Absence makes the heart grow fonder – William Shakespeare
I know you girls have seen Kat this past Match week but I haven’t seen this woman in ages!! Sightings of Kat are almost as rare as “Big Bitch” sightings! I’m so glad she came to visit, so I forced her to make this video with me 🙂
Can’t wait till we’re all together for graduation.
Hope you are doing well. Now the answer to this question is: YES! Now that match results are out, many of us will be going to new places for a few years. I’m sure most of you are aware of this – renting comes with a lot of benefits: your landlord will fix things that go wrong, you can pick up and move when needed, usually cheaper than a mortgage, etc. However, for 3+ years, we’re going to be in one place, be earning real money for the first time, not be dependent on parents (for those of us who have been), and start to really think about our finances. Which is why the idea of owning a home is so appealing – especially in a coveted area – enabling the home to become a great investment. Now, if you are moving forward as a single person, meaning, not married, don’t have children, etc., owning a home is all on you – the payments, upkeep, etc. So it’s a BIG decision! So, here are a few things/tips I’ve found in my search to help me navigate this:
- Contact the current residents at your program and ask them what they did and what they recommend
- Realize that some are married, have kids, or are single – find residents that are similar to you and your housing needs
- Rent VS Buy: Weigh the pros and cons! Look into the area, where housing is in relation to the hospital, where the other residents live, how feasible it is to buy a home, etc. What is the cost of renting vs buying? Can you head over your residency area beforehand to do some physical legwork over there before starting? If you’re in a really big, expensive city with a ton of traffic and without many housing options close by, you might need to rent.
If you’ve decided to buy…
- Make a list: What’s important to you? How many bedrooms? Full bathrooms? Attached garage? Backyard? Location – suburbs, city, rural?
- A FOREVER VS SELLABLE home: Do you want to settle here? I know it’s a very long term question, but it will dictate what/where you choose to buy. For example, if I don’t plan to stay where I do my residency, I need to make sure that my home will sell easily once I’m done with my residency. So, I need to think about the area I’m going to buy in and how easy the homes there resell. Is there a good school system? Historically, how has the resale market been in area?
- Parts of a home: If I don’t have a family, do I want to have enough room to host medical students that come to the program for audition rotations? That probably means needing 2 bedrooms and at least 2 full bathrooms. As a resident, I’ll probably be coming home really late sometimes – an attached garage may make me feel safer. Also, if I’m looking to have a pet, a backyard would be fantastic.
- Types of homes: Do I want to have a stand alone single family home? But that entails mowing the lawn, taking care of the roof, shoveling snow, etc. Or do I look at condos or town homes or apartments? There will be an extra monthly HOA fee associated with this, but my snow will be shoveled and I only worry about the inside of the home. Plus the insurance is much cheaper.
- Figure out your timeline: When is graduation? When does your program start (usually July 1)? When is orientation? When can you move in? You’ll need to get your loans in order at least 30-45 days prior to closing.
- Get in touch with a realtor: the residency program I’m joining provided us with a list of realtors and a few housing options in the area
- One realtor is part of a program that works to help physicians buy homes, a program that gives back a portion of her commission to you (in terms of your closing fees)
- The realtors from the program will have dealt with a ton of other residents and know what’s important to you – distance to the hospital, upkeep, etc. Ask current residents for recommendations too!
- Get in touch with a lender: your realtor may have some suggestions. Look into physician loans – a lot of banks offer these. Call and compare them. Different banks will have different restrictions. I’d suggest looking at 2 and comparing them to make sure you get the best deal. Will it cover your home fee 100%? Do you need a certain percent to make a down payment (5%? 0%?), and if not, will it help your loan if you do? What’s their interest rate? For how long will it be fixed? Some loans provide you with a fixed rate for 5,7,10,15,30 years – others don’t. What is the loan rate? If you’re moving in 4 years after residency, it will be cheaper to choose the lowest one! If 5 and 7 year ARMs are the same, get the longer one just in case! Is there a prepayment penalty? Make sure the lender you work with is accessible and easy to talk to!
- Physician loans can offer the following:
- 100% Financing – No Money Down
- No PMI (Private Mortgage Insurance)
- No Pre-Payment Penalty
- High DTI (Debt to Income) ratio
- Student Loans treated in a special manner – Making it much easier for you to qualify.
- Close on your home up to 60 days before beginning residency. No need for a pay stub.
- Up to 3% Seller contributions are allowed.
- Flexible Terms – Select from our PhysicianLoans Adjustable Rate Mortgages (3-Year ARM; 5-Year ARM; 7-Year ARM; 10-Year ARM; or 15-Year ARM)
- Competitive rates
- Start looking at places: Your realtor will set you up with homes that you can view. Compare locations, prices, square footage, updates, etc. Send prices and addresses to your lender – they will do a monthly breakdown of how much you’ll need to pay – including the principle and interest of the loan, taxes in the area, insurance, and HOA fees! Ask your realtor, residents, friends, family about the places you’re checking out. Look at websites like Zillow to check their financial forecasts/ previous home rate patterns.
- Check it out: Do a video tour with your realtor if you can’t view the place yourself. Make sure your realtor is someone you trust, and have them take pictures of everything that seems off at the place. Here are some questions to consider:
- How many offers have been made?
- How stable has the price been?Is it flexible? Can you keep us in the loop if there are other potential buyers?
- Why do the sellers want to move?
- What issues does the house come with?(take pictures of these)
- When was the house last updated?
- What is under the carpets?
- What does the HOA fee cover? Are there any HOA requirements to know about?
- How much do utilities cost? (Should we see a copy of a utilities bill?)
- What’s the seller’s timeline?
- What are the neighbors like?
- Has the fumigation been completed? Timeline for this?
- Diversity in the neighborhood? Age group of people?
- How’s the housing market in the area? Will it increase? Rate of increase?
- What kind of fireplace?
- It’s a match: When you think you’ve found the one, and you’ve looked into it, make an offer. Talk to your realtor about this – do you make a standard offer (at retail listing price with a home warranty, etc)? Or do you up your game and bid more for the home? Sellers are looking for the “highest and best” offer… so if there are other offers on the table, you might need to increase yours…. again, talk to your realtor, they will guide you (and probably know the listing realtor too!). Your realtor will put together your offer, including move in dates.
- Lock it down: Once your offer is accepted and things look as though they are moving in the right direction, you need to write a few checks…asap! Now there’s a pretty set timeline. You’ll need to write a check for an inspection, radon testing, and an “earnest” check to say you’re in contract with the seller. Not sure how much this can range from, but from what I’ve heard, it can be about $1,500. You should get your earnest money back at the end of closing if everything goes to plan.
- Negotiate! After the inspection, a few things may need to be fixed up. Your realtor is your advocate and will come up with a contract that should ask for most (if not all) of these things to be fixed by the seller. Now, they may not want to fix everything and both parties may go back and forth for a bit…. But remember, unless you can go early to get things set up, you want to move into a place that is READY to move into!! You’re a resident! You don’t have time to be fixing things up – so most everything needs to be in place! Again, your realtor will help you with this.
- Loans, loans, loans! In the meantime, your lender will be drawing up your loan paperwork as well. You need to look into homeowner’s insurance in the meantime. Also, your home loan won’t affect your student loans. Both should help with the amount of taxes you pay yearly.
- Work, work, work, work: You may have to pay for a few things getting fixed up, you may have to pay for a month of mortgage before you officially move in, you may get to go and take care of these things in person as well. Start to budget as well, think about expenses. Make sure you have enough money in the bank to close ($2,500-3,000). Keep in touch with your realtor, they will be your advocate!!
I hope this helps and is relatively complete. Please add as you see fit! Thank you!!
There are currently 2 different MATCHes you can participate in: the DO match and the MD match. The DO match is about 1 month before the MD match (and if you match into a DO program, you are locked in and cannot participate in the MD match).
Soon, none of this will matter as all programs will become ACGME (MD) accredited. However, there are a few things to be aware of:
DO programs: Do audition rotations! I didn’t get interviews at places I didn’t rotate at! Much of this process is based on how well programs know you/networking. Get letters of rec from former residents at the programs you want to go to or from known physicians in the osteopathic community. Also, go to osteopathic conferences (like the ACOOG conference held twice a year) to meet program directors. Make a portfolio and pass it out at said conferences. DO programs look at your holistically and try to get a good fit for their program. To be honest, my DO audition rotations (I had 2) were very challenging. At one rotation, there were 5 other students on service with me. At the other, there were 2 others. And because DO students tend to be super nice, helpful, smart people, it’s hard to compete with them. Everyone has a great personality. Everyone is a hard worker. Everyone is knowledgeable. Everyone knows everyone (especially on the East coast were a lot of DO residency programs are). I found that it helped if you knew one of the residents at the program (and had someone to vouch for you). Some programs really take the residents’ opinion into account when finalizing their rank list, others don’t. Also, some programs will require you to do a presentation – so be ready!
MD programs: Very much merit based – you’ll get an interview invite with high scores and grades. Many programs will not keep in touch with you after your interview so that all applicants have an equal playing field. My MD audition rotations were tricky because some programs don’t offer you an interview, even if you rotated there. Regardless, I think it’s really important to try for auditions. In the MD world, many people don’t do audition rotations, so when you show up with your DO, can-do, friendly, hard-working attitude, it makes a huge difference in the eyes of the program. One of the DO programs I interviewed at had an MD program director (who is awesome!) and she used to work for an MD program as the assistant program director. She actually stated that at her MD program (and as an MD), she preferred all the DO applicants! She said that they brought something more to the table and that they wanted to be there. I’ll also say this-one interview I got was because I sent an email to an MD program expressing my interest in it- so that (can) DO attitude really does go a long way.
I hope this helps you as make your decision on which programs to apply to and which programs to do auditions at!
As interview season comes to an end, I thought now would be a good time to reflect on them!
- WHAT TO WEAR: Remember to dress your best – this means a suit. Most folks wear conservative colors/styles (dark blues/grays/blacks). I know of a few people who had olive green and purple – I think that shows your personality as well – it all depends on how much of a risk taker you are! Try to wear good walking shoes (I know someone who had a pair of flats in her purse and just switched out her heels for the tour) as many of your interviews will include a tour.
- WHAT TO BRING: You can take a nice purse with you (I constantly ran into the issue of where to put my keys/phone without one), a portfolio pad, and a pen. Take a lint remover if your suit needs it (hotels might be able to help you with this in case you forget it, they did for me)! I’d also recommend to have in your car: pins, sewing kit (my blouse ripped during one of my interviews), hair tie, comb, pads/tampons, wet wipes, protein bars, and anything else in case of emergency.
- INTERVIEW STRUCTURE: Interviews vary, but the ones I went on were mostly structured as full or half day interviews with tours, lunch or breakfast (or both) provided, and a residency program presentation by program director and/or a resident. Some have you sit in on sign out as well.
- Individual interviews were often done one-on-one or 2-3 faculty/PD/residents with you. Only one interview I went on had the applicant in front of 30+ people for a 15 minute interview.
- DINNERS WITH THE RESIDENTS: You are often invited to a dinner hosted by residents. This can be out at a restaurant or at one of the residents’ homes. Highly recommend that you attend! You can ask questions, get a feel for how the residents interact with each other, and have some friendly faces you’ll recognize at the interview! I was told to dress up (business casual, no jeans), but I’ve been to events were applicants wore jeans and were super casual. Remember, if you have the option of scheduling the dinner, go to one BEFORE your interview – this way, you’ll have a good feel for things and have some familiar faces before your big day (which is way more formal!).
- PREP: Make sure you know where to go, when, and whom to contact if you are late (get a phone number!). Go to the location the night before if you can so that things go smoothly the morning of. Get there AT LEAST 15-30 min early! Check the weather, pack appropriately. You can Uber/Lyft places, but remember that sometimes this can backfire as you don’t know if your ride will be on time. I almost always rented a car (yes, more expensive, but I liked the security of knowing I was independent and had transportation at my fingertips).
- BUDGET: Interviews are ridiculously expensive-think about plane fare, renting a car for anywhere from 1-3 or more days, hotel rooms, food, and other unexpected miscellaneous costs. Being the gullible person I am, I would often listen to the rental car people and pay the insurance or extra fees they talked me into – look into these things and see if they are really necessary beforehand. Check the weather – do you need a bigger car? Or can you take the smallest (cheapest) model and still be safe to drive it? Use websites like Skyscanner, Kayak, etc. Also, use miles! I had to fly to Virginia on super short notice and the tickets would have been over $1,000 round trip! I was able to use my miles and (even though I had to take three flights there and three flights back), my total flight cost was brought down to $250.
- SCHEDULING: I know a few people who took time off just for interviews. If you are staying primarily at your base hospital and it’s easy to schedule your rotations, I think you can safely take some time off here and there for interviews. Honestly, if you are doing a ton of auditions and scheduling rotations on your own, this is challenging. I scheduled all my rotations close to home (not at my base hospital) and really didn’t have much leeway in scheduling them, so I’d ask for time off for my interviews. Most places were super gracious about this. They understand you need to take time off, but it always helps to say that you’re willing to come in on weekends to make it up!
- Also try to schedule your interviews wisely – schedule the programs you are most interested in in the middle of your interview trail – I didn’t do this and had my top program interviews at the very beginning and it was super stressful. You get better and less nervous with time, but don’t put your top interviews at the very end either, people (including the interviewers!) tend to get more tired!
- PRACTICE QUESTIONS! Know what you’re going to say! Do research on the program, specialty, and on typical questions. I was asked things like:
- Why are you interested in our specialty?
- Why our program?
- Why should we pick you?
- Define ‘hard work’? ‘team work’?
- Behavioral / Scenario questions
- What draws you to this location?
- TELL STORIES: for each question, I had a story to tell. I think people remember you much better when they can associate you with an awesome story (they’ll remember a thrilling tale much better than an applicant giving a generic answer). I’ve noticed that programs are trending towards behavioral questions – where all you have to do is give an example of time when you did ____ and the consequences of your actions. Be prepared for this!
- DON’T LOSE YOUR HEAD: If a question throws you for a loop. Take a moment, you can even ask for a second to think, collect your thoughts and start talking. There were times I didn’t know where I was going with what I was saying, but I just tried to appear collected! Hopefully that’s what the interviewers thought too!
- GETTING INTERVIEWS: Sometimes you may not hear back from a program (after you submit your ERAS) you really wanted. You can send an email to the program coordinator or call them and tell them you’re super interested in their program. This may not help, but I got one interview this way – by expressing interest!
- DOING AUDITIONS: In the DO/ osteopathic world, this is CRUCIAL. You NEED to do auditions to get interviews. It actually works quite differently – DO programs are looking for candidates they know well. Also, DO programs tend to schedule multiple student auditioners at the same time (which can make things really difficult in terms of standing out). MD programs don’t tend to do this – you’re often the only SUB-I there, so you can really shine – but this also means that there are fewer spots to audition! So make a great impression during your rotation there! Some MD programs take this into account as well and will give you an interview simply because you did an audition. Others won’t give you a courtesy interview even if you’ve spent a month with them.
Well, this is what I could come up with! Please feel free to add!
Alright, all 2% of our readers that are seriously considering pursuing Psychiatry Residencies. Please sign in at the front door, make sure you haven’t lost your mind, and proceed to enter the world of neuroses, psychoses, and wandering thoughts. If you have been mindlessly paying attention, you will know that I am really into psych and am super excited about entering into this field. This is not a backup plan for me, this is THE plan. My goal as a psychiatrist is to work with chronically, severely mentally ill persons in a community behavioral medicine setting (hopefully with integrated care) and to work in psychiatric emergency services. I have completed the psych interview trail and recently put together my unofficial rank list. I come here to give you tips on how to best approach this messy year and am most helpful to you if you are interested in psych. But feel free to ask general residency application questions.
- Psych Residencies in General:
- Psych is one of the less competitive specialties. Poor reimbursement matched with the fact that mental illness is stigmatized and worsened by the belief that psychiatrists aren’t real doctors.
- Psych is a 4-year residency with a lot of Fellowship opportunities:
- Child & Adolescent
- Addiction medicine
- Decide if you are going NRMP (MD) vs AOA (DO) Match.
- I applied to both initially because I wanted to take advantage of dually accredited psych programs. Unfortunately, there are not very many of these available and I only ended up applying to one and pulling out of the AOA match.
- If you go NRMP:
- There are 204 psych residencies and they range in size. Some of the largest programs are 16 residents, smallest I’ve seen were 4 residents. Most are tied to large academic institutions and are centrally located in suburban or urban settings.
- TAKE USMLE STEP 1. At the very least. I know programs accept COMLEX scores, but in my experience it really helps taking USMLE Step 1 to get one foot in the door. If you take USMLE Step 2, you may get both feet through. I took both USMLE Step 1 and 2 and think this really helped me get some solid interviews because it put me in the running with MD applicants.
- *Dually accredited programs accept COMLEX scores, so no stress with these ones.
- If you go AOA:
- There are 24 psych residencies and they are small. I am not sure about all of them, but the ones I looked into accepted 2-4 residents/year. Most are community-based which is really nice but in more isolated locations.
- No need to take USMLE Step 1 or 2.
- I’ve heard rumor on the interview trail that there are certain AOA programs that are more malignant than others, be on the lookout for these ones.
- The Magic Number.
- 9 if you go NRMP. I think people can typically match within their top 5 and most will match if they have at least 4 programs ranked.
- No idea if you go AOA. I would guess 4.
- Write a SOLID personal statement. NO Crap.
- No joke, I got interview invitations off of my personal statement. The idea here is that if you meet a minimum requirement in your grades, clerkships, board scores, etc. you are seen as a decent applicant. But your personal statement is what will set you apart. No need to be a prolific writer, but have a story and be passionate. I had a lot of program directors directly ask me to talk about parts of my life based off of my personal statement. In psychiatry, this matters more than other specialties because programs want to see that you are truly interested in psych and why this field matters to you.
- Doing Sub-I’s/Aways/Acting Internships:
- I would recommend doing an elective rotation at a program that you are really interested in but don’t have regional ties to or for programs that are notoriously competitive. It also shows programs that you are legit interested in psych. I had a lot of faculty and program directors ask me about what type of psych rotations I’ve done and what I’ve learned from these experiences, etc. I think it makes for good conversation.
- A lot of 4th year medical students don’t do away rotations in psych as they don’t see it as being necessary.
- If you have RED FLAGS* on your application:
- Still apply broadly. Be mindful of programs that require you to pass without any failure attempts and apply to the rest.
- *failed any board exams or clerkships or classes
I think I’ve exhausted my focus for the evening. If you have any questions please feel free to comment. I am happy to be a resource for all you.
I did my first audition rotation in Ob/Gyn at an AOA program in Michigan. This was a really insightful experience and I think it will serve as a good baseline for my future rotations. Here’s a quick summary of things I noticed/recommend:
- What can they do? This program produces AMAZING surgeons. I saw a fourth year resident do a full (open to close) c-section in 17 minutes, do a robotic hysterectomy in 45 minutes, and do a pelvic mass excision, exploratory laparotomy, and bilateral sapingooophorectomy as the lead surgeon. They start training on c-sections from day one and are incredible by their second year.
- Do they have someone looking over their shoulder or autonomy? Do they have a lot of guidance or are they left to hang dry? Look at the fourth year students–are they competent? The second years take call every other week for 24 hours at a time and attending s are not looking over their shoulders–they run the floor. By their third year, they are so knowledgeable.
- Are there other residency programs? It might be good to be unopposed for family medicine or to be in a place with other programs to meet more people and have friends outside of your residency program?
- How far along the accreditation process is this program? This hospital system is VERY on top of their accreditation for the ACGME merger.
- How on top of things is the program? They are VERY on top of administrative issues: their residents take boards during their third year, freeing up their fourth year to look for jobs and get cases.
- Do residents go into fellowships?
- Do residents have families? Kids?
- How do the residents gel with each other? What’s the vibe? Does it seem malignant? Do the residents seem jaded? how do they interact with med students? Other residents from different programs? Do you gel with them? Does your personality fit?
- How are the didactics? Resident led? Conferences? Michigan state DO programs all meet once a month and do a day of learning for the residents.Lots of conferences and education opportunities.
- How is the volume? Are residents getting the cases they need? The volume was not too crazy so there was time to learn. , but not too low… the residents still got their cases.
- How is the resident and attending relationship? The attendings were not mean or demeaning. They just helped the residents learn.
- Are their opportunities to learn? The attendings gave daily lectures to the med students.
- Do the residents close using staples or suture? It might be good to train with suture and get really good at it… you can always switch to staples later on.
- Are you doing a 2 or 4 week rotation?
- 2 week: 24 hour shift, 1 week Gyn, 1 week Ob, 1 presentation 1/2 day in clinic, we started everyday at 5:30 am (round on patients); on Gyn – go to surgeries (assigned); on Ob – watch the board, triage, c-sections, NSVDs, post partum patients
- 4 week: all of the above + 1 week nights, +1 week Gyn
- AOA vs ACGME: AOA programs are merging with ACGME programs, so it’s important to check that the program is on track to merge. Some programs have not been able to fulfill some of the ACGME requirements and are getting shut down. I would recommend doing a few AOA and a few ACGME rotations in order to compare the two.
- KIT: Keep in touch. Make at least one friend among the residents, which can be tough. Exchange numbers and message them every so often to check in and let them know how rotations are going/if they are still your first choice. This is especially important in AOA programs.
- Remember that you are ON when you are on your auditions. It was tough going from the west coast to the east coast and trying to adjust to the time change, but you have to do it and do it graciously. Wake up early, get ready, and go! Be there before the residents, see patients, and give a solid presentation (something I still struggle with). Stay late but go home when you are dismissed.
- Take time for yourself. Auditions are stressful. Take a night off, watch a movie, meditate, go for a walk, do Yoga, listen to music, talk to people you love.
- Location? What’s the location like? Will you be happy here? Are there things that you need that are close by? Do you like to hike? What about a temple nearby? Is the area diverse?
- Food? What’s the cafeteria like? Do residents get a stipend? is it only useful for the cafeteria or is money deposited in your pay check? Is it Vegetarian friendly food? Are there nice restaurants in the area?
- Do they offer classes on billing? Do they help you with loan management?
I didn’t give a full review/ name the program I went to as I am applying there, but it was a great learning experience. I learned a lot about myself as well. Anyhoo, hope this helps!