SOAP- Guide for an IMG to ace the SOAP

How to make your personal statement

Some talented IMGs will find themselves facing the toughest time of their USMLE to residency journey next month. They will be up against thousands of unmatched American graduates desperately trying to get the last few available residency spots in a period of five days. Programs will be on the lookout for these high value candidates who remained unmatched because of reasons like not having a complete application during match or not ranking enough programs or not going to enough interviews.

Everything you have heard about SOAP is true. It is difficult and unfair for non citizen IMG. But we here at AlphaIMG believe in giving our best shot at everything we do. Even if the bets are against IMGs on this one, we strive to be the BOSS at what we do.

Keep reading because I am breaking down exactly the actions you need to take and information you need to be the high value applicant that unfilled programs are looking for if you have to face SOAP.

 

# What is SOAP?– It is post match SUPPLEMENTAL OFFER AND ACCEPTANCE PROGRAM. Unfilled programs have a chance to fill their spots with unmatched candidates.

# Am I allowed to participate in SOAP?– If you have participated in the match and if you remain unmatched you are eligible. You will get an email on Friday before match week to let you know if you may be eligible in the event that you go unmatched. It does not mean if you matched or not.

So you can apply to unfilled programs during SOAP if

1: You do not match or only match to either prelim or advanced position without matching for both
2. You are ECFMG certified
3. You have signed up with NRMP
4. Did or Did not have an iv during the interview season

# What are my chances if I SOAP– as an IMG, the chances are not so great. In 2015, 13657 people (AMG+IMG) were eligible for SOAP. More than 40% of these applicants were non citizen IMGs. 25% were US citizen IMGs. Rest were AMG. 123 US IMGs were offered a position during SOAP and only 86 non citizen IMGs were offered a position.

# Can I apply to any specialty– yes, but look at your application and see if it is appropriate for the specialty. If everything fits medicines, applying to surgery will not help. Do not waste your 45 applications

# How do I prepare for SOAP– You have already submitted your application for match. You can only change certain parts of it. Like your personal statement and LOR.

# What if I do not match after SOAP- after the SOAP ends, you will have a list of unfilled programs and an opportunity of contacting them

# How much does SOAP cost? SOAP if free for eligible applications. You can apply to only 45 programs

6 things you can do to Be The Boss at SOAP

  • SOAP can be stressful. Be mentally prepared.. You will be checking your email every few minutes and have your phone handy at all times.  With each new round of offers, you will have to go through the list of unfilled programs, find the ones that you have a shot at, apply to the said programs and wait for offers.

 

  • Have personal statements ready for  other fields (IM, FM etc). Yes, you have only 45 applications. But, based on last year’s data, there will not be many programs in each field with open position. Each program will have multiple unfilled spots. So you will most likely be applying to other fields.

 

  • If you have LORs in other fields that you have not submitted for match or have received it after match, keep them ready to submit as well. You will be applying to different fields, see above

 

  • If your entire application is focused towards medicine, don’t waste your application on surgical fields. Programs are looking for high value candidates, not desperate candidates just trying to get in.

 

  • If you see a program that you have applied to before or have interviewed at and they have an unfilled position, try other programs before you waste your application on them. They did not like you the first time, chances of them liking you now are much less

 

  • Programs will generally schedule a short phone or skype interview before extending offers. If you do get an phone call, you don’t want to miss the chance. Here is what you need to do to perform your best on this interview.

Smile when you pick up the phone, it projects a friendly voice to the person on the other side.  Imagine as if you are face to face with the person when you start talking.  Do not keep your computer or any other screen in front of you, it distracts you and makes you appear frazzled on the phone.   Have a copy of your personal statement and CV in front of you as the PD will ask you questions about your CV. Be prepared to answer odd questions (not common  but it is possible): Why did you not apply to our program during match?  why do you think you did not match?
If you do not get any interview or offers, do not worry my friend. There are things you can do for next year. Be proud of yourself, you gave it your best shot.

 

RANK ORDER LIST- How to get this last step right

The anxiety is killing now. Match day is March 14, 2016 (March 18th to know where you matched). It is just a few short weeks from now but the wait seems forever.

                                        How to write a personal statement img

 

You have arrived ladies and gentleman. You cleared your USMLE exams, hustled your way into some observerships, got your name on a few stellar publications and smiled your way through interviews in high heels and polished oxfords. Now you reap the benefits of your hard work. You submit the rank order list, sit back and enjoy a glass of fine (but not too expensive) wine.

Like every other step (no pun intended!) you have taken thus far to make your dream of practicing medicine in US come true, this last step of rank order list needs to be well thought out and planned. Look on the internet about how to make your rank order list and every site will say- list the programs you think you will be happy at and do not list other programs. That sounds great, but not for an IMG with limited number of interviews or not so glorious scores.

I get it.  I have been through this myself and I get asked from  students every year before ROL submission. You do not want to spend three years in a malignant program. You are not sure yet if you want to specialize or not . You don’t want to be in a small town in middle of nowhere for your residency. You are worried if you accept J1 visa now, the waiver job will be in Podunk city on highway to ‘who knows where’
I was torn apart when getting my rank order list ready. There are so many things to consider when ranking the programs. University or community, fellowships, locations, weather, visa, family closeness, job options for spouse, gut feeling after the interview, friends who did their residency in the program and so on.

After seeing so many students go through this tough time in their life, I have realized this:

For us IMGs, it boils down to two pivotal things: fellowship and visa

  • FELLOWSHIP- If you are serious or even thinking about doing a fellowship after residency in any branch, you should rank the university program with most number of fellowship spots internally as your number 1. If you did not get an interview from any big universities with in house fellowship, then rank the program affiliated to the nearby university with fellowships. Even if it means J1 visa. Next pick the community programs without in house fellowships. The community programs will advertise how many of their residents have gone on to become cardiologists, gastroenterologist, etc. Good for them but we don’t know if they are IMGs/AMGs, what scores and applications they had. Fellowships are very competitive these days and being in a university with fellowship spots will be your best bet.
  • VISA: If you are not thinking about fellowship and would rather be a hospitalist, primary care or an urgent care doc, then focus your attention on visa. You rank the programs who offer H1 before those that do not offer H1. Plain and simple!

A few other important things to keep in mind

  • Don’t think of if the program is going to rank you or not when compiling your rank order list. Match algorithm is designed to favor applicants. That means you put programs you want to be in first (based on number 1 and 2 above). Not based on how you think the program is going to rank you. If they rank you and their spots are not filled by applicants ranked before you, your chances to match at that program are 100%
  • Deadline for Rank order list submission is Feb 24, 2016 at 9 pm
  • Rank each and every program you interviewed at on the list. The pain of not matching anywhere is much greater than matching at a program you are not too interested in
  • In USMLE exams, you do not change your answers at the last minute. Same way in ROL do not change your list at the last minute. Think it through well in advance and don’t make any rash emotional decision at the end

There are many other factors like being close to family, weather, size of the program, friends/seniors in the program etc. And they are all important based on your situation. But if you are hard core success oriented person like me then you want to get your foot in the door now instead of waiting one more year and be a year older graduate next match. You should rank the programs based on how they will boost your chances of future success

Stay in touch with programs after the interview without being annoying

The memories of my match days come flooding back in my mind. This was back in January 2009. It started getting cold and dark here in the US. The forums and blogs started filling up with posts from people who interviewed at every possible IMG friendly programs. Candidates with high USMLE scores asked others (publicly) if they should accept the pre-match offered at this program or not.

 I looked at my overused USMLE books thinking what am I supposed to do now. After a lot of hard work, I managed to get mediocre USMLE scores, interviewed at only a few places and had not been offered a prematch yet.

I thought to myself; should I just wait for the match day or should I be pro-active?

 

There are a few things you can do during this time to improve your chances to see the “congratulations, you have matched” email in your inbox from NRMP.

 

One of them is to remind the program how great a candidate you are. And the way to do it is the thank you letters.

Best graduate course personal statement

 Thank you letter act as a reminder to the program about you. We don’t want to be “out of sight, out of mind” when these program start ranking us before the match. That is the only purpose they serve. Not to reiterate your resume or ask more questions or send more documents.  Just to jog their memory a little bit about the great interaction you had with them

 

Here are some ways to make these ‘love letters’ more effective and make you stand out.

–          Write hand written notes.  They stand out in a bunch of generic thank you emails that programs receive from candidates

 –          Write something that makes them remember a conversation you had during the interview. In one of my interviews, I talked with the program director about my recent trip to India. He told me that he was planning to travel to India with his family.  In my ‘thank you note’, I told him the best time to visit that part of India and one specific thing his family would love there. 

–          Then you can say few specific things about the program that you loved

–          Think outside the box. If you did not have a great conversation with the pd or an attending, you can send a letter to the chief resident or program coordinator. When we rank candidates, we meet in a conference room with all the residents, attending, coordinator and PD and get an opinion from everyone about who should be ranked. So a program coordinator or the resident who spoke with you can impact the PDs decision

–          One candidate sent me a thank you/new year’s wishes note with his family pic (wife and kids). I thought that was well timed and thoughtful. I remembered him during match process!  

–          If the program says in their website not to send emails or notes after interview, then do not send them.  Most of the programs, do not have a specific policy. For those programs, it cannot hurt to send a thank you letter

–          Don’t expect a reply back from the program or don’t send them an email or call them to confirm if they received your note.

 

I would rather be proactive and do what I can if have fewer interviews than just be a ‘sitting duck’. I want to try everything I can to not waste one more year without residency and be an old IMG next year.  If you have interviewed at this program, if you had a great conversation with someone there and if you felt happy when you interviewed there, then there is no reason not to remind them about how well you felt when you visited the program and thank them for the letting you interview with them.  Its common courtesy… with a personal touch!

If you want me to help you personally with your ‘thank you notes’ or any part of your residency applications, contact me directly 

As always,

Stay awesome!

Identify the mistakes..

A medical student recently approached me for clerkship rotation in the university where I work. She obtained my information from my parents back in my home country. She contacted me through WhatsApp informally . She made some mistakes that I see other IMGs making in formal email communications as well. If you identify what mistakes others make, you will not make them yourself. Here is our WhatsApp conversation:


 

Student: Hi Dr. D, I got your number from your father. I need your help

Dr. D: Hi, I was aware you will get in touch. How can I help you?

Student: I am finishing up my medical school and internship in 2016. I will give USMLE step 1 after that. I want to do pediatrics in US. How are the chances for IMG?

Dr. D: I am glad you are thinking ahead. Chances for an IMG are pretty good.

Student: How is the pay in pediatrics?

Dr. D: The pay is variable depending on the practice and specialization.

Student: Can you give me a general letter of recommendation?

Dr. D: I don’t know your work so I cannot give you a LOR. Also, there is no general recommendation letter. Get a letter in the field you are going to apply.  I have a few friends who practice pediatrics. I can arrange for you to work with them and if they like your work they will give you a strong LOR on university letter head.

Student: When can I come for pediatric elective? Where will I live?  Also, I want to get some research published in PubMed. Can you help me?

Dr. D: Pubmed is a database of research journals. If you get your research published in one of the major journals, it will show up on PubMed. If you have worked on some research, I can guide you to get it published or presented at a major conference.  We can arrange for you to come in January- Feb for pediatric rotation. Once your travel plans are set, we will make accommodation arrangements.


 

First of all, I must applaud this student for working on her application in advance.  She is also well aware of things she will need to build a strong application.  If she would tweak her approach a little bit, she will have much better results with her application.  Since, my father’s friends referred her, I was patient with her. When I get emails like this from people I do not know, I am not as receptive. Here is how she could make people say yes more often to her requests:

  1. Do not mention pay in any of your conversation with people. This was an informal communication, so it is somewhat acceptable. But not at the beginning of conversation. We all think about it; we just don’t talk about it. That is what google is for.
  2. There is no such thing as a general recommendation letter. Always try to get your letter of recommendation in the field you are interested in. If one or more of your letters are from another field, ask them to write about something specific. They can write about your work ethics, professionalism, communication etc.

I learnt this after my cardiology observership. At the end of my rotation, I requested the cardiologist for a LOR. He asked me what I wanted him to write in the letter. I did not know the answer to that. He explained me that since it was an observership, he could not mention clinical skills in the letter.  I was always there on time, pretended that I was super interested all day (even though I was tired) and discussed cardiology topics with him. So he mentioned my professionalism, enthusiasm and knowledge of cardiology concepts in the letter.

Some letter writers will ask you to write a letter for them, which they will edit and sign. Keep these things in mind when you are writing a letter for yourself

  1.    Most doctors are busy and do not have time or incentive to host a medical student for a rotation. So make it easy for them to say yes.  In this case, student asked me when can she come for the rotation, where will she live etc. She is making it hard for me to say yes.  First get the rotation schedule. Then you can arrange for accommodation letter. There are online resources to find an apartment or room (rent.com, trulia, craigslist, university student group, Airbnb etc). You can ask the physician for recommendation on safe neighborhoods around the hospital.
  2. When asking for research publications or experience, it is better to look up what research the physician is working on. Then you can be a part of it if you are interested. If you are not, you can ask their guidance to proceed with your own research interest

 

In this case, after a lot of back and forth, I was able to schedule a rotation for this student in pediatrics with my friend who practices general pediatrics . She had some research work in medical school which she presented in an international pediatric conference.

We, IMGs are the most competitive residency candidates for residency programs. 1 out of every 3 doctors in the US is an IMG and there is still need for more doctors.  But we lose our confidence for reasons like low scores, accent problems, old IMGs, social anxiety or sometimes just feeling inferior to American graduates for no clear cause. The medical student I mentioned above seems bright and proactive. She just needs a little confidence boost and a little guidance to get her a great residency spot.

Stay awesome!!