Tips to Get Selected for GME – A 2021 Update

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With the recent release of the 2021 GME note, I’d like to re-post an updated version of this post. I’ve participated in the last seven GME selection boards and would like to offer tips for people looking to match for GME in the future.  We’ll cover general tips and those specific for medical students and those returning from an operational tour:

General Tips

  • You can increase your score by having publications.  If you want to give yourself the best chance of maximizing your score, you need multiple peer-reviewed publications.  Any publications or scholarly activity have the chance to get you points, but having multiple peer-reviewed publications is the goal you should be trying to reach.
  • Be realistic about your chances of matching.  If you are applying to a competitive specialty and you’ve failed a board exam or had to repeat a year in medical school, you are probably not going to match in that specialty.  There are some specialties where you can overcome a major blight on your record, but there are some where you can’t.  If this is applicable to you, the residency director or specialty leader should be able to give you some idea of your chances.  Will they be honest and direct with you?  I’m not sure, but it can’t hurt to ask.
  • If you are having trouble matching in the Navy for GME, you may have a better chance as a civilian.  By the time you pay back your commitment to the Navy, you are a wiser, more mature applicant that some civilian residency programs might prefer over an inexperienced medical student.  You’ll also find some fairly patriotic residency programs, usually with faculty who are prior military, that may take you despite your academic struggles.

Tips for Medical Students

  • Do everything you can to do a rotation with the GME program you want to match at.  You want them to know who you are.
  • We have started our transition to straight-through GME, so you’ll notice that most specialties are considering applications from medical students for straight-through GME.  If you don’t want to do straight-through and only want to apply for internship, you can opt out on MODS.
  • When you are applying, make sure your 2nd choice is not a popular internship (Emergency Medicine, Orthopedics, etc.).  If you don’t match in your 1st choice and your 2nd choice is a popular internship, then it will likely have filled during the initial match.  This means you get put in the “intern scramble” and you’ll likely wind up in an internship you didn’t even list on your application.
  • Your backup plan if you don’t match should be an alternative program at the same site where you eventually want to match for residency.  For example, in my specialty (Emergency Medicine or EM) we only have residencies at NMCP and NMCSD.  If someone doesn’t match for an EM internship at NMCP or NMCSD, they will have a better chance of eventually matching for EM residency if they do an internship locally, like a transitional internship.  Internships at Walter Reed or any other hospital without an EM program are quality programs, but it is much easier to pledge the fraternity if you are physically present and can get to know people, attending conferences and journal clubs when you can.
  • You need to think about what you will do in your worst-case scenario, a 1-year civilian deferment for internship.  Many of the medical students I have interviewed did not have a plan if they got a 1-year deferment.  I think every medical student needs to pick a few civilian transitional year internships (or whatever internship they want) and apply to those just in case they get a 1-year deferment.  Per the BUMED note, this is required.  Most medical students do not grasp the concept that this could happen to them and have no plan to deal with it if it does.  It is an unlikely event, especially if you are a strong applicant, but it is something you need to think through.
  • Similarly, if your first choice specialty is offering civilian NADDS deferments, you need to apply to civilian residency programs.  This is also required, per the BUMED note.  You don’t want to find out that you were given a NADDS deferment but you didn’t apply for civilian residency programs.  This happens to people all the time.  Don’t be that student.

Tips for Applicants Returning from Operational Tours

  • You should show up whenever you can for conferences and journal clubs.  Again, you want them to know who you are and by attending these events when you can you demonstrate your commitment to the specialty and their program.
  • Always get a warfare device (if one is available) during your operational tour.  Not having it is a red flag.
  • Closely examine the GME note and by-site goals.  You’ll see that some specialties are offering full-time outservice (FTOS) or civilian deferment (RAD-to-NADDS).  If you are in one of these specialties, you need to consider applying for civilian residency programs.  If you are unsure, you should probably talk to the specialty leader for whatever specialty you are applying for.

2 thoughts on “Tips to Get Selected for GME – A 2021 Update

    Dustin Schuett said:
    July 15, 2021 at 14:22

    Excellent post with a lot of great tips for applicants.
    The increase in straight through training is especially pertinent to anyone who doesn’t get their first choice of internship. With the push to straight through training and the need for programs to bring back prior categorical interns to complete their residency training, the ability to do certain residencies without having initially been a categorical intern in that specialty will likely be dramatically decreased.
    Some programs may be forced to take less interns per year in order to meet the requirements of having all prior interns back and all incoming interns going straight through.
    Many interns not matching to their preferred specialty initially may find the paths of prior physicians of GMO followed by repeat internship to be much less available under the new system.

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      Joel Schofer, MD, MBA, CPE responded:
      July 15, 2021 at 14:50

      Please note that the issue of residency programs requiring people to have done a categorical internship is not unique to the military. It is one of the main reasons we are moving to straight-through training. Our current interrupted system is causing us ACGME issues.

      Like

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