AN INTERVIEW WITH MICHAEL PLATT MD, MSC
Residency positions in otolaryngology-head and neck surgery remain highly sought among U.S. medical students. The number of applicants to otolaryngology residencies consistently outpaces the number of residency positions each year, resulting in a competitive matching process. While the vast majority of U.S. applicants do match in otolaryngology, there are usually highly qualified applicants who do not secure a position in their graduating class. Residency training programs differ in the qualities sough in trainees and the selection criteria used for creating a ranking list is not uniform. Generally speaking, successful applicants have a strong and well-balanced application that demonstrates a commitment to the field of otolaryngology and patients with otolaryngic disorders. Each of the listed criteria below are important factors for students to consider in their application.
What USMLE scores do I need?
USMLE Step 1 scores were traditionally used as a screening cutoff to narrow the number of applicants. More recently, programs have recognized that this one test score may be over-valued compared to other measures of factual knowledge which were gauged over a longer time period such as a core clinical rotation grade. Despite these trends, the USMLE remains the primary mechanism to compare applicants between schools. Residency programs are required by the Residency Review Committee to maintain American Board of Otolaryngology – Head and Neck Surgery (ABOHNS) pass rates in their graduates which will not eliminate the need for candidates to demonstrate proficiency on standardized tests. Some programs use cut-off values for the USMLE at 230-240 whereas others do not have a minimal required score.
What medical school grades do I need?
Success in the clinical rotations is highly valued, especially with the core surgery and internal medicine rotations. Successful applicants often have grades of honors in many of their core clinical rotations as well as their otolaryngology rotation. It would be unusual for an applicant who is interested in Otolaryngology to receive a grade of less than honors if they were interested in applying to Otolaryngology.
Do I need to do away rotations to match in otolaryngology?
Away rotations are not required for a successful match. Many applicants often do one or two away rotations to gain exposure to different training programs, learn more about other facets of otolaryngology, or demonstrate an interest in a particular program or geographic region of the country. If away rotations are sought primarily to obtain a residency position at the away institution, applicants should be aware of the realities of match process. An away rotation often does not guarantee an interview or special consideration at a program. Applicants should be prepared to work exceptionally hard as the away rotation can be considered a one-month interview by the faculty, residents, and staff in a department. I always recommend that applicants discuss their interests in away rotations with their advisors since each situation is unique.
Do I need to do otolaryngology research to match?
Participation in research is a very important aspect of the application. Those applicants who can demonstrate a genuine intellectual curiosity and desire to contribute the field with research have an advantage when applying. I am always impressed by applicants who can start and finish a research project during medical school. Conversely, applicants who overcommit to numerous research projects and are unable to complete any projects are not as desirable. We realize that some applicants find otolaryngology later than others when there is insufficient time to accomplish specialty-specific research. Research in other fields based on prior interests demonstrates an ability to perform research and a commitment to advancing medicine.
Where should I solicit letters of recommendation?
Applicants are required to have at least three letters of recommendation. These letters are extremely important for a successful match. Obtaining letters from mentors who know you well, have experience with training medical students and residents, and who are nationally recognized is preferred. Department chairs, program directors, and medical student directors are often in a good position to write strong letters of support for students. Faculty members who have experience teaching but write less numbers of letters may be able to write a more uniquely strong letter. Letters from writers who have less experience with otolaryngology applicants are not as meaningful.
Is the personal statement important?
The personal statement is an outstanding opportunity for an applicant to distinguish themselves from other candidates. Those candidates who have unique insights, experiences, and exceptional writing skills can greatly boost their application. Those personal statements with lack of attention to detail, misspellings, or minimal effort can significantly hurt an applicant. The best personal statements make reviewers say- “I can’t wait to meet this person!”
If I have weaknesses in my application, should I do an additional year of research prior to applying?
The best reason to take a year of research is if you are genuinely interested in incorporating research into your career. If an applicant seeks to bolster an uncompetitive application, they should ask themselves- does research address the weakness? It is expected that a student who performs a year of research will demonstrate significant progress with presentations and publications. Those applicants who are not genuinely interested in research can hurt their application with a less productive research year.
Are there any other factors that are considered in an otolaryngology application?
Candidates who demonstrate excellence through awards, leadership, and individual initiatives are highly successful in obtaining interviews and matching. Each medical school has different opportunities for recognition whereas individual accomplishments are possible through outreach, volunteering, and global health.
Do you have any final thoughts?
Otolaryngology is a wonderful specialty—one where we help patients of all ages in many ways, both surgical and medical, short-term and long-term, from life-threatening to quality of life-threatening. The vast majority of medical students who apply to otolaryngology have a successful match. I would encourage all students who are called to be an otolaryngologist-head and neck surgeon to work with their mentors to engage in activities that contribute to the field and set-up a strong residency application.
Michael Platt MD, MSc, is the Program Director of Otolaryngology- Head and Neck Surgery Residency at Boston University Medical Center.