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How to Pick Individual Residency Programs: FREIDA


It’s application season, and while this takes place every year, we only go through it once (thankfully), and thus the >25,000 participating med students are unfamiliar with the process. There are a TON of considerations on selecting individual residency programs to put on your ERAS application. It can seem daunting to wade through the list of endless programs out there unless you are certain of a smaller specialty from the start. We’re going to start with the basics, for those of you who are really lost.

First, head over to FREIDA Online. It’s a searchable sortable database produced by the American Medical Association with over 9000 residency and fellowship programs.  After scrolling to the bottom of and agreeing to their policies, users can select their desired specialty (including sub-specialties and combination residency programs), geographic area, program size, and academic affiliation. Results can be further filtered by benefits, ERAS or NRMP participation, research requirements, or specialty training tracks.

Searches can be saved for later viewing, although this is generally not necessary. For the more popular specialties such as Internal Medicine, paring down the perceived 3 billion possible choices by all of these options still produces a list that still feels like 567,902 programs. In actuality, you should come out with a list of less than 100. It’s still overwhelming, but much better than when you started. Trimming that list down to your “short list” of about 20 total programs to which you will apply. The final push should come from academic advisors in your desired field. If all else fails, post a question to this post, and we’ll have someone look into it.

AMA logo, producers of FREIDAHopefully though, FREIDA Online will be a highly useful first step. For those of you wondering, the AMA application name stands for “Fellowship and Residency Electronic Interactive Database.”  Sounds about right. Good luck on the application process!

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National Residency Match Program Releases 2011 Match Statistics

The National Residency Match Program (NRMP) and Association of American Medical Colleges (AAMC) recently released the 2011 match statistics, which had not been previously updated since 2009. A copy of this latest version can be found here:

pdf icon2011 NRMP: Charting Outcomes in the Match
Characteristics of Applicants Who Matched to Their Preferred Specialty in the 2011 Main Residency Match – 4th edition

Specific data included in the NRMP match statistics includes:

  • number of applicants and positions in the main residency match
  • match rates by preferred specialty
  • number of different specialties ranked
  • USMLE Step 1 scores broken down by specialty
  • USMLE Step 2 scores broken down by specialty
  • Research experiences, abstracts, and presentations
  • number of work experiences
  • number of volunteer experiences
  • AOA rates by specialty
  • fourth years coming from schools with high amounts of NIH funding
  • fourth years with graduate degrees
  • all of the above information broken down by individual specialties

This last item is particularly helpful, as breakdowns include graphs that illustrate the percentage of fourth years who matched with a given USMLE Step 1 score. While this is not a perfect indicator of matching chances into your given field, the document as a whole is a good framework from which decisions can be made.

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Sites to See: The Eyes Have It

University of Michigan Kellogg Eye Center: The Eyes Have It
As a complement to the latest post on ophthalmoscopes, we are happy to share an excellent online resource for medical students to learn about ocular findings and signs that may pop up on physical exam: The Eyes Have It, from the University of Michigan’s Kellogg Eye Center.

The Eyes Have It is a site that provides a split instructional and quiz portion to both review and solidify ophthalmology knowledge. The information is straight forward, and creates a great overview for med students in the primary care settings, and a starting point for ophthalmology clerkships.

Papilledema and Retinal Artery Occlusion

For the first-year medical students, after you purchase your ophthalmoscope for the first time, take a good hard look in as many eyes as you can.  When something looks weird, this is the site to go to as your first step.  For the third year medical students, here’s a pimp tip that will make you look like a rock star: involvement of herpes zoster on the nose is known as Hutchinson sign, and is a good clue that the eye is involves in the outbreak as well.  Bonus points are given to anyone who can comment on the pathology of the above two images from The Eyes Have It.

Iris Collage

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Best Online Histology Database: Boston University

Boston University Histology Learning SystemHistology has generally fallen out of favor and focus for many medical school curricula these days.  Some med schools still have dedicated histology courses and mandatory histo labs with ridiculously priced slide sets, but most have transitioned to incorporating histology within other broader classes, and offer newer digital versions of labs.  Due to this transition, as well as the driving field of pathology, countless databases and software packages have been developed to allow for histopathological visualization of electronic slides.

Whether your school’s applications allows for “real time” zooming and scrolling, or just splatters the screen with images, most software options are not particularly great at teaching the topic. All too commonly, we as med students have instructions that go along with slides and read something like “as it is clearly seen, the eosinophilic uptake shows…” Most of the time however, we have no idea what we are “clearly” looking at. Short of capturing a live histologist and forcing them to use the neon microscope arrows to directly point out key structures to make sense of it all, the next best thing is using a database that directly points to, circles, colors in, and directly labels what you need to know.

There are few free online databases out there, but the Histology Learning System from Boston University is among the best. Sure the background is a dull gray and the site navigation is a bit static, but the content and (more importantly) label system are a sure fire way to both learn and teach the material. This is especially useful when you find yourself needing to put together that annoying last minute power point presentation for some small group show-and-tell the next day.

The database breaks down all of histology by system, and also has a sitemap with every image listed.  Upon loading an image, users have the option of clicking on the LABEL button to figure out what they’re actually viewing, or click on a black rectangle on the image to increase magnification (enhance!) that structure. Some structures are rather straight forward and have no enhanced images, while others can go several layers deep.  Chances are, the histology professor or local guru at your medical school can recognize the BU histology database images on sight, as they are relatively well known in the community and characteristic.

Whether you need a complementary learning tool to be used with your class syllabus, a stand alone reference as you go through medical school, or a database of “normals” to contrast with pathology studying, the BU Histology website is highly recommended.

To prove your gunnery and attain bonus internet points, name the structures contained within this post by commenting here.

Boston University Histology Learning System

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Best USMLE Step 1 Score Calculator

Part of going through the United States Medical Licensing Examination (USMLE) Step 1 exam is gathering a ton of information just related to the exam itself, outside of medical knowledge. There are countless documents on the internet that overview the timeline and test taking strategy.  Some are reasonable, and some require 2 hours of sleep per night and IV fluids to get through the study plan.

Regardless of how you go about studying, being able to gauge your progress is generally an asset.  For this purpose, I recommend the Clinical Review USMLE Step 1 Score Calculator, as it is one of the best Step 1 Calculator out there, but it should be taken with a grain of salt. No USMLE boards calculator is going to be able to predict your end score with pinpoint precision (or is it accuracy?).  However, this is a rather comprehensive resource that can be used with a number of question banks to roughly track progress as you go through the studying process.  Specifically, it uses NBME CBSSA raw scores, USMLE World 3 digit scores, USMLE World QBank Percent, Kaplan Qbank Percent, and Clinical Review Qbank Percent to generate an approximate USMLE Step 1 3-digit score with standard deviation, USMLE Step 1 2-digit score, and USMLE Step 1 percentile.  Be sure to complete at least one if not several timed max-question qbank sessions for this to be meaningful.  Pulling a step 1 score from an 80% on 10 USMLE World qbank questions may make you feel like a rock star, but it’s not incredibly accurate (precise?).

A small version of their calculator is below, but you can head to their site directly if you want to see it larger.  To be clear though, this is not an endorsement for their other studying classes or materials, which seems to be generally unknown/unused by most medical students.

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