Specialty Residency Information and Advising

What UCSF resources are available within your department to support UIM-identified students applying in your specialty?

One key resource is Dr. Odi Ehie, our department's Vice Chair for Diversity. Our department web site also has information about department DEI efforts.

Anesthesia DEI Web Page

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What specialty-wide/national resources are available to support UIM-identified students applying in your specialty?

The Society for Education in Anesthesia is a national organization with a committee on Diversity, Equity, Inclusion and Justice. The American Society of Anesthesiologists has a Committee on Professional Diversity.

The three most compelling aspects of this specialty:

1. Breadth of patient care. Consider just three aspects: a patient's age, severity of illness, and location in the hospital. Even without fellowship training, an anesthesiologist in practice may care for patients less than one year of age to greater than 90 years of age. Some patients will be outpatients undergoing ambulatory procedures, whereas others may be patients with organ failure in the ICU who require emergency surgery.
2. Interaction with other specialties. The breadth of patient care in anesthesiology also includes interactions with other specialties including surgery (and all surgical subspecialties), obstetrics (e.g., pain relief in labor, anesthesia for cesarean section), interventional radiology, pediatrics, and internal medicine (including cardiology, pulmonology, gastroenterology and other medicine subspecialties). With fellowship training (described below), an anesthesiologist can subspecialize in many different areas.
3. Timeline of patient care. While there are specialties of anesthesiology that care for patients over a longer time span, most anesthesiologists care for patients in a time span of minutes to hours. Anesthesia patient care includes a combination of cognitive and procedural/technical skills that (surprising to many) requires creativity in the care of an individual patient, balancing their medical conditions and preferences for care with the needs of the procedure itself. The cognitive abilities include a sound understanding of basic pharmacologic principles, applied clinical and pulmonary physiology, implications of patient positioning and the planned surgical procedure, fluid and blood product management, advanced patient monitoring, and relevant anatomy (e.g., for airway management and regional anesthesia). Requisite technical skills include airway management, advanced monitoring (e.g., arterial and central access, transthoracic and transesophageal echocardiography, point-of-care ultrasound), neuraxial anesthesia and peripheral nerve blocks. The overarching patient care theme behind the cognitive and technical aspects of anesthesiology is patient safety. Although complications are rare, the anesthesiologist must develop resuscitation and crisis management skills to act quickly when emergencies occur.

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What is the culture of this specialty?

Most anesthesiologists work in the operating room or another procedural setting. These environments are varied, dynamic and often challenging. Depending on the setting, an anesthesiologist may work directly with one patient, or may supervise the care of a few patients as part of the anesthesia care team model. This is a very hands-on specialty with many procedures and acute interventions. Patients often present to surgery with anxiety and stress. It is the anesthesiologist’s job to address patient concerns, earn their trust and develop a safe care plan.

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What are some common variations in career path in this specialty? What common fellowship opportunities exist in this specialty?

After completing anesthesia residency, fellowship training could include critical care medicine, pain medicine, pediatric anesthesia, adult or pediatric cardiothoracic anesthesia, regional anesthesia and acute pain medicine, obstetric anesthesia, hospice and palliative medicine, sleep medicine, and neurocritical care. All fellowships are one-year in duration. Nationally, around 40-50% of residents complete fellowships.

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What does a typical work week look like in this specialty? How frequently can the average doctor in this specialty expect to work weekends/holidays/overnights?

This varies significantly depending on what area of specialization anesthesiologists pursue. For the anesthesiologist in private practice, a typical clinical day is 10 to 12 hours long, plus overnight call 2+ nights each month. The average number of hours per week depends on the group and its call structure, but typically 40-60 hours per week including call. In an academic setting (the minority of anesthesiologists), there is great variability depending on additional responsibilities outside the clinical setting. With respect to overnight work, this will depend on the practice setting. For example, at a level one trauma center, an anesthesiologist must be in-house 24/7. Similarly, a practice associated with an emergency department will have patients who require emergency procedures ranging from acute appendicitis to acute stroke (requiring immediate cerebral angiography) to a ruptured abdominal aortic aneurysm. Obstetric anesthesia also requires 24/7 coverage.

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How does this specialty support or challenge having a family?

Generalizations are difficult due to the variation in anesthesiologists' practices. For example, an anesthesiologist who primarily practices pain medicine (clinic-based) is going to have a very different career than someone specializing in transplant anesthesia (operating room based, cases at all hours). In general, if you are considering an operating room-based career, it is important to know that OR days start early (before childcare centers open) and do not always end at predictable times. Someone needs to be there to see the patient safely to the recovery room. When surgeries have to go in the middle of the night, an anesthesiologist needs to be there to take care of the patient. When a patient needs an emergency cesarean section, an anesthesiologist must be there. Anesthesiologists frequently work 12+ hour days and are on in-house call for 24+ hour shifts. In general, partners in your practice (academic or private) will split call requirements. The family-friendly aspect is that these calls will be prescheduled, your work starts when you arrive and most often ends when you leave. Most aren’t expected to be accessible on their days off. The other family-friendly aspect is that in most cases you are paid for the amount you work, and practices/partners are okay with individuals working less (and being paid less) during times when they need more time at home. There are also different practice settings that allow even more flexibility (e.g. outpatient/office-based anesthesia) and predictable work hours (e.g. pain clinic). Overall, the most important thing is that you enjoy your specialty, work environment, and what you do day to day. No lifestyle is pleasant if you are doing something you don’t enjoy.

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How competitive is the residency application process in this specialty?

Over the years, residency in anesthesiology has waxed and waned in competitiveness and desirability. Currently, anesthesiology is considered quite competitive. According to the Texas Star database in 2023, the average anesthesia resident applicant applies to 40 programs.

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How competitive is the job market in this specialty (after residency/fellowship training)?

There is currently a shortage of anesthesiologists in the United States. This translates into an excellent job market for the graduating anesthesia resident. The AAMC, which commissions an annual report on the future supply and demand of physicians, predicts an ongoing shortage even with the grown of advanced practice providers.

What are the preferred ways for an early F1 student to show interest and obtain guidance in your specialty?

• Join the official specialty interest group: Anesthesia Interest Group
• Shadow a faculty member in the specialty

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Are there specialty professional organizations that you recommend students join? If so, what are the costs of doing so, or are there resources for students with limited ability to pay membership fees? Are there specific activities (such as meetings or subgroups) that are recommended in the organization

The American Society of Anesthesiologists (ASA) is the primary specialty society for anesthesiologists in the US. They have an active Medical Student Component that includes an annual meeting. Membership as a medical student is only $10 per year.

ASA Website

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 How can students in your specialty demonstrate leadership?

Two ways include participating in the Anesthesia Interest Group or becoming active in the ASA Medical Student Component.

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For students interested in your specialty, when should students become involved in research?

Becoming involved in research is not required in this specialty

How can students best prepare for a core F2 clerkship in your specialty? Are there specific resources (websites, books, documents) that you recommend? Should a student meet with any designated faculty in the department prior to the core F2 clerkship?

One learning resource available to students during the Anesthesia 110 core clerkship in F2 is the textbook Miller's Basics of Anesthesia. UCSF Library also has physical copies of this book for loan. There is no need to meet faculty prior to the core clerkship, but feel free to reach out to your site director (or Dr. Kristine Breyer, the clerkship director) in advance with questions.

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What are the differences (if any) between between sites of the core clerkship?

The main differences in sites are the patient populations served at that hospital. The sites for Anesthesia 110 include UCSF Health (Parnassus, Mount Zion, Mission Bay), SF VAMC, and ZSFG.

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If a student develops an unexpected interest in your specialty during F2, what are the best next steps to take to become a competitive applicant?

Because anesthesia residents rotate through many specialty settings such as pediatric anesthesia, obstetric anesthesia, critical care, preoperative clinic, being a well-rounded clinical student is the best step you can take to being a competitive applicant. It is not necessary to complete an anesthesia-focused research project or become the leader of an anesthesia student group to be a competitive applicant.

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What F2 electives in your specialty or in another specialty are recommended for students strongly interested in your specialty?

Within F2, there are no specific CIEXes that are specifically recommended for a future anesthesia resident.

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How can students demonstrate excellent performance in a F2 clerkship in your specialty?

The grading overview for core clerkships including Anesthesia 110 are explained in the Bridges Curriculum web page titled "Grading Overview: Third Year Clerkships"

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What guidance should students seek to prepare for Career Launch (4th year) clerkship scheduling?

There is a group orientation session in our specialty prior to Career Launch. Students can find out about this by contacting: clerkships@anesthesia.ucsf.edu

Who in the department should be notified if a student is interested in taking a gap year?

Notifying someone in our department prior to a gap year is unnecessary.

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Who in the department should be notified if a student is returning from a gap year and plans to apply in my specialty?

Notifying someone in our department when returning from a gap year is unnecessary.

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Are there specific electives or clinical experiences in your specialty recommended for students to take in CL blocks prior to taking a gap year?

No

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Are there specific electives or clinical experiences in your specialty recommended for students returning from a gap year as a "warm up" prior to doing a sub-I in your specialty?

No

Which courses (specifically sub-Is/acting internships) are strongly recommended or required in the summer prior to residency application? Are any specific sites recommended for these courses? Is more than 1 sub-I (or acting internship) recommended in your specialty?

Courses that are strongly recommended include subinternships in Medicine (any site) and Critical Care (Parnassus or ZSFG). If you are still unsure of anesthesiology as a career choice, the four-week Anesthesia 140.01 subinternship is an excellent choice, but it's not required if you are already sure of your career path.

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What is the recommended timing of the medicine or family medicine acting internship (AI)?

Because of the removal of F1 grades, one or both of the above-mentioned subinternships should be completed before the grading deadline for the MSPE.

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What electives are encouraged (but not required or strongly recommended) during Career Launch in your field or outside of your field?

Consider rotations that enhance your overall clinical skill, such as surgery, emergency medicine, or an organ-based subspecialty of medicine such as pulmonology or cardiology.

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If away rotations are recommended in your field, what advice do you tell students about selecting and procuring this experience?

Away rotations are only recommended under the following circumstances:

Because you are coming from a medical school with a strong Department of Anesthesia, an away rotation is not required. If you are hoping to match to a specific program or in a specific area outside of California, please schedule a time to meet with a career advisor to discuss your application plan.

What aspects of an application are the most important to be competitive in this specialty?

	Absolutely essential	Very important	Somewhat important	Not at all impportant
Extracurricular leadership efforts			X
Research/publications			X
Honors in specialty sub-internship		X
Honors in medicine or family medicine acting internship		X
Away rotations				X
USMLE Step 2 scores		X
Community work or service			X
Medical Student Performance Evaluation (MSPE) comments in my specialty	X
MSPE comments in other specialties	X
MSPE non-clinical sections (including "Noteworthy characteristics")		X
DEI and/or anti-oppressive work			X
Letters of recommendation	X
Leadership roles			X

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What aspects of an application would be particularly harmful in terms of competitiveness?

	Matching in specialty extremely unlikely	Matching in Specialty will be more challenging, but possible	No impact on competitiveness
Negative comments regarding professionalism/physicianship	X
More than 1 attempt to pass USMLE Step 1 or 2		X
Below-average-for-specialty score on Step 2		X
No Step 2 score at the time of application submission			X
Multiple clerkship or exam failures that are apparent on the MSPE or transcript	X
Notation about extra time taken to complete a clerkship in the MSPE		X
Leave of absence from medical school not accounted for by outside degree program or research time		X

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Do programs in this specialty typically use "cut-off" USMLE scores to screen applications?

No

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What is the optimal timing for Step 2 CK?

If you think your Step 2CK score will be at least average for the specialty, take it in time for the initial date of MSPE release (October 1).

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How much does a high Step 2 CK score mediate the results of a non-passing attempt at Step 1 (or Step 2)?

It helps depending on the reason for the non-passing initial attempts.

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How does your specialty utilize the MSPE in applicant review? What types of "Noteworthy Characteristics" should an applicant emphasize in the MSPE?

The MSPE is an important part of the application review but there are no specific "noteworthy characteristics" that should be mentioned.

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Is research experience without publication valued in your specialty? If so, what are ways that this can be shown on their application/CV?

Research experiences have value even without publication. Describe the experience and your contribution in the experiences section of the ERAS CV. Make sure to include start and end dates, hours per week, and what your specific contribution was.

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Is research and/or publication in another specialty of value to an applicant? (This may be particularly applicable to an applicant making a late decision to apply in your specialty)

Research experiences/publication in other specialties may have value.

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When advising about applying in your specialty, are students ever encouraged to apply in a backup specialty or dual apply in a second specialty? If so, when should students consider this? Who is the best person in my department to consult about this?

No

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What departmental application events (general info, strategy, celebration) are held throughout the application and match season? Who should the student contact to be invited to these events?

We hold periodic application events, typically one near the end of F2 and another about a month before application submission time. Contact clerkships@anesthesia.ucsf.edu to be invited.

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Any departmental or specialty specific websites or resources for residency application that you recommend?

The Specialty Residency Information and Advising web page within the Advising and Career Development section of the UCSF SOM web site.

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Who are essential faculty to meet with before application (Department Chair, Main Specialty Advisor, Residency Program Director, etc)? What is the optimal timing for this meeting? What material or information should the student bring to this meeting? Who should the student contact to arrange this meeting?

We recommend meeting with one of the specialty advisors (main or confidential) either at the end of F2 or the month before applications are due. Timing depends on your questions. Bring the advising worksheet. Contact the advisor directly (info on advising web site) or the clerkships email clerkships@anesthesia.ucsf.edu

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In addition to the standard application, does your specialty use any form of supplemental application? If so, how does a student register for the supplemental application? Is there any specific advice that could be helpful in preparing a supplemental application?

In the last couple of years, some programs are starting to use situational judgment tests (e.g., from Altus). Historically, most of these programs have not been top choices for UCSF students.

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Advice on writing the personal statement? Are there important topics or themes that should be included?

This article, while over ten years old, still contains sound advice. The main thing is to make the personal statement about you - who you are, what motivates and interests you, and not just a list of the things you have done. Johnstone RE. Describing oneself: what anesthesiology residency applicants write in their personal statements. Anesth Analg. 2011 Aug;113(2):421-4. doi: 10.1213/ANE.0b013e31821f964d. PMID: 21788327.

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Who in the department should review the personal statement? When should a good draft of the personal statement be presented to faculty reviewers?

Any anesthesia career advisor (main or confidential) can review your personal statement. Allow for a couple weeks turnaround time if your advisor has a busy clinical load at that time.

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What is your recommended general approach or strategy for requesting letters of recommendation (LORs), particularly timing and etiquette?

We generally recommend that students ask for a letter as close as possible to their time working with an attending. For a student completing a core clinical clerkship in F2, this may be a full year before a letter is due, but that heads up is helpful to an attending. The other etiquette issue is to ask whether the attending would like your CV or other information. And finally, give your letter writer a lead time of at least a few weeks to a month before a letter is due.

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Regarding letter writers, what characteristics (faculty rank, years of training, on resident selection committee, etc) should be considered?

The best letter writers are more experienced clinical faculty who work with residents on a regular basis. Faculty rank and membership on selection committees are less important.

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How many programs do you recommend a student that is average in terms of competitiveness apply to?

As mentioned earlier, the national average is 40 programs per applicant. We have generally advised a UCSF student of average competitiveness to apply to at least 30 programs.

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Is there a “signaling” program for your specialty and if so, is there a strategy to use signals?

Yes, a signaling program exists. My strategy recommendations are: First, you need an estimate of how competitive you are as an applicant. If you are a competitive applicant, the signaling strategy is easy: give your top signals to the programs you most want to attend. For the 2023-2024 year, there were two kinds of signals: gold and silver. The 5 gold signals are intended to indicate your highest level of interest in a program. The 10 silver signals indicate very high interest in a program. In the 2022-2023 season, 97% of programs participated in the signaling program, as did 95% of applicants. However, the signaling program itself is voluntary. Programs primarily use signals as part of the screening process when deciding who to interview. For many reasons, signals are not generally used for ranking.

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When do interviews typically happen in your field? Is there optimal timing for scheduling interviews? During these months, what clinical or non-clinical rotations do you recommend for students?

Interview are typically held in October through January. There is no optimal timing, though students may not want to schedule their first interview at their top choice program. There is an experience curve to the interview process.

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Any advice or guidance about etiquette for cancelling interviews? Any strategy for which interviews to keep and which interviews to cancel?

If you have accrued enough interview invites, you should cancel interviews at programs that are lower down on your list. This may enable another qualified student to obtain an interview. As far as strategy for which to keep or cancel, this may relate to the geography of your program list. For example, if your desire to live in a certain part of the country is low, and you have enough interviews, cancel your interviews in that part of the country.

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Are you anticipating all in-person, all virtual, or a mix of in-person and virtual interviews?

All virtual

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During an interview, what should applicants be looking for and/or what questions should they consider asking that can help them clarify what programs will be most desirable?

Have an authentic “elevator pitch” about who you are as a person and how you will approach being an anesthesia resident in the program. Know the details of your application well and be able to have meaningful conversations about these things. Stay engaged and interested throughout your interview day and ask appropriate questions about the programs. Read up on the program and identify a talking point or two about the specific program. Show interest in the interests of your interviewers.

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What is the recommended approach to post-interview communication? Are thank you notes recommended? Are “you are my #1 choice” letters recommended?

The NRMP provides strict regulations regarding the content of post-interview communications. Its official policy states, “Both applicants and programs may express their interest in each other; however, they shall not solicit verbal or written statements implying a commitment.” Additionally, neither party can suggest that their rank order is contingent on promises from the other party. Unfortunately, post-interview communications are common, a source of stress, and frequently misleading. You should not make false or ambiguous statements in order to garner some perceived benefit. And you should be cautious about overinterpreting ambiguous statements made by residency programs. Almost all programs report that post-interview communication does not impact their rank lists. We recommend sending a single simple short email to the residency program leadership letting them know that you enjoyed your interview day. Do not write an essay. You may share your interest with programs but do not tell multiple programs you are ranking them number 1. Also, telling a program you are ranking them near the top

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Is there any special advice you give to students applying as a couple in the Match? If so, what is it?

Each member of the couple needs an assessment of their competitiveness as an applicant. Since it's rare to have a dual-anesthesia couple, this will likely involve two different specialty advisors. Based on each person's competitiveness, the other member of the couple needs to adapt their list. In general, this leads to twice the number of programs to apply to for each member of the couple.

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How many interviews should students with average (for specialty) competitiveness attend in order to have a good chance of matching?

In general, 5-10 interviews should be sufficient, though it only takes one to lead to a successful match.

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At what point in time should students be concerned about not having enough interviews? Who should they contact if that is the case?

The MSPE release date is October 1. Many programs have 700-1000 applicants and attempt to do holistic review. This takes time. In general, a student should be concerned if they have no interviews by November 15, which is 6 weeks post MSPE-release. A student can contact one of the advisors (main or confidential).

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With whom should the students consult regarding creating the rank order list? What is the best timing for this?

If needed, a student can consult one of the anesthesia career advisors (main or confidential). However, a meeting is not needed if the student is confident of their list based on their interview experience and communication with the program.

Updated October 2024 by Dr. Manuel Pardo, Jr MD 

What UCSF resources are available within your department to support UIM-identified students applying in your specialty?

The UCSF Department of Emergency Medicine is committed to supporting DEI and specifically UIM students. We host a UIM SummerFellowship for students interested in EM between first and second year. Additionally, we offer mentorship to UIM students being paired withUIM residents, fellows, and attendings throughout medical school. Lastly, our EM Diversity Council is dedicated to supporting studentsthroughout their medical school journey and beyond.

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What specialty-wide/national resources are available to support UIM-identified students applying in your specialty?

Nationally, the specialty of Emergency Medicine is committed to supporting UIM students, residents, fellows, and attendings. One specificresource is the Society of Academic Emergency Medicine (SAEM) subcommittee, the Academy for Diversity and Inclusion in EmergencyMedicine (ADIEM)

ADIEM Website

The three most compelling aspects of this specialty:

Emergency Medicine physicians are a diverse group of individuals. However, there are aspects of our clinical work that attract people with certaingeneral qualities. Each clinical shift, EM physicians work closely with team members (EM nursing, medical assistants, clerks, social workers) as well aspre-hospital personnel (EMT, firemen, policemen), consultants, and admitting physicians. Thus, EM physicians are comfortable and effective working inteams and engaging in various types of interpersonal interactions. EM physicians see all types of patients and with various severity of disease. Thus, EMphysicians have a broad knowledge base and are comfortable seeing a sick child, an elderly stroke patient, a pregnant patient with abdominal pain, or apatient with acute vision loss. While EM physicians are specialists of emergency care and may have a niche, EM physicians are comfortable involvingspecialty consultants to advocate for a patient’s care when a presentation or disease process is beyond their level of expertise. EM physicians are alsocomfortable with some degree of uncertainty and decisive decision making. Patients present with symptom complaints and the disease process at handis not established. Many times, EM physicians must act with very little information and/or time to determine if there is a limb-threatening or life-threatening condition.

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What is the culture of this specialty?

EM physicians have a diverse range of interests and personalities. Even so, EM physicians are comfortable with a team-based approach to patient care,working closely with nurses, pre-hospital providers, and medical staff as equals. Cohesive camaraderie is an appealing part of this specialty. Dedicationto patient well-being is another common theme for this specialty.

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What are some common variations in career path in this specialty? What common fellowship opportunities exist in this specialty?

There are many! Most graduates from an Emergency Medicine (EM) residency program work as a general EM physician, though a good numberundergo fellowship training for subspecialization, including EMS and disaster medicine, toxicology, addiction/pain medicine, pediatric EM, ultrasound,critical care, hyperbaric medicine, sports medicine, global health, medical education, research, social emergency medicine, space medicine, and more.The majority of graduates work in a community emergency department setting. Others enter academics and practice in an emergency departmentaffiliated with an academic EM department, and engage in research, global health efforts, and/or administration. There are also settings where graduatespractice in a community practice emergency department that has an affiliation with an EM residency training program; in this setting, one has theopportunity to engage in the clinical training of EM residents.

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What does a typical work week look like in this specialty? How frequently can the average doctor in this specialty expect to work weekends/holidays/overnights?

Every shift is different (and this is an understatement)! While on shift, EM physicians provide care for multiple patients, determining which patients needemergent or urgent resuscitation, interventions, procedures, or transfer. Whether it is a pediatric, surgical subspecialty, neurologic, or obstetric patients,EM physicians provide care for all that come into the emergency department. EM physicians also engage with consultants from other departments whenspecialty care is indicated on an urgent basis or when hospital admission is warranted. EM physicians work shifts that range from 6-12 hours, though themajority of shifts in practice are 8 hours plus time to signout and finish clinical tasks. Full time EM physicians work an average of 14 shifts per month,including 2-4 weekend shifts & 2-4 overnight shifts per month, and some of the holidays. EM physicians work closely with a team of nurses, medicalassistants, and social workers. They may work alongside other EM physicians, but do not usually care for the same patients simultaneously.

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How does this specialty support or challenge having a family?

A career in Emergency Medicine is compatible with raising a family. The defined shift work makes scheduling fairly predictable in order to spend time forfamily life obligations. Shifts may be requested or traded between colleagues to offer further schedule flexibility. However, most EM physicians shouldexpect to work a mix of day, evening, night, weekend, and holiday shifts, which can be challenging to juggle the logistics of managing a family schedule.The majority of EM physicians do not carry a pager, so time at home can be dedicated to family life. The possible exception is being on-call. This meansif a colleague is unable to work a shift, the on-call physician either needs to work that shift or arrange for another physician to work that shift. At somework environments, EM physicians are able to work additional shifts to earn more income to meet financial goals for their family.

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How competitive is the residency application process in this specialty?

The Emergency Medicine residency application process is a "medium" competitiveness specialty. Up to 2021, EM was becoming increasinglycompetitive, however the last two years (2022 & 2023) there was a significant change with fewer number of overall EM applicants as there wereresidency spots. This significant shift resulted in some EM residency programs not filling all of their match spots, i.e., there were more positions to“SOAP/scramble” into the last two years. All that being said, students interested in applying for residency training in Emergency Medicine should be ableto match.

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How competitive is the job market in this specialty (after residency/fellowship training)?

The job market is dependent upon location, with desirable cities being more competitive for jobs. That being said, due to the high volume of EmergencyPhysician positions required to staff Emergency Departments in cities across the country finding a job in a desired location should not be too difficult.

What are the preferred ways for an early F1 student to show interest and obtain guidance in your specialty?

1. Meet advisorMeet with the main (non-confidential) specialty advisor
2. Join the official specialty interest group: EMIG
3. Shadow a faculty member in the specialty

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Are there specialty professional organizations that you recommend students join? If so, what are the costs of doing so, or are there resources for students with limited ability to pay membership fees? Are there specific activities (such as meetings or subgroups) that are recommended in the organization

Emergency Medicine Residents Association (EMRA) is the largest EM student and resident national professional society, which we encourage allstudents interested in EM to join ($70 registration fee). https://www.emra.org/about-emra/become-a-member Other EM National Professional Societies(opportunities to become student ambassadors): - Society for Academic Emergency Medicine (SAEM) - American College of Emergency Physicians (ACEP) - American Academy of Emergency Medicine (AAEM) EM Medical Student resources: - Emergency Medicine: The Medical Student SurvivalGuide. Harkin KE, Cushman JT, Wei HG, eds. Emergency Medicine Residents' Association. - AAEM's Rules of the Road for Medical Students: TheGuide for a Career in Emergency Medicine. Kazzii AA, Schofer JM, eds. American Academy of Emergency Medicine.

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 How can students in your specialty demonstrate leadership?

We encourage students to follow their passion and interests while engaging in extracurricular activities through which they can get involved in leadership.Specifically, Emergency Medicine applicants often demonstrate leadership in underserved advocacy, DEI & mentorship, and research/QI.

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For students interested in your specialty, when should students become involved in research?

Before submitting an application to residency in my specialty.

If a student develops an unexpected interest in your specialty during F2, what are the best next steps to take to become a competitive applicant?

Given the broad nature of EM we encourage students to keep an open mind during F2 Core Clerkships and learn as much as possible about eachspecialty. Additionally, we recommend students take the EM CIEx during F2.

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What F2 electives in your specialty or in another specialty are recommended for students strongly interested in your specialty?

EM CIEx

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How can students demonstrate excellent performance in a F2 clerkship in your specialty?

The EM CIEx is a high yield educational experience with a low stress pass/fail grading system. Show up and work hard with an eagerness to learn.

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What guidance should students seek to prepare for Career Launch (4th year) clerkship scheduling?

1. Meet with a specialty advisor. The best timing and person to meet with is: March at the start of Career Launch
2. There byThere is a group orientation session in our specialty prior to Career Launch. Students can find out about this bycontacting contacting (please include email): Corey.Carpenter@ucsf.edu

Who in the department should be notified if a student is interested in taking a gap year?

The person to notify prior to a gap year is (name and email): Corey.Carpenter@ucsf.edu

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Who in the department should be notified if a student is returning from a gap year and plans to apply in my specialty?

Corey.Carpenter@ucsf.edu

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Are there specific electives or clinical experiences in your specialty recommended for students to take in CL blocks prior to taking a gap year?

Yes. Not required, but recommended to take at least one of the two EM subinternship rotations prior to taking a a gap year to gain experience and confirm EM as a career choice.

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Are there specific electives or clinical experiences in your specialty recommended for students returning from a gap year as a "warm up" prior to doing a sub-I in your specialty?

It is highly recommended that students returning from a gap year do not take an EM subinternship rotation as their first rotation back. Taking a "warm up" rotation with broad clinical medicine responsibilities can be helpful, i.e., IM/Fam Med acting internship or MICU rotation.

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For students planning their return from a gap year, are there any unique (to gap year) schedulingconsiderations? considerations? (For sub-Is/AIs, electives, away rotations, meetings with advisors, etc)?

Returning gap year students should meet with the non-confidential advisors in spring (May) of the year they are planning to apply to residency (orsooner). The most important scheduling consideration for EM is to complete 2 EM subinternship rotations by September 1 of the application year so thegrade/SLOE (Standard Letter of Evaluation for EM) can be submitted by the end of September with the ERAS residency application.

Which courses (specifically sub-Is/acting internships) are strongly recommended or required in the summer prior to residency application? Are any specific sites recommended for these courses? Is more than 1 sub-I (or acting internship) recommended in your specialty?

The most important scheduling issue is to complete 2 EM subinternship rotation before September 1 of the year you are applying for residency.

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What is the recommended timing of the medicine or family medicine acting internship (AI)?

The timing of the Medicine or Family Medicine acting internship is not important to the EM residency application and can be taken any timebefore graduation.

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What electives are encouraged (but not required or strongly recommended) during Career Launch in your field or outside of your field?

Ultrasound, Toxicology, EMS, ICU are some of the EM relevant electives during Career Launch, but are definitely not required.

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If away rotations are recommended in your field, what advice do you tell students about selecting and procuring this experience?

Away rotations are only recommended under the following circumstances: UCSF has 3 affiliated EM subinternship rotations at UCSF, Highland, and Fresno. Most UCSF students (~80%) will take 2 of these 3 UCSF affiliated EM subinternship rotations to obtain the recommended SLOE (Standard Letter of Evaluation in EM) to apply for residency. A minority of UCSF students (~20%) will apply via VSLO to complete a true "away" rotation in a desired program/location outside of the bay area.

What aspects of an application are the most important to be competitive in this specialty?

	Absolutely essential	Very important	Somewhat important	Not at all impportant
Extracurricular leadership efforts		X
Research/publications			X
Honors in specialty sub-internship		X
Honors in medicine or family medicine acting internship				X
Away rotations			X
USMLE Step 2 scores			X
Community work or service		X
Medical Student Performance Evaluation (MSPE) comments in my specialty		X
MSPE comments in other specialties			X
MSPE non-clinical sections (including "Noteworthy characteristics")		X
DEI and/or anti-oppressive work		X
Letters of recommendation		X
Leadership roles		X	X

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What aspects of an application would be particularly harmful in terms of competitiveness?

	Matching in specialty extremely unlikely	Matching in Specialty will be more challenging, but possible	No impact on competitiveness
Negative comments regarding professionalism/physicianship		X
More than 1 attempt to pass USMLE Step 1 or 2		X
Below-average-for-specialty score on Step 2			X
No Step 2 score at the time of application submission		X
Multiple clerkship or exam failures that are apparent on the MSPE or transcript		X
Notation about extra time taken to complete a clerkship in the MSPE		X
Leave of absence from medical school not accounted for by outside degree program or research time		X

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What is the optimal timing for Step 2 CK?

Score submitted before ERAS residency application submission date (~September 28)

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How much does a high Step 2 CK score mediate the results of a non-passing attempt at Step 1 (or Step 2)?

Somewhat

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How does your specialty utilize the MSPE in applicant review? What types of "Noteworthy Characteristics" should an applicant emphasize in the MSPE?

The MSPE noteworthy characteristics are "slightly" useful in EM residency applications. The three main areas students should emphasize include:underserved advocacy, DEI & Mentorship, research/QI.

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Is research experience without publication valued in your specialty? If so, what are ways that this can be shown on their application/CV?

Yes, publications are nice to have, but definitely not required in EM. Highlight research activity in the ERAS extracurricular activities section.

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Is research and/or publication in another specialty of value to an applicant? (This may be particularly applicable to an applicant making a late decision to apply in your specialty)

Yes, most types of research is valued in EM residency application

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When advising about applying in your specialty, are students ever encouraged to apply in a backup specialty or dual apply in a second specialty? If so, when should students consider this? Who is the best person in my department to consult about this?

Students who are less competitive or have a significant issue in their application may be recommended to apply to a backup specialty/dual apply, andshould meet early with the non-confidential advisors.

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What departmental application events (general info, strategy, celebration) are held throughout the application and match season? Who should the student contact to be invited to these events?

2 EM advising events are held every year in March and August during Career Launch. Contact Corey.Carpenter@ucsf.edu

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Any departmental or specialty specific websites or resources for residency application that you recommend?

Emergency Medicine Residency Association (EMRA) and Society for Academic Emergency Medicine (SAEM) are two national EM professional societiesthat have outstanding online resources for medical students preparing for a career in EM (preparation for EM Clerkship and EM residency applicationguides).

Emergency Medicine Residency Association (EMRA)

Society for Academic Emergency Medicine (SAEM)

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Who are essential faculty to meet with before application (Department Chair, Main Specialty Advisor, Residency Program Director, etc)? What is the optimal timing for this meeting? What material or information should the student bring to this meeting? Who should the student contact to arrange this meeting?

Main specialty non-confidential advisors (Co-Directors of EM Clerkship): Dr. Aaron Harries or Dr. Marianne Juarez meet with all EM interested students between March-May during Career Launch (the earlier the better).

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In addition to the standard application, does your specialty use any form of supplemental application? If so, how does a student register for the supplemental application? Is there any specific advice that could be helpful in preparing a supplemental application?

No supplemental application in EM

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Advice on writing the personal statement? Are there important topics or themes that should be included?

The personal statement should be no more than one page and highlight a student's unique life experiences and specific extracurricular activities thathave led them to choose a career in Emergency Medicine.

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Who in the department should review the personal statement? When should a good draft of the personal statement be presented to faculty reviewers?

Main specialty advisors (Co-Directors of EM Clerkship): Dr. Aaron Harries or Dr. Marianne Juarez are available to review personal statements in July, August, or September.

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What is your recommended general approach or strategy for requesting letters of recommendation (LORs), particularly timing and etiquette?

For the EM SLOE, we will request the ERAS letter of request form in August from any student who completed the EM subinternship rotation. For non-SLOE letters we recommend students ask letter writers in June/July if they are willing to write you a letter with a deadline of September 15 (absolutedeadline is opening date of ERAS residency application at end of September)

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Regarding letter writers, what characteristics (faculty rank, years of training, on resident selection committee, etc) should be considered?

It is recommended to select letter writers who know you well and can speak personally about your characteristics.

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Of the total of 3 (or 4) letters that are part of an application, what is considered the best mix of letters? (letter)(eg: 1 from sub-internship, 1 additional clinical letter, 1 research letter, 1 department letter)?

2 SLOEs (or 3 if completed a 3rd away EM rotation), 1 or 2 non-clinical letters from research/QI supervisor or extracurricular activity supervisor (ex.Director of underserved clinic, PRIME/JMP Director, etc)

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Does your department have a Standardized/Supplemental Letter of Evaluation (such as SLOE)? If so, how canhow is this letter drafted (and by whom)? Is there any advice you recommend for students so that they canhave have an outstanding SLOE?

Yes, EM has a SLOE which is drafted by EM Clerkship Directors, and is a description of your clinical performance on the EM subinternship rotation. Weencourage students to review a blank template of the EM SLOE, so they can understand the objective format of this letter.

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What types of variations in residency training programs are there in your specialty (eg, different tracks, different lengths)?

Two variations exist in EM residency programs. There are three-year Emergency Medicine residency programs (PGY 1-3) and four-year EmergencyMedicine programs (PGY 1-4).

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Who should students review their program list with?

Main specialty non-confidential advisors (Co-Directors of EM Clerkship): Dr. Aaron Harries or Dr. Marianne Juarez

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How many programs do you recommend a student that is average in terms of competitiveness apply to?

30

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Is there a “signaling” program for your specialty and if so, is there a strategy to use signals?

Yes, a signaling program exists. My strategy recommendations are: Signal your top programs.

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When do interviews typically happen in your field? Is there optimal timing for scheduling interviews? During these months, what clinical or non-clinical rotations do you recommend for students?

November to January. Recommend a light clinical load or research elective time.

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Any advice or guidance about etiquette for cancelling interviews? Any strategy for which interviews to keep and which interviews to cancel?

Cancel interviews as early as possible (at least 2 weeks ahead of time, if possible).

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Are you anticipating all in-person, all virtual, or a mix of in-person and virtual interviews?

All virtual

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How many interviews should students with average (for specialty) competitiveness attend in order to have a good chance of matching?

12

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At what point in time should students be concerned about not having enough interviews? Who should they contact if that is the case?

November is a good time to check in with EM advisors

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With whom should the students consult regarding creating the rank order list? What is the best timing for this?

January with EM advisors

Updated October 2024 by Aaron Harries, MD  

What UCSF resources are available within your department to support UIM-identified students applying in your specialty?

UCSF FCM Residency Program - UIM students are encouraged to meet with current residents, chief residents, and faculty to discuss experiences for UIM students

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What specialty-wide/national resources are available to support UIM-identified students applying in your specialty?

American Association of Family Physicians

The three most compelling aspects of this specialty:

1. Cultivate meaningful longterm relationships with patients, families, and communities.
2. Make a real difference improving health through excellence andinnovation in patient care, education, research, advocacy, and community empowerment.
3. Work with an inspirational, motivated group of colleaguesand patients to advocate for improving the health care system and advancing health equity for underserved and marginalized patients and communities.

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What is the culture of this specialty?

Family Medicine has a culture that is deeply mission-driven to promoting health and wellness. The culture of Family Medicine is strongly oriented towardhealth justice, social action, and advocacy for promoting health and wellness for individuals, families and communities. The approach to health care ispatient-centered, focused on continuity of care, and congruent with the primary care medical home. Long-term relationships with patients and familiesare the foundation of Family Medicine. There is a strong orientation toward preventive care and public health. Many Family Physicians are engaged inlocal or national health reform efforts that focus on providing effective, efficient and cost- effective care that meets the needs of the national population.Many Family Physicians also place a high value on promoting health equity, advocating for social justice, and caring for diverse, marginalized, andmedically underserved patient populations.

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What are some common variations in career path in this specialty? What common fellowship opportunities exist in this specialty?

There are numerous possibilities and variations after training. Full scope Family Medicine includes prenatal care and deliveries, and continuity care forpatients throughout the life cycle. Nationally, about one third of Family Physicians practice obstetrics. Other Family Physicians practice primary care forthe entire family, by providing caring for parents, children and grandparents; however, they may collaborate with colleagues in obstetrics who will deliverbabies. After the delivery, Family Physician will then care for the new baby and mother as well as the rest of the family. Some Family Physicians chooseto work in hospitals and provide inpatient care, but others do not. What unites the practice of Family Medicine is that nearly all Family Physicians spendat least some of their time providing primary care in a continuity setting. Post-residency fellowships or Certificate of Added Qualifications (CAQ) areavailable in: Reproductive Health, Adolescent Medicine, Sports Medicine, Geriatrics, Research, Obstetrics, Gender-affirming Care, Research, PublicPolicy, Health Advocacy, Complementary-Alternative Medicine, and Medical Education, Substance Use Disorder, and Family Planning. Because of thebreadth of training, Family Medicine is a highly desired specialty for global health and also for rural settings. Family Medicine is the only specialty forwhich Doctors without Borders will only give long-term placements abroad. It is not necessary to complete a fellowship to start clinical practice. Most FMclinicians do not complete sub-specialty fellowships.

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What does a typical work week look like in this specialty? How frequently can the average doctor in this specialty expect to work weekends/holidays/overnights?

This is highly variable and dependent on the career path one chooses. Practicing FM clinicians work primarily in outpatient settings, primarily in groups orlarger health care organizations (e.g. Kaiser Permanente). Some Family Physicians work as hospitalists. Others work in a Reproductive Care setting(family planning, gynecology or abortion services). Others work in Sports Medicine practices. Family Physicians also work in emergency rooms,hospitals, rehabilitation facilities, nursing homes, and other inpatient and chronic care settings. Family Physicians interested in teaching can includeprecepting medical students and residents in their clinical practice. Family Physicians may combine research, education, public health, health policy andadvocacy with part-time clinical practice. Many family physicians are engaged in promoting health equity, improving community health, and/or advocatingfor social justice.

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How does this specialty support or challenge having a family?

Family Medicine is very compatible with raising a family. In recent years, the majority of graduates entering family medicine are women. Job sharing andless than full time work is available for both men and women. Due to the specialty’s commitment to maintaining physician and family well being, and alsobecause of the high demand for primary care physicians, Family Physicians are in an excellent position to shape their jobs to work with family needs.

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How competitive is the residency application process in this specialty?

UCSF graduates are recognized as excellent applicants for residency and are often highly recruited by residency programs throughout the country. Inrecent years, family medicine residency programs have become more competitive. There are many types of family medicine residency programs in avariety of settings and with different missions. There are community programs without other training programs (“unopposed” or “solo”), academic medicalcenters with a full range of other residency programs, rural programs and urban underserved programs. There are also residency programs at institutionswith other residency programs (“opposed” or “collaborative” programs).

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How competitive is the job market in this specialty (after residency/fellowship training)?

With the increased interest in primary care and Family Medicine as the foundation of medical care, there is a demand for more Family Physiciansthroughout the country. On the job market, Family Medicine is the most frequently sought specialty for job recruitment. Salaries for Family Physicianshave increased substantially in recent years and continue to rise. There are loan re-payment programs available in Family Medicine.

What are the preferred ways for an early F1 student to show interest and obtain guidance in your specialty?

1. Meet advisorMeet with the confidential specialty advisor
2. Join the official specialty interest group: FM interest group,Primary Care Leadership Academy
3. Shadow specialtyShadow a faculty member in the specialty

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Are there specialty professional organizations that you recommend students join? If so, what are the costs of doing so, or are there resources for students with limited ability to pay membership fees? Are there specific activities (such as meetings or subgroups) that are recommended in the organization

American Association of Family Physicians

California Association of Family Physicians

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 How can students in your specialty demonstrate leadership?

Strong, sustained engagement with family medicine efforts in clinical care, research, health advocacy, community engagement, medical education, orhealth care policy.

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For students interested in your specialty, when should students become involved in research?

Becoming involved in research is not required in my specialty.

How can students best prepare for a core F2 clerkship in your specialty? Are there specific resources (websites, books, documents) that you recommend? Should a student meet with any designated faculty in the department prior to the core F2 clerkship?

Students interested in family medicine should note this on their FCM clerkship preference sheet. This will help clerkship directors ensure that they areplaced with a family physician preceptor. (Many sites also have primary care internal medicine preceptors).

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What are the differences (if any) between between sites of the core clerkship?

FCM 110 is a longitudinal rotation so students work with preceptors over all of third year. In public health settings, students work with medicallyunderserved and marginalized patients in community clinics in locations such as San Francisco Dept of Public Health, Clinical de La Raza, Contra Costa,and more. In Kaiser settings, students work with patients who have Kaiser health insurance and receive care in Kaiser's ambulatory care settingsthroughout the Bay Area. Students who are strongly interested in Family Medicine are highly encouraged to consider participating in a StructuredProgram for F2. The Longitudinal Integrated Clerkships allow students to have greater continuity with ambulatory patients and preceptors over third year.Model SFGH allows students to have a 6 month immersive experience in a public health setting at SFGH. That said, because Family Medicine islongitudinal, students in any FCM setting will have time to engage with their preceptor and site over third year. To make the most of this opportunity,students are encouraged to talk to their preceptor about how they can try to schedule patients to return when they can see them, and also to call patientsto follow up on their care. This approach will help generate insight into continuity of care, a vital pillar of Family Medicine.

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If a student develops an unexpected interest in your specialty during F2, what are the best next steps to take to become a competitive applicant?

Students should reach out the confidential or non-confidential FCM advisor. They are also encouraged to reach out the FCM clerkship directors, Dr Betsy Wan and Dr Erica Brode.

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What F2 electives in your specialty or in another specialty are recommended for students strongly interested in your specialty?

CIEx at SF Free Clinic CIEx in musculoskeletal medicine, dermatology, reproductive care, or other area that is

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How can students demonstrate excellent performance in a F2 clerkship in your specialty?

Strong, positive written clerkship evaluation comments by FCM clerkship preceptor(s) Strong, positive letter of rec from FCM clerkship preceptor(s)

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What guidance should students seek to prepare for Career Launch (4th year) clerkship scheduling?

1. Meet with a specialty advisor. The best timing and person to meet with is Margo Vener
2. There byThere is a group orientation session in our specialty prior to Career Launch. Students can find out about this bycontacting contacting (please include email) Roy Johnston

Who in the department should be notified if a student is interested in taking a gap year?

The person to notify prior to a gap year is (name and email): Roy Johnston

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Who in the department should be notified if a student is returning from a gap year and plans to apply in my specialty?

The person to notify prior to a gap year is (name and email): Roy Johnston

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Are there specific electives or clinical experiences in your specialty recommended for students to take in CL blocks prior to taking a gap year?

Yes. Suggest:

1 ambulatory FCM rotation (SF Free Clinic, Contra Costa or Santa Rosa). Outside FCM, other helpful rotations include: Derm (top choice - most helpful by far!); sports med; women's health; peds urgent care; etc

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Are there specific electives or clinical experiences in your specialty recommended for students returning from a gap year as a "warm up" prior to doing a sub-I in your specialty?

Yes. If students are doing FCM 140.40, we recommend a "warm up" rotation - ie, an inpatient, 4 week consult month based at SFGH such as cardiology etc

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For students planning their return from a gap year, are there any unique (to gap year) schedulingconsiderations? considerations? (For sub-Is/AIs, electives, away rotations, meetings with advisors, etc)?

Please meet with Dr. Vener in the fall of your gap year to plan for your return schedule.

Which courses (specifically sub-Is/acting internships) are strongly recommended or required in the summer prior to residency application? Are any specific sites recommended for these courses? Is more than 1 sub-I (or acting internship) recommended in your specialty?

Most students who are applying in FCM are recommended to take FCM 140.40, the acting internship in inpatient Family Medicine which is based atSFGH. This is a terrific rotation to see the high quality of patient care and teaching in FCM, and also to meet some great family physician role models.This rotation is scheduled through EVOS and SOM with other rotations. However, because FCM 140.40 is only inpatient, it will not be helpful for studentswho are trying to make a specialty decision between FCM and another field, because you will not participate in outpatient primary care on this rotation.Of note, in order to graduate, you need to take either FCM 140.40 or Med 140.40. Both are very similar rotations because they focus on care of sickadults in an inpatient setting. There is not added benefit (and often is not space) for doing both rotations. If you are on the fence, please talk with Dr.Vener. Students who are on the fence between FCM and another specialty should do a FCM rotation that is focused on outpatient care. This includes theFCM acting internship at SF Free Clinic, the FCM acting internship in Santa Rosa, or the FCM rotation in Contra Costa. All of these rotations arearranged by contacting Roy Johnston - roy.johnston@ucsf.edu. These are NOT scheduled through SOM. To apply in FCM, you only need to do one 4-week FCM rotation. Hence if you do FCM 140.40, you do not need to do an additional outpatient FCM rotation. That said, many students opt to do anoutpatient FCM rotation regardless (they are fun and interesting!). Bottom line: When it comes to career decisions, each student has a unique situation.Please contact Dr. Vener and we can figure out what is best for you.

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What is the recommended timing of the medicine or family medicine acting internship (AI)?

It is highly recommended to take a FCM AI prior to Sept the year that you apply. 

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What electives are encouraged (but not required or strongly recommended) during Career Launch in your field or outside of your field?

Strongly encouraged: Dermatology. Encouraged if students are interested: reproductive care, sports medicine, pediatric acute care, addiction medicine,palliative care, gender affirming care, etc

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If away rotations are recommended in your field, what advice do you tell students about selecting and procuring this experience?

Away rotations are only recommended under the following circumstances: Interested students may opt to arrange a rotation with Indian Health Services (IHS). Look for applications on the IHS website; because sites feel quickly, it is recommended that students apply up to a year in advance.

What aspects of an application are the most important to be competitive in this specialty?

	Absolutely essential	Very important	Somewhat important	Not at all impportant
Extracurricular leadership efforts	X
Research/publications		X
Honors in specialty sub-internship		X
Honors in medicine or family medicine acting internship	X
Away rotations				X
USMLE Step 2 scores			X
Community work or service	X
Medical Student Performance Evaluation (MSPE) comments in my specialty	X
MSPE comments in other specialties			X
MSPE non-clinical sections (including "Noteworthy characteristics")	X
DEI and/or anti-oppressive work		X
Letters of recommendation	X
Leadership roles	X

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What aspects of an application would be particularly harmful in terms of competitiveness?

	Matching in specialty extremely unlikely	Matching in Specialty will be more challenging, but possible	No impact on competitiveness
Negative comments regarding professionalism/physicianship	X
More than 1 attempt to pass USMLE Step 1 or 2		X
Below-average-for-specialty score on Step 2		X
No Step 2 score at the time of application submission		X
Multiple clerkship or exam failures that are apparent on the MSPE or transcript		X
Notation about extra time taken to complete a clerkship in the MSPE		X
Leave of absence from medical school not accounted for by outside degree program or research time		X

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Do programs in this specialty typically use "cut-off" USMLE scores to screen applications?

No

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What is the optimal timing for Step 2 CK?

Prior to fall the year of application

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How much does a high Step 2 CK score mediate the results of a non-passing attempt at Step 1 (or Step 2)?

Varies

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How does your specialty utilize the MSPE in applicant review? What types of "Noteworthy Characteristics" should an applicant emphasize in the MSPE?

Characteristics that align with key values in Family Medicine are important, eg: personal characteristics such as compassion, advocacy, health justice,leadership, scholarship, etc.

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Is research experience without publication valued in your specialty? If so, what are ways that this can be shown on their application/CV?

Yes. List abstracts submitted, oral presentations, and "works in progress" on CV.

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Is research and/or publication in another specialty of value to an applicant? (This may be particularly applicable to an applicant making a late decision to apply in your specialty)

Varies

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When advising about applying in your specialty, are students ever encouraged to apply in a backup specialty or dual apply in a second specialty? If so, when should students consider this? Who is the best person in my department to consult about this?

If students are considering dual applying, they should talk with Dr. Vener.

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What departmental application events (general info, strategy, celebration) are held throughout the application and match season? Who should the student contact to be invited to these events?

FCM advising events and individual meetings with career advisors Matched panel of students in Family Medicine (spring) Annual Family MedicineRodnick Colloquium (May - highly recommend) Northern California Family Residency Fair (July - highly recommend) Interested students should let RoyJohnston know that they are applying in FCM so that they will be added to the distribution list.

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Any departmental or specialty specific websites or resources for residency application that you recommend?

Dr Vener writes and distributes a year long series of emails, "Residency TIps from Margo," which walks students through the application process step bystep over the entire year. Emails are sent throughout the year with relevant information that students need for that month, eg: "What should I write in mypersonal statement?" "How do I respectfully decline an interview?" etc. The emails are written by Dr Vener and sent out by Roy Johnston. Students whowish to receive these emails should contact Roy Johnston to let them know they are applying (or considering applying) in FCM so that we can add you tothe distribution list.

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Who are essential faculty to meet with before application (Department Chair, Main Specialty Advisor, Residency Program Director, etc)? What is the optimal timing for this meeting? What material or information should the student bring to this meeting? Who should the student contact to arrange this meeting?

Students should meet with Dr Margo Vener, Career Advisor, non-confidential, prior to application in FCM.

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In addition to the standard application, does your specialty use any form of supplemental application? If so, how does a student register for the supplemental application? Is there any specific advice that could be helpful in preparing a supplemental application?

Varies

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Advice on writing the personal statement? Are there important topics or themes that should be included?

These 4 areas should be included (in any order) - Something unique important about your perspective/background/experience that you want programs toknow about you so they have insight about you as an individual - WHy FCM seems like a good fit for you - Reflection on one clinical experience in patientcare in 3rd or 4th year (so they can know how you think about key issues) - (Optional) What you could envision yourself doing in the future afterresidency.

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Who in the department should review the personal statement? When should a good draft of the personal statement be presented to faculty reviewers?

Please send a draft of your personal statement to Dr Margo Vener in the summer of the year you are applying

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What is your recommended general approach or strategy for requesting letters of recommendation (LORs), particularly timing and etiquette?

To apply in FCM, you need 3 letters from faculty who have worked with you clinically in 3rd or 4th year. At least one of your letter writers needs to be afamily doctor. If you have done substantial research or a significant project during med school, you may include a 4th (optional) letter from a research orproject mentor.

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Regarding letter writers, what characteristics (faculty rank, years of training, on resident selection committee, etc) should be considered?

Faculty letter writers should be individuals who know you well and can describe your patient care skills, eg: your third year FCM 110 preceptor, FCM140.40 attending, etc. Personal knowledge of your work is more important than picking a faculty member with a higher rank who does not know youpersonally.

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Does the department write a letter of recommendation ("Chair Letter"/ "Department Letter") for anapplicant? applicant? If so, who should they contact for this and when should they do so?

No

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Of the total of 3 (or 4) letters that are part of an application, what is considered the best mix of letters? (letter)(eg: 1 from sub-internship, 1 additional clinical letter, 1 research letter, 1 department letter)?

Letter writers should know you well. Three letters should be from faculty who worked with you clinically; you may also include an optional research letter.At least one clinical letter must be from a family physician, usually your third year FCM 110 preceptor or fourth year FCM AI attending.

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Does your department have a Standardized/Supplemental Letter of Evaluation (such as SLOE)? If so, how canhow is this letter drafted (and by whom)? Is there any advice you recommend for students so that they canhave have an outstanding SLOE?

No

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What types of variations in residency training programs are there in your specialty (eg, different tracks, different lengths)?

Nearly all FCM residencies are three years long. A few exceptions are the FCM-Psych programs, and a few four year FCM programs (eg: OHSU).

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Who should students review their program list with?

Dr Margo Vener

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How many programs do you recommend a student that is average in terms of competitiveness apply to?

15

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Is there a “signaling” program for your specialty and if so, is there a strategy to use signals?

Yes, a signaling program exists. My strategy recommendations are: No gaming or strategy - truly pick the programs that you are truly most interested in.

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When do interviews typically happen in your field? Is there optimal timing for scheduling interviews? During these months, what clinical or non-clinical rotations do you recommend for students?

While interviews can be from late October through early January, most interviewing is in late October through early December.

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Any advice or guidance about etiquette for cancelling interviews? Any strategy for which interviews to keep and which interviews to cancel?

Please cancel as early as possible to give other applicants and programs a chance to find their best fit. This is really essential! At a minimum, you shouldcancel at least 2 weeks in advance - but earlier is better. See emails from Dr Vener on this topic.

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Are you anticipating all in-person, all virtual, or a mix of in-person and virtual interviews?

Unable to predict at this time.

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During an interview, what should applicants be looking for and/or what questions should they consider asking that can help them clarify what programs will be most desirable?

We send out info about this. Look for a program where your gut reaction feels positive, and you feel like you fit well with residents and faculty and staff.

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What is the recommended approach to post-interview communication? Are thank you notes recommended? Are “you are my #1 choice” letters recommended?

Most folks send thank you notes by email or hand written. Many folks send "you are my top choice" notes in Jan as well. Talk with Dr Vener if you areconsidering this.

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Is there any special advice you give to students applying as a couple in the Match? If so, what is it?

Meet with Dr Vener late spring./early summer to plan your application strategy.

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How many interviews should students with average (for specialty) competitiveness attend in order to have a good chance of matching?

10

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At what point in time should students be concerned about not having enough interviews? Who should they contact if that is the case?

Talk with Dr Vener if you have less than 9 interviews scheduled.

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With whom should the students consult regarding creating the rank order list? What is the best timing for this?

Students should meet with Dr Vener in late December or early Jan to discuss their rank list.

Updated October 2024 by Margo Vener, MD   

What UCSF resources are available within your department to support UIM-identified students applying in your specialty?

Reach out to a career advisor so that individualized guidance can be provided.

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What specialty-wide/national resources are available to support UIM-identified students applying in your specialty?

Please reach out to Specialty Advisors for resources

The three most compelling aspects of this specialty:

1. The wide range of clinical medicine that physicians can choose to specialize in- primary care, hospital medicine, subspecialites. The breadth and depthof clinical content is fascinating, comprehensive, and ever-changing. It’s exciting to work in teams to solve clinical problems and improve the health ofpatients. -
2. The field allows physicians to develop meaningful relationships with patients, whether that be in the hospital or office setting.
3. The breadth ofextracurricular and leadership activities that internists often do balances with and is informed by their core clinical work (e.g., systems and qualityimprovement, clinical research, teaching, health policy and equity, patient safety, etc.)

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What is the culture of this specialty?

The culture of internal medicine as a specialty is intellectual, inclusive, and supportive. Internal Medicine (IM) physicians have diverse interests, butshare a common interest in the health and or well-being of the whole patient. They are able to see the interconnectedness of multiple medical problemsas well as how they interface with a patients’ values, goals of care and psychosocial needs. Internists are typically detail-oriented physicians who areoften seen by colleagues as experts in physiology, clinical reasoning, and team-based care. Because primary care physicians, hospitalists, andsubspecialists work in a variety of settings in a field that is dynamic and evolving, many choose this field as it rewards the curious mind.

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What are some common variations in career path in this specialty? What common fellowship opportunities exist in this specialty?

Internal Medicine (IM) residency is typically 3 years. There may be a variety of tracks within a given IM program to which an applicant can apply to inorder to match(categorical, primary care, or specialized research tracks). Most residents find themselves in a categorical program, which is a traditionaltraining program that is largely inpatient-based. Categorical residents may pursue careers in general internal medicine, in the inpatient (“hospitalist” or“hospital medicine”) or outpatient (“primary care”) setting, or match into subspecialty fellowships (such as cardiology, gastroenterology, oncology, etc).Primary care residency programs often incorporate more clinic time into the three-year training as well as small group seminar teaching. Primary careresidents may also pursue careers in general internal medicine, in the inpatient or outpatient setting, or match into subspecialty fellowships. Fortunately,after residency, there are endless possibilities for careers for internal medicine trained physicians including subspecialty practice, hospitalist careers,primary care practice, clinician-scientist, clinical researcher, outcomes researcher, health policy, international health, public health, and medicaleducation. After residency, there are endless possibilities for careers for internal medicine trained physicians including subspecialty practice, hospitalistcareers, primary care practice, clinician-scientist, clinical researcher, health policy, international health, public health, and medical education.

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What does a typical work week look like in this specialty? How frequently can the average doctor in this specialty expect to work weekends/holidays/overnights?

Varied! There is no one standard day for IM physicians, as it can be very practice-dependent. Clinically, general internists usually choose to workpredominantly in the inpatient or outpatient settings, though mixed practices do exist. Subspecialists may frequently see patients in both settings. Forexample, in hospital medicine, one may work 7-days on, 7-days off. In primary care, the work week may follow more typical weekday hours, withoccasional shifts on the weekends and beeper calls. Because of the built-in flexibility in schedules, many internists combine clinical practice withnonclinical work including leadership roles, research, health policy, or medical educational work.

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How does this specialty support or challenge having a family?

Careers in IM present a range of options for part-time or full-time work, which make it potentially very compatible with family or other personal needs.While some choose careers providing longitudinal care on a regular or modified work-week schedule, others may practice in inpatient fields which allowfor more flexible, shift-based scheduling. In many practice settings, hours are generally limited to normal work-day hours or have predictable shift work,so physicians may be better able to participate in child or eldercare needs.

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How competitive is the residency application process in this specialty?

There are many IM residency spots in the United States (when compared with certain very limited surgical subspecialty spots, for example), so studentshave many options to receive excellent IM training. UCSF students traditionally match extremely well in IM and are highly sought-after by residencyprograms.

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How competitive is the job market in this specialty (after residency/fellowship training)?

There is high demand for primary care physicians, hospitalists, and subspecialists throughout the United States. Fortunately, internists can practice in avariety of settings – ranging from rural to urban or community-based to academic-based settings – and everything in between!

What are the preferred ways for an early F1 student to show interest and obtain guidance in your specialty?

1. Meet with the confidential specialty advisor
2. Join the official specialty interest group: Internal Medicine InterestGroup (IMIG)
3. Attend a specialty elective through IMIG - Shadow specialtyShadow a faculty member in the specialty

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Are there specialty professional organizations that you recommend students join? If so, what are the costs of doing so, or are there resources for students with limited ability to pay membership fees? Are there specific activities (such as meetings or subgroups) that are recommended in the organization

There is no requirement for students to joint specialty professional organizations, however if a student is interested in IM there are a few professionalorganizations which may support your growing interest in scholarship, mentorship, and networking. Each of the organizations has local/regional chapters,which may help connect you with trainees at local/regional institutions. For example, American College of Physicians (ACP) has free student membershipand a lot of great online resources; they help support our Internal Medicine Interest Group. ACP’s annual regional meeting- as well as those of Society ofGeneral Internal Medicine (SGIM) and Society of Hospital Medicine (SHM)- are all excellent opportunities for students to submit academic posters andmeet local residents, fellows, and faculty.

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How can students in your specialty demonstrate leadership?

For activities that you engage in, see if there are opportunities to lead in some way (eg, develop curricular content for a volunteer science elective forelementary school students).

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For students interested in your specialty, when should students become involved in research?

Becoming involved in research is not required in my specialty.

How can students best prepare for a core F2 clerkship in your specialty? Are there specific resources (websites, books, documents) that you recommend? Should a student meet with any designated faculty in the department prior to the core F2 clerkship?

Join the Internal Medicine Interest Group (IMIG) as a member or a coordinator, which is partly supported by American College of Physicians (ACP), oneof the main national organizations for internal medicine. ACP has great online resources that explains the different pathways and options within internalmedicine as a field.

American College of Physicians

American Medical Association

Society of General Internal Medicine

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What are the differences (if any) between between sites of the core clerkship?

There are three traditional block sites:

• UCSF Health at Parnassus, Zuckerberg San Francisco General Hospital, and San Francisco Veterans AffairsMedical Center;
• Med 110 is also a core clerkship of the longitudinal integrated clerkships PISCES (Parnassus based), KLIC (Kaiser East Bay), Kaiser
• San Francisco LIC, and UCSF Fresno LIFE.

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If a student develops an unexpected interest in your specialty during F2, what are the best next steps to take to become a competitive applicant?

Most students decide on IM during F2 or Career Launch, so there is plenty of time to apply into IM and still be a highly competitive applicant. Werecommend meeting with a career advisor to discuss further.

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What F2 electives in your specialty or in another specialty are recommended for students strongly interested in your specialty?

Any medicine elective can be helpful. When trying to program your 4th year (“Career Launch”), feel free to reach out to one of the confidential or mainspecialty advisors with specific questions.

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How can students demonstrate excellent performance in a F2 clerkship in your specialty?

Focus on developing strong patient care skills (e.g., hypothesis-driven H&Ps, oral presentations and notes), clinical reasoning, and communication skillswith patients and team members. Seek out feedback for growth and opportunities to challenge yourself from your interns and residents as well as yourfaculty preceptors.

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What guidance should students seek to prepare for Career Launch (4th year) clerkship scheduling?

Meet with a specialty advisor. The best timing and person to meet with is Spring of Career Launch - There is a group orientation session in our specialty prior to Career Launch.

Who in the department should be notified if a student is interested in taking a gap year?

Notifying someone in our department prior to a gap year is unnecessary

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Who in the department should be notified if a student is returning from a gap year and plans to apply in my specialty?

Notifying someone in our department when returning from a gap year is unnecessary

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Are there specific electives or clinical experiences in your specialty recommended for students to take in CL blocks prior to taking a gap year?

No

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Are there specific electives or clinical experiences in your specialty recommended for students returning from a gap year as a "warm up" prior to doing a sub-I in your specialty?

No

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For students planning their return from a gap year, are there any unique (to gap year) schedulingconsiderations? considerations? (For sub-Is/AIs, electives, away rotations, meetings with advisors, etc)?

Consider a "warm-up" rotation to refamiliarize yourself with clinical medicine.

Which courses (specifically sub-Is/acting internships) are strongly recommended or required in the summer prior to residency application? Are any specific sites recommended for these courses? Is more than 1 sub-I (or acting internship) recommended in your specialty?

Medicine acting internship

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What is the recommended timing of the medicine or family medicine acting internship (AI)?

Before September

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What electives are encouraged (but not required or strongly recommended) during Career Launch in your field or outside of your field?

As Career Launch offers an opportunity for you to explore both your clinical and nonclinical interests, we encourage students to take electives whichprovide experience in the fields of their interest. Additionally, as this may be the last opportunity for you to get formal training in a field that you have notapplied to for residency, it may be an important time to consider skill development (i.e. if applying to IM, an elective in radiology may provide additionalskills in X-ray and CT reading; an elective in anesthesia may provide additional skills in airway and hemodynamic management).

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If away rotations are recommended in your field, what advice do you tell students about selecting and procuring this experience?

Away rotations are not recommended in my field

What aspects of an application are the most important to be competitive in this specialty?

	Absolutely essential	Very important	Somewhat important	Not at all impportant
Extracurricular leadership efforts		X
Research/publications			X
Honors in specialty sub-internship				X
Honors in medicine or family medicine acting internship		X
Away rotations				X
USMLE Step 2 scores		X
Community work or service		X
Medical Student Performance Evaluation (MSPE) comments in my specialty		X
MSPE comments in other specialties		X
MSPE non-clinical sections (including "Noteworthy characteristics")		X
DEI and/or anti-oppressive work			X
Letters of recommendation		X
Leadership roles		X

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What aspects of an application would be particularly harmful in terms of competitiveness?

	Matching in specialty extremely unlikely	Matching in Specialty will be more challenging, but possible	No impact on competitiveness
Negative comments regarding professionalism/physicianship		X
More than 1 attempt to pass USMLE Step 1 or 2		X
Below-average-for-specialty score on Step 2		X
No Step 2 score at the time of application submission		X
Multiple clerkship or exam failures that are apparent on the MSPE or transcript		X
Notation about extra time taken to complete a clerkship in the MSPE		X
Leave of absence from medical school not accounted for by outside degree program or research time		X

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Do programs in this specialty typically use "cut-off" USMLE scores to screen applications?

Uknown

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What is the optimal timing for Step 2 CK?

Before turning in application

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How much does a high Step 2 CK score mediate the results of a non-passing attempt at Step 1 (or Step 2)?

Unknown

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How does your specialty utilize the MSPE in applicant review? What types of "Noteworthy Characteristics" should an applicant emphasize in the MSPE?

MSPE comments in other specialties are important to demonstrate well-roundedness when it comes to academics. For Noteworthy Characteristics,depth in extracurricular activities is important as this demonstrates passion. If you have leadership in a field, consider highlighting this.

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Is research experience without publication valued in your specialty? If so, what are ways that this can be shown on their application/CV?

Yes. Describe goals of the project, your role, and outcomes. Include abstracts and other presentations from the project. Even without abstracts orpublications, it is important to describe the projects you were involved in.

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Is research and/or publication in another specialty of value to an applicant? (This may be particularly applicable to an applicant making a late decision to apply in your specialty)

Yes

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When advising about applying in your specialty, are students ever encouraged to apply in a backup specialty or dual apply in a second specialty? If so, when should students consider this? Who is the best person in my department to consult about this?

No

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What departmental application events (general info, strategy, celebration) are held throughout the application and match season? Who should the student contact to be invited to these events?

Virtual group information sessions, as well as sessions with Internal Medicine Interest Group.

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Who are essential faculty to meet with before application (Department Chair, Main Specialty Advisor, Residency Program Director, etc)? What is the optimal timing for this meeting? What material or information should the student bring to this meeting? Who should the student contact to arrange this meeting?

Career advisor- reach out by email in the spring/early summer.

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In addition to the standard application, does your specialty use any form of supplemental application? If so, how does a student register for the supplemental application? Is there any specific advice that could be helpful in preparing a supplemental application?

No

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Advice on writing the personal statement? Are there important topics or themes that should be included?

Can brainstorm ideas with an advisor or coach.

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Who in the department should review the personal statement? When should a good draft of the personal statement be presented to faculty reviewers?

Career Advisor

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What is your recommended general approach or strategy for requesting letters of recommendation (LORs), particularly timing and etiquette?

Don’t ask during third year – don’t have to lock them in then, no one will start writing them then; talk to your career advisor before you start asking faculty.

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Regarding letter writers, what characteristics (faculty rank, years of training, on resident selection committee, etc) should be considered?

Just that they know you well; seniority does not matter.

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Does the department write a letter of recommendation ("Chair Letter"/ "Department Letter") for anapplicant? applicant? If so, who should they contact for this and when should they do so?

Career advisor writes the letter; contact by early CL summer.

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Of the total of 3 (or 4) letters that are part of an application, what is considered the best mix of letters? (letter)(eg: 1 from sub-internship, 1 additional clinical letter, 1 research letter, 1 department letter)?

No formula – only need 2 doctors who know your clinical work + chair letter comes from career advisor. Work with your career advisor to figure out which combination works for you.

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Does your department have a Standardized/Supplemental Letter of Evaluation (such as SLOE)? If so, how canhow is this letter drafted (and by whom)? Is there any advice you recommend for students so that they canhave have an outstanding SLOE?

No

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What types of variations in residency training programs are there in your specialty (eg, different tracks, different lengths)?

See ACP website. Different tracks include categorical, primary care, molecular medicine, etc.

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Who should students review their program list with?

Career Advisor

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How many programs do you recommend a student that is average in terms of competitiveness apply to?

15-20

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Is there a “signaling” program for your specialty and if so, is there a strategy to use signals?

Yes, a signaling program exists.

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When do interviews typically happen in your field? Is there optimal timing for scheduling interviews? During these months, what clinical or non-clinical rotations do you recommend for students?

In general, early November-early January.

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Any advice or guidance about etiquette for cancelling interviews? Any strategy for which interviews to keep and which interviews to cancel?

Cancel as early as possible to allow others to get an interview. Before you cancel, talk with your career advisor.

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Are you anticipating all in-person, all virtual, or a mix of in-person and virtual interviews?

All virtual

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During an interview, what should applicants be looking for and/or what questions should they consider asking that can help them clarify what programs will be most desirable?

Tips will be provided at a future panel.

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What is the recommended approach to post-interview communication? Are thank you notes recommended? Are “you are my #1 choice” letters recommended?

These are not expected.

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Is there any special advice you give to students applying as a couple in the Match? If so, what is it?

Talk with the School's directors of career advising. Also talk about this with your formal career advisor.

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How many interviews should students with average (for specialty) competitiveness attend in order to have a good chance of matching?

No more than 12 or so

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At what point in time should students be concerned about not having enough interviews? Who should they contact if that is the case?

There is no set date when interviews are released. Generally, most interviews are given out by late November in a rolling manner. Waitlists can move.

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With whom should the students consult regarding creating the rank order list? What is the best timing for this?

Career advisor, after interviews are completed.

Updated October 2024 by Drs. Cindy Lai, Gurpreet Dhaliwal, Binh An Phan    

What UCSF resources are available within your department to support UIM-identified students applying in your specialty?

There are numerous faculty members in the neurology department with specific interest in supporting students who are underrepresented inmedicine, including Nerissa Ko, Noriko Anderson, Mercedes Paredes, Nicole Rosendale, Winston Chiong, Felicia Chow, and others. TheBALANCE group at UCSF (https://balance.ucsf.edu/) is an equity focused community in the neurology department that serves many roles,including a monthly BALANCE journal club, which provides a forum for updates in equity research and a networking opportunity for medicalstudents.

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What specialty-wide/national resources are available to support UIM-identified students applying in your specialty?

The American Academy of Neurology (AAN) has a medical student diversity program scholarship to support UIM-identified students applying inneurology. The AAN and numerous other neurological organizations also have numerous events at their conferences geared toward supportingUIM-identified medical students with mentorship, sponsorship and networking.

The three most compelling aspects of this specialty:

1. Neurologists are trained to perform a systematic and highly informative examination that provides essential information in the diagnosis andmanagement of its patients. This examination is a powerful and free tool that a neurologist will always have to offer, no matter what technologicaladvances may come.
2. Dysfunction of the nervous system leads to impairment in the way patients perceive and interact with the world, affecting deeplyimportant aspects of who they are and how they live their life. Thus neurologists will always be working with patients and families who are deeplyimpacted by their illnesses and highly motivated to seek neurologic health.
3. Knowledge of neurologic illnesses and their management is growingextremely rapidly, and going into neurology offers trainees a chance to be a part of groundbreaking discoveries and novel therapeutics.

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What is the culture of this specialty?

The culture of neurology is, of course, defined in large part by the type of individuals who are attracted to the field. Neurologists approach the care oftheir patients with compassion, careful observation and intellectualism. They appreciate and are fascinated by the complexity of the nervous system andare often motivated to share their enthusiasm with trainees, colleagues and patients. Neurologists tend to love the naturally systematic approach that isrequired to care for neurologic patients, using neuroanatomic localization as a fundamental starting point, and often are appreciative of the "puzzle-like"diagnostic reasoning and logic that can be applied to seek a diagnosis and management plan.

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What are some common variations in career path in this specialty? What common fellowship opportunities exist in this specialty?

As with most medical specialties, careers in neurology can focus on clinical practice, research, education, diversity or global health. Some neurologistsbegin practicing after graduating from residency, while many others elect to pursue a fellowship for subspecialty training (e.g. in epilepsy, neuromuscular,or cognitive neurology).

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What does a typical work week look like in this specialty? How frequently can the average doctor in this specialty expect to work weekends/holidays/overnights?

This will vary widely depending on specific career choices, but for a general neurologist the majority of one’s practice is in the outpatient setting.Neurologists see a mixture of younger patients (with conditions like migraine headaches and multiple sclerosis) and older patients (with conditions likestroke and dementia). There is also a mix of patients with chronic conditions who are followed for years (e.g. myasthenia gravis or epilepsy) and patientswith temporary conditions who are followed for only a short period (e.g. carpal tunnel syndrome or lumbar radiculopathy). The time a neurologist spendsworking on nights/weekends/holidays is highly variable depending on subspecialty choice and can range from zero time working during off-hours to moresignificant amounts of time. Even then, in-house overnight work is uncommon, and off-hours work is typically restricted to in-person weekends andholidays plus overnight remote call.

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How does this specialty support or challenge having a family?

Neurology is a family-friendly career. Many residents at UCSF have had children during residency, and other residencies are similar.

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How competitive is the residency application process in this specialty?

Not very – essentially all UCSF graduates get into one of the first-tier programs in the country. That being said, a few programs are competitive andnearly every applicant from UCSF will get into one of their top 3 choices.

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How competitive is the job market in this specialty (after residency/fellowship training)?

There is a global shortage of neurologists and job opportunities are abundant in essentially every field of neurology.

What are the preferred ways for an early F1 student to show interest and obtain guidance in your specialty?

1. Meet advisorMeet with the confidential specialty advisor
2. Shadow specialtyShadow a faculty member in the specialty
3. Get specialtyGet involved in a research project in the specialty

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Are there specialty professional organizations that you recommend students join? If so, what are the costs of doing so, or are there resources for students with limited ability to pay membership fees? Are there specific activities (such as meetings or subgroups) that are recommended in the organization

It is not required or necessary to join and professional organizations to successfully apply in neurology. However, the American Academy of Neurologyand the American Neurological Association have many programs for students and offer free membership.

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 How can students in your specialty demonstrate leadership?

In almost any way they like - all forms of medical leadership are valued by neurology residency programs. Global health work, quality improvement,clinical or basic science research, education, equity and diversity work, or even simply clinical excellence are all extremely valuable ways to demonstrateleadership.

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For students interested in your specialty, when should students become involved in research?

Becoming involved in research is not required in my specialty.

How can students best prepare for a core F2 clerkship in your specialty? Are there specific resources (websites, books, documents) that you recommend? Should a student meet with any designated faculty in the department prior to the core F2 clerkship?

There is no need to meet with any faculty members in the department prior to the core F2 clerkship. Please reference the emails and materials providedby clerkship leadership in order to best prepare. The syllabus from BMB and the elements of the neurologic examination are the main helpful materials toreview in advance of the clerkship.

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What are the differences (if any) between between sites of the core clerkship?

Please reference the materials presented each year by the neurology clerkship director in advance of F2, which describe the primary differencesbetween sites, for the most up-to-date information.

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If a student develops an unexpected interest in your specialty during F2, what are the best next steps to take to become a competitive applicant?

Focusing on doing an outstanding job on clerkships is the best thing that a student needs to do during F2 in order to become a competitive applicant. Itcan sometimes be helpful to consider whether any of the faculty a student works with during F2 might be good for a letter of recommendation, as suchletters are often more detail-rich when they are solicited soon after a rotation ends. Students should also be sure to schedule a neurology sub-I duringthe lottery.

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What F2 electives in your specialty or in another specialty are recommended for students strongly interested in your specialty?

Neurology aims to provide students on the core clerkship with a meaningful experience from which to evaluate the field as a potential career choice. Tosupplement the largely inpatient adult neurology core clerkship experience, several Clinical Immersion Experiences also are available, including multipleexperiences in both outpatient neurology and in pediatric neurology.

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How can students demonstrate excellent performance in a F2 clerkship in your specialty?

Neurology does not require a unique approach to clerkships in order for students to demonstrate excellent performance in F2 clerkships. Be the kind ofcolleague that you would want to work with - take charge of your own learning, be proactive and helpful, and work on developing and demonstrating corepatient care skills, thinking deeply and independently about your patients, proposing next steps in management, asking thoughtful questions, andcommunicating with professionalism and compassion.

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What guidance should students seek to prepare for Career Launch (4th year) clerkship scheduling?

There byThere is a group orientation session in our specialty prior to Career Launch. Students can find out about this bycontacting contacting (please include email): Wenia Lee

Who in the department should be notified if a student is interested in taking a gap year?

The person to notify prior to a gap year is: Megan Richie

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Who in the department should be notified if a student is returning from a gap year and plans to apply in my specialty?

The person to notify when returning from a gap year is: Megan Richie

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Are there specific electives or clinical experiences in your specialty recommended for students to take in CL blocks prior to taking a gap year?

No

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Are there specific electives or clinical experiences in your specialty recommended for students returning from a gap year as a "warm up" prior to doing a sub-I in your specialty?

No

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For students planning their return from a gap year, are there any unique (to gap year) schedulingconsiderations? considerations? (For sub-Is/AIs, electives, away rotations, meetings with advisors, etc)?

All neurology sub-Is are scheduled by hand by Megan Richie, outside of the lottery system. This is true for those returning from a gap year as well.

Which courses (specifically sub-Is/acting internships) are strongly recommended or required in the summer prior to residency application? Are any specific sites recommended for these courses? Is more than 1 sub-I (or acting internship) recommended in your specialty?

All students applying in neurology need to do a neurology sub-internship. The sub-I may either be an adult neurology or a child neurology sub-I; studentscan apply in adult or child neurology no matter which kind of sub-I they take. Students in neurology may do only 1 sub-I (with the rare exception made forstudents who may want to do both an adult and child neurology sub-I to help decide between adult and child neurology). Rules are not set in stone, butstudents doing an adult neurology sub-I who do their clerkship at Parnassus are encouraged to do their sub-I at ZSFG, while students doing an adultneurology sub-I who do their clerkship at sites other than Parnassus are encouraged to do their sub-I at Parnassus.

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What is the recommended timing of the medicine or family medicine acting internship (AI)?

Students applying in neurology do not have to do a medicine sub-I before ERAS opens in order to apply in neurology. The pros and cons ofchoosing to do a medicine AI before (or after) ERAS opens are dependent on the fact that the medicine sub-I is a high stakes rotation. If astudent happens to receive honors in the course before ERAS opens, this will be one small way that they can demonstrate clinical excellenceto programs. If a student passes the course before ERAS, this is great, but will not have a significant impact on their competitiveness forneurology residency. However, on the off chance that a student does not pass the medicine sub-I, this can make the student somewhat lesscompetive an applicant, though still a very good likelihood to match as long as they receive guidance from Dr. Richie.

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What electives are encouraged (but not required or strongly recommended) during Career Launch in your field or outside of your field?

Students should choose electives that will be helpful to them during intern year and will be difficult to take once already in a neurology residency.Examples include radiology elective, EKG elective, rheumatology, infectious disease, cardiology or sports medicine elective.

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If away rotations are recommended in your field, what advice do you tell students about selecting and procuring this experience?

Away rotations are only recommended under the following circumstances:: Students in neurology can do away rotations if they feel it would be extremely important for them to evaluate a program other than UCSF to see if they would like going there for residency. Away rotations are NOT necessary to successfully match in programs outside of UCSF and thus should only be done for the student's decision-making process, not to make them seem more attractive to a particular program.

What aspects of an application are the most important to be competitive in this specialty?

	Absolutely essential	Very important	Somewhat important	Not at all impportant
Extracurricular leadership efforts			X
Research/publications			X
Honors in specialty sub-internship		X
Honors in medicine or family medicine acting internship			X
Away rotations				X
USMLE Step 2 scores				X
Community work or service			X
Medical Student Performance Evaluation (MSPE) comments in my specialty		X
MSPE comments in other specialties			X
MSPE non-clinical sections (including "Noteworthy characteristics")			X
DEI and/or anti-oppressive work			X
Letters of recommendation		X
Leadership roles			X

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What aspects of an application would be particularly harmful in terms of competitiveness?

	Matching in specialty extremely unlikely	Matching in Specialty will be more challenging, but possible	No impact on competitiveness
Negative comments regarding professionalism/physicianship		X
More than 1 attempt to pass USMLE Step 1 or 2		X
Below-average-for-specialty score on Step 2			X
No Step 2 score at the time of application submission			X
Multiple clerkship or exam failures that are apparent on the MSPE or transcript		X
Notation about extra time taken to complete a clerkship in the MSPE		X
Leave of absence from medical school not accounted for by outside degree program or research time		X

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Do programs in this specialty typically use "cut-off" USMLE scores to screen applications?

No

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What is the optimal timing for Step 2 CK?

The School of Medicine advises students to take step 2 before ERAS opens to programs in late September. However, it is worth mentioning that ingeneral, neurology programs do not require a passing Step 2 score to interview an applicant, although they definitely DO usually require applicants topass Step 2 before they are willing to rank them. Therefore, students definitely need to pass Step 2 before programs begin putting together their ranklists in February, but students will still receive interview invites if they haven’t yet taken it before ERAS opens and interview season begins in thepreceding September. It is noteworthy that taking Step 2 before interview season begins has the advantage of allowing students time to take it againbefore rank lists are due if they don’t pass it on the first try.

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How much does a high Step 2 CK score mediate the results of a non-passing attempt at Step 1 (or Step 2)?

It would help to have a high Step 2 CK score to mediate the results of a non-passing attempt at Step 1.

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How does your specialty utilize the MSPE in applicant review? What types of "Noteworthy Characteristics" should an applicant emphasize in the MSPE?

The MSPE is definitely generally useful piece of data used by residency applications, although is generally not weighted as highly as letters ofrecommendation and candidate "fit" during interview (a surrogate for how likely the student will be happy at the residency program). Strong comments onneurology and medicine clerkships as well as neurology and medicine 4th year rotations are helpful. Noteworthy Characteristics should emphasizeleadership domains that the student exhibits - and all domains are valuable, including clinical leadership, educational leadership, research leadership,advocacy and DEI related leadership, global health leadership, etc.

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Is research experience without publication valued in your specialty? If so, what are ways that this can be shown on their application/CV?

Yes, these experiences should all be described on the CV. The projects should be described and any efforts to disseminate (abstract or conferencepresentation) should also be described.

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Is research and/or publication in another specialty of value to an applicant? (This may be particularly applicable to an applicant making a late decision to apply in your specialty)

Yes, research is valuable to students applying in neurology regardless of what specialty the research is in. There is little difference to neurologyprograms because the research skills are translatable between fields.

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When advising about applying in your specialty, are students ever encouraged to apply in a backup specialty or dual apply in a second specialty? If so, when should students consider this? Who is the best person in my department to consult about this?

Absolutely not; this will harm the application for students applying in neurology.

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What departmental application events (general info, strategy, celebration) are held throughout the application and match season? Who should the student contact to be invited to these events?

Wenia Lee organizes all career advising sessions for neurology and these will be advertised to the general student body. There are no extra sessionsthat neurology offers aside from these centralized events.

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Any departmental or specialty specific websites or resources for residency application that you recommend?

Megan Richie has a Q&A document that students interested in neurology should all review. There are also multiple other useful documents that shedistributes to students interested in neurology, including a comprehensive guide on resources for applying in neurology and UCSF-specific data onapplicant impressions for neurology residency programs.

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Who are essential faculty to meet with before application (Department Chair, Main Specialty Advisor, Residency Program Director, etc)? What is the optimal timing for this meeting? What material or information should the student bring to this meeting? Who should the student contact to arrange this meeting?

Students should all meet with the Main (and confidential) Specialty Advisor, Megan Richie, at least once, and that should occur during application seasonwhen students are putting together their ERAS application and making a list of programs to apply to (typically March - July of 4th year). Students shouldcontact Dr. Richie via email to set up this meeting, and be prepared with their Step 1/2 results, their grades in clerkships and any sub-Is, and a roughdraft of their CV.

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In addition to the standard application, does your specialty use any form of supplemental application? If so, how does a student register for the supplemental application? Is there any specific advice that could be helpful in preparing a supplemental application?

Not applicable

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Advice on writing the personal statement? Are there important topics or themes that should be included?

First, make sure it’s written well, with correct grammar, spelling, and organized use of topic sentences, concluding sentences and transitional sentences.Second, students should make sure it convinces the reader that they want to be a neurologist. If the student accomplish these two things, they are ingood shape. However, if they want to elevate the personal statement to the next level, students should consider what makes them distinct – is it thepatients they want to care for? The research they want to do? The factors that motivate them? The perspective they have? Students should try toshowcase that individuality in a clear and personal way, that helps make their statement feel distinct and authentic to themselves.

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Who in the department should review the personal statement? When should a good draft of the personal statement be presented to faculty reviewers?

Megan Richie is happy to review personal statements as students request, though may take up to a month to review them since doing so can be timeconsuming and often many personal statements arrive in her inbox around the same time.

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What is your recommended general approach or strategy for requesting letters of recommendation (LORs), particularly timing and etiquette?

Particularly on the neurology sub-I (where students consistently will want a LOR), students should consider asking the person they have in mind whilethey are still working with them. That will give them the chance to observe the student even more closely, write down details of their performance in realtime, and make their letter extra full of juicy anecdotes. However, in most cases, students will ask their letter-writers for letters after the rotation ends – inperson or by email are both fine. Student should ask the writers for a strong letter of recommendation, and if they can, also give them a date they wouldneed it by. The student should also include the names of the other attending(s), fellows and residents that they worked with, in case the letter writerwants to grab a few quotes from those people to include in the LOR. Finally, students can optionally offer to send their most recent CV and, when it’sready, their personal statement. The downside to doing this is that students might not have written their personal statement yet, and students don’t wantto delay asking for LOR just for that reason! If it’s been a while since a student worked with someone (>6 months) and they are asking them for aLOR, the student should send the letter writer their picture, as well as some details the student remembers about their experience with the LORwriter(including patient names & anecdotes is fine as long as the email is sent by Secure email). Even better, students can go into Medhub and pull theevaluation the letter writer filled out about the student, turn it into a PDF, and attach it to the email; most attendings don’t know how to pull old evaluationsthey completed long ago. These steps will help jog their memory and add more zest to the LOR.

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Regarding letter writers, what characteristics (faculty rank, years of training, on resident selection committee, etc) should be considered?

The only element that matters is how well the letter writer knows the student and how much convincing detail they will therefore be able to provide.Seniority, years of training, presence of a selection committee are not important.

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Does the department write a letter of recommendation ("Chair Letter"/ "Department Letter") for anapplicant? applicant? If so, who should they contact for this and when should they do so?

There is no formal "department letter" for neurology. However, attendings who write the neurology sub-I LORs deliberately include quotes from otherindividuals that students worked with during their sub-I to provide a broader range of perspectives. At minimum, what this means is that the student'sprimary letter writer will also include a paragraph from at least one another attending that the student worked with, if not some shorter quotes fromresidents and fellows. This means that at least two voices will contribute to the student's neurology sub-I LOR and it will be all that much stronger a letter.It also means that students may only receive one LOR from their neurology sub-internship since it serves as a sort of informal “department letter” thathighlights the perspectives of more than one individual.

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Of the total of 3 (or 4) letters that are part of an application, what is considered the best mix of letters? (letter)(eg: 1 from sub-internship, 1 additional clinical letter, 1 research letter, 1 department letter)?

Letter writers should know you well. Three letters should be from faculty who worked with you clinically; you may also include an optional research letter.At least one clinical letter must be from a family physician, usually your third year FCM 110 preceptor or fourth year FCM AI attending.

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Does your department have a Standardized/Supplemental Letter of Evaluation (such as SLOE)? If so, how canhow is this letter drafted (and by whom)? Is there any advice you recommend for students so that they canhave have an outstanding SLOE?

One of these letters must be a letter from the neurology sub-I. The other letters can all be from any other specialty and do not have to be from neurology.If the student happens to have done an academic project, up to 1 of the 4 letters can be from their project mentor, but if the student has not done anyacademic projects, then all 4 letters should be clinical.

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What types of variations in residency training programs are there in your specialty (eg, different tracks, different lengths)?

All adult neurology residency programs are 4 years, with 1 year of internal medicine (intern year) and 3 years of neurology thereafter. Some residencyprograms have specific tracks in research, education, global health, or master clinician topics.

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Who should students review their program list with?

Megan Richie

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How many programs do you recommend a student that is average in terms of competitiveness apply to?

This is individualized to the applicant and should be discussed with Megan Richie. The more important number is not how many programs toapply to, but how many interviews to complete, with most students needing 7-10 interviews to ensure a successful match.

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Is there a “signaling” program for your specialty and if so, is there a strategy to use signals?

Yes, a signaling program exists. My strategy recommendations are: Signals are not currently very important to most neurology residency programs in determining the value ofa resident. However, if there is a program that a student finds very attractive BUT that an outsider might not guess they were interested in – for example, a program in a city that the student has never lived in – this might be agood program to signal. Programs want residents who will be happy at their institutions. If a student signals a program, that suggests to them that the student find them an attractive program, which makes it that much more likely that the student would be happy as a resident there. Programs like this! So, if someone looking at a student CV couldn’t guess that their residency program is a great match for the applicant, students should consider using a signal for that program to help them understand their interest.

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When do interviews typically happen in your field? Is there optimal timing for scheduling interviews? During these months, what clinical or non-clinical rotations do you recommend for students?

Interviews typically happen November-January as the peak months. There is no optimal timing. Students should ensure they are on rotations that allowthem flexibility to attend interviews which typically number 10-20 interviews once preliminary program interviews are considered.

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Any advice or guidance about etiquette for cancelling interviews? Any strategy for which interviews to keep and which interviews to cancel?

Cancel interviews as soon as you know that you do not want to attend that program. Students should cancel interviews for programs at the bottom oftheir list once they have accumulated enough interviews scheduled to ensure they match (usually 10 programs) so that they free up spots for otherstudents.

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Are you anticipating all in-person, all virtual, or a mix of in-person and virtual interviews?

All virtual

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During an interview, what should applicants be looking for and/or what questions should they consider asking that can help them clarify what programs will be most desirable?

Students should ask questions about programs regarding the subjects that matter most to them. All students are different; what matters most to themmay be how material is taught, who teaches the material, what the patient population is like, what the work schedule is like, how much research supportis offered, how large the residency class size is, what housing support is offered, or any one of hundreds of other questions that distinguish residencies.

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What is the recommended approach to post-interview communication? Are thank you notes recommended? Are “you are my #1 choice” letters recommended?

Students can optionally send a short thank-you letter by email to programs or to any especially remarkable interviews; personalizing these emails withspecific details is likewise optional. Students are recommended to write a single "You are my #1 choice" letter to their #1 choice program, but not writeany other letters of interest to any other programs.

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Is there any special advice you give to students applying as a couple in the Match? If so, what is it?

Talk with Megan Richie for individualized recommendations.

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How many interviews should students with average (for specialty) competitiveness attend in order to have a good chance of matching?

Typically 7-10 interviews, usually around 10, and definitely no more than 12.

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At what point in time should students be concerned about not having enough interviews? Who should they contact if that is the case?

Two to three weeks after ERAS opens is a good time to check in with Dr. Megan Richie if they do not have enough interviews.

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With whom should the students consult regarding creating the rank order list? What is the best timing for this?

Megan Richie can consult with students regarding this list. Timing should be a month or so before rank lists are due but can be sooner.

Updated October 2024 by Megan Richie MD    

What UCSF resources are available within your department to support UIM-identified students applying in your specialty?

URI research program

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What specialty-wide/national resources are available to support UIM-identified students applying in your specialty?

Please reach out to Career Advisors for resources

The three most compelling aspects of this specialty:

There are a breadth of skills needed:

1. - primary care
2. surgical
3. L&D

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What is the culture of this specialty?

High acuity and a fast that can be stressful but also the fast pace is stimulating.

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What are some common variations in career path in this specialty? What common fellowship opportunities exist in this specialty?

Surgical fellowships (minimally invasive surgery, oncology, fertility, pelvic reconstructive surgery)

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What does a typical work week look like in this specialty? How frequently can the average doctor in this specialty expect to work weekends/holidays/overnights?

It varies significantly by career path you choose.

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How does this specialty support or challenge having a family?

It can be challenging, especially with frequent weekend/night calls.

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How competitive is the residency application process in this specialty?

Moderate

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How competitive is the job market in this specialty (after residency/fellowship training)?

It is not too competitive for generalist but subspecialties can be more competitive.

What are the preferred ways for an early F1 student to show interest and obtain guidance in your specialty?

1. Join the official specialty interest group
2. Attend a specialty elective Shadow specialty
3. Shadow a faculty member in the specialty

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How can students in your specialty demonstrate leadership?

Volunteer for QI or research project, join interest group and organize events

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For students interested in your specialty, when should students become involved in research?

Becoming specialtyBecoming involved in research is not required in my specialty.

How can students best prepare for a core F2 clerkship in your specialty? Are there specific resources (websites, books, documents) that you recommend? Should a student meet with any designated faculty in the department prior to the core F2 clerkship?

• Case files
• Blueprints
• Uworld questions

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What are the differences (if any) between between sites of the core clerkship?

• Mission Bay - insured, high income patient population with significant attending oversight.
• SF general - county hospital, low volume, resident run service

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If a student develops an unexpected interest in your specialty during F2, what are the best next steps to take to become a competitive applicant?

Talk to current residents, let team know of their interest when they are on L&D.

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What F2 electives in your specialty or in another specialty are recommended for students strongly interested in your specialty?

MFM (antepartum)

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How can students demonstrate excellent performance in a F2 clerkship in your specialty?

Show interest, be proactive, go to emergencies (no one will tell you to go because they are busy responding to emergency), ask if you can suture on c-section, see patients in Triage. Know the patients and ask questions.

Which courses (specifically sub-Is/acting internships) are strongly recommended or required in the summer prior to residency application? Are any specific sites recommended for these courses? Is more than 1 sub-I (or acting internship) recommended in your specialty?

The antepartum sub-I is a valuable experience for someone interested in OB. The Sub-I will be given a lot of responsibilities and treated as a valuablemember of the team. There are very complex patients with rare conditions and they will learn a lot on that rotation. Sub-I is not necessary to be acompetitive applicant, and I recommended doing it as an outside rotation to see what other programs are like.

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What electives are encouraged (but not required or strongly recommended) during Career Launch in your field or outside of your field?

Antepartum

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If away rotations are recommended in your field, what advice do you tell students about selecting and procuring this experience?

Away rotations are only recommended under the following circumstances: if you are interested in a program and want to see what that program is like if you are worried about your competitiveness and want to increase

What aspects of an application are the most important to be competitive in this specialty?

	Absolutely essential	Very important	Somewhat important	Not at all impportant
Extracurricular leadership efforts		X
Research/publications			X
Honors in specialty sub-internship			X
Honors in medicine or family medicine acting internship			X
Away rotations			X
USMLE Step 2 scores			X
Community work or service		X
Medical Student Performance Evaluation (MSPE) comments in my specialty	X
MSPE comments in other specialties		X
MSPE non-clinical sections (including "Noteworthy characteristics")	X
DEI and/or anti-oppressive work	X
Letters of recommendation	X
Leadership roles		X

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What aspects of an application would be particularly harmful in terms of competitiveness?

	Matching in specialty extremely unlikely	Matching in Specialty will be more challenging, but possible	No impact on competitiveness
Negative comments regarding professionalism/physicianship	X
More than 1 attempt to pass USMLE Step 1 or 2		X
Below-average-for-specialty score on Step 2		X
No Step 2 score at the time of application submission		X
Multiple clerkship or exam failures that are apparent on the MSPE or transcript	X
Notation about extra time taken to complete a clerkship in the MSPE		X
Leave of absence from medical school not accounted for by outside degree program or research time			X

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Do programs in this specialty typically use "cut-off" USMLE scores to screen applications?

Unknown

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Is research experience without publication valued in your specialty? If so, what are ways that this can be shown on their application/CV?

Any long term interests/activities are valued

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Is research and/or publication in another specialty of value to an applicant? (This may be particularly applicable to an applicant making a late decision to apply in your specialty)

Yes - Try to connect it in some way to our specialty

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When advising about applying in your specialty, are students ever encouraged to apply in a backup specialty or dual apply in a second specialty? If so, when should students consider this? Who is the best person in my department to consult about this?

No necessary unless any concern/red flags on the application. contact the residency program director

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Who are essential faculty to meet with before application (Department Chair, Main Specialty Advisor, Residency Program Director, etc)? What is the optimal timing for this meeting? What material or information should the student bring to this meeting? Who should the student contact to arrange this meeting?

Residency program director, as soon as you make the decision to apply to this specialty Bring CV, interests, goals and any concerns about your application

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Advice on writing the personal statement? Are there important topics or themes that should be included?

Speaking for UCSF, they like applicants who have a commitment to advocacy, social justice and community outreach.

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Who in the department should review the personal statement? When should a good draft of the personal statement be presented to faculty reviewers?

Department faculty, residents, residency PD, give reviewer at least 1 mo to review.

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What is your recommended general approach or strategy for requesting letters of recommendation (LORs), particularly timing and etiquette?

After working with a faculty member consistently and for a period of time (preferable after you have received a positive eval), ask if they would be willingto support your application with a LOR. Give an out if reviewer is not excited about writing a LOR. Give at least 2 mo to receive the letter. Ask for moreletter than you need.

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Regarding letter writers, what characteristics (faculty rank, years of training, on resident selection committee, etc) should be considered?

Faculty with leadership positions, medical education leadership positions, someone that knows you well is most important.

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Of the total of 3 (or 4) letters that are part of an application, what is considered the best mix of letters? (letter)(eg: 1 from sub-internship, 1 additional clinical letter, 1 research letter, 1 department letter)?

Have a wide variety letter writers from various experiences who can write about different aspects of you as a candidate.

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What types of variations in residency training programs are there in your specialty (eg, different tracks, different lengths)?

4 year categorical position some have a 1 year transitional year, will need to reapply to match to a categorical position

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Who should students review their program list with?

Contact one of the specialty advisors

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Any advice or guidance about etiquette for cancelling interviews? Any strategy for which interviews to keep and which interviews to cancel?

Cancel interviews only you are sure you are not interested in.

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Are you anticipating all in-person, all virtual, or a mix of in-person and virtual interviews?

Unable to predict at this time.

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During an interview, what should applicants be looking for and/or what questions should they consider asking that can help them clarify what programs will be most desirable?

Talk to current residents is most important. most residents are honest with their feedback. "fit" of the program is most important

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What is the recommended approach to post-interview communication? Are thank you notes recommended? Are “you are my #1 choice” letters recommended?

Only if sincere and personable

Updated October 2024 by Stacy Young MD    

What specialty-wide/national resources are available to support UIM-identified students applying in your specialty?

1. American Academy of Ophthalmology Minority Mentoring Program
2. Rabb-Venable Excellence in Ophthalmology Program 

The three most compelling aspects of this specialty:

• Blend of medicine and surgery.
• Ability to be an expert and detect systemic complications/diseases through ocular manifestations.
• Continuity of care for your patients.

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What is the culture of this specialty?

Kindness, ambition, intellect, fast-paced, collaborative

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What are some common variations in career path in this specialty? What common fellowship opportunities exist in this specialty?

Career path: There are career opportunities in the academic and private sector, or a mix of both. These could also include research/and or teaching. Most people who complete their residency training go on to pursue a fellowship in one of the Ophthalmology sub-specialties including:

• Cornea/Refractive Surgery (1 year)
• Pediatric Ophthalmology (1 year)
• Glaucoma (1 year)
• Retina (2 years)
• Ophthalmic Plastic Surgery (2 years)
• Ocular oncology (1 year)
• Neuroophthalmology (1 year)
• Ophthalmic Pathology (1 year)
• global ophthalmology (1 year)

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What does a typical work week look like in this specialty? How frequently can the average doctor in this specialty expect to work weekends/holidays/overnights?

The typical work week for a private practice Ophthalmologist is 1-2 days in the O.R. and 3-4 days in the office. In an academic setting this can vary depending on time spent on research and/or teaching. For example, an academic clinician-scientist will likely spend 2- 2.5 days in the lab and 2.5 days in the clinical arena. Most ophthalmologists do not work nights or weekends (after training). Call varies greatly but is typically home call ranging from 1 week a month to 1 week a year.

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How does this specialty support or challenge having a family?

A career in Ophthalmology is compatible with raising a family to the extent that any surgical or any intensive career is compatible with this goal. In general, about 50-80% of practice is in the outpatient clinic and about 20-50% is in the OR. The surgeries are nearly always done on an out-patient basis and inpatient call and coverage is much less than for many other surgical fields. It is family friendly!

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How competitive is the residency application process in this specialty?

Getting into Ophthalmology residency is very competitive.

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How competitive is the job market in this specialty (after residency/fellowship training)?

The job market in this specialty is not very competitive but this can be location dependent. There are jobs available in urban areas, but these jobs tend to pay less than jobs in rural areas. Finding a job that fits a person's preferences may be more difficult due to high variability of job profiles and outside factors such as private equity.

What are the preferred ways for an early F1 student to show interest and obtain guidance in your specialty?

• Join the official specialty interest group: Vision and Ophthalmology Interest group
• Attend a specialty elective: Introduction to Ophthalmology Lunch time lecture series (160.01)
• Shadow a faculty member in the specialty
• Get involved in a research project in the specialty

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How can students in your specialty demonstrate leadership?

Vision and Ophthalmology Interest Group Board member, Ophthalmology Free Shelter Clinic

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For students interested in your specialty, when should students become involved in research?

Within the first 6 months of medical school

If a student develops an unexpected interest in your specialty during F2, what are the best next steps to take to become a competitive applicant?

Speak to the advisors as soon as you develop an interest. You will also need to get involved in research. It also may be beneficial to consider taking a Gap year to strengthen your application, but the specialty advisor will be able to guide you on this (every individual case is different)

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What F2 electives in your specialty or in another specialty are recommended for students strongly interested in your specialty?

• CIEx in Ophthalmology

 

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How can students demonstrate excellent performance in a F2 clerkship in your specialty?

• Read and have basic knowledge of eye anatomy, read and have basic knowledge of common eye disorder.
• Actively participate in clinic by learning how to perform the exam and a patient evaluation.
• Assist with patient care in any way possible.

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What guidance should students seek to prepare for Career Launch (4th year) clerkship scheduling?

• Meet with a specialty advisor. The best timing and person to meet with is:
  • Dr. Neeti Parikh - The best time to meet is prior to finalizing the fourth year schedule.
• There is a group orientation session in our specialty prior to Career Launch. Students can find out about this by contacting (please include email):
  • Dr. Neeti Parikh or Dr. Shelle Libberton

Who in the department should be notified if a student is interested in taking a gap year?

The person to notify prior to a gap year is Dr. Neeti Parikh.

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Who in the department should be notified if a student is returning from a gap year and plans to apply in my specialty?

The person to notify prior to a gap year is Dr. Neeti Parikh.

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Are there specific electives or clinical experiences in your specialty recommended for students to take in CL blocks prior to taking a gap year?

No

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Are there specific electives or clinical experiences in your specialty recommended for students returning from a gap year as a "warm up" prior to doing a sub-I in your specialty?

No

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For students planning their return from a gap year, are there any unique (to gap year) scheduling considerations? (For sub-Is/AIs, electives, away rotations, meetings with advisors, etc)

You should plan to take your ophthalmology Sub I the year you are applying (ie, when back from gap year. The subI is offered May, June and July so if your gap year is off cycle and your return doesn't work with these dates, please discuss with the specialty advisor before your gap year, as you may be advised to take it before. Away rotation application deadlines are approximately in March / April, which would take place during the gap year. Students should plan accordingly if they are interested in applying to an away rotation.

Which courses (specifically sub-Is/acting internships) are strongly recommended or required in the summer prior to residency application? Are any specific sites recommended for these courses? Is more than 1 sub-I (or acting internship) recommended in your specialty?

Students must do an Ophthalmology Sub I. We offer one based out of our Mission Bay Campus (140.01A Advanced Ophthalmology Clerkship, Mission Bay) and one based out of the SF VA (140.06 Advanced Ophthalmology Clerkship, Veteran's Affairs). Please note, you only need to do one of these, not both. Due to early match, the ophthalmology sub-I should be completed in May, June, or July. An additional sub-I where honors is possible, such as Surgery, Medicine, or Acute Care, should be completed by August if possible so that the grade can be included in the application.

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What is the recommended timing of the medicine or family medicine acting internship (AI)?

Ideally prior to the application due date (which is September 1).

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What electives are encouraged (but not required or strongly recommended) during Career Launch in your field or outside of your field?

• Dermatology
• Radiology
• ENT
• Rheumatology

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If away rotations are recommended in your field, what advice do you tell students about selecting and procuring this experience?

Away rotations are only recommended under the following circumstances:

• Away rotations are helpful when students feel that their potential performance on the rotation is stronger than their written application.
• Geographical preference, getting to know a program and second time applicants are good reasons to do an away.
• We recommend meeting with advisors to discuss necessity of away rotations. They should be done before October.  

What aspects of an application are the most important to be competitive in this specialty?

	Absolutely essential	Very important	Somewhat important	Not at all impportant
Extracurricular leadership efforts		X
Research/publications	X
Honors in specialty sub-internship	X
Honors in medicine or family medicine acting internship		X
Away rotations			X
USMLE Step 2 scores		X
Community work or service		X
Medical Student Performance Evaluation (MSPE) comments in my specialty	X
MSPE comments in other specialties		X
MSPE non-clinical sections (including "Noteworthy characteristics")		X
DEI and/or anti-oppressive work		X
Letters of recommendation	X
Leadership roles		X

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What aspects of an application would be particularly harmful in terms of competitiveness?

	Matching in specialty extremely unlikely	Matching in Specialty will be more challenging, but possible	No impact on competitiveness
Negative comments regarding professionalism/physicianship	X
More than 1 attempt to pass USMLE Step 1 or 2	X
Below-average-for-specialty score on Step 2		X
No Step 2 score at the time of application submission		X
Multiple clerkship or exam failures that are apparent on the MSPE or transcript	X
Notation about extra time taken to complete a clerkship in the MSPE		X
Leave of absence from medical school not accounted for by outside degree program or research time		X

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Do programs in this specialty typically use "cut-off" USMLE scores to screen applications?

Yes. My guidance (including a Step 2 score target) about this is:

This is very program dependent and given this is an early match, Step 2 is not "required" by every program (but some do require and most will like to see a score). Some programs may even place a cut off around 250 (but again, this is program dependent and not all programs will do this).

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What is the optimal timing for Step 2 CK?

Ideally so you have your score before the Sept 1 application deadline.

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Is research experience without publication valued in your specialty? If so, what are ways that this can be shown on their application/CV?

Yes this is helpful, though not as valued as publications. There is an "other research experience" section on the SF match application where this can be shown. If significant, may also be able to discuss in personal statement or short answer questions. Ideally the research mentor can write about the body of work in their letter of recommendation as well.

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Is research and/or publication in another specialty of value to an applicant? (This may be particularly applicable to an applicant making a late decision to apply in your specialty)

Yes, when accepted for publication.

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When advising about applying in your specialty, are students ever encouraged to apply in a backup specialty or dual apply in a second specialty? If so, when should students consider this? Who is the best person in my department to consult about this?

Yes, if the student is at risk for not matching and prefers not to take another research year and try again if they do not match, then dual applying is encouraged and supported. This is something that should be discussed with the specialty advisor at the beginning of the Career Launch year. Please consult Neeti Parikh to evaluate the strength of the application and to decide if dual applying is recommended.

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What departmental application events (general info, strategy, celebration) are held throughout the application and match season? Who should the student contact to be invited to these events?

Ophthalmology career launch advising session and Mock interviews. Please contact Dr. Shelle Libberton.

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Any departmental or specialty specific websites or resources for residency application that you recommend?

Association of University Professors of Ophthalmology Medical Resources

Ophthalmology Medical Student resource wiki

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Who are essential faculty to meet with before application (Department Chair, Main Specialty Advisor, Residency Program Director, etc)? What is the optimal timing for this meeting? What material or information should the student bring to this meeting? Who should the student contact to arrange this meeting?

• Main Specialty Advisor: Dr. Neeti Parikh.
• Optimal timing: Early Career Launch (March)
• Materials and information: Have an updated CV

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In addition to the standard application, does your specialty use any form of supplemental application? If so, how does a student register for the supplemental application? Is there any specific advice that could be helpful in preparing a supplemental application?

The Ophthalmology Match is through the SF Match.

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Who in the department should review the personal statement? When should a good draft of the personal statement be presented to faculty reviewers?

Any advisors or mentors you may have. You should present your first draft by early/mid July.

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What is your recommended general approach or strategy for requesting letters of recommendation (LORs), particularly timing and etiquette?

Ask faculty who know you well, who you feel can write you an excellent letter of recommendation. It is better to have a letter from a faculty who knows you well than from a faculty who is well-known, but has not worked closely with you. At least 1 of your letters should be from a faculty member who can comment on your clinical aptitude (a clinical preceptor) Start trying to identify potential letter writers early, when you start clinical rotations or those you do research with. If you feel that you have developed a close relationship with a faculty member and that they would be able to write you a strong letter, ask them for a letter at the end of the rotation (even if applications is in the distant future). Ask them in person, then send them a follow up email with the following information: Your name ; The rotation that you worked with them on; When the letter would be due, and a timeline of when you will send any reminder emails If available; Instructions on how to submit the letter, including any direct weblinks to the submission site; An attachment summarizing any specific items that the letter writer could potentially mention (Ex: during my rotation with you, we took care of a patient with malignant hypertension. I took the initiative to research this topic and give a small presentation to the team during rounds the next day Ex: while we were taking care of a patient with a difficult social situation, I stayed after hours to make sure that the patient was able to obtain transportation to get to their appointments); And your CV as an attachment. Sometimes faculty will be too overloaded or feel that they will not be able to write you a strong letter. If this happens, ask a different faculty member for a letter.

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Does the department write a letter of recommendation ("Chair Letter"/ "Department Letter") for an applicant? If so, who should they contact for this and when should they do so?

Not at this time.

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Of the total of 3 (or 4) letters that are part of an application, what is considered the best mix of letters? (eg: 1 from sub-internship, 1 additional clinical letter, 1 research letter, 1 department letter)

• 2 from ophthalmology (ideally 1 clinical and one research)
• 1 from a non ophthalmology clinical rotation

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Does your department have a Standardized/Supplemental Letter of Evaluation (such as SLOE)? If so, how is this letter drafted (and by whom)? Is there any advice you recommend for students so that they can have an outstanding SLOE?

No

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What types of variations in residency training programs are there in your specialty (eg, different tracks, different lengths)?

A few select programs will have a research track (with an extra research year)

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Who should students review their program list with?

Dr. Neeti Parikh

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How many programs do you recommend a student that is average in terms of competitiveness apply to?

50 - 60

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Is there a “signaling” program for your specialty and if so, is there a strategy to use signals?

Yes, a signaling program exists. My strategy recommendations are signaling for the Ophthalmology match will start with the next application cycle.

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When do interviews typically happen in your field? Is there optimal timing for scheduling interviews? During these months, what clinical or non-clinical rotations do you recommend for students?

Late October to December. Best to place high interest programs in the middle of the interview season. Many programs have only a few interviews or overlapping dates so it is best to have a plan for scheduling and which dates that you want to request. We recommend non clinical rotations or research electives at this time if possible to make it easier to schedule interviews.

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Any advice or guidance about etiquette for cancelling interviews? Any strategy for which interviews to keep and which interviews to cancel?

Cancel as soon as you know you want to cancel so someone else can take that spot.

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Are you anticipating all in-person, all virtual, or a mix of in-person and virtual interviews?

All virtual

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During an interview, what should applicants be looking for and/or what questions should they consider asking that can help them clarify what programs will be most desirable?

Ask what most of the graduating residents do for their careers - this will help clarify the general direction of the program towards community health / private practice vs. fellowship / academics.

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What is the recommended approach to post-interview communication? Are thank you notes recommended? Are “you are my #1 choice” letters recommended?

Thank you notes (by email) are optional (recommended unless the program specifically asks you not to) You should only send a "you are my number one choice" email if you are 100% sure you will be ranking that program number 1.

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Is there any special advice you give to students applying as a couple in the Match? If so, what is it?

No couples match in ophthalmology unfortunately.

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How many interviews should students with average (for specialty) competitiveness attend in order to have a good chance of matching?

10

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At what point in time should students be concerned about not having enough interviews? Who should they contact if that is the case?

Interview invites typically go out in early/mid October. If you don't start getting invites by that first week (less than 5 by week 2) please contact the specialty advisor (Neeti Parikh) and/or any other mentors you may have in the department.

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With whom should the students consult regarding creating the rank order list? What is the best timing for this?

You can consult Dr. Neeti Parikh or Dr. Madeline Yung

 

Updated February 2024 by Dr Neeti Parikh and Dr Madeline Yung.

 

What UCSF resources are available within your department to support UIM-identified students applying in your specialty?

Orthopaedic Surgery Diversity, Equity, and Inclusion Website

 

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What specialty-wide/national resources are available to support UIM-identified students applying in your specialty?

RJOS, J. Robert Gladden Orthopaedic Society, PrideOrtho, Nth Dimensions, AALOS

 

The three most compelling aspects of this specialty:

1. Direct patient care to improve symptoms and get patients back to things they love to do through nonoperative and operative interventions;
2. Creativity that is applied every day from the differential diagnosis to intraoperative findings and plans;
3. Getting to work with anatomy throughout the entirety of the body including spine, upper and lower extremities.

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What is the culture of this specialty?

Dynamic field with multiple subspecialties to encompass anything you like about orthopaedics. It is often considered a work hard-play hard specialty and this pertains especially to your patients who you are helping get back to their jobs but also what they love to do. Extremely rewarding as a career!

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What are some common variations in career path in this specialty? What common fellowship opportunities exist in this specialty?

There are multiple subspecialties within orthopaedics including: spine surgery, shoulder and elbow, trauma, oncology, foot and ankle, hand and upper extremity, pediatrics, and sports.

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What does a typical work week look like in this specialty? How frequently can the average doctor in this specialty expect to work weekends/holidays/overnights?

Monday thru Friday for most, although this varies depending on what type of career you're looking for. I operate 2-3 days a week and have 2-2.5 days of clinic a week so it is a nice mix of both. Clinic includes procedures such as injections as well. I take call about 3-5 days/month and work one holiday weekend/year. Life outside of residency and fellowship is much better in terms of work-life balance!

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How does this specialty support or challenge having a family?

I think it depends on what your goals are. As we say in medicine, there is not really a "good" time to start a family. If you want to start a family, then you will make that happen. I have seen multiple colleagues have children in residency, fellowship and during their first few years of practice.

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How competitive is the residency application process in this specialty?

The residency application process is definitely one of the most competitive within medicine. I think this is largely because of how much of a rewarding career it is and what you gain as a physician practicing orthopaedics.

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How competitive is the job market in this specialty (after residency/fellowship training)?

How competitive is the job market in this specialty (after residency/fellowship training)?

What are the preferred ways for an early F1 student to show interest and obtain guidance in your specialty?

• Join the official specialty interest group
• Attend a specialty elective
• Shadow a faculty member in the specialty
• Get involved in a research project in the specialty

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Are there specialty professional organizations that you recommend students join? If so, what are the costs of doing so, or are there resources for students with limited ability to pay membership fees? Are there specific activities (such as meetings or subgroups) that are recommended in the organization?

You can definitely join the OSIG group at UCSF. Other groups such as AAOS and RJOS often have free membership for medical students but these are great groups to get involved with early. They also have excellent resources and grants for research as well as going to conferences if you are interested.

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 How can students in your specialty demonstrate leadership?

I think demonstrating leadership is important no matter what specialty you decide. Overall, I see leadership as someone who commits to something they are passionate about. A leadership opportunity is not something that happens in one weekend. Instead it is best if you show up for the project, event or group multiple times and contribute in a meaningful way.

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For students interested in your specialty, when should students become involved in research?

Before submitting an application to residency in this specialty.

If a student develops an unexpected interest in your specialty during F2, what are the best next steps to take to become a competitive applicant?

Spend time with faculty and get comfortable scrubbing in, being in the OR and being a participant in clinic.

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What F2 electives in your specialty or in another specialty are recommended for students strongly interested in your specialty?

Subi's and MSK elective. We do not have a core clerkship but we do have electives. Resources that are great for students include Netter's orthopaedic anatomy, Orthobullets and AO Trauma Foundation website

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What guidance should students seek to prepare for Career Launch (4th year) clerkship scheduling?

Meet with a specialty advisor: There is a group orientation session in our specialty prior to Career Launch. Students can find out about this by contacting Dr. Lauren Santiesteban.

Are there specific electives or clinical experiences in your specialty recommended for students to take in CL blocks prior to taking a gap year?

No

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Are there specific electives or clinical experiences in your specialty recommended for students returning from a gap year as a "warm up" prior to doing a sub-I in your specialty?

No

Which courses (specifically sub-Is/acting internships) are strongly recommended or required in the summer prior to residency application? Are any specific sites recommended for these courses? Is more than 1 sub-I (or acting internship) recommended in your specialty?

Most students do at least three subinternships and that includes one at UCSF. Some do four in total but it depends on your availability and interest.

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If away rotations are recommended in your field, what advice do you tell students about selecting and procuring this experience?

Away rotations are strongly recommended for all students applying in my field. My advice to students about away rotations (including timing, number of away rotations, site selection, meeting with UCSF advisors) is: Most students do at least three subinternships and that includes one at UCSF. Some do four in total but it depends on your availability and interest. It helps to ask former fourth years where they did theirs and what they liked about the programs. Helpful to ask current residents and your faculty advisor as well.

What aspects of an application are the most important to be competitive in this specialty?

	Absolutely essential	Very important	Somewhat important	Not at all impportant
Extracurricular leadership efforts	X
Research/publications	X
Honors in specialty sub-internship		X
Honors in medicine or family medicine acting internship		X
Away rotations	X
USMLE Step 2 scores		X
Community work or service		X
Medical Student Performance Evaluation (MSPE) comments in my specialty		X
MSPE comments in other specialties		X
MSPE non-clinical sections (including "Noteworthy characteristics")		X
DEI and/or anti-oppressive work		X
Letters of recommendation		X
Leadership roles		X

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What aspects of an application would be particularly harmful in terms of competitiveness?

	Matching in specialty extremely unlikely	Matching in Specialty will be more challenging, but possible	No impact on competitiveness
Negative comments regarding professionalism/physicianship		X
More than 1 attempt to pass USMLE Step 1 or 2	X
Below-average-for-specialty score on Step 2		X
No Step 2 score at the time of application submission			X
Multiple clerkship or exam failures that are apparent on the MSPE or transcript	X
Notation about extra time taken to complete a clerkship in the MSPE		X
Leave of absence from medical school not accounted for by outside degree program or research time		X

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Do programs in this specialty typically use "cut-off" USMLE scores to screen applications?

No.

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What is the optimal timing for Step 2 CK?

Because step 1 is now pass/fail, it can be the only guiding score so preferably before applications are due.

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How much does a high Step 2 CK score mediate the results of a non-passing attempt at Step 1 (or Step 2)?

Non-passing attempt at Step 1 is almost non-negotiable unfortunately.

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How does your specialty utilize the MSPE in applicant review? What types of "Noteworthy Characteristics" should an applicant emphasize in the MSPE?

Attention to detail, team player, enthusiastic, comes early/stays late, available, good surgical skills, able to perform at level of an intern, well-read, prepared, etc.

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Is research experience without publication valued in your specialty? If so, what are ways that this can be shown on their application/CV?

Ideally you would show completion of at least one project to publication prior to residency application. The more publications you have make you a more competitive applicant but that needs to be balanced with community service and leadership roles as well.

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Is research and/or publication in another specialty of value to an applicant? (This may be particularly applicable to an applicant making a late decision to apply in your specialty)

Personally, I think research to completion with a publication in any specialty is valuable for an application to orthopaedics.

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When advising about applying in your specialty, are students ever encouraged to apply in a backup specialty or dual apply in a second specialty? If so, when should students consider this? Who is the best person in my department to consult about this?

Your advisor is the best person to ask about this directly.

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What departmental application events (general info, strategy, celebration) are held throughout the application and match season? Who should the student contact to be invited to these events?

We have a meeting prior to subi season to discuss how to do well on these rotations.

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Who are essential faculty to meet with before application (Department Chair, Main Specialty Advisor, Residency Program Director, etc)? What is the optimal timing for this meeting? What material or information should the student bring to this meeting? Who should the student contact to arrange this meeting?

Main specialty advisor as well as anyone who you have worked with as a medical student (in the OR, with research, etc).

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Advice on writing the personal statement? Are there important topics or themes that should be included?

Overall, we say that a personal statement should reflect why you are choosing orthopaedics and what you hope to gain in this specialty as a career. You want your personal statement to be "middle of the road". It should be proofread by multiple people including an orthopaedic surgeon.

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Who in the department should review the personal statement? When should a good draft of the personal statement be presented to faculty reviewers?

Your advisor

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What is your recommended general approach or strategy for requesting letters of recommendation (LORs), particularly timing and etiquette?

You want to ask people that have worked with you for a prolonged period of time. Ideally, it is best to ask for this letter in person and to specifically ask if they feel comfortable writing you a strong letter of recommendation for your orthopaedic surgery application.

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How many programs do you recommend a student that is average in terms of competitiveness apply to?

Very dependent on their application.

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Is there a “signaling” program for your specialty and if so, is there a strategy to use signals?

Yes, a signaling program exists.

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When do interviews typically happen in your field? Is there optimal timing for scheduling interviews? During these months, what clinical or non-clinical rotations do you recommend for students?

Winter/early Spring; ideally rotations where you can leave for interviews. You will need flexible rotations if possible.

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Any advice or guidance about etiquette for cancelling interviews? Any strategy for which interviews to keep and which interviews to cancel?

Give early notice. Be polite and cordial.

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Are you anticipating all in-person, all virtual, or a mix of in-person and virtual interviews?

Mix of in-person and virtual

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During an interview, what should applicants be looking for and/or what questions should they consider asking that can help them clarify what programs will be most desirable?

You need to decide what you are hoping to get out of a program. Your subinternships will help you delineate what your goals are after experience more than one program first hand.

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What is the recommended approach to post-interview communication? Are thank you notes recommended? Are “you are my #1 choice” letters recommended?

Thank you notes are dependent on the program. Some programs will say we do not want thank you notes and they usually mean it. If you can write a sincere, non-rehearsed thank you note then I think that is better than writing a generic note to 20 people. I would usually recommend you speak with your advisor regarding #1 choice letters and they can communicate that for you or advise you how to communicate that directly to the program.

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How many interviews should students with average (for specialty) competitiveness attend in order to have a good chance of matching?

Depends on your application, at least 10 ideally.

 

Updated February 2024 by Dr. Lauren Santiesteban