Radiology Residency Application Guide

Radiology Residency Application Guide

April 2011

I. Before Applying

A. Courses

If you’re considering radiology, you’ll want to do the sequence of Rad 301A, which is the lecture-based course on basics of imaging principles, followed by a “reading room” elective month in a sub-specialty area (body, thoracic/chest, IR, Neuro, MSK, MRI, U/S, etc…). You can talk with Dr. Federle about what your interests are and when to do the Rad 301A month. For the elective course, you have the option of doing a full month in one sub-specialty or two two-week blocks in different sub-specialties. We recommend you speak with Roz Temple () as soon as possible to schedule the reading room month, as these rotations fill up quickly with visiting medical students. The most common times for students to do the reading room month are during Periods 11-3 (i.e. late spring or summer). Keep in mind, you may want a letter of recommendation from the faculty with whom you worked closely during the month, so the last month that you can do it is period 3. Here is the link to the course catalogue for radiology clerkships: http://medcatalog.stanford.edu/php/clerklist.php?DNo=837.

B. Radiology research

Start a small research project(s) with an advisor in radiology, ideally before the end of your first clinical year. The purpose should be to establish contact with radiology faculty at an academic institution. The scope and content is variable, but should aim to result in a paper/poster/presentation. A list of Stanford Radiology faculty research interests is updated annually and posted online at the RIGS website http://rigs.stanford.edu/ under “Resources”  “Radiology Faculty Research Interests”. Even if you decide on radiology later during medical school, you can still complete a small research project.

C. Sub-internships

Consider doing a sub-internship or 3rd year core medicine/surgery clerkship at either the Santa Clara Valley or Kaiser Santa Clara since both are popular preliminary/transitional year programs for Stanford students. Applicants report positive feedback during interviews due to their strong clinical work during their core or sub-I at the site.

D. Away rotations

Establish contact with an administrator at the program(s) where you are thinking of doing an away rotation. This should be sometime between January and April of the year you are applying. Please note that many schools are now using the Visiting Student Application Service (VSAS) on the AAMC website Think about what the focus of the month should be; options include clinical (i.e. reading room) or research (basic science through clinical) or a combination. Keep in mind that most programs will charge you a processing fee of $100-$150 and some programs/hospitals will charge you if you want to get credit. At Harvard, if you wish to get credits, will charge you approx $1200 for the one month clerkship. If you want to be a “visiting scholar” there is the ability Brigham and Women’s hospital to observe for the month without any fees. Websites have a ton of info; also don’t hesitate to call the administrators to inquire about opportunities. Keep in mind, away rotations are not a requirement and you may choose not to do any.

If you are seriously considering UCSF for your residency, however, doing an away rotation there is advantageous as it has been rumored to markedly improve your chances of being offered an interview and even matching. This piece of advice also applies to other competitive programs, especially in New York City and Chicago. At the same time, many Stanford applicants in the past have received interviews from UCSF and other competitive programs without doing an away rotation there.

II. Application Process

A. Curriculum vitae

Your CV should be in a semifinal form by the end of June to submit to your letter writers when you request their recommendation letter. An example can be found on the Stanford advising website at http://med.stanford.edu/md/advising/resources/residency/cv.html. Your academic advisor can give you feedback on your CV.

B. Personal statement

Your personal statement should be in a semifinal form by the end of June to submit to your letter writers when you request their recommendation letter. You should solicit feedback on your personal statement (e.g. from your academic advisor, a radiology faculty member, and others). Some advisors say that your personal statement should be 1 page, while others say 1.5 pages. An example can be found on the advising website at http://med.stanford.edu/md/advising/resources/residency/ps.html. Your personal statement need not be changed significantly for your preliminary year application—some students don’t change it at all, others change just the first and last paragraphs, others write an entirely different statement.

C. Letters of Recommendation

Request your letters of recommendation before the end of June. The cover sheet for your letters can be downloaded from the advising website at http://med.stanford.edu/md/advising/resources/residency/lor/. Some of your recommenders may give you significant feedback about your personal statement. The minimum is 3 letters for programs, the maximum is 4 letters. Some programs mandate no more than 3 while other programs may have restrictions on how many letters can come from radiologists—the only way to know the specific requirements is to look up each program’s website. Definitely have a letter from your sub-internship (medicine, surgery, pediatrics, etc…) if you do it early enough—otherwise, try to get a good letter from your medicine or surgery core rotation. One should be from your month on radiology and/or from your radiology research. You may want to discuss if the letter writer is willing to write a separate letter for internship versus radiology. Some faculty do, others don’t—it didn’t seem to matter for any programs.

D. Filling out the ERAS application

Complete ERAS ideally by the end of August if you want to submit your application in September. Keep in mind that you need two three-sentence blurbs for each of your “activities” which should be as polished as your essay. For your letters to be uploaded, you need to certify the letter writers names, positions, departments, and to which program(s) (i.e. preliminary vs. radiology) they should be sent. You need to certify and submit those names before Stanford can upload the letters to ERAS for you.

E. Submitting the ERAS application

Submit ERAS before or during the first week of September!! All programs have a limited number of interview spots / dates, and they will fill up if you submit your application late. Submit even if you haven’t finalized your list of schools to apply to; you can always add more later.

F. Where to apply

The majority of Stanford students apply to academic programs, which are associated with medical schools and tend to have a strong focus on research. However, many students also apply to community programs, especially Santa Clara Valley, which is a highly regarded training program. Community programs tend to be smaller (3-6 residents per year, compared to 8-12 at academic programs), have a larger case load, more procedures with IR, more call responsibilities, and fewer residents going into fellowships (maybe 50% at community programs compared to nearly 100% at academic programs).

Some programs, like the University of Pennsylvania, have multiple pathways to which you can apply—IR, research, and regular. There is spotty information on their website about the different programs, but if you are interested, it would behoove you to contact the programs about the different pathways.

G. Program ranking

You may be wondering how the radiology residency programs compare to each other. There is no official US News & World Report ranking. However, one can ask a radiology faculty member for his/her opinion on the top 10 or 20 programs. Additionally, the auntminnie.com forums for medical students have user-posted rankings. One particularly well-known and controversial ranking was posted by the user “p53.”

H. Number of programs to apply to

Dr. Mindelzun recommends that you apply to 30 radiology programs; however, most students applied more judiciously (15-25). Apply a similar principle to internship programs.

I. After submitting the ERAS application

Monitor for submission and upload of your letters of recommendation; those should be in by the end of September so that your application is complete with the exception of your Dean’s Letter, which is submitted in October. If letters aren’t submitted in a timely fashion, send a thank you/reminder email to your letter writer. You may also want to contact the person at Stanford who is responsible for uploads, as he gets overloaded sometimes and may not upload your letter of recommendation promptly. You can also add or substitute letters after you’ve submitted your application.

J. Step 2 CS and CK

The USMLE Step 2 exam consists of two parts—CS and CK. CS is a 12-patient standardized patient exam which you can take in LA, Houston, Chicago, Atlanta, or Philadelphia. It is pass-fail, and the vast majority of students pass. The only preparation you need is to briefly review First Aid for Step 2 CS on the flight to your exam. CK is a multiple choice computer exam similar to Step 1 but focused more on clinical diagnosis and treatment rather than topics such as biochemistry or embryology. The curve on Step 2 is higher and most students find that they score better on Step 2 with very minimal studying (ie. 2 weeks of preparation). The best strategy is to try to get through USMLE World for Step 2; if you can do that, you won’t even need to open a book! Both the CS and CK cover internal medicine, surgery, pediatrics, ob-gyn, neurology and psychiatry so you may want to try to schedule these rotations earlier in your third year.

Many students struggle over when to take Step 2 CK. If you did well on your Step 1 exam, you may want to take Step 2 CK after interview season is over so that a low score on Step 2 CK does not negate your Step 1 score. On the other hand, if you did not do well on Step 1, a high Step 2 CK score may help you get more interviews so you would have to take Step 2 CK before August to give enough time for the score to be reported. The best thing to do is to talk with your advisor about when to take Step 2 CK.

In the 2009-2010 application cycle, UCSF made a new requirement that all students would need to pass both Step 2 CS and CK in order to be ranked. Since UCSF typically ranks students in early-mid February, applicants will have to take Step 2 CK before the end of December and Step 2 CS before November. If you are interested in UCSF, you should plan on taking both Step 2 CK and CS early enough to ensure your score will be available to meet the deadline.

Since there are only five centers where CS can be taken, the slots fill up quickly. When you apply for the CS permit (and pay $1000), you are allowed to identify a 1 year time zone during which you will take the CS (as opposed to the 3 month time zone for Step 1 and Step 2 CK). For this reason, you should sign up to take CS by March of your third year. A good time to take Step 2 CS is in July because by then you would have taken the CPX exam which is a 8-station standardized patient exam administered by Stanford. The last possible date to take CS and still have your score returned on time is usually at the end of October (check the CS website for the chart on test date and corresponding score report date). Again, the CS slots fill up very quickly so make sure you sign up and schedule your date as soon as possible.

III. Interviews

A. Advanced planning of interview dates

If you want to find out the interview dates ahead of time, some are listed on the residency program websites. Otherwise, you can call the program administrator and inquire what days they interview so you can plan your schedule. You can also find dates from previous years on auntminnie.com.

B. Midwest and New York City interviews

In the past, few students got interviews at University of Chicago, Northwestern, Michigan, Mayo Clinic, NYU, and Columbia without calling and/or emailing the individual program director and specifically indicating their interest in the program. We recommend it be a genuine interest in the program and not just to garner more interviews. However, if you are seriously considering the Midwest or NYC, you may want to be pro-active about expressing your interest (or even consider doing an away rotation), because the programs think that very few Californians will go to the Midwest or New York.

C. Scheduling interviews

Most students did their preliminary interviews, particularly those in California, early in November and December while in a clerkship. That allows for your radiology interviews to be at the end of December and January when you’re not in a clerkship and after you’ve had numerous interviews under your belt. Fridays in December and January are very popular interview dates for many programs to which Stanford students apply. Programs are much more flexible than the ERAS formal system makes it seem. If you have conflicts or difficulty scheduling your interviews, call and ask about what options they have for re-scheduling. If you know you’re not going to take an interview, decline it promptly for the sake of other applicants. If you know you don’t want to go to a scheduled interview, please try to cancel at least two to three weeks in advance. Really you should cancel as soon as you know you don’t want to interview.

D. If you don’t get an interview after they are offered

If you have heard from friends or on the Aunt Minnie forum that one of your top programs has started offering interviews but you haven’t heard from them, you may consider contacting the residency program director about your interest in the program. Your radiology mentor at Stanford may be able to contact the program director on your behalf as well. Keep in mind, you should only really do this for programs you are serious about (i.e. one of your top 3 choices). Once you are rejected, its fine to send a note to the program and once again declare your interest (and reasons why). Often times they will put your name on a waitlist. Also, secretaries can sometimes make mistakes—if you are rejected from a program that you were 100% sure would interview you (ie. Stanford prelim or a place you did an away rotation at), don’t be afraid to contact someone to ask why you were rejected. Mistakes on behalf of the secretary have occurred in the past.

E. Pre-interview homework

You may or may not care to explore faculty profiles at the programs where you interview in order to have an idea of the research/work they do. Some students found this useful, others didn’t think it mattered. Everyone agrees that usually the interviewer may suggest the name of a faculty member in the area(s) you’re interested in for you to contact for more information on their research.

F. Scheduling USMLE Step 2 Clinical Skills during interviews

If you think ahead, you can schedule the USMLE Step 2 CS exam when you interview at a program in Philadelphia, LA, Houston, Chicago, and Atlanta. It saves you a flight and time later in the year if you get it done. Keep in mind however that the Step 2 CS exam can take several months to report your score—if you take the exam during interviews, you likely will not be able to submit your score report to schools (which only matters for UCSF).

IV. Post-interview

A. Communication with programs

Some programs will declare their interest in you very directly (i.e. we’re ranking you to match) through phone calls, letters or emails. Other programs may not send any post-interview communication to applicants. After your interviews are done, you may send “love letters” to your top program(s). Some advisors recommend sending a letter only to your number one program while others recommend sending letters to your top three programs. Regardless, you should probably send one letter to the program you are ranking number one to inform them and to tell them why you are interested. If you have other contacts at the hospital/program you may want to express your interest in the program to them as well.

It is rumored that many programs finalize their rank list shortly after their last interview date, which can be well before the mid-February deadline. Waiting until the last week to send your “#1” letter may actually hurt you if the program’s list has already been finalized. It is acceptable to send love letters by mid January.

B. Rank lists

After interviews some students found it useful to take notes about their experiences and what things they liked and disliked about programs. Other students kept it all in their heads. Most students used these factors in making their rank lists: prestige of program, location, research opportunities, and obviously gut feeling about the program. Remember not to be unduly influenced by one or two people’s opinion(s) of a given program – the most important aspect of the Match is finding out how to best fit your needs, and one person’s top ranked program may be at the bottom of your list.