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Student’s Guide
to Residency
Where Does It End?
Draion M Burch, DO
Council of Interns and Residents
American Osteopathic Association 1
Disclaimer!
• The goal of this lecture
is not to persuade any
osteopathic medical
student to pursue any
particular specialty,
residency program or
D.O./M.D. postgraduate
training. The purpose of
this lecture is to help you
make an informed
decision. The
information in this
lecture is subject to
change!
Outline
• 2nd year
• CV
• Portfolios
• Research
• Academic File
Outline
• 3rd year
• Unique Rotations
• Evaluations on Rotations
• Choosing a specialty
• 4th year
• Budgeting
• Post-doctoral
• Medical Licensing/Board Certification (AOA vs.
ACGME)
• Osteopathic Approval of ACGME Postdoctoral
Training Programs -Resolution 42
2nd year
7
By the end of your 2nd year
• Update Curriculum Vitae
• Start Portfolio
• Conduct Research
• Student Researchers are more desirable
to competitive residency programs!
• Review Academic File
• Make copies of items in your academic
file for your portfolio!
Curriculum Vitae Essentials
• Identification • Professional
Information Affiliations
• Education • Military
• Work Experience • Volunteer Activities
• Leadership • Honors & Awards
• Research • Special Skills
• Publications, Poster • Hobbies & Interests
Competitions,
Presentations • References
• Professional
Experience
Portfolio Essentials
• Title Page with • Honors
identification • Top 10% letters,
information, Scholarship Awards,
objective… Certificates, etc…
• Table of Contents • Research
• Curriculum Vitae • Publications,
Posters, Protocols,
• Personal Statement Papers not
• Evaluations published, etc…
• Clinical evaluation • Lectures
summary,
recommendation
• Public Relations
letters, etc… • Newspaper articles
3rd year
11
Unique Rotations To Consider
• Research Rotation
• International Rotation
13
By the end of 3rd year
Time to Choose a Specialty
17
Elective Rotations
• Elective rotations are just what they say. You get to
choose what you want to do.
19
Elective Rotations
• Apply for elective rotations 3-6 months in
advance.
20
Elective Rotations
• Acting/Sub-internship
Elective Rotations
• Most students will agree that you should try to
schedule one or both of the following:
• ICU rotation
• Acting/Sub-internship
Acting/Sub-internship
• You and another student are paired up for the month. The
two of you equal one intern. You assume the
responsibilities of an intern in terms of call, admissions,
and discharges.
26
Boards
By now, you have completed and passed USMLE
Step I and/or COMLEX Level 1. Many students ask:
27
When to take USMLE
Step 2/COMLEX Level 2?
• You should take the your second set of boards
(including the PE) by the late summer/early fall!
28
Do you need to take step 2/level
2 before residency applications?
• Most residency programs would like to see step 2
before they make their official rank order list.
• Therefore you should take the boards (including
the PE) by the late summer/early fall.
30
Reasons Not to Take the USMLE
• COMLEX is based on the COMS curriculum while
USMLE is based on the LCGME curriculum.
• A D.O. must pass all 3 parts of the COMLEX only to
be licensed as a D.O.
• If you fail any exam and the state licensing board
inquires, you must report your results- which becomes
part of your permanent record that your state licensing
board keeps!
• You double the cost, preparation time, etc. by taking
both exams.
• Some ACGME programs will accept candidates with
COMLEX only. 31
Board Preparation
• Common resources for Step 2/Level 2:
• First Aid for Step 2
• OMT Review
• Savarese
• http://www.md-
do.org/NewOMMBoard%20Review02-REV.htm 32
Miscellaneous Info about Boards
33
Residency
34
Allopathic Positions you may apply to
• Categorical
• programs that begin in the PGY-1 year and provide the
training required for board certification in medical specialties.
• Advanced
• programs that begin in the PGY-2 year after a year of
prerequisite training.
• Preliminary
• one-year programs beginning in the PGY-1 year that provide
prerequisite training for advanced programs.
• Physician
• programs that are reserved for physicians who have had prior
graduate medical education. Physician programs are not 35
available to senior U.S. medical students.
Osteopathic Positions you may apply to
36
Osteopathic Positions you may apply to
37
Osteopathic Positions you may apply to
38
39
40
Choosing a Residency…Factors To Consider
44
Documents Needed for ERAS Application
• Regardless of whether you are going to pursue osteopathic or
allopathic postgraduate training there are specific documents you
must have.
• Get an early start- ask for letters during your 3rd year!
• Don’t wait until a few weeks before you plan on applying on
ERAS.
46
Letters of Recommendation (LOR)
• Each LOR will be accompanied by an ERAS
coversheet, which includes your information, the
physicians information, and your option to waive your
right to see the LOR
• You may want to waive your right on the cover
sheet. This will allow the physician to give you a fair
and unbiased evaluation.
47
Packet for Preceptors to help
them write your LOR
• Curriculum Vitae
• Personal Statement
• Their evaluation of you during your rotation
• Thank you letter
• ERAS coversheet
• Small envelope- stamped, addressed to your address in
case preceptor wants to mail you a copy
• Large envelope- stamped, addressed to Student Affairs
for ERAS application
48
Personal Statement (PS)
• Don’t underestimate the importance of your personal
statement!
• Don’t procrastinate!
• Start writing it as soon as you choose a specialty.
• http://www.rushu.rush.edu/studentlife/career/medpst
ate.html
• http://www.ama-
assn.org/ama/pub/category/6700.html
• http://www.residencyandfellowship.com/page3.html50
Medical School Transcripts
• Request copy of transcripts for yourself and for
Student Affairs (for ERAS).
51
COMLEX &/or
USMLE Transcripts
• On MyERAS, you must release your COMLEX
transcripts!
52
Dean’s Letter
• Now known as the Medical Student Performance
Evaluation (MSPE)
• Explanation/Description of curriculum
• Grading system
• Academic achievements
• Activities Descriptions
• Volunteer work, research, clubs, tutoring,
professional associations, honors, awards,
fellowships
What does your Dean’s Letter contain?
• Facilitator Comments
57
Photo
• Use a picture of you in your business attire- it
looks more professional. Remember- you are
interviewing for a job!
58
ERAS
https://services.aamc.org/eras/myeras2009/59
What is ERAS?
• ERAS is a service that transmits residency, fellowship
and osteopathic internship applications, letters of
recommendations, MSPEs, medical school transcripts,
USMLE transcripts, COMLEX transcripts, and other
supporting credentials from you and your designated
Dean's Office to program directors using the Internet.
60
4 Components of ERAS
• MyERAS Website
• This is where you complete your application and
personal statement, select programs to apply to, and
assign documents to be received by those programs.
64
65
ERAS Timeline
• Mid June- Download ERAS Applicant Manual will
be available for PDF download by chapters or in its
entirety on the Web site.
66
ERAS Timeline
• July 1st- MyERAS website opens to applicants to
begin work on applications.
67
ERAS Timeline
• September 1st- Applicants may begin applying to
ACGME accredited programs. ACGME accredited
programs may begin contacting the ERAS Post
Office to download application files.
68
ERAS Timeline
• January- Urology Match
70
Application Process Guideline
• Step 4:Register for your Match.
71
Application Process Guideline
• Step 7:Create personal statements, create a list of
recommendation writers, and authorize transmission of
your USMLE and/or COMLEX transcripts.
72
Application Process Guideline
• Step 10:Certify and submit your MyERAS application
then apply and pay for programs.
73
Using MyERAS- Overview
• Up to 10 $60
• 11-20 $8 each
• 21-30 $15 each
• 31 or more $25 each
ERAS Application Fees
• Example 1: An applicant applies to 30 emergency medicine
programs, AAMC fees are $290. (60 + (10 x $8) + (10 x
$15)).
80
Miscellaneous Fees
US (Allopathic and Osteopathic) and
Canadian Applicants
The National Board of Medical Examiners
(NBME) charges a flat $50 fee to US and
Canadian applicants who request transmission
of USMLE and/or NBME to programs,
regardless of the number of transcripts
requested. The NBME fee is included on your
invoice and collected by the AAMC.
81
Miscellaneous Fees
• US Osteopathic Applicants
Osteopathic applicants may request an
unlimited number of COMLEX transcripts to
be sent via ERAS for $50. Applicants who
request USMLE transcripts via ERAS also pay
a $50 fee to the NBME for an unlimited
number of electronic transcripts. Transcript
fees are included on your invoice and are
collected by AAMC.
82
Payment Method
• You may use your VISA or MasterCard to pay for
your ERAS fees online. This is the safest and
fastest way to process your application.
84
ERAS Use During the M.D.
Scrambling Process
• From 12 noon on the third Tuesday in March, until 12 noon on
the third Thursday in March each year, there is a "Scramble"
period. This is before the NRMP Match Day results are revealed.
• Change location
• You will sign up in Sept. for this match after you are
provided a pin number from your medical school.
• http://www.natmatch.com/aoairp/
87
Always Register for the OSTEOPATHIC Match!
Allopathic Match Application
• The allopathic match occurs through the National
Residency Matching Program (NRMP).
• http://www.nrmp.org/
88
Interview Schedules
• Interviews at osteopathic programs typically occur
from Sept.-Dec.
89
Interviewing Skills
90
Other Interviewing Tips
• Schedule rotations appropriately for interview season.
• Choose rotations which have lighter schedules.
91
Other Interviewing Tips
• Interact with the residents during the interview day.
• They are the best source for information. Keep in
mind some residency programs allow their residents
to serve on the committee so act appropriately with
the residents.
92
After Interviews
• You should send a “Thank You” note in a
timely manner.
93
After Interviews
• You can choose whomever you like to thank, but
most applicants thank their interviewers and the
program director.
95
Letter of Intent
96
Letter of Intent
• Do not lie and say to all three programs that you are
ranking them #1, just say “highly ranked” to #2 & #3
98
Rank Order List (ROL)
• The Rank Order List (ROL) is your preferred
rankings for the residency you are pursuing.
99
ROL
• You can rank as many or as little programs as you
like. The rankings are free for programs 1-30, after
which you will be charged a fee for additional
rankings.
100
Match Algorithm
101
Not the real match algorithm!
The Match Algorithm
• The match favors the applicant!
• M.D.
• http://www.nrmp.org/res_match/about_res/algorit
hms.html
• D.O.
• http://www.natmatch.com/aoairp/ (click on
“match process”) 102
Match Algorithm Example
103
Match Algorithm Example
104
The Match Algorithm
105
Osteopathic Match Timeline
JUNE
• Beginning in June, students can download the Agreement form for
participation in the AOA Intern/Resident Registration Program (the
"Match") from this web site. To register for the Match, each student
must return a signed Agreement to National Matching Services Inc.
accompanied by the appropriate registration fee.
JULY - JANUARY
• Students must apply to programs independently of the Match (via
ERAS). Programs receive applications and interview students
independently of the Match. Application deadlines for programs
vary, therefore students should check with programs regarding their
deadline dates. 106
Osteopathic Match Timeline
AUGUST - SEPTEMBER
• Each institution offering osteopathic internship positions
beginning in 2007 must provide to National Matching
Services Inc. information on the program(s) being offered by
the institution in the Match.
OCTOBER
• Recommended date by which students should return their
Agreements and registration fees to National Matching
Services Inc.
107
Osteopathic Match Timeline
Early NOVEMBER
• By this date, a Listing of Programs participating in the Match will be
available on this web site.
Late NOVEMBER
• By this date, instructions for submitting Rank Order Lists and
obtaining Match results will be provided to registered students and
programs.
108
Osteopathic Match Timeline
Late JANUARY
• Final date for submission of student and program Rank
Order Lists. No Rank Order Lists or Agreements can be
accepted after this date.
Mid FEBRUARY
• Results of the Match are released to all participants in the
Match (students and institutions), as well as to the colleges
of osteopathic medicine.
109
Osteopathic Match Timeline
110
Allopathic Match Timeline
Mid August
• Applicant registration begins at 12:00 noon eastern time.
September 1
• Institution / program registration begins at 12:00 noon eastern time.
December 1
• Applicant registration deadline (Note: Applicants may register after
this deadline by paying an additional late registration fee of $50.00
when registering after 11:59 PM eastern time.)
111
Allopathic Match Timeline
Mid January
• Rank order list entry begins. Applicants and programs may
start entering their rank order lists at 12:00 noon eastern
time.
Late January
• Quota change deadline. Programs must submit final
information on quotas and withdrawals by 11:59 PM eastern
time.
Late February
• Late registration deadline.
112
Allopathic Match Timeline
Late February
• Rank order list certification deadline. Applicants and programs must
certify their rank order lists by 9:00 PM eastern time. CERTIFIED
applicant and program rank order lists and any other information
pertinent to the Match must be entered in the R3 System by this
date and time.
113
Allopathic Match Timeline
Early March (3rd Monday in March)
• Filled and unfilled results for individual programs posted to
the Web site at 11:30 am eastern time.
114
Allopathic Match Timeline
Mid March
• Hospitals send letters of appointment to matched applicants after
this date.
115
Can you participate in both matches?
• YES. As a D.O. applicant you can choose to apply to both
the D.O. and M.D. match, the D.O match, or the M.D.
match. The D.O. match occurs before the M.D. match.
117
Can you participate in both matches?
• There is one exception in regards to residency
requirements. If you want to pursue an allopathic
residency in ophthalmology, you MUST do an allopathic
transitional year.
• The Ophthalmologic board does not recognize an AOA
internship year and therefore you will not be granted board
certification because you failed to complete the necessary
requirements.
118
Pre-Match Contractions?
• Prematches are residency position offers outside of the
match.
121
Osteopathic Scramble
• Students who fail to match initially are provided with
information on programs with available positions for them
to contact.
123
Allopathic Scramble
124
Allopathic Scramble
125
Requirements to Start Residency
126
Licensing vs. Board Certification
127
Licensing/Board Certification
128
Licensing
129
Licensing
• When thinking about licensure there is one special
caveat all osteopathic students need to consider.
132
Importance of AOA Certification
• You can't be a COM Dean, Program Director, or
DME without AOA certification!
133
“Resolution 42”
134
What is this “Resolution”?
135
History of these Resolutions
• These resolutions began because the number of
graduates of colleges of osteopathic medicine out-
numbered the available osteopathic residency positions.
137
History of these resolutions
139
Resolution 42
• Like previous training approval policies, the new
"Approval of ACGME Training as an AOA-
Approved Internship" policy maintains a consistent
theme. That is, to be eligible for AOA internship
approval of ACGME training the osteopathic
physician must complete all six of the traditional
rotating internship’s core rotations:
• 2 months internal medicine, 1 month emergency
medicine, 1 month family practice, and two additional
core rotations (internal medicine, surgery, OB/GYN,
pediatrics, family practice, or emergency medicine) so that
a total of 6 months in these core rotations are completed.
140
Resolution 42
141
Changes in Resolution 42
143
Resolution 42
145
Additional Requirements for
Resolution 42 Approval
• The trainee must be a member in good standing of the
AOA.
YES!
Can an osteopathic physician who has
ACGME Board Certification bill for
treating patients with OMT?
YES!
149
What to do with this information?
Although it may seem overwhelming now, keep
this PowerPoint presentation tucked away in a safe
place until you are beginning your 4th year, which
is when I hope it becomes a very valuable
document.
Disclaimer!
• The goal of this lecture
is not to persuade any
osteopathic medical
student to pursue any
particular specialty,
residency program or
D.O./M.D. postgraduate
training. The purpose of
this lecture is to help you
make an informed
decision. The
information in this
lecture is subject to
change!
For more information…
• www.do-online.org
• Here you can find the list of D.O. residency programs:
go to For Students then Opportunities
• http://www.ama-assn.org/ama/pub/category/2997.html
• Freida online listing of M.D. residency programs:
• go to Residency/Fellowship Training Program
Search
• http://www.mdsecrets.com
152
For more information…
• www.scutwork.com
• A peer review of residency programs
• www.studentdoctor.net
• A students/resident online forum
154
Contact Information
Draion M Burch, DO
Region III Trustee
Council of Interns and Residents
Vice Chair Intern-Resident Committee
Michigan Osteopathic Association
Resident Representative Board of Trustees
American College of Osteopathic Obstetricians and Gynecologists
Dept of Obstetrics and Gynecology
Statewide Campus System
Michigan State University College of Osteopathic Medicine
St John Health System Osteopathic Division
Macomb-Oakland Hospital, Macomb Center
dr.draionmburch@gmail.com 155