Matthew Varacallo, MD, MBA, FAAOS | Amiethab Aiyer, MD, FAAOS, FAOA
November 12, 2024
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As you embark on the next level of your training in your pursuit to becoming an impactful physician of tomorrow, take some time to evaluate the different facets of your application.
Separating yourself from the pool of applicants can be stressful and daunting. After all, your peers and colleagues seem to be as well-rounded and competitive as you! No worries! Here is a helpful guide to keep you on track when evaluating your competitive edge heading into interview season.
Academic performance
- Step exams: Your performance on standardized tests and step 2 exams will always serve as a core that programs will use to screen out candidates provisionally. Shoot for a competitive score and be mindful of your desired specialty. A score that may satisfy entrance into one field may be completely irrelevant in a more competitive specialty. Remember, even though Step 1 is pass/fail, performance on the remainder of the application matters indirectly (through clerkship grades, recommendations, etc.). Step 2 CK is becoming increasingly important since Step 1 went pass/fail.
- Class Rank/GPA: While not as prominent, being in the top quartile of your class can strengthen your application as it demonstrates high performance at a consistent level. The relative importance of this may vary by institution
- AOA Membership: Being inducted into the Alpha Omega Alpha (AOA) Honor Medical Society is a strong indicator of academic excellence and can be a separation factor for you.
Clinical Performance
- Clerkship Grades: Another marker of consistency. Strong performance in core rotations (especially in your specialty of interest) is crucial. Honors in surgery, medicine and related electives can set you apart if you’re aiming for competitive surgical subspecialties.
- Sub-internships: Performing well in these rotations at your home or away institutions demonstrates your clinical skills and fit within the specialty. Strong performance on your Sub-I’s also opens avenues for strong letters of recommendation (more on that later…)
Research and Publications:
- Research Experience: Once considered a variable that separated applicants from one another, research publications have become very common. Remember, even if you have a relatively large list of research projects, be prepared to discuss any and all of these studies in detail when called upon.
- Publications and Presentations: Having published papers or presentation experience at national or regional conferences can distinguish your application. However, even if you do not have finished publications, you can still demonstrate your knowledge of the research process as an integral part of the team.
Letters of Recommendation:
- The perfect time to call on a mentor after you have already established an evolving and
- The goal is to secure strong letters from respected faculty members in your desired specialty. Aim to establish relationships with physicians early on and throughout your training. Be mindful of who is connected and most respected, and never underestimate the power of networking and relationships.
- A thoughtful letter should encompass insight into you as a person, including your work ethic, integrity, and character. A great letter will include insight into your clinical skills, medical knowledge, team-building traits, and dedication to medicine
Extracurricular Activities and Leadership:
- Leadership Roles: Being involved in student organizations, committees, or volunteer work shows well-roundedness and leadership potential.
- Volunteering: Do as much as you can and try to align the activity with your specialty. Volunteering is a great way to establish additional clinical skills, build autonomy, and gain unique insights and perspectives to the various sides of medicine.
Personal Statement:
- Make it a strong one, but do not try too hard and avoid coming across as inauthentic.
- A compelling personal statement that highlights your passion for the specialty, your unique journey, and why you’re a good fit for the field can help set you apart. Be yourself.
Interview Performance:
- All of the variables I have already discussed constitute how you look on paper. A competitive applicant is more than just a list of achievements and publications. Challenge yourself to perfect your interpersonal and communication skills. Programs want to see flashes of your personality, bedside manner, social graces, and articulation capabilities during this entire process. Be relaxed. Be yourself.
- Remember, the fit and flow of you with the program (and vice versa) is going to vary from program to program and the process is as much about you meshing with the program as it is the program being the right fit for you
- Mock interviews can be invaluable for practice, repetition, and mastery
Geography and Program Selection:
- Applying to programs where you have connections (like your home state or where you’ve done rotations) can improve your chances.
- Apply to a mix of competitive and less competitive programs to ensure you have multiple options
Assessing Competitiveness:
Utilize resources like the NRMP Charting Outcomes in the Match report, which provides data on Step scores, research output, and more for each specialty.
Compare your metrics (Step scores, research, grades) with national averages for matched applicants in your desired specialty.
DISCLOSURES: Dr. Varacallo Paid consultant for Johnson & Johnson, Paid consultant for Arthrex, Paid consultant for Pacira Biosciences. Dr. Aiyer American Orthopaedic Foot and Ankle Society: Board or committee member, Delee & Drez Orthopaedic Sports Medicine (Elsevier): Publishing royalties, financial or material support, Journal of Bone and Joint Surgery – British: Editorial or governing board, Miller’s Review of Orthopaedics (Elsevier): Publishing royalties, financial or material support, JAAOS (Wolter Kluvers): Editorial Board, AAOS/Orthomentor Survival Guide for Orthopaedic Rotations: Publishing royalties, financial or material support, Enovis: consulting/royalties, Vilex: consulting/royalties, GLW: consulting/royalties
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