The Importance of Away Rotations in Medical School

The Importance of Away Rotations in Medical School

By Jessica Freedman, MD, MedEdits

If you are a rising 4th year medical student, you should be seeking out away elective rotations in your desired specialty. Many students worry that doing away electives at a program they would like to attend could do more damage than good. However, unless you have a poor performance, even someone who is perceived as slightly above average as a visiting student might be ranked higher than a student with similar stats and has not worked in the department. When I was the associate residency director, I always preferred to rank highly a student who was a "known entity" and had a predictable performance rather than a student whom I didn't know.

What can you do to ensure that you are perceived in the best light during your away rotations?

1) Show up early and stay late.

2) Work harder than you have on any other rotation. Do not plan to have much free time during this rotation.

3) Read about your cases.

4) Be professional and confident (but not over-confident).

5) Be independent and a help to the residents and attending on your team; you want to be perceived as a true team player.

6) Treat everyone well -- your fellow students, residents, nurses, staff and, of course, your attending(s).

7) Go to every conference and be sure to introduce yourself to the program director if s/he is not the attending on service.

I am now working with clients for the 2014/2015 match season. Many students need supplemental guidance or advising while in medical school and throughout the residency application process. If you would like to work with us this year, I encourage you to contact me soon. As a private medical educational advisor, I work one on one with students and play the same role as I did when I worked in a formal academic setting at Mount Sinai in New York City.

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THE RESIDENCY INTERVIEW: WHO SCREENS MY ERAS APPLICATION?

Typically only one to three people per program are responsible for screening residency applications, and how they do it is important to understand. Since some programs may have up to 500 (or even 1,000) applications for only 100 interview slots, for example, it becomes the responsibility of those reviewing applications to decide who will be invited.I can tell you from experience that making these decisions is a daunting task. To decrease the work load, many program directors apply filters to applications to decrease the number of applications that must be reviewed to a reasonable quantity. What kinds of “filters” are used? There are many. Some filters may be applied so program directors only review applications who have a certain United States Medical Licensing Exam (USMLE) step 1 score as a threshold, others may use a filter that only views applicants who have graduated within five years, while others may use no filters and manually review every application submitted. Some programs then assign “points” for everything: research, USMLE scores, and letters of recommendation; you are invited for an interview only when your “score” meets a minimum number. More often, however, a great deal of subjectivity goes into the decision to invite an applicant for an interview, whatever the grading system. Often, the screener’s personal interests and outlook play a part in the review of your application–especially if you are a “borderline” applicant. For example, if reviewer A always had to struggle with standardized tests yet managed to succeed while reviewer B always had board scores in the top 5th percentile, reviewer A is much more likely than reviewer B to screen in an application with lower-than-average board scores.

This blog entry is an excerpt from The Residency Interview (CHAPTER 1: THE INTERVIEW PROCESS).  Click her to read more.

MEDICAL SCHOOL INTERVIEW MYTHS

Some pitfalls of the medical school interview are obvious: Don’t ramble, don’t say “um” too much, don’t be rude to people, don’t chew gum and don’t greet your interviewer like this: “Hey Dave. It is great to meet you. I read everything I could find about you on the internet.” But what pitfalls might not be so obvious?

Not being prepared

You studied for the MCAT. You composed multiple drafts of your personal statement. So, why is it that you think walking in cold to your first medical school interview is acceptable? I find that many outstanding medical school applicants who have an impressive list of accomplishments are often not able to clearly articulate their motivations and paths to pursue a career in medicine. All great performances require practice, and speaking about yourself and essentially marketing your candidacy is not easy. So, practice, practice, practice. Most undergraduate career centers offer mock interviews. Or you can grab a friend, teacher, parent or relative who has more experience than you do in this arena. Practicing also builds confidence, which helps your performance.

Overpracticing

On the opposite side of the coin, practicing too much can also hurt you. Why? First of all, you don’t want your answers to sound rehearsed or canned. Ideally, you want your medical school interview to be conversational so if you are fixated on what you have rehearsed, a conversation pattern for which you didn’t prepare can make you overly anxious. In the same way, over-rehearsed applicants often stumble when they receive a question they weren’t anticipating. This is also an issue for the fortunate applicant who has multiple interviewers. Try to keep your answers fresh, which can be challenging after being asked “Why do you want to be a doctor” for the 17th time.

Getting psyched out before the interview

“Everyone there already had at least 5 acceptances.” “I was the only one at the interview from a non-Ivy League school. I have no chance.” Sometimes the interactions between candidates as they wait for their interviewer or a presentation about the school can be harmful. Obviously, you don’t want to seem like a social outcast and sit alone in a corner of the conference room while the other applicants are chatting. But at the same time, you don’t want these casual conversations to cause you unnecessary anxiety before you enter your interviewer’s office. Though it’s tough, try to stay away from, “So, where else have you interviewed/been accepted” type of topics. And, if such questions do arise, answer vaguely or change the topic without being rude. If you were invited for an interview, you are just as qualified as everyone else sitting in that room with you, and each interview is an opportunity for acceptance.

Adhering to strict rules

“I heard I should speak only for a maximum of three minutes per answer.” “I heard that I need to ask my interviewer at least three questions to seem interested in the school.” Many myths are out there about what you “must do” or “not do” on interviews. Remember that your interviewers are not robots; they are individuals. The vast majority of interviews are not scripted so the rhythm and flow of an interview will depend on many factors, including your interviewer’s style, level of experience and even his or her mood that day. It is important to enter each interview with an open mind as to how the interview might progress. For example, some less-experienced interviewers may feel uncomfortable having a fluid conversation whereas the more experienced medical educator might purposefully get off topic and start a conversation about something in your background that you didn’t expect.

Telling them what they want to hear

It is important to research your school before your interview so you have a clear idea of its mission and values. You also want to try and tailor your answers so you fit these ideals as best you can. But the applicant who says something that is not sincere or that is inconsistent with her background has fallen right into a major pitfall. For example, the school that values community service is seeking students who have a demonstrated commitment in this area but also wants students who have other interests. When an applicant who has no background in community service says that she hopes to become involved in helping the underserved during medical school, her assertion seems patently false. Be true to yourself and make sure that everything you say is consistent with your background and experiences.

Trying too hard to “stand out” or “be distinctive.”

Applicants are always concerned about standing out from the crowd. “What can I say that will make me different than everyone else?” “What can I do that will be unique?” First of all, you cannot change who you are on your medical school interview day. Most interviews are somewhat biographical so your experiences are what they are. I find that when applicants try too hard to be “different,” they often undermine their own success. Medical schools are not evaluating you on your distinctiveness, per se; they are trying to assess your motivation for a career in medicine, intelligence, communication skills and level of compassion, among other qualities. Sure, candidates who have accomplished something truly unusual are evaluated differently, but these candidates are the exception. Ironically, applicants who exude confidence, enthusiasm and authenticity and who are “comfortable in their own skin” are often the individuals who stand out. So, be yourself. A seasoned interviewer can sniff out insincerity. Trying to be someone or something that you are not will inevitably negatively impact your performance and your interviewer’s evaluation.

Ultimately, every interview dynamic is affected by the rapport between the interviewer and applicant, the interviewer’s approach and the applicant’s comfort level in speaking about himself, his motivations and his ideals. Be aware of the common pitfalls and be able to express who you are, why you want to pursue a career in medicine and how you got there.

By Dr. Jessica Freedman, www.mededits.com

Author: The Medical School Interview and The MedEdits Guide to Medical School Admissions

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THE MULTIPLE MINI INTERVIEW (MMI): DO EXTROVERTS HAVE AN ADVANTAGE?

A study about personality type and performance on  the multiple mini interview (MMI) found that extroverts do well in this format and that exhibiting extroversion and agreeableness boosts the likelihood of getting an offer. This finding, by researchers at the University of California, Davis, School of Medicine, is no surprise, though it’s great to have data to support the similar sentiments that Dr. Freedman expressed in a letter to the editor in the New York Times.

I find that medical school interviewees are often focused on giving “the right answer,” which is not really what the MMI interviewer is seeking. MMI interviewers instead are concerned with understanding your thought process, gaining insight into how you navigate a problem and work with others, and with getting a sense of your values and ideals. This is why extroverts, who are good at talking, discussing, and listening, and enjoy being around new groups of people, tend to perform better than introverts, who tend to be more reflective and comfortable with small groups of people whom they know well. For many extroverts, the MMI format is ideal. For introverts, however, it can be incredibly anxiety provoking and may hurt their chances of acceptance.

Perhaps MMI interviewers should take into account that introverts might have different interview styles and approaches and should be evaluated accordingly. Introverts prefer to be alone and like to “act” only after they have had time to reflect – they often don’t “move quickly enough.” Not great for an MMI interview. Is it time to evaluate applicants differently depending on whether they are introverts or extroverts?

Regardless of your personality type, everyone does better on medical school interviews if they practice with us. Let us hear from you if you are interested in our medical school mock interview services.  Contact MedEdits Medical Admissions at www.mededits.com

LETTER OF INTENT FOR MEDICAL SCHOOL

At this point in the application season, I receive many inquiries about how to write a letter of intent for medical school. If you are waitlisted at your top-choice school or waiting for the post-interview decision at a medical school you know you will attend if accepted, it is time to get writing! Even for medical schools that don’t release admissions decisions until March, you want to send your letter of intent well before then.

Below is an outline of what information you should include in your letter of intent to your top-choice medical school.

1) Communicate that if you are accepted to the medical school you will attend—but don’t write this if you don’t mean it.

2) Write about the specific reasons you are interested in the medical school. Try to reach beyond the obvious on the home page of the medical school’s website and seek out opportunities that relate to your own interests and accomplishments. For example, if you have a demonstrated interest in global health, find out about the medical school’s global health programs and point out that this school will allow you to develop your already established interest.

3) Express why you are a good fit for the medical school. You can often accomplish this via item #2 if you compose this part of your letter effectively.

If you need help with your letter of intent, please contact us. Read sample letters of intent in The MedEdits Guide to Medical School Admissions. We are also starting to work with clients who are applying to medical school in 2013/2014. If you are interested in working with us, please contact us soon because we will get booked once the next medical school admissions season is underway.

Visit: www.mededits.com to schedule your FREE 15 minute consultation.

MEDICAL SCHOOL ADMISSION: INCREASING YOUR CHANCES IN THE WINTER MONTHS.

I encourage applicants to think of the medical school admissions process as fluid. Assuming you are not accepted to your top choice school right off the bat, it is important to provide medical schools with more evidence that you are an excellent candidate. What can you do to convince a top choice medical school that it should interview or accept you?

1) Send an update letter. Include academic updates, such as first semester grades and information about any recent accomplishments. You should also express your specific interest in the school to which you are applying.
2) Send a letter of intent. If you are waitlisted or have already interviewed but have not heard from your top-choice school, send a letter of intent. Include the information outlined above, and also explicitly state that the school is your #1 choice and, if accepted, you will attend.
3) Send additional letters of reference. It is always wise to send new letters of reference from individuals who support your candidacy.
4) Recruit an advocate. Your premed advisor, professor, or mentor can call the admissions office of a school in which you are interested to offer support for your candidacy.

Remember, submission of your application often is just the beginning of the medical school admissions process.You must embrace a proactive role throughout the application cycle until you have been accepted to the medical school that you will attend.