!

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