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Surgery Residency
Application Guidebook
This guide was adapted from the University of Michigan Surgery Application Guidebook
2013 edition
Managing Editor: Chad Becnel
Contributors:
Katie Carsky, Colleen McDermott, Maria Ragas, Dr. Patrick McGrew
2020, Edition 1
Introduction At the end of medical school, it comes down to this - doing
everything in your power to find the best training programs
for you and maximizing your chances of matching at one of
those programs. At the end of the day, this is an imperfect
science and most of us will only have to go through this
process once (thankfully). This book is a compilation of
advice regarding the match process and represents our
best efforts to provide you with a reliable source of
information specific to students interested in matching in
general surgery. We fully acknowledge that there are many
ways to go about this process and we have not attempted
to cover every possible scenario, but rather to provide some
guiding principles and suggested approaches that worked
for us and others. We wish you the best of luck as you
embark on the interview trail and much success when all is
said and done!
This book can be used as a reference for any stage of the
application process, but keep in mind that it is simply a
guide created by students and should not represent the
information you can receive from a mentor or from the office
of student affairs. One theme of this book is that it is
important to get feedback from many different sets of eyes,
especially mentors you trust and respect.
Table of Contents
Introduction
Critical Dates in the Application Process 1 Tulane Surgery Overview and Timeline for T3-T4 2
Pre-Interview Period:
Finding Mentors 3
Away Rotations 6
ERAS Components and Personal Statement Tips 8
Choosing Letter Writers 10
Choosing General Surgery Residency Programs 11
Scheduling Interviews 12
What To Do If You’re Not Getting Interview Offers 15 On the Interview Trail:
Getting to Your Interviews - Planning Logistics 17
Preparing for Interviews 19
Interview Day Strategy 23
Evaluating Programs 25
Thank You Notes 27 Post-Interview Period:
Making your Rank Order List 29
Post-Interview/Pre-Match Communication 31
Applying to Integrated Programs 37
Example Personal Statements 40
Example Interview Questions 45
PRE-INTERVIEW PERIOD
Critical Dates in the Application Cycle July 1: ERAS opens – first day you can access the system and
begin filling out your application September 15: ERAS submission begins and NRMP
Registration Begins – first day you can submit applications.
SUBMIT ON THIS DATE AND DO NOT BE LATE. September 15 – 30: Programs begin inviting applicants for
interviews October 1: Dean’s letter (MSPE) is sent to programs. Majority of
programs begin sending interview invites AFTER they have
received the Dean’s letter. October 24 – 31: Some programs hold their first interviews
during the last week of October November 1: Application deadline for the vast majority of
programs
November 30: NRMP Registration deadline November – January: Vast majority of programs hold their
interviews during these 3 months
Mid-January: NRMP Ranking (R3 system) Opens First Three Weeks of February: Faculty meet to rank applicants 3rd Week of February: Rank list due for applicants and programs. Ensure you are Certified and Submitted! You will receive an email confirming this. 2nd Week of March: Match status (matched/unmatched)
released to applicants. Unmatched applicants participate in
SOAP (scramble) to secure open positions or preliminary
positions. Specific placement (which program) revealed five
days later on Match Day. Mid-June: Intern orientation starts for most programs *Use this timeline as a checklist to ensure you have completed all steps with ERAS and NRMP
Tulane Surgery Residency Application Guide 1
Tulane Department of Surgery T3-T4 Year Overview
Tulane Surgery Residency Application Guide 2
Strongly advise taking CS as early as possible.
Finding Mentors
How to Find Mentors The process of applying, interviewing, and finally choosing a residency program is
one with many nuances and high stakes. Luckily, you are surrounded by mentors
who have gone through the process before you and who have helped generations
of students through it all. Good mentors are a powerful resource that you should
utilize to set you up for success. Ideally you should aim to seek out and maintain relationships with
Main Points: mentors in many different professional
stages (resident, full professor,
• Have multiple mentors at people in different administrative and
different points in their leadership roles, etc.) and who can
career path speak to different aspects of who you
• Understand each mentor’s are and eventually hope to become. As
the mentee, you play a crucial role in
role and background directing and managing the relationship
and use their knowledge with your mentor. In order to best utilize
and advice accordingly each mentor’s strengths, you should
• Consult your mentors have a general idea of what each
mentor has to offer and have some
frequently; they are your understanding of their background
best resource! and biases. Do your homework and be
familiar with where your mentor has
trained, worked, what kind of research they do, with what other non-clinical activities they are involved, etc. Below are
examples of people you can and should reach out to for advice and the kind of
advice that each might be able to offer:
• Surgery Clerkship director(s): Be in communication with them
often and early on in the process. They have lots of experience
and advice to offer and it will be to your advantage to establish
familiarity and a good working relationship. They can offer realistic
advice about where to turn for your next decision, who to seek for
additional mentorship, or where to go to look for research.
Tulane Surgery Residency Application Guidebook 3
• Surgery Residents: Great first-line of advice for the nuts and bolts of the
interview season. You can ask about their experiences with specific
programs’ interview days, how they evaluated the programs they saw,
their decision-making process, how to prepare for interviews, etc. Keep in
mind that they have a limited sample size from which to draw some of
their impressions. • Junior Faculty and APDs of Home Program: Often they will have a very
good sense of the current status of residency programs, recent changes in
training paradigms (work hours and the shift toward early specialization),
and have contacts with faculty and program directors at other programs. • Letter Writers: Ideally your letter writers are faculty who know you well and
have worked closely with you (more on this later). However, they often will
also be more senior faculty and you should be prepared to present a fairly
polished front when meeting with them. Your letter writers will often not be
people to whom you will send emails about minor questions, but from whom
you can elicit opinions re: your list of programs, your rank list, and who may
be willing to make calls or reach out to people at programs that you are
especially interested in when interviews are all done. • Residents at other Programs: Any residents at other programs to whom
you have personal connections or who are Tulane alumni should be
considered as good sources of inside information. Emailing before or after
an interview to solicit advice or honest opinions about things you feel you
might not have gotten an accurate picture of before, during, or after an
interview is reasonable. However, remember that their allegiance may be
at least partially to their program so you should be reserved and respectful
in sharing your opinions of different programs with them. • Alumni: Use the Tulane Match Map! Faculty and fellows who are alumni
of programs where you are interviewing are usually happy to share their
perspectives. Recent medical school grads and residents who are now at
different institutions are also great resources.
Tulane Surgery Residency Application Guidebook 4
• Senior faculty: Senior faculty have a great historical perspective on
programs and can assess a program’s stability over the years. They will
also often be familiar with the program directors, chairperson and other
senior faculty at other institutions. However, it is important to note that
residency programs can change rather quickly, and reputation and rumor
often lags behind the real-time changes that a program might be going
through. Be sure to not get all of your information from senior faculty, as
this could skew your outlook on what is happening now.
• Surgery Chairperson: All students applying in general surgery should
meet with the chairperson at least once and will get a letter of
recommendation. It is important to be prepared at this meeting because it
is your chance to make an impression and to communicate the things that
you think make you a unique and outstanding candidate and that you hope
will be highlighted in the letter. Think about your future goals, your
motivations for pursuing a career in surgery, and be able to verbalize a few
key characteristics that you want all the programs to know about you.
Additionally, the Chairperson may want to know a bit more about your
personality, leadership style, and any hobbies or interests you have so that
they can create an accurate picture of you in their head. Approaching Mentors: Be prepared to provide an updated copy of your CV,
personal statement, and to provide any additional information that you think is
pertinent to the advice you hope to elicit. For each mentor that your
approach, your familiarity with their background will help you to direct
questions that will make them draw upon their experiences and share their
insight on particular topics of interest.
Tulane Surgery Residency Application Guidebook 5
Away Rotations
General Surgery is a specialty where away rotations are not required, but
they may help you to get an interview or even Match at a specific program.
Do an away at a program that you have specific interest in, and be sure to do
this rotation at a time in the year when you KNOW you will perform at your
best. You will be given mixed advice on away rotations because data is
mixed on their efficacy in General Surgery, but definitely do them if you are
particularly interested in a program or area of the country. Additionally, when
you select you away sites, be strategic in the service you choose. It is
helpful to rotate on the PD or APD service to get facetime. You can rotate
at a place that’s a little bit of a ‘reach” which might help your chances, but do
have a legitimate reason for selecting that program.
You are not guaranteed to get an interview from a place where you did an away, but you do have a great chance at interviewing (and a statistically higher probability of matching) at a program where you did an away. TIPS for How to Do Well on Aways: 1) An away should ideally not be your first sub-i rotation. Learn how to write notes, put in orders, write dc summaries, nail presentations, do handoffs and many other good patient care skills that you might have not done as a T3 before you do anything else. A surgery sub I would be ideal, but even IM is a useful place to learn these skills. 2) Be prepared. Even if the hospital, EMR, staff, or program is familiar, be prepared. Get to town a few days in advance and find a connection. It may help to find a local med student early to show you around. If not, most places have an orientation where you will go over basics. PAY ATTENTION because they usually take you around the most frequented spots. 3) Take initiative. Know how to put a Foley in, get comfortable with self-scrubbing, be eager and willing to do any case, etc. Make all pretenses of planning to stay for every case. Better to have the resident tell you to go home two mins after you get scrubbed in than to have them wonder why you’re not there! Perform at intern level. 4) Be helpful to everyone. When you get to the OR, introduce yourself and your team to the circulator and write your names down, ask them what size gloves your attending and chief wear and get them for him/her. Help prep the patient. If your attending is a literal foot taller than you get a stool in place on either side of the bed before the case starts. Help nurses, techs, etc.
Tulane Surgery Residency Application Guidebook
6
5) Read before the case about BOTH the case and the patient. Read up on the disease, the relevant anatomy and the major steps of the operation. If the attending left the room, could you and the resident finish the case? Read up on the patients’ history too. Know who operated on them before and what was done. Know what comorbidities they have and what meds they’re taking, and also one social history component. It’s hard at the beginning of the rotation when you didn’t meet the person in clinic the week before, but that gets easier. ALWAYS introduce yourself to the patient in Pre-Op; it is often easy to get stressed about your performance that you forget this is the biggest day of the patient’s life.
6) Be able to present well (and adjust your presentations on the fly). Surgeons like brevity, but a lot of academic surgeons like being academics just as much. Also, if your chief asks you to present on a teaching topic, be prepared to present it always (keep notes in your white coat). They might ask for it three weeks later and they’ll expect you to know it still. You should be eloquent and well-read. 7) You will be judged more for how you react to making a mistake than the act of making one. They don’t expect you to be perfect, they just expect you to be a good person who’s doing their best. Don’t EVER lie about something- it’s far better to explain that you didn’t know. Be humble. 8) Meet with the PD at the beginning and end of the rotation. Bring a suit to your Away. Depending on the time of year, it may be important to send your cv, step scores and transcript ahead to the PD so they can have a realistic meeting with you. You can highlight things you're proud of to them and also have a chance to explain anything that might give them pause. It’s important to ask what they value in their program and what they’re looking for when they select applicants to interview. Some sites will interview you at the end of your rotation. Come prepared as if this is an official interview, and wear your suit. 9) If it is an early enough rotation, ask for a LOR. If you do your away before ERAS submission (or if you want a 4th letter) and you feel like you did well, ask one of the attendings you worked with for a LOR. This can be in person or via email, but you want to ask for a strong letter of recommendation. See LOR section for how to approach.
Tulane Surgery Residency Application Guidebook 7
ERAS Components What’s in ERAS?
• 3-4 letters of recommendation (includes Chairperson’s letter but not the Dean’s or MSPE letter)
• CV - activities/awards/publications/etc. - will be entered into an online
format
• Personal statement • List of programs to which you are applying
With each of the ERAS components (personal statement, CV, letters), it
really, really helps to start early. Having your draft CV and Personal
Statement (even if in a rough, but presentable draft form) ready for your
Dean’s letter writer and other letter writers will help make each item more
compelling. Personal Statement For most people, this is the most difficult part of your application. In general,
you want to fly under the radar by writing something compelling but relatively
“in bounds”. Generally, 10% of personal statements are very good, 80% are
solid, and another 10% are deal-breakers. The goal is to have a personal
statement that is solid. Many of your interviewers may merely skim it for red
flags or interesting things to talk to you about (remember: anything you put in
your CV/PS is fair game for your interviewer to bring up).
Some Personal Statement Tips:
• Cater to the skimmers and write something simple (ONE PAGE).
• A good “hook” works very well. This is usually an opening statement
(or one within the first few sentences) to grab your reader’s attention.
• To write your personal statement, the single best thing you can do is
just sit down and write something – and do it early. Doing so will allow
you to get feedback from your letter writers, who probably are or have
been interviewers themselves and know what makes for a solid
personal statement.
• Put the Personal in Personal Statement. Most PD’s are looking for
someone they want to meet in person. Talk about something
interesting about you that makes a program director wish they could
talk to you face to face and learn more about your life.
• Do not use patient anecdotes. It’s a trope that’s overdone and most
PD’s don’t like it.
Tulane Surgery Residency Application Guidebook 8
• Don’t explain what surgery is. Actually avoid lines that say “Surgery
is…”
• Programs are looking for qualities that will make you an asset to the
residency. Explain how your life story has given you these qualities
and substantiate them. For example, if you’re an athlete you can
demonstrate that you know how to pick yourself back up after a
setback or loss. If you have an MPH, you’ve been taught to value
people who are different from yourself, etc. Do some research (ask
your mentors!) about what qualities they would want in an ideal
resident, identify those that you feel in yourself, think of where you
learned those and convey that in your PS.
• You can convey your specific interest in a region in your PS and write
several different versions to send to specific programs. Programs
actually read the PS, so this may be your chance to get a bit specific.
• (Example personal statements at the end of this guide) Letters Give each of your letter writers as much notice as you can to get their letters in
for you, but also give a hard deadline that is several weeks before you want to
submit your ERAS. Everyone is busy. Remember to always be extremely
cordial with your reminders. Your letter writers should be SURGEONS who
have worked with you clinically and ask each if he or she would be able write
you an “excellent” or “very strong” letter. When you email each letter writer, it is
often best to set up a physical meeting to discuss writing your letter and to
provide a copy of your CV and PS. Again, giving each writer your CV and PS
forces you to get several rounds of feedback on each item. Additionally, they
have more information to highlight in their letter. (See “Choosing Letter Writers”
on next page)
CV Everything on your CV is fair game for questions on interviews. With that
said, there are two forms of your CV that you need. First, a CV that you can
give to letter writers to facilitate their writing awesome letters. Second, your CV
in ERAS form. For the latter, just like on the medical school application, you
have a couple lines (~1000 characters) to explain each activity. There is a
“print CV” option in ERAS that will help after you’ve input your activities and
experiences. Like your personal statement, start ASAP and sit down and write
a CV, then revise, revise, revise after having your advisors look it over.
Tulane Surgery Residency Application Guidebook 9
Choosing Letter Writers
Surgery Faculty from Third Year Ideally, you have stayed in touch with one or two
surgery faculty whom you met during your 3rd year
rotations. Clerkship facilitators are often a good source, because you have met with them outside of regular clinical duties and medical student education is important to them. Try to meet as early as possible with these surgeons so that your third year is fresh in their minds.
Other Faculty from Third Year
It is not recommended to include letters from faculty
in other disciplines besides surgery. The only
exception would be if you have done extensive
research with that physician. Many residency
programs value surgeon letters significantly higher
than non-surgeons. Plus, a surgeon knows the
attributes someone needs to excel in the field and
can best highlight those in a letter.
Research Mentors Important if you are interested in academic residency programs. Instead of just focusing on your clinical acumen, these letters emphasize a different skill set that will be important in the future. Moreover, you will probably have spent more time with these faculty, so they truly know you better and can write more anecdotally.
Surgery Faculty from 4thYear
The majority of letters will often be from this group. Sub-Is in May, June, and July are ideal. It is best to request a letter right after working with someone, so they can best remember your performance. You
have learned a lot during your 3rd year and can
really shine during these rotations, giving faculty a lot of good things to write about.
Chair Letter
The Chair of Surgery will write a letter for all
students applying in general surgery. STUDENTS
SHOULD set up a meeting or risk not getting a
letter. Be prepared for this meeting as it may be
your first and only chance to make an
impression and communicate things you’d like
highlighted in that letter.
ERAS Requirements A. You can store as many letters as you want in
ERAS, but you cannot send more than 4 to any one program.
B. “Finalize” each potential letter writer in ERAS and print a cover sheet before asking for a letter. “Finalizing” just creates a slot for the LOR to be uploaded and does not mean you have to send out that letter to programs.
C . ERAS allows you to send different letters to different programs, which is ideal if you’re applying to both General Surgery and integrated programs.
D. Although it is possible for letters to be uploaded after submission of your ERAS application, try to avoid this. Ask early!
How to Pick Specific Faculty
1. Pick faculty whom you have spent the most time with and who know you best.
2. Letters from full professors as opposed to associate or assistant professors may carry slightly more weight. Letters from faculty who are well known nationally in their field may also carry more weight.
3. Pick faculty who can highlight your different strengths: research vs. technical skills vs. patient management, etc.
4. Ask for letters with the phrase: “Can you write a
strong letter of recommendation for me?” 5. Try to ask for letters in person with a copy
of your CV, personal statement, and list of programs. You can also solicit advice about programs and your personal statement at the that time
6. Send faculty thank-you notes after they submit your letters to ERAS
7. Faculty write letters every year, so they know to expect requests. Try to give as much lead time as possible and follow up with polite reminder emails as necessary
Tulane Surgery Residency Application Guidebook 10
Choosing General Surgery Residency Programs
Academic, Community, or Hybrid Programs Large academic centers are usually best suited for those with a robust interest in research and/or other academic interests outside of a clinical career in surgery. Many academic programs require 1-2 years of research time during residency while other programs offer optional time for academic development; these programs vary from 5-7 years in length. Some will have “research optional” but be sure to get clarity on what that means because it is different from program to program. Community programs are usually more clinically focused, may have higher case volumes, and are usually 5 years of clinical training. Hybrids are just that: community-feel programs with a bit more opportunity for research. These may have a small medical school attached to the hospital or may have more academic faculty.
Geographic Restrictions Do you want to live in a big city, near family, or only on the East/West Coast? Where is the nearest airport and how expensive are tickets? You have to live there for 5-7 years, so truly try to imagine your everyday life there. Many of the top programs have similar clinical and research opportunities, so location really separates them. Though geography matters, your support system matters, too!
Faculty/Mentor Suggestions Faculty can offer good insight into programs’ reputations. Junior faculty mentors are an ideal starting
point as they are far enough along in their careers to understand some of the pros and cons of
different training paradigms and close enough to the residency process to know about more recent
changes in program characteristics and reputations. Senior faculty have a great deal of experience to
draw from, but their knowledge of programs may be dated, depending on how closely they follow
current events. Usually the Chair, PD, APDs, and other faculty with medical education backgrounds
are some of the best sources of information because they are aware of new developments and
resident education at institutions. The key is to solicit suggestions from multiple sources and to find consensus.
Resident Suggestions
Residents are great sources of information because they have interviewed recently at many of the programs to which you will apply and may have friends at other institutions. If you hear a program recommended over and over again, it’s probably worth applying to.
Specific Program Characteristics to Consider 1. Research faculty/projects or multidisciplinary research centers that correlate
with your interests/expertise. 2. Quality of fellowship programs that residents match into. 3. Prominence of particular department of interest. 4. Reputation for collegiality vs. hierarchical environment.
Main Points: 1. Talk to many people to solicit advice and suggestions. 2. Include both “dream” and “back-up” programs. 3. Take all advising with a grain of salt. This is YOUR match.
How many programs should I apply to? There is no great way to predict how many programs you should apply to. Application creep
has occurred over the past few years, with the 2020 average being around 67 applications per
applicant. The graph for number of applications is increasing exponentially. Projected average
applications for the next 5 years are: Year 2021 2022 2023 2024 2025
Projected Applications 70.9 76.2 81.9 88.1 94.8
*source: ERAS applicant data. Projection based on 2011-2020 historical data. Equation y = 31.847e0.0727x
Tulane Surgery Residency Application Guidebook 11
Scheduling Interviews
GENERAL RULES:
1. Be near your phone/computer at all times from September 15 – Early November. Programs often send more invites than they have spots for, so you need to be fast in responding to invites. When scheduling or rescheduling interviews, spots fill up very quickly, so prompt communication will maximize your chances of getting the dates you want.
2. Be courteous – A program’s surgery education office is responsible for
scheduling and rescheduling interviews. They are the gatekeepers. If you
come off as even slightly rude, you may be blackballed before you spend a
dime on traveling there. Be courteous, even if the person you’re talking to
isn’t.
As Interview Invitations are Sent:
• If you want, you can use the Reddit General Surgery spreadsheet to get
a ballpark of what programs are offering interviews. TAKE REDDIT WITH
A HUGE GRAIN OF SALT because people often mislead and lie (hiding
behind anonymity).
• Once you get an invitation, you can quickly browse through the
potential dates of other programs to minimize clashing and to try to
schedule programs in the same city together
• Invitations are sent by email, and spots fill up very quickly. Check your
email frequently, or you may miss out. Smart phones with “push”
notifications for email are very helpful. “Push” means your phone goes
off whenever you get a new email (you don’t have to manually check it.
• Set up email forward to text on your phone so that any message with the
word "interview" or from "[email protected]" shows up as a text. Also
set this up to go to your mom or significant other’s phone and train them
how to log into your Gmail, ERAS, and calendar. Keep all interviews and
dinners in one calendar.
• Many people will have a family member or significant other check their email or download to their phones just in case you are scrubbed in or on an away rotation.
Tulane Surgery Residency Application Guidebook 12
Accepting Invitations:
• Respond ASAP – spots fill up very quickly • Respond in the way they tell you: email, form response, or specific
websites. • Read the invitation carefully before responding. It often asks for
specific information in your reply
Example: Accepting Invitation by Email
Hello ___________,
Thank you very much for the invitation. I was hoping to
interview on December 4-5 if that session is still available.
Please let me know if you need any further information from me.
Thanks again for the invitation. I very much look forward
to interviewing at [program name]. Best,
____________
How many interviews should I go on? Based on NRMP data, 12 or 13 interviews is the “magic” number to match into general surgery. With this being said, many people will advise you to go on as many interviews as you are able to. This is a multifactorial decision, but if you receive more than 13 offers, you should go on interviews at programs where you are confident that you would attend residency. Use the “Interactive Charting Outcomes” tool on the NRMP website to help with this and more regarding competitiveness.
Tulane Surgery Residency Application Guidebook 13
Cancelling/Rescheduling/Declining Interviews:
• Don’t worry – programs expect some applicants will cancel/reschedule, so
they are usually forgiving if this is done with appropriate lead time.
• Being courteous and professional is of particular importance. Lack of
gratitude when cancelling interviews will burn bridges.
• Whenever possible, notify the program AT LEAST 2 WEEKS in advance
so they can reschedule you or offer your spot to another applicant
• If you cancel/reschedule on short notice (< 2 weeks), you need to have
a convincing reason (death in family, severe illness)
• If you cancel/reschedule ahead of time (> 2 weeks), you do not need to
give a specific reason
Example: Cancelling Interview by Email > 2 weeks ahead of time Hi _____________,
My name is ________ and I am currently scheduled to interview at [program name] on January 12th. Unfortunately, I will have
to cancel my visit. I am very sorry that I will not be able to
make it. Please convey my sincerest apologies to Dr. [program
director]. Thank you again for the invitation. I sincerely regret
having to cancel my visit. Best,
________________
Example: Rescheduling Interview by Email > 2 weeks ahead of time Hi _____________,
Thank you very much for the confirmation. I was wondering if
it would be possible to reschedule my interview for December
15th. December 8th would also work for me. I understand that a limited number of candidates are
interviewed on each date, and would be happy to keep my
previously scheduled date (Jan 5th) if this is not possible. Thanks so much. I very much look forward to interviewing at
[program name]. Best,
________________
Tulane Surgery Residency Application Guidebook 14
What to Do If You’re Not Getting Interview Offers
Key Points • It’s OK to freak out: After that, take a deep breath, talk to your
faculty mentors, and take action.
• When to Start Worrying: A few days after the Dean’s letter is released on October 1st. If you’ve only received a handful of interview offers in the first 2 weeks of
October, you may need to submit additional applications to less
competitive programs.
• Critical Timing: Application deadlines for most programs are October 15 or November 1st. If you’re starting to worry and want to apply to
more programs, you need to do it before this. GET FACULTY
INPUT.
• Remember: Programs offer interviews in several cycles, and applicants
can match to outstanding programs even when they are among the last
to be offered an interview. If you get a late interview, it does not diminish
your chances of matching at that program.
The Setup
You’ve submitted ERAS and all your letters are in. You’re waiting for
interview offers to arrive and nothing. Alternatively, you’ve received some
invitations, but haven’t heard back from more competitive programs.
Additionally, you may know other applicants have already received
invitations from these programs.
Timing
Programs can begin downloading ERAS applications on September 15.
Most will wait until after the Dean’s letter is released on October 1 before
sending out invitations for interview. A few programs do issue interviews in
late September, but the majority of programs, especially the larger
academic institutions, send interview invites after the Dean’s letter is
released throughout the month of October.
Another important date to keep in mind is October 15 and November 1.
These are the most common application deadlines for the majority of
programs.
If you haven’t received many offers in the first two weeks of October, it is
important to evaluate the need to take some extra steps. This includes
working with programs you have already applied to or applying to
additional programs.
Tulane Surgery Residency Application Guidebook 15
What You Should Do
1. Talk to your mentors. Bring a copy of your CV (board scores, clinical
grades, research) and your current list of programs. If there are particular
programs you are interested in, ask if they have connections at those
programs or could connect you with faculty who do. Some faculty will
directly offer to make phone calls on your behalf for interviews. Ask them
if you need to apply to a few less competitive programs.
2. For programs you have already applied to or those that you may have
added already: Emailing the coordinator or PD is usually the best option.
Be sure to include specifics about the program and why you are
interested in interviewing there. Make it personal and briefly describe
how the program pertains to your own strengths/future interests.
Mentioning family ties, city interests, and specific personal reasons for
wanting to be there. Sincerity goes a long way here.
3. For programs you are considering applying to: Call ahead to see if they
are still offering interviews. Once you have submitted your application,
email the residency coordinator to inform him/her that you’ve just
submitted your application and follow step 2 above to mention your
specific interest in the program.
Tulane Surgery Residency Application Guidebook 16
Compiled interview offers from the 2020 Reddit General Surgery Spreadsheet. This graph shows the majority of interview offers were extended by early October.
ON THE INTERVIEW TRAIL
Getting to Your Interviews - Planning Logistics
Once you’ve scheduled your interviews there is a good amount of planning
that is needed to help make the interview trail run smoothly, minimize
stress and help you get where you need to be on time. The major logistic details that should be addressed before each interview:
1. Getting to the city where the interview is being held a. Check the schedule for the interview day(s) and social event
when purchasing your tickets. Most programs will have a social
event (dinner or reception) the evening before the interviews and
then a day of interviews following, but there are many variations
on this theme. It is always a good idea to ask when the interview
day officially ends, before booking travel.
2. Getting from the airport to your next stop, which is usually your hotel
or the social event.
a. There will be times when you will arrive without enough time to
stop by your hotel to drop off bags and change. Plan ahead and
have your outfit easily available so you can change at the
airport if you need to head straight to the venue. b. Map out how long it takes to get from the airport to your lodging
so you know your time constraints. If you rent a car, you can
inquire ahead of time about the parking situation both for the
social event and on interview day.
3. Getting from the social event to your lodging. You should have a plan
for how to get home after the event so you’re not stranded or stuck
staying later than you want at the event when you have an early day
ahead on interview day. Plan for the worst, including weather. Pack an
umbrella, snow shovel, whatever you *may* need.
4. Interview Day: Getting from lodging to interview site. You will usually
get information about meeting time and location for interview day at the
social event the night before, if not in advance via email. Make sure you
know how to get to the meeting place and know how long it will take
you to get there. If taking an Uber, test out the location and map
beforehand to gauge timing and distance. Some places will offer a
shuttle. If walking, allot extra time if walking in heels. Aim to show up
10-15 minutes early.
Tulane Surgery Residency Application Guidebook 17
5. Interview site to next stop, either back to lodging or to the airport. Again,
plan ahead to determine if you have enough time to go back to your
hotel, pick up your bags and head to the airport. If not, you should bring your bags with you to the interview day and make sure in advance
that there is a place to leave your belongings, and that the interview day
coordinator is expecting you to come with bags. You should leave
yourself extra time on interview day morning for this.
6. Finally, interview’s done and it’s off to the airport and then home or to
another interview. There may be times along the interview trail when
you will have back-to-back interviews and will be on the road for days to
weeks at a time without a stop back home. Plan and pack accordingly.
Remember to take into account changing time zones when planning
travel. If you check your bag, always carry-on your suit in case your
bag gets lost. Timing: It can be difficult to plan all these details because interview invitations
will roll in over a few weeks and you may find yourself with schedule conflicts.
Before you find yourself in this situation, you should have a rough idea of
which programs you would prioritize before others, so you feel comfortable
cancelling/rescheduling according to the interviews you want most. Some
programs will announce their interview dates and you can create a calendar of
possible interviews to see where potential scheduling conflicts will arise.
Because most interviews do not take place during peak travel season, it will
usually not be difficult to find the flights needed, even when booked only 2-3
weeks in advance. TIPS:
• GET A TRAVEL CREDIT CARD. The points will benefit you at a later time whether during interview season or in T4 post-interview season.
• Southwest Airlines: no fee for changing itineraries, free checked baggage
• Most programs will have discounted or free lodging, so wait until
you are given this information before you book.
• Find a consistent way to keep all your interviews and travel schedule organized, and make sure to update it as you switch/cancel interview dates. Most people use Excel or Google sheets.
Tulane Surgery Residency Application Guidebook 18
Preparing for Interviews The Highlights:
• However you practice, make sure you practice and have answers
to commonly asked questions.
• Go through your CV and make sure you can succinctly discuss
each aspect of it.
• Approach the answer to every question as an opportunity to highlight
a unique aspect of yourself and of your application - be thoughtful,
demonstrate insight. DO NOT BE NEGATIVE.
• Get feedback from faculty The Full Story: Congratulations, you have received your interview invitations, set the dates,
bought the plane tickets, and set up the lodging. It is now time to prepare for
your interviews. Fortunately, to have gotten to this point you have already
bypassed the first cut-off. Over 1000 students apply to each program and most
programs will interview less than 100. You have already made it to the
program’s short list. With that being said, the interview is the most important
aspect of your application and can make the difference between matching at
your first choice and falling lower down your list. Being properly prepared for
your interview will allow you an opportunity to display your accomplishments
and your personality. Practicing for your Interviews The first step to prepare for your interviews is practicing. Students prefer
different methods to simulate interview situations. Mock interviews provide a
secure environment to practice interview techniques, body posture, eye
contact, as well as common interview questions. You can seek out mock
interview sessions with the school counselors/career advisors or practice with
a friend. Practicing with friends offers a relaxed environment to rehearse
different answers to common questions but lacks the professional opinion on
substance and style that other methods provide. Likely, the best option for a
mock interview is a faculty mentor in surgery. Schedule these mock interviews
early and be prepared to take constructive feedback to improve your interview
skills.
*Tulane also typically interviews home students very early so that you can get
a feel for the process and receive feedback on your interview abilities.
Tulane Surgery Residency Application Guidebook 19
Along with mock interviews, being prepared for common questions can help
ease some of the tension involved with surgical interviews. Some students find
that outlining the answers to specific questions is beneficial. While the outline
provides the student a chance to think about a question, it also maintains an
answer’s sincerity in real interviews. The golden rule: BE YOURSELF. Some Common questions are included at the end of this guide. A great starting point for situational questions is the STAR method: Situation, Task, Action, Result. This gives a great framework for how to properly setup and deliver a proper response. It is also important to think of answers to questions specific to your application. For instance, if there is a specific deficiency in your application, you should be ready to answer questions regarding that deficiency in a positive way. Also be ready to describe any and all aspects of your application. If you included a research project from prior to medical school, you should be able to describe the project in detail in your interview. Some interviews have ethical questions so it is important to develop your own method to answer these types of questions. Think of ethical scenarios you witnessed during med school and be prepared to discuss the reason you or your team acted in that manner. Going into your interviews you should also know the assets of the programs at which you are visiting. Most general surgery programs have good websites which can provide you with the program’s mission statement, the basic structure of the program, recent accomplishments of the faculty, research opportunities, and recent graduate placement. Mentors can also help you by pointing out a program’s strengths and weaknesses. Having this information can aid you in developing well thought-out questions for your interviews. Gathering this information will also help later down the road when making your rank list. On the topic of questions you should ask in interviews, there are generally two categories: questions you are asking in order to get information and questions you are asking in order to steer the interview. This may sound superficial, but the truth of the matter is that you may get half of the allotted interview time to ask questions, and this is your opportunity to lead the interview. You should absolutely ask any questions to clarify information on the program, residents, etc. Beyond these informational questions, you can also ask questions that may steer the conversation toward an area of discussion that you would like to talk about (or that your interviewer would like to talk about). This is a bit of psychology here, but you want your interviewer to shake your hand at the end of your time thinking you are the best person they’ve talked to in a while. Take a look around their office, read their questioning style, know their specialty/research, and ask questions accordingly. This is not to say that you should answer questions the way you think they want to hear it. The opposite is true: answer all questions truthfully and be yourself. But in other discussions and questioning, you can be the person to do everything in your power to leave a positive impression on your interviewer.
Tulane Surgery Residency Application Guidebook 20
Looking the Part It is important to keep your clothing professional and conservative. This is not
the time to try out new fashion trends or hairstyles. Men should wear a black,
navy, or grey suit. The shirt should be a solid color and should be matched to
an appropriate tie. Shoes should be black or brown. Hair should be maintained,
and facial hair should be well trimmed. Women should wear dark pant or skirt
suits. Non-collared shirts are perfectly acceptable to wear under your suit
jacket. Again, no low cut shirts or short skirts. In general, hair longer than
shoulder length should be tied. Remember, these interview days are long and
there usually is a tour of the facilities involved, so shoes should be comfortable.
Proper attire at the night-before resident meet-and-greet events is also
important, and ranges from casual to business casual. You can email the
residency coordinator prior to your interview to find out the dress code. For
men, it is usually appropriate to wear black or khaki pants with a button-down
dress shirt and for women a blouse/cardigan with a skirt or slacks is pretty
standard. Pre-Interview Dinner
Not only do the meet -and-greet events provide a great opportunity for the
residents of the program to get to know you, it also provides the interviewee an
important opportunity to discover the personality of a program. While these
events are normally not absolutely essential, it is always recommended that
you attend. These events are usually only for residents and interviewees,
however, as mentioned above, faculty may attend at some programs. Ask
questions! Where are you in your training, what specialty are you interested in,
where do you live, what’s the culture of the program like, any advice for
interviews tomorrow (this one can be surprisingly valuable).These events are
usually billed as a relaxed environment to get to know the program’s residents,
but it is important to remember that most programs will seek feedback from
residents following the event. With this in mind remember to remain
professional. Alcoholic beverages are supplied at most of these events, and
while the residents may drink more heavily, keep yourself to a maximum of 1-2
drinks. Every year there are embarrassing stories of applicants drinking too
much at these events, and these stories can easily spread to other programs.
Tulane Surgery Residency Application Guidebook 21
Finally, here are some tips to remember when going into your interview: It is
important to be on time. This can be difficult as you may not know your way
around this new city. If you have time, try to find the hospital the day prior to
the interview. Make sure to leave with plenty of time in the morning and to
ask your hotel the easiest way to the hospital. At your interview, remember to
be nice to everyone you meet. Shake hands, say please and thank you, and
smile. You never know who is watching and who will offer an opinion
regarding your application.
Once again, congratulations on obtaining your interviews. Preparing for
interviews will help you stand out as a lead contender for the residency
positions. Utilize mock interviews, rehearse your answers to common
questions, and do your homework with regards to the programs at which you
are interviewing. Dress professionally and conservatively. Enjoy your time at
the night-before event, be on time, and, finally, remain cordial and friendly
throughout your interview. Although this can be stressful, remember that this
is an exciting time where you get to meet surgical leaders throughout the
country and visit new cities across America. Have fun!
Tulane Surgery Residency Application Guidebook 22
Interview Day Strategies What to bring to every interview:
• Copies of your ERAS application and CV. (If you are an artist, you may bring a few copies of your work. Not a full portfolio, but maybe 3 examples of best/diverse work.)
o Interviewers will ask you specifics about your research experiences,
personal statement, or prior activities – it is always good to refresh
your memory! • Consider drafting responses to questions you are totally expecting and
bring this with you • Can just be bullet points, helpful to review while waiting for flights
Things to prepare for each program:
• List of people you may meet: o Faculty members with your research interests, specialty choice
o Chairs, Program Directors, etc. – Make a list of names and
specialties • List of the reasons you were interested in the program in the first place
o You will frequently be asked why you wanted to apply or join the program
• Include specific research interests, strong clinical experiences,
global health, etc. o If you went to the night before, comment on what impressed you
about their residents
• List of questions to ask the program – For both residents and
faculty interviewers
o You will be asked “do you have any questions for me?” more times
than you can imagine.
You may only get 10-15 minutes with your interviewer, so frame some of
your questions to get the most out of your time.
On Interview Day:
• Always be “on.” Treat everyone you meet with utmost respect and
kindness. Your behavior must be polished from start to finish.
• There will be down time. This is not let “your hair down” time. Stay polite,
courteous, and genuinely professional.
• Do not talk badly about other programs, including your home program.
If you didn’t like it somewhere, this is not the time to air your grievances.
Be professional and positive.
• You will definitely talk to other applicants throughout the day. These people
will be your peers for your entire career, so treat them as such. Make
friends, exchange info, and have fun!
Tulane Surgery Residency Application Guidebook 23
Interviews:
• Pace yourself, interviews are anxiety-provoking so take a breath to
organize your thoughts before answering questions.
• Be confident in your responses, always answer questions honestly,
positively, and succinctly.
• Be able to tell your story in 1, 3, 5, and 7 minutes (i.e. have different
versions of your “pitch” to fill the time appropriately). A good way
to practice this is be able to answer the “tell me about yourself”
question concisely but also be able to get through the interview if the
interviewer says nothing else.
• Don’t be afraid to ask about things you are concerned about –
research, specific lab experiences, strength of individual departments.
Do not be offensive when asking “concern” questions.
• Stress questions or harsh interviews will happen. It is on you to
always be positive and show how you react to stress (sometimes
these stressful interviews are on purpose to see your reaction).
• Clinical scenarios, technical skills, and “what would you do if…”
questions do happen in general surgery interviews. Answer honestly
and perform to your best ability. Be coachable, teachable, and
confident yet humble. • Illegal questions will happen, but an interview is a bad time to take a
stand or make a point!
• Give them whatever info you are comfortable with, but do not get
upset during the interview.
• Fill remaining time with questions, and try to make it conversational.
If you are given 15 minutes for an interview, they may finish asking you
questions at minute 5. You don’t want to end your interview in 5 minutes,
so it is on you to lead the interview for the next 10 minutes to paint the
best picture of yourself. See pg. 20 for additional strategy. After Each Interview:
• Write notes about what you discussed with each interviewer, it is really
easy to fall out of this habit but it makes thank you notes so much
easier/ faster. You can update a spreadsheet or Google Sheet to keep
track if you want as well. This strategy is discussed later in the guide. • You can easily plug a specific sentence about what you discussed,
then they know you remembered the conversation
• Before leaving, ask the residency coordinator for emails/addresses if
you plan to send thank you notes.
Tulane Surgery Residency Application Guidebook 24
Evaluating Programs Short version:
• Pick criteria, apply them to all programs, expect them to evolve with time • Keep a journal or spreadsheet and write down your impressions
right after each interview
• Use both a qualitative (gut feeling) and a quantitative system
(point system) of evaluating programs There is no consensus on rankings of the “best surgical programs” because
everyone’s criteria differ. In truth there are a large number of excellent
programs that will train you well as a surgeon. In evaluating programs you
should take into account all of the factors below, knowing that not all are
equally important to you in making your final decision. Take into account things
outside of just your clinical training - i.e. family, academic interests, health
policy, etc. Remember that although the interview is a time for you to sell
yourself to programs, it is also the time when you should be critically
evaluating the programs to make sure they are right for you.
Create a spreadsheet which includes all your interview programs and
columns for all your priorities. You can update this as you interview, and
it may help to have a numerical ranking system for your programs but
also some qualitative data for you to reference when you are ranking
programs in the Spring.
Tulane Surgery Residency Application Guidebook 25
FACTOR THINGS TO CONSIDER
Location Close to family, friends? Cost of living? Will you enjoy living in this place for 5-7 years?
Social event Was there good resident turn out? Did the residents seem to genuinely like each other
and get along well?
Residents Were the residents fun, interesting, people you could see yourself working with? Are the
residents happy? Can they name specific things about the program that they like?
Physician extenders Is there good support from PAs, NPs, etc. to help you with floor work so you can get to
the OR even as an intern and PGY-2?
Program Director, Is the Program Director approachable, do the residents consider him/her to be a good
Chairman advocate for residents? Is the Chairman someone who prioritizes resident education and
training and who will keep the program on solid footing?
Didactic curricula What is the curriculum for ABSITE and general didactics? Is there a structured
curriculum for lap skills, surgical knowledge, or is it a do-it-yourself program?
Academic/Professional Many academic centers will have the option or the requirement for residents to engage in
Development Time some sort of academic development period. Most often this will be for a 2 year period
after the PGY2 or 3 year. What are the resources available (salary/grant support), what
types of experiences are approved (additional degree programs, research, international
experiences, etc.) does the program have mentors that you would want to work with?
Sites What other sites will you cover as a resident in addition to the main hospital? Is there a
VA or a city/county/community/private practice hospital experience? Often times you will
have much greater autonomy and higher case loads at training centers like a VA or
county hospital
Strength of specific depts., If you have a specific interest in a sub-specialty or academic topic, inquire as to the
researchers resources and strength of those departments
Stability of program Have there been recent changes in leadership or impending changes that would disrupt
your training? Recent ACGME violations, probation status?
Culture What is the overall culture of the program? Soft and cuddly, malignant, work hard, play
hard, etc. Beware that many programs will have reputations that prove to be false. Make
your own determination after you see the program
Work hours compliance What measures have been put into place to achieve compliance - hiring of physician
extenders, night float, etc.? Are residents routinely working more than 80 hours and
pressured to underreport?
Benefits, vacation Not the most important things to base your decision on, but important to note and may say
schedule, salary something about the program’s philosophy
Fit An overall impression of whether or not the program’s structure, resources, people and
culture create an environment in which you think you can thrive
Tulane Surgery Residency Application Guidebook 26
Thank You Notes When: ASAP –next day if possible, but within a week is fine. You want their
impression of you to be fresh when they read the note. Who:
For All Programs: Program director + all people who interviewed you (if
the chair interviews any applicants, then he/she should get a thank you
note under the assumption that he/she is fairly involved in the rank
process). NO GROUP THANK YOUS. Individual notes only.
If Particularly Impressed: Chair and interview coordinator How:
1. Be sincere, succinct, honest 2. Include specifics about your conversation with the person 3. Avoid being formulaic. Thank you notes are included in your file and can
be read by all faculty
4. Avoid specifics on where you’ll rank them (even late in the interview season)
5. Double-check everything (names, spelling/grammar). Errors will
reflect very poorly on you.
Why: Most programs expect to get one – not sending one demonstrates
clear lack of interest. Point: Even the most eloquent thank you note is unlikely to elevate
their opinion of you Counterpoint: A poorly-written, late, or non-existent thank you note CAN worsen their opinion of you (ex: well-qualified candidate comes off
as arrogant) Bottom Line: Write your notes carefully and promptly, but don’t slave
away over them Handwritten vs. Email: Frequently debated point, but largely a matter of
personal preference. Doesn’t matter much in the end as long you as send
a well-written note promptly.
PROS CONS
Demonstrates thought and attention- Time-consuming to write and deliver
Handwritten
to-detail
There is a certain romanticism about a Faculty rarely respond
handwritten note.
Must write neatly
Faculty who were impressed will often
reply and say this to you
Faster to write, instant delivery May be frowned upon by “old-
school” faculty.
Good if you have bad handwriting
Tulane Surgery Residency Application Guidebook 27
Example: Thank You Note to Faculty/Resident Interviewer Dear Dr. _________,
Thank you very much for taking the time to meet with me during
my visit. I very much enjoyed hearing your perspective on how
the training for vascular surgery continues to evolve. Throughout my visit, I was greatly impressed by the program’s
commitment to excellence in patient care and clinical
training. I was also particularly impressed by the residents
and faculty. Their camaraderie and dedication to fostering an
outstanding training experience truly set this program apart
from others. They are exactly the kind of people I hope to
work with during residency. Thank you again for your time and consideration. I was greatly
impressed by the program and hope to receive strong
consideration for a residency position. Sincerely,
_____________
Example: Thank You Note to Program Director Dear Dr. __________,
I wanted to thank you again for inviting me to interview at
[pro-gram name]. I very much appreciated having the opportunity
to spend time with the residents currently rotating on the
vascular service. During my visit, I was greatly impressed by the faculty and
residents. Their collegiality and dedication to fostering an
out-standing training experience truly set [program name] apart
from other programs. They are exactly the kind of people I hope
to work with during residency, and I would consider myself very
fortunate to have the opportunity to train at such an
outstanding program. Thank you again for your time and consideration. I was greatly
impressed by [program name], and hope to receive strong
consideration for a residency position. Sincerely,
_____________
Tulane Surgery Residency Application Guidebook 28
POST-INTERVIEW PERIOD
Making Your Rank Order List Everyone is going to have different criteria and reasons rank one place over
another, but beyond that single program or location that you may be banking
on, it can be challenging to feel completely confident about your ROL. Below is
the method some use to figure this all out. It is just one way, but it works. Before interviews: After all interview offers and cancellations have been made,
you will have a final list of programs. Go ahead and make a preliminary rank
list and tuck it away for later. This may be based largely on reputation of the
programs, and this rank list should change. During interviews: After you complete each interview and evaluate the pro-
gram, feel free to tweak your list. Some programs might drop quickly in
your list while others rise to the surface. But treat it like a living document
as you complete interviews and evaluate programs. After interviews: Congrats! Now it is time to really work on your list. At this point
you have probably done a bit of soul searching and have boiled down your
method for evaluating programs into a few critical elements that will guide
ranking. It may be quality of program and reputation, opportunities in the
specialty you are pursuing, and quality of living (based on the lifestyle that
matches your personality), etc. Essentially this comes down to meshing the
list of programs with your list of priorities.
Step 1: Send any program you do NOT want to train at to the bottom
of the list. So ask yourself, “Worst case, would I rather match here for 5-
7 years or SOAP” - this is something that should be discussed with a
mentor, but SOAP is typically NOT ADVISED as an option. The one
caveat is please attempt to rank at least 13 programs on your final ROL.
Stats show that every unit less than 13 further reduces applicant chances
of matching.
Step 2: Break your list into groups. Top group is first tier programs you
would love to go to. The middle group can be first tier programs that you
kind of liked or second tier programs that you really liked. And the bottom
group is second tier programs that you kind of liked or third tier programs
that you really liked. (This “tier” system may be based on rankings,
research, or your own grading method prior to interviews). You will
probably end up with 3 or 4 programs in each group. From here on, the
ranking becomes more “head-to-head” to move programs up and down.
Making progress!
Tulane Surgery Residency Application Guidebook 29
Step 3: Hash out the details. This is usually the hardest part —zooming
in and figuring out your true preferences. For each group, it might help to
make a separate ROL for each criterion you value. For example, make a
list based purely on location. Then one for quality of program. And so on.
You might start to see some patterns or at least be able to solidify a few
spots on your list. Refer back to the criteria in the ‘Evaluating Programs’
chapter for other factors that may be important to consider. Step 4: Allow plenty of time! As soon as you can enter your rank list,
DO IT and CERTIFY IT. Let it sink in for a few days and see how it feels.
Then make adjustments as your frame of mind evolves throughout the
month prior to the deadline. It is also recommended to get early input
from your mentors, letter writers, family, and advocates. Eventually your
list will settle in, and you will become confident in my choices. Step 5: Make sure your ROL is certified. It should say Certified ROL.
You’ll get a confirmation email and that is it. If you make any changes
just hit the certify button again. Try to avoid making changes right
before the deadline. Stats show a high rate of regret among
applicants who do this. So give yourself the necessary time. After that,
good luck!
Tulane Surgery Residency Application Guidebook 30
Post-Interview/Pre-Match Communication The Short Version:
• THIS IS ALL OPTIONAL. You can have zero communication and
match perfectly fine.
• 3-4 weeks before your rank list is
due: o Find faculty who will advocate for you at your #1 choice o Send an email to program directors at your top 3-5 programs
• General rules to follow when communicating with programs:
o Never mislead a program about your rank list o For your #1 program: tell them in no uncertain terms you’re
ranking them #1 o For #2-5 or so: convey sincere interest, but no specifics on
where they’re ranked
• When responding to messages from programs: o Take everything with a grain of salt. o Be prompt, positive, and truthful.
• Caveats:
o Not all programs send out emails, even to applicants they will be ranking highly. Don’t get nervous if you don’t hear anything
from your top-ranked programs o Some programs may send out emails that overstate how
highly you will be ranked; never base a rank decision based
on these communications.
––––––––––––––––––––––––––––––––––––––––––––––––––––––––
THE LONG VERSION
So you’ve made a preliminary rank list and identified your top choices. It is up to you whether you would like to communicate with them at this point. You may want to try to convince your top programs to rank you as highly as possible, but you also do not want to mislead anyone.
The program may reach out in some way. They have the power in this
scenario, and they will use their power to try to convince their top applicants to
rank them as highly as possible. DO NOT CHANGE YOUR RANK LIST
BASED ON THIS INFORMATION.
TIMING: Most programs make their rank list 1-3 weeks before it’s due.
Make your move before this.
Tulane Surgery Residency Application Guidebook 31
The rules: Rule #1: Follow the rules set by NRMP
• Programs can’t ask you specifically about your rank list
• You can’t ask programs where they’re ranking you
• Both parties ARE allowed to volunteer this information to each other Rule #2: Never mislead a program about your rank list. The most common example is telling multiple programs you ranked them #1.
You will not be able to hide from the truth once the match results are released.
If a program thinks you lied to them, you can forget about any future
opportunities there (fellowship, faculty positions, etc). Important Tangent: This rule also prohibits ambiguous statements such as
“at the top of my list.” It is too easy to misinterpret this as ranking that
program #1. In addition, program directors weren’t born yesterday. Most will
interpret “at the top of my list” as NOT #1. If a program is not your #1 choice,
sincerely state your strong interest in the program, but avoid any specifics
about where you ranked them. Rule #3: Programs like applicants who like them The reality: For most applicants, once interviews are finished, your position
on a program’s rank list probably will not change no matter what you do.
That being said, tactfully executed strategies may move you up on a
program’s list, and certainly will not hurt your chances. What you can do: These steps need to be done 3-4 weeks before the rank
list is due Ask faculty at your institution to advocate for you. General Surgery is a
small community, so a trusted colleague advocating for an applicant has the
most potential to help. Reserve this for your #1 choice. When deciding
whom to ask, the ideal faculty advocate should:
• Know you well and think highly of you
• Have a personal connection to the program director, chair, or institution
• Be well-respected as a surgeon Admittedly, it is difficult to find an advocate who meets all three criteria. That
being said, remember that any advocate who knows you well and thinks
highly of you has the potential to help. At Tulane, receiving support from the
Chair is the ultimate support at this time in the form of a phone call or email.
Tulane Surgery Residency Application Guidebook 32
Send an email to the program director: Directly communicating your interest
in the program is a crucial step (see Rule #3), although it is admittedly lower
yield than having faculty advocate for you. Think of it as a “box to check” for
your top 3-5 programs. Emails need to be succinct and sincere (see Example
1). Specific instructions are outlined below:
• For your #1 program: State in no uncertain terms that you are
ranking them #1
• For programs ranked #2-5: Sincerely state your strong interest in the
program, but avoid specifics about where that program is on your list.
For example, do not tell your #2 program they are “at the top” of your
list (see Rule #2). Responding to messages from programs: Programs will sometimes throw
you a bone. Typically, this happens after they have made their rank list. The
program director will contact you and tell you anything ranging from “we were
very impressed with you” to “you’re ranked to match.” Here are some pointers
on how to react to this:
• Take everything with a grain of salt. If a program is reaching out to
you, you know they like you. The question is: how much? Applicants
tend to rank programs more highly if they think they were well liked
there. Programs know this, and often tell many applicants (not just their
top 10) that they were “very impressed” with them. Again, DO NOT
LET THIS AFFECT YOUR RANK LIST.
• Respond promptly (within 24 hours). Delays in responding make
you appear uninterested and leaves programs feeling slighted (see
Rule #3). If contacted by email, respond immediately. If contacted by
phone, let it go to voicemail first. Then, listen to the message, think
about how you’d like to respond, and then call them back.
• Be positive in your response. Even if that program isn’t in your top
3-5, you need to convey sincere interest in the program. If they
ranked you highly, you want to keep it that way in case you don’t
match in your top 3-5 (see Rule #3).
• Remember Rule #2. You should definitely tell your #1 program that
you’re ranking them #1. For everyone else, tell them you’re sincerely
interested, but avoid any specifics about where you are ranking them.
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Example 1: Emails Sent to Top 3-5 Programs: Dear Dr. _________ (program director),
I hope this email finds you well. < I wanted to let you know that I will be ranking ________ #1 on my rank list. > OR < Having finished interviewing, I continue to be greatly impressed by __________. > The strength of clinical training and research opportunities clearly set the program apart from others. It
would be an honor to have the opportunity to train at such an
outstanding program, and I hope to receive strong
consideration for a residency position. Thank you again for your time and consideration. I hope I will
have the opportunity to work with you in the near future. Sincerely,
___________
Example 2: Responding to Email from Program Director Email Sent From Program Director to 30+ Applicants (why you
should take everything with a grain of salt): Dear ____________,
Thank you very much for taking the time and effort to visit us
in __________ and learn about our program. All the faculty and
residents were greatly impressed by you and your
accomplishments. We all thought you would be a great fit for our
program and could do very well here. I hope you will seriously
consider us for your future surgical training. Feel free to
contact me if you have any questions about our program. I hope you have a Happy Thanksgiving,
______________ (program director)
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Email Sent from Program Director with Reply (if program not ranked #1): Dear ___________,
I wanted to thank you once again for your interest in our
program. All of us who met with you were thoroughly impressed by
you, and we would all be thrilled to have you become a part of
our program. I hope that we were able to convey to you our
eagerness and commitment to train and mentor you to become an
accomplished clinical surgeon and surgical scholar and to
achieve whatever goals you set for yourself. We plan to rank you as one of our top ___ applicants, assuring
that you will match here if you choose to do so. If you should
match elsewhere, we hope that you will consider us for future
fellowship training or faculty positions. We also hope that you
will keep us apprised of your progress, and that you will feel
free to contact us at any time if we can be of assistance to you
in any way. We wish you much success.
Sincerely yours,
____________ (program director)
–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––
Dear Dr. ______________ (program director),
Thank you very much for your message. I was greatly impressed by
your program during my visit. The strength of clinical training,
supportive culture, and breadth of research opportunities clearly
set ___________ apart from other programs. It would be an honor to have the opportunity to train at such an outstanding program.
Sincerely,
___________
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Integrated Programs
Applying to Integrated Programs
There is a growing trend toward integrating general surgery residency and sub-
specialty training. Currently there are integrated training programs in plastic,
vascular, and cardiothoracic surgery. As many of these integrated programs
are highly competitive, applicants to these programs should take into account
many specific considerations that differ from applicants applying solely to
general surgery programs. The decision to apply to integrated programs and
the approach to doing so is nuanced and should be discussed with faculty
mentors, but the brief guide below covers some of the highlights. Getting your application ready:
• TALK TO YOUR PROGRAM DIRECTOR to determine whether you will
apply only to integrated programs or whether you will apply to both
integrated and general surgery programs. • It is completely ok, and very common, to apply to general surgery
programs in addition to integrated programs; however, in this case
you should: o Have two completely separate applications- one for your general
surgery and one for your integrated
• This means SEPARATE personal statements • If possible, have different sets of letters of recommendation
o For example, having 4 letters of recommendation all
from plastic surgeons looks suspicious to general
surgery programs. o Having some general surgeon letters in your integrated
application will not hurt you (but it is helpful to have
some letters from faculty within your integrated field) • You should never apply to both the integrated program AND
the general surgery program within the same institution
because programs may see this and you will lose out in both. • For your general surgery application, you will still need the Chair of
Surgery letter o Err on the side of full disclosure and be completely honest during
your meeting with your Chair, letting them know you will be
applying to integrated programs.
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How to choose which and how many programs to apply to: • Again, review your resume with faculty mentors within your integrated
field and the Chair so they can gauge your competitiveness and give
you advice tailored to you. • Always overapply and cast a wide net- interviews are very difficult to
schedule, and especially with integrated programs they may only offer
one or two dates, so if you apply to 40 integrated and 40 general
surgery programs, you may only be able to schedule 9 integrated and 3
general surgery based on your competitiveness. Difficult scenarios during interview season:
• Integrated programs may think you’re also applying to general surgery
programs, and many of them would say you would be crazy not to, so
do not worry if they ask you about this, just BE HONEST • If your general surgery application is suspicious for you having
applied to an integrated program (heavy vascular or CT research
projects, multiple letters of recommendation from vascular or CT
attendings, personal statement, etc), you WILL get asked about
whether you also applied to integrated programs o If this happens, DO NOT LIE. Tell them the truth but follow with why
you decided to apply to general surgery programs too and use this as
an opportunity to mention why you applied to their program specifically • You may be advised otherwise, but it is typically not recommended to
volunteer the fact that you are an integrated applicant in your General
Surgery interviews. Some programs will not rank you if they specifically
know that you are dual-applying. • Be ready to answer the question: “So, is general surgery your
backup?” (The answer is NO, even if in your case it is…). This is a fine
line between not lying about dual applying and putting your best foot
forward on the interview. Though they may be a “backup,” you applied
to the program because you would be interested in training there if
your integrated Match does not work out. Frame this in your mind
appropriately and do not go into these interviews lukewarm. Other
people are trying their hardest to Match there, and you should too!
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On the interview trail: • You will be interviewing with the same 20-40 people at most places
o Making acquaintances/friends quickly can relieve some of the
financial burden of interviewing- share Ubers, etc.
o These friends will be a part of your field for your entire career; you are
all in this together! • NEVER say anything negative about any person or program, as this
will come back to you because the circle is so small (although you
should never do this anyway) • HAVE FUN! Interviewing is awesome because you are networking with
great faculty across the country. Make a good impression regardless of
your interest in the program because it really is a small world
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Sample Personal Statements
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My first encounter with surgery occurred when I was in sixth grade. One
afternoon in February, I developed back pain that rapidly worsened over
the next several hours. My parents took me to the emergency room, where
a pediatric surgeon was consulted and brought up the possibility of
necrotizing fasciitis. Exploratory surgery confirmed the diagnosis.
Postoperatively, I developed septic shock and went back to the operating
room twice for further debridement and wound closure. Although I was
only eleven at the time, the experience sparked my interest in surgery.
Later in college, as I considered pursuing a career in medicine, I often
thought of the doctor who had performed the surgeries and managed my
care. These efforts allowed me to make a complete recovery. My family
and I were able to return to our normal lives. I wanted to have this
kind of impact on the lives of others, and that was my motivation for
pursuing a career in medicine. Once I entered medical school and began considering different
specialties, surgery seemed like a natural place to start. Not
surprisingly, I was initially drawn to how surgeons treated the most
critically ill patients, and the potential impact they could make on the
lives of these patients and their families. During my clinical
rotations, I was also impressed by how surgeons took ownership of
patient care, from preoperative evaluation to performing surgery and
managing postoperative care. Having trained as an engineer during my
undergraduate studies, I was also drawn to the methodical, data-driven,
and results-oriented approach of surgery. The strongest impression,
however, was made after I reflected on the diversity of surgeries I had
scrubbed during my clinical rotations: laparoscopic appendectomies,
below-the-knee amputations, liver transplants, Whipple procedures.
General surgery was the only residency program that would provide me
with such a broad base of clinical training while allowing me to
visualize pathology with my own eyes and correct it with my own hands.
At this point, I already knew I wanted to work with critically ill
patients – now I knew this was the way I wanted to do it. Throughout my clinical rotations and research, I found that my
undergraduate training in chemical engineering has been one of my
greatest strengths. It provided me with a strong foundation in
leveraging scientific fundamentals and statistics to objectively inform
decision-making. As with surgery, engineering was also team-based and
results-oriented with a focus on effective communication. From a
research perspective, I was able to utilize this foundation throughout
the research process, whether it was coordinating and training a team of
my peers to collect data, drafting manuscripts and responding to
reviewer feedback, or presenting findings at surgical conferences. I
look forward to continuing to build on this foundation at the next level
of training. Looking towards the future, my goal is to become a specialized surgeon-
scientist at an academic center with an active role in clinical
practice, research, and teaching. Ultimately, I hope to make the most of
my career in surgery, whether it’s providing care to patients, improving
clinical practice through research, or training the next generation of
physicians.
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Sample Interview Questions
CV questions: - Tell me about your research; what journal was this in? What did you find? - How do you stay involved with your hobbies in New Orleans? - Tell me about your leadership - Tell me about (hobby) - Tell me about (activity from cv) - What have you learned from your research experiences - Tell me about your leadership experiences - Tell me about what you learned from your research - Tell me about what you learned from your mph years - Very detailed questions about your research (what datapoints did
you get form UNOS? Where did you get donor data? Why did you choose to use alemtuzumab as an induction agent in this transplant paper?)
- What was your favorite project you worked on and why? Vs what was the hardest research project you worked on and why?
Role- Playing/Scenario Questions: - What would you do if you were the PGY2 on the team and your chief was screaming at the med student and you felt it was unwarranted? - What would you do if you came for sign-out in the morning and the night resident was nowhere to be found and now you're unprepared for rounds and your team is mad at you? - Pretend im a 75 year old man with a mass at the head of the pancreas. Talk to me. - Pretend im a patient POD3 from a vascular graft and now I have an ischemic limb. Talk to my family about what we should do. - Your pager goes off 3 times. One is a 6hr post-op chole in the PACU with a nurse complaining of nausea/vomiting and incisional pain. One is a Medicine resident calling from the floor with an active GI bleed. One is a floor nurse calling about a 12 hour post-op thyroid with some shortness of breath. Who do you go see first? What are your steps in decision-making?
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Personal Questions:
- Who are your role models? - What’s the coolest thing you’ve ever done? - What is your greatest achievement? - Tell me about a time you’ve worked with someone difficult? - Tell me about your leadership style? - Which rotation do you think you’ll like the least as a resident? - What motivates you? - Give me three things to tell the ranking committee about you. - Tell me something that’s not on your CV. - If you couldn’t be a physician what would you do with your life? - What’s your ONE biggest failure? - Why did you go to medical school - Do you think having a parent as a physician influenced your decision to be a doctor? - Why surgery? - If you couldn’t be a surgeon what would you be in medicine - So why not be a _______? - What’s your favorite operation/case? *Be able to describe it* - What would you change about Tulane? - What would you add to the ___community? - What would you do if you couldn’t practice medicine that you think you would also be equally good at? - Tell me about a case that was meaningful. *Again, be able to describe it.* - What’s your favorite book? - Tell me about a time someone was difficult to work with and what did you do about that. - So residency will obviously be stressful talk about a time you handled stress in medical school. - When was the last time you cried? - Tell me about a team that you’ve been on for longer than 4 years, and a challenge you’ve overcome together? Cannot be family
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Tough Questions:
- Immediately: “So what questions do you have for me?”
- Why would I pick you? - Why would I pick you when you didn’t come here for college/med school without a regional tie. Why would I believe you want to come here now? - I already know people like the outdoors here- why else would you want to come here? - I think your research is questionable don’t you think? - Who is your favorite surgeon in history? - Tell me about people you don’t like to work with and how you handle them. (While not particularly “tough” this one is hard to answer because it is basically asking you to complain. Be positive!) - Why is your Step score low? Didn’t Honor surgery clerkship? Not AOA? Aspirational Questions: - What are you looking for in a residency? - What type of surgery do you want to practice? - Where do you see yourself in ten years? - We have two research years here: what would you do with them? - Would you want to continue doing outcomes research or basic science? - What do you hope to do with your other degree (if dual-degree student)? Quirky Questions: - Teach me something interesting that I don’t know about or tell me something funny. - What would your patronus be? - What house would you be in in harry potter? - What character would you be in the wizard of oz? - What’s the spiciest thing you’ve ever eaten? - What superhero would you be? - I see you have exercise listed as a hobby, did you workout this morning before the interview?
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Illegal questions:
- Why would you pick ___ over Tulane? - Are you interviewing at (place you did an away)? - Why would you come here instead of there? - Where else are you interviewing? - How many other interviews do you have - How many interview offers did you get, how many are you going on, and how many are you ranking? - “Do you have a boyfriend?” - What are your top 5 programs? - Are you planning on having children in residency?
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