Tag: SOAP

Not Matching Into Residency

What up?!?

This is normally a pretty touchy subject for students. Match day is stressful, and everybody is terrified about not matching. But as you know, I don’t shy away from touchy. Also, this actually isn’t that painful for me.

What are you talking about Joyce?

Well well well my chillens…. I didn’t match. Nope. I didn’t match at all. Nada. Big fat didn’t make the cut first round.

Alas… I’ll forever be the kid picked last on the playground!

JK. Well, it’s true I did not match. Although I interviewed very well, I only had 3 interviews in general surgery. And at most of those programs, they had very few slots available despite all 3 being D.O. programs or accepting mostly D.O. candidates.

So my chances were very slim to begin with. Now, that didn’t stop me from being hopeful. But again, I’m very much a believer that you are meant to be where you are led, even if it isn’t the path you chose for yourself. So I’m letting the universe guide my wayward soul to wherever it needs to be.

WITH that being said, I had “5” sub-I’s. Although several of them I was too sick mentally and physically to really show up for. But also, on those rotations interview season was closed or practically closed so I didn’t really care as much since they weren’t going to give me an interview. But I did notice that after choosing general surgery for fourth year, my mental health greatly declined.

Again, a touchy subject for people. I was excited at first to do surgery, however I slowly started to feel like I lost part of my soul in 4th year. I had a very hard time getting up and going to work; which if I was super excited to do I would want to get up and go. But I had a really hard time with my mental health and struggling to feel like I was smart enough, capable enough, independent enough, worth it, confident enough, etc. Like I’m talking it was a good day if I left my room to eat or shower. I was in a state.

And so my downward spiral began. And instead of getting better at each new location or as the year went on, it got worse. I thought it was just severe burn out and I needed a vacation. But because of the way things have panned out, I’m starting to think that maybe because I feel like I lost part of myself and that maybe, surgery just isn’t really for me.

I thoroughly enjoy being in the OR and using my hands. It’s hella fun. However, the lifestyle takes a certain type of person. And quite frankly, I’ve had a hard enough life in certain aspects (won’t get into that here) and maybe, just maybe, I sub-consciously need a break. If I would have been at this crossroads when I was younger, truthfully I would have still had a full enough tank to tackle this. But given where I am currently in life, I clearly needed some divine intervention. Obviously the spirits, angels, and my ancestors were NOT a fan of how this season of my life was shaping up and decided to step in and do an intervention. AKA, me not matching.

It’s aiight. I get it. I wouldn’t wanna watch my favorite character tank either.

And so here I am, in the evening of the day that I found out I didn’t match. So what are the next steps?

SOAPing steps

So, you sign into the NRMP site (match site) that Monday of Match Week. There are helpful videos on the NRMP site explaining how the SOAP will go and the timeline of everything. They also walk you through things on the ERAS site. At exactly 9am ET, you find out if you match or not. If you didn’t match, your school was sent a list of students from that school that didn’t match earlier in the morning to help them prep contacting you and assisting you, supporting you, etc. The site will also email you saying if you matched or not.

This is technically the “scramble” part of the match. It was renamed the acronym SOAP several years ago. However personally, it makes more sense to call what happens after the SOAP the scramble in my humble opinion…

If it says “sorry, you did not match” you are automatically signed up for SOAP if you are eligible. Since you were eligible when you applied for the match the first time around you should be eligible for SOAP. This year, we had exactly 1 hour from NRMP releasing if we matched or not and access to start re-applying to open slots on ERAS. As soon as you find out if you match or not, you can look at the list of “unfilled positions” under the SOAP tab up top. It basically shows you how many specialties have unfilled positions, how many are categorical, how many are preliminary, how many are for those who did a transitional year/prelim year and are applying their second year of residency, etc. You do the clicky clicky where you want and it will pull up a PDF list of all the sites open for that specialty.

I then used FREIDA to look up these programs. For surgery at least, there are LARGE hospitals that will have several prelim spots. Like I’m talking 12-25 spots. They usually always have space for prelims. However, they will work you like a dog and likely not take you into their program the following year (so I have been told by other surgical prelims). So, take that with a grain of salt when applying. So I used FREIDA to help determine how many prelim spots programs had compared to how many categorical spots they had. If there was a large portion of prelims compared to categorical spots, then I likely wouldn’t match to that program after my prelim year. I also used it to find out if they tended to take D.O.’s, if they took COMLEX scores, and percentage of D.O.’s in that program, etc. If they were MD biased or didn’t take into account COMLEX, I passed.

You get 45 application slots on ERAS. You do NOT have to use all 45 slots. You search the programs that you want to apply to on ERAS and apply just like you did for residency the first time around. The difference is the site will tell you if you click on something that you can’t apply for (like a categorical that isn’t available or a program that isn’t on the SOAP list). You don’t have to spend any additional money on applying during SOAP. It is $0.00 to apply during this time. Make sure to assign everything and that there is a green notification next to each attachment for your application. Just like the first time around; your LOR’s, COMLEX/STEP scores, personal statement, photo, all of that need to have a green notification next to it for each program. If they do not, your application is not technically complete.

I ended up applying to 24 surgical prelim spots and 2 unfilled categorical spots for general surgery. There was an additional categorical spot in Michigan, however I know that hospital and have heard from many DO students that they turn their nose up to DO’s and don’t even offer them sub-I’s. So you bet your ass I wasn’t going going to waste a spot on that sorry excuse of a program. (Hair flip, thank you!)

THEN, after a long discussion with my significant other and some soul searching (I was honestly surprised that I hadn’t shed a tear at all at this point) I decided that maybe surgery wasn’t for me. I took most of the day to contemplate if I wanted to do this or not, but I decided to go for a transitional year spot as well.

I did this with the following thinking: If I ended up in a surgical prelim, I would continue to pursue surgery. I spent all of 4th year doing surgery thinking that this was for me. If I ended up with a transitional year, I would look into a medicine specialty that I overlooked before.

EITHER WAY, I would be getting valuable experience as an intern. I hope at this point that this will help boost my confidence and the repetition in knowledge to help me be a better doctor. Because right meow I do not feel like I know or remember anything. I can take a mean history and an okay physical, but the rest of the shit I’m supposed to know how to do is shaky at best. So this next year will be helpful.

I could have applied straight into a medicine program; however I didn’t have any LOR’s ready and I really wasn’t sure if I wanted to commit to something in medicine yet. I want to explore all that shit and then make an educated decision. It is my future after all.

So, the remainder of my 45 slots went to transitional positions around the U.S. I picked programs in states/areas that I wouldn’t mind living. I wasn’t going to be worried right now on if I would have to move again at the end of next year. That is a next year problem for next year Joyce. She can figure it out then.

Tuesday and Wednesday of SOAP Week:

Interviews:

So these two days are set aside for programs to contact you for interviews. You are not allowed to contact a program during SOAP before they contact you. It is a violation and you will basically be pulled from the SOAP process if you do so. Programs are allowed to look at applicants at 8 am on Tuesday of Match week. Some people (according to reddit) started to receive a call by the afternoon or evening. A lot of people didn’t hear anything my year.

During Tuesday I was still in good spirits. I was able to keep myself busy. I spoke with friends and family. Took walks. Read books. Tried to keep a decent schedule. I went on a long drive (I’m in Arizona for a rotation) and enjoyed the weather.

Wednesday is when some people started getting interviews. I was told by my school that surgical programs typically called in the evenings. However I got nothing. Nada. No interviews.

Surprisingly I was still okay. I had a little bit of anxiety and that pit/hollow feeling in my chest but was able to still be busy and productive throughout the day.

Thursday of SOAP Week:

SOAPing rounds:

You can look on the website, but there are 4 rounds. 9 EST, 12 EST, 3 EST, and 6 EST. Or at least these were the times set for the rounds for my year. Since I was in AZ, my day started at 6 am. The way it works, is you are given offers at each round. You can either accept or reject offers. It is HIGHLY recommended you accept whatever is given to you. Once you reject an offer you are not offered it again.

My first two rounds I got nothing. At this point I actually had a little breakdown. Truthfully I’m surprised I lasted so long without doing so. But I started to get anxious and question life and you know the whole story because I’m dramatic. I be cursing out the universe. Ya know, normal dramatic Joyce things over here.

40 minutes before the next round I got a phone interview. I believe it went well and I was nervous that it was too close to the next round of SOAP offers but I was also super excited that I even got an interview. Given that I had heard nothing all week.

Thankfully, I was offered a spot at the place that interviewed me and I will be doing a transitional year!

IF YOU DID NOT SOAP, you can either try contacting programs directly to see about open spots or do a research year. Some programs don’t meet the cutoff for SOAP, etc so a list of programs that weren’t available before may be available after SOAP rounds finish. Those are the programs you can reach out too. This varies from year to year.

FRIDAY of SOAP WEEK:

MATCH DAY!!! This is where you find out where you matched. If you were lucky to find out you matched on Monday, then Friday is when you find out where you matched. If you had to SOAP, you already know where you matched from the SOAP process and get to celebrate with your classmates. Typically this is a day of celebration for everyone who matched.

Recommendations:

Well first and foremost- if you need to take time to process not matching do so. Give yourself an allotted time to grieve if you need to, or just settle and accept what happened. Likely, there wasn’t anything additional you could have done to change the outcome. I bet in most cases that you are being nudged to either look at your current position and reflect; either re-address and go a different route, or re-assess what you overlooked. Maybe you didn’t apply to enough? Maybe you didn’t get enough interviews? Maybe your LOR’s weren’t as strong as you liked or your personal statement could have been better.

Two, make sure to research the places you are SOAPing/applying too. Also, make a list of the places you applied. That way when they call you for an interview, you can look up what program it is, where it is, and what speciality it is for (if you applied to more than one speciality during the SOAP rounds).

Three, you can absolutely draft an email for the scramble/SOAP if you need too. Maybe it will help prep you. You may even need to actually use that email. However, things have changed and this current year you were not allowed to contact any programs until they contacted you. If you feel you need to send an email to that program after an interview with them, then having a drafted email with all your information, personal statement, MSPE, etc linked for easy access.

Four, get yourself some patience. There is absolutely nothing you can do to hurry shit up. Programs will contact you on their terms on their time IF they contact you for interviews. Programs don’t get to see anything of yours until Tuesday morning, meaning most places don’t call until that afternoon or the next day. Make sure you have things to help keep you calm and distracted; you’ll need it.

What’s Next?

Well, I know I will be moving to Florida for my 1 year transitional intern year. After that I will have to re-apply. I will let ya’ll know (when I have time to write) how that works, how re-applying has been, etc.

Congratulations to all those who matched this year! Congratulations to those who SOAPed! And for those who did not, do not give up. You didn’t get to becoming a physician by stopping when shit hit the fan. It’s just a bump in your road. Pick yourself back up and don’t let someone tell you no. At least that’s always worked for me 🙂

Cheers!

Residency Interviews!

Alrighty! You asked and I’m delivering. Actually you didn’t ask but I’m delivering anyways.

You welcome.

Residency interviews are a bit different than medical school interviews. It isn’t trying to convince someone why you want to do medicine and why you have the determination and persistence enough to succeed as a doctor. No. You’ve already done that.

You did your time. You’ve shown you can make it through medical school.

Now it is about trying to find a program that fits well with you and if you fit with them. Sure, some places weight board scores heavily. NRMP director’s report tells you how residency programs tend to weigh/prioritize your application responses. [Go to page 10 on this report; there are multiple charts you can look at for this information.] Other data from the match site itself is available for you to look at as well. But overall, doing a sub-I/audition can make or break your ability to get an interview especially if you try and get along at that institution.

They want to know typically more why you want to do that specialty. Sometimes why that program, but mostly why that specialty. Can you show you are passionate enough in the way you answer/speak about the specialty? Other than that, questions can range to nitpicking apart your application to just wanting to get to know you to see if you are a reasonable and likable person. Remember, you are about to work with these people very closely for 3-5 years (in most cases, unless you do neurosurgery…). They need to know you are a hard worker, can take direction and be taught, and get along well with others. Can you handle when people get upset? Can you take direction from a resident above you in their training even if they are younger than you in real life?

All of these questions are things that need to be answered when a place is interviewing you. Again, residency is more about the fit between you and the program. Whereas med school was more about can you succeed if we take a chance on you.

What an Interview Day Looks Like:

I have asked a few students to tell me how their interview days were across a few specialties. In general, it seemed like medicine interviews were longer days with many more individual interviews, whereas surgery tended to be shorter days/interview times and with either less people or you would interview with many people in a room with you.

These responses are based on the average/overall from several interviews during their application cycle. Each interview likely ran different, even if only slightly. Please take this into consideration with their responses.

From someone applying ENT:

  • Interviews were usually 30 minutes maximum.
  • If you did an audition it could be as little s 10 minutes for an interview
  • In this case, residents also interviewed by hosting breakout rooms. This individual had interviewed with a chief and/or two junior residents this way as well

From someone applying Ortho:

  • Interview day usually lasted 3 hours to half a day.
  • An average of 5 interviews the day of with different people, one of which was a chief resident or another senior resident

When I applied general surgery:

  • My shortest interview was 10 minutes. My max interview was 45 minutes.
  • 2 of my interviews (as these were virtual) had myself and several people all in another room or connected from different rooms. There were a range of residents present on my interviews (including chiefs) and several faculty members and the PD.
  • The one place where I interviewed in person, I had 3 separate interviews ranging from 10 minutes to 30 minutes.
  • One interview had second years available for us to answer questions about the program in-between people interviewing.

Internal medicine (from several students):

  • Some places gave an itinerary for the interview day
  • Interview days on average seemed to be half a day or somewhere between 4-5 hours.
  • Range of interviews from one student: 2-8, another: 3-5, and another: 2-10.
  • Interview times with individuals would range between 15-25 minutes amongst the answers given.
  • Some students also attended morning report and noon conference on their interviews.

Number of Interviews Per Specialty for Successful Match:

Now, this doesn’t mean you won’t match if you don’t get this many interviews. This is just the average. I have personally known cases where someone has only had ONE interview in their specialty of choice and had matched there. They worked their ass off at that audition, but they matched with only one interview. It is possible; it is just not the norm or commonality.

I only had 3 interviews for general surgery. Again, I am a DO, and I had shitty board scores. 2/3 interviews were at places I auditioned at. One was a DO specific program in my home state.

Probability of U.S. DO Seniors Matching to Preferred Specialty by Number of Contiguous Ranks

Specialty80% Chance of Matching90% Chance of Matching
Anesthesia69
Dermatology68
Diagnostic Radiology69
Emergency Medicine68
Family Medicine46
General Surgery911
Internal Medicine46
Interventional Radiology79
Neurology46
Neurosurgery20 
OB/GYN912
Otolaryngology79
Orthopedic Surgery68
Pathology15
Pediatrics45
PM&R812
Plastic SurgeryNo data availableNo data available
Psychiatry810
Vascular Surgery34
Data provided to me by my school’s residency coordinators. Not sure how up to date this is.



Prepping:

So, just like with every other interview you need to prepare. Again, just like my medical school interview, I didn’t do a ton of prepping. Because let’s face it….. I like to fly by the seat of my pants. However some people spend an entire week prepping.

Things you should do:

  • Review your personal statement/familiarize yourself with it
  • Review your application. What did you put on there for experiences? Do you remember your scores? What did you put under about me/what you like to do?
  • Look into the program you are applying at. While some of your interviews may be at programs that you randomly applied too, make sure you get the underlying gist of the program. You will need this to ask questions. They may also ask you why that program.

I’ve had questions asked about all of these to me. So at least review what you put. It won’t hurt to refresh your memory and give you good ideas of things to talk about. Some of my interviews were very by the book like this and they straight up asked me to confirm things/expand on my application what I put. Some really just asked me random things/wanted to get to know me.

I have put some links that I used to prep. There were definitely curveball questions at one site that I wasn’t expecting and no amount of prepping would have helped.

Common Interview Questions

110 Residency Interview Questions

100 more Residency Interview Questions

A common thing I was asked was to explain my poor board scores and how I planned to improve my scores in residency. Some places just wanted to know I had thought about a plan to improve. Since my board scores were my weakest part of my application, this one was asked at 2/3 places I interviewed at.

THINGS YOU SHOULD NOT BE ASKED:

Yes, actually. There are things that they cannot ask you (but try to anyways because they are pricks) and shouldn’t ask you. I found a blog post interviewing another physician on these types of questions and different ways you can answer them. This post/blog is very woman-centric but the information in this post is very good.

Here is a study done on what questions were asked and the percentage that was asked. Very interesting read. Titled “Potentially Discriminatory Questions During Residency Interviews: Frequency and Effects on Residents’ Ranking of Programs in the National Resident Matching Program.” Honestly, I would have picked a shorter title but whatevs.

Tracking Interviews:

As a suggestion from another fourth year, she recommended keeping an excel sheet/google sheets document with dates of your interviews and zoom links. Along with other information. This way, you don’t need to panic trying to find the one email in your inbox with all this information on it. You can also organize it in a way that makes sense to you.

Additionally, if you are lucky enough to get multiple interviews or more than you feel you need, you do not need to take all of them. Make sure if you did auditions there you do try to interview with them (as you did take your time to go to their program). But if you feel you have too many or there are programs that you threw your application into the wind at and just aren’t feeling it, you are able to decline their interview offer.

Wardrobe:

At this point you should know how to dress professionally. NOT BUSINESS CASUAL LIKE WHEN YOU WORK AT AN OFFICE. Needs to be a suit and tie for men. And a suit and/or appropriate work dress with suit blazer for women. Women should wear nylons or tights if wearing a skirt/dress. Otherwise, I think you can figure this out.

In Person vs Zoom?

So, I preferred zoom just because I didn’t have to travel back to a location that I did a rotation at and it was easier. I had a slip-up with one of mine due to time changes and let me tell you I was glad I was already home. Straight up threw on a blouse and suit jacket and left sweatpants on. You know… classy.

Zoom will save you money on traveling and time. But if you are able to get an interview while rotating there in person I do think in person is the best way to gauge a program. You get to physically feel the room and how things are going. Plus, while there you’ve either been working there or visiting there and you get an idea of the program and people itself. Hard to do over zoom.

Call Schedule

Make sure you ask about this. It is appropriate to know several things since you will be a resident there. If the call schedule seems wayyy to hectic maybe not the program for you. You are gunna be run down and tired as a resident. No need to make your life harder if the call schedule is insane.

  • How often do you have call?
  • Do you have a post-call day? Or are you expected to work the entire full workday following call?
  • Is call based on nights vs weekends, is it a full 24 hours, etc.
  • Do you have a buddy system for first years?
  • How many teams are you responsible for during call?


QUESTIONS TO ASK YOUR PROGRAM

These questions are by far going to change based on location/program/and specialty. These were mine. You can add/delete/change things for yourselves and obviously you need to ask questions that will work for you and your specialty. Again, this is just to help you out if you are stuck. I do recommend if you are rotating there you will come up with questions while you are there so make sure to have a list. If you get offered an interview, ask the most pressing questions you want to know during the interview. Usually 1-3 are fine per person/group of people. The rest ask the residents.

  • what % of graduates that pursue fellowships get accepted?
  • any global health opportunities?
  • How frequent are residents required to travel to other cities for rotations? (If they have other locations this is something to ask).
  • what opportunities are there to practice my skills outside of the OR? I.e. skills labs?
  • what are you doing to improve the program?
  • what advice to you have for me to succeed in this position?
  • early intra-operative experiences?

Hope this was helpful and good luck. Cheers!