31 Do’s and Don’ts for Writing a Medical School Personal Statement
by: Mohammad O. Hussaini,MD
Do’s of Writing a Medical School Personal Statement
1. Be concise.
2. Be unique.
3. Be concrete. Show; don’t tell.
4. Have a theme.
5. Start early.
6. Have friends and family look over your essay.
7. Have your essay professionally edited.
8. Address any weaknesses or irregularities in a succinct, effective manner when possible.
9. Be positive.
10.Be mature and dignified in your writing style.
11. Get to the point.
12. Be interesting.
13. Subtly highlight your achievements. State them; don’t harp on them.
14. Explain any transitions in your life (such as going from a corporate job to medical school).
15. Brainstorm for a long time before writing.
16. Keep the grammar and punctuation flawless.
17. Try to spin negatives into positives without dwelling on them.
18. Write in active voice, e.g., “Completed reports” instead of “Reports were completed.”
19. Stay focused on one thing at a time.
20. Use stories when you can.
21. Try to get a physician to look over your personal statement.
22. Contact the admissions officer at the medical school(s) to which you are applying,
and get their input as to what they are looking for in a candidate.
23. Include wording that reflects the input from #22 above, in your personal statement.
24. Come up with an outline before writing the personal statement.
25. Revise your essay several times before submitting.
26. Even if your life is just plain blah, try your best to give it a fresh angle. Market, Market, Market.
27. Make sure your essay flows and is easy to read.
28. Be personal.
29. Demonstrate diversity, interest, honesty, commitment, compassion, drive, sensitivity and/or enthusiasm
in your essay if you can. Medical schools are looking for these qualities.
30. Close with your paragraph that summarizes the essay and ties in everything.
31. Be YOURSELF! (This is what the admissions officers repeatedly request from applicants).
Don’ts of Writing a Medical School Personal Statement
1. Don’t exaggerate.
2. Don’t make up information.
3. Don’t wait until the last minute.
4. Don’t make excuses.
5. Don’t put down other applicants.
6. Don’t brag.
7. Don’t use the personal statement as a comedy forum.
8. Don’t use clichés.
9. Don’t be general.
10.Don’t be too philosophical.
11. Don’t be vague.
12. Don’t try to use language or vocabulary that is unfamiliar to you.
13. Don’t rewrite your CV or resume in prose.
14. Don’t bring up negatives for which you don’t have a positive explanation.
15. Don’t make your personal statement one long story.
16. Don’t come off as too naïve.
17. In trying to be unique, don’t come across as weird.
18. Don’t get into controversial topics.
19. Don’t copy someone else’s essay.
20. Don’t submit your personal statement without thorough editing.
21. Don’t rely solely on Microsoft Word’s spelling and grammar check.
22. Don’t be fake.
23. Don’t mention that the real reason you want to go to medical school is to make a lot of money
and drive a nice car.
24. Don’t fail to let the real you shine through.
25. Don’t include too much information about high school achievements.
26. Don’t forget to include references to research projects and publications in which you have been involved.
27. Don’t include information that you will have difficult substantiating during an interview.
28. Don’t start your essay with, “I want to be a doctor because….” or end your essay with, “In summary
…” or “In conclusion…”
29. Don’t be afraid to start over if the essay is just not coming out right.
30. Don’t be cute.
31. Don’t underestimate the importance of your essay in the admission process.
References:
http://www.uic.edu/depts/mcam/osa/careers/index.html
http://www.bestpremed.com/essayedge/lesson1.htm
http://education.yahoo.com/college/essentials/articles/med/medicalschoolessaysecrets.html
http://www.ama-assn.org/ama/pub/category/6700.html
http://owl.english.purdue.edu/handouts/pw/p_perstate.html
http://www.stanford.edu/group/spa/admit/pstmnt.html
Interviewing for Residency Programs
When you apply to residency programs through the Electronic Residency Application Service (ERAS), the programs will review your application, and if they are interested in you, they will extend an invitation to interview. The program will offer you a list of interview dates and ask that you choose one according to your schedule. If you choose a certain date and an unforeseen circumstance or scheduling conflict arises, you can generally call the program, explain your situation, and reschedule (if you do so early enough). Also note, the earlier you apply through ERAS, the greater flexibility you will have to schedule interviews.
You can expect a 40 to 60 percent interview rate (the number of interview invitations divided by number of programs to which you applied). However, this figure will vary depending on the number of programs to which you apply, the specialty indicated, and your qualifications.
Interview season starts around late September and continues into January and February. It is a myth that interviewing early is not advantageous. However, if you do interview early, it is a good idea to touch base with the program directors around the time they start drafting their rank-order lists. You can do this by revisiting them, writing a thank-you card (which you should do invariably), sending an email, or calling them to re-express your interest in the program.
The interview process can be quite draining. To interview effectively, you will need to strategize. Try not to schedule back-to-back interviews. Not only will your clerkship attendings dislike it (assuming you’re on a rotation at the time), but more importantly, you might not be able to bring much-needed energy and enthusiasm to each interview. Try to interview at your top-choice programs toward the middle of the interview trail. This way, you’ll already have some interviews under your belt, so you’ll know what to expect. Try to schedule interviews in the same geographic area together, as travel and hotel costs add up really fast.
Before the interview, make sure you do the following:
1. Acquaint yourself with the program. You don’t want to be an expert, but you should know what is on the departmental webpage.
2. Acquaint yourself with interviewers. Sometimes you will be given the names of the individuals with whom you will be interviewing.
Do some research about them the night before. Run a Google Scholar or PubMed search and see what they have published. Go through
the abstracts. If you don’t know your interviewers, at least try to know about the program director and department chair.
3. Develop rehearsed answers to questions that you anticipate are going to be asked.
4. Make a list of questions you are going to ask.
5. Keep your CV, personal statement, transcripts, printouts of the department webpage, and other information together in a folder.
6. Make sure all your clothing is ready.
7. Know your CV cold. If you published something years ago, go over the materials and be ready to discuss it during interviews.
On interview day, you want to dress professionally. Err on the conservative side if you are not sure (blue, black, or charcoal suits). You will generally arrive around eight a.m. to your interview. It will take all day, so be prepared. Most interview days begin with a welcome and an introduction to the program. Throughout the day, you will be interviewed by a series of attendees, the program director, and sometimes the chair of the department. Most interview days incorporate a tour of the facilities and lunch with the residents.
So, what will the interviewer ask you on interview day? There is no formula, but certain questions are so common that you should be prepared for them:
1. What led you to this field in medicine?
2. Why our institution?
3. Tell me about an interesting case.
4. What are your plans for the future?
5. What are your strengths and weaknesses?
6. You may be presented with an ethical dilemma and asked to proffer a solution.
7. What is your research background?
8. Where do you see this field in the future? What trends are there in the field? (Interviewers will try to assess interest
in the field by how much you know about it, you probably won’t be asked clinical questions, thought this does happen
on occasion.)
9. Tell me about yourself.
10. What do you like to do outside of medicine?
During the interview process, try to be as positive, enthusiastic, and professional as possible. Be nice to everybody, from the department chair to the secretary. Take notes as you go along; these will serve you in the future after you have interviewed with 30 programs and can’t remember who’s who and what’s what. During the interview, you will be evaluated on the basis of your reliability, commitment, motivation, communication, knowledge, clinical track record, and organizational skills. If asked inappropriate or illegal questions (regarding marriage plans, age, religion, or the like), try to finesse your way around the question (e.g., “I’ll have to give that more thought,” or “I’m still contemplating that issue in my personal life,”). You cannot tell the program how you are going to rank them and vice-versa, but both parties can express strong interest in each other. Make sure you don’t tell them exactly how you are going to rank them, as this is a violation of NRMP regulations.
While at the interview, you will be prompted to ask questions after they are done grilling you. Ask good questions, such as the following:
1. What is the future of the program? Where do you see it ten years from now?
2. Describe to me the culture and work environment at the hospital. How do you work together?
3. What research and learning opportunities are available for residents?
4. What type of access do residents have to attendees?
5. If you were an applicant, what would draw you to this program? What is unique about this program?
6. What are the strengths and weaknesses of the program?
7. What do graduates go on to do? Do they have difficulty finding fellowship spots?
8. How do residents perform in service exams? How do residents do on boards?
9. Ask about anything you are confused about or anything you want to know more about the concerning program.
At the interview, make a good first impression. Be confident and don’t ramble. Smile a lot! Come across as the type of person that they would like to spend the next three to five years working with. Don’t put down other programs or applicants. Pay attention. Thank the appropriate people as you leave. After the interview, send a thank-you note to the program director and other key decision makers.
If you make any significant changes to your CV after you interview at a given program, don’t hesitate to pass that information on to the program director. Doing so brings you, the applicant, back to the program director’s mind and reconfirms your interest in the program.
The interview is one of the most integral components of the residency application process. Don’t shortchange yourself. Prepare. Practice. Perform.
Alphabet Soup: The ABCs of the USMLE Step 1
By: Samir Mehta, MD
All medical schools require passing the USMLE Step 1 as a pre-requisite for graduation, some even before entering into clinical years. Successful completion of the examination as part of the licensure process is designed to ensure a solid foundation for the safe and competent practice of medicine.
There are multiple resources to help prepare medical students for the USMLE Step 1. The resources used are dependent on multiple factors, including study habits, most comfortable style of learning, cost, ease of use and familiarity with the resource. For example, if a student requires structure and a focused environment, a Step 1 Review Course could be taken. A course like this would require a focused review on a daily basis for eight to ten hours every day, based on a curriculum created by the course director or the company offering the course. On the other hand, review sources purchased during medical school (Step-Up, BRS, NMS, etc.) could be used again to re-assimilate knowledge already learned during your courses. In the end, you should always remember your ABCs for the USMLE, which are:
A – Assess each question thoroughly before answering, as there are distracting answer options among the multiple choices.
B – Basic science, despite the “clinical vignette” style of each question, is still the focus and mainstay of the USMLE Step 1.
C – Comprehensive review sources (like Step-Up and Step-Up to the Bedside) provide an excellent way to bookend your studying, and are also useful for your coursework during the first two years of medical school.
D – Distracting answers are common on the USMLE. There is only one correct answer. However, almost every question has at least one other answer that could be correct if the question was altered. Be careful.
E – Exercise and take time for yourself while preparing for your USMLE Step 1. Even though it is imperative to stay on schedule while studying, part of your schedule should include time for yourself.
F – Feedback during mock tests and from annotated answers can provide some information as to your performance; however, no resource mimics the USMLE Step 1 completely.
G – Get a good night’s sleep prior to the examination.
H – Holidays (particularly those around New Year’s or during the Winter Break) are a good time to get organized and create a study schedule.
I – Images on the examination are often not of high quality, but they will be pathognomonic and will only portray the most typical feature of the clinical scenario being tested.
J – Justify each answer with facts from the body of the vignette rather than guessing wildly. Usually, three of the five answer options can be eliminated without significant difficulty.
K – Keeping good notes in a comprehensive review book will make studying and reviewing material easier and also improve recall.
L – Listen to the advice of those from your medical school who have taken the exam, as they are the most useful resource in terms of planning and emphasizing your studying.
M – Manage your time during the examination. There are seven 60-minute blocks with 50 questions each.
N – Nervousness is a natural emotion prior to the examination.
O – Obvious answers may not always be right. Read and re-read the question prior to choosing an answer.
P– Pay attention during the first two years of medical school. It will be difficult to learn new material the last few weeks prior to the USMLE.
Q – Questions. Questions. Questions. While no resource directly and adequately replicates the style and design of the NBME questions on the USMLE Step 1, doing practice questions can help convey knowledge and “get you in the mode” of answering questions.
R – Review resources that you are familiar with or have used over the course of medical school to prepare for the USMLE. Using brand new resources or review books right before the USMLE can cause more confusion and take more time.
S – Stay on schedule. Once you prepare a board review schedule, particularly for “crunch time” right before the USMLE Step 1, stick to it. Make sure your schedule is realistic and that you cover all of the subject areas (either systems-based or subject-based).
T – Time yourself during a simulated examination.
U – Understand the material rather than memorizing it.
V – Vignettes are the format in which the questions are asked. While they have a clinical spin, the root of the question within the vignette is still basic science.
W – Wrap up your block of studying with a comprehensive board review book (e.g., Step-Up).
X – X-rays, color plates and graphs will be additional information presented on the examination to answer questions. Often, the question can be answered without the image, and the image can be used to confirm your answer selection or eliminate other incorrect answers.
Y – Years later, the USMLE Step 1 can play a role in obtaining interviews for residency, so try and do the best that you can.
Z – Zero in on key concepts.
Centor Score
Here is some useful information that will help you answer questions you might be asked after seeing a patient with a sore throat. The Centor score helps delineate management of a child or adult with potential Group A streptococcus (GAS). There are four parts to the score, and each receives one point:
1. Fever (greater than 100.4°F or 38°C)
2. Exudates or swelling of tonsils
3. Tender lymphadenopathy of anterior cervical nodes
4. Lack of cough
Recommendations state that a patient with a Centor score of 2 or 3 should have cultures taken, with treatment only if results are positive. A Centor score of 4 or more should be treated empirically. The purpose of creating this scoring method was to reduce the number of unnecessary antibiotics that were being prescribed for non-GAS sore throats. Physicians still, however, employ many different practices when it comes to treating sore throats. For example, physicians often perform rapid strep testing on all patients with scores of 2 and 3, and then treat the positives and culture the negatives. If any rapid strep negatives show positive cultures, then those are treated at that time. Remember, the only significant reason that we treat GAS pharyngitis is to prevent rheumatic fever; it does not change the incidence of post-strep glomerulonephritis.
Understanding SCID
By: Nathan York
Severe Combined Immunodeficiency Disease (SCID) is a devastating disorder of the immune system — the disease most commonly associated with the idea of a “boy in the bubble.” It is actually a group of different diseases characterized by a lack of functional T cells, functional B cells, or both (see Figure 1). Phenotypically, these diseases all manifest similarly, with recurrent infections by viruses, bacteria and fungi. These infections can be caused by common agents such as S. aureus and S. pneumoniae, but the patients who have them are also susceptible to recurrent Candida infections (thrush and severe diaper rash), as well as opportunistic infections such as Pneumocystis carinii. This susceptibility is the first indication of SCID in infants. If diagnosed early, then the prognosis is good with a bone marrow transplant. Children can be treated with antibiotics, but vaccination with live, attenuated organisms is contraindicated. If left untreated, children who have SCID will die by the age of two.
Of the different manifestations of SCID, the most common is a version known as X-linked SCID. It constitutes about half of all SCID cases. This version of the disease is caused by a mutation in the γ-chain common to several different cytokines, including IL-2, IL-4, IL-7 and IL-15. Without these cytokines, patients cannot produce mature T cells. They can make functional B cells; however, the lack of a T cell response, coupled with the inability to respond to IL-4, severely limits B cell response.
The next most common variant of SCID is caused by adenosine deaminase (ADA) deficiency, which accounts for about 20% of all cases. ADA deficiency shows an autosomal recessive inheritance pattern, and is characterized by a total loss of both T and B cells. Adenosine deaminase normally functions in the purine salvage pathway. It is found in all cell types, but its loss is particularly noticed in the lymphocyte subgroup, causing buildup of toxic waste within the cells. This buildup inhibits lymphocyte function, leading to a progressive susceptibility to infections. Therefore, early detection is critical for successful management of the disease. Deficiencies of other enzymes, such as purine nucleoside phosphorylase and recombinase, cause a similar SCID-like presentation, but these forms are much less common.
Less common variants of autosomal recessive SCID include bare lymphocyte syndrome (BLS) and Omenn syndrome. BLS is caused by lack of HLA expression on cells. The only form of BLS associated with immunodeficiency is associated with the lack of HLA class II expression on antigen presenting cells. Interestingly, numbers of circulating lymphocytes in these individuals may be normal, but without HLA class II expression, CD4+ T helper cells cannot be activated. This prevents B cell activation and class-switching, as well as cytotoxic T cell activation. Omenn syndrome presents clinically in a manner similar to graft-vs.-host disease. These patients have limited recombinase activity, and are therefore immunodeficient. They produce a limited number of T cells, which tend to express Th-2 type cytokines, and no B cells. These patients have a low success rate of bone marrow transplants due to graft rejection.
Figure 1: The Effects of SCID Variants on the Adaptive Immune System. SCID is a group of diseases all characterized by loss of T cell function, B cell function, or both. This diagram shows the stage of development that is disrupted by the various diseases that cause SCID. Two of the diseases affect development in the bone marrow, and thus prevent any mature cells from entering the blood stream. X-linked SCID affects cells both in the bone marrow and in the periphery. The fourth SCID variant affects the TCR-APC interaction, and therefore prevents activation of B cells and CD8+ T cells by CD4+ T helper cells.
References:
1. Coico, R., Sunshine, G., Benjamini, E. Immunology: A Short Course (5th edition).
2003. John Wiley & Sons, Inc. Hoboken, NJ.
2. Gupta, K., Pulliam, L. Concepts in Microbiology, Immunology and Infectious Disease.
1997. Parthenon Publishing Group. New York, NY.
The Answer Is?
1) BUG
I am a gram-negative, facultative, anaerobic bacillus that infects the GI tract by direct contact with food products, such as milk or uncooked meats. In children, I can cause an invasive enterocolitis with symptoms such as fever, colicky abdominal pain, and blood and/or pus in the diarrhea. I can confuse doctors into thinking their patient might have appendicitis. You can get rid of me with aminoglycosides and trimethoprim-sulfamethoxazole. What am I?
2) DRUG
I am an antimetabolite that inhibits ribonucleoside diphsophate reductase. I am used in the management of chronic granulocytic leukemia and other myeloproliferative disorders. I am also used in sickle-cell patients because I increase the production of fetal hemoglobin, which makes the red cells resistant to sickling. My major side effect is hematopoietic depression. What drug am I?
3) MUSCLE
I am the strongest supinator of the forearm, especially when you use a screwdriver. I am innervated by the musculocutaneous nerve. I have origins on the supraglenoid tubercle and coracoid process and I insert into the radial tuberosity of the radius. What muscle am I?
1) Yersinia enterocolitica
2)Hydroxyurea
3)Biceps brachii
The Business of Medicine
How Do Hospitals Get Paid?
Patients flow into and out of hospitals every day. Depending on the hospital where you work, these patients may come from all levels of income, as well as all levels of insurance coverage. It is important to know how the hospital is compensated for its time and resources, because your salary may be based on a specific payment structure. There are five overall payment structures:
1) Payment Per Procedure: Fee-for-Service
2) Payment Per Day: Per Diem
3) Payment Per Episode of Hospitalization: Diagnosis-Related Groups (DRG)
4) Payment Per Patient: Capitation
5) Payment Per Institution: Global Budget
Back before “modern” medicine took a business twist, doctors would get paid for their services with one of many different payment methods (money, goods or other services). This type of payment is known as Payment Per Procedure, or Fee-For-Service. Today, if a patient went to the hospital for a particular problem and received a series of tests, he or she would receive a bill for each of those tests, at their set price. With today’s prices, this bill could potentially cost more money than you earn in two years! Some insurance companies work on this premise. One thing they have done (and continue to do) to offset costs is to negotiate lower charges for such services rendered to their clients. For example, a CT scan, which normally costs $1,000, would be given at the reduced cost of $700 to a patient who is covered by a specific insurance company.
The next form of payment is Payment Per Day, or per diem rate. Companies using this method charge a set amount for each day the patient is in the hospital. For example, Mr. Sickly comes in with a stomachache and is admitted to the hospital for three days. His insurance company has a contract with the hospital to pay $1,200 per day (for a total of $3,600), regardless of the amount of procedures or tests performed. In these cases, the hospital has an incentive to keep Mr. Sickly a couple of extra days to help recoup its costs, since most of the testing is done early in the stay. Hence, if Mr. Sickly’s bill were $3,000, the hospital would lose money if he left on day two, but make money on day three.
A similar strategy is one that is used by Medicare, and known as a Diagnosis Related Group (DRG). With this system, a patient’s diagnosis tells the hospital how much money the insurance company will give them. Using this method gives the hospitals an incentive to try to discharge patients more efficiently, since their pay is not going to increase with length of stay, unless of course another DRG is made.
The fourth payment type, Capitation, is a form where the hospital receives a set amount from the insurance company per patient, per month. For example, say a person paid $100 per month for five years and never went to the hospital; the hospital would profit the entire $6,000. However, if this same person was admitted to the hospital and had an extended stay costing $60,000, then the hospital would bear the cost risks of their patients, since they deal with admissions, length of stays and resources utilized. Because of this, capitation is practically no longer used.
Finally, Global Budget is a system where a predetermined amount is offered per person, per year. The hospital then holds the responsibility of balancing all of the monies received with all of the monies spent. A classic example of this system is the Kaiser System in the United States, along with the Veterans Affairs (VA) system, and systems used in other countries. With Kaiser, patients pay into the global budget and are able to use the resources as needed. It is up to Kaiser to utilize these funds and resources in order to cover the healthcare needs of its patients.
Each of these types of payment plans has advantages and disadvantages. While proper care of a patient is the foremost priority for any medical professional, it is also important to understand the different strategies used by insurance companies. With this knowledge, you will be able to communicate more effectively with insurance companies and with your patients.
Filling Out an Application with MyERAS
MyERAS is the online program that applicants use to create their residency application. MyERAS has four parts:
Account
In this section, you will enter all of the logistic information concerning your application. Your profile (name, address, etc.) is entered here. If you’ve started an application, you can return to this section to see how much of your application is complete, and track your applications once they have been sent. The account section also houses a “Messages” component, which holds communications from residency programs (including interview invitations). The system is set up so that any messages sent to your “MyERAS Messages” section are also forwarded to the email account you provide.
Application
In this section, applicants enter educational information (university and medical school), work history, experience (in the three provided categories of Work, Research and Volunteer), honors, publications, race, basic USMLE/COMLEX examination information, hobbies, languages, etc. It is the meat of the application. The actual form is referred to as the Common Application Form, or CAF. Program directors will review your CAF through ERAS (via the PDWS portal). They (and you) have the option to view the application in either curriculum vita (CV) or application form. However, you do not have the option to upload a previously generated CV onto MyERAS. You must fill out MyERAS field by painstaking field. MyERAS will display the finished CV/CAF in a standard format.
Documents
It is in this section that applicants upload their personal statement (or statements, if they are applying to more than one field of medicine). Applicants will also enter information about the people who have written their letters of recommendation. Finally, applicants will certify transmittal of their USMLE/COMLEX scores. In essence, this section contains all of the supporting documents that will be assigned to specific programs. (You will assign documents to programs in the “Programs” section).
Programs
In the “Programs” section, applicants list the different programs to which they are applying. They can also assign specific documents (uploaded to the “Documents” section) to the appropriate program(s). For example, if you have two personal statements (one for radiology and another for pediatrics) and seven letters of recommendation (three for radiology and four for pediatrics), you can assign the radiology materials to the radiology programs for which you may be applying, and the pediatric materials to the pediatrics programs for which you may be applying. In this section, you can also search for, select and apply to residency programs.
Once your CAF is complete and documents have been assigned to the proper programs, only the click of a button is required to submit the application to a program. Before you submit an application, you will be able to preview your invoice. Payments are made directly in this section. Applicants are charged based on how many programs per specialty for which they apply. Below is the fee schedule for the 2007 application process.
| Programs per Specialty | Cost |
| <10 | $75 |
| 11-20 | $8 per program |
| 21-30 | $15 per program |
| >30 | $25 per program |
You will be required to make an initial payment at the time you first submit your application to programs. This does not mean you cannot apply to more programs. You can still apply to more programs, and the balance (if any) will be billed. Once the application has been submitted to a program, its status can be tracked in the “Programs” section. You will have the ability to see whether the program for which you have applied has downloaded your application.
Filling out an ERAS application takes a considerable amount of time, but knowing what to expect can help to significantly cut down on the time and effort required.
Should You Consider a Public Health Degree?
By: Ixsy A. Ramirez, MD, MPH
Have you ever considered pursuing a degree in public health? What does a degree in this field entail? The most encompassing, yet simple answer to this question is one that I heard from a mentor: Public health is life. It truly is. Public health includes many aspects of health, from health education to health-services evaluation to biostatistics and epidemiology to eradicating polio — public health’s largest initiative. Public health is the water you drink, the community in which you live, your place of work, and the aspects of each that affect your well-being. It would be difficult to choose a facet of life that does not have a demonstrable impact on public health. It’s all tied together. The main difference between public health and clinical medicine is the focus on a community as a whole rather than on individuals. Public health strives to find solutions to community problems through the use of education, empowerment, economic development, and philanthropy, among other means. If any of these subjects sound interesting, then a Master of Public Health (MPH) program may be right for you.
Gaining Experience
Before you apply to schools of public health, there are a couple of items to tackle. Hands-on experience in the field is crucial. If you plan to apply to schools immediately after you complete your undergraduate or medical degree, now is the time to take advantage of summer programs, internships, volunteer opportunities, or research, depending on which track of public health you plan to pursue. Avenues to gain experience may include activities such as volunteering for a Meals on Wheels program, working with a mobile-health van, doing community research in the United States or abroad, or assisting with philanthropic organizations. Speaking with someone who is currently pursing a degree in public health, or someone who has worked in the field for years, could also provide other ideas you may have never considered. If you have been out of school for a few years or longer and would like to obtain an MPH to support the work you are already doing, you likely already have the necessary experience to apply to a program. There is no right or wrong path to take to attain a degree in public health. Program administrators are interested in creating a well-rounded group of incoming students, so that each individual can enrich one another’s education.
Entrance Exams
What about entrance exams? Luckily, there’s just one: the GRE. In my opinion, this exam is much less stressful than the MCAT or the USMLE. It is a three-and-a-half-hour exam that covers verbal reasoning, quantitative reasoning, critical thinking, and analytical writing skills; and these areas are not focused on any one topic. The cost of the test is $130, and it’s computer-based. You can find more information on the GRE website (www.gre.org).
Choosing a Field
-
- Biostatistics
- Epidemiology
- Environmental Health
- Health Education
- Health Policy
- Health-services Administration
- International/Global Health
- Maternal and Child Health
Deciding which track to choose will depend on your future goals and career choice. This is why it’s important to speak with public health professionals and learn why they chose their field, the pros and cons, and the opportunities that await an individual who has pursued a given track. You may be surprised by the opportunities available within each field.
When you’re searching for possible programs, one of the important items to consider is accreditation. Not all public health programs are accredited. This is important when it comes to getting grants, scholarships, internships, and jobs after graduation. Do not overlook this important detail when you’re applying to programs.
Schedule Requirements
Another important consideration is whether you will be a part-time or a full-time student. Both options are available to fit your schedule. You may be working full-time and would like evening or weekend courses, or you may be ready to dedicate yourself full-time to your degree. Find what is best for you and your needs.
With so many available choices in regard to schools, fields of public health, and opportunities after graduation, you may become overwhelmed by the possibilities. However, these same possibilities will provide ongoing stimulation throughout your career. Whatever your choice, all public health fields will offer the knowledge necessary to improve the health of communities, while complementing the medical knowledge you gained in medical school and through your residency.
Ixsy A. Ramirez, MD, MPH, is a pediatric resident who received her degree in public health from Yale University, with a focus in global health.
U.S. Residency Opportunities for International Medical Graduates
International medical graduates (IMGs) made up almost a quarter of the physician workforce in 2005. Fortunately, every year, there are 30 percent more residency spots available than the total number of U.S. graduating seniors. This means there are many spots open for IMGs to fill.
The top four primary specialties into which IMGs place are internal medicine, anesthesiology, psychiatry, and pediatrics. Statistically speaking, the odds are greater that IMGs will match to primary-care fields rather than to competitive specialties such as dermatology, orthopedic surgery, and plastic surgery. Competitive programs almost invariably give first preference to U.S. medical graduates. Since there are more than enough U.S. graduates vying for the open positions in these programs, IMGs often aren’t given consideration. This is not to say that they shouldn’t apply to the competitive fields; with the right credentials, IMGs can be extremely competitive in the match. IMGs can increase their competitiveness in order to place into one of these specialties or to train at a renowned facility by:
- Achieving high scores on the USMLE exams
- Doing research
- Presenting and publishing research materials
- Obtaining an advanced degree such as an MPH, an MS, or a PhD
There are many similarities between IMGs and U.S. graduates with regards to becoming a licensed physician in the States, but there are some significant differences as well. The main differences are:
- IMGs need Educational Commission for Foreign Medical Graduates (ECFMG) certification. This certification is required for graduate medical training (residency training) in the United States. Without it, IMG applications will not be considered.
- IMGs who are not U.S. citizens need visas in order to train in the United States.
ECFMG certification involves several steps:
- The applicant must demonstrate that he or she has four credit years of medical education at a recognized medical school as listed on the International Medical Education Directory. The ECFMG will verify credentials and graduation from the medical school indicated.
- The applicant must pass USMLE Step I, USMLE Step II CK, and USMLE Step II CS (formerly the CSA) exams. The ECFMG does accept some older medical-science exams in lieu of the USMLE exams; visit the AMA website for more information about the alternative exams that meet the requirements.
With the exception of the ECFMG certification, an IMG’s application to a residency program is in many ways similar to that of a U.S. senior. Applicants will fill out an ERAS application online. IMGs generally apply to 20 to 30 programs. If a residency program is interested in the applicant, the program will extend an invitation to interview. Non–U.S. citizen IMGs will need to secure a B-1/B-2 visitor visa, allowing them to stay in the country for two to six months, which is more than enough time to complete the interview process.
If an IMG matches to a program in the United States, then he or she will need a visa to train and work here. There are two types of visas that are extended by the sponsoring residency program: J-1 and H-1B visas. The J-1 visa is a nonimmigrant visa, which means that the individual must return to his or her home country after completion of training in the States. The J-1 visa is very restrictive, but the application process is easier. Under some circumstances, waivers for the J-1 visa are awarded. In contrast to the J-1 visa, the H-1B visa requires much more paperwork. IMGs should aim to get the residency program to sponsor them on this type of visa (as it can be changed to Permanent Resident, or green card, status). IMGs can offer to bear the attorney fees required to fill out the paperwork for this type of visa. Also, keep in mind that a passing score on the USMLE Step 3 exam is required before one can obtain an H-1B visa. Applicants are advised to review U.S. Citizenship and Immigration Services Bureau regulations, as specific policies may change from year to year.
Though obtaining a residency position in the United States poses some additional challenges for IMGs, there’s no reason to despair. Remember that almost one out of every four physicians practicing in the U.S. is a graduate of a foreign medical school. With hard work and due diligence, securing a residency training spot here can very much be a reality.
