¶ Career Paths and Importance of Mentorship
When you talked about introspection , that made me think of a colleague of mine who spent seven years trying to get into a residency program . Finally , I was like you need to tell me about one of your last interviews . The conclusion that I came to was that you are cocky and this is why you're not getting into residency .
So , introspection .
How are you navigating your own personality , I guess , beyond just the I check this box and I pass the step three . Listen , check boxes ain't gonna get you everywhere . You gotta learn how to relate to people .
Certain people we recommend Mock interviews you please sit down with somebody and I tell people all the time cause they're like , oh , you know , I wanna be myself 100% of the time . I don't want no program that don't want me . I get that , but they're also making one of these decisions and you need to treat all of these like first dates , you know .
Yeah , bring the best parts of you All , right , everybody , welcome . Welcome , welcome to another episode of Docs Outside the Box . I am your host today , dr Renee . I'm flying solo . I kicked Dr Ney off the podcast and he is no longer with us . Okay , I'm just kidding .
Dr Ney may or may not be joining us a little bit later , but today we do have a very special episode for you all , and we're really excited to continue on with the kind of partnership that we have going with the Student National Medical Association , or otherwise known as the SNMA , which is an organization that is near and very dear to my heart , that I've been
a part of since I was a student and continue as an attending , being a part of , and we are doing this particular episode , or these series of episodes , to really commemorate the 60th anniversary of the Student National Medical Association , which started in 1964 at Howard University School of Medicine , as well as Morehouse School of Medicine or , excuse me , yeah , no ,
mahary .
Mahary , Mahary .
Mahary .
I worked at Morehouse School of Medicine , but the SNMA started at Mahary School of Medicine as well as Howard University School of Medicine , and the reason that you can if you're watching on YouTube that our guests were smiling is because we have two guests with us today that went to the Howard School of Medicine , right , howard University School of Medicine , and
today we have back Dr Love Anani , who was on our previous episode I believe is 397 , and we are joined by his lovely wife , dr Uche Anani . Anani , correct ? Mm-hmm , yes , yes , okay , that was the one thing I didn't check before we got on here . No worries , dr Uche Anani as well . Dr Love Anani .
If you guys listened to the last episode , you'll know that Dr Love is an ER doc and Dr Uche is actually a neonatologist . However , she is the assistant program director in a pediatric residency program . So I wanna welcome you both here , because today we are gonna talk about career paths . I know we all three have been through career paths .
Yes , yes , yes , and you know , here , on Docs Outside the Box , we often talk about , we talk about money , we talk about pop culture , but when we do talk about medicine , it often is about the career path of medicine and just how we navigate that , and so that's why we're talking with both of you today .
So , dr Uche , you see a lot of residents come through your residency program . Obviously , as an assistant program director , what are some of the challenges that you would say that you see with applicants ?
So , before we get to the actual residents , what are some challenges that you see with applicants coming through that path and trying to navigate whether or not they're even going to even get matched to a residency program ?
Okay , that's a great question , kind of starting from the beginning , and so I feel like everyone , it's a daunting path . When you get into medical school it's like , okay , it's survival mode , like let me just get through these preclinical years . Now you get thrown into the clinical and you're like what the heck ? And now I gotta decide on a specialty .
I'm sure we'll talk a little bit more about decisions of training program versus not but you're making a decision , going to a training program . You're like , okay , we'll say , for example , I think I'm landing on peas . How do I know that I will do well in the specialty ? How do I know if I'll be considered a competitive candidate , all the things right .
And so .
I think the challenges those are kind of the initial challenges right Like really finding yourself of like what's gonna be well suited for me and have I gotten enough exposure to make that determination ? To be honest , it's just kind of like , whatever lands with you and whatever kind of sits within you I think it's helpful to have .
I think it's never too late to always have like a mentor , like . So I think it's very important to have a mentor early on , or people that you feel that you can trust to just talk it through right . So I think it's important to be able to say , like I'm thinking about this and these are the reasons why I'm interested in this specialty , versus not .
But also , how do I align that with what is my kind of like goal as a person in terms of my future , like what's the lifestyle I wanna live Like , what are the things that are important for me outside of my career ?
That I also wanna make sure I'm able to align my career with that , and so I think it's important to be able to have those conversations at a time . So that's , I think that's one thing that I think students will struggle with and I think really being able to assess their like am I competitive or not ?
Oh yeah , yeah , that's cute and .
I definitely have a conversation , or definitely have a lot of conversations , a lot of discussions with students who are really trying to like get a sense of that .
And that's where , again , I'm gonna emphasize this probably throughout an entire conversation is mentorship is important Having people you can rely on to be able to have those conversations and kind of work through the kind of mental process of like what is this really gonna be like for me ? And then walk through the hey , the technical .
You already know who it is . This is your boy .
Ah , ah , ah , ah , ah ah ah , ah , ah , ah , ah , ah , ah , ah , ah ah .
Okay for those of the application . So the reason we're laughing , folks , if you are not watching on YouTube is because Dr Need just walked in here trying to bow guard Kick in the door , waving the full four .
That's what I did , how y'all doing .
You walked in like Brother man from the fifth floor .
That's what you walked in like .
Remember me ? Yes , brother man upstairs , fifth floor .
That is true . I can't hear him , that's true . He can't hear you because I got my earpiece . Oh , I guess I'm gonna hear wax .
He said you walked in like .
Brother man from the fifth floor .
So that's the best part about doing a podcast is because it's not like regular you know , cnn or whatever it may be Like . We can have this type of crazy interruption and it's still flow .
Keep it flowing , keep it flowing , how y'all doing .
Very good we're good we're good .
So yeah , we were just talking before you came to hijack the podcast , because I had literally already taken it over .
We were just talking about some of the challenges , about you know applying or even getting to the point of application for residents or for medical graduates , and one of the things that Dr Uche talked about was the competitiveness right , like how do you even know you're competitive ? Do you even have a mentor ?
You know what are the kind of the what's the pre-work that you have to do before you get to the point of even thinking about what specialty you're going to apply to if you're competitive to that specialty , and then forget about , like , where exactly you're going to be .
You know applying to right Cause that's a whole different that's a whole different thing . Isn't a competitive reading the US news and reports , that book that tells you everything about the Med School ? That's being competitive , right ?
That's what we're talking about , you need to believe . Right , exactly , I'm not saying believe .
Yeah , I know the problem is is , yeah , Working with students as a mentor , what we tend to see a lot . Oh , I got to do one thing real quick Before anyone emails us or texts us . We are very well aware we know Howard goes by Howard University College of Medicine .
Yes , Howard . Oh , excuse me , College of Medicine , Because from school to medicine people .
You know our doors about to be kicked down . Yeah , I'm on the team , right , but the board's up Exactly . But , uh , trying to figure out what's competitive .
Unfortunately , a lot of students try to get in the minds of program directors and assistant program directors and they try to assume what these program directors want and everyone starts with the same thing Scores , scores , scores . And we used to have an easier one , step one . You take that after your sophomore year . You know exactly where you landed . That's past .
Fail now . So now everyone has shifted their desire to be competitive , or thought to be competitive , from step one to step two . We're seeing students take that earlier and there's a lot more focus on that , all the while more students are failing step one now there were before .
There were before , really yeah .
That's the stats , yeah , or the percentage has gone up . The percentage has gone up . So it's kind of like , but there's no score now . So the theory is our students not putting that same fervor . They were into step one grinding every day and now it's just like oh , it's past fail , I get to it when I get to it and I'll grind for step two .
Right and at the same time . If you don't pass that first time , that's still a bad knock on you , right , I don't care if you got a 250 on step two . You didn't pass the one , the first go . They still see that .
Yeah , yeah , yeah , and you know it's funny because that was one of the things that we talked about a couple of years ago , when step one actually went to pass , fail , you know , my thought was well , you just move to step two and just use that , right , because numbers are very easy to cut off .
The problem with that , I think and love you can speak to this is that oftentimes , students are grinding for the score . Right , students are grinding for the score , but are they thinking about all the other things ? Right , that pre-work that I talked about ? What is that pre-work besides just the score that is going to make you competitive for a residency program ?
You know , are our students doing that ? And what is that pre-work ? Mm-hmm .
And a lot of students do that on the back end , right ? So the easy stuff is extracurricular , right ? That's what you get on the application . Now you get a whole section . You get to pick your extracurriculars now , and now the ERAS application highlights the extracurricular activities you find the most interesting .
So now when people get applications , it's not just scrolling to the list . They can say , all right , what 10 things now did you do throughout med school and which of these top three are the most important to you and why ? Yeah , yeah . So you know , you know you played yourself , we know you didn't really do nothing , right ? So start .
You can't put start in a podcast or you can put the time window .
Yes , and if you put something and it was a month , I was like I'm sorry that doesn't register well . Yeah , Like if you only did something for a month and that's your most meaningful experience , like that's not going to work on the application .
But if you can show a story right Like , oh , I was a SNMA member my first year , I was chapter parliamentary in my second year , national parliamentary in my third year , speaker of the house the fourth year , they can see that like stretch out and then you can write all of those things .
That great , mind you , I want everybody to know that that was actually Dr Love's SNMA resume . It was , it was .
It was , it was . I was able to string that along . You can see that story of leadership . And it wasn't just like Uche said , like oh , I did this for a month . Oh yeah , I went to the SNMA community service drive every Halloween . Okay , what ?
you say about it , right , I'll tell you if you use all the characters we know you would have made this Dr Love , how you know my CV . I do think it's also important to know that everyone comes from a different like kind of like place in life and every like a different background .
Right , like some people may thrive in terms of doing like extracurricular activities that align with their like passion , their goals , others might be like , listen , I'm focused on just trying to get through class because I have all these other needs I have to do that are priority right , whether it be family or support , whatever , and I think that's also important
too , and that can still come across very positively in your application . But that's where I feel like you need that advisor or that mentor early on to be like okay , this is what , this is what I'm interested in doing . How do I make sure I'm doing aligning my pre-work or what I've done thus far to really showcase .
This is why I would be a strong candidate , and whatever specialty I may be , so you don't have to be someone because I was not SMA anything , whatever she wasn't , but let me add her up for a sec .
¶ Mentoring and Passion in Medical School
You put the word pediatrics in everything , and Uche was there .
You know the .
Pediatric Association President Uche throwing a pediatric residency . Fair , uche , you know going to national conferences .
Uche , who's the first one to go to ?
nationals or not . National Children's national .
And yeah , yeah , whatever your passion , show through anything . Pediatrics .
So that's your passion . Yeah , show through and spend the time on that . Right , right yeah .
But don't let your passion be getting a 245 .
Yes , yes , so basically what everybody who's listening you're really passionate about something , just double down on that .
You know yes .
Don't make it up as you go and say , well , I'm going to pick up crayon or basket weaving and show that off . No like if you're passionate about pediatrics and you're not passionate about something else . Focus on pediatrics , or what have you ?
Yeah , yeah .
And I find a lot of students you're waiting for that day you want to see somebody get basketball .
Yes , everyone always makes jokes about basketball . I swear one day Go show up .
You know someone's listening right now , like underwater , like what Somebody has .
Exactly , I was like I'm pretty sure they're out there .
Me . I can't with you anymore . I really just can't . Somebody go , come up from underwater . You're like yo .
I'm basket weaving .
Anywho .
That's the joke .
Exactly . Underwater basket weaving is always the joke . Somebody can , someone is awesome at it , and I'm waiting to see that person .
Waiting to see him . Yeah , and that's really good to know that . It's so important . And I'm sure , Dr Uche , you see that as part of the application process right . So now we're , you know , now , as we kind of go through the process , we you're looking at applications , saying , okay , well , what , what is actually here , what's substance here ?
And sometimes , you know , sometimes students can really portray their stories very , very well .
Other times , you know , it's kind of like , well , this chronological timeline of just all of the academic things that they did , essentially repeating their CV almost verbatim , but just in a story which really doesn't necessarily bode well and I it's about as tough though , like if you don't have any experience , kind of showcasing yourself , right , if you're just , I
work hard , I study hard .
Now , in essence , I got a brag about myself or at least like write an essay or something in a fashion that , Like I , have to almost like be a mind reader .
That's a really tough thing , particularly like someone where we came from right , Like you know where you like , like we don't get taught those type of things , so it'll give me a really tough thing to not just like have verbal spaghetti and like regurgitate your CB .
Absolutely . You know what I'm saying . Absolutely , no , I mean . But but , dr Uche , you mentioned also , this is where mentoring comes in . Yes , right , yes , this is where mentoring comes in . This is where mentoring comes in for sure .
Yeah , and I will say for honestly , I think to give a plug to SNMA and Torford University , I was just going to say that like those are , like those are avenues for students , particularly those who are of us who are underrepresented , consider like historically marginalized whatever , that you can access the programs through those organizations to really get access to
mentors , advisors , and ask those questions early on too and just get the guy or just , or even to just understand the process as a whole , right , cause you know what you know and you don't know what you don't know .
Right , so I think it's important to like be able to just have that plugin early , because then you can like get the exposure and be like oh okay , I didn't know I need to like raise my application in this way . Or , you know , this is how I should like think about my personal statement .
Or , oh , I didn't realize that's something that was a strength of mine . Oh , I can . I can actually put that on my application . Right , that's huge , and this , yes , right , and that's where I feel like it's important to like just have people you know and trust that you can just rely on me , like , hey , do you mind ? Not just me and Tor , but just I .
Just I want , I want to seek advice and I talk to you from time to time and just check in . Exactly .
I want to piggyback off of that Right . Like we always joke , that match day is the draft for med school and residency right yeah , what do you ? Do when you know you're going to enter the draft , you go and get an agent Right Like that's a good one . You don't just show up on your . That's how I'm buying everything about self-help .
Listen to our show I like that .
Come some good stories . No , dr Love you .
Dr Love , you are encroaching very , very closely to something that I have kind of on my back burner Right Okay .
Exactly , oh Same . So go and get your agent people . Go and get your mentor . I kicked off as a co-host .
Now Dr Love , Dr Love , my co-host , my co-host . Yeah , I need a new co-host .
You know it's funny , you mentioned that . Right , and I also think it needs to be reversed . Like mentors , like if you're listening and you're mentoring a student , like have the patience .
Yes .
Yeah , and constructive criticism , like if you see an essay that , yes , I mean you're 10 years out or five years out and that essay doesn't , you know , keep up to par , so to speak . Don't clown them , you know .
Support them , cause I'll be really honest with you , I I didn't tell anybody this , but my medical school essay and my residency essay was basically a version of my high school essay that I used to get into college , and I had a mentor who helped me get into a summer program while I was in high school who said , no , you need to rewrite your essay so that
you can get into this program . And then what I did is I used that format to change into a college admission essay , and then I was doing the same thing , not talking to anybody , and so in four years I just never updated it , then another four years , I rate .
So for me , I was just working with this outdated essay , but it worked once well , not work again . And I felt a little embarrassed to kind of talk to people and say , hey , can you help me with my writing ? Like I don't know if I'm writing something . Okay , that's what I'm talking about , you know just to have someone say okay , let me take a look .
You know , maybe we should change this . Maybe you need to talk more about this extracurricular activity or maybe tell us more about your story . Those are the type of things the reps that I think a mentor can really help out at , because there's a lot of people floating around , you know , with those type of stories .
Yeah , oh , I mean , it becomes very , very challenging to know what , like you said , what you don't know , especially if it worked before and you think it's gonna work again . So , you know . Now let's talk also about now that you've applied . You've gone to the draft day . You up , you up , it's time for the draft . You open that email .
For us it was open to envelope . I don't know if they still send out envelopes .
Some schools do , I guess .
Howard Bates Okay , howard College of Medicine does so . You open up your envelope , open up your email and you ain't get in .
¶ Considerations for Reapplying to Residency Programs
What do you think of that point , though ?
No no , no , I'm talking about the actual day , like that . What is it the Wednesday or the Monday ? What is it Monday ?
The Monday right .
The Monday is when you find out whether or not you actually got in . Then by the Friday you find out where you're going , when you match .
remember that's when you're in a suit that still has the tag on it , because you're like I gotta take it back . Got it Right ?
right Now so you didn't get in right . I'm gonna tell you something Two years ago , the match that happened two years ago , I had no less than about five or six un-matched students who called me , and of those five or six , only one of them was I am . The others were OBGYN .
Now I wanna tell you that there was a very weird trend going on at that time that I figured out because everyone was saying well , I don't know , maybe I should do an extra year at my school and do a research program and then reapply , and I was like why is every single one of you telling me Every single one , Actually , you're in med school ?
Yes , every single one . There was a post on Instagram , TikTok , something where somebody did that and they had all watched that post . These are people who didn't know each other . They had all watched that post and somebody posted that they stayed an extra year and then reapplied and then they got in . So everybody was like that's the ticket .
How do you do that Like ? I'm gonna tell you why .
I'm gonna shoot a T . Yeah , I'll tell you I'm gonna get your help .
No , no , no , no , no , no , no , no sure Tell me about that .
What was that ?
The theory on and hopefully she can sign light on the theory because she's behind the closed door .
But the theory on this side of the door in Reddit and on all the mentor applications or mentor spaces , is that when you apply to residency , you look better when you are not a graduate of medical school versus a graduate reapplying Because you already have an MDDO degree .
There are some schools theoretically I don't know , I can't say they have filters on people who have their degree already . So , when you're a student . They look at you as a student still . So , even though you could have graduated , you say no , I'm gonna take this research year . Your school does not confer on you that MD degree or DO degree .
You go back and you reapply in the match again as a student . Therefore , you're not reapplying as a graduate and it's thought that you look better when you're applying as a student . Now kick it to someone on that side of the door .
I just wish I would say , you would say you , I need to know .
I think there's some stats behind it and I think there's also some kind of general background . So I think the caveat is that there is data through NRMP that shows that there's a higher match rate into certain specialties if you are a graduating , fourth year or graduating student , as opposed to you were already graduated and now you've completed your degree .
So the stats show that Part of that is large population data , right , but it doesn't necessarily mean that that's the best fit for you as an individual . So I think that's again , I'm gonna say it again mentorship . That's where you connect with those people to talk about okay , this is what's happened .
Let me talk about from a personalized standpoint , what's gonna be best for me in terms of reapplying next year , if that's what I wanna do , et cetera . And do I stay on another year , knowing the pros and cons of extending your medical career and more loans and et cetera ?
I think the other thing to take into account is for and I'll just speak from my personal lens like I think it's important to know that when you're transitioning into a residency program that you haven't had a long time away from clinical medicine , right ?
So I think your letters whether you didn't match this year you're reapplying this year , you still wanna have letters that speak to your clinical acumen , like how skillful you are in that regard and knowing that you can transition well . So it is important to keep that in mind too if you are planning to reapply .
I think , whether you decided to do a research year , whether you decide to do whatever that gap may consist of like knowing that you still have some connection to clinical activity , observation , participation , so that you can have letters whether it be from your prior letter writers or , more than likely , you need at least one from like during that gap year as well
that hopefully can reflect on you as an individual growth potential , et cetera . So that's kind of the . That's my understanding . I think , there's actually data that kind of shows like oh , it's probably a higher likelihood for me to match if I'm still a graduating student as opposed to graduated .
Right , right , that's a big price . Yeah , that's what I was gonna say , cause that's a lot of just to do a research year .
Okay , do you wanna talk about the money ? I was wrong talking about the money , because these students pop up and the reason why tends to be a big deal , right ? So I'm going to tell you one of the students I worked with last year and then I'll tell about one year before . So the one last year had not passed step two .
So my recommendation was you need to grind for two months doing nothing . So if you stay a student , you can get those student loans up front . You know your rent is covered , your food is covered , you can graduate later on , and that was my advice to him . Even though that price tag adds on a year , you don't have to worry about it .
You can do nothing , you're fine . Another student I worked with in the past just didn't match . So I was like all right , do you know anything else you can do ? Yeah , a buddy of mine says he can get me a research position . All right , we'll graduate . Stop taking those loans , go earn money as a physician , technically , do that research and then reapply .
So it just depends , as Jay said , what do you need to do ?
Yeah , yeah , because I felt like that year there was like a one size fits all kind of approach with every single one of these students who obviously were not all in the same boat . They weren't even applying all to the same type of residency programs , right , Social media could be dangerous right , oh yeah , in one way .
You want social media to inform people , as many people as possible , about all the opportunities . And then , if they get stuck on that , one little piece of advice we talk about student doctor network all over again . That is the form that shall remain nameless .
Yeah , yeah , yeah yeah .
But yeah , I mean the financial implications of just that decision in and of itself is just . You know , it's just crazy , especially if you fall into a category where you didn't actually have to do that , like your second student , right . You don't absolutely have to do something like that .
The other part of it , when we're talking about the money , is even applying to residency , because you know that's hella expensive , yeah , Hella expensive , right . And we did a presentation for NRMP a couple of years ago and one of the parts of our presentation oh , you'll appreciate this , Dr Uche it was in pediatrics .
There were some stats that showed that people who apply to pediatric programs , if they apply to 13 or more programs or , excuse me , if they apply to more than 13 programs , that their chances of getting into a residency program did not improve significantly at all .
And which is really interesting , because I will tell you the number of people , including myself and this man standing right next to me , who applied to like 40 plus programs . I mean that's a lot of money to you know , throw into your , throw into your education .
And my thing is my question is especially on your side , Dr Uche is you're getting so many applications . What would you say is the percentage of applicants that you're even offering interviews to right , Because I don't necessarily think people are thinking about that Like , yeah , I'm gonna put out 40 applications , 50 , 70 applications , but how many people ?
Or what's the percentage of people that these residency programs are even offering interviews to , because you ain't got room for everybody ?
No , you don't , you don't . And now that we've transitioned to virtual , I think , which makes it maybe scheduling a little bit easier , you're not doing that , maybe doing a little bit more .
So I want to say the ratio , and this is just me guesstimating , but I want to say it's like one , like for every residency slot that you have , you want to interview X amount of number to ensure the probability as high that you fill all your your slots right .
And so say , if you have 20 programs or 20 slots , you want to interview at least , I want to say at least eight applicants per slot right so like eight to 10 is kind of the number I'm thinking in my head , just based off of some of the numbers I've seen . So , yeah , so if you but you're an approach , take , for example , internal medicine right .
Internal medicine programs see a lot of applicants that come through and so they're in the order of thousands . But if you only have 30 slots , right and max , you're probably gonna be interviewing 300 , 350 . So like you have two , 3000 people who applied , you're only getting like a fraction of those who are going to interview . So it's , it's .
Yeah , I mean it can be challenging
¶ Changes in ERAS and Signaling Programs
. Now there are a lot of changes with ERAS , with program signaling which basically says that like I'm kind of designating you as a program that I'm interested in , would like to go to . Is that the token . In every specialty , rather , it's not the token . The e-Rise token is to be able to apply into e-Rise , which I don't really understand , okay , okay .
It should be like this register . It's like a token , like a registration token , gotcha . But like signaling is like when I apply to say I'm applying to 20 programs , but in pediatrics you're allowed to signal up to five programs that are your top priority programs .
So you signal them and that gives them an indication that like oh no , I really am out of all the programs I'm applying , I'm considering you one of my top five and I want you to know that . And then programs can utilize that information if they wish to kind of help prioritize how they want those they want to interview .
Yeah .
The very little signaling was supposed to take the old hey , you're my number .
One email you're my number one email you're supposed to send out .
The signaling was supposed to take that out . It still happens .
It still happens . How seriously is signaling do you think ? Like , how seriously are programs taking signaling ?
I think programs are taking it serious .
Because I think again , because of the changes with like , step one and like and I'll be very honest , like I'm a huge proponent of holistic application review , like looking at more of the holistic picture of an applicant as opposed to like just certain numbers and metrics , it's another data point to signal whether or not someone may be interested in coming right .
It's not the only thing right that was going to designate whether or not you come or get come for an interview or not , but it's just an additional data point . It shows the interest and engagement and , depending on the program , the specialty , the location , things like that that can carry , carry a lot of weight .
We have a friend who's a program director . I won't put them on blast because I don't need their numbers to go up . He said she interviews everyone who signals the program , unless your application is just trash . But if you have a standard , regular application and you signal , you'll get an application . You'll get an interview invite .
Okay , so that's good to know , that's good to know . So at least you're putting that particular resource to good use , because before it was just a free-for-all and , like you said , everybody was like you're my number one . It was like a horrible , horrible bachelor's day in scene . You know what I'm saying .
Does signaling cost more money ? Nope , no , yeah , and it varies for a specialty too .
Some specialties , like I'm , forgetting Like .
OB had gold and silver signaling and it's like that's like .
Order of like 10 to 20 . I can't remember exactly , but yeah , as opposed to like I'd mentioned , like pediatrics and other specialties . So it just depends .
Yeah , yeah , okay , that's good to know Because I think , yeah , having that resource one might actually help to decrease the number of programs that people are applying to which might actually help them to save a little bit of money . I hope , I would hope , I would hope that I would hope that . I mean , I'm not sure what the stats are on that .
I guess NRMP will kind of figure that out . You know , do like the five year and then the 10 year and then the 15 year .
I'll be curious to know what . I'll be curious to know what the trend is , I will say , with transition , with the transition and virtual . I've seen , like I've seen , the numbers go up in terms of applications .
Like if you're in a highly competitive place , though I'm sure everybody who's applying is signaling Exactly . Like if you're at Harvard or if you're at another like well to do establishment , whatever the specialty is , people want to say you're my like . How do you even distinguish from that ? So I don't think the Harvard has always had those problems right .
It's the smaller places , like where our friend is a program director like doesn't get as many . So when you do signal like you only let's use P's . You only have seven . If you use one of your seven , I'm going to go back to what I used in my in the last episode six or seven .
I'm going to use the state I used in my last episode , even though I like that state . If you're in Idaho and you get one of those six like signals , you're like , oh , you must really rock with us to come out to Idaho and be your top six . So yeah , it matters there . Yes , harvard probably .
Harvard probably wonders why you didn't signal them like you didn't signal , exactly , you know that's how . Harvard uses signaling .
Yeah , don't signal . Yeah , that'll make them like you more .
There it is Okay , it's toxic yeah . So , toxic academics .
I would say the best change of all eras from when we were in it To now . It's not even on the student side , I think it's on the program side . Certain specialties like OB have instituted dates where they will tell applicants we are sending out interviews on this date and we're sending out interviews on this date .
If you don't get an interview from us on one of these two dates , you probably know you ain't coming Exactly . So I think that has allowed some students to realize oh , I have two OB interviews by the end of the season .
I might need to check that family route right quick and people have been able to pivot a little bit more than we have in the past , just hoping on a wish and a prayer .
And that's the one thing that I always say to Renee , because I know a couple of people who and you probably know some people who have graduated from medical school don't have a place to match . They may do a traditional internship or a rotating internship , depending on MDDO route , and then they still can't match .
And then maybe they go several years not matching and they're just struggling in silence . Everybody knows , right , and I just think that is one of the saddest thing to have this type of professional degree and not either be able to train or not be able to use your degree , but you have hella debt , right ?
Yeah , I just I never understood that , right , like there's got to be another way , there's got to be multiple layers to make sure that whoever graduates with either MD or DO , that they can do something productive in the healthcare system , whether they match or not . And I just I struggle with that because we know somebody who's gone . Now , what ?
Seven years now ?
At least Seven years it's probably more Going from traditional internship to house officer House officer . Yeah .
House officer . Now the person is trying to get into a really hard sub specialty or residency and we're just like yo , you need to consider something that's a little bit more realistic , and they're like no .
But also , at the same time , we've seen the opposite , too , where people are like yeah , I'm going to consider something that's a little bit more realistic from a specialty standpoint or residency standpoint , and they still can't get in .
Right .
And .
I'm sure a lot of FMGs can you know they understand what we're talking about , like wait how is it that they can't get a job Like you have to get these folks a job Somehow , some way .
Yeah , you know , you so kind of you guys segwayed into the career path change right that people . So there there's the career path that people say , okay , I'm just going to change , right , Like I got into this residency program , I don't be here no more . This sucks , you know , I don't want to do this specialty anymore .
And then there's the involuntary change , meaning you either didn't match or you matched but you got kicked out .
And though , like those things can be one very differently navigated because they hit you differently , but two , like like me , was talking about , if it , if there is , if there is a an issue with trying to figure out how to get back into or how to even enter training , then you're stuck in this conundrum because oftentimes people don't tell other people that they
are stuck there . And that goes back to the mentoring that you were talking about . Again , dr Uche , with you know , listen talking to your mentors , identifying a mentor , but also be very realistic about what the mentor is telling you . You know if you want to get into a very competitive program . But you've been out eight years . Let's kind of talk about you .
Know what's going on , do you ? Have you seen , dr Uche , because you are the assistant program director what is the approach to those residents or those medical grads who may either have matched or left their programs , or the non-traditional one , or got kicked out , right ?
And the reason I'm not using non-traditional is only because the non-traditional is so different in each one of those cases , you know . So I mean what ? What's your approach ? Or are you even seeing a lot of that ?
So I can't speak from my own professional exposure . I can speak from more personal exposure with friends , colleagues and stuff who've gone through this process . And you're right , it's different for everyone and it's like again you have to take this kind of personalized approach , really assess and say , okay , do I want to do this , Do I want to go back ?
If I do want to go back , what does that process look like ? Do I find an open spot elsewhere ? Do I reapply , depending on what year you're in in the training ? Do I consider another career path altogether ?
And I think it's also complicated by the fact of where you are in life , Like what are the other things that are going on that you need to be mindful of and taken to that equation when making that decision , Like what opportunities are available ?
right Like it might be , if we're talking about , we'll say I use internal medicine because there's so many number of programs and lots available yeah it may be available to do that right To transition to another place elsewhere , but for a more competitive , limited number of slot specialty that may not be the case . So then I don't know .
I think it takes a lot of soul searching . I think it takes a lot of introspection . I think it is a very challenging decision and for those who I know have gone through that pathway I know those who've been able to get back in . I know those who have not and have decided upon a different path and are completely happy and living their best life .
So it just depends on what you feel passionate about and what you're willing to , kind of like , commit to and do .
¶ Challenges and Considerations in Medical Residency
Because I feel like you usually have like your three big reasons right . Big reason number one you did not pass some marker that the program puts in front of you right , I'll use step three as a general example . So you got removed from your program . Usually it's easier to reapply there . The program director is the program still likes you .
It's just like , look , they couldn't pass it . If they can pass it now , somebody else should take them . That's real easy . Number two you didn't pass rotations within your program . That's a little harder , that's a little different . Right , that means you didn't pass and someone failed you on purpose within that program .
So now you get to ask for letters from that program to go somewhere else and you failed . So those when it's like that sometimes , it's usually like you really may want to switch specialties . And then number three is like you get moved out because you harmed a patient , right Like if it's a serious harm in the program that you go .
That again can be a little difficult to navigate because if they have to report that that's gonna follow you no matter what you do as a physician . So those are the three big categories I've kind of encountered in , you know .
I will also add to that . I think it's not always because I always lump those into like , that process of like . So we're not remediation , but maybe you guys are understanding what I'm saying .
Like where you encountered some type of like process in the kind of matriculation process through training , right , like some interruption where you didn't meet the marker or didn't meet the score or whatever that may be .
But there are situations where life outside of you know , residency changes and you're like , well , I can't continue because now this life thing has changed and I need to either pivot , like step away , maybe come back . And for me , you know I interact with a lot of people who are starting families .
So like , sometimes obviously residency should accommodate or parental leave and et cetera for having children . But I know of people because around like family planning or whatever that may be around family , close family , that they had to stop , they had to step away .
And so the question is obviously , like you know , jobs , institutions , program should be able to allow for you to take that FMLA . That's stopping .
And come back , but if it's something that's gonna be more permanent , prolonged you know prolonged or like I need to like move you know like I can't stay here , what does that look like , you know , and so making that decision , you know , is also very equally hard .
Yeah , and the financial implications of all of that ? Right , because you know very likely chance that you're gonna have student loans , you know , and whatever you know , whatever job you're going to get , it is very likely that is not going to be , you know , paid high enough for you to be able to just zip through your loans .
And so you know you feel the financial burden of that as well . And you talked about introspection and that made me think of that , made me think of a colleague of mine years ago who spent seven years trying to get into a residency program he had never actually matched .
He was interested in a program in a specialty that was , I would say , semi-competitive I mean it was , you know , one of the top competitive ones but then kind of went , you know , went his way like , navigated through different specialties in terms of applying every single year for about seven years and about year six , year six he contacted me because he had
graduated only the year after I did . I didn't realize that he was not in residency , and so when I found out he wasn't in residency , I was like , oh my gosh , like who's helping you through this ? He was like I was doing this on my own , contacted my mentor and was like listen , I need you to help me navigate this because I don't even know .
You know , I don't even know anything about this . Now one of the things that we talked about was when you go to an interview , because he was getting interviews , he was getting interviews . Yeah , you see how your face just went , yeah .
I did because it's like you know , okay , so then that's interesting , right , that's a ding , ding ding .
Yeah , so he's getting interviews . Finally , I was like you need to tell me about one of your last interviews . Yeah , and I won't put the whole story out there , belong story short . The conclusion that I came to , and that my mentor came to listen into this same story , was that you are cocky , you're cocky and this is why you're not getting into residency .
Now his response to me was you're reaching , you're reaching , and I'm like I'm not reaching . I went and I had to tell him I went through residency . You didn't .
And I know that if you approached my residency program , the residents in my program , in the way that you approach those residents , we would Annihilate you and just be like done , go to the program director and be like we don't want to work with this person . So introspection , what are you doing , especially if you're getting interviews ? How are you navigating ?
Your own Personality , I guess , is kind of the way to think about it , right , like , how are you navigating ? Do this process Beyond just the ? You know , I check this box and I pass the step three . I check this box and I still have clinical experience . It's like listen , check boxes ain't gonna get you everywhere .
You have to say you , you got to learn how to relate to people .
Um , and sometimes I think , sometimes I think we're a little bit reserved , even as mentors , and telling people like , dude , your personality kind of sucks , you know , and if that's the problem , then I think and I think I don't think that that's the problem for most people , but I think if that is the problem , especially if you have a very extended gap , I
think that's something that needs to be explored and it needs to be approached very directly , you know . So , um , I just thought that that was interesting because you talked about introspection , but I wanted people to know it goes beyond just . Well , what steps did I take ?
Yes , yes , yes , and that's why certain people we recommend .
You know , and I know you know a lot about this dr Rene mock interviews you please sit down with somebody . Talk , let's let's see what your setup looks like , let's see how this goes Um , let's see how you come off . And I tell people all the time because they're like , oh , you know , I want to be myself 100% of the time .
Uh , I don't want no program that don't want me . I get that , I understand that , but they're also making one of these decisions and you need to treat all of these like first dates , you know , you know you know show up to first dates and sweats , even though you're more comfortable , like that right , like you dress up . This is very , very similar .
Right , yeah , bring the best parts of you .
Yes you know , it's .
It's okay . You know that you got we all got parts of us that aren't the best , yes , but you know that's not . That's not the thing that you actually want to showcase first .
You know what I ?
mean . So I think that that's really important for people to understand . Now , for those of you who are not watching dr D , stepped away again .
You already know who it is .
It's your boy . So I have hijacked the show again .
But no , I really enjoyed this , this discussion , um , because , like I said in the beginning , we talk a lot about careers in this , you know , in this Um podcast , and I think it's important for people who are listening , who are either , you know , medical students getting ready to graduate or residents , to understand that the end of the road doesn't stop because
you don't match . The end of the road doesn't stop because you might have to have a career Change , because you had to change to another specialty or go to another program , like these are not ends , ends of the world or ends of the road for you .
But I think the most important thing that you can leave with here today is to understand that you need to get some mentoring . Yeah , you know you really need to get some mentoring and again , you need to do that introspection to figure out how are you Potentially anyway contributing ?
How is you know , maybe the the stars didn't align , but if your , if your gap is getting Way bigger , you know , then you have to start thinking about what potentially could you be contributing to make your situation not as desirable as you want it to be ? Um , so please understand that . Um , the other thing is your resources .
We talked a lot here about the student national medical association and One of the things I will tell you all that if I have a student who doesn't match or who's afraid that they might not match , that's another thing . Preempt , you know , pre , preempt just tells people yeah . We ain't got to be reactive . What about preventive medicine ?
You know , Before match day yeah , Give yourself some proof .
You know preventive academics , you know . I'm saying you know , and I tell every student I'm like , listen , if you think this is going to be a problem , you need to go to every single booth at the s and m a conference which , by the way , this year is going to be in new Orleans . Do you know ?
the dates . Love you know the dates . Uh , I always say Easter weekend , that way I don't miss it . I'm missing the weekend .
There you go , there you go . It's the weekend , the Wednesday , thursday .
Friday , saturday , sunday , easter ending on March 30th , 34th , yes , yes , the last .
It's the last weekend in March this year .
So you know , if you're out there and you're like I don't know , I didn't pass step One or I didn't pass step two or whatever , if you think you have an academic issue , even if you are not yet Graduating , preemptively Start talking with people and figuring out you know what kinds of programs will look at you , um , and don't go up there and just get like
information on their program . They don't know you . You got to get them to know you . Right , it's people always who you know . It's like no , it's who knows you .
So yeah , exactly , and . I will say , to hype it up again , march 28 through 31st , if you think it's not that good , it's not that bad sold out . The booths are sold out for the residency , for the med schools and for the residency programs . So if you're a pre-med and you're like I don't know , this is worth it again . We are sold out .
There are programs on a waitlist coming to talk to students at our conference For those in med school thinking they want to get into residency . We are sold out , right ? Schools are having to coalesce into one just to have enough space , right ? Certain people have a lot of space shout out to north western , you know .
But whatever specialty you want north western gonna have a person there , right ? That is what I'm saying . So , like dr Renee said , if you even think , man , I may need someone on the inside to help my application across the finish line , this is where you meet that person . You get them your business card , your linkedin website , get across that finish line .
Exactly same thing for the pre-med students . You know love dr Love just mentioned you know the pre-med Exhibitor fair is sold out , which means all of the spaces for all the possible medical schools that can be there . I mean , they're all taken up .
So that means that you need to get on down to new orleans and figure out how you're going to get through every single one of those schools and prepare your spiel . You know , talk to your mentors before you go so that you know exactly what you're going to do , exactly what you're going to say . Um , we're gonna be out there also , docs outside the box .
We're gonna be out there as well Doing a couple of episodes , maybe some carpet interviews . So if you want to chat with us , we'll be there , um , but I I definitely encourage all of you Again , because we're so focused on careers on this podcast , to get out there and do what you possibly can to move your Career in the direction that you want it to go .
So a little sunshine out there just a little bit , yeah , yeah get into residency , because on the other side the doctor , some of the box , said a hundred times I'm making a hundred One that when you get through residency , that's when people start begging for you . All right , those Chow .
¶ Actor Opportunities in the Medical Field
Let's see . Actress , whatever social tea you want , you're probably gonna get it . Um , because the numbers are in your favor . You want to do child immunology ? Go ahead . You want to come down to Nashville ? There are whole peas fellowships waiting for you . Child Nephology wants you . Um , so just when you get to the other side , you are , you are the highlight .
So just make it through people . We're here to help you through that . Yeah yeah that that that is a great thing to end on is that you are definitely going to be wanted . Ain't . No more begging . The begging is over .
Yes .
Because the odds are ever in your favor .
So get your key sweat on right now .
Well , thank you so much , dr Uche . Dr Love , dr , love , love having you here . I wasn't here with you the last time , so this was really fun for me . Um , dr Uche , this is the first time we're actually meeting .
I know , like you know , talking to each other , yes , yeah , yeah so , but I enjoyed having you both on this was such a great topic To discuss and especially your expertise as an assistant program director .
We really , really appreciate that and I hope people you know take everything that we've talked about today and hopefully apply it however you can to your situation . So we will see you at the s and m a conference East of weekend . People , we're gonna say peace , peace .