Blog Archives

How Race and Gender Affect Medical Specialty

The AAMC published an interesting piece recently showcasing the results of their Physician Specialty Data Report on the interplay of race, gender, and specialty. 

It’s worth combing through the data yourself, but here are a few takeaways:

Doctors from underrepresented groups are more concentrated in primary care fields. These specialties are extremely needed and noble, but since primary care is less well remunerated than surgical specialties, it’s worth thinking about the disproportionate density of minority physicians.

Women make up the majority of medical school students for the fourth year in a row.  

Women represent a significant minority in surgical specialties like orthopedic surgery (5.9%), thoracic surgery (8.3%) and neurosurgery (9.6%). Ouch.

Focusing on another demographic, the doctor workforce has grown older. Over 46% of active U.S. doctors are 55+. That number was ~38% in 2007. 

For more details, read the report here.

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We Need to Decrease the Stress and Inefficiencies Associated with the Residency Application Process

Inefficiencies in the residency application system have been a problem for many years. While the AAMC and NRMP have made efforts to improve the process, including the move from the Scramble to SOAP a few years back, the lack of adequate slots for a large number of candidates leads to a tremendous amount of unnecessary stress and waste. With the introduction of virtual interviews, hoarding became a new problem.

To their credit, the AAMC is considering some reforms to the system. Allowing applicants to identify favored residency programs, called “preference signaling” through the supplemental ERAS, for example, has improved candidates’ abilities to get interviews at chosen programs. Additionally, some specialties – with AAMC’s support – have implemented a common interview invitation release date and a minimum response time for invitees. In the latter case, for example, most surgery programs provide candidates a minimum of 48 hours to accept or reject an invitation, such that applicants don’t need to sleep with one eye open, jumping to respond to an invitation to avoid the wait list. There has even been a consideration of capping the number of interviews each applicant can have to avoid interview hoarding.

I recommend reading this piece on proposed reforms to the system. Having gone through the stressful process myself, I wholly support strategies that would increase transparency and decrease unnecessary anxiety. 

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AAMC Report on Residents 2021

The AAMC recently published their Report on Residents 2021. Of note,

  • The percentage of medical residents who identify as Black or African American and as Hispanic, Latino, or of Spanish origin has increased since last year.
  • Women make up the vast majority in obstetrics and gynecology (85.2%) and pediatrics (72.7%).
  • Only 27.0% of the 2020-21 graduates intended to train in the specialties they had listed as their preference when they began medical school.
  • The majority of medical residents (57.1%) who completed residency training from 2011 through 2020 practice in the state where they completed their residencies.
  • In a tip of the hat to my favorite state, physician retention after medical residency is highest in California (77.8%).

There are more goodies; the information is summed up in this table.

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Supplemental ERAS Application

A few clients have asked me about the new supplemental ERAS application for dermatology, internal medicine (categorical and preliminary), and general surgery (categorical) applicants. The application is more work for these candidates, but the AAMC says the supplemental app will foster a more holistic approach to the residency process. For more information, check out the PowerPoint presentation from a recent webinar the AAMC held on the topic. The supplemental application opened last week.

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How to VITAlize your VITA interviews

At the end of the spring, with the weightiness of COVID clearer, the AAMC (much to their credit) strongly recommended that medical schools and residencies conduct virtual interviews during the upcoming admissions season. Upending years of in-person sessions, the announcement has made a huge impact on this season’s admissions process. Virtual interviews will likely diminish some of the bias that plagued the system previously and will save everyone a bundle of money

The AAMC did not urge the use of any particular platform, but it does provide its own, called the Video Interview Tool for Admissions (VITA), for interested medical schools. The AAMC describes VITA as a one-time, one-way recorded video interview to help medical schools assess applicants’ pre-professional competencies that are important for success in medical school. 

The AAMC indicates that VITA questions will target the below capabilities:

  • Social Skills
  • Cultural Competence
  • Teamwork
  • Reliability and Dependability
  • Resilience and Adaptability

An applicant’s VITA session will include six questions presented in text form (no interviewer), and applicants record a video response after having one minute to read and reflect on each question. Candidates then have up to three minutes to record a response. If an applicant needs a break between questions, that’s not a problem: All six questions can be completed in one sitting, or candidates can choose to have breaks of any desired length between questions. (Of course, the interview must be submitted by a medical school’s deadline.)

According to the AAMC, questions can be related to personal experience (e.g. “Why did you choose medicine?”), past behavior (“Describe a time…”), or hypothetical situations (“Imagine you are… What would you do to resolve this issue?”). 

These types of questions can be tricky without practice, but are bread-and-butter for someone who is prepared. 

Remember the time you spent a week studying for the MCAT? No, you don’t ;). That’s because one week is not enough time to study for the MCAT! Along those lines, it’s important to start early, preparing yourself fully for VITA and other virtual interview platforms. Much of interviewing is confidence, which can be developed. Please hire me now for help. 

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About Dr. Michelle Finkel

Dr. Michelle Finkel

Dr. Finkel is a graduate of Stanford University and Harvard Medical School. On completing her residency at Harvard, she was asked to
stay on as faculty at Harvard Medical School and spent five years teaching at the world-renowned Massachusetts General Hospital.
She was appointed to the Assistant Residency Director position for the Harvard Affiliated
Emergency Medicine Residency where she reviewed countless applications, personal statements and resumes. Read more

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