|
|
Office
of Student Affairs
MSB
5.202
(713)
500-5160
2003
ACKNOWLEDGMENTS
Many thanks to the following contributors from The
University of Texas Affiliated Hospitals Residency Programs:
|
Anesthesiology |
Susan
Luehr, M.D. |
|
Dermatology |
Adelaide
Hebert, M.D |
|
Emergency Medicine |
Ginger
Wilhelm, M.D. |
|
Family Practice |
Carlos
Dumas, M.D. |
|
Internal Medicine |
Mark
A. Farnie, M.D. |
|
Internal Medicine/Pediatrics |
Mark
A. Farnie, M.D. |
|
Neurolog |
Mya
Scheiss, M.D. |
|
Obstetrics/Gynecology - Hermann
Hospital LBJ |
Manju
Monga, M.D. Edward
Yoemans, M.D. |
|
Ophthalmology |
Judianne
Kellaway, M.D. |
|
Orthopaedic Surgery |
Kevin
Coupe, M.D. |
|
Otolaryngology |
Kevin
Pereira, M.D. |
|
Pathology |
Margaret
O. Uthman, M.D. |
|
Pediatrics |
Sharon
Crandell, M.D. |
|
Physical Medicine & Rehabilitation |
Gerard
Francisco, M.D. |
|
Psychiatry |
Edward
L. Reilly, M.D. |
|
Radiology |
Sandra
A.A. Oldham, M.D. |
|
Surgery |
John
R. Potts III, M.D. |
|
Transitional Year |
Michael
Bungo, M.D. |
|
Urology |
Michael
Ritchey, M.D. |
DEPARTMENT OF ANESTHESIOLOGY
1. Thumbnail sketch for
this specialty:
Anesthesiology is primarily hospital-based because
services are concentrated in the intensive care unit and operating room
setting. The Department of Anesthesiology has primary responsibility for all
anesthetic services in Hermann Hospital, which has 25 operating rooms as well
as additional outside locations (e.g., Radiology suite) and completes roughly
25,000 cases annually. The majority of patients (60 percent) are outpatients who
come into the hospital through the Day Surgery unit, whereas 40 percent are
inpatients. The pain service is divided into both inpatient (20 percent) for
acute pain management and outpatient (80 percent) for both acute and chronic
pain management.
Anesthesiology is a procedure-oriented specialty.
We perform intravenous and arterial cannulation for infusion of drugs and
monitoring purposes. We specialize in both routine and difficulty airway
management by the use of various techniques and perform many other procedures,
including nerve blocks for the relief of pain. Additionally, regional
anesthesia can be used as the sole anesthetic or as a supplement to general
anesthesia. Diagnostic fiberoptic endoscopy, bronchial lavage and line
placement or changes are performed routinely in an intensive care setting.
2. How
competitive is this Specialty?
Although
there was a decline in recruitment of Anesthesiology residents 4–5 years ago,
with the nadir in 1996, the specialty has once again become popular. In 2000, the number of graduating seniors
entering anesthesiology from U.S. allopathic medical schools rose from 425 to
549, a 29percent increase compared to 1999. When recruits from other sources
are included, the total number rose from 656 to 801, (a 22 percent increase.)
In 2001, NRMP results show a 21percent increase in recruitment, with 713
graduating MS IV’s entering the field of Anesthesiology. 2002 NRMP results
revealed a 27 percent increase with 904 graduating U.S. MS IVs entering the
specialty. Those 904 matching into
anesthesiology represent 6.3 percent of the 14,335 U.S. MS IVs in the
match. This is close to previous record
highs that occurred in 1997 (6.7 percent) & 1992 (6.6 percent).
3. How
competitive is this Program?
Our
Anesthesiology program continues to be competitive in both the national and
local arena. Out of all anesthesiology
residency-training programs in the country, less than 25percent filled in 1997.
We were the only Anesthesiology Program in Texas to fill in 1998, and we have
continued to fill our classes to date. In 2001, The University of Texas–Houston
Department of Anesthesiology was #2 in the nation in terms of medical student
recruitment, with 23 of 168 graduating medical students entering the field of
Anesthesiology. Additionally, we ranked #5 in the top 20 schools and anesthesia
programs in the country in the NRMP Match Results 2001. In 2002, the UTHMS
Department of Anesthesiology was once again in the top 5 nationally in terms of
recruitment of medical students and top 20 programs in the nation. We recruit
physicians from higher levels of training into our program and have maintained
our numbers of residents.
4. What
are program directors in your field looking for in residency applicants?
We are looking for well-qualified individuals with strong educational backgrounds who are interested in our specialty. Outgoing personalities with exceptional people skills are definitely a plus. We look at medical school grades, USMLE scores, as well as National Board scores in our screening and final evaluation process. Although not necessary, clinical and research experience in anesthesiology is viewed very positively and encouraged for those applying to our specialty.
5. How
many letters of recommendation are the norm in your specialty? From which
departments and what ranks of the faculty should applicants obtain letters?
We
require two letters of recommendation when applying for a position in our
training program. Applicants may obtain
these letters from faculty of any rank. We advise applicants to request letters
from the Department of Anesthesiology if they have had a rotation in either
anesthesia or intensive care, although letters from any department are
welcome. A Dean’s letter is encouraged,
but no longer required.
6. What
time frame is the norm or recommendation for the application process in this
specialty?
We
recommend that applications be submitted along with letters of recommendations
and transcripts in the fall of the academic year (Sept – Nov). All applications
should be completed by the time you interview.
We usually begin the interview process in mid–November/early December
each year.
7. Are
audition electives commonly required or strongly recommended by programs in
this specialty?
We
strongly recommend that applicants take an anesthesiology and/or ICU elective
for one or two months early in their senior year if they are interested in our
specialty, so that we have a chance to work them and letters of recommendation
can be requested from our faculty. We
take less MS IVs in the months of July and August, since we start our new
residents these months and a great deal of attention is given to them at this
time. Additionally, fewer procedures and complicated cases are available for
our senior students and we want to ensure them an excellent and comprehensive
rotation.
8. What
advice should be given to the student applying in this field about their
personal statement and curriculum vitae?
I
advise medical students to be honest and candid in their personal statement and
specifically address their reasons for choosing anesthesiology as a specialty.
The curriculum vitae should be organized, concise and typewritten. Applications
simply appear more professional when presented in this fashion.
9. What
advice would you give student about interviewing?
The
interview process is designed to be a two-way process of exchange in
information. Not only do we learn about the medical students, but also hope
that they are very interested in our program and want to learn about us. I
advise students to behave professionally, dress appropriately, and act
interested and enthusiastic. Also, I encourage applicants to have a list of
three to five questions that they may ask of the interviewers. Although salary
is important, I do not encourage verbal questioning on the subject. Residency
education (curriculum), clinical training (number of cases, clinical
rotations), and daily work schedule are appropriate topics of discussion. If
interested in the program, students should try to formulate a relationship with
a faculty member or anesthesiology resident in order to obtain a better
understanding of our training program.
10. Other:
Residents
in training receive three weeks of vacation and on week of meeting time
annually, as with most training programs. A travel allowance in the amount of
$1,000 is given to each resident in order to attend scientific courses. Course
syllabi and various textbooks, review books and reference books are distributed
throughout their training. On a daily basis, residents are taught clinical skills
and attend formal didactic sessions.
Residents are also taught informally in the operating room setting.
Specialty Board review, incorporating both the written and oral examination
process, is emphasized on a regular schedule throughout the year.
In our
department, we have an enthusiastic group of young faculty with an expressed
commitment to research and teaching. In addition, several senior faculty
members with established national reputations and a number of full-time basic
scientists lead the department’s academic activities.
DEPARTMENT OF DERMATOLOGY
1. Thumbnail sketch of
this specialty:
Dermatologists serve as
primary care givers or tertiary consultants for any cutaneous disease, any
disorder affecting the hair and nails, and any mucous membrane condition. Most
of our patients are seen in the outpatient setting, although our dermatology
program has a very active consultation service at Hermann Hospital, M.D.
Anderson Cancer Center, and LBJ General Hospital. Dermatologists perform
numerous surgical procedures, particularly for skin cancer and cosmetic
reasons, most of which are performed in the outpatient clinic setting. Patients of all ages are seen. Although sometimes stereotyped as mostly
acne and warts, dermatologists actually see a wider range of different unusual
diseases than most specialists. Dermatology subspecialties include pediatric
dermatology, internal medicine-dermatology, dermatologic surgery,
dermatopathology, lasers, and basic and clinical research. Fellowships are
available in all of these.
2. How competitive is
this specialty?
Dermatology remains one
of the most competitive of residency programs. There are only about 100
programs in the U.S., most of which are at universities rather than community
hospitals. All departments receive more than 100 applications per position, but
because many applicants are applying to 30-50 programs nowadays, actually about
30-40 percent of applicants from American medical schools are successful. There
is currently a nationwide shortage of dermatologists, and the job market is
excellent.
3. How competitive is
this program?
Our program at The
University of Texas-Houston is exceedingly competitive, receiving more than 350
applicants each year for our 3 to 4 positions. Typically only about 30 are
granted interviews. Many of our residents are AOA or highly ranked in their
class, community leaders, have done research, and have published during their
medical school training. These requirements, however, are not absolutely
mandatory to be accepted into this residency training program. Many of our residents go on to fellowship
training, and a significant number of graduates are in academic careers.
4. What are program
directors in your field looking for in residency applicants?
Whether they go into
private or academic practice, we are looking for candidates who will do great
things that make us proud. We are committed to taking residents who are seeking
academic excellence in their training program, and who are fully committed to
training three years at our institution. We seek team players who get along
well with others and develop excellent patient rapport. It is helpful for
applicants to have done research and to have had direct supervision by academic
dermatologists, with letters from these dermatologists stating a favorable
evaluation of that individual student. We also look for letters from the
chairman of the dermatology program in which the student trained. We look very
critically at the letters from the applicant’s previous teachers and mentors.
5. How
many letters of recommendation are the norm in your specialty? From which
departments and what ranks of the faculty should applicants obtain letters?
We generally recommend
at least three letters, plus one dean’s letter. It is recommended that if a
dermatology applicant has worked closely with a faculty member in another
department in any area of research, that this research be detailed in a letter
of recommendation. At least one and
preferably two of the letters of recommendation should be from dermatologists.
6. What
time frame is the norm or recommended for the application process in this
specialty?
Most programs, like
ours, require that students apply via ERAS. A few programs do not participate
in ERAS. Most programs, like ours,
participate in the NRMP match, but this varies from year to year, and you
should check with individual programs. Dermatology is a three-year program
beginning in PGY-2 following an internship that is most commonly a one year
internal medicine year, but transitional years or training in some other
clinical internships is acceptable.
During the regular March match that is used for most other specialties,
dermatology candidates match for a PGY-2 dermatology position in the same match
in which they simultaneously select a PGY-1 internship. A few programs will match for four years of
dermatology as a PGY-1 position. The deadline for receipt of all documents,
including transcripts and letters of recommendation, is typically in October of
the senior year of medical school, but a few programs have earlier deadlines.
Transcripts from both the medical school and the undergraduate institution are
required in our program. Interviews
typically occur in November through early February.
7. Are
“audition electives” commonly required or strongly recommended by programs in
this specialty?
Audition electives are
not routinely required, but some students have found it helpful to do outside
electives at various institutions to gain an understanding of other programs
and to enhance their visibility as a candidate at those programs. Some students
have done up to two outside electives, sometimes in the dermatology
subspecialties mentioned previously, to avoid repeating a general clinical
dermatology elective. Any resident interested in applying for dermatology
should have completed at least one month of clinical dermatology, and have done
extremely well on that rotation prior to considering a career in dermatology.
8. What
advice should be given to the student applying in this field about their
personal statement and curriculum vitae?
We recommend that the
applicant’s personal statement be no longer than a single page and include the
student’s name, address, e-mail address and telephone number. The curriculum
vitae should also include the student’s name, address, e-mail address and
telephone number, and carefully detail any community service that has been
performed, regardless of when it was performed during the student’s lifetime.
9. What advice would you
give the student about interviewing?
Of course, applicants
should arrive in a timely fashion and should be dressed appropriately (business
suit). Applicants often ask about the
day-to-day operations of the programs, program strengths and weaknesses,
potential upcoming changes in the programs, board exam pass rates. Beware of programs that don’t let you meet
their residents. It is helpful to find
out from residents the facts about a program when faculty are not present. Programs often ask applicants about their
future plans (private practice vs academic careers) and research
experiences. It is often wise to avoid
offering detailed answers to queries about controversial topics. Applicants who are excessively shy or
arrogant tend to be downgraded by most programs.
10. Other:
Students
interested in a career in dermatology should seek a dermatology elective early
in their senior medical school year (July through September). Contact with
residents and faculty for mentoring or research opportunities prior to that
time may also be extremely helpful.
department of emergency medicine
1. Thumbnail
sketch of this specialty:
Emergency
Medicine is a specialty that encompasses all aspects of medical and surgical
care. The philosophy is based on a broad knowledge of acute illness and injury
with special competence in relevant procedural skills. Emergency departments in
the U.S. also serve as a primary source of medical care for a varied
population. Often the emergency physician is the only care provider available
to patients on a timely basis, and the specialty has come to serve as the
“safety net” for society providing round the clock primary care. The specialty
provides primary care, acute care and intensive critical care. Physicians
entering this field must be aware of these characteristics, as well as the lack
of continuous, longitudinal care relationships.
2.
How
competitive is this specialty?
The specialty has become one of the fastest growing and most competitive residencies. The programs are becoming more competitive due to the increased awareness of the specialty, its unique characteristics, and the attractive remuneration and scheduling opportunities.
3. How competitive is this program?
The UT-EM program is moderately competitive and is getting more so each year. We receive about 500 applications, interview about 80 candidates, and “fill” well below that number for our ten positions.
4. What are program directors in your field looking
for in residency applicants?
Most program directors are in search of bright, enthusiastic applicants with a desire to devote themselves to a lifelong practice in the emergency department setting. Medical school grades, USMLE scores and other academic awards greatly help the applicant stand out, yet personality and ability to translate knowledge into competent acute care is paramount. Those applicants who demonstrate this ability often have an advantage over those students with “better credentials.” For applicants with middle rank grades, a rotation to demonstrate this ability is advised. Research is not required for applying but it does demonstrate a deeper interest and understanding of the field. Demonstration of the applicant’s devotion and self-motivation to academic pursuits is desirable.
5. How many letters of recommendation are the norm in
your specialty? From which departments and what ranks of the faculty should
applicants obtain letters?
Recommendation letters are probably the most carefully read portion of the application. At least three (3) letters of recommendation are needed. One or two of those letters should come from Board-certified emergency physicians. Those with academic ranks are preferable, especially those affiliated with a training program. The positions of chairman, residency director, and assistant residency director or medical student coordinator are recognizable to other directors even if the names of those individuals are not. If a student does a rotation in emergency medicine affiliated with an EM residency, typically, the type of letter generated is a standardized one designed by the Council of Residency Directors for Emergency Medicine (CORD). There is usually one faculty member designated to write the standardized letter (SLOR), and that faculty member is most often the Medical Student Director. The author of the standardized letter typically includes input from faculty and resident who worked with the student. A good letter from anyone is still a good letter; it just should not be the sole basis of your recommendations. Those writing letters should also be politically correct when discussing the specialty and not use terms as “ER Doctor.”
6.
What
time frame is the norm or recommended for the application process in this
specialty?
Applications should be complete and submitted early in September or October at the least. Letters of recommendation should be sent at this time as well. Even though the Dean’s Letter does not arrive until November, many programs already have several interview slots filled. Our program usually does not offer interviews until after the Dean’s Letter has been read. Applications received after November 1 would be considered “late”, and applicants are less likely to be interviewed. Plan on interviewing in November, December and January.
7.
Are
“audition electives” commonly required or strongly recommended by programs in
this specialty?
For those students strongly interested in a
particular program, audition electives are suggested. For those with less than
stellar grades, it is often mandatory for consideration of the applicant. Any
EM elective in which the student has performed well should have an evaluation
form mailed to accompany the applicant’s file.
8.
What
advice should be given to the student applying in this field about their
personal statement and curriculum vitae?
The personal statement should be brief and to the
point. Do not resubmit your “Why I want to be a doctor”, statement which you
used for medical school admission. Prior experiences in emergency medicine,
EMS, rescue, or other related fields should be touched upon. Try to impress
upon the Director your appropriateness for this field. The curriculum vitae should
include the appropriate honors. Research background or assistance, involvement
in organized emergency medicine (ACEP, SAEM, TCEP or school EM organizations)
especially if leadership roles were assumed. Do not spend time or paper stating
how much you like your free time, but it is important to present yourself as
well balanced, with a demonstration of interest in activities outside of
medicine.
9.
What
advice would you give the student about interviewing?
Without interviewing, no position will be offered. Be sure to respond quickly to interview offers and give them any information requested. Show up neat and on time. Be courteous to anyone who might answer a phone, show you the restroom, or give directions. If you must cancel an interview, be sure to give proper notice and don’t be a “no-show.” Bad impressions travel fast and far. In the interview, you are demonstrating what type of personality you have and how it would be to work with you. EM relies upon teamwork, energy and an outstanding work ethic—exude this in the interview. Try to make as many interviews in different EM residencies as your time and budget will possible allow.
10.
Other:
Although competitive, emergency medicine is a “matchable” choice for those who have made an informed decision. Be prepared by doing the necessary groundwork, ask questions of those involved in an accredited training program, and present any flaws in the most optimistic light. Spur-of-the-moment decisions to enter this specialty usually do not meet with success.
Information
about residencies in emergency medicine, including ours at UT is available
on-line at the Society for Academic Emergency Medicine website at www.saem.org then click on Residency Catalog.
Information about our residency in Emergency medicine at UT-Houston is also
available at http://oac.hsc.uth.tmc.edu/uth_orgs/emer_med/.
More information about our specialty is available at the American College of
Emergency Physicians at www.acep.org. Also,
there is an excellent website about choosing a specialty developed by the
Association of American Medical Colleges.
department of family practice
There is one family practice
residency that is directly administered by the Department of Family Practice at
The University of Texas-Houston
Medical School. This is the UT-Houston Family Practice Residency Program.
There are also fellowships
available within the Department, for further training after residency. A
two-year Primary Care Fellowship is offered to graduates of internal medicine,
pediatrics or family practice residencies. In addition to strengthening primary
care, administrative, research, educator, ad leadership skills, the fellows
obtain a Masters in Public Health. A one or two year Geriatric Fellowship is
available for graduates of internal medicine or family practice residencies.
Please note: The American Academy
of Family Physicians (AAFP) has a publication available for student members, Strolling
Through the Match, that gives pointers in many areas described below,
including the standard format for a curriculum vitae, letters of reference, and
what to anticipate on interview day. Please locate the AAFP web page, or
contact the president of the Family Medicine Interest Group here at UT-Houston
or a staff member in the Pre-doctoral Division of the Department of Family
Practice and Community Medicine to find out how to obtain a copy.
UT-Houston
Family Practice Residency
Inpatient hospital training is
primarily at Hermann and LBJ General Hospitals. Outpatient training with the
resident’s private panel of patients, for all three years, is at either the
Hermann Professional Building (Suite 250) or at one of two Harris County
Hospital District clinics (Acres Homes or Aldine Clinic).
1.
Thumbnail sketch of
this specialty:
Family medicine is the primary care specialty for the entire
family regardless of age, sex or pregnancy status. As a result, it is the most
comprehensive of the primary care specialties. In their role, modern family
physicians heavily apply an evidence-based approach to healthcare, often
utilizing computerized databases. They may also be called upon to act as an
advocate for their patients or their community. The family physician acts as a
leader for the health care team. They also act in a manner similar to a
computer systems analyst, both to improve the efficiency of the health care
team and to troubleshoot any difficulties encountered. By nature of their
training, family physicians are the best prepared for the primary care
specialties to provide comprehensive, continuous preventive care and to promote
wellness for individuals, families, and communities.
The
majority of patients seen by family physicians are in an outpatient setting.
However, family physicians are also fully trained to manage inpatient care,
fulfilling the criteria necessary to be a hospitalist. Women’s Health,
including delivering babies and office gynecology, is an important aspect of
the training of family physicians as well as a formal requirement. The care of
children in the emergency department, in an inpatient setting as well in the
ambulatory setting is also an important aspect of training family physicians.
In addition, family practice is the only specialty that has formal requirements
to teach residents how to run their future practices or “practice management.”
Various fellowships are available for family physicians upon
completion of residency. Board-certified family physicians that have completed
a one-year fellowship in either Geriatrics or Sports Medicine and pass a
national examination are eligible for a Certificate of Added Qualifications
(CAQ) in that area. Fellowships are also available in Research, Primary Care,
Academic Family Medicine, Rural Family Medicine, Correctional Medicine,
Emergency medicine, International Medicine and Adolescent Medicine. Various
pathways exist to become a physician executive, such as obtaining a Masters in
Public Health or a Masters in Business Administration.
2. How
competitive is this specialty?
In the last two years, more students have chosen to train in
primary care than ever before. As a result, family medicine has become much
more competitive. Among many factors, market forces such as supply and demand
have continued to increase the starting salaries of graduating family
physicians. Although increased numbers of physicians are choosing to train in
family practice, current national, state and local workforce data strongly
indicate there will be additional need for family physicians for many years.
3. How competitive is this program?
Over 260 applications were received in 2002, and over 80
were interviewed to fill 12 PG-1 year positions.
4.
What are program
directors in your field looking for in residency applicants?
Program directors are looking for
students that are academically competitive, possess a high level of personal
integrity, are compassionate, mature, and whose personal mission matches that
of the residency program. Leadership skills, the ability to work with a team,
multicultural skills, and excellent interpersonal skills are important for
future family physicians. The ability
to understand, explain and apply the latest scientific advances including
diagnostic procedures and pharmaceuticals agents, when they become available,
is an important trait. The ability to tolerate uncertainty of diagnosis as well
as outcome while knowing limitations is important for a family physician.
Computer skills and the ability to apply evidence from the medical literature
for patients, their families, and their communities are important skills for
family physicians.
2.
How many letters of
recommendation are the norm in your specialty? From which departments and what
ranks of the faculty should applicants obtain letters?
We require three letters of recommendation. Preferred
letters are those from clinical faculty or private practitioners that have
actively supervised the applicant with direct patient care. If many choices are
available, letters from physicians practicing in primary care and/or ambulatory
settings, especially family physicians, are helpful. Letters from clinical
faculty in any specialty that would be supervising the applicant if they came
to our program are always helpful. Letters from famous or very well known
faculty or persons are only helpful if the applicant is actually recognized and
known by that faculty member. Letters describing the applicant’s goals, their
leadership abilities and/or their community service activities can also be included.
These can even be from community leaders involved in professions other than
medicine.
When asking for a letter of
recommendation, the student should ask the person if they are willing to write
a “good” letter of recommendation for them. If the person hesitates, the
student should seek someone else.
6. What
time frame is the norm or do you recommend for the application process in your
specialty?
We accept applications from October through February. There
are a limited number of interview appointments available, and they are from
November through the middle of February.
7.
Are “audition
electives” commonly required or strongly recommended by programs in this
specialty?
Audition electives are not
required, and the vas majority of individuals on our Match list have not done a
rotation with us. However, the best way to get to know the program, our faculty
and our residents is to do a rotation in one of our clinics or on one of our
inpatient services. Students with any history of academic difficulties can certainly
enhance their chances with our program by demonstrating their clinical skills
on a rotation with us.
Developing camaraderie with one of
our residents on one of their various rotations during the interview process is
very important, because our residents have significant input into our Matching
and ranking process. Along with the faculty and staff, they will also be
available to answer questions later in the interview season. Maintaining this
relationship, and/or a second visit to the program will clearly demonstrate the
applicant’s interest in our program.
8.
What advice should be
given to the student applying in this field about their personal statement and
curriculum vitae?
Personal
statements should be very sincere and precise. They should describe the
student’s personal mission in life, and why they have chosen family practice.
This should be supported with information describing their background,
including times in their lives where they have demonstrated leadership skills
and the ability to work as a member of a team. This may be the opportunity for
the student to describe any involvement in research or community service, if
either is applicable. A description of hobbies or interests outside of medicine
also demonstrates balance. Research, community service, hobbies and interests
outside of medicine can be listed only on the curriculum vitae if they are not
part of the student’s personal mission in life.
Something that is very important in the personal
statement, as well as in the remainder of the application, is that there should
not be any spelling
or grammatical errors! Most word processors have the ability to screen for
these, and such errors might indicate that the student, as a future resident,
would not pay close attention to details! Such inability to pay attention to
details can be fatal in medicine. Even after using the word processor to screen
the application, have someone proofread it for content, grammar and spelling.
The curriculum vitae should include some personal
background, and the entire educational background and employment history. It
should be unique, yet follow a standard format. Any prior experience in
clinical care, research or publications, even if not in medicine, should be
listed. Community service activities should also be listed. Listed again on the
vitae, a description of hobbies or interests outside of medicine demonstrates
balance.
Note: We suggest consulting the AAFP publication Strolling
Through the Match, as described above, for a description of the standard
format of a curriculum vitae.
DEPARTMENT OF INTERNAL
MEDICINE
1. Thumbnail sketch of this specialty:
It might be helpful to think about internal
medicine as a discipline, a career and as a residency.
The discipline of internal medicine encompasses a
broad and ever-growing body of knowledge related to the effects of disease on
humans. The internist studies causes of disease, pathophysiologic mechanisms,
effects of disease on individuals as well as groups and populations, and
responses to treatment. This knowledge is rooted in the more fundamental
disciplines of biochemistry, molecular biology, neuroscience, microbiology and
immunology, behavioral science, pharmacology, pathology, epidemiology and
statistics, all of which remain highly pertinent throughout the career of the
internist.
As a career, internal medicine is remarkable for
the vast number of options available. The internist may work in a rural or
urban environment, in an office-based or hospital setting. The internist may be
a solo practitioner, a member of a small or large group, a member of a health
maintenance organization, or perhaps an employee of the government, a large
corporation or a university. Internists may engage in medical practice,
teaching or research, to varying degrees. Participation in research may be at
the level of clinical observation, studies of clinical physiology and
pathophysiology, evaluation of the effects of treatments, or investigations of
basic biochemistry, physiology and molecular biology. Internists play major
roles on the faculties of medical schools, and in the administration of
health-related organizations such as health maintenance organizations,
pharmaceutical companies and public health agencies. The work of the internist
may be general in scope or highly specialized. The subspecialties of internal
medicine include:
clinical pharmacology clinical epidemiology and community health
allergy and immunology infectious diseases
pulmonary medicine critical
care medicine
nephrology cardiovascular
medicine (and subspecialties thereof)
endocrinology and
metabolism gastroenterology
(and subspecialties thereof)
rheumatology medical
genetics
hematology medical
oncology
geriatrics preventive
medicine
occupational and environmental medicine
Of all the medical specialties, training in
internal medicine forms the foundation for the greatest variety of careers.
The standard model
for residency training is a three-year categorical residency. The standard
residency includes a mixture of ambulatory and inpatient experiences, in both general
internal medicine and the subspecialties listed above. Internal medicine
residencies always include a continuity clinic of at least one-half day weekly,
experiences in the emergency department, the intensive care unit and/or
coronary care unit, and block rotations in ambulatory medicine. At least 24 of
the 36 months must consist of “meaningful patient responsibility”, in which the
resident takes charge of all aspects of the medical care of his/her patients.
This leaves up to 12 months for rotations in which the resident acts as a
consultant to primary care physicians. Typically, in the last two years of the
program there will be several rotations in which the resident takes charge of
an in-patient service consisting also of first-year residents and medical
students.
2. How
competitive is this specialty?
Internal
medicine has been, for at least the last five years, the most popular specialty
among U.S. medical graduates. In 1998, 28percent of U.S. graduates entered
categorical training in internal medicine (including medicine-pediatrics,
medicine-psychiatry and primary care internal medicine), and another 6.5percent
undertook the preliminary PG-1 year. The growth and popularity of
medicine-pediatrics is especially striking: over the last five years, the
number of U.S. applicants matching to these programs has more than doubled.
Nationwide, the number of positions available in internal medicine is greater
than the number of U.S. seniors who apply, so a well-qualified senior medical
student should be able to find a position in a good program. In 1997, only
2.2percent of U.S. seniors went unmatched in internal medicine. These
statistics conceal a large degree of variability in competitiveness among the
approximately 400 U.S. residencies in internal medicine. Some highly
prestigious institutions have more than 10 to 20 well-qualified applicants for
every position available.
3. How
competitive is this program?
In 2002-03, 1406 candidates applied (441
preliminary / 965 categorical) and 397 were interviewed (126 preliminary / 271
categorical) for the medicine and medicine-pediatrics positions.
4. What
are program directors in your field looking for in residency applicants?
We are
looking for applicants who are intelligent, inquisitive, interested in the
welfare of their patients, and generally considered to be cooperative
individuals who work well with others.
5. How
many letters of recommendation are the norm in your specialty? From which
departments and what ranks of the faculty should applicants obtain letters?
Letters of recommendation should be from faculty
who have worked directly with the applicant in a clinical setting. Our
application asks, in bold type, for a letter from the chairman and two letters
from members of the faculty of internal medicine.
Letters from private physicians or part-time
faculty, and letters from residents are generally discounted. Also, letters
from faculty of other departments, with the possible exception of departments
such as pediatrics or neurology, which are similar in many respects to internal
medicine, are totally discounted. Do not send letters from persons who have not
worked directly with the applicant in a clinical setting.
Letters from laboratory colleagues or research
supervisors can be helpful, to the extent that they illuminate aspects of the
applicant’s intelligence, resourcefulness, and problem-solving abilities;
however, these types of letters should not substitute for one of the required
letters from a clinical supervisor.
When a file contains letters only from other
departments, the applicant may not be rejected out of hand. The interviewer
wonders why the applicant is not better acquainted with the faculty of internal
medicine.
6. What
time frame is the norm or recommended for the application process in this specialty?
Students must discover this information by
communicating directly with directors of the programs in which they are
interested. A senior student who is truly interested in a career in internal
medicine will take the time to become acquainted with one of more members of
the full time faculty and discuss the application process with the faculty.
With respect to our own residency program, we are
happy to receive letters of inquiry at any time. We have our own application
form, which is easy to complete. For supporting materials, we ask for a
transcript, Dean’s letter, and letters of recommendation from the chairman of
internal medicine as well as two members of the faculty of internal medicine.
Interviews are scheduled from November through mid-January. It would be best if
all application materials were received by the end of December.
7. Are
“audition electives” commonly
required or strongly recommended by programs in this specialty?
There is no particular senior elective which will
enhance an applicant’s chances.
8. What
advice should be given to the student applying in this field about their
personal statement and curriculum vitae?
The applicant’s personal statement should be
concise and straightforward. Tell the program director why you are interested in
internal medicine, what your long-term plans are, and why you think you are
well qualified to undertake a residency. Avoid extensive personal anecdotes,
expansive philosophy, and anything that might be considered cute. You should
list non-medical experiences, which form a significant part of your life; for
instance, extended periods of volunteer work with underprivileged populations
in this country or abroad. Avocational activities, such as enjoyment of fishing
or playing the guitar in your spare time, will not influence the interviewer as
to whether you are qualified to be a resident in internal medicine.
A curriculum
vitae (CV), similarly, should be concise and to the point. It should list
genuine accomplishments. Publications should be in peer-reviewed journals. The
old adage of “less is more” applies especially to CVs; the reader will use the
CV to assess your perception of what is important.
9. What
advice would you give the student about interviewing?
If you list a research experience, oral presentation,
poster or publication, be prepared to talk intelligently about the work. An
individual who has completed eight or more years of postgraduate education and
is about to embark on a career which involves taking serious responsibility for
other people’s lives should not have to be told how to behave during an
interview.
10. Other:
The preliminary year provides training at the PG-1
level for individuals who are going on to advanced residencies in other
specialties. This is a full year of internal medicine, under the educational
direction of the chairman and faculty of the department, and should not be
confused with a rotating or transitional year. Preliminary years of internal
medicine are especially popular among individuals who wish to pursue residency
training in dermatology, neurology, physical medicine and rehabilitation,
radiation oncology, anesthesiology and psychiatry. Primary care internal
medicine residencies offer many of the same curricular elements as the standard
residency, but with greater emphasis on rotations in general internal medicine,
ambulatory care, and experiences in related disciplines such as non-operative
orthopedics, adolescent medicine, otolaryngology, etc. The basic requirements
for specialty certification, and the certifying examination, are the same for
the standard and the primary care tracks.
Residencies that combine training in internal
medicine with other disciplines also may be arranged. The internal
medicine-pediatrics residency, which prepares the individual for certification
by both specialties in four years of training, is growing rapidly in popularity
throughout the U.S. Some institutions offer combined training in internal
medicine and psychiatry.
Yet
another alternative is the clinical investigator pathway, which combines
condensed training in clinical internal medicine, intensive training in
biomedical investigation, and clinical subspecialty training into a six-year
curriculum.
COMBINED MEDICINE/PEDIATRICS
1. Thumbnail sketch of this
specialty:
Primary care - 45percent