Historically, this extremely competitive specialty has always attracted the very best and brightest medical students. Get involved with the department at your medical school early on. During the preclinical years, study hard so that you will be prepared for the USMLE
Step I examination. Neurosurgery residency programs often have cut-offs for academic credentials. Although earning a top score of 270 does not necessarily guarantee a Match, it will certainly keep you in the pool of highly sought after candidates. You should aim for a score in the mid-240s.
Extracurricular activities only matter if they are significant. It is much more impressive to have a few outside interests to which you are truly dedicated or in which you had a leadership role. Life experience and achievement in research, however, are more valuable than extracurricular activities. The highly competitive programs basically require some form of research. After all, everyone loves students who have published a lot. At many places, you will interview not only with neurosurgeons, but also with neuroscientists associated with the department. In the clinical years, work hard to get stellar grades in your surgery and medicine clerkships, as well as the neurosurgery subinternship. AOA membership is helpful, but not necessarily a prerequisite for matching.
Audition rotations at other hospitals are generally not helpful. No matter how many physicians you may impress, it only takes one faculty member or resident whom you may have rubbed the wrong way to keep you out of the program. If you are a strong applicant, only complete rotations at your home institution. Program directors generally value letters of recommendation only from neurosurgeons. Obtain at least three of them, particularly from the chairperson of the department at your medical school. Because the personal statement is more likely to hurt you than to help, keep it neutral (unless you have something really amazing to say). At application time, apply to as many programs as possible. Your best chances of matching are often at your own institution—where people know you, like you (hopefully), and want you to remain there for residency. Because neurosurgery is a very small community, the interview ends up being an extremely important factor for selling yourself to selection committees.
Although fewer medical students are entering obstetrics and Gynecology
, it is still a moderately competitive specialty (especially for the most highly ranked programs). During the preclinical years, spend time getting familiar with the field. You should find a mentor within the department, go to grand rounds, and attend national meetings if possible. Extracurricular activities are important credentials, so make sure to do some volunteer work related to women’s health in underserved settings (like STD clinics). Research is not necessary for matching, but it looks great—especially as an ongoing interest rather than an isolated project.
To be most competitive, students should earn a score of 215 or higher on the USMLE
Step I. Work hard during the required OB/GYN clerkship for an honors grade. During your senior year, you should take additional electives in the specialty. For the most competitive programs, audition rotations can be very helpful (but only if you make a good first impression). Applicants must obtain at least two letters of recommendation from prominent and well-respected obstetriciansgynecologists. The ideal references are upper-level faculty members and the departmental chairperson. After all, connections are important. Additionally, your personal statement should concisely explain your interest in obstetrics-Gynecology
and how your community service experiences will lead to better patient care. Although the numbers are important, selection committees ultimately look at the bigger picture. They want residents who are personable team leaders, go the extra mile, and have positive attitudes.
Stellar grades, high Step I board scores (average was 225), and AOA membership are very important for matching into this second most competitive specialty. Although high academic achievement is a prerequisite, most program directors place the greatest emphasis on a candidate’s letters of recommendation, clinical evaluations, and interview. Many are willing to consider the applicant as an individual with unique abilities and talents and look past any minor academic deficiencies— but only if compensated for by other outstanding qualities. Demonstrate your interest and commitment to Ophthalmology
by getting involved in clinical research projects, spending time shadowing residents and faculty in clinic, and scrubbing in on lots of surgeries.
Depending on your school’s policy, complete electives in Ophthalmology
as early as possible. To improve your chances of matching, it is advantageous to do a few away rotations at programs of highest interest. (Just make sure to work hard and impress them with your superior knowledge base). Obtain at least one glowing letter of recommendation from an ophthalmologist who knows you well, especially if he or she is the chairperson or program director. Mediocre references— ones that do not give any insight into your performance—from well-known names can actually be detrimental.
Inundated with top-notch candidates, selection committees often use the personal statement as a deciding factor for interview invitations. Your essay must be more than interesting, informative, and readable; it should differentiate you from other applicants by showing the intangibles that make you a good doctor. Because most programs grant interviews on a rolling basis, aspiring ophthalmologists should submit their applications as early as possible.
This very competitive specialty requires a great deal of planning for success in the Match. Medical students need to work hard throughout all 4 years to achieve the best academic record possible. Earn stellar grades in all of your classes and rotations (especially the surgical ones!), because many competitive programs screen out candidates who have not been elected to AOA. Meaningful research projects, especially in orthopaedics
, can look very good on your application and will boost your credentials. Programs really put a lot of emphasis on having high board scores, so it is important to do well on the USMLE
Step I. Although there is no magic number for making the cut for an interview, aim for a ballpark range around 230.
Orthopedic surgery is one specialty in which it is almost mandatory for students to complete as many well-planned audition rotations at other hospitals as possible. You must work your gluteus
off and shine (without being annoying). Many applicants with less-than-stellar credentials can maximize their chances of matching by impressing the program director with hard work during a subinternship. Most students send out upward of 40 applications. Candidates should submit three to four letters of recommendation, which are typically the most important part of the application. At the minimum, two should be from orthopedic surgeons who know you well, especially if he or she happens to be the program director or departmental chairperson at your medical school. Avoid sending letters from nonsurgical specialties like pediatrics, Psychiatry
, or internal medicine.
The personal statement should be brief, concise, and honest. Discuss what makes you unique and how you came to choose orthopedic surgery, but leave out any poetry or quotations and do not mention your parents if they are also orthopedic surgeons. Avoid listing personal inquiries as a reason for career choice. Around the time of assembling rank lists, have your advisor or chairperson make calls on your behalf if possible. After all, being proactive and using connections may sometimes make or break your chances at matching at a first-choice program.
Like other surgical subspecialties, otolaryngology (or ENT
) is very competitive to match. You have to excel at many areas to stand above the rest of the competition. First, from the beginning of medical school, get to know the faculty at your institution so they can guide you and help you. Nearly all programs seek applicants with extensive research experience, particularly in ENT
. Early in the preclinical years, make an effort to seek out an otolaryngologist and get involved in some small basic science projects or case reports. Although it is still possible to match into ENT
without research, having your name on a published paper or presenting a poster at a national conference will only further enhance your credentials.
When it comes time to take the Step I board exam, you should aim for breaking at least 220. (If you score below 210, it might be wise to have a back-up plan, such as applying for general surgery as well). During the clinical years, an outstanding performance in surgery is the bare minimum. Future otolaryngologists should also earn honors grades in medicine and other clerkships. With top grades, membership in AOA gives an applicant an advantage. However, it is important to know that many students without AOA match at top academic institutions, and others with AOA status can find themselves unmatched. This is why letters of recommendation are very important in otolaryngology. You should obtain references from at least two otolaryngologists, particularly from someone well-known in the field. In the small ENT
community, everyone knows each other, so connections can make a big difference. To obtain stellar letters, complete at least one audition subinternship at a large academic hospital with a well-known department. Work hard on these rotations and impress the faculty members. When it comes time to apply, students should submit as many applications as financially feasible. In the personal statement, make sure you clearly state your reasons for entering a career in otolaryngology. At rank list time, applicants should have as many programs as possible in order to ensure a match.
As more American medical graduates discover Pathology
, this unassuming specialty has become competitive again. In fact, the top-ranked programs like to see candidates with Step I board scores of about 220 or higher. In your preclinical years, learn all the basic sciences well. Research projects, publications, and presentations at national meetings are important credentials for matching at the most academic programs. A few of these institutions even do not consider granting interviews to anyone without a PhD in a basic science discipline. All students should demonstrate a committed interest in Pathology
, primarily by completing a monthlong rotation. After the second year of medical school, some apply for competitive post-sophomore fellowships—1-year positions in which they function at the level of a Pathology
resident.
Although Pathology
is developing more interest among medical students, some applicants come to it later in their training. The absence of specialty clerkships, therefore, is not viewed as an absolute negative for matching in this specialty. During the senior year, audition rotations (which are generally unnecessary) could substitute for not having a PhD when applying to the most competitive programs. To impress the program director, you should always take the initiative, help out the residents, and conduct many literature searches during these rotations. At application time, letters of recommendation from any type of clinical faculty are acceptable; make sure at least one comes from a pathologist who knows you well. Most important, in the personal statement and interview, never say that you chose Pathology
because of “lifestyle reasons.” Doing so will instantly drop you to the bottom of every director’s rank lists.
The fun-loving nature of pediatricians makes applying for this specialty a much more enjoyable process. There are excellent programs all over the country at both university and community hospitals. If you are seeking a position at top programs in pediatrics, the competition is stiff. You will need higher board scores and stronger clinical grades than your peers. During medical school, it is not necessary to pursue research to enhance your credentials. Instead, take the time to immerse yourself in outside interests and other extracurricular activities, particularly those that involve kids. Become involved in substantial leadership, volunteer, or research projects. There are no unofficial board score cutoffs for pediatrics. Earn an honors grade in your required pediatrics clerkship, and follow this up with a stellar performance in a subinternship.
If you are interested in exploring a particular program, away rotations are helpful but not necessary. Most candidates submitted about 10 applications. Obtain letters of recommendation from one or two pediatricians who know you well. The rest can come from any specialty. If you are set on a particular program, do an outside rotation there, work hard to impress them, and obtain a letter of recommendation. The personal statement, an important part of the application, should be honest and straightforward and discuss how you decided on a career in pediatrics. Do not simply say “I love kids”—prove it with examples of what you’ve done. Pediatricians are easy-going folks in general. They are mainly interested in whether they will be able to work with you for 3 years, so relax!
This specialty has been largely undiscovered by most medical students. Positions in physical medicine and rehabilitation (PM&R) are available for nearly any interested student. Like most specialties, however, competition for the most highly ranked programs is intense. In the preclinical years, pursue outside interests that relate to the practice of physiatry, like working with disabled people, athletic events, or public health issues. Research experience will definitely provide a distinct advantage when attempting to attract the interest of the top academic-based training programs. But just because applicants to PM&R do not have publications or presentations listed on their resumes does not mean that they are locked out of this specialty. It is certainly by no means a requirement. This specialty is, after all, broad enough to attract physicians with a wide variety of talents, education, and personal backgrounds. So go ahead and pursue your own interests and extracurricular activities. Just make sure to study enough to earn an above average score on the Step I board examination. This will place you in a comfortable position to be competitive during the application process.
In the clinical years, solid performances in the internal medicine, neurology, pediatrics, and surgery core clerkships are important. Complete a PM&R subinternship or elective early in the fourth year to make sure that it is the right specialty for you. Depending on the specific institution, audition rotations may have some benefit. If you want to enhance your chances of matching at a certain hospital, make sure to work hard during an away elective because selection com mittees will keep a close eye on you. You will need three letters of recommendation, with at least two of them from PM&R physicians and the remainder from other core fields. Obviously, if you are interested in pediatric rehabilitation, a reference letter from a pediatrician with whom you have worked is logical. Likewise, if someone has an interest in sports medicine, a letter from an orthopedic surgeon who practices sports medicine would be suitable as well. Just be sure, however, that the accompanying personal statement is truly personal, honest, and well-written. Make sure to explain genuinely how you became interested in this field of medicine. Be creative, but avoid gimmicks.
Depending on their credentials, most candidates apply to around 10 programs to ensure a match. If possible, have a well-placed connection make a tactful phone call on your behalf to a program director. Most important, never say that you chose this field because of the lifestyle, or that PM&R is a backup specialty after orthopedic surgery. It will be doing yourself and that residency program a huge disfavor.
It takes a lot of preparation and achievement to match into plastic surgery—the most competitive specialty among all areas of medicine. Hundreds of impressive candidates are seeking one of the few spots in the integrated, or categorical, plastic surgery programs (5 to 6 years long). During the preclinical years, students should link up with an academic plastic surgeon and find out more about what the specialty involves. Hang out in the clinic and operating room to gain more exposure. Immerse yourself in extracurricular activities and outside interests. Program directors look for students who are great at what they are expected to do, but the candidate with outstanding unexpected achievement is looked upon very highly (e.g., organizing a mission to an underserved area, training for the Olympics, writing a book).
Almost all selection committees look for achievement in clinical research (and most expect it), so make sure to plan some kind of plastic surgery project and get yourself a publication. If you are graduating from a mid-level school, work hard in your courses and rotations to earn membership in AOA. For everyone, it is imperative to score high on the Step I boards, because most programs look for scores around the 90th percentile. In the clinical years, get top grades in your core surgery and plastic surgery rotations. By exposing your limited knowledge of plastic surgery, audition rotations at other hospitals can be disadvantageous—particularly when other programs see that you have gone somewhere else for a subinternship.
Applicants must submit letters of recommendation from the surgery departmental chairperson, the plastic surgery divisional chairperson, and one other plastic surgery attending. (If you apply to general surgery as a backup, make sure you have two sets of letters that refer to the correct specialty). In the personal statement, discuss your motivations and experience in plastic surgery and highlight any outstanding achievements. Selection committees look closely at academic achievement and reference letters to determine if you are a dependable, honest, smart, and hard-working team player.
A solid performance in medical school can land you a position in nearly any Psychiatry
program. The top programs, however, only accept the most stellar of candidates. If you are aiming for these hospitals, high board scores on Step I and II are helpful. Your clinical performance in the Psychiatry
clerkship is key to success in matching. In addition, above-average evaluations in other rotations and a thoughtful, complete application are sufficient to garner interviews at some of the best hospitals in the country. Audition subinternships can be helpful for specific programs, but are not completely necessary and may even work against you if your rotation performance goes awry.
Letters of recommendation should come from at least two psychiatrists who know you well in addition to one other clinical faculty member. The personal statement is an extremely important part of the application. It should address your reasons for entering a career in Psychiatry
and the type of residency program sought. The style must demonstrate maturity, empathy, and honesty.
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