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USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


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  #1  
Old 12-09-2010
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Idea! What Program Director has to say!

I am a former program director and have been reading posts here for a while and thought I should do a bit of education about what program directors are looking for. Most of the posts here are totally off the mark and focus on "credentials." I am afraid many of you are wasting your time heading off in the wrong direction and some posts seem angry because they have not been invited or accepted in spite of "good credentials." What are we looking for:

1. Board scores - These are used only as a screening tool. Most larger programs will get 3,000 to 8,000 applications from international graduates. They have to use something because they do not have the manpower to read all of the applications. For those programs scores of 95 and above are usually sufficient and for medium size programs 90 and above will be sufficient for us to review an application. In small programs that receive fewer applications they may have the manpower to review scores that are lower as long as they are passing. Keep in mind board scores are only used to review the application in more detail. We know that there is at best a weak connection between board scores and residency performance. Board scores only get your application reviewed.

2. US clinical experience - you should have some experience in the US medical system. Externships are ideal but any experience is useful. Why? Because we are going to ask you about your insight about the US system. If you have no experience with it you will not have anything to make a judgment on.

3. Research - Has no correlation with residency performance. It is the lowest priority. Do it only if you have lots of time and nothing else to do.

4. Personal qualities - This is really what we are looking for. These include: being motivated, self-directed, caring, teamwork, leadership, teaching ability, humble, compassionate, enthusiastic, interpersonal skills, communication skills and awareness of american culture. These are much harder to identify. Anyone can say they have these qualities in their personal statement or in an interview. That doesn't make it so. We look for actions that demonstrate that you have these. If you really cared about people you would have experiences that demonstrated that and I am not talking about "volunteering" in some Drs office.

Many applicants have come to this country and just sat and studied for their exams for months at a time and in some cases for a few years....and done nothing else. With all that time on their hands they could not think of something else to do. If you really care about people get out there and help people. If you are saying you want to help people why haven't you done it. There are lots of people who do not have enough food to eat, are homeless, have substance abuse problems, kids with no role models, teens who need coaching and so on. There are an infinite number of ways you can help and show you care about something other than self promotion and are willing to serve even the "lowest" members of society. Of course if you do not have these qualities and do not care please don't bother doing these things but then why are you applying to residency if you don't care? I am serious. Think about that question. Not everyone cares. Some are here to earn more money than they would back home, to work with technology (imaging) at their ready use, or just the prestige and recognition of getting a US residency position. If this is your motivation than you should apply to programs that value this and do not waste your time and money on the others.

These activities are a striking difference between US applications and international applications. Good US applicants have dozens of these kinds of activities that demonstrate the qualities programs look for while many international grads have only a day of volunteering in the Pulse Polio campaigns. It is just part of American culture and international graduates must understand that to successfully integrate into American society. Besides caring for people, physicians are leaders in their communities and you are expected to do this.

Interpersonal skills is probably the most important quality. There are a lot of aspects about this. First make sure your English is fluent and work on accent reduction. Excellent communication is essential in providing excellent care and we expect residents to provide excellent care. While many countries teach in English and your English may be grammatically correct if your accent and use of words are difficult for American patients to understand you will struggle in residency and will not be providing excellent care. You will not improve your English much by watching CNN or the Discovery Channel. You must take an active role. Take classes in a college that require speaking in class. These do not need to be English classes. Join a group. We see lots of people joining an Indian dance group. That won't help with this. Find some interest group that you are interested in where Americans will be. Expand your friendship circle beyond people from your own country or a group of foreigners and include American's that you hang out with, play sports with etc. In general Americans like having friends of lots of different cultures as long as there are some common interests. Get a job if your visa allows or volunteer in a position that requires you to speak to people all the time. If you are volunteering in a soup kitchen and the position does not require you to speak to people all the time find opportunities to speak to people there anyway. Shyness will get you exactly nowhere.

Interpersonal skills goes beyond just English. It includes ability to work with people and negotiate with them and being diplomatic. These are teachable skills but if you can not be diplomatic in e-mail communications or phone conversations with the program coordinator you probably will not be a desirable candidate for the program. We see many applicants "kiss up to the program director" and treat others poorly. Sometimes it is amazing that they treat other faculty poorly thinking only the PD is important. We watch how you treat the janitors and the hotel staff. There is no hierarchy here. Everyone is to be treated with kindness and respect. Applicants often leave off experiences they have had that would demonstrate these skills simply because they think they are not related to medicine. Working as a customer service representative or a waiter/waitress are very relevant. We recognize that many applicants come from countries where the learner is expected to be quiet and not speak up. It is not that way here. American's tend to be outgoing and we expect you to speak up. You may have to be outside of your comfort zone with this and should practice it before you get to the interview. We are also less formal and rarely call people "sir." Not that I mind but I think it reflects some thoughts about a more rigid hierarchy than we have here and I wonder how the people on the lower end of the hierarchy will be treated.


I hope this clarifies things a bit. If you are having trouble understanding why some applicants are successful and others are not with similar "credentials" there is a lot more to it than comes across on this forum. In the meantime if you have time on your hands and you are trying to decide whether to do research or another observership you should do neither and get out there and help people.

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  #2  
Old 12-09-2010
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@ kundra

Thanks for this useful post...
__________________
Knowing is not enough; we must apply.
Willing is not enough; we must do.
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Old 12-09-2010
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Really useful post Kundra - where did you get it - is it from valuemd? do you have the link?
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Old 12-09-2010
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thank you for such a useful post. this will be of tremendous use for many for sure. good job. thanks again.
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Old 12-09-2010
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This post is so on-point! Pretty much everything this PD said is true, not just for residency applications but it was also that way for med school application. I am from another country also, but I have lived in the US for a while and when I first came here I worked really hard to enunciate my words and speak clearly. Also, at my school pretty much everyone does a ton of volunteering...I have volunteered (and have a leadership position) at a student run free clinic for patients without insurance one day each month for over 2 years. Lots of other students volunteer as translators. They really do look at this stuff!
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Old 12-09-2010
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Post LOR?

hello,
does that mean, LORs dont matter much? how much importance do program directors give them? and how much should we work towards getting a good LOR?
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Old 12-09-2010
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Default ashish here's the link...

i read it in another forum,here's the link to it..
http://www.usmleforum.com/files/forum/2010/4/552804.php
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Old 12-09-2010
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i did a lot of volunteering while i was in Pakistan but we never used to get any certificates cuz i gues we never did it for tht purpose..u think i can mention it in my resume without havin the certificates?
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Old 12-10-2010
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I deny to one point of his i.e. regarding research.I think research publication has a great importance.
Can anybody throw light on it.
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Old 12-10-2010
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Quote:
Originally Posted by usmle2011 View Post
I deny to one point of his i.e. regarding research.I think research publication has a great importance.
Can anybody throw light on it.
The importance of research depends on where you want to match, and also the field in which you are trying to match. If you are trying to match at a top research University based hospital (Harvard, Hopkins, Stanford, Yale, etc), then research is critical regardless of what speciality you are trying to match in. If the institution is not so big on research, then research is only important for those very competitive specialities (radiology, derm, optho, anesthesiology, surgical subspecialties such as CT, plastics, etc). Some specialities like neurosurgery also have up to a 2 year period of research time built into the residency, so for those it's critical to have research experience before applying. However, if you are trying to match in a community based hospital in residencies such as IM, Peds, research looks good on your resume but the value is minimal compared to your boards score or community activities. Research is probably least important in Family medicine (I know a bunch of folks in Family medicine who never did a day of research). Hope that helps!
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