DIP Episode 327 - 26 Rules For ERAS and The 4th Year of Medical School (+ 7/14-17 2CK Course Reminder)

Okay, welcome. My name is Divine. This is episode 327 of the Divine Intervention Podcasts and in this podcast I'm going to be you know branching out a bit from the classic stuff I discuss and I'll talk about the 26 roles for the era's application cycle and for your fourth year of medical school. This will be a short and sweet podcast. I'll just kind of hit on a few high points real quick and then we will go from there. Just as a quick reminder I know many of you love the life lessons. I've got in tons of emails on this. The life lessons I put at the end of my podcasts. I'm still going to be putting some you know at the end of podcasts every now and then but I actually started a podcast another podcast website, Divine Intervention Life Lessons.com where I put life lessons again may have you listening to this podcast not a Christian so I just put a bunch of life lessons on there. There are all less than 10 minutes long and I also have the podcasts on Apple Podcasts so if that's something you're interested in you can subscribe to the website or you know go to that subscribe to your Apple Podcast and you'll get more information on that. So far I think I've uploaded about seven episodes and I'll keep uploading episodes pretty pretty frequently and then if you're taking step two, see you step three soon. Basically I have two groups of things I'm doing. If you're taking your exam very soon I do have an MBME Testicons Strategy Score. Sticking Police this Wednesday from 2 to 4 30 p.m.

Pacific Standard Time and then on Friday Saturday Sunday. I mean sorry on Thursday Friday Saturday I have a course that's taking place a comprehensive step to see case step three review course. Obviously it's also pretty useful for people taking complex level two and three. So if I'm interested in any of those things just shoot me an email through the website, through the contact button and then in addition to that I have released information for all my course dates from basically late July. So you'll have a dinner your test very soon you should be taking the course this week. But then I've released course dates for late July all the way to like mid- September and again the course covers PEEDS surgery internal medicine, OBGYN psych, Neuro, healthcare systems, communications, ethics, biostatistics and multi-system processes and disorders. Okay and then the Testicons Strategy Score really helps you break down NVME questions and answer them correctly. Okay so let's just jump right into our 26 rules right so what is row number one? So this podcast applies to 40 years and people that are going through the era's process. So what is row number one? Row number one is if you've not taking step two CK go ahead and take it now. Go ahead and take it now. Take it no later than the first week in September. Again as many of you know step two CK is becoming a very important exam in the eyes of many program directors.

So the thing is step two CK would confidently say at this point is way more important than step one. Obviously you still need to do well on step one but I suspect the time will come especially probably from next year next year probably be like the big inflection point where if you don't have a step two CK score the application is probably just dead in the water. The only people that this row does not maybe really apply to unless you took step one and you got a really high score in it like something in the 250's, 260's, 270's then I will say in those circumstances you can probably delay you exam a little bit but they're just certain specialties that just really want your step two CK score while your era's application is going. So again if you want your scores to come out in time for your era's on September 29th and you want to make sure you have your score you want to make sure you have your exam done probably by the 10th of September at the latest and then row number two is stop working on your personal statement. It's amazing how long it actually takes to get a quality personal statement down. Many people leave the personal statement for the last minute but that's not a wise thing to do. The reason it's not a wise thing to do is one you're gonna need multiple edits to make it a masterpiece that's one.

Two some people that write to recommendation letters they actually want a copy of your personal statement even if it's a draft so you can give them some inspiration in writing your recommendation letters and that leads us to row number three. Rule number three is to just go ahead and make sure that you call all your recommendation letters. Right? The thing is usually the smartest play with era's applications is to ask you for your recommendation letters as early as possible as recently as possible. So let's say for example you rotate with a person in January you should be asking them for recommendation letter as quickly as possible after that because the thing is months later they may have forgotten the quality of the work you did in writing your thoughtful recommendation letter. So corral those recommendation letters you see some people they'll wait till July, August, September to start asking for rec letters but the thing is at that time just like you're asking for rec letters there's probably 20 other people asking for recommendation letters from the exact same person and then obviously for person is only has like one recommendation letter that he has to write. He will probably put more thought into that than OG. I have like 15 to 20 recommendation letters I need to write.

Obviously in that case the quality is going to be diminished because the person just does not have unlimited amounts of time because many of these people are attendants and many times many students forget that many students have families of their own. They have clinical responsibilities. They probably have research and teacher responsibilities as well. And then the fourth rule is to prepare for your interviews right. So prepare for your interviews. Again there's nothing like just having that confidence boost that you know what oh I feel pretty good about my interview skills going into an interview. So make sure you have more interviews with a resident and with an attendant. You know also do more interviews with people but again if you're interested in that just hit me ship me an email through the contact part of the website and I'll say some more things about my eras advice in the end. And then rule number five is use personal reliable email for your eras application right. I generally tell people don't use school emails. The thing is school emails have a lot of IT requirements they must make. Have a lot of security requirements they must meet. Have a lot of hip-hop requirements they must meet. So the thing is sometimes you may be surprised. A residency program is sent out an interview invite in in the morning and your school email will put it in spam when it won't come across until hours later.

And then by the time you're logging into eras to choose a date all the dates are gone and it's just crappy interviews that are remaining or they may be no interview dates at all right. I've learned this lesson the hard way when I was applying to med school believe it or not. So you know and they are certain email providers that are just not reliable. Okay again obviously I'm not gonna say anything about those but I will tell you that in general a Gmail address is usually pretty reliable with with eras applications. So that's just something you want to keep in mind. And then the role number six is a digital eras application for grammatical errors. You'd be surprised again because I've edited tons of errors apps for more errors apps that I can count. And you'd be amazed at the number of grammatical errors that people have in their errors applications. So that's just something you want to be careful about right. And the thing is when you're describing your experiences in your eras applications don't write long paragraphs really pair down your paragraphs because again many times your application is being read by some very busy program director or some very busy program coordinator or some very busy attendant right. If they see that you get to the point then you will tell them the higher parts of your app right.

But if they see that you're just being fluffy fluffy fluffy then they'll just breeze through your app and then they will miss out on key portions of the application that you want to really want to put in front of them. And then role number seven is that is your if your application is low on research. Consider a bank in out as many case reports as you can. The thing is if you're very and there are many websites online that show you ways to write case reports. A case report is busy like a really long like admission notes with a big discussion at the end right. So the thing is bang out as many case reports as you can. The thing is it can actually help and otherwise research law application look better right because you can list them as publications on your eras application. I mean if you're very motivated you can have a case report don't within like three four days if you're very motivated and their role number eight is make each section of the application thoughtful. Make each section thoughtful. Make it a masterpiece. Make it well put together. Get rid of fluff. Don't in multiple parts of the application keep rehashing the same thing. Again, I did many applications in the past. And you see people did just put all this fluff all the stuff that just is not necessary at all for the applications right or less it's an experience where you need something for an hour. Again, those things don't add much value to an eras application. Put your valuable experiences right.

Sell yourself in the best way possible. That's a very important thing. Don't rehash like something you're going to extensive detail on your personal statement. Don't go into extensive detail on that in your eras application. Just put quick highlights most times when you're describing your experiences give you two to three sentences. And then the next role number nine is a key some key thoughts I guess to keep in mind in writing an eras personal statement or one you want to describe are you how you got into medicine briefly right you talk about why you love the specialty right talk about what are your future plans and goals are talk about what you desire in a program many times what you desire in a program you want to put it in the conclusion right and then you can also talk about what you want to contribute to the discipline long term. The thing is many times some people try to get like extremely creative with their eras up with your personal statements and then the end of writing things that are very complicated to follow very difficult for program directors to follow because the thing is believe it or not most people will probably spend no more than five to ten minutes reading your personal statement. So again you want them to get your point so you want it to be well organized you want it to be a decent size no more than a page and a half at the most or usually tell people a page and a quarter at the most.

So those are just some key rules to keep in mind and then rule number ten is if you have a specific location where you have from geographic altize let's say like your spouse is a resident at some institution in that state or you have significant family in that state or you were brought up in that state or there's like a rural area that has a residency program you really love then the thing is you want to emphasize it in your concluding paragraph you absolutely want to emphasize in your concluding paragraph obviously you're gonna essentially make like a separate personal statement where you just make these changes at the end right because again sometimes you obviously don't want to send this to other programs that are not in that geographical area you're pretty much putting a pin in your application by by doing that and then rule number eleven is don't crap on other disciplines in your personal statement you see some people they say let's say for example you're applying to general surgery you're like oh you know I I lot I absolutely loved my general surgery rotation I didn't get anything from other rotations right when you torpedo order because remember medicine is an interdisciplinary science if you torpedo order disciplines your personal statement it comes across across very bad and then rule number 12 take good photos again the thing is when you're putting your application again you don't want to have a photo that makes you look like a war criminal or makes you look like like you see some people some of their photos are just too casual it's almost like a beach photo kind of thing no don't do that right you're going into a professional discipline you're going into a setting way you expected to be professional one element of professionalism is just taking good photos right so invest the money and take high quality photos most times your dean's office will know someone

that is really good at your job and then rule number 13 try to make the second half of your fourth year really mellow right you know the thing is when you're going into residence you're literally going into a very hard working part of your life right so it's very important kind of slow down a little so from that like generally to me period where you've not studied residency you know try to like relax a bit try to travel a bit right the thing is you see some people they try to do multiple rotations related to their discipline in the second half of fourth year that's usually not a smart thing to do again the thing is many times those rotations will get you ahead a bit but the thing is you're still going to be overwhelming residency that's just the truth right so those rotations don't end up benefiting you as much as you think until you become like the primary decision-maker for the patient it doesn't really give you as much experience as you think so again it's not wrong doing it but just don't burn yourself out doing that and then rule number 14 especially for the cycle is attend as many interviews as you physically can right I know this sounds ridiculous but attend as many interviews as you physically can the thing is we're going through a zoom cycle right and again as some of you maybe have been aware of they were quite a number of oddities that happened with the last era's application in fact I did make a podcast on this earlier this year but I would just say go on as many interviews as you can right go on as many interviews as you can that's just I mean especially if you have lower scores go on as many interviews as you can you know if you're a very high scoring person like 260s on both USML exams you know you probably don't need to go like super overboard you but you should probably still go on a few more interviews that you'd honor really go to if we're not deal

ing with a zoom cycle so again it's very important because again until this zoom business with a residency interview dies down you probably should be applying you probably should be going on as many interviews as you can at least within reason and nothing going 200 interviews right but going on five interviews or just ten interviews is probably not the smartest thing in the world even if you have the very high and then row number 15 is as you interview don't pass your programs with so many emails you see some met students and it's almost like they become their residency programs worst nightmare you see them the like if for example you are like oh I have some questions try to call out a few to get done just ask but you see some people they almost email pro like the same program like three four times a week the thing is programs will begin to see you as a pest and when they see you as a pest they won't look favorably on ranking you they may even trash your application just as a result of that right so again just have some kind of situational intelligence when you're sending all these emails to two programs again the thing is even your email communication with programs makes a big impression as to who you are so that's something to be very careful about believe it or not there are some students that I work with one on one for Eras applications where I sometimes have to edit the emails and guidance that they are sending out to two programs again just something to kind of keep kind of keep in mind and then row number 16 be tight-lept right the thing is these days people just share way too much don't tell all your information about your application to people that just literally don't need to know the thing is every now and then I come across a story of someone that torpedoed a presence chance at another residency program for their own benefit again the thing is unfortunatel

y the Eras process the residency application process is very competitive right so the thing is sometimes is just very important to be discreet it's a sad reality but it's absolutely true and then row number 17 clean up your social media clean up that social media right remove video evidence remove audio evidence of you being recorded doing stupid stuff right or at least at the very least heavily restrict people's access to it right and the thing is this is one thing I want to say don't let other people record you for any reason don't the thing is it again it may be a little paranoid but again I've advised many students in the past I've advised many students that have gone through this process for multiple Eras cycles and the thing is again sometimes just a video and a video file an audio file or a picture of you doing stupid stuff like drinking on the beach or whatever can really turn off a person on an admissions committee on a residency selection committee and that'll be the thing that again just pretty much boss your bubble with your application so again clean up your social media like the thing is really if you're pressing that practices health care you really shouldn't have a heavy social media presence and again I don't just mean only Facebook or Twitter no no also things like Tik Tok and things like that just kind of wise in those regards because again programs many times they know that by reading a person's posts by seeing a person's pictures they can begin to draw certain inferences on the character of that person and again that could influence their decisions on who they accept and who they don't accept and then rule number 18 if your scores are not super competitive be realistic be realistic again I'm not saying don't shoot for the stars but also give yourself good options you see some people they have low scores and the for sure for sure say you know what I

'm only going to apply to California programs right again you're just not setting yourself up for success right because again that you may like again I think people that have worked with that had low scores that match into California programs absolutely absolutely the thing is they are ways and means of getting a low score individual to a highly ranked program right but the thing is again you still need to be realistic you still need to apply to programs that are within your reach programs where you're like a reach for them just be realistic the disciplines you are applying to the number of programs you are applying to again have an honest assessment of exactly how strong your application is right have an honest assessment of exactly how strong the application is and the rule number 19 review the spreadsheets associated with your discipline right the thing is many times if you just do a search there are many of these links on Reddit right they are always gold mines of solid information right sometimes you may be surprised that programs recycle the scene interview questions from year to year right so if you're able to catch wind of those questions at least that can help you with your prep for those interviews and in row number 20 if you're a foreign medical graduate that has graduated already this is this is an optional right but if you're a foreign medical graduate that has graduated already consider taking step three before the end of the December the thing is I've actually seen a few international medical graduates the applications being helped by doing this by having a step three score right so the thing is if you're if for some reason you're eligible especially for people that are reapplying for residency let's say they failed too much in a previous cycle you really should be taking step three if you've graduated from medical school already again some programs bec

ause the thing is once you take step three a program basically like it makes your lower risk can be deeply basically tells programs that come what may at least this pressing can get an unrestricted medical license to practice right because the thing is after it takes step three and in many states once you have like one year of clinical experience under your belt then you're able to apply for a full unrestricted license and again if you plan to moonlight in residency then I'll say that you know you should probably you should probably like again plan on having that step three business sorted out again obviously if you've not graduated from medical school there is absolutely no way you can take take step three okay now uh run number 21 right before sending the I love you email to a program right where you're saying oh your my number one be absolutely certain that that is where you want to go first I'm not going to repeat this much many people know this already they don't want to say your my number one to like 50 different programs that is not a good thing to do again don't burn bridges right don't burn bridges because you can negatively affect you in the future and then rule number 22 is don't believe anything you hear from a program or any of its representatives don't let those things drive your ranking decisions the thing is at the end of the day a program works for its own benefit not for your own benefit again they can tell you all the sweet words they can give you all the honey they can make you drink all the cool aid don't let those things drive your decisions make decisions based on where you want to go not based and also being realistic right but again don't believe what programs tell you a program tell you that can tell you that oh they've ranked you too much and then you notice on match day I'm telling you like match day I feel like is a day that reveals many s

urprises let's put it that way right so don't be calling that wave of oh because a program said all these sweet words to me I'm gonna rank them high don't do that don't absolutely absolutely do not do not do that and then rule number 23 remember to think the people that helped you in your plan to residency the thing is you don't know where you need these people in the future right it's unfortunate but this happens a lot in medicine after people have gotten help from someone once they've gotten that help and they've gotten good results from that help they just immediately trash that help don't do that the thing is medicine more than many people realize is a very small world it's an extremely small world right so I'll encourage you remember to think those people beyond good terms with those you may be surprised in the future when you're applying for fellowships or when you're getting into some trouble in residency I need someone to speak up for you is those same people that you've abandoned right that would then ultimately end up helping you in fact I'll talk about that as a life lesson at the end of of this podcast and then rule number 24 is reading ahead for residency is not a bad idea but the thing is it's probably not worth you spending copious amounts of time right you see some people the four five months before residency starts is almost like a dedicated period for them don't be in that category right again you need to rest because you're an engine a period of your life where you have very little if any control over your schedule and you'll be working very long hours right so again just be mindful of that if you're like oh let me spend an hour or two every day just gonna study ahead for residency there's nothing wrong with that but spending seven eight nine ten hours a day studying for residency ahead of time is not a smart idea right again it's not gonna put you

ahead as much as you would as you would be led to believe and one thing I would say is consider listening to my podcasts on the high-eared intern actually do have podcasts I think is episode 86 and episode 235 if you want search by this specific episode numbers on the website you get some very good information from those podcasts and then rule number 25 some broad strokes for doing well in residency again listen to that episode 86 and 235 and you know maybe I mean me more podcasts on this in the future but some broad strokes for residency keep your head down right keep your head down don't be too loud you see some people they want to be the center of attention basically it's almost like the histronic resident they want everybody to notice them no you don't have to be that person in residency right many times when you're on people's radar that's where they can start finding things to use to put you in trouble with don't be on anyone's radar right so keep your head down in residency don't be too loud don't be the one always involved in drama there so people that are just like just drama drama drama drama it's almost like literally if you if you observe their lives as residency it's almost like you're watching like some reality TV show right the thing is just work hard do solely working residency work on your efficiency one of the most common causes of people getting into problems with the higher ups in residency is just being inefficient right so work on being efficient work on being accurate what efficient right and the thing is half processes for doing things if you have processes for doing things it's almost like having a quality improvement mindset to approaching patient care you can get a lot of things done very rapidly and also very accurately as well right so don't be that problematic person don't be that person that always tries to fight authority that always li

kes to contest everything again and there's some things you should contest probably what residency is probably not the right arena for that because whether you like it or not medicine is a is a is a discipline that depends heavily on hierarchies if you're seen as the person that will not come to submission to the higher ups then you can be out of a career very soon and many people that are in residency you've spent 10-15 years of your life just working up to these things you don't want some attending that you did not submit to to be the person that completely torpedoes your career I mean obviously if it's something that involves something really bad like you know like sexual abuse or whatever no you don't need to do something about that right but the thing is that just certain battles that you should not be fighting right you should not be fighting sometimes just put your head down do solid work get your medical license move on and then you can do whatever you want after that and then rule number 26 and the final rule is be careful of buying unnecessary things that you won't need in residency I don't know for whatever bizarre reason some people the moments they figure out that they've got into residency is almost like the just think of it as a license to just start doing stupid stuff right you see some people they completely upgrade their lives because they are going into residency they just splurge you see them they go on this like shopping spree it's almost like a way to reward themselves for finally matching to residency guys that is usually not smarter at all you see people they buy like new iPads new phones new computers new everything and then at the end of the day those things start collecting dust in their apartments I also find this irrational behavior and people that that just got into medical and they are studying medical in a few weeks the thing is most ti

mes in residency pretty much all you need is like a stethoscope you just pretty much need a stethoscope you need a pen you need a note pad that's pretty much it most times you can get by for maybe like 99% of your residency tasks by literally just having stuff like that right so just be mindful of these apps that you start paying for many times your residency can get your free subscription to those things right so just be mindful of that so that's my final rule again as I do at the end of every podcast I go for one or one tutoring for all the USML exams step one step two CK step three pretty cool medical exams 30th year clerkship shelf exams and also if you need help with and I obviously also offer these review courses especially for step two CK step three and complex level two and three and then if you need help with your ERAS application again I've been on admissions committee in the past and I've worked through I've worked with tons and tons and tons of people on many parts of the applications ERAS applications personal statements recommendation letters mock interviews again I've worked with many people in those regards and those many people have worked with now are residents so the thing is I have a very good temperature on many of the different disciplines I've worked with people applying from all the way to family medicine to neurosurgery to dermatology to ortho to ENT to peeps to psych to surgery I've worked with people applying to many different specialties so again if you're interested in any of those things just shoot me an email through the contact button on the website and I'll give you some more details on on cost again I have I have a very good track record with people that I have worked with so my quick life lesson for today is about not being a use and dump person don't be a use oh actually before I talk about the life lesson real quick I do have again

if you I do have a website divineinterventionpodcast.com if you go to that website you'll see all the podcasts I have and actually if you subscribe you'll get an email notification whenever I make a new podcast and then also have these podcasts on Apple podcasts Google podcasts and Spotify I get a subscribe to those podcasts apps and you get the most recent 150 podcasts if you want all the podcasts from episode one then you need to go to the website and then I also have a You Tube channel divineintervention usmly podcast and videos where I post all my videos although the slides associated with those videos are all on the website right so you have to just find search and do those episode numbers and you'll find the specific episodes that you're looking for and then again I have an organizational tool on the website if you go on exam topics list if you click on it you'll give it get you to a spreadsheet and it breaks down issue sml by subject and by the podcast that are relevant for that so that that can tell you oh this is the thing I should listen to for this specific problem that I have and then obviously there are also notes to many of my podcasts linked on the website if you go under episode notes you'll find Google links to many of those things and also there is a divine intervention podcast deck it's called a DIP deck that exists out there for a lot of my step 2ck step 3 content so what is my life lesson for today well my life lesson for today is the importance of not being a user dump person right again unfortunately we live in a world and in a society actually where this is a very common thing people befriend you just for what they can get from you right but in the moment they get what they want from you they immediately throw you under the bus they immediately dump you the thing is whenever you have people like that as friends those are not good friends to hav

e I'm telling you those are people you want to avoid and you own ticket as a personal responsibility they should be your brothers keeper don't be a user dump person right the thing is when you are you a user dump person it shows that you have a very shallow personality right and people with shallow personalities they will end up meeting some kind of fork in the road down so I'll encourage you and the thing is over time people will begin to know that you know what this person is not a true friend this is the kind of person that can sell you down the river is very unfortunate but there are many medical students that do this many people in medicine that do this when they start befriending you when they start talking to you they're just doing it because of what they want to get from you the moment they get what they want they stop picking your calls they block you or they can even start bad mouthing you to other people right so again don't be that kind of person right the thing is in the midst of a world that may have a lot of people that have that character you can rise above you can be different right the thing is there like there's this common statement in Nigeria there to be a Daniel right there to be different right the thing is while other people are gossiping and doing the wrong thing you don't have to join them in fact there's this part of the bible that says come out from among them and I'll receive you unto myself right come out from that crowd you can be different the thing is the people that are noted are people that were unique for something good right so be you are people that are unique and obviously you can be unique for something good and can be unique for something bad right but I'm challenging you today be unique for something good and all be well with you so I wish you all the very best God bless you thank you I'll see you next time

No later than the first week of September.

As early as possible after completing a rotation, to ensure the recommender remembers the quality of work performed.

Do not let them be last minute; they require multiple edits and drafts, and recommenders may request copies even if they are rough drafts.

School IT requirements can cause critical emails (like interview invites) to be filtered into spam or delayed, leading to missed opportunities.

Attend as many interviews as physically possible, especially during a virtual cycle, even if scores are high.

Try to make the second half mellow; avoid overwhelming oneself with multiple rotations related to the specialty, which can lead to burnout.

No more than 1.25 to 1.5 pages at most.

The concluding paragraph of the personal statement, ideally requiring a separate version of the letter for that program.

Programs may view the student as a "pest," negatively affecting their ranking or potentially leading to application rejection.

Keeping their head down and focusing solely on working hard and being efficient/accurate in patient care.

Be discreet (tight-lipped); do not share application details with people who do not need to know, as this can compromise chances at other programs.

Taking Step 3, which helps reduce perceived risk and aids in obtaining an unrestricted license later.

No more than 1.25 to 1.5 pages at most.

The concluding paragraph of the personal statement, ideally requiring a separate version of the letter for that program.

Programs may view the student as a "pest," negatively affecting their ranking or potentially leading to application rejection.

Keeping their head down and focusing solely on working hard and being efficient/accurate in patient care.

Be discreet (tight-lipped); do not share application details with people who do not need to know, as this can compromise chances at other programs.

Taking Step 3, which helps reduce perceived risk and aids in obtaining an unrestricted license later.