.light at the end of the tunnel or an oncoming train?

What do you want to do with your life?

RULE #1 Dont freak if you dont know, work hard

RULE #2 If you do know, still work hard

RULE #3 Work on developing the knowledge and
skills youll need to be a great doc

RULE #4 BE HONEST WITH YOURSELF
Are you interested in the common patient complaints?
Are there patients you really dont like dealing with?
Are there patients you would be miserable not seeing?

Lifestyle choices?
Practice choices?
Your colleagues
Geography
Try to see as many patients as you can third year
If you are really unsure talk to some fourth years and talk to
faculty
Back to RULE #1 Do NOT freak out.
Fourth year will be different for EVERY single
person
Four parts:
The Tests
Things required for MUSOM
Things required for your residency goals
Things required by/for you (aka FUN)
By July 1, 2011
ACLS: Two sessions offered by MUSOM

By December 31, 2011
Step 2 CK: Essentially just like Step 1, only generally considered
easier and 1 block of questions longer
Step 2 CS: 12 patient OSCE that you have to travel for, pay lots of
$$ for, but not study much for

By April 1, 2012
MUSOM Radiology Exam: On-line 100 question exam
4 weeks of IM at the VA

4 weeks of Emergency Med at CHH

4 weeks of Surgery (1 wk anesthesia + 3 wks of
subspecialty)

Plus22 weeks of electives/away rotations/rural if you
need it
The things for your residency goals & for FUN
Away rotations
Extra rotations in your field or subspecialties
Stuff you may never see again
International or Wilderness electives
Time off for interviews/vacation/having babies
http://musom.marshall.edu/students/senior-handbook/
Listing, description & contact info for all the fourth year electives
Check them out BEFORE the scheduling meeting so you have an
idea what is out there
What do you want to do?
Do we have an academic department?
Is it a highly competitive specialty?
Do you want to go to a highly competitive area/specific
program?
How strong of a candidate are you?
Do you need to take Step 2 early?
Do you need to apply to more than one specialty?
Will you need to do a lot of interviews?
As for the answers

http://www.nrmp.org/ - then go to the Data & Reports
section, then entire 281 page PDF is there for all specialties
Help you honestly gage your chances as an applicant in your
chosen field
Guide for away rotations, where to apply, personal
statement
Letter of recommendation (youll need at least 3).
If you dont have one find one!
Join the American College of Whatever Specialty, some
have virtual mentors
Current MS-4s
Access to faculty is a MUSOM strength use it!
Isersons Getting into a Residency (library or purchase)



When to take Step 2 CK?

When to take Step 2 CS?

Away Rotations: Yes or No?

Interview Season Scheduling?

Your Residency Candidacy
If step 1 low: need a boost, take early
If step 1 high: maybe consider late, but earlier usually better

Preparation
Have you struggled on mini-boards?
Do you know you need extra study time?

Timing
Have to sit by end of December but fit around away
rotations, required rotations, interviews, etc.
Takes 3-wks to score, if going for the boost try to take by
the end of Sept at the latest so score will be in by Nov 1st
Time & Resources MUCH more varied than Step 1 (1-6 wks)
Kaplan/USMLE World QBANK (Both are pretty good)
Step 2 Review Course Pretty Good, 2 weeks, mostly half days
First Aid Step 2 unlike Step 1 this is only ok not the best
Step Up to Medicine Great, but long and detailed
Secrets Very popular detailed
Crush Step 2 Very Popular very general

Main Focus of test:
Internal Medicine As pathology was to Step 1
OB/GYN & Pediatrics MUSOM typically perform well here
Surgery (subspecialties) Use Qbank for review
*Neurology/Biostats Fill in your knowledge gaps, biostats VERY
high yield
Psychiatry First Aid for Psychiatry is great

Travel: Houston, Chicago, Philly, Atlanta or Los Angeles
(Philly hardest to schedule)
Does NOT require a lot of preparation, no advantage to
waiting
Realize it is administered directly by the USMLE not
Prometric
First Aid for CS is all youll need. Review it the couple of
days before your test
Squish it in whenever is it convenient given the travel.
Schedule ASAP (you can change it relatively easily if you
have enough advance notice)
You should definitely consider if:
MUSOM does not have an academic department
You want to go to a
specific program
specific city
extremely competitive residency or place
Everyone: just to see a different way of doing things

Visiting Student Application Service (VSAS)
http://www.aamc.org/programs/vsas/
Other Institutions check their websites

Most are 4 weeks
Rotations are usually subspecialties
Highest yield for resident exposure
Define whats most important: what or when
Apply to 2-3 for the same month
Personal contact/connections
Frustrating how slow schools are with getting
back to you
Respond promptly

Programs/schools are grouped into somewhat arbitrary
tiers there is no 10-best list
Ask Faculty in the field
Expect some Bias
See Linda Holmes for list of graduates in a specialty
Ask MS-4s going into that specialty
Freida (on the AMA site)
Specialty Training Statistics
StudentDoctor.net
http://forums.studentdoctor.net/
US News Best Hospitals
http://health.usnews.com/sections/health/best-hospitals


Cannot miss any days of your anesthesia week

Check with away rotations on interview policy
BEFORE committing

Flexible electives (academic medicine, medical
spanish, readings in international/rural health,
medical education)
October November December January
Anesthesia
------------------ -------+++++++ +++++++++ +++++++++++
Derm
------------------ ------------------ ++++++++++ ++++++++++
ER
------------------ -------+++++++ +++++++++ +++++++++++
Family
-------------++ ++++++++++ +++++++++ +++++----------
Gen Surg
------------------ ++++++++ +++++++++ ++++------------
Internal
-------------+++ ++++++++ +++++++++ ++++------------
Neuro Surg
------------------ ++++++++++ ++++++++ ++++---------
ObGyn
-------------+++ ++++++++ +++++++++ ++++------------
Ortho
------------------ ------------------ +++++++++++ ++++++++
Peds
-------------++ +++++++++ +++++++++ +++++----------
Rads
------------------ ++++++++++ ++++++++ ++++++++
Required rotations:
July/August if that is your field
Christmas and NYE if live nearby
Strategically schedule interviews
Away rotations:
Earlier than later, be wary of interview season
Interviews:
Clump together geographically

Preference will be given to the first three months of
your schedule
Required/away/elective/step 2
Required/sub-I/away
Away/away/step 2/elective
Away/away/away, etc
You can trade required times with your classmates
$$ is a issue for interviews & aways you do NOT get
much school loan money
Credit cards, parents, residency & relocation loans


Start planning/thinking about things NOW (but not to the
detriment of your rotations!)
You should start working on your application in LATE
spring it will take WEEKS to finish it (due Sept 1
st
)
Personal Statement
Letters of Recommendation (Ask early!)
Compiling all of your extracurricular activities
Research
Community service
Leadership/Awards
Hobbies (be VERY honest here you will get a lot of
interview questions!)
Things more complicated if you do Ophtho, Peds Neuro,
Urology, Military

in mid-march (shortly after Match Day)
The dirty details of the Applications (ERAS)
Interviewing 101
The Matches & Ranking (NRMP)
Small-group discussions with freshly matched
MS-4s and current residents
http://musom.marshall.edu/students/senior-handbook/

http://www.nrmp.org/

http://www.aamc.org/programs/vsas/

http://forums.studentdoctor.net/

http://health.usnews.com/sections/health/best-hospitals