It was a tough decision between medicine and peds. I did electives
and subi's in both fields and still ended up liking both. The pros
and cons for each field worked out almost evenly so that I was left
in indecisionville for quite a long time. I actually ended up applying
to both fields through ERAS.
How did you prepare yourself for application to
your chosen specialty?
As mentioned above, I did electives and subi's in both. I have a
Ph.D. in skeletal muscle physiology/electrophysiology which didn't
really help differentiate between medicine and peds. It did, however,
help in the context of what I saw myself doing in 10 years. My premise
ended up being that I was probably going into some sort of academic
medicine in the field of cardiology device development. With this
in mind, the established channels for research in cardiology are
significantly better established for adult vs. peds cardiology. Moreover,
I wanted to leave some options open for career ventures outside of
medicine. Having a general internal medicine background would likely
be a more useful preparation in this context as well. I solicited
advice from dozens of people, literally. Current MD's, PhD's, MD-PhD's,
people in the corporate world, and of course fellow students. I even
interviewed at both peds and medicine residency programs before eventually
pulling out of my remaining peds interviews (interviewing at 2 disciplines
within the same institution is a no-no, if you didn't know already).
The sum total of all the advice along with my own "gut feeling" had
me going into adult internal medicine.
Who wrote your letters of recommendation for your
I ended up having 2 sets of letters for medicine and pediatrics.
Most were from full-time senior faculty within the fields, but when
assigning letters via ERAS, I always included the appropriate department
chair's letter along with a letter from my laboratory's principle
investigator. Also, I assigned letters based on whether or not the
author might have some particular influence with a particular program
director. For example, one of my internal medicine letters came from
someone who know Stanford's program director very well. My letter's
author even suggested that I especially include his letter with my
documents to that program.
Which programs did you apply to and why?
I applied to most of the competitive medicine and pediatrics programs
for a total of 22. These included major academic centers on the West
coast and the East, including UCSF, Stanford, UCLA, Children's Hospital
Los Angeles, Harvard, etc. I then withdrew from most of the pediatrics
programs and ended up doing 11 interviews total.
What kinds of questions did programs tend to ask
All questions were more or less the same. More of social visit and
heavy recruiting than any kind of strenuous "diagnose this patient" kind
of questions. Most interviews were very relaxed and unstressful.
What would you have done differently in applying?
No regrets. Strategy was highly effective.
What was the most difficult part of the application
Trying to discriminate between programs. All the quantitative stuff
blends in together (# call nights, open vs. closed ICUs, etc.). The
thing that worked for me was trying to come up with a single word
or phrase to describe my gestalt feeling about a program within a
couple days of my interview.
What should I look for on my interview and tour
Believe the hype. All colors run together eventually. Keeping extensive
tables and charts about each program may work for some uniquely type
A individuals, but the majority will become frustrated with this
exercise in futility. Try to pick out feelings you had during the
day--what made you uncomfortable, what got you excited, how well
you meshed with the current faculty and housestaff.
What questions should I ask of residents, faculty,
and program directors?
Just be honest with yourself and ask those questions that would
most have an impact on your lifestyle and happiness at a particular
program and city.
How did you form your rank list?
Location is very important to me. I personally have always wanted
to go to Boston for medicine training, so my first two choices were
straightforward. The only west coast program that I really liked
was UCSF, so I ranked it third. The rest of the list kind of followed
with my personal feelings towards them defining where they ranked.
What other advice can you give seniors applying
in your specialty?
To match at the top programs in internal medicine, a strong research
background is a huge leg up on the competition. AOA is a plus as
well, obviously. Just as with medical school in general, if you have
a plan and a passion and have shown some ability to execute these
elements along your career, you'll do well. If you're just interested
in matching, however, medicine is also a good bet because of the
multitude of spots available.