A Program Director's Tips For ERAS

Donald Morrish, MD

Donald Morrish, MD is a former Associate Residency Program Director and a board certified practicing physician who knows how to compete for a residency training position. He provides ERAS® application and personal statement editing and review, one-on-one mock interviews and strategic planning for a post-graduate residency training position. Today he answers some questions we have regarding applying to residency!

How much does Step 2 actually matter? Can a good Step 2 score make up for a below average Step 1?

HUGE! I'll say it again...it's HUGE! Here's the play. If you have an ok USMLE I and a great, or significantly improved USMLE II there are so many ways to benefit from this accomplishment. You exhibit a growing fund of WORKING medical knowledge (that's what step II tests and PDs evaluate, your medical knowledge) it exhibits your self improvement skills, being able to analyze your performance, set a plan and execute it and produce! It exhibits professionalism, working medical knowledge, self-improvement, maturity, etc. You can use it as a strength during your interview as well. PD asks, what are some of your strengths your response..." I'm goal-oriented. I recognized the need to improve my fund of woking medical knowledge that would be translated in to better patient care activities so I did a little reflection, changed my study habits, improved my test taking skills and achieved my goal of scoring a 260 on my STEP II." That a hell of a lot better than the standard med stud response, "I'm hard working, good team player." The goal oriented response score some major points and distinguishes you as a strong candidate with solid interpersonal and communication skills too. Wow, that's a lot but that's how much a difference a professional can teach you. It's all in the details! Best of luck and do a killer prep for step II.

Did you find a good correlation between the success of your residents and their step scores?

This is a really good though difficult question to answer. On first answer, strong step scores = residents with good in-service scores. That being said in-service scores aren't everything. PDs evaluate residents on interpersonal and communication skills, professionalism. Practice-based learning and Improvement, Systems-based practice and Patient care abilities too. These remauing 5 areas can be easily evaluated through the quality of your ERAS app, supporting documents (LORS, MSPE) your interview too. Hope that answered your question. Best of luck!

Does the status or prestige of the person who writes your LORs matter?

Yes, immensely. Not all LORs are created equally. The boots on the ground preceptors who know what PDs are searching for should be your authors not residents, podiatrists, dentists. There's a ton to learn on obtaining a phenomenal LOR and it's one of the biggest mistakes candidates make in submitting the wrong number, wrong author and poor content. I wish you the best of luck, get what you deserve a phenomenal LOR whenu perform well during a rotations.

Do readers have an eye for breadth vs depth wrt activities? I know some who will list multiple single occasion volunteer experience as if they were each long-term projects.

The ERAS application requests information on the dates of the activities and let me tell you. PDs are a r pretty savy group of accomplished individuals who know the ins' and outs' of when their are being bs'ed! Candidates who pad their apps loose out because most PDs have been around the block a few times and spot padding a mile away. Solid activities that are socially redeeming and NOT a "Health Fair" such as Big Brothers' Big Sister's are great organizations where you as an candidate can exhibit your substantial volunteer work. I always tell med suds, add meaningful content to your application because it only gets reviewed once. Good luck!

How much time was spent reading each personal statement? Any point in putting in some serious effort? What made some personal statements stand out?

Pds will read your entire personal statement if your ERAS app piqued their interest. Oftentimes, PDs will ask themselves, does this candidate interest me enough to interview?...it's simply that important. Write a personal statement that distinguishes your candidacy. Let a PD want to meet you in person. Write about your interest in the specialty, give examples about why your the best cnadidate and express your true likable personality. Best of Luck!

To those of us who still have a few years before ERAS, what steps can we take now (besides scores) to make ourselves as competitive as possible?

Research, network within your intended specialty, advanced certifications, strong personalized LORs, and a commitment to setting yourself apart from those who do the basics! Good luck you're on the right track!!!

Where does continuity in your chosen specialty rank among factors for matching? For instance, if I'm interested in EM and have been continually involved in EM (research and volunteering), how does it appear to PDs in the grand scheme of things?

Big! It speaks to your professionalism. A core competency PDs evaluate residency candidates on. Consistent involvement involvement in the specialty score points and it will give you more street cred when you claim in your personal statement EM was a mature, professional choice based on first hand experience. Good luck!

When doing away rotations, I understand it's our opportunity to "audition ourselves" to the PD/institution. Is there any real way surefire to obtain a letter of rec from the chair in an away rotation? I guess I'm just really unsure if there's an appropriate way to do it (especially if you've maybe worked with the chair a few times)

Thanks!

When someone sends me a chair's letter I don't place much value in it. Multiple reasons, Chair's are very busy docs the have admin responsibilities, some do clinical work, some do consulting, (like myself) and don't get to know med studs as much as the PD, Division chiefs etc. Chairs don't write phenomenal LORs, you get a form letter and last but probably most important. PDs know Chairs don't spend much time with med studs, they're with their residents. Bottom line go for the boots on the ground docs who know how to write letters and can attest to your abilities. One last comment, don't ask for a lor on the fly be professional, make an appointment and provide them with solid information about you. The extra effort pays off tremendously. Good luck! 

Can you match into a competitive specialty without research at all?

Anything is possible but if you're looking to increase your odds research is one of the important characteristics strong candidates exhibit to garner more interviews. Research isn't all about peer reviewed journal publications, it can include abstracts, poster presentations, etc. There are great ways to exhibit Practice-based Learning and Improvement Skills (research) without formal research experience and publications! It's my secret weapon in teaching candidates! Best of Luck and try to get some experience! the higher the overall rating the better the chance for an interview and once you get your foot in the door, promote and distinguish your candidacy! Best of Luck!!! 

Among the thousands of applicants that you've considered, is there one in particular that still stands out to you to this day?

Yes, there's one application that stood out. The applicant's ERAS application was "good" not great though met our criteria then I read the individuals LORs, that had killer content and then their personal statement was so honest that I wanted to interview the applicant. What made the LORs stand out was the content of each lor was individualized as if the author knew the candidate and spoke of their specific skills, qualities and accomplishments and then added a personal note. Not a typical form LOR, the author wrote specific interesting qualities about the candidate to validate their first hand knowledge of candidate. Then the applicant's personal statement spoke to me as a PD and as a human. The candidate told me why those chose the specialty (with sincerity) backed up their claim of great skills and qualities and let me in on their personality. I wanted to interview the candidate myself and I was happy I did. Bottom line, strong LORs (can be done easilty though not the usual way) a solid, well-written personal statement that gives another dimension to your candidacy. Good luck.

How could you tell that the applicant was writing sincerely.. was it more a matter of content or writing style?

Great! It was both, let me teach you a very important lesson. The content and the style of the personal statement was solid. But what impressed me more, the writing style found on the applicant's ERAS application was consistent with their personal statement. Candidate's oftentimes have professionals write their personal statement and then the PD looks at the quality of the ERAS description section. If they appear dfferent, you didn't write your own personal statement or ERAS application. Your ERAS app will be tossed into the round file! The mistake is what I call the ERAS application/ personal statement Mismatch...no pun intended. It's great to get expert advice and editing but not legal to have a inexperienced (re:residency) write your personal statement. Good luck!

What sort of things should be included in a personal statement? Also, how badly will 1 poor grade in a clerkship hurt an otherwise strong application?

Why you chose the specialty, what specific qualities, skills and accomplishments you bring to the specialty and program. Promote your candidacy in a modest though interesting way. Clinical vignettes, talk of a dying family member (although life changing, PDs' don't want to read it again), choosing to be an MD/Do at ean early age, etc is so pedestrian and boring. Perform a self assessment of your skills, the you chose the specialty, highlight the skills PDs seek. If your aa Psychiatrist, have stellar interpersonal and communication skills, the quality of your ERAS descriptions, attention to detail, a fluid personal statement, etc. will open doors. One poor grade shows your human. If you say some died or you thought your preceptor was an idiot, I wouldn't hire you. If you claimed responsibilty for the "shortcoming" and told me what you did to rectify it and exhibited proof, cool, I'll look at your application. Submit a stellar application and personal statement then interview like a pro and one less than perfect score will not impede your success! Good luck!

Hi Dr.Morrish, I wanted to know your take on having research done in college/achievements obtained while in college on our ERAS app? Thank you!

If your ERAS application lacks some significant meaningful content such as recent pubs and advanced certifications, etc. then place the research on your app. I know I'm beating a dead horse on this comment though...highlight the research skills, qualities and accomplishments you worked so hard to learn during the project. Eg, biostatistics, epidemiology, etc. The project itself isn't too important to PDs. I wouldn't include the college achievements b/c PDs will say to themselves what have you done lately. Best of luck! be able to discuss your research during interviews and programs thinking you'll add value.

I'm not a medical student, but I am wondering for more selective specialties, how are multiple research in different fields looked upon? Let's say I wanted to go into...I dunno....say Ortho. And I have 2 posters of Anesthesio here, 1 abstract from a Plastics basic science research stint, 2 pubs from a clinical ortho lab, and 1 paper from endocrine basic science lab. If you were an ortho PD, would you care only for the 2 pubs from the Ortho lab or would you look at the entire package?Also how do you view publications/research done in undergrad/gap year if they were in a medical field?

My pleasure, you're a part of a great group! Good question, maybe u should pursue ortho! Entire package because I'm looking for the skills, qualities and accomplishments not the specific project. If you have an application that doesn't distinguish your ortho candidacy and it's so generic and not geared towards ortho that you have some "splaining" to do. You'll need to convince a PD you're a good ORTO candidate otherwise will chose another awesome candidate and there are plenty to chose from.

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