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Family Medicine

Where to start

You have many great resources available to you. Talk to anybody you can find: family docs at UMB, other family docs you know, FP residents, fourth year students going into FP, and your fellow classmates. Dr. Rooks , the residency program director, is a great resource about different programs and about setting up your fourth year. Dr. Rooks and Dr. Reavis and the OSA Deans: Dr. Donna Parker , Dr. Joe Martinez , Dr. Elizabeth Lamos are also wonderful resources. Be sure to tell them your grades, board scores, and extra-curriculars; ask their opinion about how many programs you will need to interview at and rank, given who you are and which programs you are considering. If you are thinking about family medicine but don’t know much about it, attend FMIG activities – they are a great place to learn about family medicine and meet FP residents and attendings in a casual atmosphere. If you also feel like you don’t know enough about FP or its programs, consider attending the national meeting for the AAFP, where there are representatives from almost every FP residency across the country (and the best barbecue you’ve ever eaten). This conference is in early August in Kansas City, and there is often scholarship money to attend from both National AAFP and the Maryland AAFP ! Virtual FMIG is a great resource also.

Types of Programs

  • University vs Community, e.g. Univ of MD (university) vs York (community): With university programs, you will be at a tertiary care hospital with lots of other residents, fellows, med students, etc. With community programs, FP might be the only, or one of very few, residencies in that community hospital. Both have their pros and cons. Many university programs also have substantial training in community hospitals – e.g. their “home base” is a community hospital, but they do their Peds or OB rotations at an academic center. There are also many programs that are “university-associated,” which have a tertiary care center with many residency programs, but do not have a medical school attached to them.
  • OB vs. non-OB: OB-heavy programs often have 100-150 deliveries in 3 years, 3 months or more of OB in the curriculum, and opportunities to do C-sections. Less heavy OB programs have 40-60 deliveries in 3 years and 2 months of OB in the curriculum.
  • Reproductive Health Education In Family Medicine (RHEDI) Programs : A growing number of family medicine residencies now offer comprehensive training which includes didactic and clinical training in contraception, pregnancy options counseling, hands-on abortion training, and pre- and post-abortion care. Some programs offer training and services in the residents' continuity clinics as well as in high volume settings. The residencies listed provide abortion training that is integrated into the residency curriculum or offer a local elective. These programs are interested in attracting residents who seek training that includes abortion care.
  • Programs will be suburban vs. urban vs. rural depending on its location. Overall, you should consider applying to a variety of programs, as there are a lot of different kinds of programs and interviewing at multiple programs can help you get a better sense of what is out there. You may be surprised.

Timeline

July

  • Look at the Directory of Family Practice Residency Programs at www.aafp.org or in the OSA. The directory gives some basic information on each program. You can also utilize Frieda online if you have an AMA log-in.
  • Decide which type of programs you are interested in, but remember, you don’t have to decide everything before your interviews. Most people recommend applying to at least a few of both university and community programs to get a flavor of the differences.
  • Think about where you may want to live. Location of the program is going to be almost as important a factor as whether or not you choose a community vs. university program. Think about if you can see yourself living in that city/town.
  • Start updating your CV and thinking about ideas for your personal statement.
  • Do away electives if you are interested in being in a particular institution or geographic region. These are definitely NOT essential for the Family Medicine match process, as they are for some specialties, but might help give you a better sense of a place if you think you are interested.

August

  • AAFP’s national conference for students and residents is in late Jul/early August in Kansas City. This conference is a great resource and opportunity for you to meet program directors, faculty members, and residents from residency programs across the country. There are also several information sessions that cover applying to residency, writing a personal statement, parenting during residency, and other great topics. If you are interested in going, contact Dr. Colgan about the possibility for scholarships to attend.
  • Letters of recommendation. In this specialty it is not as important to get a “big name” recommendation as it is in other specialties, or to worry about getting recommendations from people in certain fields. Every field is relevant to Family Medicine. It’s really more important to have people write for you who know you well, from both a clinical and personal perspective.
  • Narrow application focus to ~20 programs.

September-October

  • Review transcripts before they are submitted to ERAS on September 15th.
  • Go over your program list/CV/PS with an FP attending or trusted mentor and ask for any advice they have to offer before submitting.
  • Applications – all use ERAS. Most deadlines are late Oct. to late Dec., but FP begins arranging interviews earlier than other specialties.

October

  • Proofread MSPE with an OSA Dean.
  • Begin to arrange interviews.

October-January

  • Typically, candidates for FM interview at 10-15 places (it’s ok to do more or less!). Be sure to attend dinner the night before with residents – this is often the best setting in which to get to know the people with whom you will actually be working.
  • Thank you notes or emails. (Not essential to match into a program). Be sure to respond to a program you intend to rank if they send you a personal email or letter after your interview.

January

  • Second look visits, if you want them.
  • Start thinking about your rank list. Decide what kind of program is important to you, where you can see yourself living, which group of residents/attendings you met that you could see yourself working with.

February

  • Rank list due. FP is known as a non-competitive specialty at this time, but it is becoming more so. Coming from Maryland, you can reasonably expect to match at one of your top 5 programs, if not your top 3.

March

  • MATCH DAY

Electives

Consider doing an elective at one of your top choices in order to see and be seen (again, this is NOT essential for matching). Arrange electives in March-June or at least 2-3 months ahead. Try to schedule electives in October/November/December. Consider a FP/ambulatory elective away from UMD so you know what FP is like at another location. York is just an hour away, an easy commute (they also provide free housing and meals). A great way to really see what FP is all about, if you are unsure about your choice of specialty. Otherwise, pursue electives based on YOUR interests in medicine – anything will be relevant to your career as a family doctor.

Sub-I’s

Almost anything will be useful. Try to do at least one month of general internal medicine. UMD/VA = teaching and supervision, Mercy and Family Medicine inpatient service = independence and self-confidence. Also consider CCU/MICU or Peds month. If done in July or August, a sub-I may be a good source of a letter of recommendation, especially an FP sub-I. However, don’t panic if you are unable to schedule one before applications go out. For FP, doing AHEC early on in the year might be worth just as much as doing an early sub-I. If you choose to do a Sub-I at an away institution, remember that it will be considered an elective, not a Sub-I, for your credit.

Letters of Recommendation

The majority of programs require 3 letters; however there are a few that require 4. Letters may be from any field, but some might require FP letters. Ask people who you feel know you well and would write a good letter including insight into your personality and character. Once again, VIP letters do not weigh as much as they do in other fields. A good way to ask is “Do you feel that you know me well enough to write me a good letter or recommendation?”

Personal Statement

Programs really do read these, and a fair number of programs will ask questions based on something written in your personal statement. One page single-spaced (you will be limited by what ERAS permits in terms of space). This is your chance to convey your personality and your enthusiasm for family medicine. Don’t simply rewrite your CV. Discuss interesting experiences, projects, electives, travel. Programs want to know about your motivation - why FP? This is one of the specialties in which AHEC can really be a benefit to you, especially if you intend to practice in a rural area. In addition, if you have any other special interests like sports medicine, behavioral medicine, geriatrics, academics, etc, it is important to discuss that and any experiences you may have in those fields in your personal statement. Feel free to ask one of UMB’s family doctors to look over it; they interview a lot of applicants and know what makes for an interesting and honest personal statement.

Applications

All done through ERAS. If you are applying to far-away places, it is even more important to get your applications in early to increase your chances of getting your choice of interview dates. Programs usually offer a limited number of dates, but if you can, try to cluster several interviews in a single trip - it saves time and money.

Interview Day

Allow sufficient time to travel. Have dinner with residents the night before if possible. This is a good chance to catch the residents when they can be completely honest with you. Review the program brochure/website and make up a list of questions. FP interviews provide a lot of time for you to ask questions; you don’t want to be sitting in silence when they ask what you want to know. Some programs provide lodging at their expense. Bring your significant other to the pre-interview dinner if you want – most places encourage this (this is family medicine after all). Get to know the residents – some programs let the residents decide about the applicants. Furthermore, these are the folks you’ll really being working closely with. Are they people you think you would get along with and enjoy? Find and meet any Maryland grads - OSA keeps track of grads. Get residents’ phone numbers or e-mail addresses for follow-up questions. Drive around the area and a get a feel for the place.

FP interviews are usually very laid-back and low stress. Usually you meet 1-2 residents, 1-2 faculty, and the program director.

Expect 3-5 interviews on a typical interview day. You will tour the hospital and clinic and have lunch with the residents. They will be selling their program and seeing if you are compatible. Review your CV and PS before the interview to refresh your memory. Remember what you wrote in ERAS, including your hobbies. Questions you are guaranteed to be asked: Where do you see yourself in 10 years? What kind of practice do you see yourself having? What do you do with your free time? What are you looking for in a program? Talk about a challenge you have faced. How did you hear about our program? How did you get interested in FP? Do you have any questions about the program?  

If you have not heard from a program, call and inquire about the status and completeness of your application.

Have questions ready to ask every interviewer

  • What are the strengths and weaknesses of this program (can ask residents what things they would change about the program)?
  • What changes do you foresee in the near future?
  • Where do your residents go after graduating?
  • How many grads practice OB?
  • What sort of procedural training do residents receive?
  • What is the service/board exam pass rate? How easily do problems get solved?
  • How much input do the residents have?
  • What are the demographics of your patient population?
  • What is the personality of the program?

Think about who you are talking to when you ask certain questions – residents, clinical faculty, research faculty, and program directors will have different things to say.

Second Looks

If you interviewed somewhere early, remember liking it, but are hazy about details, consider a second look. Most places do not grant further interviews, but you can often hang out on a service or meet more faculty and residents. Make sure the program allows second looks.

Questions

Fourth years students are a great source of information, and all of us would be more than happy to help you with any questions you may have. Also, all of the FP residents and attendings at Maryland are glad to help and offer any advice thy can. Good luck!

Last Revision: May 1, 2018