Hello everybody, we're happy to welcome you to our final week of member May. I'm Christina Ganam, I'm the member engagement coordinator at the Academy. Just gonna go over some housekeeping notes real quick before I pass it on to our council board. The views expressed during this session are those of the individual presenters and participants do not necessarily reflect the positions of AAPMNR. AAPMNR is committed to maintaining a respectful and inclusive and safe environment in accordance with our code of conduct and anti-harassment policy, which is available at aapmr.org. All participants are expected to engage professionally and constructively. This activity is being recorded and will be made available on the Academy's online learning portal. An email will be sent after this activity with a link to bring you to the recording and an evaluation. For the best attendee experience during this activity, please mute your microphone when you're not speaking. To ask a question, you can use the raise your hand feature and unmute yourself if you're called upon or use the chat feature to type your question in. Just note that time may not permit for the panel to field every question that you have. Without further ado, I will pass it on to the council board. All right. Hi, everyone. I'm Buddy. I'm gonna let everyone else introduce themselves in a second. I am a PMNR resident with Michigan Medicine and I struggle with technology. So give me a moment in multitasking. All right. Maybe. Can everyone see the slides? We got it. We're not in presenter view, but we're getting there. Yeah. All right. What do you guys see? Just a slide? Same presenter view. Okay. Oh boy. All right. Do you guys see the slides? Just the slides now? Yep. Perfect. We're cooking. All right. Welcome to this Member May session, a match made in medicine, a guide to residency success with myself and then a bunch of other people that are much more successful than I am. Disclosures, we wish they had them. It's the classic joke, we're all broke. We're just like actually probably more broke than you guys know that we're in residency and just struggling to stay around and survive. We've all got lots of debt. So in all seriousness, we're all in this together and we are 15 minutes ahead of you guys. So just when you're asking questions tonight, remember like you are our future colleagues. Welcome to PM&R. Please ask any questions. I want you guys to feel safe to ask whatever you want. There's no dumb questions. I want to make you make sure you can have an informed decision with this process. Here's our panelists. I'll just briefly introduce myself again. I'm Buddy. I am the veep on the board. I'm with Michigan Medicine. I'm a PGY3. Fun fact about me, my dog is the world's largest chihuahua. He's a 47 pound chihuahua mix. Technically, he's nine different breeds. So we thought he was a bunch of other stuff that he's not. So fun fact about me, I'll let people one by one introduce themselves. Rosie, you're top left. So we'll just kind of go around clockwise from there. Hi, my name's Rosie. I'm a PGY4 at the University of Florida. I headed to Mayo Clinic Jacksonville for pain fellowship next. My fun fact is I've played tennis kind of since I was in seventh grade. So since I was in first grade, since I was seven years old. So it's been a fun time. I'll pass it off to Shauna. Hey, everyone. I'm Shauna. I am a PGY3 at UT Health San Antonio. I did not know we had to prepare a fun fact. So I'm just going to say that I'm a little bit ambidextrous after breaking my hand in the first grade. Kevin, you're up dude. Oh yeah, I got you. I don't know if it was HJ or me. Well, I'm Kevin. I'm a PGY2 at Vanderbilt. I'm originally from Southern California. And then my fun fact is I can touch my nose with my tongue. I'll pass it off to Andrew. Drew Woods. My fun fact, just to get out of the way now, I have three kids, one of which is sitting next to me right now. She's three and a half. So if you hear her, that's who that is. Wife is currently wrangling the two year old upstairs. I'm a PGY3 at UofL. So really happy to be here with you guys. And we saved the best for last with HJ. Well, I have a tough act to follow. My name is HJ Clark. I'm with Stanford PM&R. And I know Buddy was saying something earlier, but he's a chief resident. So he's awesome and successful. So I just want to plug in there. And my fun fact is I'm a huge musical theater gal. So I was in two world premiere musicals before I even started high school. So there you have it. And the show must go on. So objectives. Pretty simple. Discuss the factors in getting selected for an interview, including signaling and away rotations. Explain factors in the interview and ranking for programs. And identify approaches to ranking programs and addressing match surprises. Like we said, we really just want to make sure you guys feel prepared for this kind of next chapter of residency. And again, please feel free to ask any questions. Below down, we're going to go over some basic stuff. We're going to cover some facts, the pre-application interview process, interview post-interview process, and some new things for the cycle. So general planning and advice. Have a go at what your goals are. Do you have any specific training goals, whether it's maybe a certain specialty in mind or a location? Even though PM&R is a pretty niche field, you'll be surprised once you hop onto ERAS how many programs are actually out there. So it's a good idea to kind of do I know this region. And not every program has maybe as much heavy of a subspecialty exposure as others in something you might be interested in, say spinal cord injury. So make sure you do your homework on that. Start early with the process. Personal statements take time. I remember for myself when I was writing mine, I thought I'd be knocked out in a day or two, and it turned into a several week process. And I was really proud of what I put forward. But you're trying to really sell the brand of you and what makes you special. And that personal statement is that chance to tell that. So tell an authentic story and sell what makes you special. Also, letters take time. Thoughtful letters should take time. On top of that, though, the letter writers are sometimes a little distracted. They are attendings. So it's just important to be aware of that. You want to give them a buffer. And I didn't say this, but sometimes maybe you give them a little bit earlier of a deadline than the actual deadline is, too, just to be a little safe. Have people review your application. That's another one that's great. Typos, just punctuation things, formatting, all of it. You want to be as polished as you can. All those little things, they're helpful. They just make sure they really refine all the hard work that you put forward to make that application, the content behind it. So you want to make sure you're marketing the content the best you can. Ayse, you're up. So in terms of timeline, I think, you know, as kind of Buddy was alluding to, keep yourself organized. Make sure you know what your next steps are as you're going through. So the big deadlines right now, which you're all about to enter in a few days, June 4th is when your season officially begins. And I think the aptitude opens shortly after. So another key thing that was helpful for me when I was applying is, you know, you don't have to sit down and do all the chunks in one day. Do little by little. You can figure out the basic bios. You can fill in all the extracurriculars, you know, two at a time. So just kind of pace yourself so that you're not cramming all the way until the submission day. September 3rd is, you know, the official date that you can start to submit your ERAS. And unlike MCAS, which is, you know, you're a medical student, but I remember you had to really submit like really right when they open. I think residence is a little bit different in the sense that, yes, you still want to be early, but I think the programs really start pulling the apps starting September 24th. So I think quality probably matters a little bit more than trying to get in as fast as you can, I think, compared to the medical school app. And then fast forward, because it is a pretty long journey, you know, starts on June 4th, but you know, the match is not until March. So your rank list will happen sometime in the spring. Your interview will be sometimes in between that, which we'll all go into later on. And then the happy match day is for the upcoming year, the day before St. Patty's Day, it'd be March 16th. So that's the overall timeline. All right, way rotations. Kevin, this is your piece, my man. Yeah, I'll try to speak a little bit on it. I will give the caveat and I would love if anyone else can chime in here as well that I didn't actually do any away rotations, but given through my year in PM&R, I've had a lot of students come through on away rotations and things that I felt really made them excel or stand out was always kind of being available there to help and just willing to learn and not really boxing themselves in and saying like, I really want to do pain, I really want to do spine. They were very open to all aspects of PM&R. I think being okay with being wrong with how you're presenting certain physical exams. We're all learners through this and we're going to, that's the way we kind of grow through the process. So it's okay, you're going to be wrong. And I'm already being wrong through multiple aspects of my rotations, but just be very comfortable with that. And then for, I will say for a caveat before kind of handing it off to other people who did it in a way is my medical school actually didn't have a PM&R program. I ended up taking a year off getting a master's. By the time I came back, I didn't have time to do it. So I kind of formulated my own little makeshift PM&R rotation at my school where I found a bunch of PM&R trained physicians who were in pain, orthopedics, the VA, and just cold emailed people to hopefully create my own. And I feel like that was a beautiful experience. And also I was able to use that during my interview process to show kind of like initiative. So also a backup option for those who are unable to do away rotations, whether it be finances, travel, or your school won't let you. But if anyone else of my colleagues did away rotations, I would love to kind of have them give their insight. I would just say, I would add just from being on the other side of it now, I'm talking please, just from being on the other side of it now, what I've recognized is the people who do away rotations, it really is a double-edged sword. So I've seen people that come in with not a great paper application, they do an away rotation, and they rocket up our boards. Or the vice versa happens. They have a great paper application, they have a subpar or even just an average in-person rotation, and they fall. And so if you're like an outstanding applicant on paper, away rotations might present more of a risk than a benefit for you. If you're an applicant that isn't as strong on paper, but feel like you have good people skills and you have good in-person clinician skills, an away rotation could be right up your alley. So definitely take an honest look at yourself in your application when deciding whether or not to do an away rotation, because it really is the biggest risk, but also the biggest benefit. I matched somewhere that I did not do an away rotation at, but it was in my opinion less so. It was more of like a family situation as to why. And we were also, it was weird, our class was in the middle of COVID and so we were all restricted in terms of how many we could do. So I recommend to everyone, do two or three if you can afford it. But the more, the merrier. It's just you got to be in your game 24-7, right? So one slip up to the wrong person and you just tank your entire month. So it really is a risk-benefit analysis. Yeah, to go off of that too, I think timing of away rotations, if you are able, if you're on the, at the end of the day, do whatever makes you go to sleep at night, because that's the most important thing. And if you as an applicant feel strongly about doing this, then do it. Just show up, work hard, be a good human and show a willingness to learn. They don't expect you to be a physiatrist, they expect you to be a good person with a good brain that is willing to learn and be kind to others. And those little things like help the nurses transfer a patient and following therapists around and preparing. Maybe I saw this cool thing, I'm going to read about it and talk to you guys about it earlier. Showing those initiatives is super helpful. Something that I try to tell people that I learned from, I did two auditions, both of mine were based out of Ohio because of COVID times. And then I ended up getting, I was blessed to get my top pick, which is here at Michigan. So they definitely play a role in maybe getting some connections, some letters, stuff like that, but they aren't the end all be all with matching. But the timing of the rotation can be very helpful or hurtful. If you're dead middle of the interview season, which for at least from my memory was late October, starting November through January, into February, maybe a little bit. But I remember November, December kind of being that sweet spot of things. I was finishing up in a way in November and it was a kind of a weird spot because they were very kind and allowing of me to take interviews as I kind of had to, but I felt weird leaving that learning opportunity and that potential relationship to go basically like hang out with someone else. It's like you're dating someone, but you're also dating someone else. It was just weird. And then mentally too, I was very ready to just be like, I want to focus on my interviews. I want to smash these interviews. And when you're still trying to stay plugged in, like Drew said, and not make that slip up, it's definitely, it adds a layer of distraction that might not be a healthy distraction. So just food for thought there for everyone. And also lastly, to piggyback on what both Drew and Buddy said. So I actually was a medical student liaison for this coming year. So I saw every single medical student come through. The one advice is, if your home institution has a PMR service, it's really great to start there, get the feedback, and then do your addition rotation. And I can only speak to Stanford about this, but we do have to say that every single person who matched this year did do an away rotation with us. That doesn't mean that you have to. I think it just helps when you have, I think what Drew and Buddy said, if you are kind of excelling in your clinical skills and you're on your A game throughout the entire month, it can really go a long way. Based on my conversation with the PD today, I think at least Stanford is kind of shifting towards that way where we want to see people who are interested. By you rotating there, it's already demonstrating interest, but if you can also perform strongly, that's going to go the extra mile for you. But also, just know thyself. Don't get burned out in the process. Fight as much as you can chew. I think it can be a long journey. Great advice. Anyone else have anything else to add before I go to the next one? I was just going to add on to a little bit of what Drew was saying with the multiple rotations. If you're going to do two or three and you really have a place that you want to go to, maybe not starting out doing your audition at that place where you don't really know what you don't know or kind of how you're going to react and kind of giving yourself a chance to grow before you get to the place where you potentially maybe really want to match too, I think is also something to be aware of. All right. Shahana, this is you for research. Awesome. So kind of the big question of do I have to do research? I'm someone who personally doesn't love doing a whole lot of research. It's just not really where I thrive. But kind of with that being said, I still ended up doing research, especially as I'm hearing and seeing that PM&R is getting a lot more competitive. It was something that I kind of checked off my checklist and that a lot of applicants and what I've heard from my PD personally is that it's one of those things where because there's so many applicants now, it's just one of those checkboxes where it's important to kind of have. So at least I would say if you have one or two things that you can actually speak to that you enjoy. So it doesn't necessarily have to be in the field of PM&R necessarily. I did like sleep medicine for my friends that did different things that are in PM&R, but they were able to speak to it passionately during interviews and they knew a lot about it. So I would also say if you're going to do research, know exactly kind of what your research is about because those things actually will come up in your interviews and it will be important on your kind of residency trail. But do something that you actually care about. Don't necessarily just do it just to say, oh well I want to make sure it's related to this specifically. If an opportunity presents itself, I would say be open to it. And I think as physiatrists, we're curious and very kind people. And I think if you can exhibit that through your research and just say, oh I really was interested in this and this is why, we can relate almost anything back to form and function honestly with PM&R. And so I think that's something to keep in mind. And then in terms of kind of going about doing research, you can cold email people. This is a place where connections kind of also play a role. And I will say even away auditions, I had a resident at my institution here who was able to let me hop onto one of her projects when I was auditioning. And so even something as small as that of like, oh can I write this up as a case report could be considered your research. So there's a lot of ways you can go about it that I think, and I know this is a topic that kind of really stresses people out, but I think just taking a step back and thinking about what interests you and kind of going from there. But I do think it's important to have it as a part of your application at the very least one or two pieces to say I've done this, I've been involved in this project and this is why it's important to my application, this is why I care about it. Anyone else want to chime in? Yeah, can I just add? So in terms of research, great to have obviously for research, but really for anything. If it's on your CV, if it's on your application, it is fair game to be asked about. And if you cannot speak passionately about every single thing that's on your CV, take it off. Because if you get asked about it on an interview and it sounds like you're BSing me, it's a major red flag. Because now I'm not, you know, and maybe it was just I happened to pick the one thing on your CV that like wasn't a strong point in terms of what you're involved in. But now I'm questioning your entire CV, right? Did you inflate everything that's on there? So please, please, please be sure if there's anything on your CV, but especially reach, especially research, because we try and, you know, hey, let me jump on this project and just help out, right? If you can't speak to it, and it comes up in an interview, and you get caught flat footed, it will hurt you way more than just checking that checkbox. So for research, but for anything on your on your application, make sure you can speak to it passionately, or just don't put it on there. I'm gonna go ahead, Rosie, I was gonna say, so make what I did, like, if you have a lot of research projects, I kind of made a PowerPoint and just like, bulleted, like the key findings of each one. When I was interviewing the first time around, because I applied to Durham, I didn't match. So I have a bunch of Durham research for Durham, legitimately, one person went down my CV and was like, what did you find in this abstract, this abstract, this abstract, and I was like, okay, good thing I reviewed this, because I did not expect this. So that can be helpful. And the other thing is, like, don't lie. So if you weren't involved in something, don't put it in. I read somebody's ERS application this last cycle, I was like, I know this person was not involved in this. And I just put their application in the do not interview pile. So going off of that, like, I, I'm doing a pain fellowship interviews right now. And I've listed backpacking medicine, which is a two week online course I did in med school, because I was curious if anyone asked me about that. And they asked, like, tell me about this backpacking medicine class that you did. I was like, alright, cool, we'll do this. But like, yeah, so just be prepared to talk about it. It doesn't need to be this long winded story, but just be well informed. And make sure it's a meaningful thing you can talk about, you're better to having a bunch of a few meaningful things than a million things you really can't speak to. All right, we'll go to the next one slide here. Hj, this is all you. Yes, so I won't, I'll just be brief on this one, actually, because, you know, at the end of the day, you want to use a multimodal resources in many ways. So I think, low hanging fruit, residency website, social media, even I think a lot of the nowadays with COVID, people try to showcase things on social media, Frida. And I think most importantly, if you're able to do so talk to the current residents. And that's why I think away rotations are pretty helpful, because you can talk to the resident, you can see the resident culture. And when I was a little medical student, I actually like called dm, I'm going to be a big Twitter person. Sorry, it's x now. But I x dm people directly asking, Hey, can I just talk to you about the current program experience that you're part of. And so I have a lot of good social media friends now that I met at conferences, and we still keep in touch. So I think, I think a lot of the residents, I think we, I mean, everybody on here, I think will be happy to, you know, talk to anybody if anybody reached out. So I think that's one thing that'd be just good for you to get a hold of. And sometimes, you know, like, how do I how do you know which resident to reach out to? I think a lot if you go to like social media, like people do have what institution that they are part of, at least on Twitter, even LinkedIn, I literally called her the email somebody UW, she's currently the chief resident now, and we actually share the room during a P so you never know how long these how far these relations can build if you do it, right. So I think don't be afraid to reach out to residents, if you're able to be a social media via email, happy to provide my email at the end of all this. So feel free to reach out. And also, PMR scholars used to do this, um, I don't know, they're gonna do it this year again, but they also have residency fairs. So they have by different regions, and it's like 20 minute presentations. So before I interview with programs, I just kind of take a look at those, those video slides that they record and also put on a podcast to learn more about the program, more so like the logistical nitty gritty so that you're not repeat asking some of these questions that are readily available on websites and this webinar to when you're interviewing. So those are some of the places where you guys can go to to look for resources. And I'll open it up to anybody else. Oh my gosh, they also have. Oh my gosh, yes. I gotta be on brand here. So yes, we also have, I think we also had a residency fair, I think last year, which was awesome. So yes, amen to that. And then to add on top of everything that HJ said was gold. Most of the programs when you do get an interview to and get into that process, they usually have socials the night before, or maybe a few days before. I feel like that's where you can really get into the lowdowns of law, the residents and kind of get their vibe, ask them I use the question like when's the last time y'all hung out outside of like work and kind of see that aspect and then really see if it's like a workhorse program or if they have the specific specialties or rotations that you really look for in your training. Famous plug for UofL, we do in-person interviews. So we take you out to a nice dinner. That's so nice. That's Southern hospitality for you right there. At its finest and Dr. Wood will be there with this amazing additional perk. Also open houses is a big thing. Virtual open houses are a big thing. I think Stanford might do it this year, so be on the look at like on social media and things, but I think those are also great to go into if you're interested in a particular program. So next, we're going to do a little back and forth about advanced versus categorical. I'm talking, so I'll just hop in. I'm in an advanced program with Michigan Medicine. I weighed this a lot in my head, advanced versus categorical. For me, personally, I came down to the I don't want to move twice mentality, and a lot of that was really because my wife, who is a PhD, and I graduated one day apart, so I was kind of doing a weird unofficial couples match. And when I looked at programs, it was more of did I like this program, and if they're not categorical, how many TY prelim things are in the region, and I would apply to that region's intern years, and then whatever interviews I got from those intern years, rank them. I would say I'm more mixed, like Ohio State has like a three and three, if I remember correctly. Some are categorical, some are advanced. I would personally say my TY year, to not take it too far in the weeds, was the best intern experience I could have asked for, for what I wanted, and for me, what I wanted was a good medicine base, but don't keep me on the floors for 10 months, because that's a bad idea for everyone. I'm not God's gift to medicine, but I wanted to be a good poor man's hospitalist coming out of my intern year, and I wanted some elective time to really round out my physiatry and adjacent stuff, so I did like room and neurology, and I think I did like a wellness medicine type, lifestyle medicine type thing for a little bit. It was just a good all-around year. I got all the base stuff that I felt I needed, but be honest with yourself about what your goals are, and if you're not taking it too far in the weeds about IM versus prelim, prelim versus TY versus surgical years, but there are subtle differences, but my class is a representative from all three things, and they all came in very ready to do PGY2 year at Michigan, where we have a good level of complex patients in IPR. They just had different learning curves, and everyone had different things to adjust to, but I felt perfectly comfortable working with my co-residents, and if anything, they felt I felt more comfortable with them than they probably did me, so you can get great training where it's a matter of what you utilize with it. And then I went to a categorical program here at Vanderbilt, so I can speak a little bit to that. Kind of similar to Buddy, my wife is a pediatric resident, so we couples match, and that was something that was very near and dear to our hearts is really to stay together, and so categorical programs are really put to the forefront, and even with that, we still looked into some advanced programs and trying to do kind of the TY internal medicine, and it just became way too much of a domino game, as you will figure out after interviews, but I feel the categorical experience was really nice. Now kind of going through it and looking back at it, finishing PGY2 now, one, I feel Vandy is very well known for the internal medicine aspect of it, so I will say I did learn a lot, and now I'm not scared of anything really medicine-wise, but you do get to form that bond with a lot of your internal medicine colleagues, your surgical colleagues in that first year, so that way when you come into the rehab hospital and a lot of the patients I usually get are from that same institution, you have all of their numbers, you know how that process works, and so it becomes a smoother transition where you need to get discharge summaries, you need to have people follow up, you can ask questions very quickly, and so I think that was a huge benefit towards it, but as Buddy kind of says, it really, I feel your internal medicine skills, you really get one year, or even your surgical kind of exposure, you really get that one year, and then you're off into learning your rehab medicine, so depending on your famous thought, really maximizing that one year is a good time, depending on what your skills that you're looking to build. I did a TY, I put a link in the chat to a recent AB PM&R article that was just published, so they looked at, I forget how many years they went back, but looked at the board pass rates of PM&R residents who did a TY versus an IM versus a surgical year, and they found that if those who did an IM medicine year had the highest board pass rates, so there is something to be said that you're giving yourself a stronger foundation, like Buddy had said, so I did a TY, there was definitely a steep learning curve for me. When I first got to Louisville, we take transplants, we take LVADs, like stuff I never saw at a community hospital TY year that I did. I did three months of medicine in a month of ICU, like it was fine, but it was not enough, at least based on the acuity of patients that I saw. With that said, there's some TYs, though, that are just as exhaustive or more so than some prelims. They're really preliminary medicine programs that disguise themselves as TY years, so there's really a fine balance. Every situation is different. I was in a similar situation that Buddy was of like I needed to stay near Louisville, and I didn't actually match to our preliminary medicine program, but I matched to the TY program two hours away. Louisville this year is categorical for the first time, so I'll be interested to see how the interns, when they become TYs and they know the system, kind of how steep is their learning curve, because, you know, all of us came in as TYs not knowing who to page or anything like that, and now our TYs, not this year but next year, will come in already knowing the UofL system, so I'm really interested to see how that goes moving forward. And I think I'm bleeding into the next slide a little bit, but I did an internal medicine advanced year, also I guess prelim year, and then I did an advanced program, so just want to make a quick note that not all programs will offer categorical, and if you're confused about the terminology, I think a categorical, comprehensive, all-in-one place, advanced is you're separating your intern year from the programs, so just number one, look at, you know, what program each offers, because some programs will offer both some prelim versus some categorical positions. I think I chose to do internal medicine because I think I just wanted a strong foundation as I kind of went into an inpatient heavy year, so my very first rotation coming out of my intern year was actually spinal cord injury unit, and I think at least at the hospital I was rotating through, that was just notoriously very medicine-focused, and as even a PHY, I felt very comfortable doing calls and just kind of managing the medically complex patients, because I did 10 months of inpatient as an intern, so I did three months of ICU, and I guess you do the math, seven months of just inpatient, it was the hardest year of my life, I do have to say that, but I think I did walk away feeling pretty confident in my medicine knowledge and medical abilities, so, and also one other thing, if you're interested in moonlighting, which is probably, you don't have to think about that now, but as a resident, you know, you could moonlight at certain places, at least at Stanford, we can't moonlight if you're a TY year, it's only prelim, internal medicine, or surgery, or so, just something to think about down the lines, too, because some institutes may not let you moonlight if you're TY, but it's very institutional dependent, and I'm just speaking for my own institution. And I can add a little bit more on top of that, you guys sparked a lot more things in my brain, going off of the moonlighting, with categoricals, and I'm not sure of kind of the rest of the program, but here at Vanderbilt, you can moonlight as an internal medicine kind of doctor, covering the NP services, and that's like 900 to 1,000 per shift, where you're seeing less acute patients, and you're working less hours compared to your intern year, which is sweet to us. And then the second thing that I wanted to say was, I'm not sure if all categorical programs are like this, but at least at Vanderbilt, you do get to do a few weeks of PM&R during your elective times, which kind of really gives you that little bit of crispness that you're like, you know what you're looking forward to after you finish this year, which I'm not sure if that exists at the TY or IM programs, or all the other categorical programs, but just another plug for categorical. So I did a surgical prelim, because I could not stand internal medicine, and then TY as a foreign medical grad is pretty hard to get into, so I really enjoyed my surgical year, and even though it is surgery, like not all surgical programs, prelims are made the same. I got into OR a decent amount of, for a decent amount of cases, their goal was typically 50 to 100 cases, even as a PGY1, but we also had pretty strong medication management and stuff for a surgical program, but not all surgical programs are like that. Mine just happened to be that way. It was a lot more medicine than I expected, but it did end up preparing me relatively well for PM&R too. I ended up only applying advanced programs, because I, and I would say if you're in the case where you didn't match and you don't want to repeat your prelim, that's kind of the route to go. Just for clarification, go ahead, go. Oh sorry, just one last thing. I also did categorical, and kind of agree with everything that everyone else said, great advice. I also went back, and for my prelim, IM, and TY years, which is what I applied to, and then ultimately the categorical years, the intern year that was included with the categorical years, I looked at kind of exactly what the rotations were, because I was also of the mindset that I want to have a really solid medicine background, and so different categorical programs will have different internal medicine years as well, so that's something that is always a good question you can ask during the interview day as well, to get more information, because ours was also very medicine heavy, and then we had some ICU months, but they were all pretty relevant to PM&R, and then we had like rheumatology, ortho built in, and I will say like building those relationships early was really invaluable, especially when you're a two, and having to call so many consults when you're your primary on patients, and then you know, you're like this, sometimes it's consults that you don't necessarily want to call, and your attendings are like you should call this consult, and it makes it a lot better when they're relationships and friendships there, that I think is something to consider, but that's also something you can kind of compare, so if I know it's not apples and oranges, but you can still look at kind of the breakdown of what the rotations are if you're kind of stuck between the two. The last thing about this, so just a caveat for those that might not be aware, IM versus TY, like prelim versus TY are different ACGME criteria, that is why TY has more like flexibility in the schedule, versus a prelim year you're considered basically on paper an IM resident for that year, so you have a little bit more restriction under ACGME things, that is why the TY years tend to be a little bit more flexible, and then within that when we're applying, we're also applying with my current residents for like radiology, dermatology, like all the other cool fancy fields out there, so it's a wider pool, and a lot of these people are looking at it saying I just want to avoid the floors, usually, and again to people's prior points, you have to look at the curriculum, usually the TY years have less floor months, so they tend to be a little bit more competitive with TYs, but there are TYs out there that don't fill, so it really just, my best best view advice, look at the curriculum, if you're looking at these programs, look who they currently have, look where they went, that'll tell you a lot about who they're willing to match, who they're interested in, and the kind of learning experience you could have. At the end of the day, if you leave your intern year knowing how to manage UTIs, pneumonia, recognize sepsis, like you're probably going to be okay, like if you can sneak in some wound management, that'd be great, like and like that's the kind of the high yield things of like make sure you can recognize when someone is dying and routine complications that an IPR patient will have, you can add to it as you go, but just at least for context what the IMT prelim versus TY subtle differences are. Oh Rosie, did you get about ranking and stuff too? Yeah, so this is great, that's gold Rosie, so to elaborate what I think she's saying here, if a program has like Michigan for instance, we have only advanced spots versus like I guess Ohio State does know that because I auditioned there, they have categorical and advanced, so what you can do is you can say your preference is I want to be at Ohio State for four years if I can, rank Ohio State say here on my list for categorical, the next slot is Ohio State advanced, it's a different code, you put your rank list in and then you can rank individually all of your prelim years and that rank is different every, can be different every time for your prelims, meaning if I matched at UC San Diego or Stanford, I would like to, and they're only advanced we'll say, I would like to be going to these prelim TY whatever years in this order and you can save that list, so for me like my Midwest PM&R programs, I had a Midwest entering your rank list and you can shift that around every time and your primary match is your PM&R match, not your intern year match, I know people that matched PM&R but they didn't match intern year for whatever reason, whether it was they didn't like it, they just didn't rank anyone in that area etc., they ultimately they match PM&R and they soap for their intern year, intern year spots as last I checked are not filling, so they are available out there and don't worry about if I rank St. Joe's Ann Arbor number one for my TY but I want to go to Stanford, that it's not your St. Joe's match that's going to match first, it's your Stanford match, does that make sense everyone? I'm happy to say that again but we'll go, if there's questions just message me in the chat. Next one, geographic preferences, this is something with signaling and everything else coming too, it's going to be helpful, the interview process with COVID created a lot of change, change can be good, change can be bad and also changes about perspective whether it's good or bad, the number of applications, so I was the first, I want to say the first or second class from my school that was like kind of dealing with this COVID stuff, so when I applied my program was like you need to apply to X amount of PM&R programs based off of our data, the problem is I start talking to my friends, I'm like how many programs are you applying to because everything went virtual and I was told maybe 15 programs and my friend said well I'm applying to 80 programs and I'm like for PM&R because I can and it's virtual so what's going to stop me, so it creates this kind of like freak out, everyone shotguns their applications everywhere, I didn't do 80, I did object, honestly I applied to 40 programs and it all worked out, being able to set your geographic preference and then the next slide which we're kind of, I'm just going to because we're kind of organically getting into this, knowing your signals and everything else too are very important because it allows you to kind of tell the program like where do I want to be and for me, this is a good advice from my experience, I'm a midwestern guy on paper but when I applied I needed to be by a large body of water, whether it was salt or fresh, my wife does aquatic habitat restoration research, so when I applied to like I don't know Florida where Rosie's at, they're like why is this dude applying from Ohio, like he's from cornfields and stuff but like I have reasons, so you can signal regions but for me I didn't fit a region, so I personally emailed individual programs that really stood out to me and explained my situation of you stand out for these reasons and then you're good for my wife and I kind of scenario but my situation was unique. Before I go into the new things for this year and we actually have the illustrious Dr. Woods to talk about this stuff too because he's been literally at the table for these discussions, does anyone have any questions about geography? Cool, all right Dr. Woods, you're up. Yeah, so like Buddy had said, I'm also the resident representative on the AAP's resident and fellowship program director subcouncil, so I was actually sitting at the zoom table when these changes were made, so I provided the resident and student perspective on these, so full disclosure ahead of time, I'm representing my own views not AAP's or AAP Menards or University of Louisville's, but so the signals are going from 8 to 20 which is a pretty large increase. The reason behind the increase in the signals is that what we found is the majority of the signals, I don't remember the exact percentage, were going to like 10 programs, right, we can all name those 10 most likely, I won't name them here, and then what they found was there's a large drop-off from those 10 to the other programs, and so what that told us is that a lot of people were using those eight signals to shoot their shot at one of those top, you know, 10 programs and then they were just blasting 80 applications to the rest of the country, which is fine, but if I'm University of Louisville, right, I'm cognizant enough to know that we are not one of those top 10 programs, and so when you signal or when you apply to my program without a signal, I have no idea if you really want to come here or not, or if I'm just one of those 80, and so what we found in our interview process was that a lot of times we would be offering interviews to people that we thought might want to be here in Louisville and it would take five minutes in the interview to realize they didn't really want to be here, right, this was just another interview for them to check off, and so that feedback got back to the RFPD through the program directors that meet at the AAP, so that led to the increase in the signals, so basically what this is going to boil down to is if you don't signal my program as one of your top 20, chances are that you're not necessarily going to be a strong candidate for an interview because if I don't rank in your top 20, do you really want to be here, so what this does is it kind of reduces your all's overall cost because the benefit of applying to 80 programs is now pretty minimal, and so in reality you should be applying to 20 to 30 programs, and from the program perspective we're now going to have a larger bulk of signals to pull from that then allow us to see who is truly interested in coming to our program, so using Buddy's case as the example, the Florida programs would be in his top 20, right, He would have used one of those 20 signals for the Florida programs and it would have been, you know, allowed him to signal direct interest. And if I'm the Florida program, why would Buddy signal me if I'm not one of his top programs, right? So it allows for both sides to have a more clear and honest representation because this is truly putting your money, in this case your signal, where your mouth is and really, you know, forcing you to really make a decision. So I believe that the signals are going to be really beneficial. There's other specialties that have done what we're calling big signaling. So you know, the big signal is basically 20 or more and they've all found positive results. So we're still obviously, you know, this is the first year, but we'll find out how this goes for PM&R. So that's for the signals. The one thing I will say is it really forces you to have a really honest conversation with yourself. So every single year the AAMC releases the match data from the year before. So you'll be able to see from match of 2024, I believe that data is already available. What were the mean board scores? What were the mean research numbers? What were the, you know, mean volunteer opportunities that were listed? All of those things get put together. Look at yourself and compare your numbers to those numbers. And if you're average, consider yourself an average applicant. You know, maybe you have an outstanding CV and you give yourself a little bit of a bump, but use that to kind of fit yourself around. Don't go shooting your shot to 20 programs because you're going to wind up wasting your signals. You know, maybe shoot your shot with two or three programs. Apply to 15 that are more reasonable and five that you consider a quote unquote safety application. You know, I have strong geographic ties. They're not a top tier program. And you know, I know a couple of the residents that are there, right? That's a better strategic approach to your application. In regards to the SLO, so the standardized letter of evaluation, that is a new implementation as well. ER has been using it for many years now. That's kind of where we took a lot of the data from to do this. And what we found is that the SLO reduces overall variability in terms of racial biases, gender biases that are inherent to any narrative format program or excuse me, a letter of evaluation. So this is going to reduce the overall kind of narrative letter that you would be asking a physician for. And only a physiatrist can write these letters, these SLOs. So it's restricted only to physiatrists. It's like the golden grail, the holy grail of a letter of recommendation. So this is what you want to try and do. AAP cannot force programs to only adopt the SLO. So what we're recommending is that each program request one SLO in addition to the other letters of recommendation. So basically one SLO replaces one letter of REC. My personal belief is that you should have one SLO, one letter from another physiatrist, a narrative one, and then the other would be, I would recommend having from like an internal medicine doctor or a neurologist or someone that's PM&R adjacent, but not a physiatrist that knows you well and has spent legitimate time with you because they are going to be able to speak more to your surrounding characteristics. So yeah, there's gonna be a ton of information coming out as we approach match time from AAP, PM&R, from AAP, from AOC, PM&R, all the various organizations are doing everything that they can to blast all this information out and to try and, you know, help not just the applicants, but also those who are, who are on the other side, the, the program side, because this is new for everybody. So unfortunately you guys are the first ones to go through it, but I think you'll reap a lot of the benefits from it as well. Buddy, can you pull the PowerPoint back on the screen for a moment? All right and just for transparency with everyone, we are coming up on time, not quite there. So we're gonna, here's just the SLO. This is just a few examples of kind of like Rosie pulled this from DERM and other websites, RADS. So it's kind of like basics of what it says. And then it gives like, what is the context of how much time they've spent with medical students in residence and teaching in direct contact, et cetera. Next one. And then it'll go into the actual nitty-gritty of like the applicant's actions and traits. And this one's in the 10th, like zero to 10, 11 to 20th percentile. And then they can pick where the student falls. Because right now, if you've ever seen a letter of rec, sometimes they'll say this student is great or excellent or outstanding. Well, where do all these compare? And some people used to actually have that in the Dean's letter and the Dean's letter actually had a code at the end where it said like, if they're outstanding, that means they're in this percentile. If they're excellent, they're in this percentile. So this is also a way to kind of eliminate that and give a good comparison with others. So in this case, they talked about communication, work ethic, intellectual curiosity, fundamental knowledge. Andrew, I don't know if they have actually published like what the PMNR one is going to look like. It has not been published yet, but it looks almost identical to that. Okay. And then they have a narrative section. So I actually, when I was applying previously, one of the programs required a standardized letter of rec. I actually had them do like a normal letter of rec that we just attached and they uploaded those things together. I don't know how program directors really viewed this, but you also just have the narrative section here where you can put in your rec. All right. Next one, which is always an issue is like, I got asked to write my own letter. So now how do you do this? You could say like, yeah, I can't really do this, but sometimes it helps to just like even draft, like look up what a regular templated letter of rec is, and then say like, and come up with some specific event that may have happened during your rotation, something that may have made you stand out in a positive way. That way also the letter writer, when they go back over it, they can be like, oh great, I remember this. Now when it comes to ranking yourself on this standardized letter, I hope that nobody asked you to do that because that is very hard. You don't necessarily know how you compare. Did anyone else get asked to write their own letter? No? No. And just for purposes, because the chat is not being recorded, so the slowly for PM&R has not been published yet. It will be hosted through AAP hopefully soon. Yeah. All right. What are the programs looking for in the app? In simple terms, is this person a right fit for physiatry? Are they looking at it for plenty money relaxation? Like it is, it's transparent to know that PM&R has a better lifestyle than other fields. With that being said, it's not plenty money relaxation. Like we do work, it is a phenomenal career with lots of job satisfaction. I'm very happy I did it, but there are days I question my life decisions, like as we all should, we work this hard. So when you apply, they want to see, are you a good person? Are you going to be good to work with? Do you have good fit for PM&R? Does your story make sense? Does your application make sense? And it doesn't have to be a classical, oh, like for me, I'm your typical jock that got hurt that was never surgical and I found PM&R and yay. Like, no, it can be your own story. Just make sure you tell your story through your personal statement well. And like Rosie had her own issue, her own story with Durham and everything and still was able to like sell herself and clearly be extremely successful. Like she's the president of the resident of stuff for our society. So it's your story, write it, make sure the app makes sense and have good quality letters or good quality slows. To Drew's point about earlier, the slow is very objective. Make sure if you can get a physiatrist thing, have a physiatrist fill that thing out, maybe use a subspecialty. Like I had an OB-GYN attending that did lots of leadership stuff in med school. She wrote about my leadership skills. Anyone else have anything else to add to that? I want to add one, but he pretty much tackled it all. I'm just going to give you the program director's perspective because I literally asked my program director this question today in preparation for this panel. And he, so these are his words, showing interest in PM&R, whether that is via all the things we talked about, but via research, via national organization involvement, you know, there's a AP, I know we are open up opening on medical student terms, but there's only two spots. So there's other ways that you can involve in national society, whether you're like the president of your state, PM&R state board. And also you mentioned like away rotation, because now the boards are becoming pass fail. I think doing away rotation holds a little bit more weight than it has in the past. So those are some of the additional things from the PD perspective. So I got an interview, now what? I'll let other people chime in, but be prepared. It's a simple version. I'll let other people out there to share their nuggets though. I think doing your research on each program, right? Because you want to read their mission statement and vision statement if it's available. They're all going to sound similar, but I think, you know, each organization has one. So speaking to that language will be helpful. And I think with the interviews, just knowing your why's, you know, why do you want to go into PM&R? You know, I think initially it was like, oh, what do you want to become a doctor? But now, why physiotherapy? There's so many other specialties out there. So telling your story, and that's why your interest in PM&R, your demonstrated interest in PM&R comes in handy. Because you're now saying I'm interested in PM&R, you know, through your involvement, I think that speaks volumes and your leadership or your research or your volunteer opportunities and what have you. And so just like telling your, being able to tell your story and packaging that well, and just knowing your audience, right? I think if a program gives you these are the people you're going to, you know, interview with in advance, then look them up. You know, look what, you know, institution they trained, look at their research, because research often tells you what their interests have lied. So I think those little things can go a longer way, because then you can make a little bit more of that connection with your interviewer. Because I think, you know, interviewer views are great, but it can also be a little bit subjective. It depends on who you interview with. And I think if you are doing a rotation, then speaking to a sense of like, okay, during your rotation, these are the things you've seen and how you fit into the culture of the organization will be helpful. And then piggybacking on what AJ was saying, having those typical questions ready and answers for it. What are strengths? What are weaknesses? What's a time you had a conflict? Typical things that you probably got during your medical school interviews, but now you've been through four years, if not more of medical school and having these patient encounters that you can talk about in an elegant way. As AJ was saying, why physiatry? Can you describe what PM&R is? What does it mean to you? I feel like that was a very common thing. Just weed out people who maybe not know too much about the specialty. And then there's one more thing I wanted to say. Oh, the have questions ready for the interviewers. I feel like it was, you go through the medical school process of getting in, and there's very much this separation where you're just like, please love me, get me in. Once you get into, I feel residency interviews, that separation shrinks a little bit. Still knowing your audience, these are going to be your colleagues, there's going to be your attendings. But I felt like it was a little bit more of a level playing ground, at least during my process, where they really want to see if you're a fit for them, but if they're a fit for you. And so some of the questions directed towards the chiefs or towards the faculty was like, oh, I saw that you trained here, and now you're practicing here. What attracted you to be at this place? Just get a good vibe of why they're here. Is there something that you can connect with them in that aspect? I feel like having those questions are always good. I would add on to what Kevin is saying, and having your elevator pitch for questions that are super common, like, tell me about yourself, because you're going to get that one so, so much. It's going to evolve over the course of your interview trail, but definitely that's a big one. And then even just like, yeah, YPMNR, things like that. And even behavioral questions. One of the residents that was above me was like, I googled a specific list of 100 questions, and she was like, and I would go through it with a friend or a family member, and they would just ask it to me sometimes on the fly, and I would have to be prepared. And so it's a fun game, but it helps you kind of prepare for interviews, especially if you're someone who gets nervous. And then the other thing I will say is for the questions as well. I think having questions that you're going to ask the attendings, the people that are going to interview you versus residents, I think is also important, because you don't, might not necessarily ask the same questions. And I feel like with the residents, you can ask them more about their experience right now, and kind of things that are more current and how they feel in their shoes. And so kind of having a list of both of those, so you always kind of have a talking point, and you're you know, able to get a lot of your questions answered as well. So yeah. Gold all the way around. Before I hop to the next slide, something I did, I had a rolling document of good questions, and it was like stuff that I came up with, but if I was on like a meet and greet, something that's a great question, I type that thing in there, added it, that way when I'm doing my thing, I'm interviewing here, I got my screen here, like I'm looking at the screen right now, and they could be like, hey, do you have any questions for me? And I could quickly look out of the corner of my eye, and like had in my one blank, I had 15 options to just read some words in front of my face. So that way you sound thoughtful and meaningful, even if you get nervous, and it actually allows you to kind of predetermine, like I'm going to ask the PD this question, or I'm going to ask this to Kevin's point earlier about like knowing what they did, like maybe this person's a stroke expert. So give yourself an opportunity to maybe ask about stroke education, knowing what their expertise is. Don't ask a pediatric physiatrist about how much neuromodulation they do in their department. They're not going to be able to answer that question, even though I'd love to know the answer to that question. All right, next slide. Oh, one last thing I wanted to add, buddy. These are like weird questions or like fun questions that sometimes people get really thrown off for. Those were kind of fun things that I did with my med school friends, where we would kind of just be like, tell me what your spirit animal is, or things like that, or like fun facts that you can just pull out, and that you don't really have to think too much about, because I feel like on the spot, sometimes you're already a little nervous, and so just kind of having those ready to, as much as you possibly can, just is helpful, honestly. All right, what are programs looking for on the interview? I think we already kind of addressed this, and we are getting a little close on time, and I want to make sure we respect everyone's time. Be prepared, ask thoughtful questions, be professional, have your background. Like, it doesn't have to be like, I don't know, the lighting, make the lighting good, make it somewhat interesting, don't look like a serial killer on a bland background behind you too. Like, it's better to have that than like crap on the wall, but also like, make it you. Like, I have coral things back here, because my wife did research in that, and like, she decorated it. It's cool when people ask about it, I can talk about my wife. I was a bachelor in my interview process with residency, so I had like this anatomy poster behind me that I got when I started med school, or resident, or undergrad, that one, and it was like this kinesiology poster. So, have something unique. One of my buddy co-residents had paint, like, very nicely professional looking, like, hand-painted Marvel characters, and when he matched into my program, I was like, oh, it's the Marvel guy. So, you can kind of sell a little bit of yourself that way too. Don't make it too bad or weird. You're better off going very, like, conservative, simple behind you more than anything. Have good lighting. Make sure half your face isn't blacked out, so you don't look like you're, like, in a spotlight kind of thing, and then to be prepared for the interview. Look professional. Moving on to the next one. To think or to not think. This is a great one. I'll tell mine briefly since I'm already on the mic. I had my tentative top five or so in the interview season. I would, my thing was, I wrote just a brief, like, thank you so much within a week kind of email, and then later on, like, a week or two later, I would hand write just like a, as a reflect kind of thing. It was authentic to that program. Don't make it a template, especially if you're, like, copying and pasting. It just looks bad if your dates are wrong, and I love Lexington, but you're really interviewing for, like, I don't know, somewhere in Idaho. That looks bad. So, like, if you want to hand write something, that's always helpful. The person that you guys really want to make sure you're paying attention to, though, is program coordinators do a lot of work behind the scenes, so please make sure you're thanking them. It is kind of like Christina is behind the scenes. Like, these are the people that are driving the engine behind the camera being off and everything, and we truly, you should be thanking them whether you are going there or not, because without them, you would not have the interview. Anyone else want to add anything? Coordinators are literally, I just put in the chat, are literally, like, the only reason why people know how to get dressed in the morning, it feels like. So, your coordinator, any time that you email the program, always cc the program coordinators, because I can guarantee you they're the ones that are keeping track of it, but, yeah, like, be nice to literally everybody, but especially the coordinators, because they hold way, way, way more power, but also do way, way, way more than you ever would imagine behind the scenes. And I will add to that, our year for COVID year, the program coordinator at San Antonio actually just found this out this year. She said, like, I basically was, like, a big part in selecting, like, your class specifically, so we have a lot of say, too, for rank lists and all those things. How do you decide ranking? My dad is an ER doc and I remember calling him about this and was just like, dad, what do I do? And he is the quintessential, like, it's some, he just has these weird one-liner pieces of advice. He goes, go where you're happiest. And for me, like, that's what I needed to just be like, I'm going to rank off of where I think I'm going to because if you're not happy there, then you're not going to succeed. But that's knowing me and my values. I have a buddy who's your classic neurologist who made an Excel sheet, had a metric value that he ranked on a one to 10 point scale for all the metrics he valued in a program. And after every interview, he added them up and had that summate and then re-auto-rank programs based off of summation. And he ran the data by his wife, just to be clear. And I'm just like, bro, you're such a neurologist, like, that's great, but that's not me. But do what makes you happy. So because at the end of the day, you worked really, really, really, really hard to get into med school. You worked really, really, really hard to put the application together. And you spent a lot of money along the way. So put your best foot forward that you can be proud of and be happy with and you can sleep with. If that means ranking this program before that one, do that. But you need to do what makes you happy and you can be proud of that way, wherever the chips fall, you have no regrets. But that's my personal opinion. A lot of other people chime in. 100% agree with Betty. I think, just think about where you want to go, not like how the program you think it's going to rank you. Because I think some people rank it based on, oh, I think I have a high chance to participate in this program. They send me like a love letter and all that, but just block all that out. Like, what do you want out of a program? And everybody's value is going to be different. Some people, it can be location, some other people, it can be location, because you have significant others with that family, but also some places may have specific niche things that you're interested in. So figure out what those three things are for you. And I think it will be very personal choice. But I think at the end of the day, you should be happy with any top three to five programs that you rank in. You should be happy to go there, not because it's like a backup choice, but because you're truly excited to be there. So whatever that choice is, I think there is no wrong decision, but you just have to make those personal decisions for yourself as you go along. One thing that was helpful as I was kind of going through the interview process, I'm an auditory person. I have a lot of feeling that I get through my voice. So I actually voice recorded myself, I actually voice recorded my reaction after the interview. And later on, because I forget, you know, if you do an interview, then I just go back and re-listen to how I actually felt like coming out of the interview. And I can hear, oh, yeah, I was actually really happy, you know, coming out of the interview here because the people were exciting, and the program really excited me. Oh, this program, probably not as excited as the other programs, you know, whatever those method is to remind yourself and keep your list of pros and cons and what have you, I think that's really helpful as you're kind of going through and making your rank list as you're going through instead of sitting in, like in February and trying to remember what you did then. So have a running list going and it's okay to evolve as you go through. Definitely keep notes. I did something similar. I just had a little, for fellowship, do it right now, reflection journal. Right after the interview, I don't call anyone, I go right to that Word document. I put X program I interviewed with, and I wrote right about how I felt. And whatever those first raw emotions are, do it before you start talking to someone and you start intellectualizing things, because we're all very smart humans. We're med students, physicians. So and then go back. If you have, and for me, what I did, I automatically would know, like, this is where this program is probably going to be in my rank list, and if it was close to another program, I just pull up my personal notes, reference the two, make my decision, and that was it. But everyone's got their own process. Yeah, I kept a running list and I pre-ranked programs as I was going through the pain application. So it helps. And it helps to write down what is key for you. So like, I don't know, you want more SCI experience, then you have that up top, so that, you know, you can kind of keep track as you go, because everything will jumble up in your head. For example, like elective time, some programs have one month, some programs have five months. Can you do a Waze or not? All these things are things you, can you moonlight? So just kind of have a running tab of what matters to you. I was just going to piggyback off a little bit of what Buddy said, like that first impression, because eventually for me, like the pro cons list, everything, when it came time to rank, I got really overwhelmed and ended up just kind of throwing that all out of the window and just going with like gut feeling. And so getting that first impression of like, how did I feel truly about this program? And do I still feel this way? And that's really how I made my rank list. And I think I was just brutally honest with myself. And I think the reminders like that of just writing exactly how you felt and maybe like why you felt that way are really helpful. Do I message my number one? Here, this is a personal thing. Everyone's going to tell you probably a different answer. My personal thoughts are, I get this, sorry, guys. My personal thoughts are, your classical top 10 programs are probably going to get for the most part who they want. So they probably won't put a lot of stock in that. If it's not one of those top 10 programs, it might give them a little bit of a head and give them a little bit more like, okay, this person's heavily interested in me. At the end of the day, again, do what makes you sleep at night and you feel good about. My top few, I just expressed a heavy interest in right at the end of interview season. It wasn't 20 programs. It was like three that really stood out to me. I said, hey, keep comparing other programs to you. I really appreciate our time. Best of luck. Something probably correct. But you don't need to say this. If a program asks you where you're ranking them, you do not enter that. That is an ACG violation just so everyone's aware too. Yeah, I really love Buddy's continued kind of whatever helps you sleep at night. It really is just great advice, right? All of our opinions are fine, but they're our opinions and we're not the ones. We have matched, right? Our anxieties about match are gone. I feel like as a mentor, I get more anxious for my mentees on match day than I ever was for myself. But this is your life and this is what you have to live with. If you feel like you're going to regret not sending a letter, send it, right? So just whatever is going to help you sleep at night, do that. But yeah, I love that advice. I feel like that's for everything. When in doubt, if it'll help you sleep better, just do it. I will also add that, obviously, I feel like this is common sense, but do not message more than one program or say to more than one program that you are my number one. That is, those are words that cannot be taken back. And I have heard about people getting blacklisted and PM&R is a small world. So just be very wary about that. So I feel like if you, once you know for sure, that's kind of the time to tell them if you feel very strongly about it. But just be careful about that. You can tell them that they're one of your top programs, but don't send that you're number one to multiple. Because if you say you're my number one and they rank you, say they have five spots, they rank you in the top five, they don't get you, that's weird. And also saying I loved you guys so much to 15 programs. It's a small field, but not a small field, but it's a small field. Like you're going to be like, wow, there's a lot of programs to get through. But at the same time, like it's crazy how interconnected we are as residents. Oh, you know that person? I know that person. The program directors have been doing this for years. So they know each other by their, like they have each other's cell phone numbers. My program director, I'm sure I know someone that Vandy. So if things seem fishy, they're talking too. So just be authentic, don't lie and do what makes you sleep at night. And hopefully that gets you through a very stressful time. And hopefully you can enjoy the journey too, because it is a, it's a long process to get there. And if you get focused on the destination, you lose process the enjoyment of the journey. And to have works hard enough to have the opportunity to even do a residency is a pretty special thing. You should be proud of that. Yeah, and don't intentionally leave bad comments about programs on Excel, unless it's like actually true. So they happened to somebody on the radiology side and they got doxxed. So they were just trying to get people to steer away from a certain program so that they'd be more likely to match there. That's not the kind of behavior you want to, in person, you know, present yourself with. Yeah. And coming up on the end, last few slides here. Thank you for those of us that are still on the feed. I stuck to the, what's going to help me sleep at night. I have no regrets. I have friends that do have regrets because they really, they objectively in my, at least I guess subjectively in my opinion, they overthought it. And they're like, well, this program seemed more interested in me. So I ranked them higher. And this program I really liked, I ranked them lower. So do what's going to make you happiest, make sure you sleep at night, recognize your values. My wife is the most important person in my life. So that was a huge portion of my value system, but that might not be yours. Also, if people ask something that we skipped over in the questions, feel free to ask the question again. Um, so this is our last slide. So yeah, if anyone has any last minute questions, feel free to throw in the chat or ask everyone is sharing their contact information that's been here. So thank you team. Um, to be honest with everyone, like the resident lineup we have here is very awesome group. You can't go wrong. Reach out to any of these people. If you have questions for any of us, these I you're I've been involved with it for a couple years now, and I just get blown away how nice of people these people are and how intelligent and kind they are. And then you realize like, because I choose for a lot of that they're just night, overwhelmingly like you get your bad eggs everywhere but there's just so many good people so don't be afraid to ask questions, make sure you're making good informed decision. Things I didn't expect during the match how tiring it was that's I guess my quick Pearl interview seasons long I remember getting close to my last few interviews and like I left my suits and Cincinnati sweater wear suits when I was 20 pounds heavier, it was a mess but thank God for virtuals. If you're really eager about a program try to get a few under your belt so you're less nervous on your day you're a little bit more season to like my, I was lucky to have like my heavy hitters I was able to line them up and like a week and a half. And they were all freshly in my mind so I can compare them well, and then they're all like two three weeks into my interview season but I was very lucky to have that opportunity just happened to work that way for me. So yeah, that would be the last bit I have. Yeah, Rosie don't rank the places you would be absolutely miserable. That is so important, and also like recognize like if you do this is what playing devil's advocates I have a friend who say well, it's better to have no job than it is to have a job and no job but like you value yourself you value, I'm on kind of team Rosie here like value your happiness value your self worth and betting yourself. That is the last we really have anyone else I'm going to open it up I'm going to stop sharing here. I do want to add one add the thing just based on that last slide is something that I didn't expect was, you are going to see a lot of these same people in all your different interviews, and as buddy has said and all my other colleagues that is such a small group and you're going to continue to see each other in the annual assemblies through residency. I just got back from the PGY to retreat that a PM and are posted and I remember seeing all these people in the residency interviews and now we're comparing programs and bonding so you are going to constantly see these people over and over again so enjoy the process, faculty as well. You know, whether they actually mean they're not like I really wish we got you and like they, but who knows, and then you'd like I wish I landed with you and I got a job. Yeah, it's future jobs future connections right so that's another reason why you're nice to everybody. No, I just want to say thank you buddy for spearheading and running this show and I think I know there's one more question in the chat that I think we can just read it out loud but when you talk about fellowships associated with the program. It seems like you have a specific interest. I did good to things open on there, just, you know, I think if you are passionate about something definitely bring that up as a entry into you know how you got into PM and are, but I think just based on what I spoke with the PD is not good to like lock yourself into a specific fellowship because you're, you know, you may change I came into sports and now I'm going into interventional pain along with my buddy over here. So just keep things open but I think it's okay to talk about your interests and and ask what the program, if the fellowship if there's a genuine interest just keep things genuine I think it's long as you're passionate genuine I don't think you can go wrong with that. And with that, thank you for coming and don't ask the TBI attending or actually don't ask the SCI attending what is your sports experience in the program, like, know your audience because the out the inpatient attendings are get very flustered and annoyed not as many people are picking the inpatient side of PM and are now. So, it may actually be to your detriment. If you're asking that for sports or pain specifically. Great, you're all here on like a Wednesday night, you could have done anything else so thanks for joining and good luck in the journey and you're excited to see you on the road and be colleagues in the near future. And plug for the new medicine positions have been a team and our keep your eyes out for that apply for that stuff. As you're going through apply for fit fit ambassadors is also cool state plug in a PM and are because we're all here for a reason and a PM and are is a great way to get that first cool experience of human or I had as a med student it was very special to me so the societies are awesome and they're also great opportunities for experiences that you can put in your CV and everything. As you go through your personal application process. So, and learning. So, use the societies, not just a PM and are but definitely a PM are cool. All right. Um, Christina, do you have anything else to add oh there's she put the link in Thank you Christina this is. I think you guys did a great job. I don't know if you guys added all your contact information in the chat. I'll just add the recording will be made available by at the latest next Wednesday so late as June 4, if not sooner than that, which would be awesome. And so far the recordings for the other member may sessions are available on the member may web page on our website. Thank you for being here, not just my, my co resident team here but everyone is here for just taking the time to kind of hear us out. We're happy to help wherever we can have a wonderful night everyone and good luck with your process.

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