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Ниже описан мой опыт участия в матче 2006-2007. Часть информации (большая:)) приведена на английском, остальное по-русски. Не обессудьте, времени нет делать в едином стиле. Я опускаю очевидные вещи (типа "что такое матч") - если вы дошли до этапа участия в нем, знаете и так. Если нет, не тратьте время, узнаете потом. Для начала эссе по поводу матча в целом, потом подробности и частности. Если что-то совсем не понятно, пишите, отвечу по мере сил. Не забудьте посетить полезный форум http://www.russiandoctors.org/forum/index.php - там приведены ответы на большинство часто задаваемых вопросов.
Everything is possible (my match story):
First i/v –freaking out with almost happy end:)
The second i/v - (Allegheny, Pittsburg)
Everything is possible (my match story)
“What the hell are you thinking about??” – I asked myself
one hundred times even before applying to the match 2006 - “With such
credentials you can hope only for a rustic preliminary IM or FP program in the
middle of nowhere if you are very very lucky”.
Here we go:
Scores: 76/186, 92/226, passed (ECFMG certified, Sept 2005), 81/199 – pretty
miserable except for step 2; besides, I applied without step 3 results (I set
for it in Dec 2005 only).
Old grad (1997);
USCE – 0;
American/Canadian LORs – 0;
Visa status – 0, meaning I need J1 (or H1B which is highly unlikely).
Chosen field – pathology (not very competitive but there are only about 545
first-year positions all around the States).
I’ve matched somehow and here is the whole story with my suggestions and
comments.
Steps
3 years ago I was planning to move to NZ, and fortunately New Zealand Medical
Council required step 1 and step 2 before sitting for NZREX (now NZREX is not
necessary if you have an ECFMG certificate). They don’t care about scores and so
didn’t I: in spite of everybody’s advice to aim for the better result I was sure
that 75 will be fine. I’ve got even more, 76:). I was very happy that time (and
still pretty cool with it:)) but it caused me some problems later while choosing
the residency programs: a lot of them had 80 min cut-off. What about NZ?
Immigration rules have changed so I switched my course to the States.
Positives: I skipped reading at least 10 recommended books and saved some money
on Kaplan q-bank (just a joke, don’t take it seriously).
Conclusions:
1. Never say never:).
2. Try to get 85 on step 1 and 90+ on step 2 just in case;
3. Never ever give up if you got less than 80! Nothing is lost yet, you still
can get a desirable position!
Step 2 was much easier for me – it’s clinical; besides, I decided to get a bit
higher score and even read most of the high-yield books. I’ve got 92 without
doing Kaplan q-bank and UW.
Clinical Skills was even better than step 2 (more interesting) and Step 3 isn’t
worth mentioning at all.
Conclusions:
It’s possible to pass all exams living in Russia, working full-time and doing
everything else (travelling, volunteering + the rest of my hobbies). If you have
an option not to work and study whole day long – fine, if not – no panics,
you’ll do it anyway! Moreover, what are you gonna write in your CV? “I spent 2
years for my exams?” I’ve heard many times that nobody cares about non-the US
work experience… Ok, if you have several months of USCE – great, you’ll be
talking about it on your i/vs but if you haven’t? My opinion: any medical work
experience is better than nothing.
Old grad
Fortunately there are plenty of programs in different specialties with 10 years
after- or no cut-off at all. Everybody has different opportunities and if you
came to USMLE by the age of 30 – it’s fine, no worry and sweaty hands. We have
some knowledge, skills and great stories to tell:).
USCE
Helps a lot as everybody says. How to get it living in Russia without any
connections with the American medical world? If I hadn’t matched I would have
written to all programs there I was on-hold and had i/vs + the rest IMG-friendly
there I forgot to apply asking for a month of observership. You can try the same
approach before applying to a residency and probably you’ll be invited
somewhere.
LORs
I had one LOR signed by the director of Human Morphology Research Institute
where I attended all possible CME courses. Since I couldn’t sit still staring my
microscope, he remembered me well and agreed to sing the letter.
Another LOR was from the head pathologist of the West administrative district of
Moscow. There are not many pathologists in our district, so he knows me well.
My third and probably the best one was from my volunteers organization –
Malteser Hilfsdienst, Moscow branch (Order of Malta Ambulance Corps) signed by
the medical director.
I’ve got the fourth one from the American Red Cross in Feb 2006 (I was preparing
for the match 2007:)) but obviously I had no opportunity to use it.
All LORs (except for the Red Cross) have been written by myself and checked by a
literate native speaker, the guys only signed them (two of them can speak both
English and German but they were busy to write).
Application
I applied in Sept 2005 to 50 patho- programs and at the same time registered on
Step 3.
I’d made a lot of mistakes…Number one: “wrong programs” like Mount Sinai or
Emory. Yep, all of them gave me their requirements (nothing special) but I
should have made some research on them – they are too good for me. I could have
saved a handful of money not applying to at least 10 out of 50. I also
discovered an interesting thing about NYC programs: they don’t sponsor any
visas! The same thing was with West Virginia: “your credentials are ok for us, I
like your PS but we don’t sponsor any visas. Get a Green card, apply next year”.
Sure, ma’am, I know one shop at the corner of the street where Green cards are
sold 100 bucks each… I wrote to all of them before applying, said that I need a
visa, and nobody told me that they don’t sponsor it. Number two: I missed such
“shitty” programs like St. Barnabas, Hovard (actually nothing is wrong with
Hovard – I spent whole day there), etc. No kidding, I’d rather had gone there
than to IM prelim.
BTW, about the back-up: against all good advice and common sense I didn’t apply
to IM or FP. I was ready to try it for the post-match but in September 2005 a
thought about it was killing me. You ask me why? I couldn’t imagine me spending
at least one year doing a job am not interested in anymore.
Outcome: I’d got 2 i/vs out of 50 + 4 on-holds till the end of the i/v season
with the letters “if we have slots during post-match and you are still
interested, we’ll give you our full consideration”. I was touched:).
Conclusion:
1. Proper research on programs saves money. Start it early, in spring-summer;
use Freida on-line, scutwork.com, don’t be lazy to read programs sites,
residents’ forums and write them a letter asking application requirements. Be
sure to mention your scores, graduation year, visa status but keep it short and
simple.
2. I guess a number of programs after the third ten won’t increase you chances
for getting into a residency.
3. Don’t panic while waiting for the invitations: i/v season in patho- and
general surgery starts a bit later then in other fields. IM and FP send
invitations starting in Sept.
4. “On-hold” means rejection and nothing else.
5. Back-up (IM, FP) is a good idea, think it over; I decided against it but
nobody guarantees that you’ll be as lucky as I.
Interviews
I publish my stories in the way they were presented on the forum (see bellow).
Nevertheless,
I want to add some details.
Mention everything in your CV and CAF (common application form): work
experience, volunteer experience, awards, English proficiency (I have a valid
IELTS certificate, passed it for NZ), CME, professional societies, hobbies. You
can laugh and think that I have gone crazy but hobby section helps a lot:). On
my i/vs apart from the standard stuff we were talking about my Moscow work
experience, my volunteering and my hobbies! Everybody was really interested
which countries I’ve been in by bike, how off-road races look like in Russia,
what is geocaching (or how it looks in Russian version – I met 2 players); they
asked a lot of questions about my truck, about British Council writing award, am
I good in English writing (unfortunately, not:((), about travelling suggestion
for Iceland, Copenhagen, Russia, etc. They were interested what I’d seen in the
States and a story about the Blue Ridge Parkway summer trip from the beginning
to the end by car impressed them enough (the same thing with Niagara Falls in
winter:)). What else could I discuss?? I have neither USCE, nor Phd with
publications… Whatever, at least they remembered me, and don’t forget that your
task is to be the center of attention:). My friend Alec said once: “I don’t know
that much about medical i/vs but in general a big part of it is not about skills
and knowledge but about personality, and your personality is quite remarkable,
believe me, Helen”:). Probably he was right:).
I’ve heard many times that i/v is not that important, that the selection process
had been made beforehand, that programs invite IMG like I only because they are
obliged to do this. Even if it’s true, you can change a lot during an i/v, am
sure; so don’t screw it up!
First i/v –freaking out with almost happy end:).
Disclaimer: guys, I believe my experience will be in no
help for the most of you - am a real loco, you know that:)). However, if you have
q-s towards me, feel free to ask.
I’d never felt so nervous before especially considering the fact that am not a
freaking out person.
12 of Dec,
5 am – sleep, stupid you
6 am – shoot, it’s still too early to get up…
7 am – ok, I’d better get up, I need a cup of coffee
8 am – a phone call, it’s my friend Alec: “Helen, how are you?” – “Are you
kidding?? Am panicking, I forgot what I am supposed to tell, I forgot all
English, I…” – “Helen, do you still have a paper with answers “tell me about
yourself”, “where do you see yourself in 5 years” and so on?” – “yep, it’s in my
pocket” – “return to your room, write a bit more, read it loudly in front a
mirror, then throw it out and go to you interview” – “Alec, are you crazy???” –
“Just do what I said, ok? I’ll call you at 9.30, you must be at Albany Medical
center by that time. Got me?” – “Ok, as you say”. I did (I know that we are both
nuts:)) and surprisingly felt a bit better.
9.30 – Albany medical center, a phone call – it’s Alec: “Helen, how do you
feel?” – “Fine, am not nervous anymore. Whatever, I don’t care.” – “Do you know
what questions to ask?” – “Yep” – “Tell me” (told all I could invent) – “Do you
remember all “don’t’s?” – “Yep, don’t interrupt, don’t say “of course I know”
then asked something” – “Helen, just be yourself, and you’ll do fine. Give me a
call after it’s all over” – “thank you, Alec, I’ll do”.
9.45 – chatting with a program coordinator, a nice and pleasant women. I guy
(appeared to be Dr. David Jones) came in. “Hi, Elena, could you please tell me
your last name one more time?” – Told him and added: “Just call me Dr.B or
Helen” – “O, we call our program director like that so you’ll be another one.
Ok, are you ready?” – “Yep”. First q-n he asked: “I read from your cv that you
are fond of mountain biking and know how to use GPS. What else do you do in your
free time?” Told him about my volunteering and the rest of my hobbies and he
spent 15 min describing outdoor activities in Albany area:)). We chatted a bit
about rock climbing and snowboarding then he asked me if I had any q-s about a
program. I asked 5 or 6, pretty specific, he became exited, spent 10 min
answering then asked me “tell about yourself” and “where do you see yourself in
5 years” but not in a straight form. He also asked in what fellowship am
interested, am I good with computers (fortunately yes:)) and some professional
q-s. We ended up discussing my trip to Niagara falls and he even came at the end
of my I/v day when I was gathering my stuff and said: “Helen, Niagara falls!
Don’t forget to program your GPS and drive safely” (I didn’t tell him that am a
reckless driver, he just asked me how many hrs It took to come from MD to
Albany:)). Then he introduced me to Dr. Foulke and asked him to give me
suggestions about hiking in Niagara region. We discussed that hot topic, than
talked about gestational trofoblastic diseases, endometrial pathology and
program details. After that I was introduced to Dr. Aida with 2 last names (I
forgot them). She asked me why I decided to come to the States, about my
clinical pre-pathology background and after we talked about pathology manuals,
board exams, and my Moscow work experience. Before a lunch time program
coordinator asked me about my impression and said that if I am really interested
in program I must tell that openly to a program director. Lunch was a lot of fun
– all guys were friendly, with good sense of humor, answered all q-s we had and
then showered as all patho- facilities, even a frozen section room in OR. After
I talked to a chairman and PD – they both asked me how life in Moscow has
changed since early 90-s, what I think about Khodorkovsky case and tons of
professional stuff + am I ready to move to Albany, how long I’ll be in the
States that time, what type of visa I prefer, do I like winter, am I ready to
live in small community and so on.
Overall impression: the guys looked through my papers very carefully. I was
asked about every single line in CV, including ICU experience, volunteering and
hobbies. They even remembered that I gave an address in MD and all of them asked
about my friends I currently live with. Everyone asked what programs I applied
to, what I/v I got and what I/vs I expect in Jan. Everyone asked a lot of q-ns
about my Moscow patho- work. Everybody (even residents) were interested what I
think about living in a small community and how do I like winter:)). All of them
said that my English is good and asked me where and how I studied it. (The guys
just tooo polite:)). Unusual q-s (apart from the US traveling and outdoor
stuff):
- Can you drive on manual transmission? (much better that on automatic:)).
- What countries have you been in?
- What’s the weather in Maryland right now? (We laughed a bit about closed
schools because of 1 inch of snow:))
- What are your plans for X-mas?
I liked that place very much, but have no idea how are they gonna rank me.
That’s all am pretty tired (several hrs of driving +snowing + darkness) so
cannot remember anything else right now.
The second i/v - (Allegheny, Pittsburg)
It was a long day full of strange situations, anyway, I
had some fun as usual:).
I thought I would miss it – traffic in Pittsburg is much like in Moscow and it
was raining; I had to drive about 8 miles but it took about 1 hr! So am sitting
in the car with zero thoughts and blank mind and of course my friend Alec calls:
“Helen, what’s up?” – “Sky is up! Am stuck on this fucking so-called freeway and
I’ll never be in time” – “Do whatever, get a speeding ticket, but be in time or
you’ll ruin your interview. And Helen, have you heard a weather forecast? I
don’t want to scare you but driving back home to MD today will be tough so my
suggestion you’ll stay in Pittsburg for tonight” – “Alec, I want to come back,
am a bit tired of traveling and need a brake” – “Ok, we’ll discuss it later.
Relax, you still have some time”. My first talk with PD was scheduled at 8.30
and I appeared at her office at 8.27:). It’s not like in Albany – nobody’s gonna
meet you so I spent some time asking everybody where is the third floor of the
south tower because nobody knew where is Patho- department:). The i/v was
completely different from Albany. I talked to 12 faculty members, and the worst
meeting was when 3 guys were questioning me simultaneously – I was under
pressure whole 30 min. “Let’s check what is your IQ” – “Ok, what scale do you
prefer?” (I know I shouldn’t have told that:)) – “Pardon?” “What would you do if
I am your attending and we are looking through the slides and I say “it’s
gastritis” and you are sure that it’s carcinoma” – “I’ll explain you my concerns
and reasons and ask somebody for the third opinion” – “I am your attending!” –
“Ok, in this case you’ll sign the report and it will be your responsibility. I
simply don’t know how things work in the States in this case” – “Leave her
alone, she said everything fine” (it was the only one nice doctor at this
meeting) – “What would you do if you are not sure if a tumor is benign or
malignant” – “I’ll ask the second opinion” – “You asked 2 guys and got 2
different results” – “So it’s like in the “Final Diagnosis” book by Arthur
Hailey?” (I know I shouldn’t have told that:)) – “Pardon?” – “Yes, just go
ahead” (it was a nice doctor) – “Ok, in this case I’ll make my own decision”. –
“What’s your energy level?” – “Am a Russian Rocket” – “Tell me more about your
personality?” – “Am incredibly bright” (After some point I didn’t care about my
answers that much). There was a Russian Fellow and she helped me a lot giving me
warnings and suggestions, she also talked to me by phone afterwards and said
that at least half of the faculty members liked me (and I liked them) and they
are gonna include me in the match list (they have 40 people for 3 positions, 80%
of them are Americans). Overall impression: I liked Albany more but this program ain’t no bad either. My last talk was just hilarious: a nice black woman asked
me about St.-Petersburg traveling suggestions, my hobbies, listened to a couple
of my stories and then reminded me about a snowstorm: “If you change your mind
about going back to MD, you can stay with me for tonight” – “Thank you very much
but I’d rather drive today” – “It’s about 300 miles and it’s snowing heavily” –
“It’s ok, my car sacks, but I’ll be fine” – “You are not scared of driving, are
you?” – “Not at all” – “You are always in trouble, aren’t you?” – “Well, you
figured it out – am always very close to it, but I always escape it” – “Let’s go
to PD for a final talk” – and she persuaded PD to allow me going 1 hr earlier
skipping 2 last appointments. Well guys, I thought I would never come back.
Before I’ve driven in snow 1000 times but on 4x4 and sometimes with low gear:).
I spent 8 hrs for 300 + miles, I was stuck in all traffic-jams (there were a lot
– overturned trucks, crashed cars), I practiced blind driving about 100 miles,
cause bloody renting company left water instead of alcohol for windshield
cleaning and the result was awful – I couldn’t see anything at all and drove
with an open window from time to time. I was close to overturning several times
but fortunately I know how to handle a car in this situation. Things became
easier in MD – it was raining but the road was clear. Alec was nice enough to
pick me up at BWI where I dropped the car. He was very surprised that I came
home in one piece:). Uf, I need a small brake and on Mon I’ll start calling the
rest of the programs - who knows, probably I’ll get a couple more.
Twilight zone
I had my own one after I was done with all i/vs, got my step 3 results and
basically had nothing to do except for calling on-hold programs every week, the
Red Cross stuff (not every day), some writing and entertaining myself and my
American friends in all possible ways. It wasn’t fun all the time. I was
worried, depressed and desperate many times, chain smocking and listening to the
most depressive music I could find. A little bit more and I would have started
singing my own blues and drinking cheap whisky before noon:). My friends and
relatives had great expectations for my residency and I couldn’t put up with a
thought that I’d failed. Fortunately I always could call two rescue numbers: my
best friend in Moscow and Alec in the States were pretty successful as
psychotherapists:). The culmination of my misery came on 31st of Jan when I
found out that a program where I had a chance withdrew itself from the match. I
spent a couple of agonizing hours but my friends managed to fix my brain rather
quickly: “It’s not the end of the world. You still have a chance this year even
with one program. If not, you’ll try post-match; the worst case scenario: you’ll
try next year with you best friend applying to IM as well”. Alec, you don’t
understand, I’ll loose 1 year, my profile won’t be better and I don’t want IM!!!
“Calm down! Who cares what you want or don’t want? You swim or sink, hon. You’ll
pull through it – I know it, and more important, you know it. And Helen, if it
helps, you can crash my car after a dinner tonight”:)).
Lina told me exactly the same, but in Russian and without a car crash offer:)).
Moreover, she made me promise not to drive at all that night:). No kidding after
talking to them I indeed calmed down and started thinking over post-match,
observership and other match-related stuff.
Happy end
So I came back to Moscow, wrote follow-up letter to both programs, submitted my
ROL with the only number 1 and started preparation for the post-match.
Fortunately, I didn’t participate in it. I’ve matched.
I was asked several times recently who helped me. O, a lot of people: my
friends, my relatives, forum members! Guys, thanks a lot!!!! Poor Alec and Amy
(his sister) suffered more than everybody:). They’ve learned everything about
the US medical residency. However, Alec was pretty well-informed about the match
game cause he has a friend who is a resident in pediatrics:).
“So, they hired a Russian Rocket!” – They’ve made a mistake, Alec, but they
don’t know about it yet. – “They’ll find it out pretty soon:). Poor Allegheny
General! Helen, we are very proud of you, Amy and I.” – Thanks, Alec! You know,
it’s your match too… – “C’mon, Helen, don’t make me blush! Just don’t forget
about me when you win your first national writing award”:).
According to NRMP Stat (www.nrmp.org):
out off 525 PGY1 positions offered in Pathology 315 (60%) were filled by
the US seniors during the main Match with median number of positions in every
AMG applicant Ranking List (ROL) 4,3 (the last number is the most important:
it's actually the number of interviews an applicant should get, successfully
pass and put in ROL for >90% success guarantee in Match).
For ALL applicants including IMGs the magic number was 7,2 (although it's still
possible to match with just one interview ).
For comparison:
-the least competitive Family practice: 2711 positions; 41,1% filled by AMGs;
numbers for AMGs and all other applicants are 2,6 and 6,2 respectively.
- Anesthesia (highly popular among all groups of applicants): 552 positions
offered; 451 (81,7%) filled by AMGs; numbers are 8,2 vs, 10,3.