The path to residency...

Since I'm heading into residency interview season, I decided I needed to write a post explaining the entire process to my dedicated readers. Even if it has been explained to you 100 times, it's so hard to remember/understand if you aren't somehow connected to it personally. I feel this way about the military. I have had it all explained to me 1,000 times, and I still struggle to remember the ranks and the branches and correct terminology, so if you have to ask me 100x about residency stuff, don't feel bad. Ok, so first a quick recap of the path to M4 year...

Pre-Med

1. Undergrad-you have to have a college degree to apply to med school. In addition you need certain science courses as pre-requisites. You don't have to be a science major (although this would take care of all the pre-reqs), but you must have all the required courses-both science and otherwise-before you can start. The pre-reqs are why I moved to IC to take a bunch of science classes before applying to med school.
2. MCAT-the med school admission test. Similar to the ACT/SAT, but this tests Physics, Chemistry, Biology, etc, etc. Your score is required to apply to med school.
3. Med School application/interview-you apply through a central service to all the med schools you are interested in. You interview, they accept or reject you

Medical School:

1. M1 year: Basic science coursework: Anatomy, Biochem, Cell bio, Genetics, etc etc. All lectures and tests
2. M2 year: Disease processes & 'medicine' stuff: Pathology, pharmacology, microbiology, etc. Again, all lectures and tests (you may recall this was the year I dropped off the face of the earth bc I was studying like 17hrs a day).
3. USMLE Step 1: May/June after your 2nd year you take a test over all of the material from M1 & M2 year. Your score from this test is important for your residency application bc it's a way for programs to compare students across schools.
4. M3 year: Starts July 1 following your M2 year/Step 1. You actually go into the hospital/clinics and see patients everyday. A bunch of required core clerkships (rotations) - Internal Med, Peds, Ob/Gyn, Surgery, etc etc
5. M4 year: A few more required clerkships (rotations), lots of vacation time, time off for interviews, etc etc. You have to decide what kind of doc you wanna be by Sept of your M4 year.

Residency application process: ok, we're back to this now. This all takes place during your M4 year.

1. Pick your specialty: Somewhere around July-Sept of M4 year, you decide on the specialty you're going to apply to (General Surgery, Ob/Gyn, Ortho, Peds, etc).
2. ERAS application: You complete an online application with all of your activities, grades, transcripts, letters of recommendation, etc.
3. Apply to programs: Through ERAS you choose the programs you would like to apply to (ie-Univ of Iowa, Univ of Nebraska, Univ of Wisconsin, Northwestern, etc etc). This sends your app to those programs.
4. Wait for interview invitations: The programs you apply to can either invite you for an interview (if they like you), reject you (not invite you), or just ignore you and leave you wondering (way more programs do this than I think is appropriate). If invited for an interview, you can accept and schedule an interview, or decline
5. Interview at programs: This is where I am right now. From Oct/Nov-Jan programs hold interviews for applicants. Usually this involves a social with residents the night before the interview, then the interview day involves presentations about the program, interviews with you and a resident, you and faculty members, you and the department chair (just depends on the program). They can be 15min-1hr in length. You also get a tour of the facility, get to ask questions, etc etc.
6. Rank list: In February of your M4 year, after you are done interviewing, you make a rank list of all the programs you interviewed at. This is exactly what it sounds like. You rank them from your favorite to least favorite. 1 is where you REALLY want to 'match' or be for residency. The last place on your list should be somewhere ur still willing to go, but is much lower on your preferences. The programs also make a rank list of the people they interviewed from their favorite applicant on down.
7. Some crazy algorithm magic happens: Once rank lists are in a computer goes through an algorithm and "matches" applicants with a program based on the applicant's preference and the program's preferences. This is where it's a little complicated. Basically imagine you are part of a group of 100 people who are all applying for one of 90 jobs. You go through the interview process and probably interview at about 10 of the companies. You then rank order those companies. These companies interview random combinations of these 100 people and they also have their favorites, so they make their list, too. Then imagine you have to go through and compare each company's list to each applicant's list and try to make as many people and companies happy as possible. If John Deere wants John Doe, and he wants them - that's easy. But if John Deere wants Jane, but she wants Caterpillar who would prefer someone else, it gets more complicated. This is what the computer does - it goes through your list of programs and tries to balance what YOU want with what the program wants. But there are 100 people and only 90 jobs, so not everyone will match. When what you want and the what the programs want really, really don't match up, no match can happen, and that REALLY sucks.
   
8. Match Day (always the 3rd Thurs of March): Click here for the post on Brendan's match day. This is the day the results from #7 are revealed. Technically you find out on Monday of this week IF you did in fact match, just not where. On Thursday at 12:00 Eastern Time literally everyone across the country who is participating in the match gets their envelopes at the same time. Inside the envelope is a letter stating what program you have matched to. Participating in the match is a contract, so you are obliged to go to the program you match to. You literally open an envelope and find out where you are going to work for the next 3-6yrs (for me 4yrs). For some people this could literally be anywhere in the country. Your chances of it being your top choice depend on how competitive of a specialty you have chosen (derm, ortho, oto (ENT) and radiology are very competitive; peds, family med, ob/gyn less so, for example), how competitive of a candidate you are (your grades, board scores, social skills, letters of rec, etc), how competitive the program you want is, and some dumb luck of liking the place that likes you.

Ok, this is getting long, hope that helps clear things up a little. To recap- I will find out on Thurdsay, March 15, 2012 where I will be going for the next 4yrs. Iowa does have a program, and it is most definitely my first choice, but they take 5 residents from the hundreds they interview, so it is definitely not a sure thing. I do have a slight advantage being from their med school, but that said, there are 12 other people in my class going into Ob/Gyn, and at least a few of those would also like to stay at Iowa. As a general rule, most programs will take 1 person from their med school per year regardless of specialty. Some programs will take 2, and occasionally 3 depending on the situation. I applied to about 18 programs, and I am interviewing at 7 as of now. I would like to interview at a few more than that, but it doesn't seem likely I will get anymore invitations this late in the year, so hopefully one of those 7 will like me enough to keep me!!

Alright, enough for now! I'm heading to Wisconsin this week to interview at Univ of WI (Madison) on Friday and Medical College of Wisconsin (Milwaukee) on Saturday. Wish me luck!!