Tag: ERAS

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What Is The Difference Between Categorical And Advanced Radiology Positions?

categorical and advanced radiology positions

Question About Categorical And Advanced Radiology Positions:

Dear Dr. Julius,

I wasn’t sure of the difference between categorical and advanced radiology positions. What should I tell the applicants this year? Could you let me know the differences?

A Confused Program Coordinator

 

Answer:

For some reason, I have been receiving this question about categorical and advanced radiology positions a lot this year. Perhaps, it has something to do with how ERAS lists our residency program on its website. In any case, I had to look it up to make sure to give you the correct answer!

Definitions

First of all, some of you know that an Advanced residency, according to ERAS, is any residency that begins after the postgraduate one year. On the other hand, a categorical residency is any residency that begins at PGY-1 year. This categorical spot must continue for subsequent years until the end of the training. 

In this situation, how is it possible for some radiology programs to have a categorical spot when radiology training begins during the PGY-2 year? Well, some radiology programs have an affiliated prelim year at the same institution. And, usually, there is some form of agreement between the two programs. This combined prelim year could be any of the approved PGY-1 slots for radiology, including Prelim surgery, Prelim medicine, transitional year, etc. Therefore, if you are not applying to the prelim spot at the same institution, you should not apply for a categorical slot in radiology.

If Interested In A Prelim Spot At The Same Place As Radiology Residency, Ask!

Also, if you are interested in completing the PGY-1 year at the same institution as the radiology residency, make sure to ask the radiology program director if they have a categorical connection with the same institution’s prelim year. Some do, and others don’t. If they do, sometimes the radiology residency can make a phone call to the prelim program. In this case, this connection can give you a better shot of getting the prelim year slot at the same institution. Why? Because programs want to make sure that you will have an ACGME accredited prelim year before starting residency. Likewise, it’s harder to ensure that outside the institution.

However, if you apply to prelim and radiology spots at the same institution, you may or not be applying to a categorical position! It all depends on the residencies and agreement among the programs. Bottom line, make sure to check with the program director or the graduate medical education office.

Hopefully, you now know what you need to know about categorical and advanced positions!

 

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The One Phrase You Should Ask For In All Your Letters Of Recommendation

letters of recommendation

ERAS season has recently begun. And, with applications to radiology residency and fellowships on the system now available, medical students and residents are scurrying about trying to find letters of recommendation from their faculty and mentors. On that note, if you are applying now, I would advise you to read one of my previous blogs (Cracking The Radiology Residency Application Code).  Previously, I have mentioned that references are one of the less significant discriminators in getting an interview for radiology. However, that statement only applies to decent letters of recommendation. It does not mean that you should find the wrong ones.  That can become a disaster. Remember. Program directors have so many excellent applications from which to choose. So, one lousy recommendation can lead yours into the DNR (Do Not Rank) pile. In the case of a horrible reference, it becomes a great discriminator!

In any event, as always, I want to distill the essentials of applying in the world of radiology into a few simplistic nuggets. Therefore, I am going to let you in on a little secret about what you should be looking for in a recommendation writer not only to avoid this situation but instead, I want to make your recommendation into the reason you may have success getting into your program of choice.

So, here it is, a simple phrase strategically placed within the recommendation, preferably at the end. And it is this, “Your name is the type of student that we want to take at our radiology residency program.” As an application reviewer, that phrase gives me more confidence about an applicant than any other.  If your mentor wants to take you into his program, especially another program director, then why wouldn’t I? So, how do you get that person to write that into your recommendation? I will give you some simple instructions on how to do so to achieve the results you want.

Perform Well On Rotations With Potential Reference Writers

OK. Performing well on rotation may seem obvious. But, on occasion, some residents will ask attendings to write a recommendation when their performance was marginal. Why does this happen? Well, usually, the resident feels more comfortable with obtaining this written reference due to the mentor’s easy-going personality. Don’t let that fool you! When a mentor has many other applicants to write for, your recommendation will not be of the same quality as his favorites!

Befriend Your Mentors

For many medical students, befriending your mentor is a tall order. Often, he may be twice or even three times your age. Or, your interests may significantly differ. However, make that attempt to get to know that person well before asking for a recommendation. Then, when you finally request one from this person, he will feel much more comfortable with writing one. I can’t tell you how many times a medical student or resident will come up to me and ask me for a recommendation when we have barely spoken. It reflects in the written letter!

Tell Them What To Write!

Lastly, this step can be the most critical. At this point, you know your mentor well, feel comfortable with her as a reference, and you know she feels the same about you. And, she is more than likely willing to help you out in any way she can. But, many reference writers do not know what program directors are looking for in a recommendation. So, it is your job to help them out. Ask them if they can slip the key phrase into their letter- “I want you in my program.” (Of course not that verbiage exactly but you get the point!)

Even better, some writers will ask you to make a version of the reference letter. Guess what, slip that phrase or something similar into the end. It has the potential to make your application stand out from the pile!

Capturing The Magic Phrase On Your Letters Of Recommendation

Now you know precisely how to proceed to get the best possible recommendation from your mentors to help you get into the spot you want. It does take a bit of work, forethought, and, most importantly, personal interaction. So, make sure to ask mentors on rotations where you have performed well. And, only request them from those that know you well enough to write you one. Only then will you be able to obtain a recommendation with the phrase that will significantly increase your chances of admission!

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Can I Get Into Radiology With Poor COMLEX Scores?

Question:

 

Hello Dr. Barry Julius,

I am a 4th-year osteopathic medical student that is struggling to figure out how I can pull off getting into a radiology residency with disappointing COMLEX scores and a completely sub-par application.

Background:

I finally realized what I wanted to do in medicine and now I fear it’s too late. I come from a surgical background having been a Certified Surgical Technologist and First Assistant for ten years before getting to medical school. I realized during my 3rd year that I didn’t want to be a surgeon.

I fell in love with radiology during my ER rotation this year. I loved feeling like I was finally helping patients by reading films. So many times, I felt like I never got to the root of a patient’s problems in internal medicine and family medicine but with radiology, I felt like I was solving a problem. As soon as the radiology bug bit me, I immediately started researching requirements for getting into a diagnostic radiology residency. This task broke my heart into a million pieces. All I found was how competitive the programs were and how essential board scores were.

Main Problem

Passing COMLEX level 1 was the hardest thing I’ve had to do in medical school. I failed twice and finally barely passed on my 3rd attempt. I’m both ashamed and proud of how many times took the exam. I’m proud because I never considered quitting. Medicine has always been my passion, and nothing would ever make me give up on the dream of becoming a physician. I never felt like COMLEX was ultimately going to defeat me.

I’m also proud because I learned a lot about how to study and how I learn best. I’m ashamed because it made me feel like I wouldn’t make a great physician. Many mentors and patients have told me that I would make a fantastic physician. In my heart I know I would.

My Current Situation

I made friends with the radiologist at the hospital where I did my ER rotation, and I’m doing an elective rotation with him starting next week. I’m really excited about this opportunity but lingering in the back of my mind is maybe I have no chance of getting into a radiology residency. Tons of people have told me there is no way to salvage my situation, but I can’t accept that. I’m a fighter and always have been.

Even if you never reply to this message I honestly appreciate the chance to vent. The bottom line is, I will never give up trying to achieve what I want especially now that I’m so passionate about it. After reading some of your posts, I just wanted to know what you would do in my situation. What is your advice for someone like me, with a worthless application, but a strong drive to do whatever is necessary to achieve a goal?

 

Regards,

Worried Radiology Applicant

 

Answer:

Sorry, I have been unable to get back to you sooner. It has been a crazy week. However, I have had some time to mull the issues that you present in the letter and I have come up with a potential solution. But, it will take some soul searching, grit, and determination.

Why are the medical school exam board exams so critical for radiology residencies? Simply because the radiology boards is also a multiple choice question computer exam that is difficult to pass. And, most residencies would not want to commit resources to a resident that will not be able to pass the boards.

Get To The Bottom Of The Situation

So, this is what do you need to do. First, you need to figure out why you have such a hard time with the exam. This may be the most difficult part for you, to admit there may be a psychological problem with test taking to begin with. Many times this is a simple issue that can be easily solved. They have testing psychologists that can get to the root cause. It would be well worth your time to splurge a few thousand dollars now to get the answer that may save you hardship down the road.

For some, the issue can be solved with something as simple as anxiety exercises before the test. For others, it could be a learning disability that you were not aware of. Regardless, make the time and effort to complete this step. It will be well worth it.

USMLE: The Solution

Second, you need to take the USMLE. The good news for you: Most radiology residencies do not like to use the COMLEX as a screening tool. So, if you were to do well on the USMLE, they would never even care about your score on the COMLEX.

So, finally, I would dedicate a year to studying for the USMLE exams and doing well on them. How would I approach it? I would take a year of research in radiology to stay involved in the field. And, I would study at the same time so that you can get the scores you need.

Bottom Line

It will take a lot of from you to really tackle the issue of passing the USMLE and getting into radiology residency. But, if you really want it that bad, there is a way.

Regards,
Barry Julius, MD