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Radio Silence


Have you ever had a period in life where you had to be quiet about something? I’ve recently had one of those times where I’ve gone silent due to life, life, life and more life. This picture is of me when I was practicing medicine. Since my last post the following things have occurred:

・I stopped practicing operating room anesthesiology

・I started writing music and embraced my passions as a songwriter and musician

・I became a mom who drops kids off to school and deals with a screaming toddler 24/7

・I became FREE in all senses of the word

This is a departure from what the status quo in medicine and in life. We are taught to be born, grow up, work, work, work and more work to pay our debts and then die. We are to run around, stay in traffic, not see our family and we expect to be happy. We expect that the money we are getting should be enough, but often end our days feeling that something is missing.

My decision to leave the operating room was one of being honest with myself and my needs. I have a specialty in Pain management and much prefer practicing in this capacity. I thought this was why I needed to go, and while certainly this was part of it, something else was bothering me. I’ve always had a longing to write music and impact the world through the healing power of music. Once I pursued medicine however, I suppressed my desires and passions. I figured after I trained, I could pick it back up. Then I pushed that to after Boards were finished. Finally, my dreams were relegated to retirement.

In my pursuit of making money and “taking care of business”, I threw my dreams away. I looked up one day and 20 years passed. I didn’t make progress in the thing I loved, but I did accomplish some amazing things including dual Board certification and being good at my career. When I took inventory, I realized I was dying inside and not fulfilled with my role in the OR.

So, against conventional wisdom, I started working on my passion, writing songs, playing music, singing, producing- all things I convinced myself I couldn’t do, or that I wasn’t good enough to do. I don’t have a “safety net” and most people are like- “are you crazy?”, but I have to do what I know is the best move for me. My family life is alive and thriving, I’m better overall, especially mentally, and I’m doing another thing that I feel that I’m put on this earth for.

People ask if I feel I wasted my training. This makes me shake my head a little. I don’t believe anything is wasted. All experiences inform us in some way. I still very much have my training, experience and 7 years of practice. Nothing is ever wasted and yes I still have opportunities to practice medicine. Currently my focus is shifting to prioritize my other callings in life outside of medicine.

My message is simple and is this: Don’t throw away who you are to be a doctor. Become a doctor with ALL that you are. If you love to dance- please keep dancing. Even in residency, make sure you warm up and find classes you can attend. Yes, you may sacrifice the day to day practicing of what gives you joy while you are in training, but it is VITAL that you don’t STOP doing it all together.

I gave half-baked effort to music my whole career while I gave 1000% to medicine. Ironically, music is what I always loved deep down. Now it’s my turn to give myself to making music and to improving my musicianship. I couldn’t be happier with where I am. I believe we are multidimensional and that we are breathing to accomplish certain goals. Some people are suited for one career, while others accomplish multiple pursuits. It’s all good and vital and needed.

So premeds and trainees: PLEASE BE YOU to the fullest. You can’t do everything at the same time, but please keep your passions alive. Make time for them. Medicine will make room for them eventually and depending on how important they are in your life, you will find a way to make room. I had to stop practicing a specialty I didn’t love in order to practice another specialty in a way that accommodates music. My choices now prioritize what I truly love and it feels awesome. Remember, YOU practice medicine and make sure it doesn’t practice YOU.

I am here to provide guidance through the medical school application process and beyond. As a former admission committee member and graduate of the UC system, I know first hand what it takes to make it to and through training and beyond. I am passionate about helping students like you to navigate this process.

If you want access to a course and materials that guide you through the medical school application process, email me at premedconsultants@gmail.com.

Remember, BE YOU!

Candice Williams, MD

Premed Consultants

Featured

School is Starting! Ready? Tips for Success!

Ready for your upcoming year?

School is starting, summer is ending and the kids are going back to school. If you are premed, you are likely preparing for your next school year or in the midst of applying to medical school. Being organized and having a plan is key for pretty much anything we do in life, including school and application season. Below are some tips to get you started on the right foot for next year!

1. Make a plan: Seems obvious but write down your vision and plans for the year. It’s important to have a long term vision and a shorter term vision. This way you can make progress towards your goal.

When I was a premed student and a college student in general, I wasn’t very organized. I just registered for classes, put on sweats (i.e. pajamas) and showed up. I didn’t understand the effects of that “early class” or being late or which professor was easier to pass a certain class etc. I ended up with a lot of C’s which I had to plan later to retake or do more upper division courses to correct. If I had a better plan, I likely would have avoided some of these pitfalls. This leads me to #2.

2.Organize a friendly class schedule: Do not take Biochemistry and Calculus with English and other classes simultaneously. Spread out your Pre Med prerequisites wisely. 


Yes- I didn’t do this. I was young and thought I could conquer it all and I was going to get into med school faster! Nope. I walked away with a B- or C and was frustrated. I was so fed up in fact that I left premed for taking the music placement exam in my junior year and tried to ditch premed to be a music major. I could sing and play for grades. I loved music. I saw another student with an O-Chem book in our music course and felt like a failure. She was a double major. I thought wow, I gave up just because things were hard and because of a few setbacks. I honestly thought I wasn’t good enough or smart enough. Couple that with being the only African American student in many of my classes or one of the few, this had a psychological effect on me. The University of California, Berkeley was a place full of opportunity, but it was large, and often an intimidating place to be. When I met with the music dean, I found out it was too late to graduate with a music degree from my school. I went back to premed, but never lost my passion for music. (More on this in a later blog post). These course corrections caused me to graduate later than desired, but fortunately I took my sweet time to apply to medical school AFTER I corrected my grades and had a decent MCAT score.


3.Space out your work schedule: Be careful to space out your hours at the lab or in your job so it accommodates your study time for classes and/or the MCAT. If you work too much, you may not be able to study effectively, thereby defeating your efforts.

I worked in all kinds of places as a premed student. I worked in a soil chemistry lab that I hated and people treated me terribly. I beat rocks for a living. It was horrible. They treated me like I was stupid and basically like I didn’t belong. It was clear it wasn’t going to work out. I tried another lab and it wasn’t a fit either. None of the labs I was interested in would accept me and I was frustrated. I worked instead in the school of Law and Society and one semester in Genentech. The School of Law was flexible and helped me survive financially. It was the perfect job to balance coursework with. Genentech was cool, but a disaster. I had to drive a long way, work as a lab tech and then tried to take Biochem and Calculus at the same time. I had to drop these courses. It was just too much. Learn from my mistakes and really consider your financial needs vs. taking coursework. Find a job that is flexible and not necessarily a “premed” job. You can get experiences later in formal research programs or other pursuits. This is what I did eventually to build up my experiences.

4.Plan out your application strategy: For those of you ready to apply (i.e. fixed grades, MCAT score > 75th percentile but preferably > 80th percentile, 1-2 years of medically based experiences (where you touch people) AND research with a clear motivation to apply!!!) you MUST have a game plan.

Here are some tips.

  1. First, KNOW YOUR MCAT SCORE BEFORE APPLYING.
  2. Then, APPLY EARLY! I mean if AMCAS opens in June, then start putting in data. Submit in June/July.
  3. Have a game plan for writing essays. You will need it. Write about a difficult experience and how you overcame it. You will be glad you did. Expand on your most important volunteer or life experiences so you have these ideas written already.
  4. Save cash for secondaries and have good credit for AMCAS. The application fee alone is $170 processing fee and $40 each school for 2020 application. The FEE ASSISTANCE PROGRAM is key to apply for is you have financial hardship and can save you lots of money. Secondaries cost usually $100 each. Apply widely to schools that fit your criterion using MSAR and it’s ok to have a few “reach” schools, but bear in mind that each school has an additional fee to add to AMCAS. Use MSAR to plan out your application strategy and depending on your situation you should aim to apply to 25 schools or more.
  5. Plan financially for how you will afford interviews, flights and travel. Do your best to coordinate trips to states together or closely to save money. Stay with friends or family in other states if you can.

I know this is a lot of information, but these are things I WISH I knew when applying and as a college student. As a former premed student, med student, resident etc. I intimately understand the process of applying to medical school and navigating the training process to become a practicing, board certified physician.I know first hand the University of California educational system and how many students are intimidated and discouraged from pursuing premed as a field due to the rigor and competitiveness. As a former admissions committee member, I also have seen poorly planned applications and the difference between students who had polished applications vs. those who were not adequately prepared.

I hope this advice helps you prepare for your upcoming school year. Continue to visit our blog for more tips and insights. If you are interested in Premed Consulting and Coaching, contact me at premedconsultants@gmail.com to set up a discovery call.

Candice Williams, MD

Premed Consultants

NIH Research Programs!!!

I’ve had several inquiries from premeds saying they don’t know what to do for a Postbac program or that they need a more robust research experience. I personally did the Medical Research Scholars Program in medical school and it was a year long enrichment experience that solidified my CV and helped since I didn’t have honors in my rotations. I matched my first choice program and I attribute it partially to this year at the NIH. I saw the process in a way I didn’t know existed.

Medical students: here is the link. This program can really set you apart in the difficult to match specialties.

Premeds: there’s good news! There’s the corollary program for premeds that lasts 2-3 years and gives superlative research and clinical exposure. Find the link describing the requirements here.

Don’t underestimate the power of the National Institutes of Health on your CV. I published 3 papers 2-3 years later and it has helped my career trajectory. I’m not academic but do have research in my background and this is a boost.

All the best premeds and medical students!

Residents: they have programs for you too once you graduate!

Candice Williams MD

Premed Consultants

Uncertainty: How do you deal with it?

Hello all,

Summer is upon us and for many, this means you are starting the application cycle, filling out applications, taking the MCAT or starting residency. Things are new, you are embarking on a new journey and not sure how things will pan out. How do I know? I’ve been there and oddly enough, I’m there now.

You see, just because you become an attending, it doesn’t mean that is the end of life changing and needing to shift. Sadly, I have to break it to you that things can and will change and it’s normal to feel unsure or uncertain. I’d like to share with you my situation and how I’m coping with uncertainty as a working anesthesiologist, spouse and mom.

Long ago in the dark ages of residency, I was trying to envision a future where I kept my passions alive (music, family) AND working as an anesthesiologist. It seemed impossible as I was barely keeping my head above water with working and being a new mom. I just saw a dark future and really had to visualize better times to make it through. Along the way I had many jobs, bounced around and experienced many disappointments with my working situations and environments. I didn’t anticipate ever having to quit, change jobs or move anywhere. In residency and as a medical student, I thought you just get a job and stay there and everything is perfect and happily ever after. I came to find out that instead, I was experimenting and finding what is the best fit for me and my family.

Recently I’ve once again realized it’s time to shift and return to my specialty of pain management as I’ve been practicing OR anesthesia in a great group for the past year. I’ve had such a challenge finding the right environment to practice in while staying in the place I want to live. Many have suggested – just open a practice – as if it’s that easy. I will write more on this later as the current landscape in medicine requires so much of independent physicians that its designed to make it hard to survive. I’ve doggedly insisted on not moving and on not having a practice because of the work, money, time and commitment involved. I wanted to pursue locum tenens (temporary work) but this didn’t pan out either.

So now I’m left in an uncertain place. I know I need to move on and practice in my specialty, but there’s no opportunities that fit my needs or that fit my practice style. So- I’m continuing to pray, soul search and open myself to more opportunities. I’m exploring more practices in other locations and I’m simultaneously drawing up plans for a solo practice.

I’m writing mission statements and really envisioning what an ideal Pain practice would be. I am passionate about being part of the solution of the opioid crisis and I am a believer in non opioid adjunctive pain medications, interventional pain procedures, physical therapy, occupational therapy, mental health strategies, exercise, regenerative medicine and other strategies that emphasize a multimodal approach to pain management. I’m in a place with a lot of competition and I am currently assessing the landscape I’m in and feasibility of opening a practice that will thrive and serve patients well.

So, I’m right in the thick of it. I don’t have an answer today, but trust me I know what it’s like to be uncertain and not knowing the future. I trust that God knows what is best and that I will find my way. I am trusting that for all of you as well.

Stay strong, keep pushing, studying and striving to be your personal best no matter what stage you are in. It can and WILL get better.

Email me at premedconsultants@gmail.com or reply to this post about your uncertainty and where you are right now. This is a safe space and we should be able to share with each other. I’m here for a listening ear and to answer any questions you have about the path to becoming a physician.

All the best in your endeavors,

Candice Williams, MD D. ABA
Premed Consultants

How did Operation Varsity Blues make you feel?

Hello there medical community,

I’ve been waiting to comment on the college admissions scandal, aka Operation Varsity Blues, as it struck a chord with me immediately upon hearing the charges and accusations. This is a sensitive subject, and the opinions shared here are simply my own thoughts on the scandal and higher education. You may choose to agree or disagree with my point of view, but I feel it is important to share as a physician of color and advocate for students.

Everyone thinks the system is built solely on merit, but as suspected, this story is one that shows that is not always so. I for one resented the assertion that someone with wealth could simply bribe their way into institutions that I and several colleagues spent years preparing for and working our tails off in order to get in and graduate from. UC Berkeley, my alma mater, was named in the scandal, as well as UCLA, my medical alma mater. These schools were literally hell to get into and make it through, especially as an underrepresented minority student from inner city Los Angeles. I was told in no uncertain terms many times while on campus, that I did not belong there. I was questioned on many occasions why I needed to take Organic Chemistry, or if I was on a sports team. I was pretty out of shape for any sport, so these comments were difficult to take at 17 years old. While the scandal is about money and someone buying their way in, my feelings immediately went towards the students who couldn’t buy their way in AND who were told they didn’t belong, myself included.

During a silent protest that I participated in while on the campus of UC Berkeley that was to bring to light that the voice of African American students on campus was not being heard, various insults were hurled at us calling us Nigger, saying the only reason you got in is affirmative action and the most hurtful – a professor told us that this campus was not designed for people like you.

These words stuck with me. Although they stung, I was determined to prove the campus was for people just like me. I graduated with a Molecular Biology Degree, music minor and was well prepared for my future career in medicine. I conquered that place and as a practicing anesthesiologist and pain specialist, I seriously consider the question – “Who is the University of California designed for?”

The answer is that these campuses are designed for the diverse student body that reflects the population the state of California. I and my black colleagues had every right to be there because we worked hard and earned it – not because our mom or dad paid someone to let us in.

I’ve heard the argument of “race doesn’t matter” in admissions assumes that a meritocracy would be inherently fair. This isn’t fair if those with resources to get the grades needed are only from certain ethnicities while others are purposefully left out. It’s definitely not equitable if some with money are allowed to simply buy their way in. This scandal has caused many to lose faith in the system – the one that says – if you work hard, you can gain admission.

On the cusp of decision day for UC Berkeley and many other schools, I reflect on the lack of diversity, especially concerning students of color and it’s disturbing to me. There are so few African American students admitted that will attend both UC Berkeley and UCLA (medical school included) compared to the population in the state. A couple of years ago, I attended a welcome event for students accepted into UC Berkeley in Southern California. I saw 1 African American student at this large reception with at least 200 students. I was disappointed, but realized that in this day and age, many students are opting for other environments other that UC, such as historically black colleges or private universities.

It was often assumed I didn’t belong in undergrad and in medical school just because of the color of my skin, but someone else who is another race inherently is assumed to belong. I think of so many students of color who are treated as if they are taking away spots from the “good” students, with the assumption that every African American student has a 1.0 GPA and just walked in the door with no credentials. These ideas are often freely shared on SDN (Student Doctor Network) and other premed sites. This was an unhealthy place for me as a premedical student and eventually I learned to make other communities and connections. These assertions are patently false. This experience prompted the creation of Premed Consultants and this blog.

Sadly, racism, classism and discrimination are rampant in higher education and there is an idea that certain students are deserving and others are not. In regards to medicine, medical schools in particular need to put their actions where their statements are and truly make strides to ensure they are treasuring diversity, treating students well and as if they belong, no matter their culture. If this occurs, maybe UC Schools wouldn’t have as much trouble in their recruiting efforts amongst some ethnic groups.

I hope this admissions scandal brings these conversations to light and helps everyone understand the importance of diversity and transparency in higher education. No one should be able to buy, lie or cheat their way into a school at any level of education.

What are your feelings about the admissions scandal? Should the students have their degrees taken away? Should parents be solely responsible? Should universities be held liable?

Blessings to all,

Candice Williams, MD

Premed Consultants

MATCH 2019: What happens when you don’t match?


Hello all MS4s. Congratulations to those of you who have successfully navigated the matching process. I fondly recall that day in 20xx then I matched and realized I could stay home with family and loved ones through my training. It was a truly blessed and overwhelming day. All of my work so far culminated in this moment of opening an envelope.

Some students have a different story. Some match a choice that takes them away from their home, loved ones and security, while others can return home. Other students found out this week they did not match. So what happens when someone doesn’t match?

The process is called SOAP: Supplemental Offer and Acceptance Program. It is a secondary match if you will, in which programs reach out to students via ERAS to match into their unfilled program spots. Unfortunately ERAS has been having technical difficulties for the past couple of days, leaving thousands of students wondering how they will navigate this process or if they match this year. My thoughts and encouragement goes out to each and every student coping with this. It’s hard enough to go through, but the uncertainty can be unbearable. Just know that you are worthy, you are capable and be determined to improve your application in your year off if need be. I recommend a research year, preferably paid if you can get it, applying to an NIH program for medical students such as the Medical Research Scholars Program https://clinicalcenter.nih.gov/training/mrsp/index.html

My thoughts on this are that things are different now than they used to be. There were approximately 42,950 applications to AAMC accredited residency programs in 2018-2019 vs. approximately 90,000 seats in medical schools. Granted there are 4 years of medical school, but even if you assume only 1/4 of those students graduate, you have 22, 500 people across specialties only accounting for US medical grads. https://www.aamc.org/download/321526/data/factstableb1-2.pdf

When you factor in medical grads from non US medical schools, students who didn’t match in prior years and consider what specialities are involved, the number of applicants easily outstrips the number of available residency positions. More residency positions should be made available as students invest so much time, money and effort to pursue medical school, and barring any glaring deficiencies, they should be able to earn their MD. Unlike other allied health professions such as nursing, there is no staging of degrees. You cannot practice medicine without completing a residency, but some alternatives include pursuing an MPH, policy degree, research career or working in industry.

A final thought to Match Applicants: There are many options, but whatever you choose, please do not feel sorry, embarrassed or ashamed of your journey. We (physicians) are here to support you and we are cheering you on no matter what path you choose.

Candice Williams, MD

Premed Consultants

It’s About Time

Hello All,

It’s been quite some time since I’ve written. In all honesty, I’ve been contemplating what to write about, and what would helpful to students. I’ve been spending time concentrating on being a good physician, wife, mother and adjusting to life changes.

During the early part of my blogging, I moved and transitioned my family back to our original home. It took a lot of sacrifices and required me to not only quit my job, but to decide to leave a less than ideal situation in order to do so. Things appeared not quite right early on, but I stayed in order to keep the peace for my family’s sake. Eventually, the toxic environment took a toll on my health and well being, and I would argue that of my family as well. This year, I decided it was about time to put myself and my family first.

This meant that I had to have the courage to leave a seemingly cush, coveted job that was “comfortable” with guaranteed salary and choose one in which I was paid only when I worked. I gave up benefits, pensions and loads of “stability”. What I traded it for was my sanity and my freedom. I needed an environment where I was free to be creative in other pursuits and where I was not tolerated, but celebrated. This was not without sacrifice. I gave up so much, and I had to re-immerse myself in my core specialty of anesthesiology. I was practicing pain medicine for the prior 2-3 years, and yes, this is a different specialty entirely. It involves clinic, continuity of care and procedures that you need specialized training to do. I enjoyed this work and the training, but the environment just wasn’t right for me.

After I left, I joined a group that provides intra-operative anesthesia services. I hadn’t worked in this capacity for a couple of years and jumping over this hurdle seemed like I was scaling Mt. Everest! With a supportive boss and fantastic colleagues, I was able to bridge this seemingly unsurmountable gap and become an OR anesthesiologist once again. It never left, but truly it was like riding a bike.

I did this for myself, my sanity, and my family. We needed to move back home and my job environment was truly toxic for me. I had to choose life and choose myself. This took grit and sacrifice, but so far it has been well worth it. I tell this story from the perspective of what it is like to be a physician and the realities. Even as an attending physician, you still have to find your place and the right fit for your career and interests.

What are the takeaways from my story? There are several –

  1. Don’t be afraid to choose yourself. Your profession will be there, but if you aren’t ok, you won’t be. Make decisions based on your core beliefs and those that serve your needs. When you are in training, this can be difficult to do. Don’t forget to seek help and especially mental health services.
  2. Training in a subspecialty gives flexibility. In anesthesiology, pain medicine gives the option for work in the procedure suite, the clinic, or in the operating room as well. Research is also another way to add dimension to your specialty and to your work. There are academic positions, private practice opportunities and jobs at large conglomerates. Do your research and consider what environment is best for you.
  3. Whenever there is transition or change, there is sacrifice involved. Sometimes this requires courage, doing some things that are uncomfortable and there is definitely a period of transition. Give yourself grace to adjust.
  4. If something is wrong, admit it. Don’t simply stay in a job because you need to pay your bills or because you have to. Save up, prepare yourself and make plans to transition. You owe it to yourself to be happy, healthy and whole.

I hope sharing my story helps some of you out there realize that there is light at the end of the tunnel. One day, you will be able to make these types of decisions. Being a physician gives you the freedom to choose and to change. I can be an independent contractor, own a business, be a consultant and do many things that feed my soul. Don’t listen to those who say it doesn’t get better than medical school or residency. It does get better. When you have the chance to make career decisions, make sure you choose for yourself and get informed about your options. It’s important to choose for yourself and your own wellness.

Enjoy your family and friends in this holiday season,

Candice Williams, MD. DBA

Premed Consultants

 

Interview Season is Upon Us….

Hello Premeds and Medical Students:

Interview Season is here! It’s such an exciting time. It’s the time to show the medical school or residency program of your choice that YOU belong there. You landed the interview, they’ve seen your file, your writing, your motivation for medicine. So now you get the chance to sell it! But how do you do this? First- let me share some of my experiences with you.

When I was a premed student like many of you, I doubted myself and my ability to be a physician, let alone a good one. I didn’t feel I belonged in my undergrad science courses at UC Berkeley, let alone in medical school. So – how did I go about mustering up the courage to stare Dean’s of admissions in the face and tell them – I’m the one you want, I belong here and I can contribute something to your class? The honest answer is I’m not entirely sure, but I know that I wanted it so badly. I came so far, I invested so much and I was not going to let anything stop me from achieving my goal, including fear.

I employed a number of strategies that I found worked for me, and I want to share them with you. These also apply to residency interviews as well, so medical students, don’t check out. 🙂

1. I prepared for my first interview well as a template for the rest of my interviews.

What does this mean? I looked up the Dean of Admission and Assistant Dean, their specialties and major research areas in the medical school. I rehearsed speaking out loud at a mirror stating why I wanted to pursue medicine and what it is about the school in particular that made me want to study there. I took care to wear a black, conservative suit and pearls. I did everything I could think of. I arrived, and I can pretty much say my interview day was anything but successful. I remember being asked why I wanted to attend there, why would I come there, and when I gave answers, I was simply grilled further. I was asked to design a research study on the fly. This threw me for a loop as I hadn’t given thought about this before. I tried my best but I knew I was floundering in both my interviews. Finally, the one of the Deans of Admission used a term that I interpreted as harkening to the Old South and slavery. For me, this was the last straw.  I instantly knew this place was not for me, no matter how badly I wanted to attend medical school.

So what was that? A failure? A flop? No. It was practice. Yes, I used this first interview to get the kinks out, to learn how to think on the fly and to answer unanticipated questions to the best of my ability. I realized that if an interviewer was hell bent to seeing me in a negative light, all I can do is present my best self – that is all. So in each subsequent interview, I did just that. I learned from the first one, devised a sample research study based on my prior work, knew my research projects inside out and was able to discuss them in detail and shored up those weak areas so that I shined on subsequent interviews.

2. I want to say that I rested well, took care of myself and all those things. It’s just not true. I was a tragedy mess on my medical school and residency interview trail. I was on flights, in and out of airports and walked in New York once so far in high heels I had a blood blister on my foot the whole interview day. I’m confessing this because I don’t want you to do this. Don’t walk through New York crying because you didn’t bring the right shoes. Wear tennis shoes with your suit and change a block away. Bring a purse big enough to house said shoes. Bring a nice portfolio with you to carry around with you. Bring extra deodorant, mints, pins for your hair etc. Believe it or not, these simple things can help allay the stress and anxiety that comes from preparing for one of the biggest days that determines your admissions status to medical school or residency. If you are rested, calm and collected, that goes a long way. I also must stress to SMILE even if you are not a people person. Smile at the staff, greet the front desk people, shake hands, look them in the eye. DON’T look down at your phone continually. Be a human being and be polite to everyone. This helps believe it or not. The admission staff have very much pull in this process. If you are rude to them over the phone or in person, especially on interview day, this could ruin your chances of admission or matching.

3. I made sure to let my first choice institution know that I would go there above any and all schools. Interestingly I don’t remember my medical school interview at UCLA. I do remember my residency one, and I embarrassingly messed up on a question I knew the answer to with a faculty member I knew. I was scared. It happens. I tried my best to recover. I another interview with the Chair of Anesthesiology, I asked her how she trailblazed as a woman to be Chair and what advice she would give an up and coming student who wants to pursue academic medicine. This changed the tide of our interview and the tone. It was not going in a good direction as she was questioning my involvement in a minority based program and implying I was excluding those who were not of color. I told her, on the contrary, the organization I worked with was national and appealed to all students and those who had a passion for serving underserved populations. Just as I felt that this was not going well, I  asked this when she asked – Do you have any questions for me?

This is key. You MUST come prepared with questions.This is paramount. I did this and it saved my residency interview. I also recommend that after you finish the interview, send a thank you letter by email or snail mail or both. In this letter to UCLA during my medical school application process, I stated unequivocally that UCLA was my first choice. Further, after I was waitlisted to the school, I emailed the Dean of Admissions in a last ditch effort plea to let him know that UCLA was where I felt I belonged and could contribute a diverse perspective to their student body as a woman of color that is from Los Angeles and who desires to serve the patient population locally. I didn’t think this would work and I don’t necessarily recommend that everyone try this approach as it is a real gamble. I did however a few weeks later, receive acceptance from UCLA off the waitlist. It was my first choice and I was elated.

I hope these tips help you in your interview season and beyond. Hit me up with questions via email or in the Forums. What questions do you have about the application process to medical school or residency?

Candice Williams, MD, D. ABA

Premed Consultants

 

What Is The Match?

UCLA Anesthesiology Class of 2012. aa77fa0e7e2471849ee1a7bf01791da22012_07_17_14_21_40.jpg

Hey there. I want to address the next step in the medical journey after medical school – Residency. How do you get there? It’s called the NRMP Match. It’s a national program that matches medical students with residency programs. US, International Medical Grads and Osteopathic Medical students can apply. In short, students apply to programs, through NRMP, they are granted interviews, then afterwards they rank the programs in order of preference. Programs rank candidates in their incoming class. On Match Day, medical students nationwide find out where they complete their medical training all at the same time. Most students have a ceremony that commemorates this monumental occasion. It’s a day full of excitement and emotions. The picture above is of my graduating class in Anesthesiology at UCLA. I’m the one in the black and white dress. I was so excited to be graduating finally and starting a career. I was so fortunate to Match  in 2008 as my first choice program.

What happens if you don’t match? Things have changed since my time, but now there is a secondary match called SOAP. Students can rank programs from various specialties and the secondary match will Match most students. For example, after about 30 k positions nationwide, after SOAP 2017, 101 spots remained unfilled.

In spite of these statistics, I encounter students from the US or IMG students who fail to match. How does this happen? Often time what hinders students from matching involves below average Step 1 score, any comments or disciplinary actions or needing to repeat portions of a medical school curriculum among other factors. For IMG, the reputation of their medical schools can be a barrier. Programs look more favorably on IMG candidates who have 1 year clinical experience, especially those who completed an internship in the US and are applying for PGY 2 positions.

Let’s go over some stats from the 2017 Match. The 2017 Match showed many US medical grads matched their top 3 choices but only 48% matched first choice. Also more IMG from US matched than ever before in terms of percentage (about 50%) but overall numbers were lower. The key is that they matched PGY1. For US IMG – You must get the internship. However the rates of matching into categorical Family of Internal Medicine (20% and 14 %) are higher than many PGY 1 only spots (about 6%). You could match a categorical IM spot then you can try to get a PGY 2 Position in your specialty of choice.

For anesthesiology, 74/1200 matched at US IMG. About 6% Chance. People faired much better matching internal medicine or Family. Internal Medicine, Surgery or Transitional PGY 1 are accepted by most anesthesiology programs, but as stated above these are competitive.

Here is the link to the Match Data.

http://www.nrmp.org/wp-content/uploads/2017/06/Main-Match-Results-and-Data-2017.pdf

So what are the take home messages and what can you do to improve your chances of Matching?

1. Mentorship is key. You need mentors in your specialty of choice to give you a realistic view of whether you’d match and how to improve your chances. These faculty members can give you concrete numbers you need and look at your application. These usually are at your institution if in the US, or if an IMG, connecting with a US program director to meet with you and give you an honest opinion would be key.  Ways to consider how to improve your application are research in the field, subinternships at reputable programs and letters from leaders in the field.

2. Having above board conduct and not too many academic red flags are important especially for competitive specialties. Programs do not want someone with ethics violations, problems following rules and order or those with academic problems. If you’ve had these, having additional research or clinical experience with people to vouch for you may help your situation. I found having 1 year of NIH research with pending publications greatly helped strengthen my application, and these programs are once in a lifetime opportunities. https://clinicalcenter.nih.gov/training/mrsp/

3. Audition rotations at programs of choice help. Most importantly performing well and forming relationship with leaders there help your case. If they remember you and like you, then you likely will match depending on specialty and competitiveness. This is general advice and every specialty has certain nuances to applying.

4. If you are an IMG, based on the numbers, it’s much easier to match Family or Categorical Internal Medicine. The key is to get your foot in the door. There are some IMG from US and outside who matched Anesthesiology. The rates were around 6-8% of applicants. These applicants likely were stellar in terms of their numbers. An above average and upper tier >235 Step Score is a must. If you are in the 218-234 range you have an uphill battle but it’s still possible. You must max out all applications in your specialty, all PGY 1 transitional, IM, Surgery and in my opinion apply for categorical IM and Family spots. The fact is specialties for US grads are competitive and more so for international grads.

I hope these tips help you all on your journey. Whether you are premed, first year medical student or are looking to Match, it’s good to know the process and ways to navigate it. IMG students don’t lose hope. This past year had a higher percentage of grads matching PGY 1 in a long time, and with some perseverance and strategic relationships you can navigate your way to success.

 

Best,

Candice Willams, MD

Premed Consultants

Medical Schools that prepare well for Anesthesiology

Read this article featuring Medical Schools providing strong preparation for aspiring anesthesiologists that offer a third-year anesthesia rotation. I’m in agreement that UCLA did an extraordinary job on my third year rotation and especially sub internship with helping me get involved and understand that anesthesiology was my specialty of choice. Look for large teaching institutions that offer a wide variety of specialties and experiences including research. You never know what you will end up doing. I did not go into medical school planning to be an anesthesiologist, and I didn’t know I was headed in this direction. I am fortunate to have scored decently on Step 1 and to have met with the program directors and my sub internships to let them see what I knew and my interest and commitment to matriculating at UCLA for residency. These are some of the tactics I suggest for medical students.

For premeds, you don’t have to go to the same medical school as your residency. You could drastically change your mind a few times as I did. It’s generally a good idea though to have a variety of large institutions you apply to. If not, all you need to do is perform your personal best and do audition rotations where you’d like to go for residency or summer research. Seek out mentors at the places you are interested in. Research helps open the door for some, or a strong performance in audition rotations. Try your best to plan ahead medical students. Matching is becoming more competitive. Good luck everyone and check out the article.

Candics Williams MD

Premed Consultants

https://www.usnews.com/education/best-graduate-schools/top-medical-schools/articles/2018-05-24/how-to-find-top-anesthesiology-med-school-programs