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Urology

The Field

Urology is a great surgical subspecialty that offers a broad variety of surgery as well as significant clinic time and minor, office-based procedures. Urologists control how much time they spend in clinic and OR, and therefore the lifestyle is extremely controllable and desirable. It is also an intensely academic field, and offers strong academic opportunities, in addition to community practice. Urology is often on the forefront of technological advancement, being one of the first specialities to use the Da Vinci robot. Talking to Dr. Naslund as soon as you are interested can be very helpful to set yourself up to maximize your chances of matching. The other Univ. of Maryland urologists are also a great resource, any of them would be happy to sit down with you and talk. Programs are between 5 and 6 years and contain variable amounts of research (0 to 12 months), general surgery training (6-24 months), and Urology (3-4 years clinical).

The Application

  • Urology is a separate, early match (Mid Jan). However, the application is still through ERAS and opens on the same date (~Sept. 15) as those applying for the match in March. You will submit your application through ERAS and submit your rank list on AUA (first week of Jan). (http://www.auanet.org)
  • It is a competitive field, with a match rate of ~65% (295 of 433 who submitted lists matched in 2015). Grades, board scores, and letters of recommendation are very important: interview invitations are commonly based on these criteria. Some programs do use board scores as a way to make the intial cut and screen through applicants for interview invites. Research, either clinical or basic science, is helpful and gives you something to talk about at interviews. AOA membership is a bonus, but is not absolutely necessary.
  • Meet with Dr. Naslund AS SOON AS YOU ARE INTERESTED; you can meet with him or the other attendings again later with further questions.
  • Away rotations in Urology are a must. Programs like a “known commodity” and this will be a great opportunity to increase your chances of matching at a specific program.
  • Most people complete 2-3 away rotations (more often 2). You should plan on getting a letter of recommendation from the Program Director or Department chair at each away.
  • Step 1 is required by all programs, Step 2 is not required by most programs.
  • If your Step 1 is lacking, Step 2 can be a boost (although if your Step 1 misses their cut-off, they may not look at your Step 2).
  • If your Step 1 is solid, don’t worry about taking Step 2 until later in the year (unless you want to get it out of the way early). The caveat to this is that you’ll likely be taking it in the fall after completing a few urology aways and are further removed from Medicine/Surgery and the core clerkships from third year (you will forget a lot of general information during this time). Also, you’ll have to balance studying with interviewing and/or being on another rotation. If you take Step 2 after mid-September you can choose whether or not to release the scores to programs.
  • Nearly all programs accept applications through the ERAS system.
  • You should submit your ERAS application on the ERAS submission date (Sept 15 in ’17), as programs will start to offer interviews upon receipt of applications. Applying late will disqualify even competitive candidates, as programs receive upwards of 300 applications and interview only 30-50 students.

Timeline

3rd Year

August-December
    • Decide if you are interested in Urology. If you are then schedule a meeting with Dr. Naslund.
    • Try to get on a Urology related research project. An abstract, poster, or publication in the field will be a huge help during the application process.
December-January
    • Start to think about where you want to do Away Rotations. Go to student health to get all necessary vaccinations and titers (Hep B, MMR, varicella)
February- March
    • Apply for away rotations. Continue to be involved in a research project. Reach out to former Maryland students who are now Urology residents. They are a great unbiased resource and are close to the process.
March-June
  • If possible try to complete a Sub Internship or an Elective in Urology at Maryland. This will allow you to do more away rotations or other school requirements during the summer of your 4th year.

4th Year

July-August
  • Urology sub-I rotations during July, August, or September. These may be home or away institutions. If you did urology as a 3rd year, you might be advised to not do urology at home, as you could feasibly already have a couple letters of recommendation lined up from your time on the urology service. Away rotations are essential to show your interest in the field of urology, as well as obtain additional letters of recommendation.
  • Make sure your academic record is current. All discrepancies should be resolved, and all third-year clerkship grades should be in. Request your LORs starting in July, so they can all be collected in August and you have time to chase down any stragglers. Start to work on your personal statement.
  • Meet with Dr. Naslund (chairman) and another other urology attendings that you have connected with. They are your best source of information and your advocates during this process.
  • During these months you should become familiar with the AUA (American Urological Association) Matching program which you can learn about from the web site www.auanet.org. They have a listing of all the programs participating in the match this year, including whether or not they will be using ERAS or if they use their own application. It’s $75 to register for the AUA match.
  • Start compiling a list of programs to which you want to apply. Think about program size, location, length, research time (if any). An average number might be 50-60 programs, depending on your grades and board scores. If any do not participate in ERAS, you will have to contact them so they can send you an application packet.
  • You need four letters of recommendation. Urology is mostly interested in letters from urologists. One must be from Dr. Naslund; the others should preferably be from Urology attendings from UMMS and/or your away rotations. You may not know anyone very well, but bring a CV and personal statement with you, and with a quick meeting they should be glad to write you the letter. Urology is a very small, tight-knit field where everybody knows everybody, so getting a good letter from a known name during your away rotation can carry a lot of weight. Similarly, letters from non-urologists may not strengthen your application unless the letter writer knows you a lot better, or in a different way than your other letter writers.
August-September
  • Complete personal statement
  • Complete the ERAS common application, and any other applications for non-ERAS programs. Definitely try to have the application submitted, with 2-3 letters of recommendation also uploaded, on the first day. Programs will accept later letters of recommendation, but make sure to have them in no later than the middle of October.
  • Be sure to note the deadline for each program. In general, get yours in as soon as possible, preferably on the opening date.
  • September-October
  • You will hear from the different programs as to whether you are offered an interview or not. Schedule as many as you can fit in immediately, hoping for 10-15 interviews. Later, you may find conflicts and will have to choose which you most want to attend. Give the programs at least 1 weeks’ notice on cancellations.
November-December
  • Attend interviews. The earliest interview in 2017 was mid-October. The latest was in the middle of December. Schedule easy rotations around this time if possible (i.e. radiology, anesthesia, AHEC), or take these months off.
  • Send thank you notes to interviewers unless you were explicitly told not to. This includes chairmen, program directors, and anyone else you interviewed with during your visit to a program. Thank-you notes may be handwritten or e-mailed.
  • You may want to leave some extra time to visit programs for a “second look.” It can go a long way to show your interest in a program, but they can be a double-edged sword. You may learn more and show your interest, but also be prepared to get pimped, so stay current on your urology knowledge or the second look may be counterproductive. Remember the programs are trying to limit their own effort, so they may not want extra students around. The programs that look favorably upon a second-look will usually tell you during the interviews (directly from the chairman or PD, do not trust what the residents tell you in this regard).
  • Maryland will not interview you since you have already spent time on the service and they know you. However, if you have questions regarding urology at Maryland, try to meet with Dr. Naslund at some point after you know what you want in a program to answer any questions.
  • The interviewer wants to know two things: are you a hard worker, and can I stand to spend the next 5/6 years in very close contact with this person. Unlike medical school interviews, these interviewers have a direct stake in selecting people they want to be around. Common interview questions include:
    What questions do you have for me? (this may get asked 10+ times in one day) so come prepared with different questions for attendings and residents. (I.e. it is not appropriate to ask attendings about call schedules, etc.)
    What are you looking for in a program?
    What makes you better than the other applicants in the waiting room? (don’t answer this one directly, just talk about your strengths)
    Why did you choose Urology? (you probably already talked about this in your personal statement)
    What do you bring to this program?
    Tell me about (interesting activity in your application).
    Tell me about some research you’ve done.
    What do you like to do in your spare time?
    Do you see yourself in academics or private practice? (A good answer would be "I don’t know yet.")
    Is there an area of urology that in which you want to complete a fellowship? (Ditto.)
    Tell me about a challenging experience during medical school and what you did to overcome it.
    What is the most recent book you read? (take a book with you on the interview trail to read on planes)
    Tell me a joke
     
December-January
  • Talk to Dr. Naslund (and any other adviser or mentor you may have) about your list.
  • There’s debate on whether or not to contact your top choices and tell them where they stand. Some program directors tell you that this is illegal and that they don’t want to hear from you. Others will call you to find out your top choices. This is also illegal and you have the right to refuse to tell them anything. In all, it might be helpful to contact your top choices via mail or email to let them know you are interested, unless the director says otherwise. Second looks are an option if you can’t decide. If you decide to contact your top programs, tell your top program that they are “number one” and other programs in the top 3 that they are ranked “very highly.”
  • Send in your list by the deadline. This year, the deadline was January 3rd and match results were sent on January 18th via email. Sorry, no ceremony.
  • Note: Regarding away rotations: Students find this helpful if there is one place you are considering and want to get a more in depth look at the program. Also, Urology is a small world and this gives you one more thing to talk about at interviews. This also helps get your foot in the door, as many programs offer you an automatic interview if you do a rotation there; some will offer an opportunity to interview while you are there, others will invite you back for a formal interview. At any given program, there are 200-300 applications for 40-50 interview spots for two to three positions. So anything you can do to improve your odds may help. Jul-Sept are good times for an away sub-I. This also might be a good way to get another letter from a prominent urologist. Choose programs you are seriously considering for residency to do aways at. Also keep in mind that if you are an applicant who has spent most of your life in the mid-Atlantic or East Coast but would like to do residency in another part of the country, it is in your best interest to do an away rotation in that part of the country. This tells other programs in the area that you are serious about training in the Midwest, West Coast, etc.

Note: Most programs look to see if you have any research on your CV. This need not be focused in urology. If you have done work in either college or med school and have your name on a paper, this should suffice. If you don’t have any publications to date, then you might want to put something together with a member of the urology department. The programs just want to see that you have an interest in research and that you can talk about it. Others have no research and still have no problems matching because the rest of their application is strong.

GET TO KNOW DR. NASLUND, WORK HARD ON YOUR SUB-I AND AWAYS, BE NICE TO EVERYONE, AND TURN YOUR APPLICATION IN AS EARLY AS POSSIBLE! 

For more information please contact:
Nancy Ye
Alex Wang

Last Revision: March 20, 2018