Years ago when I was a radiology resident I questioned an OB GYN for ordering a CT on a pregnant patient. I wondered why there was no concern for irradiating the fetus, for which the OB GYN simply responded: “No mother, no baby”.
Learned an important lesson that day.
Residency MATCH week is here so please keep in mind.
If you match, people will see success but not all the hardship and hard work.
If you don’t match, people will see disappointment but not all the hardship and hard work.
Match or no match, the sacrifices remain the same.
Unpopular academic medicine post!
If you really care about diversity, it should be put into practice at all levels. Not interviewing IMG and/or DO students, but then having them as faculty when already accomplished is quite frankly too convenient, in my opinion.
#diversity
In this thread I will tell Monica story, who has been my mentee for the past two years. Her story is the story of medical dreams crushed by a system that often takes advantage of the vulnerable. A story of hope, hard work and invisibility.
This is her story.
1/9
Seems like most programs across all specialties are receiving considerably more applications this year.
>1000 applications for 8 spots seems excessive. This system has a lot of waste, which benefits only a few 💵, and we should advocate for a more efficient and fair process.
An applicant who previously sent us a letter of intent changed their mind and sent an email to let us know.
We'll still rank them high, specially now that we know honesty is high on their priority list.
Yet again - rank based of your preferences, not the programs.
#match2021
Offered first batch of interviews (40/130) today. Spots filled in less than 15 min.
It would be unfair to expect applicants to be glued to their phones 24/7 manically checking for offers. For that reason, we should never extend more offers than available spots.
#match2022
A student asked me today how I made it into Radiology. 🤔
That was a long time ago, but truth be told, nobody ever invited me to the party. I invited myself.
Sometimes you have to make your own path.
My 3 y/o boy made a fuzz today because he wants his Mom to stop being a physician. He doesn't care I am a physician. I felt sad and guilty. I try to support my wife's career. But it's not enough. A 3 y/o wouldn't lie. This MD journey is more difficult for women. And that's a fact
Not sure what
#MedStudentTwitter
and
#futureradres
needs to hear this, but we haven’t sent a single interview offer yet. Hopefully this week, as we continue to read applications and collect data.
Applications are long and adequate evaluation takes time.
#Match2022
Evaluating medical student applications is a humbling experience. Particularly because if I was applying to residency nowadays, my application would end up in countless of virtual trash cans.
Jokes aside, students are amazing and keep getting more and more amazing every year.
When you hangout with the residents and they make you sit in the middle for a group picture you feel very old but also like The Godfather of education. 😂🤔
I worry about her, in particular about her daughters and mental sanity. Yet, while carrying the weight of the world in her shoulders, she always finds a way to smile, crack a joke and offer her help to others.
Monica, like many other IMGs, deserve to be seen.
9/9
Random
#Match2022
Tips!
When you write an email to a program:
1. Don't cut and paste generic content and change three lines to make it personal. We can tell you spent 5 seconds. 👀
2. Spell names correctly.
3. Be short and to the point.
4. Always CC the program coordinator.
Look who I found at the hospital today!
@mburgosmd
, one of my favorite mentees!
Funny because this day last year we were discussing how she would approach the MATCH for the 3rd time.
Today, she’s taking care of patients at the CCU as a FM resident!
Si se puede! 💪🇵🇷
Unpopular post about LOR😢
👎 "Best student ever that we'll rank to match" to then see the applicant go unmatched. 🙅♂️
👎👎 "Research fellow will be a true asset to your residency program" - but not even considered at their own program. 🤷♂️
Respect starts with honesty.
There are only 2 rules regarding the MATCH rank list:
1. Rank in order of whatever is important to YOU. Not your friends, Doximity or Twitter experts. None of them will do residency for you.
2. Ranking WILL NOT affect your chances of matching. If in doubt, see rule
#1
.
R1 = “I didn’t know Radiology was so hard”
R2 = “I’ve learned so much doing call! I’m ready for anything now!”
R3 = “I’ll never be able to learn all I need to know for the Core Exam”
R4 = “All this knowledge is starting to make sense”
Faculty = “I know when I don’t know”
The night before an interview day - sometimes long, but always interesting.
Tonight I read 3 LOR by radiologists that I trained and graduated.
Two PS quotes:
“Radiology is the glue of the medical puzzle”
“Radiologists are the unseen and unsung heroes of medicine”
#Match2022
You don't need to be a big shot, well published and recognized academic doctor to serve as a mentor and sponsor to medical students and residents.
All you need is your experience and an honest desire to help and give back.
It’s been a difficult week. This year I willingly mentored 47 students as they applied for residency. Most achieved their goal, but a few didn’t. To those few, I’m sorry.
But as a PD, I will take this evening to celebrate the positives.
Tomorrow, I’ll be back at it. 💪
I believe in a true and fair meritocracy, because I also believe in kindness and hard work. But try talking to unmatched students who are facing so much disappointment and debt, with no jobs or hope after so much sacrifice. It’s heartbreaking. We can do better and we should.
You can love your job and not want to be there all the time.
Enjoying your job and expecting to leave on time are not mutually exclusive.
Using all your earned time off is not laziness.
Not answering work emails during your time off is not irresponsibility.
Classic Radiological Signs in PSORIATIC Arthritis!
🤜 Mickey Mouse ears for para central erosions.
🤜 Pencil in a cup deformity for severe osseous resorption and periarticular erosion.
🤜 Sausage digit for fusiform finger soft tissue swelling.
#MSKRad
#radres
Being Hispanic is part of what defines who I am. A rich culture that nurtures my soul and guides me through community and work.
I am a proud Hispanic and unapologetically Puerto Rican Strong! 💪🇵🇷
#HispanicHeritageMonth
Interview Tip.
Make sure you can carry an engaging and interesting conversation about your hobbies.
You WILL be asked about the hobbies in your ERAS application and is a great opportunity for you to be in charge of an enthusiastic conversation. Don’t waste that opportunity.
I have an educational YouTube page, IG account and Podcast. Yes, it's a "waste" of time - there's no money, no PMID and no awards. I do it because it brings me joy and perhaps one day it can give students an audience to showcase their work and interest. That's it.
#MedEd
A respectful reminder to all my PD colleagues.
👉 Puerto Rico has 4 LCME accredited Med Schools
👉 Education is 🔝
👉 Students are US citizens and underrepresented minorities (no need for Visas, green cards, etc.)
👉 Most students have no geographical constraints
#MedTwitter
I’ve worked hard to be where I am. But one thing I’ve learned through years of mentorship is that many work as hard or harder and still don’t reach their intended goal.
Success takes hard work. But also luck and knowing the right people from the right place. Also lots of help.
I’m a radiologist because patient care is my priority and every patient has a life-saving story that can only be seen through the eyes of specialized imaging.
Imaging that takes immense expertise to produce and interpret.
Radiology - Shedding light from a dark room since 1895.
The two challenges of residency application.
1. Getting interviews.
2. Performing during interviews.
Beauty vs substance - you can't show what you're made of if nobody ever notices you.
Be out there. Be visible. Participate. Get an advocate.
#Match2022
Program Director Diaries.
If you’re a medical student trying to figure out if you’re competitive enough for residency, start by seeking validation within and trusting yourself. It’s sometime difficult as we often doubt ourselves, but when you trust yourself, it really shows.
Quick reminder for
#Match2022
It takes at least 20 min to read an application. Then all that information is "converted" to more objective data and then analyzed again. It takes a lot of time.
Progress towards fairness means waiting a little longer for interview offers.
Good time to remind all my academic medicine colleagues…
👉 If you use geography as a criteria to offer residency interviews, please include Puerto Rico!
👉 4 Med schools in PR, all accredited 💯
👉 US citizens 🇺🇸 (glad 99.9% know this, but just in case 😉)
#Match2022
Enviando un saludito a todos los
#latinx
estudiantes de medicina que le dieron duro al match!
Que si eso eso es muy difícil. Que si no hablas bien el inglés. Que si vas a necesitar suerte.
¡Bah! ¡De Latinoamérica pa’l mundo!
Tranqui que voy a ti. Y pago doble. 💪
Different MATCH week, same reminder.
If you match, people will see success but not the hardship and hard work.
If you don’t match, people will see disappointment but not the hardship and hard work.
Match or no match, the sacrifices to get here remain the SAME.
I’m going through a Radiologist mid life crisis! 🥴
Seeing all these studies of patients with degenerative joint disease, osteophytes, bad spines, atherosclerosis, tortuous vessels and realizing they’re all my age.
😭😭😭😭😭😭😭
Long and painful road, but Mónica always persisted with the best of attitudes. Never disrespectful. Never bitter. She listened to her mentors, persisted, reinvented herself and against all odds, she succeeded!
If you ever doubt yourself, think about Mónica.
Proud mentor. 💪🏾
From the resident manual nobody ever reads:
"Ultimately, you are responsible for your medical education; a responsibility that will continue for the rest of your career. Your success will require a continuous plan for study and self-directed pursuit of educational experiences."
Failure to Match Thread.
I have to admit that mentoring unmatched students has been a struggle for me, mostly because there is little I can actually do to help. After several weeks of mentoring and listening to so much disappointment, here is the best advice I can give you
1/8
As a program director, I learned that residents don’t expect you to give them everything or have an immediate solution to every problem. They just expect you to care, to be honest, supportive and optimistic, which is not the same as pretending everything is always perfect.
The Shady Interviewer and the Puerto Rican applicant!
If you get an inappropriate or personal question during interview (which is very uncommon) ...
1. Stay calm
2. Try to deflect any controversial topic
3. Don't argue
4. If extreme, stay silent and smile
#match2021
Through all my years as a residency program director, I got criticized the most for not sending rejection letters. Some even accused me of “ghosting”. That was never the intention.
Here is a brief explanation. I don’t expect everyone to agree. Just an opinion.
#Match2022
In my experience, medical students going through SOAP don’t expect programs to suddenly love them. They just want programs to see and respect their commitment, perseverance and hard work.
There’s no respect in keeping unmatched students unseen and invisible.
#MedStudentTwitter
Interview Series, num. 3!
Don't be like this cool guy, instead...
1. Be humble
2. Don't lie
3. Stay engaged
4. Don't be a robot
5. Don't be monosyllabic
6. Smile
7. Go prepared
#futureradres
#match2021
Lately I’ve been thinking about my years as a PD. Specifically about the things and characteristics that made a good residency applicant and resident. Things we may not think about.
Here’s one of those: How to create a storyline for yourself - consistency vs resiliency.
Today is my last day as a full time faculty at UT Health SA.
It’s a very difficult day, but life always finds a way to make other plans while you’re busy doing what you love.
Thank you UT. For everything, and know I’ll be staying around part time!
@UABRadiology
… I’m back!
Hey
#MedStudentTwitter
!!
If you schedule an interview and then can't or don't want to attend, please cancel! Over scheduling is normal and happens every year.
But please be kind. I'm sure you don't want to "rob" the opportunity of others to show who they are.
Kindness matters.
Congratulations to all those that matched today!
Yet, I still dislike the MATCH.
The disappointment of not matching is unlike any other. Those shattered dreams, sacrifices, sleepless nights and monumental debt. All for nothing. It’s heartbreaking.
The curse of the mentor. 😢
How do I know if a program accepts IMGs and how do I ask?
1. Some programs don’t consider IMGs and won’t explicitly let you know even if you ask.
2. Don’t ask, it’s a waste of time. Check current residents in program website - although not a perfect way, highly reliable.
1/3
PD Confessions:
I didn’t have time to read all the letters of interests sent to me. But when I read them, they were short with realistic and relatable reasons to our program.
Long generic letters = SPAM. Skip those & invest your time perfecting ERAS & working hard on rotations.
It was brought to my attention that our DR program
@UTHealthSARad
had a USMLE Step 1 cut off score of 240 at the AAMC residency explorer tool.
That’s a mistake and it’s been corrected. We don’t have cut off scores for USMLE Step 1, Step 2 or COMLEX.
Dealing with nursing shortages by constantly hiring traveling nurses and paying them three times as much as the loyal overworked nurses is for the most part a death spiral.
Have been told three times this week that my Tweets about education are too harsh and controversial.
Honest apologies if I offended anybody, but that's the nature of advocacy. Change, no matter how positive, never comes easy.
✌️
Childcare is important, but leaving on time to pick up your child is as important.
While starting times are usually strict, leaving times are expected to be flexible and malleable.
We need to normalize the expectation of leaving on time, even in medicine.
Lately I’ve been getting a lot of questions through DM and email. I can’t answer them all, but when time allows, will try to answer them with a Tweet.
👉 How do I get noticed by programs beyond having a good Step 1 score, good grades and research?
👀Visibility👀
#Match2022
10,000 Followers!
Thank you for the opportunity to connect with you!
But most importantly, thank you for the opportunity to mentor, educate and bring interest to the wonderful world of medical education!
#MedEd
I’m always intrigued when people are not fully satisfied when I tell them I’m from Puerto Rico.
As in: “Yes. But where are your ancestors from?” 🤔
Truth is that I don’t know and I don’t care. Being from PR is enough for me. Being human should always be enough.
#equals
Program director post Match happy but crappy dance!
It's a happy day for those who matched. Go celebrate! You deserve it!
And remember... no matter where you end up matching, it'll be a memorable journey if you decide to make it so! 💪
Program Director Lessons
I learned that millennials respond much better to positive rather than negative reinforcement.
Giving residents privileges and then asking them to prove you right always worked better than taking privileges away and then asking them to prove you wrong.
Holistic evaluation of applications is not just reading the entire application. There's gotta be a plan to consistently evaluate for qualities important to your program. Otherwise, you're just making decisions purely based on personal preferences - the anti-holistic.
#Match2022
As a student I was told that all you’re given in this country is an opportunity.
Then I became a PD and realized that even the opportunity had to be earned.
Then I became a mentor and got convinced that opportunities are just not equal for all.
It broke my heart and still does
Slowly losing hope for
#Match2023
. I went unmatched last year, I was heartbroken, but didn’t give up, I did rotations, got new letters, did research, presented posters, doing everything I can, this year match season it’s just not fair. Don’t know where to find hope now
So unfortunately you didn’t MATCH. What now? Start with this.
1. Take time to HEAL and recover.
🧳🧘♂️🛫🏖🏕
2. Honest introspection.
3. Stay active next year: Internship or research.
4. Get involved in all societies of your specialty.
5. Time to revamp ERAS.
All our residents passed the ABR Core exam. I know it's bragging, but I don't care. It was a crazy bumpy ride for this group and I'm extremely proud of them.
Two MSK radiologists that love education met at the
@RSNA
….
Ideas came up and future projects are in the works!
Thank you
@AwanRad
for all you do! Your work makes a positive impact on many. We all appreciate you!
#RSNA2022
We ranked 105 applicants. Yesterday, I was wishfully hoping to match 105 applicants. It didn't happen.
Wishful thinking aside, I couldn't be more excited to match these amazing physicians!
Sweepstakes Winner! 🙋♂️
@ghannam_sammar
@kimcoffmanmph
@mahad_minhas
This past week Despacito was playing in the MSK reading room crappy radio so I started dancing and singing...
Fellow: So you know that song?
Me: 🙄 Eh? I’m Puerto Rican!
Fellow: So what this song has to do with Puerto Rico?
Me: Do you really want to graduate?
Las cosas como son
The neurosurgery residency program at the Univ. of Puerto Rico just lost its accreditation. Terrible. 😥
Please help these residents find a new home. They’re all excellent and hard working.
Puerto Rico needs them to finish training, now more than ever.
“When I was a resident 20 years ago… Blah, blah, blah…”
Please, save it. Nobody cares and if making lives better for others bothers you so much… consider taking a chill pill. ✌️
🙄
#SorryNotSorry
🙄
On board heading to Puerto Rico. Little girl sitting behind me gave me this - a candy cane and ear plugs, just in case she got nervous and cried.
I still remember first trip with Ami as a newborn and how mean some folks were when she cried.
Be kind. Always.