Residency preparations: Advice from a fourth-year DO student

by Elizabeth Griffith | Mar 25, 2019

By Ethan Charles Blocher-Smith, OMS-IV, M.S., edited by Elizabeth Griffith, M.S. | March 25, 2019 

What (besides the obvious) can I do to succeed as a busy medical student?

Ethan Charles Blocher-Smith OMS-IV, M.S.When you’re a med student, people talk to you about boards scores until you’re both blue in the face, and they’re right to do so. You need high scores if you want to keep your options and range of specialties/programs open. However, what they don’t tell you is how to make yourself an exciting candidate to a program once you get the interview. Remember, the touted statistics on rates of matching by number of continuous ranked programs are the average, not including everything you do can move that value up or down.

Let’s start with the obvious: Get a good boards score. The blog posts covering studying methods, resources you can use, test-taking techniques, etc., are already plentiful, so I won’t be discussing those topics here. Although, higher scores are almost always better, in the end, you need to have a high score AND a compelling application.

Rotations
If you want a specialized program, you’ll want to add a rotation at the place you want to match to. And when your rotation starts, be early, be interested, stay as late as they want you to. No slouching, no complaining, no phone time, and most of all, look competent! It doesn’t matter how smart you are if you have a personality or habits the residents hate. Watch your conversational tics, too. If you don’t get your notes done in time or show up even a few minutes late each day, they’ll notice. Residency directors, their staff, and their residents have to put up with you for at least three years (for some programs up to seven). Imagine seven years of hating a habit of one of your coworkers, all while working 80 hours a week, including 24-hour shifts, dealing with difficult patients, and constantly being pushed to learn and improve by everyone in your program. Whew. Every time you slow them down by not knowing what you’re doing, you’re putting their entire day and schedule on hold. 

Study here, study there, study everywhere
While on rotations, if you’re not actively doing something, you should be either looking up information pertinent to what you will be doing that month, or practicing boards questions. If you’re on surgery, know the case list for the next day and be informed on the surgical anatomy, the steps of the procedure, the usual hospital course, etc. If you’re on emergency room, brush up on interpreting blood gases, differentials for altered mental status, best practices lab testing, etc. For family medicine, research cough, diabetes, HTN, HLD... I could cover all the specialties, but you get the idea. 

Watch your language
Practice switching between speaking to patients and speaking to practitioners. Using medical terminology is great for doctors, but you should be saying “high blood pressure” to patients, not “HTN.” The same goes for “water pill” vs. “diuretic,” “HLD” vs. “high cholesterol,” and “heart attack” vs. “MI.” Learn the standard medical abbreviations, since they will be used by most physicians, and using them yourself will save valuable time on note writing (COMLEX Level 2PE, anyone?). 

Do your research
If you can get presentations, publications, first author works, chapters in textbooks, and/or editor work for journals (all of which are entirely possible as a medical student if you have a strong research background), then you’re set. Achievement in this space could be from your previous research in college, grad school, or from your first-year summer with medical faculty or Eli Lilly. Network through other students/faculty with research labs in the area, such as myself, Dr. Mikhail, Dr. Larsen, a preceptor of yours on a rotation, your mentor, or even a guest lecturer from one of the classes in years one and two. Spending free-time on research while you still have will get you moving to where you want to be. 

Be wary of the grapevine
Everyone talks, and the medical field is much closer knit than you think. For all you know, the physician who was always hard on you during a rotation, whom you hated, is also best friends with the director of the program you want to attend. There are enough classmates, luncheons, and people who attend the same church that if you are unprofessional, it will get around. Oh, and NEVER be rude to the nurses… or the janitors… or to anyone where you are working. Everyone at the hospital has to work together. Everything you do will come back to you, good or bad. It’s better to have advocates singing your praises. Remember, you want this to be your career—make a habit of being someone you would want to work with and build positive relationships with colleagues.

Expand your interests
Lastly, have something interesting that you do that is not medical related. During an interview, they check that you have something to decompress with; a support structure to keep you sane when you’re constantly bombarded with work, and stress, and sleep deprivation. To be clear, you don’t have to have a decade of service at a nursing home. Be in a band that jams regularly. Be a comedian, a clown, or fly planes; any of these would make for great discussion topics. Show your dedication, and speak enthusiastically about it with a high-level of details.

To sum up:

  • Get a good boards score.
  • Be professional during your rotations.
  • Build positive interactions with everyone you contact.
  • Make good impressions.
  • Read up. Hone your skills.
  • If you need research, start early. Use the school’s resources and your connections.
  • Do something you care about outside of medicine.

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