key: cord-0759730-tfaxc5pa authors: ROYCE, Celeste S.; EVERETT, Elise N.; CRAIG, LaTasha B.; FLEMING, Angela; FORSTEIN, David A.; GRAZIANO, Scott C.; Star HAMPTON, B.; HOPKINS, Laura; MCKENZIE, Margaret; Kang MORGAN, Helen; Madani SIMS, Shireen; MOROSKY, Christopher title: To the Point: Advising Students Applying to Obstetrics and Gynecology Residency in 2020 and Beyond date: 2020-10-07 journal: Am J Obstet Gynecol DOI: 10.1016/j.ajog.2020.10.006 sha: 0a0e2725bfbe62c2b949a27e492595c23a2f483e doc_id: 759730 cord_uid: tfaxc5pa This article, from the “To the Point” series by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, is a guide for advising medical students applying to Obstetrics and Gynecology residency programs. The residency application process is changing rapidly in response to an increasingly complex and competitive atmosphere, with wider recognition of the stress, expense, and difficulty of matching into graduate training programs. The COVID-19 pandemic and societal upheaval make this application cycle more challenging than ever before. Medical students need reliable, accurate, honest advising from faculty in their field of choice in order to apply successfully to residency. The authors outline a model for faculty career advisors, distinct from mentors or general academic advisors. The faculty career advisor has detailed knowledge about the field, an in-depth understanding of the application process and what constitutes a strong application. The faculty career advisor provides accurate information regarding residency programs within the specialty, helping students to strategically apply to programs where the student is likely to match, decreasing anxiety, expense and over-application. Faculty career advisor teams advise students throughout the application process with periodic review of student portfolios and are available for support and advice throughout the process. The authors provide a guide for the faculty career advisor in Obstetrics and Gynecology, including faculty development and quality improvement. Medical students often cite career advising as an area of unmet need, and rank guidance from Medicine (CiM) website. 14 Students can access CiM for career choice guidance. FCAs should 117 also be aware of student-led websites which may be less reliable than those of professional 118 Specialty FCA teams should meet regularly to review recent changes in the application 120 process, ensuring equitable, accurate advice for all students. Successful teams work together to 121 maximize outcomes for all students. 122 Medical students often have a limited understanding of the residency application 123 process. 4 Women, first generation and under-represented minority students may be less likely 124 to use networking or have mentors. 8 Once a student decides to pursue OBGYN, the FCA should assess a student's motivation 134 and ensure understanding of residency training commitments. 19 Discussing career goals, plans 135 for fellowship, research, advocacy, and topics such as abortion and assisted reproduction helps 136 the FCA guide students' program choices. 13 137 The FCA should review the student's curriculum vitae (CV) using the standardized AAMC 139 CV, or a school's recommended style. 14,20 The student should accurately describe activities and 140 research, taking credit for work done, but not overstating achievements. If a student 141 participated in research without a resulting publication, the FCA can recommend poster or 142 abstract presentation opportunities, or suggest writing a manuscript with the research mentor. 143 The CV should highlight activities highly valued by residency programs including 144 leadership, advocacy, teaching, honors and awards, such as the Gold Humanism Society and 145 Alpha Omega Alpha (AOA). Student membership in professional societies such as the American 146 College of Obstetricians and Gynecologists (ACOG) demonstrates commitment to the field. 147 The FCA should review potential weaknesses, including illness or adversities which 148 affected academic achievement. A low grade or score can be an opportunity to demonstrate 149 resilience. For students with a lapse in professionalism, legal action, or criminal conviction, the 150 successful match. 152 The FCA should also assess interpersonal skills and offer communications or public 153 speaking training if needed. 21,22 154 FCAs must understand the school's grading rubric and the Medical Student 155 Performance Evaluation (MSPE), the standardized narrative summarizing the student's 156 achievements, grades, evaluations, and class rank. 23 Many schools invite students to highlight 157 achievements for the MSPE. FCAs can advise students to list attributes based on personal 158 knowledge of the student and of factors valued by residency programs. 159 FCAs advise students on post-clerkship electives, research and extracurricular activities 162 to promote professional development and build a competitive portfolio. 18 163 Due to COVID-19, in 2020-2021 the AAMC recommended limiting away rotations to 165 students whose medical schools do not offer equivalent clinical experiences. 6,24 FCA's can 166 reassure students there appears to be no association between completing away electives and 167 matching at an institution, while a poor performance hurts a student's chances. 25 The FCA should ensure students meet with the Chair to discuss the departmental letter 180 of recommendation (LOR). 40 The Chair may delegate writing the LOR, but personal knowledge 181 of the applicant is desirable. The student should send the CV and personal statement for review 182 prior to the meeting, bring extra copies to the meeting, and be prepared to discuss their 183 application. Meeting with the department Chair helps build student confidence for interviews. The PS should focus on the student's goals, what the student seeks in and brings to 211 residency, rather than a patient or family story, or why the student chose medicine. 45, 46 The 212 tone should be professional and positive, avoiding criticism of the field, particular institutions, 213 or individuals. Weaknesses should be addressed in a psychologically safe manner, with an 214 emphasis on growth from adversity. 42,47 The FCA should proofread and suggest edits, but 215 refrain from revision. The PS should be the student's own work; a recent report found a 2.6% 216 incidence of plagiarism in the PS. 48 217 Modern professionalism includes cultivation of an online social media presence. 49 Over 219 half of PDs report screening applicants' social media for unprofessional behavior. 50-54 220 Reassuringly, a recent study of 87 OBGYN applicants found no unprofessional postings. 55 Social 221 media is also an opportunity for student networking with the medical community through 222 education, research, and commentary. 56-58 223 224 Interest in OBGYN has grown recently, with 5-6% of US medical school graduates and 2% 227 of foreign medical graduates entering OBGYN residencies. 30 applications. 61,65 Students frequently over-apply out of concerns for not matching. 7 FCAs can 270 guide students to limit the number of programs at which they apply through a strategic 271 approach including student interests, plans, and academic record. 272 In deciding where to apply, students consider clinical interests, academic 273 competitiveness, geography, couples-matching, and finances. 13 Research and advocacy 274 opportunities, patient population and diversity are additional factors. FCAs can help students 275 limit the overall number of applications by considering other aspects of their planned career 276 paths in selecting programs at which to apply. For example, students interested in a non-277 academic career may consider community hospital programs over academic medical center 278 programs, while students planning to subspecialize may wish to apply to programs with 279 are certain they will not stay for residency. 281 In determining the number of applications, the AAMC "point of diminishing returns" 282 tool (PDR) uses Step 1 scores to predict the number of programs needed to apply to match 283 successfully. 14 In OBGYN, applicants with a score >=230 needed to apply to 14 programs 284 (confidence interval, 13-15) to reach the highest likelihood of matching successfully: adding 285 more applications did not increase the chances of a successful match. For scores 214-229, the 286 PDR was 21 programs (CI, 19-23), with an 82% likelihood of matching. For scores < 213, the PDR 287 was 28 programs (CI, 26-30) with a 76% likelihood of matching. Approximately 90% of OBGYN 288 applicants ranking >=10 programs matched; over 99% of applicants ranking >=20 programs 289 matched. 14 Because of the decreased expenses associated with virtual interviews, students 290 may consider over-applying during the 2020 application cycle. FCA's can use the PDR to 291 encourage limiting the number of applications. In this fluid, competitive environment, less 292 academically competitive students may need to apply to up to 30 programs in order to receive 293 interviews (and thus rank sufficient programs), while highly competitive students may need 294 only apply to 10-14 programs . 5,7 295 The process of deciding which programs at which to apply may become simplified with 296 proposed changes resulting from the pandemic, including more transparent communication 297 from programs regarding program values and desired applicant characteristics. 6 298 The FCA can assist students with mock interviews and review recent graduates' 300 experiences. 21, 22 Since few students have experience with online interviews, FCA teams should 301 a pre-pandemic online interview pilot demonstrating equivalence of outcome with in-person 303 interviews may reassure students. 64 Students should explore program websites, and attend 304 online social events if offered, to understand programs' values, mission, and desired candidate 305 qualities. 6 During interview season FCAs should contact advisees regularly to review interview 306 invitations, reflect on impressions and rank programs as they complete interviews. 66 307 Students are often unsure about communicating with programs after interviews. 309 Programs generally welcome notification of new publications or awards. Students should not 310 falsely promise to rank a program first but may wish to inform a program of specific reasons 311 they are ranking a program first, such as a spouse at the same institution. Communication from 312 a program does not necessarily indicate a student will be ranked highly. Both candidates and 313 programs are governed in behavior and communication by the NRMP Code of Conduct which 314 prohibits programs from mandating second interviews, audition rotations, or asking how the 315 candidate will rank the program. 61 316 Prior to submission, the FCA should review students' rank list. Students should rank 318 programs in their preferred order. By ranking a program, the student is agreeing to 319 employment at that program. Students should not rank a program they do not wish to attend. 320 The NRMP recommends submitting the list before the deadline, as internet or website failures 321 have occurred. 61 322 FCAs should understand the special concerns of couples matching, described in detail at 325 the NRMP website (http://www.nrmp.org/couples-in-the-match/ ). For couples, each student 326 must rank the same number of programs or options, up to a total of 300 combinations of 327 residency programs , including "no match" options. 61 The couple will match to the most 328 preferred pair of programs on the rank order lists where each partner has been offered a 329 position (or a "no match" option is listed). A frank appraisal of each student's competitiveness 330 in their specialty is essential to ensuring the best match for both students. In general, both 331 students will need to apply to more programs than an individual student. 61 landscape evolves, the application process will undoubtably change, and specialty specific FCA 391 guidance will remain invaluable. residency applicants' professionalism? 591 #DocsOnTwitter: How Physicians use Social Media to Build Social Capital From Tweetstorm to Tweetorials: Threaded Tweets as a Tool for Medical 594 Education and Knowledge Dissemination CREOGs Over Coffee: Feasibility of an Ob-Gyn National Resident Matching Program. Charting Outcomes in the Match Residency Selection: Can the process be improved? 603 Presented at National Resident Matching Progam Annual Conference 604 Accessed 21 Virtual Interviews in the Era of COVID-19: A Primer for Comparison of 615 web-based and face-to-face interviews for application to an anesthesiology training 616 program: a pilot study The core of mentorship: medical students' experiences of one-621 to-one mentoring in a clinical environment National Resident Matching Program. Policies and pitfalls for applicants, SOAP Considerations for medical students and advisors 627 after an unsuccessful match Finding Them a Spot: A Successful Preliminary Residency Application Process in the Wake of COVID-19 Forthcoming 2020 Education Institutions of LCME-Accredited The Coalition for Physician Accountability's Work Group on Medical Students 639 in the Class of 2021 Moving Across Institutions for Postgraduate Training The Impact of COVID-19 on Medical Education. Cureus Medical Student Concerns Relating to Association of Professors of Gynecology and Obstetrics and Council or Resident Education in 648 Training Faculty to Do Career Advising Is it a match? a novel method of evaluating medical 654 school success How well did our students match? A 658 peer-validated quantitative assessment of medical school match success: the match quality 659 score APGO: 688 Association of Professors of Gynecology and Obstetrics; FREIDA: Fellowship and Residency 689 Electronic Interactive Database; NRMP: National Residency Match Program Acknowledgements, prior presentations, prior postings: none 394