What's in an ERAS Application?

ERAS season is almost here already! It feels like yesterday that I was filling out my application. I remember the angst and anxiety I felt leading up to application time and a lot of it centered around making sure my application would look good and that I'd be able to add valuable information to all of the different elements of the application. As applicants we are basically on our own as far as the application goes. There is no one to hold your hand and make sure you know exactly what you're doing and that can be stressful! This post is dedicated to just helping you familiarize yourself with the application and the things that will be asked in it.

First, I want to clear one thing up. I have a lot of people ask me about the "CV" portion of the application. You don't upload a CV per se...ERAS generates one using the information that you enter into the application. So don't worry about how the CV should look or what format to use. That being said, this is a great time to update and polish your CV because you will want to send it to all of the physicians writing a letter or recommendation on your behalf. It can really help them add depth to your LOR especially if they haven't known you for a long time.

Below I will list the components of the ERAS application. It's a great idea to start compiling any information you have now so that it will be streamlined when applications open. That being said, you've got about 3 months to work on your application once it opens so there is no need to panic! For this year (2018) the applications open on June 6th. At that time you can start entering all of your information and deciding which programs to apply to. You can start actually applying on September 6th, and programs receive applications September 15th. It is a really good idea to have everything done before programs receive the applications on the 15th. You want to show that you were prepared and enthusiastic about applying so applying after that could hurt you somewhat. If at all possible, you want ALL of your USMLE scores in before the application goes in so try to consider that when planning out when to take your exams. USMLE Step 2 CS can take 3 months for results, so you want to do it by June 1st to be safe. USMLE Step 2 CK takes about 3 weeks, so try to get it done by the first or second week of August at the latest!

General Information

Name

Email

Gender

Birthdate/Place

Citizenship status

Mailing address and phone number

History of any criminal records

This section is self explanatory so I won't elaborate :)

Medical Licensure

ACLS

PALS

BLS

Any medical licenses or board certifications 

Past history of malpractice suits

I'd advise having current ACLS and BLS certification at the time of application if you can. This shows that you stay up to date and current with your certs. I would recommend PALS if you are applying for Peds, Med/Peds, Family Medicine, or any other specialty where you will see children.

It is not expected that you have any medical license or board certifications at the time of application. This is more for people who may be changing fields or who have medical licenses in other countries and are now trying to come to the USA to practice.

Medical Education

Your medical school(s), dates attended and date of degree

Date of degree can be empty if you haven't graduated, you can also put the expected date of degree and make it a future date.

Medical School Honors/Awards

Any special recognitions or awards you receive during medical school can go here. Things like making the Dean's list or awards given out at graduation are some examples. Every school has different incentives and awards so I won't go into too much detail.

Membership in Honorary Professional Societies

Alpha Omega Alpha ?

Gold Humanism Honor Society ?

Others

Many schools don't have AOA or Gold Humanism Honor society so don't worry if you haven't heard of these!! 

It is important to obtain membership in the professional societies to which you are applying. For example, for Pediatrics you would want to join the American Academy of Pediatrics (AAP). Other things that can go here are memberships in red cross, AMSA, or others. Programs like to see that you are interested in being involved and staying up to date with the issues going on in your field and this is a great way to show your commitment! 

Education

Type of Education (Undergrad/Postgrad)

Institution and Location

Dates attended

Degree

Degree Date

Field of Study

All of your undergraduate and postgraduate education (except medical school) goes here! Even if it isn't related to the medical field, I would still include it. The more education the better!

Current/Prior Training

Institution, Location and Training Type

Program Director

Program Supervisor

Dates Attended

Month(s)
Discipline

This is for applications who have other post-graduate training. An example would be that you matched into a Preliminary Spot for PGY1 and are now applying for a different PGY1 spot or a PGY2 spot. If you haven't been a resident before you don't need to worry about this section - it certainly won't fault you!

Experience

Work, Volunteer, and Research Experience.

Organization and Location

Position

Dates

Supervisor

Average Hours/Week

There is a separate section for work, volunteer, and research experience. 

Work experience should be limited to experience in the healthcare field or experience that will help you as a resident. Programs won't care that you worked at Subway in high school - keep it relevant or it might look like you're trying too hard to just fill in space.

Volunteer experience is a bit different - it doesn't necessarily have to be related to healthcare. Volunteering is a great way to show that you like to be active in your community and give back. Volunteering in areas outside of the medical field can also show that you are a well rounded person. For example, I volunteer with an organization that helps supply underprivileged children with clothing and school supplies. It isn't medical per se, but reiterates my desire to help children.

Research experience - structured research experience goes here. Publications are different. If research results in a publication you can have it in both sections.

Publications

Simply a list of your publications. This isn't research, that goes in section above. This is a list of your published work(s) if you have any.

Language Fluency

You input the languages you speak and how well you speak them in this section

Hobbies

This is a free text box that you can list your hobbies in. Programs like to see that you are well rounded and have interests outside of medicine. This section certainly won't make or break your application but it can show that you are into other things. A lot of my interviewers used my hobbies as ice breakers to get conversation going in the interviews so be prepared to take about them if you list them!

Other Awards/Accomplishments

This is a free text box where you can list anything else that you want the programs to see. Awards for community service would be an example of something you could put here. You don't HAVE to put anything - I didn't because I simply didn't have anything and didn't want to list something that would be a stretch just to have something there.

Personal Statement

Personal statements don't go under the main application, you upload them separately. You can upload as many versions of your personal statement as you want to! I uploaded a very personalized personal statement for programs I was especially interested in and then had a generic one that I sent to the rest. This is also important if you are applying to more than one specialty. You will want a personal statement for each specialty explaining why you are applying for that specialty and why you'd be a good asset.

Hope this helps to ease a LITTLE of the application anxiety I am sure you are all feeling! Best of luck in the match!

IMG Friendly Pediatric Residency Programs 2018

Matching into a US residency program is a tough thing to do these days. It is especially tough for international medical graduates. Just over 50% of the international medical graduates who apply to the match successfully obtain a position. This creates a huge amount of anxiety and stress through all four years of medical school. You sacrifice so much while in school and having such low chances of getting a position makes it feel even more daunting than it already is. That being said, thousands of international graduates do get a spot every year and there are lots of things that you can do to strengthen your application and help your case. The residency application process is lengthy and costly, so knowing which programs to apply to can be half the battle. You literally pay for every program that you apply to. Many IMGs are applying to several hundred programs which can cost thousands and thousands of dollars. You also have the expense of traveling for interviews, so anywhere you can save money helps a lot. Applying “smart” is very important. There are more than 200 pediatric residency programs in the country. Doing research to ensure you’d even have a shot at a program is the best way to make sure you aren’t spending unnecessary money. 

Before getting into my list of IMG friendly programs, I’ll caution you to be careful with programs in NYC. The state of NY has a “12 week rule” that states that any student who does more than 12 weeks outside of their home country are not eligible for medical licensure or residency in the state. There are exceptions that can be filed but it gets sticky. A simplified explanation and a list of exempt schools can be found here: http://medclerkships.com/new-york-states-12-week-clerkship-rule-explained/

This list is just meant as a guide to get you started. It is important to research the programs you are applying to in order to make sure they will be a good fit and that you meet the requirements. In your program search, you might notice that a lot of the big name hospitals (Cleveland Clinic, Harvard, etc) do have several IMGs on their roster. This might make it tempting to apply, but it's probably smarter to save your money. Most IMGs that match at these programs have connections there. That being said, if you score very competitively on boards (higher than 245 on both), I'd say go ahead and give it a shot! Another variable to consider is your location...programs often consider those who are native to the area that the program is in. If you are from the USA, be sure to apply to any programs that are near your home town!

The interview trail is fun, but exhausting! You travel a lot in a short amount of time. My biggest regret is not having enough time to truly get a feel for each of the locations I visited - it just wasn't possible. I definitely had a few favorite interviews. LSU in New Orleans definitely won for best food. They had a dinner the night before that the residents cooked homemade food for and it was to die for! They also took us out for a great lunch on interview day. Geisinger was the most friendly and hospitable. They made me feel at home right from the start. They provided a really cozy hotel room and thanked us repetitively for making the trip there. University of Buffalo had the most impressive facilities! They just opened a brand new stand alone children's hospital that is absolutely incredible. University of Arizona was definitely the prettiest place I visited...I am a sucker for those mountains!

Programs that were nice enough to grant me an interview:

William Beaumont Hospital - Royal Oak, MI
University of Buffalo - Buffalo, NY
Sinai Hospital of Baltimore - Baltimore, MD
Louisiana State University - Shreveport, LA
Louisiana State University - New Orleans, LA
University of Arizona - Tucson, AZ
Marshfield Clinic - Marshfield, WI
UConn School of Medicine - Hartford, CT
Michigan State University - Flint, MI
Geisinger Health Care - Danville, PA
Maimonides Medical Center - Brooklyn, NY
New York Medical College - Newark, NJ
Hofstra Northwell School of Medicine - Staten Island, NY
SUNY Upstate - Syracuse, NY

Programs that other IMGs were invited to interview at (I know people who had interviews at these places personally):

Lincoln Medical Center - Bronx, NY
Texas Tech - El Paso, TX
St. John Providence - Lansing, MI
Brookdale University Medical Center - Brooklyn, NY
St. Barnabas Health - Brooklyn NY
Flushing Hospital Medical Center - Flushing, NY
Bronx-Lebanon Hospital Center - Bronx, NY
St. Peter's Medical Center - New Brunswick, NJ
University of Texas Medical Branch - Galveston, TX
University of Florida - Pensacola, FL
SUNY Downstate - Brooklyn, NY
Case Western Reserve University - Cleveland, OH
NY Presbyterian Hospital - New York, NY
Richmond University - Staten Island, NY
Monmouth Medical Center - Morristown, NJ
Homer Stryker School Of Medicine - Kalamazoo, MI
Icahn School of Medicine - New York, NY
Mount Sinai Hospital of NY - Elmhurst, NY
Nassau University Medical Center - Easy Meadow - NY
Driscoll Children's Hospital - Corpus Christi, TX
Jersey Shore University Medical Center - Jersey Shore, NJ
Woodhull Medical Center - Brooklyn, NY
University of Kentucky - Lexington, KT
East Carolina Vidant School of Medicine - Greenville, NC
University of Florida - Jacksonville, FL
Tulane University School of Medicine - New Orleans, LA
Hackensack University - Hackensack, NJ

As I said before, this list is definitely not exhaustive. It is meant to be a place to start if you don't know where to. Best of luck! I will be posting more match tips soon :) 

I MATCHED!!

That’s right! My dream has come true!  All of the hard work has finally paid off. I have matched into a categorical pediatric position at Geisinger Health in Danville, PA!!! I know I have been on a bit of a hiatus from posting about my journey, but the match process is a lengthy one and I wanted to ensure that things turned out well before I shared information about process. I have lots of great posts planned such as tips for matching into a pediatrics program, components of the ERAS application, interview tips, and more!

First, a little about this wonderful program that I matched to! Geisinger is an enormous health care system in central Pennsylvania. They’ve got 27 residency programs and 21 fellowship programs making it a real hub for tertiary care. The hospital is just shy of 600 beds, has a 5 helicopter emergency trauma program, and contains my new home - the Janet Weiss Children’s Hospital! The children’s hospital has every subspecialty for pediatrics you can think of! From pediatric trauma to pediatric neurosurgery to a dedicated child abuse unit, there isn’t much that can’t be handled at the hospital. Though the hospital is in the small town of Danville, it has a catchment area of over 3 million people as it’s the only facility of it’s type in the area.

I will be spending my next three years there at minimum completing my training in pediatrics. I am super excited for the awesome education that I know I will receive there! I fell in love with Danville on my interview day. It was the first interview I went on and it was in the middle of October. I drove there from Chicago and was so enchanted by the rolling hills and beautiful colors of the changing leaves! The fresh air and small friendly feel was such a welcomed change from Chicago. It really reminded me of home, more than any place in the US I have been thus far. Patrick and I love to mountain bike and hike and there will be lots for us to do there! I am taking a trip there next week with my mom and my mother in law to look for apartments since Patrick is really busy with rotations right now and can’t get away. We’ll be moving at the end of May and I’ll be starting up shortly after that! For my colleagues, please stay tuned for lots more posts about the match process, and if you have questions or suggestions for blog topics feel free to email me as always at drnicolefox@gmail.com

Thanks for reading and congratulations to all of my friends who had a successful match season! This year was one of the best for our school and I am proud to be a part of it!

What We Can Learn From Nurses

As I creep further along in this medical school program and start to spot the finish line, I have been reflecting a lot on this journey. I have sure experienced a ton and have gone through a lot of personal growth since packing up my bags and moving to the island almost four years ago! Lately, I have been thinking a lot about how thankful I am to have had my experience as a nurse behind me, helping to guide me and mould me into the best physician that I can be. I can confidently say that my experience as a nurse is definitely going to positively impact my practice as a doctor, and there are many reasons for it.

This reality really struck me the other day. I am currently doing an elective rotation in allergy and immunology at Cook County and Rush Hospital in Chicago. We were rounding on our patients with the team which consists of an attending, two fellows, three residents, and three students. We had to perform a pretty uncomfortable test on an older gentleman who had a ton going on with him. He was in pain, had been through a lot, and had tubes and machines attached to just about every part of his body. In order to perform the test we were doing, we needed him to be semi-sitting up which was a pretty uncomfortable position for him to be in. After the test was finished, his wife politely asked if he could be repositioned in a way to make him more comfortable. As I looked around the room I watched eight sets of eyes open wide, and then one of the fellows quickly said “we will get his nurse right away and have her get him comfortable, I’m really not sure how he is supposed to be positioned”. We left the room, and the fellow found his nurse and relayed the request. I saw the familiar “internal eye roll” that nurses give doctors when they are approached and given a task that seemingly anyone could perform. I didn’t even need to have a conversation with this nurse to know what was going through her head. “Nine perfectly capable people in white coats, and not one could just help reposition the man? Like I don’t have enough to do”. I was so odd to see this situation play out from the other end. How many times had I thought a doctor was lazy or didn’t care, when really they were just worried they might do something wrong?

This illustrates one of the biggest reasons my experience as a nurse will help me - I am going to be able to understand and relate to the nurses I work with really well. Having seen and done things from their point of view will really help me communicate well with them and anticipate how I’ll be able to help them and even how they’ll better be able to help me. Good nursing care for your patients is so paramount. Being able to work together with the nurse caring for your patients is the best way to ensure that they receive great care.

Nurses spend their entire day with their patients. They are there for it all. They see every up, down, twist and turn that is thrown at their patients during their hospital stay. Nurses really get a feel for what their patients go through. They understand what happens during painful tests and how patients react to getting certain medications. They can anticipate what their patients are going to need and when. It’s not just about “caring”. I feel that most people in the healthcare field are there because they care, but being at a patient’s side every step of the way teaches you HOW to care for people. Until the skill of how to care for others is learned, all the caring in the world doesn’t go very far. It’s about anticipating those needs and comforts, regardless how big or small they might be. If you’ve got a nurse in your life - a loved one, a family member, a friend, or even an acquaintance, be sure to give them a big hug and say thanks! Nurses are amazing and really do deserve all the gratitude in the world.