Presentation on theme: "THE FOURTH YEAR Adam Stevenson MD Associate Dean of Student Affairs January 14th, 2014 (C) 2013 University of Utah School of Medicine."— Presentation transcript:
THE FOURTH YEAR Adam Stevenson MD Associate Dean of Student Affairs January 14th, 2014 (C) 2013 University of Utah School of Medicine
Match Day – March 2015
Commencement – May 2015
t (C) 2013 University of Utah School of Medicine
t Todays Schedule Step 2 requirements and Grad Review – Helen Anderson Financial Aid and AOA – William Shiflett Match and MSPE – Adam Stevenson Career Advising – Adam Stevenson Break and snacks 4 th year Curriculum – Dr. Dani Roussel Lottery and Visiting Rotations – Carol Stevenson Class Address - Reetu and Chris (C) 2013 University of Utah School of Medicine
t 2014 MATCH (C) 2012 University of Utah School of Medicine (C) 2013 University of Utah School of Medicine
14 months and counting…
t National trend: 2013 Match 40,335 total applicants 17,487 US allopathic seniors 29,171 positions, an increase of 9% National match rate = 93.7% 78% percent match in top 3 choices t (C) 2013 University of Utah School of Medicine
t National trend: 2013 Match t (C) 2013 University of Utah School of Medicine
t Unmatched Seniors vs. Unfilled positions NRMP (C) 2012 University of Utah School of Medicine
UU SOM Match 2013 Military Match1 San Francisco Match 4 Urology Match 1 NRMP only 66 t Primary Care26 Surgical15 Other % Initial Match rate 97.2% Match rate after SOAP
UU SOM Match Specialties Ophthalmology4 Orthopedic Surgery2 Otolaryngology3 Pathology1 Pediatrics4 Triple Board1 PM&R1 Psychiatry3 Radiology (Diagnostic)6 Urology1 (C) 2012 University of Utah School of Medicine t Anesthesiology3 Dermatology2 Emergency Medicine9 Family Medicine10 General Surgery5 Internal Medicine 4 Prelim Medicine (Only)2 Medicine/Pediatrics2 Medicine/Psychiatry1 Neurology2 OB/Gyn3 (C) 2013 University of Utah School of Medicine
t 2013 The Un-Matched Record number of applicants were not fully matched 13,808 total 2,076 US seniors Record number of US seniors remain un- matched after the SOAP process 528 US seniors without a job! t (C) 2013 University of Utah School of Medicine
t My Goal To get you matched! I need your help now to do this….. (C) 2013 University of Utah School of Medicine
t What is your likelihood of Matching? Very little to do with how good of a student you are Has everything to do with your preparation and backup plans Very specialty and student specific NRMP CHARTING OUTCOMES DATA t (C) 2013 University of Utah School of Medicine
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t NRMP Program Director Survey t (C) 2012 University of Utah School of Medicine
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t Specialty Specific Information NRMP Charting Outcomes NRMP Program Director Survey AAMC.org/CIM t (C) 2013 University of Utah School of Medicine
t Careers in Medicine t (C) 2013 University of Utah School of Medicine
t Specialty Specific Information NRMP Charting Outcomes NRMP Program Director Survey AAMC.org/CIM You need to know what your likelihood is for matching into the specialties you are consiering t (C) 2013 University of Utah School of Medicine
t What is your likelihood of Matching? Very little to do with how good of a student you are Has everything to do with your preparation and backup plans Number of applications Which programs to apply to Dual applications Improving LOR Step 2 Rotations t (C) 2012 University of Utah School of Medicine
t SOAP Replaced the Scramble in rounds of a electronic Supplemental Offer and Acceptance Program Lots of sitting and waiting for the phone to ring Miserable and not very helpful t (C) 2012 University of Utah School of Medicine
t Eight Utah SOAP Students ( ) Mix of specialties Some had obvious difficulties Step 1 failure, clerkship failure, etc Some were strong applicants Average Step 1 score 234 Too few applications Interview issues? t (C) 2013 University of Utah School of Medicine
t Where Our Students End-up? 1 Orthopedic surgery candidate SOAPd into Surgery- preliminary position 1 Radiology candidate SOAPd into Anesthesia position 1 Radiation Oncology candidate SOAPd into Surgery- Preliminary position 1 Diagnostic Radiology found a position in May outside of the SOAP 2 Emergency Medicine Candidates found prelim Medicine position in May outside of SOAP 1 still looking for Family Medicine position 1 still looking for Med/Peds position t (C) 2013 University of Utah School of Medicine
t Summary You want to be Matched! SOAP is miserable and is not a backup plan Not finding any position is extremely miserable Determining your specialty now helps immensely Use NRMP data now to determine your likelihood of matching Start thinking about backup plans now if you need them (C) 2013 University of Utah School of Medicine
t What do you need to do in the next 6 months? Identify a specialty, Track and a Mentor (Carol) Complete the 4 th year lottery process (Carol) Determine your Step 2 times Review your LOR options Ace your clerkships Be ready for 4 th year Orientation Meeting in June t (C) 2013 University of Utah School of Medicine
t ERAS Technically optional but almost everyone uses it All NRMP match uses ERAS Military match uses ERAS Urology match uses ERAS and AUA San Francisco match uses CAS Very separate from NRMP and NBME (C) 2013 University of Utah School of Medicine
t ERAS Students responsibility: Letters of Recommendation (shared) NBME scores (shared) Personal Statement(s) CV Photograph Program List We will talk about each one of these in the Longitudinal Course (C) 2013 University of Utah School of Medicine
t ERAS Tokens Released end of June Allow students to access and input information Residency programs have access to their side only at this point (C) 2013 University of Utah School of Medicine
t ERAS Residency Programs Use ERAS to access all of the information from you, SOM, and NBME First time available to them is Sept 15 th (C) 2013 University of Utah School of Medicine
t Letters of Recommendation Four slots in ERAS for LOR Few student will meet four letter writers in the next eight months You need to start finding them now Rholinda will discuss in June the detailed process for getting LOR into ERAS (C) 2013 University of Utah School of Medicine
t Letters of Recommendation Qualities of a good letter writer: Attending (not resident or chief resident) Clinical exposure is my primary consideration I do not care about rank or national status (some specialties might) Research letters are the main exception to the clinical focus Someone that can attest to your professional identity (i.e. brand) (C) 2013 University of Utah School of Medicine
t Letters of Recommendation How to ask? Set up a meeting Bring your CV Be prepared to answer What should I focus on in the letter? Provide a deadline For now, have them keep the letter (C) 2013 University of Utah School of Medicine
t NBME Deadlines Schedule exam by June 15 th (recommended) Take CK by October 31st (required) Take CS by December 31 st (required) Disability and accommodation request must go through main campus CDS SINGLE PRACTICE CK EXAM PROVIDED BY THE SOM (C) 2013 University of Utah School of Medicine
t Step 2 timing More program directors are using Step 2 for initial interview decisions (C) 2013 University of Utah School of Medicine
t Word of Caution… Our evaluation of applicants includes the USMLE Step 2 CK score. I would be happy to further evaluate this applicant once I have that score. Program Director, 2012 Match (C) 2013 University of Utah School of Medicine
t Step 2 timing More program directors are using Step 2 for initial interview decisions Clear decline in scores the further away from Clerkships Institutional requirement to take exam by Oct 31st (C) 2013 University of Utah School of Medicine
t Oct 31 Deadline MSPE released ERAS due NBME Deadline to take exam and have results available for ERAS? NBME Deadline to take exam and have results available for MSPE?
t Step 2 timing In general, it is nearly always better to have a CK score posted by September 15 th. In order to post by Sept 15 th, you probably need to take the exam by ~July 29 th CS not typically used for granting interviews (unless you fail it or have significant problems with clinical evaluations) (C) 2013 University of Utah School of Medicine
t Longitudinal Course - Mentoring ERAS Step 2 Personal Statements Letters of Recommendation NRMP data Making a program list Interviews Making a rank list t (C) 2013 University of Utah School of Medicine
t What do you need to do in the next 6 months? Identify a specialty, Track and a Mentor (Carol) Complete the 4 th year lottery process (Carol) Determine your Step 2 times Review your LOR options Be ready for 4 th year Orientation Meeting in June Ace your clerkships t (C) 2013 University of Utah School of Medicine
t MSPE National History Wide variation historically Guidelines published by AAMC in 2002 Letter of evaluation rather than letter of recommendation Standardized format Release deadline moved from Nov 1 st to Oct 1 st
t Local history Excellent adherence to AAMC guidelines Input fields from all other areas of Deans Office (OIO, PEL, Med ED, etc.) Compilations 8-10 pages in length
t My Vision Accurately portray the true consistent performance of our students Provide useful information to the end user (program directors) Maintain institutional integrity Foster student desire to excel rather than compete
t First Page IDENTIFYING INFORMATION Chelsea Smith is a fourth-year student at the University of Utah School of Medicine applying to your program for residency training. This letter is meant to provide an overview of Chelseas academic performance and personal characteristics to assist you in your assessment of her application. Chelsea came to the University Of Utah School Of Medicine in 2011 after earning a Bachelor of Science degree in Biology from University of Notre Dame, and her PhD in Anthropology from the University of Utah.
t First Page UNIQUE CHARACTERISTICS Chelsea is a resourceful innovator, looking for opportunities in learning and service. As a first year student, she noticed that there were plenty of opportunities addressing global health for medical students, but none addressing the unique needs of Utah's own population. Over the course of the year she developed contacts within the Utah Navajo Health Service. In doing so, she created an alternative spring break program for students interested in volunteering for under-served populations just hours from Salt Lake City in Montezuma Creek and Monument Valley. Chelsea has held positions of leadership. She served as the president of the Pediatric Medicine Interest Group. Chelsea is also very excited to be the principal investigator for her research project, a quality improvement study to help identify possible socio-demographic factors contributing to poorly controlled asthma in the pediatric population. She expects to publish her abstract and to present her research findings later this year.
t Unique Characteristics The Unique Characteristics is the first page of your MSPE (8-10 pages total) You will write a Personal Statement for your ERAS application, this is a different document. I will finalize and edit this statement using material that you create. Remember, this is written from my perspective t
t Second page
t ACADEMIC HISTORY Combined Degree:No Leaves of Absences, Extensions, Gaps:Yes. Chelsea took a personal leave of absence from August 2012 to December Coursework Remediated or Repeated:Yes. Chelsea successfully remediated her Comprehensive Clinical Skills Examination at the end of her third year. Disciplinary Action(s): No
t ACADEMIC PROGRESS: PRE-CLERKSHIP YEARS (Phases I and II) Pre-clerkship Academic Record: Chelsea successfully passed all courses during the first two years of medical school, including the following units: Foundations of Medicine (Pass/Fail only) Molecules, Cells and Cancer - Honors Host and Defense Life Cycle Brain and Behavior - Honors Metabolism and Reproduction Circulation, Respiration and Regulation Skin, Muscle, Bone and Joint
t ACADEMIC PROGRESS: PRE-CLERKSHIP YEARS (Phases I and II) Clinical Experiences: Chelsea successfully completed all expectations for her Longitudinal Clinical Experience (LCE) and Subspecialty Clinical Experience (SCE) in her first two years of medical school, giving her over 1,700 hours of clinical exposure before beginning her Clerkship Year, Phase III. Details on LCE and SCE are provided in the Appendix. Chelseas LCE faculty attending physician noted the following: Very professional and interested in outpatient medicine.
t ACADEMIC PROGRESS: PRE-CLERKSHIP YEARS (Phases I and II) Scholarly Expectation: Medical students are required to participate in an independent program of study that promotes students expertise in one or more areas of medicine, their ability to perform inquiry-based research, to ask scholarly questions and to effectively communicate the rationale for and results of their scholarly work. Chelsea reviewed patient charts and culled data from an Intermountain Healthcare database of infectious diseases affecting Utah communities. She used these data to examine the relationship between community viral infections and childhood leukemia. Chelsea presented her work at the 2010 annual Frank Tyler Medical Student Research Symposium in Park City, UT.
t ACADEMIC PROGRESS: PRE- CLERKSHIP YEARS (Phases I and II) Community Service Learning Experience: All students are required to participate in community service learning projects in the first two years of the curriculum. Chelsea exceeded the service requirements of the UUSOM, completed at the following venues: 4 th Street Clinic 4 th Street Triathlon Flu Vaccines for the Homeless Maliheh Free Clinic Chelsea received an Honors in this service-learning requirement. Honors is awarded to students who completed 75+ hours directly with Utah and the surrounding communities in clinical, education and premedical programs supervised by the Office of Inclusion and Outreach.
t ACADEMIC PROGRESS: PRE- CLERKSHIP YEARS (Phases I and II) Professionalism: The professionalism of our students is routinely addressed throughout all elements of the 4-year curriculum. Chelsea has met the professional expectations of the UUSOM as outlined in the Student Handbook, including: Honesty, Confidentiality, Respect for others and Responsibility.
t ACADEMIC PROGRESS: PRE- CLERKSHIP YEARS (Phases I and II) MSI Comprehensive Clinical Skills Examination (Pass/Fail): Pass MSII Comprehensive Clinical Skills Examination (Pass/Fail): Pass
t ACADEMIC PROGRESS: CLERKSHIP YEAR (Phase III) Student performance is based upon achievements in the areas of medical knowledge, patient care and professionalism. Each component is used to calculate an overall clerkship score using a four point scale: 4 = Exceptional; 3 = Above expectation; 2 = Meets Expectation; 1 = Below Expectation; 0 = Unacceptable. Narrative comments are provided by faculty and clerkship directors and are edited the Associate Dean of Student Affairs only for grammar and length.
Clerkship MSPE Example Internal Medicine (12 weeks) Score: 2.97, Pass Chelseas Internal Medicine attendings made the following comments about her: Chelsea had a solid performance during this rotation and I am sure she will go on to do well. Student was very engaged during rounds, would read about her patients issues and overall did a very good job on Medicine. Chelsea was a valuable member of the Internal Medicine team during her first third-year clerkship. Chelsea was easy to work with. She seemed to really care about her patients. She was a hard worker and sought out responsibility. Excited about patient care and medicine. Took responsibility for patients and would call consultants. Very helpful. Organization, willingness to learn, works well with team (are her strengths).
t ACADEMIC PROGRESS: CLERKSHIP YEAR (Phase III) Cumulative (year-long) performance on individual clinical competencies required for passing the clerkships Clinical Knowledge Professionalism Patient Care Scores (0-4 scale) taken directly from Clerkship Final Grade Form
t Clinical Knowledge Score
t ACADEMIC PROGRESS: Track Curriculum (Phase IV) Grades and narrative from any courses that have a grade submitted prior to Sept 22 nd. A list of fourth year courses scheduled to be completed
t SUMMARY Chelsea is a caring professional who is dedicated to her profession and to community advocacy. As of the submission of this letter, she has successfully completed the University of Utah School of Medicine curriculum. Based on all aspects of Marys educational experience, she has demonstrated competency in all of the general domains established by the medical school and is prepared to enter residency. She is considered to be an excellent candidate for your residency program.
t AOA Calculation and Class Description AOA Calculated at the completion of Phase III Includes Junior AOA calculation and clerkship scores No class rank is every released or made public No quartile is calculated Descriptors are used instead of class rank or quartiles
t Summary Descriptor Descriptors of summary performance Outstanding, Excellent, Very Good, Good Describe the criteria needed to achieve each level Provide relative percentages for top descriptors (i.e. Outstanding)
t Summary Descriptor
t Descriptor Criteria Large list of potential inclusion points Will includes Phase II score and honors, Phase III score and honors, and Step 1 scores End of year 3 OSCE?
t So what do you need to do in the next month? (Ace your clerkships) Use your token to open your ERAS account Begin your Personal Statement Begin your Unique Characteristic paragraph Set an appointment with me to review your UCP Schedule your Step 2 exams Review your LOR options t (C) 2013 University of Utah School of Medicine
t What do you do if you do not know your specialty? Relax Do well on your clerkships Differential diagnosis approach Most likely, most dangerous, off the list, different paradigms Create opportunities to refine the list Shadowing, rotations, research, mentors t (C) 2013 University of Utah School of Medicine
t What do you do if you do not know your specialty? Ask your friends and family Ask Why? AAMC.org/CIM Its OK to put your nickel down and be wrong Its OK to dual apply t (C) 2013 University of Utah School of Medicine
Timeline JanFebMarAprMayJuneJulyAugSeptOctNovDecJanFebMarAprMay Administrative Lottery ERASMSPE RankMatch Grad Exams OSCEStep 2 CK (Oct 31st) and CS (Dec 31st) Interviews Courses off Transition Course Mentoring Pre-lottery Pre-ERAS LOR, CV, PS Submit Interviews Rank List
General Requirements 32 weeks total credit minimum 22 weeks in University of Utah system 4 weeks of local Sub-Internship Minimum 8 weeks of clinical electives Variable specialty requirements Required courses Longitudinal Course Transition to Internship Course
Assessment Honors, High Pass, Pass and Fail Some courses are pass/fail only 4 week deadline for grades Four types of evaluation forms: Sub-Internship Clinical Elective Didactic Elective Research Elective
Tracks and Specialties Applied Anatomy General Surgery Specialty Surgeries OB/Gyn Pathology A cute Care Emergency Medicine Anesthesiology Primary Care Internal Medicine Pediatrics Family Medicine Psychiatry IM-Peds Triple Board Medical Sciences Dermatology Medical Genetics Radiology Neurology PM&R Radiation Oncology Nuclear Medicine
Track Directors Primary Care Rick Henriksen, MD Family Medicine Applied Anatomy Amalia Cochran, MD Burn Surgery Medical Sciences Phil Caligiuri, MD Radiology Acute Care Megan Fix, MD Emergency Medicine
Sample Track Requirements
Track Mentors Specialty Specific Required for Approval of Phase IV Initial Schedule Request A Resource throughout the Year Personal Statements Program Lists Mock Interviews Rank Lists
Changing Tracks Allowed at any time up to Transition Course Find the right specialty for you! Held to requirements of new track Stay in communication with your Mentors, Track Directors, and Student Affairs Contact Rachael Smith to formally change tracks
Longitudinal Course Mentoring content Choosing your specialty ERAS application process CV Personal Statement Program lists Residency Interviews Rank Lists Curriculum content Relevant to Intern Role Effective Communication Risk Management Health Care System Navigation DNR/DNI
Longitudinal Course Attendance Attendance is Required Excused Absences Allowed Absences Away Rotation Residency Program Interviews Not Allowed Vacation USMLE Step 2 CK or CS Make-up Assignments For Excused and Allowed Absences
Longitudinal Course Questions?
Transition to Internship
Transition to Internship Course March 30-April 24, 2015 No concurrent course enrollment allowed Class, Track, and Specialty sessions Skills Foundational Knowledge Processes Procedures Communication Codes, Mega-Codes Task Trainers Simulation Labs
Transition Course Questions?
Hints Relax Focus on your Sub-Internships Remember you can switch tracks Prioritize the time prior to the MSPE being released (Oct 1 st ) Begin thinking of Letters of Recommendation now Be mindful of deadlines Enjoy fourth year
Fourth Year Scheduling Basics January 2014
JulAugSepOctNovDec JanFebMarAprMayJun Block 1Block 2Block 3Block 4Block 5Block 6 Block 7Block 8Block 9Block 10Block Fourth Year Fall Semester (7/7 – 12/19) Spring Semester (1/5 – 5/22) 2 and 4 week rotations 1 week = 1 credit
JulAugSepOctNovDec JanFebMarAprMayJun 7/7–8/18/4 –8/299/1–9/269/29-10/2410/27-11/21 11/24-12/19 1/5-1/302/2-2/273/2-3/27 3/30-4/24 Transitions 4/27-5/ Fourth Year ERAS app due 9/15 Step 2 CS deadline 12/31 Step 2 CK deadline 10/31 MSPE due 10/1 Graduation 5/24 Match Day 3/20
Creating Your Fourth Year Schedule
You will need - 1. Track Curriculum Outline 2. UUSOM Senior Elective Catalog 3.Copy of the 2014/15 Fourth Year Graphic 4.Faculty Mentor 5.UUSOM Lottery Course Scheduling system
1. Track Curriculum Outline - Outlined by Dr. Dani Roussel
4. Faculty Mentor - select a recommended mentor within chosen Track - they agree to review your proposed schedule and discuss plans
Faculty Advisor Form Faculty Advisor Form (return to Rachael Smith by March 3, 2014 ) _____________ and I have discussed his/her plans for the upcoming year and reviewed his/her fourth year schedule requests. I have considered the career interests, interview schedule, Boards requirements, and curriculum for this student. I find this schedule request acceptable. ________________ _________________ Printed Name/Advisor signatureDate Preliminary Track Designation __________________________ Preliminary Specialty Designation __________________________ *Note: an alternative to this form is to have your faculty advisor (from their own account) a brief message stating they have met with you and approved your scheduling requests. Include Faculty Advisor Form for XXX in subject line
5. Lottery Course Requesting system - previously used for third year lottery
5. Lottery Course Requesting system, cont. - select me the password - HSC account only
5. Lottery Course Requesting system, cont. Guidelines -10 is highest priority, 20 is second highest… - only request ONE Sub-I in the lottery (others added later) - try to request 20 – 24 credits* - select coursework for blocks you anticipate away rotations * Six credits of Transitions and Longitudinal courses work will be added for you
Coursework to Consider
Think about - 1.Course selection - 22 departments, 160+ courses 2. Track requirements 3. Personal interests/Scheduling issues 4. Advice of faculty mentor
Think about - course selection - Certificate Programs INTMD 7036: Geriatrics (UU Graduate Certificate) - Continuity Clinics Family Medicine Internal Medicine Pediatrics Med-Peds - Honors courses and deadlines DERM 7700April 15 FPMD 7220April 1 OBST 7090Early Spring OPHTHO 7600April 1
Think about - course selection - Humanities courses INTMD 7992: Dr/Pt Relationship in Lit. – Imagining Medicine (Fall semester) Medicine In Arts (Spring semester) Writing the Dr/Pt Relationship (Spring) - Global Health Elective - Newly created courses Continuity Clinics Peds ED Vascular Surgery Sub-I Medical Students as Teachers *new courses announced throughout year
1. Research* - contact department regarding approval for registration provide research proposal, preceptor name and contact information project scope - leave space in schedule for planned research - 40 hours effort = 1 week = 1 credit 2. Restricted courses* - certain courses require departmental approval prior to registration with Student Affairs (Palliative Care, Internal Medicine in the Community, Pediatric IV Wound Care) * have department contact me via giving their approval for registration, noting course number and month of enrollment, so the course may be added to your schedule
3. Away Rotations - Rotations must be at LCME accredited institution - information regarding VSAS to be mailed this week ($35 for first application, $15 for additional applications) - non VSAS institutions utilize alternate application system
Other Scheduling Considerations
Unscheduled time - 1.NBME Board Exams - Oct. 31 for 2 CK - Dec. 31 for 2 CS (no enrollment for Spring 2014 if deadlines missed) 2.Interviews - leave Nov. through Jan. unscheduled
Mar. 3Faculty Mentor form due Mar. 10Lottery closes Mar. 14Fourth-Year Schedules sent to you* April 5NBME 2 CK/CS registration due May 1Must achieve 32 weeks registration June 15 (rec)NBME 2 CK/CS date selection due *scheduling changes/waiting lists available after schedules sent to you