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A D.O. Student


A D.O. Student s Guide to Residency Where Does It End? Draion M Burch, DO Council of Interns and Residents American Osteopathic Association * Disclaimer! – PowerPoint PPT presentation

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Title: A D.O. Student

A D.O. Students Guide to Residency
  • Where Does It End?
  • Draion M Burch, DO
  • Council of Interns and Residents
  • American Osteopathic Association

  • The goal of this lecture is not to persuade any
    osteopathic medical student to pursue any
    particular specialty, residency program or
    D.O./M.D. postgraduate training. The purpose of
    this lecture is to help you make an informed
    decision. The information in this lecture is
    subject to change!

  • 2nd year
  • CV
  • Portfolios
  • Research
  • Academic File

  • 3rd year
  • Unique Rotations
  • Evaluations on Rotations
  • Choosing a specialty
  • 4th year
  • Budgeting
  • Scheduling and Applying for Elective Rotations
  • Audition Rotations and Acting/Sub-Internships

  • 4th year (cont)
  • Boards- (COMLEX Level 2/ USMLE Step 2)
  • Tips for selecting a residency programs (AOA vs.
  • Preparing to Apply for Residency
  • Electronic Residency Application Service (AOA vs.
  • Residency Interviewing Skills
  • The Match and Scrambling Processes (AOA vs.
  • Requirements to Start Residency (AOA vs. ACGME)

  • Post-doctoral
  • Medical Licensing/Board Certification (AOA vs.
  • Osteopathic Approval of ACGME Postdoctoral
    Training Programs -Resolution 42

  • 2nd year

By the end of your 2nd year
  • Update Curriculum Vitae
  • Start Portfolio
  • Conduct Research
  • Student Researchers are more desirable to
    competitive residency programs!
  • Review Academic File
  • Make copies of items in your academic file for
    your portfolio!

Curriculum Vitae Essentials
  • Identification Information
  • Education
  • Work Experience
  • Leadership
  • Research
  • Publications, Poster Competitions, Presentations
  • Professional Experience
  • Professional Affiliations
  • Military
  • Volunteer Activities
  • Honors Awards
  • Special Skills
  • Hobbies Interests
  • References

Portfolio Essentials
  • Title Page with identification information,
  • Table of Contents
  • Curriculum Vitae
  • Personal Statement
  • Evaluations
  • Clinical evaluation summary, recommendation
    letters, etc
  • Honors
  • Top 10 letters, Scholarship Awards,
    Certificates, etc
  • Research
  • Publications, Posters, Protocols, Papers not
    published, etc
  • Lectures
  • Public Relations
  • Newspaper articles

  • 3rd year

Unique Rotations To Consider
  • Research Rotation
  • International Rotation
  • International Research Rotation
  • Do a research rotation at a residency program of

Evaluations On Rotations
  • During your clinical years, you will receive
    grades per rotations.
  • Try to earn HONORS on all of your clinical
    rotations- especially in your specialty of

By the end of 3rd year
  • Time to Choose a Specialty
  • You should have narrowed down your choices of
    specialties to 1-2 .
  • You can apply to more than one specialty via
  • If not, dont worryyet! The earlier you decide,
    the easier this process will be for you.
  • Once you have decided on a particular specialty,
    apply for out rotations/electives in either this
    field or in one of its subspecialties.

  • 4th year

  • Expenses during 4th year include
  • Boards USMLE Step 2 /or COMLEX Level 2
  • COMLEX Level 2 Physical Examination/Clinical
    Skills Travel expenses to testing site
  • Elective Rotations
  • Application Fees, Travel expenses
  • ERAS application
  • The number of programs you are applying to
  • The number of specialties you are applying to
  • Transcripts (COMLEX/USMLE and Medical School)
  • Interviews
  • Travel expenses such as flights, hotels, rental
    cars, meals
  • Costs can range from 100-5,000

Elective Rotations
  • Visit potential residency programs by applying to
    do elective rotations or acting internships
    (AI)/Sub-internships (Sub-I).
  • Try to rotate in these residency programs between
    July-Dec. Try to interview while you are rotating
  • Pursue a well-rounded medical educationthis is
    your last chance to truly see anything and
    everything before you begin your residency or

Elective Rotations
  • Elective rotations are just what they say. You
    get to choose what you want to do.
  • Complete rotations that will help you get a
    well-rounded education.
  • Use this time to see various residency programs.
  • If a program director is in a specific
    subspecialty, do an elective rotation in that

Elective Rotations
  • Check hospital websites for
  • Intern and residency programs (Graduate Medical
    Education Links)
  • Application requirements and deadlines for
    elective rotations
  • Student (Extern) Rotation Application Form- may
    be an online application process.

Elective Rotations
  • Apply for elective rotations 3-6 months in
  • Hospitals will fill these rotations with their
    home medical school students before they place
    students from outside schools.
  • However, if you apply early you will be on the
    top of the outside school pile.
  • Some hospitals charge an application fee
  • 20-250

Elective Rotations
  • Some hospitals do not provide housing, travel
    expenses, or meals.
  • Apply to 2-3 rotations for the same month.
  • You may be rejected from an elective rotation.
  • Cancel a rotation if you have another scheduled
    that you plan on completing so other students can
    have the same opportunities as you.

Elective Rotation Paperwork
  • Hospital Student Application Form
  • Immunization Records
  • Letter of Good Standing
  • Professional Liability Insurance Certificate
  • Copy of Transcript
  • Copy of USMLE Step 1/COMLEX Level 1
  • CV or resume
  • Criminal Background Check/Fingerprint Analysis
  • Additional paperwork specific to the hospital may
    be required.

Elective Rotations
  • Most students will agree that you should try to
    schedule one or both of the following
  • ICU rotation
  • Acting/Sub-internship

Elective Rotations
  • Most students will agree that you should try to
    schedule one or both of the following
  • ICU rotation
  • Acting/Sub-internship

  • You and another student are paired up for the
    month. The two of you equal one intern. You
    assume the responsibilities of an intern in terms
    of call, admissions, and discharges.
  • Glimpse of intern year while still having someone
    looking over your shoulder.
  • Chance to shine and show a particular program
    what you are capable of.
  • Great way to get a good letter of recommendation,
    which carries more weight.

Audition Rotations
  • Remember rotations at hospitals you will be
    applying to for residency should be considered
    Audition rotations.
  • Show the program why they should take you. Get
    your face seen and known. This way when they
    receive your application they will remember the
    impression you left.

  • By now, you have completed and passed USMLE
  • Step I and/or COMLEX Level 1. Many students ask
  • Do I need to take step 2/level 2 before I apply
    for residency?
  • Do I need to take the USMLE to apply to an
    allopathic program?

When to take USMLE Step 2/COMLEX Level 2?
  • You should take the your second set of boards
  • (including the PE) by the late summer/early fall!

Do you need to take step 2/level 2 before
residency applications?
  • Most residency programs would like to see step 2
    before they make their official rank order list.
  • Therefore you should take the boards (including
    the PE) by the late summer/early fall.
  • Some programs may not rank you until you have
    completed both parts of step 2 (CK and PE)!
  • Make sure to check with the programs you are
    interested in as these requirements are

Do you need to take the USMLE to apply to
an allopathic program?Do you need to take
the USMLE to apply to an allopathic
  • Answer yes no.
  • No program can deny your application if you just
    submit your COMLEX scores however, they may
    choose to not consider you.
  • This is program dependent. At some programs, your
    chances may be increased if you take the USMLE.
  • Choosing to take only COMLEX depends on how
    competitive an applicant is and how competitive
    their specialty choice is!

Reasons Not to Take the USMLE
  • COMLEX is based on the COMS curriculum while
    USMLE is based on the LCGME curriculum.
  • A D.O. must pass all 3 parts of the COMLEX only
    to be licensed as a D.O.
  • If you fail any exam and the state licensing
    board inquires, you must report your results-
    which becomes part of your permanent record that
    your state licensing board keeps!
  • You double the cost, preparation time, etc. by
    taking both exams.
  • Some ACGME programs will accept candidates with
    COMLEX only.

Board Preparation
  • Common resources for Step 2/Level 2
  • First Aid for Step 2
  • Boards and Wards- great resource for rotations
  • Crush for the Boards
  • Usmleworld.com or Kaplan Question Bank
  • OMT Review
  • Savarese
  • W. Crowe COMLEX Review
  • http//www.md-do.org/NewOMMBoard20Review02-REV.ht

Miscellaneous Info about Boards
  • You can take the USMLE Step 2, without taking
    USMLE Step 1.
  • There is not a consensus if this is helpful,
    however, I would like to make you aware of this

Allopathic Positions you may apply to
  • Categorical
  • programs that begin in the PGY-1 year and provide
    the training required for board certification in
    medical specialties.
  • Advanced
  • programs that begin in the PGY-2 year after a
    year of prerequisite training.
  • Preliminary
  • one-year programs beginning in the PGY-1 year
    that provide prerequisite training for advanced
  • Physician
  • programs that are reserved for physicians who
    have had prior graduate medical education.
    Physician programs are not available to senior
    U.S. medical students.

Osteopathic Positions you may apply to
  • OPTION 1 (OGME-1 Resident) Specialty Track
  • The first postdoctoral year will be the first
    year of residency. This is the same as the
    current specialty track model. All trainees will
    receive residency credit for this 1st year of
    training. These positions will be known as OGME-1

Osteopathic Positions you may apply to
  • OPTION 2 (OGME-1 Preliminary) Special Emphasis
  • The first postdoctoral year is not included in
    the residency, but is a specific preliminary
    entrance requirement into the specialty to
    produce an enhanced educational opportunity for
    that specialty. The trainee will have been
    accepted into the OGME-2 specialty while a senior
    in osteopathic medical school. These positions
    will be recorded by the AOA as Preliminary
    interns and be known as OGME-1 Preliminary.

Osteopathic Positions you may apply to
  • OPTION 3 (OGME- 1 Traditional) Traditional
  • Rotating Internship
  • This first postdoctoral year is not included in
    the residency, but is available in the format of
    a Traditional Rotating Internship. It may be
    utilized by any osteopathic graduate uncertain of
    residency plans or those who want a single year
    program. These positions will be recorded by the
    AOA as OGME-1 Traditional.

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Choosing a ResidencyFactors To Consider
  • Location and proximity to family
  • Didactics
  • Volume (Surgeries, Deliveries, Procedures)
  • Fellowship opportunity
  • Program Reputation/Rankings
  • Program atmosphere (residents/attendings/facility)
  • Research opportunities
  • Night float vs. overnight call
  • Amount of scutwork
  • Board pass rates
  • Amount of autonomy

Information about Residency Programs
  • FREIDA Online Website
  • http//www.ama-assn.org/ama/pub/category/2997.html
  • DO Online Website Opportunities
  • http//www.do-online.org
  • Student Doctor Network Website
  • http//www.studentdoctor.net/
  • SCUTWORK Website
  • http//www.scutwork.com
  • Washington University SOM Website
  • http//residency.wustl.edu/
  • Great website with helpful information about
  • MDsecrets
  • http//mdsecrets.com
  • List of unfilled allopathic residencies

How do you know if a program is DO Friendly?
  • Look at the programs websites and see what their
    specific requirements are- also look to see if
    there are any DOs in the program.
  • Some programs require passage of USMLE Step 1 to
    apply for their residency program!
  • If they list resident contact information (email
    address), contact the residents especially if
    there are DOs.
  • Dont hesitate to contact the program directors
    or program coordinators if you have any

What if I choose not to do an Osteopathic
  • There are five states (PA, OK, FL, WV, and MI)
    which require completion of an osteopathic
    internship in order to be licensed to practice in
    that state.
  • Without this internship or osteopathic approval
    you are unable to participate in a residency,
    fellowship, or practice in these five states.

Documents Needed for ERAS Application
  • Regardless of whether you are going to pursue
    osteopathic or allopathic postgraduate training
    there are specific documents you must have.
  • You will need
  • 3-4 good letters of recommendation
  • (1 from your specialty choice)
  • Updated CV
  • Personal statement
  • Deans Letter
  • USMLE/COMLEX Transcripts
  • Medical School Transcripts
  • Photo

Letters of Recommendation
  • You will need at least 3-4 good letters of
  • Dont get them all in one specialty. Programs
    want to see that you are a well-rounded candidate
    (not only did you do well in Pediatrics, but also
    Surgery and Psychiatry)
  • Get an early start- ask for letters during your
    3rd year!
  • Dont wait until a few weeks before you plan on
    applying on ERAS.
  • Consider completing an acting internship for a
    final letter of recommendation.

Letters of Recommendation (LOR)
  • Each LOR will be accompanied by an ERAS
    coversheet, which includes your information, the
    physicians information, and your option to waive
    your right to see the LOR
  • You may want to waive your right on the cover
    sheet. This will allow the physician to give you
    a fair and unbiased evaluation.

Packet for Preceptors to help them write your LOR
  • Curriculum Vitae
  • Personal Statement
  • Their evaluation of you during your rotation
  • Thank you letter
  • ERAS coversheet
  • Small envelope- stamped, addressed to your
    address in case preceptor wants to mail you a
  • Large envelope- stamped, addressed to Student
    Affairs for ERAS application

Personal Statement (PS)
  • Dont underestimate the importance of your
    personal statement!
  • Dont procrastinate!
  • Start writing it as soon as you choose a
  • Have several individuals review your PS-your
    advisors, residents in your specialty, the
    residency program director at your medical

Websites to help you write your Personal
  • http//u101.com/articles/med-school/residency-pers
  • http//www.rushu.rush.edu/studentlife/career/medps
  • http//www.ama-assn.org/ama/pub/category/6700.html
  • http//www.residencyandfellowship.com/page3.html

Medical School Transcripts
  • Request copy of transcripts for yourself and for
    Student Affairs (for ERAS).

COMLEX /or USMLE Transcripts
  • On MyERAS, you must release your COMLEX
  • On the other hand, you do not have to release
    your USMLE transcripts!
  • May be changing for future classes. Make sure you
    look into this if you took the USMLE.

Deans Letter
  • Now known as the Medical Student Performance
    Evaluation (MSPE)
  • Your Deans letter is a formal institutional
    reflection of your academic background and
  • It is NOT a personal letter of recommendation.
  • Your medical schools student affairs uses your
    Personal Academic File along with your
    Curriculum Vitae to write your Deans Letter.

What does your Deans Letter contain?
  • Confirmation of good academic standing
  • Anticipated Date for D.O. degree
  • Your undergrad/grad degree
  • Degree, year, where conferred
  • Undergraduate Activities Descriptions
  • Volunteer work, research activities, clubs,
    honors, teaching, etc.

What does your Deans Letter contain?
  • Explanation/Description of curriculum
  • Grading system
  • Academic achievements
  • Activities Descriptions
  • Volunteer work, research, clubs, tutoring,
    professional associations, honors, awards,

What does your Deans Letter contain?
  • Facilitator Comments
  • Board Exam Completion (percentile included if in
    top 30)
  • Rotations to date, including
  • Positive comments from each rotation
  • Final assessment marginal to honors
  • Closing paragraph to summarize and recommend

Request a copy of your Deans Letter
  • Request a copy in early Fall of Senior Year

  • Use a picture of you in your business attire- it
    looks more professional. Remember- you are
    interviewing for a job!

What is ERAS?
  • ERAS is a service that transmits residency,
    fellowship and osteopathic internship
    applications, letters of recommendations, MSPEs,
    medical school transcripts, USMLE transcripts,
    COMLEX transcripts, and other supporting
    credentials from you and your designated Dean's
    Office to program directors using the Internet.

4 Components of ERAS
  • MyERAS Website
  • This is where you complete your application and
    personal statement, select programs to apply to,
    and assign documents to be received by those
  • Deans Office Workstation (Student Affairs)
  • This is ERAS software used by staff at your
    designated Dean's Office. From this software they
    create the ERAS Token that applicants use to
    access MyERAS. They also use this system to scan
    and attach supporting documents to your
    application, such as photograph, medical school
    transcript, MSPE, and letters of recommendation.

4 Components of ERAS
  • Program Directors Workstation (Hospital Graduate
    Medical Education Office)
  • This is ERAS software used by program staff to
    receive, sort, review, evaluate, and rank
  • ERAS Post office
  • This is a central bank of computers which
    transfers the applications. You can monitor the
    activity of your files in the ERAS Post Office on
    the Applicant Data Tracking System (ADTS).

How does ERAS work?
  • Applicants receive an electronic Token from their
    assigned Dean's office, and use it to access the
    MyERAS Web site.
  • Applicants complete their ERAS application,
    select programs, assign supporting documents, and
    transmit their application to programs.
  • Schools receive notification of completed
    application, and start transmitting supporting
    documents transcripts, letters of
    recommendation, photos, MSPEs.

How does ERAS work?
  • Examining boards receive and process requests for
    score reports.
  • Programs contact the ERAS Post Office on a daily
    basis to download application materials

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ERAS Timeline
  • Mid June- Download ERAS Applicant Manual will be
    available for PDF download by chapters or in its
    entirety on the Web site.
  • Late June- Schools may begin to generate and
    distribute MyERAS tokens to applicants.

ERAS Timeline
  • July 1st- MyERAS website opens to applicants to
    begin work on applications.
  • July 15- Osteopathic applicants may begin
    selecting and applying to Osteopathic Internship
    programs ONLY. Osteopathic Internship programs
    can begin contacting the ERAS Post Office to
    download application files.

ERAS Timeline
  • September 1st- Applicants may begin applying to
    ACGME accredited programs. ACGME accredited
    programs may begin contacting the ERAS Post
    Office to download application files.
  • November 1st- MSPEs (aka Deans Letters) are
  • December- Military Match

ERAS Timeline
  • January- Urology Match
  • February- Osteopathic Match
  • March- NRMP Match results will be available.
  • May 31st- ERAS Post Office will close to prepare
    for the next season.

Application Process Guideline
  • Step 1Research/Contact programs of interest to
    find out their requirements and deadlines.
  • Step 2Request your token from your designated
    Dean's Office and download your applicant manual.
  • Step 3Register on MyERAS.

Application Process Guideline
  • Step 4Register for your Match.
  • Step 5Obtain documents and send them to the
    designated Dean's Office to be scanned and
  • Step 6Create your Profile and MyERAS

Application Process Guideline
  • Step 7Create personal statements, create a list
    of recommendation writers, and authorize
    transmission of your USMLE and/or COMLEX
  • Step 8Search/Select programs of interest.
  • Step 9Assign documents to programs.

Application Process Guideline
  • Step 10Certify and submit your MyERAS
    application then apply and pay for programs.
  • Step 11Check the status of your applications.
  • Step 12Adding programs/Updating assignments and
    keep your Profile current.

Using MyERAS- Overview
  • Account
  • Profile
  • Checklist
  • Messages
  • Password
  • Application
  • Home
  • Page One - General Info
  • Page Two - Education
  • Page Three - Medical Education
  • Page Four - Previous Residency/Fellowship
  • Page Five - Experience
  • Page Six - Publications
  • Page Seven - Exams
  • Page Eight - Licensure Info
  • Page Nine - State Medical
  • Licenses
  • Page Ten - Race
  • Page Eleven - Ethnicity
  • Page Twelve - Misc Info

Using MyERAS- Overview
  • Documents
  • USMLE Transcript
  • COMLEX Transcript
  • Personal Statements
  • Letters of Recommendation
  • Programs
  • Search Allopathic Programs
  • Search Osteopathic Programs (Visible to
    Osteopathic Applicants only)
  • Programs Selected
  • Programs Applied To
  • Preview Invoice
  • Apply to Programs
  • Invoice History
  • Assignments Report

ERAS Application Fees
  • Number of Programs Per Specialty AAMC Fees
  • Up to 10 60
  • 11-20 8 each
  • 21-30 15 each
  • 31 or more 25 each

ERAS Application Fees
  • Example 1 An applicant applies to 30 emergency
    medicine programs, AAMC fees are 290. (60 (10
    x 8) (10 x 15)).
  • Example 2 An applicant applies to 20 OB/GYN
    programs, and 10 family practice programs. The
    fees are 200. (140 for OBGYN and 60 for family
    residency programs).

ERAS Application Fees
  • Example 3 An applicant applies to 23 internal
    medicine programs, and 7 radiology programs. The
    fees are 245 (185 for internal medicine
    programs and 60 for radiology programs).
  • Example 4 An applicant applies to 12 internal
    medicine programs, 10 emergency medicine, and 8
    family practice programs. AAMC fees are 196 (76
    for internal medicine programs, 60 for emergency
    medicine programs, and 60 also for family

ERAS Application Fees
  • Example 5 A military applicant applies to 5
    military family practice programs, 3 military
    internal medicine programs, 2 military surgery
    programs, and 7 civilian pediatrics programs. The
    fees are 120 (60 for the 10 programs
    consolidated under the military and 60 for the 7
    civilian programs).

ERAS Application Fees
  • Special Instructions for Osteopathic
    GraduatesAlthough the ERAS 2008 fee structure
    is the same for osteopathic and allopathic
    programs, it is administered differently. For
    osteopathic internships, the fee is applied based
    on the total number of programs applied to,
    regardless of the specialties to which the
    applicant applies. Applicants applying to
    allopathic programs are assessed based on the
    total number of programs applied to within a

Miscellaneous Fees
  • US (Allopathic and Osteopathic) and Canadian
    ApplicantsThe National Board of Medical
    Examiners (NBME) charges a flat 50 fee to US and
    Canadian applicants who request transmission of
    USMLE and/or NBME to programs, regardless of the
    number of transcripts requested. The NBME fee is
    included on your invoice and collected by the

Miscellaneous Fees
  • US Osteopathic ApplicantsOsteopathic applicants
    may request an unlimited number of COMLEX
    transcripts to be sent via ERAS for 50.
    Applicants who request USMLE transcripts via ERAS
    also pay a 50 fee to the NBME for an unlimited
    number of electronic transcripts. Transcript fees
    are included on your invoice and are collected by

Payment Method
  • You may use your VISA or MasterCard to pay for
    your ERAS fees online. This is the safest and
    fastest way to process your application.
  • You also have the option to pay your ERAS fees by
    selecting the check/money order option, printing
    out the invoice in the payment module, and
    sending your fees by check (U.S. currency only)
    to the address on the invoice. Your
    application(s) may be withdrawn if payment isn't
    received within two weeks.
  • All fees are payable in U.S. funds on U.S. banks

Payment Method
  • If your check is returned for insufficient funds,
    you submit partial payment, or there is a problem
    with your credit card payment, ERAS will endeavor
    to collect fees owed and your application may be
  • If ERAS withdraws your application due to
    nonpayment, your application will be withdrawn
    from each program to which you applied.

ERAS Use During the M.D. Scrambling Process
  • From 12 noon on the third Tuesday in March, until
    12 noon on the third Thursday in March each year,
    there is a "Scramble" period. This is before the
    NRMP Match Day results are revealed.
  • During this period, applicants who did not match
    to a position attempt to fill remaining
    positions. ERAS is available to applicants to
    apply to a maximum of thirty (30) programs free
    of charge who meet the following criteria
  • The applicant must have participated in ERAS
    during the regular season. This means you must
    have applied to (and paid for) at least one
  • The applicant's account must be paid in full no
    less than two weeks prior to the Scramble period.

Additional Scramble Information
  • FindAResident is a company created by the AAMC to
    help applicants find open residency positions.
  • http//www.aamc.org/students/findaresident
  • It is an effective resource if you wish to
  • Change specialties
  • Change location
  • Switch residency or fellowship programs

Osteopathic Match Application
  • The osteopathic match occurs through the National
    Matching Services (NMS).
  • You will sign up in Sept. for this match after
    you are provided a pin number from your medical
  • The initial fee is 60 to sign up for this match!
  • http//www.natmatch.com/aoairp/
  • Always Register for the OSTEOPATHIC Match!

Allopathic Match Application
  • The allopathic match occurs through the National
    Residency Matching Program (NRMP).
  • You will sign up on Sept. 1 for this match after
    you receive your AAMC number.
  • The initial fee is 45 to sign up for this match!
  • http//www.nrmp.org/

Interview Schedules
  • Interviews at osteopathic programs typically
    occur from Sept.-Dec.
  • Interviews at allopathic programs typically occur
    from Nov.-Jan.
  • Make sure to schedule rotations and vacation time

Interviewing Skills
  • Before you interview, try to go through a mock
    interview with a faculty member.
  • Review the list of potential questions to ask
    during your interview.

Other Interviewing Tips
  • Schedule rotations appropriately for interview
  • Choose rotations which have lighter schedules.
  • Cluster interviews-if within the same city
  • i.e. CCF/Metro/UH

Other Interviewing Tips
  • Interact with the residents during the interview
  • They are the best source for information. Keep in
    mind some residency programs allow their
    residents to serve on the committee so act
    appropriately with the residents.
  • Schedule interviews, even if its not at the top
    of your list.
  • A program can feel different in person. Dont
    base your decision on their website or literature

After Interviews
  • You should send a Thank You note in a timely
  • This can be in the form of an email, phone call
    to the program director, or a hand written thank
    you note.

After Interviews
  • You can choose whomever you like to thank, but
    most applicants thank their interviewers and the
    program director.
  • Make sure to get business cards from all of your
    interviewers. After each interview write down
    some highlights from the interview that you can
    mention in your thank you note. This will help
    you stand out and will not look like a generic
    thank you.

Letter of Intent
Letter of Intent
  • After you have finished interviewing some suggest
    that you write a letter of intent to your top one
    to three choices.
  • State why you want to be there are what this
    residency program offers that makes you want to
    train there.

Letter of Intent
  • Do not lie and say to all three programs that you
    are ranking them 1, just say highly ranked to
    2 3
  • This is a great way to keep in contact with a
  • Residency programs typically rank applicants in
    late Jan/ early Feb.
  • Some programs rank applicants immediately after
    you interview!

After Interviews
  • After you have completed the interview season,
    you are now challenged to create a Rank Order
    List (ROL)
  • When creating a rank list remember to rank the
    programs that you want to go to in the order YOU
    want them and not based on your chance of
    matching there.

Rank Order List (ROL)
  • The Rank Order List (ROL) is your preferred
    rankings for the residency you are pursuing.
  • For the D.O. match, your ROL is created on the
    AOA Intern/Resident Registration Program website
  • www.natmatch.com/aoairp/
  • For the M.D. match, your ROL is created on the
    NRMP website
  • www.nrmp.org/

  • You can rank as many or as little programs as you
    like. The rankings are free for programs 1-30,
    after which you will be charged a fee for
    additional rankings.
  • Applicants will have a greater chance of matching
    if they rank more programs.
  • You can only rank programs you interviewed at.

Match Algorithm
At first look it may seem like a foreign
language, but with careful observation the match
really gives the applicant the advantage.
Not the real match algorithm!
The Match Algorithm
  • The match favors the applicant!
  • Here are the websites explaining the algorithms
  • M.D.
  • http//www.nrmp.org/res_match/about_res/algorithms
  • D.O.
  • http//www.natmatch.com/aoairp/ (click on match

Match Algorithm Example
  • If your number one ranks you highly (ex. if they
    have 12 spots and you are within the top 12) you
    will match at your number one.
  • However, what happens if you are number 16 and
    the first 12 applicants all have this hospital
    ranked as their number one. Then you dont match
    there and you continue to your number 2.

Match Algorithm Example
  • If your number 2 has you listed highly (again if
    there are 12 spots, and you are listed within the
    top 12) you will match.
  • Note Even if the 12 spots are filled by other
    candidates you can bump off the last candidate
    if you are ranked higher.

The Match Algorithm
  • This is why you should always rank your list
    based on where YOU want to go.
  • You can find another example involving several
    theoretical applicants at
  • http//www.nrmp.org/res_match/about_res/algorithms

Osteopathic Match Timeline
  • JUNE
  • Beginning in June, students can download the
    Agreement form for participation in the AOA
    Intern/Resident Registration Program (the
    "Match") from this web site. To register for the
    Match, each student must return a signed
    Agreement to National Matching Services Inc.
    accompanied by the appropriate registration fee.
  • Students must apply to programs independently of
    the Match (via ERAS). Programs receive
    applications and interview students independently
    of the Match. Application deadlines for programs
    vary, therefore students should check with
    programs regarding their deadline dates.

Osteopathic Match Timeline
  • Each institution offering osteopathic internship
    positions beginning in 2007 must provide to
    National Matching Services Inc. information on
    the program(s) being offered by the institution
    in the Match.
  • Recommended date by which students should return
    their Agreements and registration fees to
    National Matching Services Inc.

Osteopathic Match Timeline
  • Early NOVEMBER
  • By this date, a Listing of Programs participating
    in the Match will be available on this web site.
  • By this date, instructions for submitting Rank
    Order Lists and obtaining Match results will be
    provided to registered students and programs.

Osteopathic Match Timeline
  • Late JANUARY
  • Final date for submission of student and program
    Rank Order Lists. No Rank Order Lists or
    Agreements can be accepted after this date.
  • Results of the Match are released to all
    participants in the Match (students and
    institutions), as well as to the colleges of
    osteopathic medicine.

Osteopathic Match Timeline
  • Institutions must complete an institutional
    contract for each matched student, and send it
    within 10 working days after receipt of the Match
    results to the student for signature. Each
    matched student must sign and return the contract
    to the institution within 30 days after receiving
    the contract from the institution.

Allopathic Match Timeline
  • Mid August
  • Applicant registration begins at 1200 noon
    eastern time.
  • September 1
  • Institution / program registration begins at
    1200 noon eastern time.
  • December 1
  • Applicant registration deadline (Note Applicants
    may register after this deadline by paying an
    additional late registration fee of 50.00 when
    registering after 1159 PM eastern time.)

Allopathic Match Timeline
  • Mid January
  • Rank order list entry begins. Applicants and
    programs may start entering their rank order
    lists at 1200 noon eastern time.
  • Late January
  • Quota change deadline. Programs must submit final
    information on quotas and withdrawals by 1159 PM
    eastern time.
  • Late February
  • Late registration deadline.

Allopathic Match Timeline
  • Late February
  • Rank order list certification deadline.
    Applicants and programs must certify their rank
    order lists by 900 PM eastern time. CERTIFIED
    applicant and program rank order lists and any
    other information pertinent to the Match must be
    entered in the R3 System by this date and time.
  • Early March (3rd Monday in March)
  • Applicant matched and unmatched information
    posted to the Web site at 1200 noon eastern

Allopathic Match Timeline
  • Early March (3rd Monday in March)
  • Filled and unfilled results for individual
    programs posted to the Web site at 1130 am
    eastern time.
  • Early March (3rd Tuesday in March)
  • Locations of all unfilled positions are released
    at 1200 noon eastern time. Unmatched applicants
    may begin contacting unfilled programs at 1200
    noon eastern time.
  • Mid March (3rd Thursday in March)
  • Match Day! Match results for applicants are
    posted to Web site at 100 pm eastern time.

Allopathic Match Timeline
  • Mid March
  • Hospitals send letters of appointment to matched
    applicants after this date.
  • Note Any contact between programs and unmatched
    applicants (or their designees) prior to 1200
    noon eastern time Tuesday, March 13, 2007, is a
    violation of the Match Participation Agreement.
    Contact between programs and matched applicants
    prior to the general announcement of 2007 Match
    results at 100 pm eastern time Thursday, March
    15, 2007, also is a violation of the Match
    Participation Agreement.

Can you participate in both matches?
  • YES. As a D.O. applicant you can choose to apply
    to both the D.O. and M.D. match, the D.O match,
    or the M.D. match. The D.O. match occurs before
    the M.D. match.
  • If you apply for both matches and you match into
    an osteopathic residency program you will
    automatically be withdrawn from the match. This
    match is a binding contract. Therefore you cannot
    break it to try to match in the M.D. match.
  • If you dont match at a D.O. spot, and you
    applied to both matches, you will then be entered
    in the M.D. match.

Can you participate in both matches?
  • You can match to a D.O. intern year and then
    match into an M.D. program if that program
    requires a prelim year (i.e. anesthesia, PMR,
    path). You will apply to the M.D. match for a
    PGY-2 spot.
  • If you choose to pursue just the allopathic match
    you should withdraw from the D.O. match on
    natmatch.com. There is an option for withdrawal
    that states you will be competing in the M.D.

Can you participate in both matches?
  • There is one exception in regards to residency
    requirements. If you want to pursue an allopathic
    residency in ophthalmology, you MUST do an
    allopathic transitional year.
  • The Ophthalmologic board does not recognize an
    AOA internship year and therefore you will not be
    granted board certification because you failed to
    complete the necessary requirements.

Pre-Match Contractions?
  • Prematches are residency position offers outside
    of the match.
  • Prematches are available to D.O.s and FMGs
    applying to the allopathic match.
  • As a D.O., you can accept a prematch from an
    allopathic residency program. However, if you
    pursue this route, make sure you have a signed
    contract. Do not skip the match based on a
    verbal agreement.

Pre-Match Contracts?
  • Also you may want to have an attorney look over
    the contract for any loopholes.
  • If you accept a prematch, you must withdraw from
    the match.
  • Prematches occur before Jan. 31, which is the
    last day programs have until they have to notify
    the NRMP of the number of seats (quota) available
    for the match

What if you dont match
  • If for some reason you do not match you can
    always scramble.
  • The scramble is a brief period of time that is
    set aside for those applicants who did not match.
    The Scramble gives applicants an opportunity to
    contact unfilled programs and possibly secure a
  • Both matches (D.O. and M.D.) have post-match
    scrambles for applicants who did not match into a
    perspective residency program.

Osteopathic Scramble
  • Students who fail to match initially are provided
    with information on programs with available
    positions for them to contact.
  • Likewise, programs with available positions are
    provided with information regarding unmatched
    students to contact. Thus, opportunities to
    obtain a position may still exist after the
  • Unmatched students may receive emails from
    programs that did not fill.
  • If you have to scramble, go back to your medical
    school in order for them
  • to help you!

Allopathic Scramble
  • Unmatched applicants who submitted a certified
    rank order list will be given access to the
    Dynamic List of Unfilled Programs at 1200 p.m.
    EST on Tuesday of Match Week. Applicants may not
    contact unfilled programs prior to 1200 p.m. EST
    that Tuesday. The list is updated by the NRMP
    every hour to reflect the number of remaining
    unfilled positions.

Allopathic Scramble
  • If you have already applied to a program, but
    that program still has unfilled positions, you
    may contact the program and inform them that you
    wish to be considered a Scramble applicant. That
    program will not count towards your thirty (30)
    Scramble programs on MyERAS. Also, during
    Scramble, you may NOT apply to more than thirty
    (30) programs using MyERAS, even if you wish to
    pay for them.

Allopathic Scramble
  • During this period, applicants who did not match
    to a position attempt to fill remaining
    positions. ERAS is available for applicants to
    apply to a maximum of thirty (30) programs free
    of charge who meet the following criteria
  • The applicant must have participated in ERAS
    during the regular season. This means you must
    have applied to (and paid for) at least one
  • The applicant's account must be paid in full no
    less than two weeks prior to the Scramble period.

Requirements to Start Residency
  • Each residency has its own requirements. There
    are also state requirements that must be
    completed for a training license.
  • When applying through ERAS, check with your
    residency program for the necessary requirements
    prior to the start of residency.

Licensing vs. Board Certification
  • ?

(A.T. Stills original medical license)
Licensing/Board Certification
  • Do not get these two terms confused.
  • Your license is state dependent.
  • Your certification is based on your residency

  • You will be licensed by the state you are
    training in.
  • At the beginning of your residency you will be
    issued a training license
  • By the end of your residency you will apply for a
    full practicing license.

  • When thinking about licensure there is one
    special caveat all osteopathic students need to
  • There are 5 states that require an osteopathic
    internship or its equivalent for licensure
    purposes. (PA, MI, WV, OK, FL)
  • Without this internship year, you can NOT train
    or practice because you will be denied a license
    from the associated state osteopathic
  • There are options, which we will get to later.

  • Your certification is based on your residency
  • If you pursue osteopathic training you will be
    boarded by an affiliated osteopathic board
  • (i.e. IM will be boarded by the American Board
    of Osteopathic Internists ABOI)
  • If you pursue allopathic training you will be
    boarded by an affiliated allopathic board
  • (i.e. IM will be boarded by the American Board of
    Internal Medicine ABIM)
  • States have no regulation over your certification

  • Should you choose to train in an allopathic
    residency program or practice in those 5 states
    and you are unable to complete an osteopathic
    internship year, you can seek to get approval of
    your first year of residency.

Importance of AOA Certification
  • You can't be a COM Dean, Program Director, or DME
    without AOA certification!

Resolution 42
  • If you decide to pursue an allopathic residency
    program there is a path you can pursue to get AOA
    approval of your intern year.

What is this Resolution?
  • Some students who pursue allopathic training will
    mention Resolution 42.
  • This is a resolution created by the American
    Osteopathic Association to help osteopathic
    physicians remain connected to the AOA.
  • These resolutions require certain criteria to be
    met during the intern year.

History of these Resolutions
  • These resolutions began because the number of
    graduates of colleges of osteopathic medicine
    out-numbered the available osteopathic residency
  • In 1986 Resolution 65 was developed. The AOA
    allowed graduates from the classes of 87-89 AOA
    approval of their first year of training as long
    as they participated in the AOA match, but did
    not match and then pursued ACGME training.
  • In 1996 the AOA replaced Resolution 65 with
    Resolution 22.

History of these Resolutions
  • Resolution 22 allowed AOA approval of the first
    year of ACGME training if there were special
    circumstances and if the applicant completed the
    rotational requirements of an osteopathic
  • In 1998, Resolution 19 replaced Resolution 22.

History of these resolutions
  • Resolution 19 did not require an osteopathic
    curricular component for approval.
  • In March of 1999, the AOA suspended Resolution
  • In July of 2000, the AOA passed Resolution 42.
  • Resolution 42 was designed to clarify the meaning
    of special circumstances. It also required a
    commitment to osteopathic principles and practice
    and it allowed current and past trainees a route
    for AOA approval.

Resolution 42
  • Resolution 42 is the latest idea created by the
    AOA for approval of the first year of ACGME
  • Resolution 42 "Approval of ACGME Training as an
    AOA-Approved Internship" is a policy to grant AOA
    internship approval for appropriate ACGME

Resolution 42
  • Like previous training approval policies, the new
    "Approval of ACGME Training as an AOA-Approved
    Internship" policy maintains a consistent theme.
    That is, to be eligible for AOA internship
    approval of ACGME training the osteopathic
    physician must complete all six of the
    traditional rotating internships core rotations
  • 2 months internal medicine, 1 month emergency
    medicine, 1 month family practice, and two
    additional core rotations (internal medicine,
    surgery, OB/GYN, pediatrics, family practice, or
    emergency medicine) so that a total of 6 months
    in these core rotations are completed.

Resolution 42
  • Unlike previous policies, the new "Approval of
    ACGME Training as an AOA-Approved Internship"
    policy responds to the needs of current and past
    trainees who have completed their first year of
    training in an ACGME-accredited program.
  • Like the superceded Resolution 19, special
    circumstances must be present to request approval
    of ACGME training as equivalent to an AOA
    internship, as indicated in Resolution 42.

Changes in Resolution 42
  • Special circumstances has been Eliminated!

Results of Resolution 42
  • Not everyone that applies for Resolution 42 is
  • As of November of 2005, a total of 937 applicants
    have applied under Resolution 42.
  • 557 (men), 380 (women)
  • 544 applicants received approval (58)

Resolution 42
  • For more information regarding Resolution 42, you
    can call the AOA Division of Postdoctoral
    Training at
  • (800) 621-1773, extension 8276.
  • Bulger, J. Approval of ACGME Training as an
    AOA-Approved Internship History and Review of
    Current Data. JAOA. Vol. 106 (No. 12). Dec.
    2006. 708-713.
  • You can also check out the AOA website
  • https//www.do-online.org/index.cfm?PageID

So what does this mean?
  • Resolution 42 will allow approval of an
    allopathic intern year to be counted as an
    AOA-approved internship year.
  • This will allow students to pursue training or
    practice opportunities in the states (PA, Fl, WV,
    Ok, MI) requiring the osteopathic internship.

Additional Requirements for Resolution 42 Approval
  • The trainee must be a member in good standing of
    the AOA.
  • Trainees are responsible for negotiating
    rotational changes with their programs.
  • A trainee may attend an AOA annual meeting, state
    osteopathic annual meeting, specialty college
    annual meeting or prepare and conduct an
    osteopathic clinical presentation to satisfy the
    educational activity requirement.
  • All osteopathic clinical presentations are
    reviewed and subject to approval or disapproval
    by a representative of the Program and Trainee
    Review Committee.

Miscellaneous Info
Can an Osteopathic Trained Resident obtain an
Allopathic Fellowship?
  • YES!

  • Can an osteopathic physician who has ACGME Board
    Certification bill for treating patients with
  • YES!

What to do with this information?
  • Although it may seem overwhelming now, keep this
    PowerPoint presentation tucked away in a safe
    place until you are beginning your 4th year,
    which is when I hope it becomes a very valuable

  • The goal of this lecture is not to persuade any
    osteopathic medical student to pursue any
    particular specialty, residency program or
    D.O./M.D. postgraduate training. The purpose of
    this lecture is to help you make an informed
    decision. The information in this lecture is
    subject to change!

For more information
  • www.do-online.org
  • Here you can find the list of D.O. residency
    programs go to For Students then Opportunities
  • http//www.ama-assn.org/ama/pub/category/2997.html
  • Freida online listing of M.D. residency programs
  • go to Residency/Fellowship Training Program
  • http//www.mdsecrets.com

For more information
  • www.scutwork.com
  • A peer review of residency programs
  • www.studentdoctor.net
  • A students/resident online forum
  • Iserson, K. Getting into a Residency A guide
    for medical students
  • Desai, S. The Residency Match 101 Biggest
    Mistakes and How to Avoid Them

Contact Information
  • Draion M Burch, DO
  • Region III Trustee
  • Council of Interns and Residents
  • Vice Chair Intern-Resident Committee
  • Michigan Osteopathic Association
  • Resident Representative Board of Trustees
  • American College of Osteopathic Obstetricians
    and Gynecologists
  • Dept of Obstetrics and Gynecology
  • Statewide Campus System
  • Michigan State University College of Osteopathic
  • St John Health System Osteopathic Division
  • Macomb-Oakland Hospital, Macomb Center
  • dr.draionmburch_at_gmail.com
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