Medical School - 4th Year

Early in Fourth Year: Working Closely With Your Pediatrics Advisor

Everyone who is starting down the path to residency application needs a guide. By the end of the third year of medical school, it is important to identify a pediatric faculty member who will serve as your residency application advisor. It is the student's responsibility to work effectively with this advisor to forge a successful working relationship. Essential elements of success as an advisee include preparing for each meeting, identifying tasks to be accomplished and deadlines, asking the right questions, and listening carefully. Topics to be discussed include those listed below.

  • Grades and Board scores
  • Any "red flags" in your academic record (e.g., unexplained gaps in education)
  • Anticipated problems with interviewing
  • Couples matching
  • Geographic preferences/restrictions
  • Deadlines
  • Career decision (rationale for your choice or reasons for uncertainty)
  • Curriculum for your fourth year
  • Content of your personal statement
  • Your curriculum vitae (CV)
  • Letters of recommendation
  • Potential programs
  • Managing the interview schedule
  • Creating a program rank list for the National Resident Matching Program
  • Practice interviews
  • Advisor available for general counseling/advice

Specific Questions for Advisors

Fourth-year Schedule

  1. How many pediatrics electives should I do?

  2. What kinds of pediatrics electives should I do? (e.g., subspecialty consult service, sub-internship (sub-I)/acting internship (AI), general pediatrics, ambulatory pediatrics, emergency room (ER), pediatric intensive care unit (PICU)/ neonatal intensive care unit (NICU), or others?)

  3. Should electives be 2 weeks or 4 weeks long?

  4. When should I schedule away electives?

  5. Should I schedule a sub-I? During what part of the year should I do a sub-I?

  6. When should I take United States Medical Licensing Examination (USMLE) Step 2 clinical knowledge (CK) and clinical skills (CS) tests?

  7. Should I do research?

  8. When is the best time to participate in international electives?

  9. Should I do electives in areas of medicine which interest me but to which I may have limited exposure in the future?

Program Selection

What kind of program is a good match for me? 

Consider the following:

  • Program size
    • -Children's hospital vs. general hospital
    • -Community-based vs. academic medical center
    • -Geography (restriction or preference)

  • Lifestyle and call schedule

  • At which programs will I be competitive? What is a reach (long-shot program)? What is a good back-up (safety program)?

  • How many programs should I apply to?

  • How should I balance the number of competitive programs vs. backups? How many of each should I apply to? 

Away Electives

  • Should I do an away elective? Where?

  • Is this a reach program?

  • Is this a program that could be my first choice?

  • Will they learn more about me? Will I learn more about them?

  • Does this program offer an area of clinical expertise not available at my own institution?

  • When should I do the elective?

  • What is the last date to influence a program's assessment of my application before the Match?

  • Is it advantageous to do it earlier or later?

  • What kind of away elective should I do?

  • Consult service in subspecialty (which one?), Sub-I, general pediatrics or other ambulatory experience, ER,   PICU/NICU, or other?

  • Where will I learn the most?

  •  Where can I shine the most?

  • Where will my work be observed?

  • Will my performance be communicated to the residency program director?

  • Should I make an appointment to speak with the residency program director while doing an away elective?

  • Can I schedule other interviews while doing an away elective?

  • How long should an away elective be?

  • Can I drop away electives? How does that reflect on me?

Letters of Recommendation

  • Who will write my letters of recommendation? 

  • Should all my letters of recommendation be from pediatricians?

  • Should I get a letter from an away elective? 

Personal Statements

  • How long should it be?

  • What is the usual structure?

  • Are there any topics that should be included?

  • Are there any topics that should be avoided?

  • Should "red flag" areas be addressed in the personal statement?

  • Should I write about specific patient care encounters that were meaningful to me? 

  •  Should I discuss my rationale for choosing pediatrics? 

  • Will my advisor be able to provide feedback? Who else should I ask to provide feedback? 

Interviewing

  • What is the optimal timing for interviews? (October/ November vs. January)

  • When should I expect to hear whether I have been granted an interview?

  • What kinds of questions will be asked? Will I be asked medical knowledge questions?

  • If there are red flags in my record, how shall I prepare to address them?

  • What should I wear?

  • Should I attend the "optional" social event with the residents?

  • What is the best way to prepare for each interview? What do I need to know about the program?

  • Should I write thank-you letters to each interviewer? Is an e-mail acceptable?

  • Should I tell the program that they are my first choice?

  • What kind of questions should I prepare to ask the interviewer?

  • What questions should I be prepared to answer?

  • Should I expect to hear back from the program if they liked me?

  • At what point is it too late to cancel an interview?

  • How many interviews should I schedule in a week?

  • Do informal conversations with residents during the course of the day influence the Match?

  • Should I go for a second look?

Preparing a Rank Order List for the Main Residency Match

  • How many programs should I rank?

  • How many back-up programs should I rank?

  • Am I at risk for not matching?

  • If I do not match, what happens?

  • Should I send a "first choice" letter or e-mail?

  • Should I send an "I am ranking you highly" letter or e-mail?

  • What should I do if the program director contacts me?

Bottom Lines

The early part of the fourth year of medical school will feature intense demands on your ability to organize and focus, not only in your clinical work but also in the residency application process. Building a successful advising relationship by preparing for meetings with your advisor, taking responsibility for keeping in touch with him or her, and carefully considering the advice you receive, will help to optimize Match results.

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Year 4 - The Application Process >>>

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