This is a session specially created to give you tips and tricks, do's and don'ts about residency applications. Before I even get started, just a general show of hands, how many of you are applying to residency this year? Excellent. And how many are going to apply the following year and are prepping in advance? Very good. Thank you. And anybody who's here to listen to applications process program directors, people who are not applying, but thank you, but enjoy the topic. Thank you. All right. So we have a carefully chosen panel of program directors from different walks of life who will give you tips about the experience of being internationally trained and applying for psychiatry residency here. But it doesn't mean if you're not trained internationally, these tips don't apply to you. So this is basically an overview of the highlights of applying for residency with special tips for IMGs. I'm Tanuja Gandhi. I'm going to be moderating this session. I don't want to take credit for what I'm not going to do, which is give a talk. I have the honor and privilege of introducing the speakers. To keep the session focused on the content, I'm going to introduce all of them first right at the get-go. They'll give the talks, and then in the end, we'll have a panel discussion with a lot of time to answer questions. So first speaker is going to be Dr. Vishal Madan, who is the chief of education and deputy medical director at the APA. In his role, Dr. Madan leads content development and innovation of the APA educational programs, including those offered throughout the annual meeting, online APA learning center, educational grants, accreditation efforts, and even this particular IMG track. So we've had a lot of support from him to develop this particular track, including a lot of members of the IMG subcommittee. Dr. Madan works closely with the Council on Medical Education and Lifelong Learning to provide high-quality and innovative medical education for psychiatrists and other mental health clinicians to advance patient care. Prior to this, Dr. Madan served as a tenured associate professor in psychiatry at the University of Virginia's health system in Charlottesville, Virginia. In addition, he served there as training director of the UVA Child Psychiatry Fellowship and as the founding director of the Center for Psychopharmacology Research in Youth. So there's a lot that I'm not reading, but you have a very well-accomplished academician and very versatile speaker who's going to start the session. The next presenter is Dr. Nurpinder Mali. She is the director of Child and Adolescent Psychiatry Clinic and Multidisciplinary Autism Program. She's authored articles in Psychiatric Times on worldwide events and its impact on psychiatrists. Dr. Mali is very well-accomplished and very humble about her achievements. So the bio I have is three lines, but that does not speak to the amount of work she does. And I'm hoping when she starts, she can talk about her position as the residency program director. Following Dr. Mali, we'll have Dr. Sadiq Naveed, who currently serves as the editor of BMC Psychiatry and has authored several peer-reviewed publications. He also serves as an associate professor of psychiatry at the University of Connecticut and Quinnipiac University. He's been recognized as a fellow of the APA and distinguished fellow of ACAP, which is your Academy of Child and Adolescent Psychiatry. Again, another person, very well-accomplished, very humble in describing those achievements, passionate about talking to applicants about residency applications. And our fourth presenter is Dr. Vineet Jhan, who's a professor and vice chair for education in the Department of Psychiatry. Dr. Jhan is also the director of the Geriatric Psychiatry section and is actively involved in various educational initiatives directed towards enhancing domain expertise among residents, psychiatry residents. He received his medical training from the Christian Medical College in Vellore, India, completed his adult psychiatry training at Tufts New England Medical Center, and fellowship in geriatric psychiatry at the University of Miami Jackson Memorial Hospital. In addition, and if this is not enough, right, he also holds an MBA from the University of Pittsburgh School of Business. Now the reason we also go through the bios in length is not just to highlight the various accomplishments of the speakers and the versatility of their academic interests, but also to highlight in a different way how much time it takes from becoming a trainee, going through all the psychiatry residency painful match process, to actually becoming an academic who's at the level as most of our speakers are here today. So with that, thank you all for being a part of this session. And Dr. Madan will go first. Thank you for the applause from the mic. So thank you all for joining us this afternoon. And I hope you've had a good time in New York, hope it was a fun meeting so far. And there's many more sessions planned for you. And I just want to also thank Dr. Gandhi for keeping us on track, making sure we were not lagging behind in anything that we needed to do, and posing a lot of pointed questions that you'll be asking us. So the way we envisioned this session was more of a discussion, panel discussion. So there's plenty of options or time that we'll dedicate to your questions. We'll try and go through our talks, our presentations fairly quickly, trying to take 10 to 12 minutes each. And so we have enough, more than half or almost half of the time for our presentation. So I'll try and go through some basics. A lot of this information that I'll be presenting, you'll probably be able to find in a variety of spaces. So that's why I wanted to, and we discussed it, I think it would be good to have more of a conversational format thereon. None of us have any formal disclosures or conflicts of interest, other than we've all been working towards mentorship for many, many years. And that comes with a lot of gratitude and respect that comes with. And so I'm thankful for my faculty colleagues here who have been taking time to work on this project that we have. Just wanted to share a couple of slides about where the trends are. This is on the IMG track. So just wanted to share some of the challenges, some of the trends that we've seen over the past several years. As you'll see, and as you know, the number of IMGs that come into as PGY1s, those have gone down substantially over the past five to seven years. This one looks at the total number of applicants for psychiatry residency. And the ones in blue are the total number of applicants. And the ones in orange are the IMG applicants. So you can see how the trend has been on the lower side, partly because as we've been calling it psychiatry is a new dermatology, which is like a lot of interest from folks everywhere to apply, and that somehow and somewhat squeezes out some of the IMGs. And there's also the intent about what else can I do if I'm not getting in, right? So that's something to be aware of. This is the numbers, again, similar numbers, but the ones with the dotted pink line, that looks at the number of applications per applicant. And those have gone up from, let's say, 45 a few years ago to now 64 applications on an average per applicant. It's also interesting to note, which reinforces and reiterates the point I was trying to make, which is that this is true for all. This is true for the USMD seniors, it's true for USDO seniors, as well as for IMGs. So just the extra interest that's out there. So I'll focus on the personal statement piece, and then I'll hand it over to my colleagues who will talk about each and every aspect of getting into a residency, so we can try and cover some of these things. Personal statement, in my mind, is the most critical component before you start on your journey for the application. This is the way you can define yourself. This is your own story. Remember, program director probably right now gets around 2,000 to 2,500 applications each season, and how do they distinguish? Because the staff is the same, they are the same one person, right? They may have a SCA training director, a coordinator, this and that, and some faculty support. But that's a lot of work that goes into it. And so what's critical is how do you define yourself? How do you set yourself apart, right? And the black thing up there is called the hook. The hook is the initial line, the initial couple of lines that draw attention of the reader to your personal statement, that gets them engaged right there. That's truly, truly critical. Because if you're writing, and this is a pet peeve of mine, where you say, oh, your cousin had a mental illness, that's how he got arrested. That's like every single applicant's personal statement. So be mindful of how to engage the reader, engage the learner. And also, remember, this is your story. This is not a story that you need to repeat. People have read this over and over for years. So try and think through what's authentic, what can you come up with that will get someone hooked into your application that will make it a draw for them to pull from the whole heap that they're reviewing, right? The second important piece is the body of the personal statement. And that's critical in the sense that what you're highlighting there are your strengths. And that doesn't mean you have to go on a hyperbole talking about superlatives, that you're the greatest gift to medicine, right? That's not the interest there. The interest is, yes, you pulled out, for example, a big team, a strong team while working on some patients. There were some complicated patients that you figured out what were your skill sets that it took to do that, what were some of your personal achievements that you pulled together that were helpful in, again, sending your application out. The other important piece here is to look at any gaps. So if you had a lot of IMGs, obviously, as you're working through the USMLEs, it takes time, right? We all know that. There are wait times for the next exam. There are times when they might be bureaucratic, visa-related hassles. All of those things are there. We all are aware of that. But this is, again, if you have a year, two years that you've been waiting or working on your application, this is a good space to talk about what happened. Because when, and Dr. Male is going to talk about the CV next, when someone's going to review your CV, they'll see a gap of, let's say, even six months or a year. They want to know what were you doing, right? Were you doing something good? Were you in jail? Were you doing something right? Because they have to understand what's the content here and how is it clinically relevant. And we'll have some discussions later on about folks who graduated early, how to handle that, because there's all of that, right? So how do you bring that into the picture? And this is a good space, again, to say, oh, I was busy research, or whatever research space you were working on, and how that impacted your clinical learning, right? So just kind of bring that in somehow, and hopefully, as you think through these things, that's something that will be helpful to bring on. Taking ownership is really critical, right? If you had some challenges, if there was a failure on a step, whatever happened, right? If there's a red flag that you see or think that the program director is going to catch on, explain it here now, okay? Because if not, then they won't know, and you may not get an interview call, because they'll be like, oh, I don't know what happened here. And that's something to, again, be mindful of. When you explain, again, this is my thoughts, and my colleagues may have other opinions or better opinions, but I would say whenever you're explaining such gaps or challenges, I would not go beyond two or three lines. I would not spend, like, two paragraphs or the whole middle of the statement on explaining that, because that's not the intent. The intent is to share, you know, what the information is. And the other intent is to bring up what you learned from that, right? Because everyone's looking at, okay, everyone makes mistakes. We're all humans, right? Everyone has some challenge or the other. How did you come out of it? What did you learn, and how were you successful after taking that into consideration? And then the last thing on the statement, as I see, is the final punch, right? This is where you can knock the training director out, right? That's the intent. So how do you stand out? What are you looking for, right? What sets you apart? Not too much hyperbole, but really critical to think through. You know, it could be, you know, talking about integrity. It could be talking about, you know, what are your specific skill sets that may stand out compared to the others? What are your learning experiences? There might be some life experiences that you may have had that you may want to highlight. So all of those things are, you know, really critical. There's a concept of miles traveled, right? Also in the residency process as to, oh, you might think, oh, I'm, you know, I've been an older graduate. I've taken so much time. There's also this concept of miles traveled, which is, like, what were you doing that made you more successful, and how would that be a good fit for the program, right? So if you're into flow charts and algorithms, this chart is for you. You know, this talks about basically what we were discussing. So taking time to brainstorm, think about words that describe you early on, which is sort of the hook that I was talking about. You know, what are your strengths? What are your proudest accomplishments? What were the obstacles you overcame? And things like that. And then doing some reflection on that. How does this impact? How do you think, you know, your program is going to read that? The other important thing is here, is there a way you can personalize that? So if you're looking at, let's say, specific programs that you're too keen on, make sure you personalize your personal statement as to how that will cater to a particular program. Because if you keep doing, you know, generic stuff, then obviously everyone gets to know those things that they're reading. But as a training director, it's always good. Like I was saying, you get 2,000 applications, how do I pull one that will be a good fit for me? And if you somehow indicate what your interest is, why that interest is in that program, it's always good for folks to look into. I think the other critical piece here is to really, you know, look into incorporating the answers from what you're thinking, what's in there, what's the brainstorming that you want to, you know, put in, and revisiting, making sure there's no grammatical errors, making sure, you know, you've had somebody read it carefully, make sure you've read it multiple times over, and before you send the final, you know, submission that's out there. If you have an advisor who can help, that's always helpful. Sometimes the challenges for us as IMGs are English is not our either first language or native language, and how do you work on it? So again, use some potential online tools for grammatical stuff, not to generate a personalized statement because that's not going to help, right? So think through some of that. So in terms of what the basic do's and don'ts are, like I said, the opening act, which is really drawing someone into it, staying authentic, staying focused, and staying upbeat, okay? Do not blame people for whatever may have happened in your life. Focus on, yes, this happened, this is how I overcome it, right? So that's really the three, if anything you would want to take as authentic, focused, upbeat. Those are the three things you need to focus on. Like I mentioned, if there are strengths you want to talk about, give some examples so people understand where things are, and personalize, like I was mentioning, right? Try and not go too far beyond one page. I mean, a couple lines here and there, two, three lines is fine. Just understand that there's a lot of folks whose applications are being read. The more spread out is, the more bored the person is going to be, which goes back to staying focused, right? Don't do overselling. Stay, again, goes back to being authentic, you know, and then not blaming others, and do not use chat, GPT, or Copilot, or whatever, other perplexity, whichever one you want to think of. Try and stay authentic. So sometimes you'll find yourself this way, right? Try, try, retry, edit, and some days it's going to be like that. But the other most important message, I would say, is this. Do not wait. This is really a critical piece that will get you an interview. Work on it. Do not procrastinate. Do not think, oh, last two weeks, I'm going to just focus on it. That isn't, that's not how life works, and this is a critical piece to go for. These are some resources. Feel free to take pictures, and I think the app may have the PDFs, too, or if not, I'll make sure it gets there, okay? With that, I would like to welcome Dr. Malhi to talk about, oh, you're still taking pictures? Go for it. Thank you. Thank you. Thank you, Dr. Madan. So my section would be focusing on CV and letters of recommendations. So you have known one important part of the application, which is personal statement. So let's dive a little bit deeper into your CV and other important aspects of the application. So I have no disclosures to make. So the objectives of this presentation would be reviewing the key elements for the CV, and then also the importance of letters of recommendations, which are the critical element of your application process when you're applying for residency. What is curriculum vitae? So it's one of the items that's used by professionals in academia, medicine, teaching, research, as a way to showcase your accomplishments that are relevant to the academic realm. It's an important tool for the programs, as we receive thousands of applications. How do you decide who is the right candidate? How do you invite for the interview in your program. And it allows the programs also to even search you after filters are applied, general filters where you are trying to look for, I don't miss this applicant or that applicant. So CV is one of the ways where you can put relevant information so you get acknowledged. And it's used by the program directors and faculty what to talk about in the interview. So that's going to be the basis for your interview where you're going to have conversations with your interviewers. And it's a beneficial tool, which you can utilize even before applying to the residency when you're asking for letters of recommendation. So don't underestimate the importance of CV. It's one of the important aspects of your application before you apply. So what are some of the general considerations? So for residency, it's a little bit easier that what we get on our side is the digital eras that you put all the information in the eras and it generates a CV. So that's good. But now you have to think about how to put all that information that's relevant in the eras. So when it generates a full CV for programs to review, it contains all the relevant information that you need them to know about you. Start building your CV as early as possible. Don't wait until the last minute. That, oh, I'm going to work on this thing at the last. Even start planning some rough draft is also a good idea so that you can start putting the information. And when it's time to put in the eras, you have all of it ready with you. Before starting to work on it, one of the things to do is if you have access to any of the other CVs, maybe residents who have already been selected in the programs, if you have access to any of those, reviewing some of that information would also be beneficial. So you can see how people have done it before you. And brief descriptions, preventing unnecessary word clogs in the CV that may not be very beneficial. Be unique. You want to make sure that you capture any activities that you have done that can set you apart, either it's in clinical experience or in research or publications or even in your personal activities that make who you are. So it's important to acknowledge those things and make sure to find a way how you can put that in your CV. Some of the things that are important to consider is clear, being well-organized. The CV should be readable, easily understandable. I thought I'm doing it. Be concise. Like when you're putting the information, suppose it's a clinical experience you are talking about, you don't want to write paras and paras about it. So make sure you enter the information that you feel is relevant to that experience and how it made an impactful experience for you. And what did you learn? So try to be each and every word that you put in the CV has to be thought through so that you can understand the importance of that information that you're giving to the programs. It has to be complete. All the relevant information should be included. Consistency is very important. So the way you put your information at one section, try to implement across all the sections so the information appears as more consistent. And then current. Include everything. Include the dates with all the information so they can know what you have done so far. And even if there are gaps, you figure out a way how to explain those gaps. So there have been some recent changes to the application process that shows up on your CV also. Like you can add now total experiences which can be up to 10. Usually 10 experiences would show that you have done like incredible amount of work. I would say normally what we see is two to three experiences which is also good enough. Meaningful experiences are up to three. Impactful experiences, they are optional. Usually one or two people we have seen but it has to be impactful. So think through it. If you have any impactful experiences, do add it. If you don't have it, don't try to oversell yourself. Recent change in the signaling also from this cycle. There is gonna be up to 10 programs that the candidates will be able to signal and I think one of my colleagues is gonna talk more about it. And then geographic preferences. So that is also important in a way that can help you identify the programs to identify if any of your geographical preferences are so that you can be considered on that basis. But many times what we have seen is for, especially for IMGs, if you don't have geographical preferences, that's okay. You can write it over there that I'm ready to explore across. So that is also very acceptable. Some do's and don'ts for preparing the CV. Some of them I have already talked about but let's review them together. So one is take time to prepare your CV. That's very important. Include as many relevant details and specific about your skills, talents, and experience. Simple, concise language. Be honest. Do not try to put things in there which just to kind of fill the gap. Honesty is what is gonna be something that the programs are looking for. If you put something and you're not able to explain, that can really go against. So try to be authentic and be yourself. Use active voice rather than passive. Impactful experiences, as I said before. Include information about the problems you solved and also see it as an opportunity how it added to the growth of your own self. Describe the results of the work you have done. And if it's measurable and quantifiable, that would be even better. Like if you have any clinical experiences or things like that, what did you learn there? So describing in a way that can add more meaning to the growth of your own professional journey. Arrange qualifications, experience, and the categories and then chronological order which I think I'm sure you guys all know that. I always look for hobbies and interests. I think that's like one of the areas that can give an insight for the person who you are. So if you have done something credible, like you are doing some activities that keep you engaged and how you take care of yourself, it's okay to include that over there as part that gives the reflection into your own self. Seek feedback. If you have an advisor that can take a look at the CV, I think that would be the most acceptable way so that you can ask for feedback and the things to improve. Some of the don'ts is like including too many details like writing long, long paragraphs, explaining your experiences. We get like, all the programs I'm sure like these days get thousands of applications. So faculty, review committee may not have that much time to read long paragraphs. So try to be concise but at the same time include all the relevant details. Sloppy writing, irrelevant details, do not be misleading or dishonest and don't include the judgment of your own skills. Let others be the judge of what the work you have done and not accounting for gaps in your CV. So that's also something is very relevant. If you have gaps and then try to explain that in the CV if you can but also be prepared to talk about in an interview as well. And then my last part is the letters of recommendation which are the critical component of residency application. Usually three to four letters of recommendation are needed. Three is minimum, four is also like we have seen four as well. So it's important to consider first like who I'm gonna ask for letter of recommendation. So build a relationship with the faculty that you're gonna ask for LOR because they need to know you and be able to personalize who you are and be the voice for you. It's like a representative for yourself that you're sending to the program that now consider me for an interview. So that's very important to have a letter of recommendation from someone who can be champion for you. So specialty specific champions can be very, very useful. If you're applying to psychiatry, having someone who in the field could be useful to have letter from that person. Must be genuine knowledge and confidence in the applicant. Sometimes it's like don't take it as oh I'm gonna check off the list. Having a genuine and authentic letter about you can go long, long ways. And then I consider strong letters of recommendation who someone who knows your skill can write highly about you. That's definitely very helpful. And give the faculty that you are asking for letter of recommendation, give all the pertinent details about you. Making sure that even if you have your CV ready or your updated personal statement, have them, give them to review you. So they wanna, that can also give them a little bit more depth of information about you, what to write in the letter. And timeline. Do make sure that you know when to ask for the letter and give them enough time so they can write the letter and keep a one or two weeks in hand for you. Sometimes people can get busy, so it's okay to give a gentle nudge also. Hey, looking forward to get the letter from you so that they can take time to write it. And these days standardized letters of recommendations are one that's coming up, but haven't been extensively utilized. But that's something hopefully in the future. I don't know if that would take. There are mixed reviews. We do sometimes get standardized letters of recommendation from some faculty. It's a, format is a little different. But both letters of recommendation and standardized letters of recommendation are acceptable. So these are some of my references. So I will hand over to our next speaker. Thank you. Thank you, I love this background music, it was keeping me awake. So I'm going to talk about signaling and program selection. So I don't have any disclosures. So signaling, you know, in some ways has been going on for a long time in an informal way when you send a letter of interest and you tell the PDs that you're really interested in their programs and, you know, then program directors can look at the application and see, you know, if they want to interview you. So it has been more streamlined recently in different forms. So a more formalized way is geographical preference, setting preference, and program signals. I'll talk about geographical preference and setting preference later. But for program signals, as Dr. Mully also mentioned, that program signals has gone up from 5 to 10, which is, I think, you know, it's a great thing for IMTs because being an IMT I will match, I don't care in Alaska, I will match in New York, California. So you have a chance to show your interest in multiple programs. And being an IMT, I understand that IMTs can go anywhere because you've traveled far from Pakistan, India, Nigeria, South America. So at least I don't take it personally against anyone, especially with five signals. How is it going to help you? So make sure that when you have 10 signals, you use them very carefully. If you are signaling a program, there are likelihood of chances, almost 100%, that your application is going to get reviewed. So use those signals effectively. Use those programs where you feel like you are compatible with the program. Your program application, your credentials meet the program application criteria. So don't lose any signals in places where you don't have hopes of matching. Obviously, you know, don't undersell yourself either. And we did talk about, you know, how does it help. So your application is likely to get reviewed with signals. Now with geographical preference, so how does it look on our site? And this is from screenshot from one of our match applicants, incoming PGY1, so I have the permission. If you see this person is an IMT, and what she chose is I don't have a division preference. So you can pick up to three U.S. Census subdivisions to show your interest. For me, you know, especially for IMTs, it really does not serve a purpose because I can pick three and that will cover me from Boston all the way from Philadelphia. So if someone has been, you know, let's say went to undergrad in New York, did graduate school in New York, med school there, there's a likely chance they're going to stay in New York. I hope they decrease it to one, geographical preference, but they didn't listen to me this year when I gave my feedback. But you know, you can, as an IMT, you can pick I don't have a geographical preference. I would rather have that than you saying that you don't have a, you have a geographical preference because we try to play safe and we want to go to those 90 programs, optimize my chances. But if you will pick I don't have a geographical preference, I'm not going to hold that against you. At least you are being authentic of where you want to be. Similarly, setting preference. So for setting preferences, you can pick urban or suburban and rural. So this person also picked for no preferences in the setting preference. And you can pick one of them. So that's how it look on the PD side. And this is another matched applicant with us, incoming PGY-1, she picked for a division preference for another area. But then she reached out and she said that I'm interested, can you look at my application? So we interviewed her, we liked her, and she's going to be with us starting July. So this is how it looks on your side. So I think discuss with your mentors, discuss your situation. If you have a geographical preference, then pick a geographical preference. But you know, don't pick it to optimize your chances. I would rather have someone say I don't have a geographical preference. I took it from Residency Explorer. So the data is relatively old on this. So PDs are still learning. So hopefully when new data will come out, hopefully we'll know more. So if you see a geographical preference when it is aligned, what does that mean is when you pick, let's say ECHN. So my geographical preference would be northeast. And my setting preference would be urban or suburban. So when you pick that in geographical preference and setting preference, that means that your geographical preference is aligned. So your percentage of getting an interview is 15%. But if you don't have any geographical preference, then it goes down to 5%. And for geographical preference, non-aligned is a little bit lower, but about the same, about 5%. But just remember, this was the first time it was done. PDs are still learning about that. So we'll wait for the new data. So use what fits for you. Now this is more for the signals. So if you sent a signal for the program, so you see the number of interviews that are offered that is about 50%. If you signal the program, there is 50% chances that you're going to get an interview from there. And I can tell you from talking to different PDs, there is more than 95% chance that your application is going to get reviewed. Now if you did not signal the program, the chances are lesser. Now sometimes people say that, oh, I signaled the program, but I never got an interview. So I can give you an example from last year. We were signaled by a candidate. And when I opened that application for that candidate, the LOR said, Dear Internal Medicine Program Director, and obviously that person is not going to get an interview. So also look at, that's where you need to look at your application credentials and see if that aligns with the program. So the program application, as Dr. Madan mentioned, number of application per applicant has increased. The fee schedule also has increased. So you really need to wisely apply to the program. So 30 or more programs, this is $27 each program, and it can very easily cost for IMGs. If you're applying to 100-plus program, very easily it can cost $3,000, $4,000. So be wise about that. So a lot of people talk about applying broadly, right? You all heard that. Applying broadly does not mean applying blindly. So review the program application criteria. Look at their website. There are some other resources where you can look for that. Frida is one of them. Residency Explorer, I love Residency Explorer. It will give you some idea about the program criteria. It pulls the information by itself. In Frida, I have to go in and put the information in there, but Residency Explorer pulls that info by itself. You can also reach out to the program and look at their website and see if you meet their criteria. It's better to apply to 100 programs after tailoring your program list, rather than applying to 200 programs blindly, where you don't meet the criteria for most of the programs. So that definitely helps you cut the cost. And there are a lot of programs that use holistic review of the application. They will say, we holistically review the application, but even that, they will look at scores. There is some cutoff for scores, but that means that they also look at the other attributes of the program. And a lot of time, it helps if you reach out to the PDs ahead of the time and ask them if they're willing to look at your application. So let's say, if you have done home country residency, so your year of graduation is more than four years or five years, if that is the cutoff for the program, reach out to PDs and see if they can look at your application. Obviously, they will look at it, and they will consider you for a possible interview. Now, what's a good number to apply? I don't think there's a good cutoff. So assess your financial situation, look at your pocket, and see how many you can apply to. I always ask people, make three or four good friends, and look at applications criteria together. So in this way, you can join hands. And then, like Dr. Madan said, it's the time now to work on the personal statement. The time to look at the program application criteria is now. So start working on it so you can do a thorough job. And just go through the program timeline in September. You can apply. It doesn't matter whether you apply on September 20th or September 26th. Your application will be reviewed at this time. This is my son. I think he was six. He was probably four to six weeks old. Thank you very much. So I'm going to invite Dr. John. He's going to talk about interview process. He'll do it. So you have to exit there. I just want to apologize for all the noise. They break down the exhibit space on Tuesday afternoons. It's kind of too close after the session. So they sent a message to see if they can start on the other side or whatever. We'll see. Thank you. Thank you, Dr. Gandhi, Dr. Madan, Dr. Mali, and Dr. Naveed. Clearly, your commitment and passion towards being guideposts for our younger generation is very evident. I know we are all looking at residency, but there is clearly the truth is you're all going to make it. I've done this once with Dr. It's my third time doing it, and I've seen people who have been in the first session who are now attending. So it's going to happen to all of you. But then, since it is an IMG session, I just want to think about getting into residency is just one part of it, but being a resident and to be aware of some of the challenges you might have in terms of there could be potential bias if you're an IMG. You're also learning in two ways. You're learning to be in a new country. You're also learning to be a trainee. There could be, as some of our esteemed faculty talked to us today, communication challenges. There might be knowledge deficiencies. And there is practice gap. The mental health ecosystem in the US is totally different than what we probably experience in our own home countries. And our supervisors can either love us because they just love the passion and curiosity we bring, or they could have their own misplaced expectations as well. I'll talk a little bit about the shock phase in a second. This is a study done in Canadian psychiatric residency, and you could see the challenges are mostly about navigating the EMR knowledge base regarding mental health. And also, as an immigrant, as trying to get into a new country, trying to balance out professional and personal life becomes a challenge as well. Just wanted to prepare you. And this could potentially come as a kind of conversation of what culture shock might mean to any of us is this term which embraces numerous phenomena which follows the impact between a person of a certain cultural background and a relatively strange culture. Any culture we're moving into could be particularly strange. And it is stressful, anxiety provoking, and most importantly, it comes with a face of mourning. We mourn the loss of a family, friends, language, music, food, and all the culturally determined values, customs, and attitudes. So something to sort of be aware of as we navigate our life as a resident. And finally, to realize that there's always this coexistence of these two themes, that you have the encounter, which is also followed by this painful mourning. But then also be aware that the fact that you're all here, the fact that you have sort of navigated some of those labyrinthine roads towards residency makes me think that you will do really well and you're going to thrive. Some of the factors are your linguistic versatility, the capacity for you to talk about the research you've done either in your home country or right here in the US. Dr. Navid talked about if you're doing residency back home, that that becomes a formidable success factor for you here. And also, we'll talk more about being psychologically minded and openness. And then if you have some experience in psychotherapy, that becomes a powerful kind of a game changer for you here as well. So this is something I stole shamelessly from Dr. Rajesh Thampi, who is the chair of the department in Nebraska, Creighton University School of Medicine. And I think in a way, this is actually correct. And I think the PDs here would acknowledge that your application package could look really well and they were excited to talk to you. But then there was a sense of disappointment because the interview didn't go well. So I think interview is very critical. You need to put everything what they had talked about together to reach the interview phase. But then navigating interview is also very important. So I just wanted to quickly go down the list with you, maybe what people are evaluating. You heard this term, a holistic interview, where it's not just the scores. It's your whole kind of commitment to the field, which is important. Your motivation or enthusiasm should be very evident. Not only that, I mean, if they're asking you a very simple question, then you may have to sort of demonstrate your understanding and deep awareness of the specialty, communication skills, your curiosity, evidence of scholarship. If you have done papers or published in textbook chapters, if you have had public forums where you've spoken, all these things are important. They also look for red flags. A lot of times, gaps came up here. And this kind of intuitive sense, everybody kind of talks about fit. Even Dr. Naveed mentioned about apply broadly, but don't apply blindly. So you're also having a sense of what may be the perfect program for you. What is emotional intelligence? Is this kind of a term which has been around in the kind of psychological realm for the past 30, 40 years? But it's basically what we all are, the sense of awareness of our own emotions, navigating and managing our emotions, extraordinarily able to understand other people, demonstrate a sense of empathy, and then this social skills. I met some of you, and you're all wonderful with regards to the ability to communicate your passion and to also maintain relationships. So how could we demonstrate emotional intelligence during our interviews? Number one is extraordinarily anxiety-provoking. You are really excited about being part of a program, but you're also nervous how you'll perform. So managing that anxiety is very important. And Dr. Madan talked about authenticity, and authenticity is not just about writing the personal statement. It's about giving them a sense of who you are. So if you're a humorous person, try to use humor. And then most interviews are now virtually, but a lot of times I try to sort of see it as in-person interviews as well. But then it's not going to go smoothly, and an attending may not show up, or they are scrambling to get another attending. So being comfortable with it, letting them know you're willing to wait. And if we had situations where our attending forgot, and then we couldn't get another attending on time, I felt very embarrassed about navigating that with the applicant. They were wonderful. They said, no problem. They'll come on another day or get into Zoom. So be comfortable with that, navigating the unexpected. Constantly able to demonstrate your drive to achieve. And then let's say there's always a kind of a conversational session you have with the residents. And if there, you could make authentic connections. Even with the coordinators, trying to talk to them, they'll try to reach out to you through email and helping you schedule the interview. And then we are very prepared, because this is the interviewer we're waiting for. But sometimes the interviewer is just coming from a very busy clinic. They probably had a really tough day or session with a patient. So acknowledging those challenges will be helping us, too. And then your curiosity is about learning more of the program. I agree with Dr. Navid that try to learn about as many programs as possible. Be inquisitive. Also let people know you are not just an applicant with a score that you have great interest in art, culture, and science. Most of your interest in psychiatry are those amazing group of people. And then able to learn more about the lives of faculty. How is it to be part of this department? I love that question, because it's sort of probably one of the few times all of us are reflecting back on who we are and why we are staying. Someone asked me, why do you stay in this department? Or what attracts you to continue to work for this department? Those are the kind of things it shows your curiosity as well. So coming to that theme I just put together is this model, because sometimes we just need a model or a kind of mantra to help us navigate these complex tasks, right? So it's a combination of preparation, practice, presence, and performance. Preparation is really important. You have to collect any kind of application materials. You've got to have content expertise about psychiatry. If you're interested to discuss a case you are in an exposed to clinical scenario doing externships or professional trainee or serviceship, whatever it may be you're coming across great cases, be able to talk about that. About your program you're interviewing, please read up about the program, about some of the things they're very proud of. And of course, if there are red flags in the application, be able to talk about them. We'll talk a little bit about this traditional behavioral questions. I put planning and travel, but for time immemorial now, I mean, we probably will be constantly in the virtual world, which is difficult for you and us, because we like to sort of show we are warm people. We have great facilities. And for you also to sort of feel like you're constrained by this computer screen, so to speak. And then after the interviews, thank you notes and communicating interest. So traditional questions are so deceptively simple. But all of the group here can tell you that with a simple question like tell me about yourself, I mean, a plethora of questions and answers would come out. And some of it would have that hook Dr. Madan talked to you about in the personal statement. A story sticks out. I remember a silly story about one of my residents who's now PGY2, who told me that he was a house officer in Nigeria. And he was posted to a village health office. And he sort of heard a commotion in the village square. People are trying to stone a woman because they thought she was a witch, because she was sort of acting strange and acting as if she was hearing commands from God. And he was able to rescue her and send her to a psychiatric hospital. A story is powerful because it talks a lot about misconceptions and stigma and some of the challenges that patients are going through, the attributions of what mental might be in certain cultures. Even the question like why are you choosing psychiatry? You have to be able to sort of convey what has led you to that moment into that interview day with your passion, your experiences, your interests, so on and so forth. People could even ask you about the future. I mean, we are all going through tremendous changes in our field of psychiatry, whether it's through digital or new innovations in treatment. How would psychiatry look for you in 2050? And where do you see yourself in 10 years? What do you like in a training program? Is there any particular questions in research you're very fascinated about? So again, what I'm kind of saying is that don't let the simplicity of the questions mislead you. I've had some candidates just give me like one sentence for why psychiatry, right? I mean, so if you're not prepared, then this is what could happen. There's a lot of interest now about how you could potentially navigate a difficult situation, whether it is getting a feedback which is difficult or handling a stressful situation or about a major challenge you might have faced, or even a question about capacity to change our behaviors because we've been told that we have done a mistake. I'll tell you, program directors can take someone who doesn't know too much about psychiatry. But what we can kind of, in a way, feel hopeful is someone who cannot remedy a situation. After being given multiple feedback. So maybe that question is something about that. I would say after the preparations practice and everybody who talks to me about being prepared for the interview, I tell them about this. But everybody neglects it, right? It is very painful to do this part because you have to go over a significant amount of content mastery, communication skills. How do you come across? Maybe get a coach, maybe join Toastmasters. Trying to kind of anticipating these questions we talked about, how do you prepare your responses? You could self-tape yourself. You could get someone to sort of look at your interviews. You could review your performance in mock interviews. Your attendings are always dealing with the residents, PGY1, PGY2. And then they are sort of asking about an important case. And you have to sort of think about how would a resident present this case? What kind of sophisticated way they would bring in, right? And then, of course, creating micro-lectures is good. So I just wanted to put these themes together for you to sort of think about. Because this is where a lot of curriculum and a lot of interest among program directors are going in these themes. Do you know enough to talk about social determinants of health? Do you know about ketamine and psychedelics? What is the relevance of biomarkers in psychiatry? Is there any kind of a way digital medicine is gonna transform the psychiatric clinic? So these are all things one could prepare. And then the presence, right? This is an actual quote by Joshua Safran about this particular actress who acts in Quantico. She walked into the room and it was like molecules shifted in that way. That's what the superstars have. I was very confused because I didn't know who she was, but we all sat up straighter. Obviously, that's why she's an actress and that's why she's married to a singer and all kinds of stuff. But there's something called presence. We all have it, but we can improve it. You know, it is about coming back to owning and telling our stories, being much less self-absorbed and anxious, because once we get self-absorbed, we get more anxious and this is bidirectional. But continue to practice on conveying who you are with confidence, without arrogance. And also, even if it is a kind of virtual setting, be very clear about body language and posture. And the final theme in the 4P model is what I would call performance. You can't be passive about this interview. Like anything else, like even we're all doing a little bit of performance here, it is a performance of sort. And you have to manage your energy, your attention, and there should be adequate time for rest and sleep. And have this capacity to have the conversation, not make it very stilted. Some of the best interviews is when my applicants let me talk a little bit about myself. So, you know, it's not about just telling them, it is about the whole experience of the interview, which is very important. You've got to, I mean, we have that with people. Some people, when we have conversations with them, we feel happy, we feel great. Why is that? Because somehow they acknowledged us and they're still able to convey what they are, who they are, but then everybody feels good. So, performance, so realize that. Interview is also performance. This is my final slide. This is about what we call fit. And fit is always the sense you have when you are in this interview with a group of people, you meet their residents, you have a sense, you have a sense that this could be a good place for me. This is a good place for me to be a trainee. Sort of be very sensitive to how the residents are. Do they look tired? What's their morale like? Look at how they have described the faculty. Are they engaged? And then there's this very difficult balance all of us struggle in our trainees how much of service and education, how do you balance that? And residents, look, the residents are the most, I would say, authentic and honest peers you could ask for. And they will tell you if they're working too hard, the call structure is not so good. And be, I mean, not that we are all worried about the call structure, but at least have a sense of like, what is the balance? And also is a program invested in resident accomplishments? Does the program give you time for research? Does faculty also have funding? And then do we, I mean, you would have probably seen a lot of programs sending the residents to conferences. And then sometimes I think it's not a bad idea to be part of a health kind of universe where there is a school of public health and other business schools and all that because there's a lot of cross-pollination and transfer of ideas. And as a resident in certain areas, you could probably take a course or even have an extra degree like Master of Public Health or some of my residents did in Pittsburgh, an MBA and so on and so forth. So that also is something that sort of gives you a sense of attracted to the program. That's all I have. All the best. So at this point, we move to the panel discussion. We have just like two or three of you, the usual questions and then we'll open it up for Q&A from the audience. I think one question I've gotten a lot is, like Dr. Madan addressed, what if I use ChatGPT to write my personal statement? It's still me. It's my story, but somebody else wrote it. One is that okay? And second is, and I've done it. Should I be worried that the program's going to be finding out that I use ChatGPT? Can I talk about it honestly? Where do we stand with that? Yeah, I think that's a great question. My personal take is, remember, what's the personal statement? It's personal, right? So it's not ChatGPT personal. It's not that. You can use help. You can get some context, but make sure that you modify it correctly. If you're using pieces of it, make sure it's not something that comes out as canned or something that, yes, training directors also have access to the same things, right? So they can and they're very masterful in reading through some of these things because they've been doing that day in and day out, season after season. So they'll catch you and your application will be shunted out. That's my personal take on it. I'm pretty sure others have different opinions or maybe something you all want to add. I can just add that I would say that make it own it. That's the most important part of your application. Using ChatGPT for, like, okay, correction of grammatical mistakes or some language change, but the concept should be your own because you want to talk about it and you want to be comfortable in your skin when you're in an interview, what did you write there? So that's my take. I won't totally go for ChatGPT, but utilizing it as a tool to make your, like, from a language proficiency, that's great. But other than that, it has to be original. Do you want to go for a question? Next question? So the next question was that this has come up in a lot of, like, these forums that we've organized. Nowadays, in personal statements, people want to write personal story. So you might talk about, like, mental illness in the family, patients you've taken care of or deaths in the family. And with my experience of doing both residency and fellowship interviews of candidates, sometimes it feels like less is more. And sometimes you don't know enough. So where do you draw this, like, fine line of using a personal story in a personal statement? And what would be, like, an insider tip on, yeah, this is one thing you don't do? Yeah. So I think one thing that I look for application is in authenticity. So and, you know, there are so many personal stories. So if you have a personal story that connected you with psychiatry and medicine, you can use it. But you have to link it. How did that, you know, develop your interest in psychiatry? A lot of time when I read personal statement, even before become PD, people describe developing their interest as a transactional experience. It's not a transactional experience. You don't go to sleep one night and you wake up having an interest in psychiatry. So it develops over time. So you have to have a longitudinal, you know, way to describe that. One thing that I have noticed, especially with IMGs, with so much anxiety, you know, there is so much same content that comes up. If it is, you know, cardiology personal statement, internal medicine, there is a grandmother who died with myocardial infarction and you want to fix the world. If it's a psychiatry personal statement, your aunt had schizophrenia, one of your cousins had schizophrenia, and it's okay to use those stories, but just, you know, think about what got you interested in psychiatry. If you feel like, you know, once you were not interested in psychiatry, it developed over time, and you are, let's say you are applying for two specialties, you are applying for family medicine or psychiatry, or you pecked with internal medicine, but then you thought, okay, I should go for psychiatry because that will help me. Then why, just think about it this way, why did you not pick pediatrics, pathology? Why psychiatry? There must be something that got you interested in psychiatry. So more authentic that you can keep, and in the interview process, you know, people, what are trying to judge us, the authenticity, you know, how connected you are with the application. So I will give you, you know, an example, I like to quote stories. We had this applicant who applied, was, had a lot of Durham experience, and went probably en masse then, it was in a transitional year, and then applied to psychiatry. It's quite okay to switch specialty, specialties, and he was also in Durham Interest Group. I would have been fine if he would have said, I did my transitional year, I got really interested in psychiatry, but if you're saying me, telling me that you got interested in psychiatry in third year, then why were you in Interest Group in Durham in fourth year, and you were not doing Psych Interest Group, and your publications are mostly about Durham? So it's, when, look at the application as the whole package. It's not only personal statements, so keep it very personal, keep it very authentic. So tell a compelling story, and the story all fits together. Yes, yeah. We were in another session, this question came up, I would say that if you don't have anyone with mental illness, you can have various other reasons also why you got interested in psychiatry. So it's okay not to always have family members, or cousins, or mother, grandmother, somebody have bipolar schizophrenia, so that's all right. So that's not going to make you any less credible candidate. So you just have to see your journey, how did you develop the interest over time? I was going to comment on the same, I think with the COVID and post COVID times, at this point, that's a very straightforward way of tapping into, if you're not having a personal narrative to share, everyone knows how the anxieties have been, everyone knows where mental health went in these past three, four years. That's a pretty straightforward channeling information. Second thing is Dr. John's slide had, actually it's up there, the one previous one where you talked about some of the, there was one other, just keep going, so they can reread those. Anyway, so yeah, this one, yeah, the themes one. So you can see all of these themes are pretty relevant, and that's something you can pick on if there's a specific area that you feel goes beyond, above and beyond what you're talking about, the usual, the cousin example that we read about. This is a great way of tapping into, of course, then be prepared to answer questions on these areas when they, because what's going to happen next is if you say, oh, I'm so keen on TMS, the next thing is they'll put you in with an interview with someone who does TMS, right? So be mindful of those things, don't overshoot it, and just be careful. But that's how I see it personally. That's a pet peeve of mine. I do not like to see those standard first paragraph, how they got it. And the other piece I would say is it's okay to talk about, you know, a lot of medical schools have, let's say, no more than two or three weeks of psychiatry in international schools. Here as well, you know, those interests have declined sometimes. So it's okay to say, you know, this was a limited experience and then how you grew into it and, you know, just think of some of these things, the COVID, the, you know, instabilities in the world. You know, there's so much to talk about, the advances in psychiatry, there's a bunch of things to think through. Just one of the pre-prepared questions, again, very common. I don't know how to weave it in, but across sessions, we've had women applicants, women psychiatrists come and talk about the unique challenges that comes to being women in the field and women IMGs in particular. From my side of the world, I haven't seen that be a barrier or a certain criterion when it comes to applying for residencies, putting that application, doing interviews. You can definitely talk about the unique challenges, but does that come up in your applications and interviews at all as something of concern? So, I mean, I think being, if I understand your question correctly, being a woman, being a mother, is that a concern? Yep. So they can ask you questions about family, children, and you know that the unique challenges to being an IMG and especially a woman IMG. So does this feature in like applications or interviews or any part of the process that you feel comfortable commenting on? So I think for at least for my program and mostly colleagues, I have talked to as being a woman IMG, being a woman applicant is not a concern for me. This is part and parcel of the life, you know, having kids, growing with a family, and you know, we are happy to be part of that journey. And if a program asks you that question, maybe that's not a program where you want to be. But mostly, you know, people I have talked to in PD circle, they are quite okay. We are proud of our women psychiatrists, what they do every day. You know, they're a lot more busier than I am. And you know, when I had my son, then I realized how tougher it is for our women IMGs and women psychiatrists. So I'm very appreciative of the work they do every day. Thank you. This, Dr. Madan, Dr. Mali, sorry. So I would say that that question do come up at times. I have a very female-heavy program, majority of my residents are females in my program, and I didn't choose it that way, it just happened, just to be full disclosure. But I would say that sometimes candidates do ask that how about having children in the first year, second year, that also comes up. And they have to be aware of, okay, what's a call schedule look like so they can plan accordingly. But we do make them aware of the benefits that would be available. They can get in touch with HR beforehand as well to know the policies and procedures. But we haven't had any babies yet in my program, but I'll be totally fine. It's okay. We'll support it. During my child fellowship across three tracks, we had five trainees who were pregnant, and we had like a baby shower for the entire fellowship. I mean, it was once in my program director's lifetime, I'm imagining, and I think she'd like to keep it that way. But it was something. You guys are scaring me. I have seven residents, female residents out of eight, so. I would say, again, the paternity break is similar these days, so that shouldn't create any issues. Also be mindful that in terms of the number of psychiatrists, for example, women are actually right now more than 50% compared to the total number. And as some of the studies have said, they are somewhat better physicians. So it's okay. I think people can work with that. The only other thing I would add is if you do not bring these, if a program director or faculty brings up these kind of questions, like you were saying, these are not appropriate questions to ask in an interview. If you bring up a question, then obviously they'll answer whatever the policy might be. But more or less, I don't think first year incoming people typically don't get into those questions because their aim is more to get into the pipeline, and it gets more to the fellowship side of things when a lot of these breaks happen. And that's totally, we are all human, and being a parent is a blessing. Thank you. This question has come up across sessions so many times, so I'm like, you know, the elephant in the room needs to be in the room, and like, addressed as an elephant. But jokes aside, supporting families is a part of the process, so that applies to women and men equally. Now with that, we open it to general questions, so anybody who has a question, please feel free to get up to the mic. Hello. I would like to make a comment, but before, I would like to thank all the program directors here because they're bombarded with texts and emails, everyone trying to get in, and maybe there's a lot of family and friends that a lot of the people might tend to share their experience, but here the program directors share with all of us in the public, so especially thank you for that. And the comment that I would like to make, and I was an applicant over the last year as well, so the geographical preferences, if I make a northeastern preference and there's a California program, that program doesn't see that I'm not, I applied to northeastern, but just sees that I didn't make a preference, so I just want to make that comment. Thank you. So just so that I get it correctly, you're saying if you show your geographic preferences in the northeast, programs in California will not see that you've made that preference? Yes, and you're able to make three geographical preferences, and the ones that are not in those three will see that you didn't make one. If that program is in that, I don't know if it changed, but I think this might be the least. So for others to provide contact, so if you picked my program and my geographical area, then it will show me, otherwise it's going to appear blank as I just showed up on the slides. So it does not, it plays to your advantage if you want a program and you signal them, but it does not become a disadvantage because you signaled one to actually have a chance with the other one, that you didn't say anything. Not the signal, but the geographic preference that he's talking about. Thank you again. Thank you. First of all, thank you so much for this valuable talk, both the organizer and the, can anyone, can everyone hear me? Okay. Just a little closer. Can you hear me better now? Okay, thank you. So my question was that, as you mentioned, it's really important to have connections and mentorship within psychiatry to match, and I was wondering if there would be some sort of support group or maybe a caucus of IMGs that we could kind of lean into and ask for support maybe with the faculties or maybe just in the student level that we could kind of apply to a register. And another thing was that in terms of making connections with the program, what would kind of be your recommendations of how to do, how to make those connections? Thank you. I can answer the first one. So APA does have IMG caucus that you can become a member of it, and they do have like quarterly meetings so you can attend those meetings. Those meetings are publicized when the meeting is happening, different faculty members attended. And if you have areas of interest you want to bring it up over there, if anybody's there to mentor you, that could be a good one platform to get connected with any of the faculty members or the senior psychiatrist. Thank you. I can add from the APA side, you know, everyone in this room who is not a member, please take a minute to, you know, go ahead and sign up. It's for international medical graduates this year we've increased or changed the definition of what a medical student is just to, you know, bring in people within. So what happens as IMGs, you're done with med school, but you're not in residency so you're caught in limbo and you don't know where to go because there's no category. So the membership for as a medical student that has been increased to three years after graduation, so it allows you to, you know, go through USMLEs knowing that matching is not easy. So that process is in place already. So once you join, it's free, obviously, for medical students, so I don't see any reason why you would not do it, you know, and then I would say like Dr. Mali said, so there's an IMG caucus. All you got to do is check mark and you'll start getting, you know, emails and things like that. You get connected. The other thing that, you know, Dr. Mali and Dr. Gandhi were part of an IMG workforce and one of the recommendations that we haven't gotten to is trying to develop a mentor mentee sort of, you know, track and that's something as she takes on the chair of the membership committee, I'm pretty sure that's something that's on the agenda. Thank you so much. Hi everyone. So firstly, thank you for taking the time to provide us all with such great insight. My question is that how is, you know, research, sorry, like experience, clinical experience in countries that are not the United States viewed in general and then more specifically how are like LORs from physicians that are not training or haven't trained in the U.S. or practiced in the U.S. viewed by your programs? That's a great question. They may need a little bit of help from you in terms of how they write their LORs. Sometimes they could be very generic and that's not going to help you. So as we heard today, the LORs should comment on, number one, who you as a person and then a certain sense of like your passion for the field of psychiatry if they are able to comment on it. And then the other qualities of you as a medical student when you work with them or as a resident you work with them in terms of accountability, in terms of capacity to take an extra load going beyond the traditional kind of parameters for patient care. So there are a lot of qualities we have which may not be really relevant exclusively psychiatry but it sort of demonstrates and highlights your qualities as a physician. And if your mentor could comment on all those, then it becomes a much more complete and comprehensive letter. So all I'm kind of saying to you is maybe when you're asking your professor, maybe helping them to understand what the program director is looking for here. So if I divide your question into two parts, so one is about letter of recommendation, and another is about clinical experience, I think staying clinically active is really important, because that keeps you more up to date with the clinical knowledge. So having residency experience back home, that's definitely an edge. So try to stay clinically active. About the second part, letter of recommendation, my personal thought is that more than who wrote it, it's what's in there that really matters. And that's where Dr. John also mentioned that usually what happens is letter writing is not a strong pursuit back home. So if you can send them the core competencies, their definitions, and what can go in there, your current CV, so they can write a letter of recommendation. So usually from IMGs, their struggle is if they have a letter from back home, it can be very generic, and their MSP does not help in a lot of cases either. So that's where you can guide them and see what they can do. So that's the answer for your question. For the last part, besides the PA-IMG caucus, there are ethnic organizations. There are at least AAPIs there, IEAPAs there. On the Pakistani side, there are organizations who can help and support you. Edpert also had webinars last year. And if you want to connect with the program, just see if they have clinical opportunities at the program, or if they have research opportunities, that's one way for you to connect with the program. Thank you. And if I could add, we've created a resource guide not too long ago. It's on the APA website. It has a bunch of things ranging from availability of observerships, where they are, what to look for, potentially all of the things that we've tried to cover, to other basics related to acculturation, financial management, a lot of things. So it's like 70, 80 pages. If you have time, please go. It'll be helpful. So with the letter to your question, from the other side now, I think when I compare my letters from India, where I did med school, to the letters I see from students from med school here, our dean's letters are not as compelling, because they'll have a general format for a dean's letter for all the kids in the school. The other thing is, we don't highlight the same kind of achievements, because that's not how medical school is in every other country. So that's one area, which you can't change much. You can't have a personalized dean's letter. But the letters that also come from attendings are geared towards what you do in that particular country. So just like all the esteemed panelists have said, helping your writer know what to highlight, you can give them bullet points, which are actually real and need to be highlighted, and tell them, why don't you use this as a guide? But these are the things that will help me look like a compelling candidate, relevant to the program I'm applying to. And they might not pick it up on their own. Thank you so much. Hi, I'm Daniel. I'm an osteopathic medical student applying psychiatry this fall. So my question is regarding, outside of USMLE and COMLEX, and taking both to be a competitive applicant for MD primary programs, now due to ACGME being kind of, including DO and MD applicants, what's your advice as a DO kind of in the MD landscape? For residency programs that primarily haven't taken DO applicants, how should DOs kind of speak up, talk about their programs? Because like my DO school, for example, we train at a academic hospital. We are with residency programs. So I feel like a lot of MD schools and bigger research institutions don't know that. So what's your advice for that? So you are asking, how can we address the disparity? How can I, as a DO applicant, be competitive in an MD institution outside of taking both exams? That's kind of what everyone's already done. But how can I kind of have leverage? So I think there is a disparity when it comes to overall the landscape of residency between MDs and DOs. But thankfully, except a few institutions, it is not widespread. So still, people take DOs and MDs. And if you apply to many of the programs, they're not going to take it against you if you have done complex and you have not done USMLEs. If you can take it, that's great. If you cannot take it, that's fine, too. How to address this is you can do other stuff. So for example, volunteer opportunities, research experience. APA has district branches almost in every state. So if you can be more active in those district branches, and they can have opportunities for medical students and trainees. So be active on those platforms, too. That's something also help you build networks, too, or connections. So do those things and see. And obviously, then at the end, it's about interview skills. Yes, you guys are anxious about matching. We are also anxious about having good candidates. So the better you are, it will put you out of the line. Not out of the line in a way you're not going to be matched. I think it's critical to keep in mind a lot of programs are holistically looking at the application. They're not looking at DO versus MD versus non-USMD in terms of where things stand. A lot of programs are headed in that direction. Used to be a question like, oh, I've taken complex. I did well, but do I need to take a USMLE? I don't know if it really strengthens your application. I would go with what Dr. Navid said, which is try and build on a broader skill base if they are potentially volunteer, research, or leadership opportunities. There can be medical student-run clinics, those sort of things, where you can display what you actually did. That's what folks are looking for. And as he was mentioning, training directors get to be equally or more anxious than the applicants because they have also all the clinical services to run. So they want to make sure everyone's in good skill set and obviously somewhat of a leadership and interpersonal skills. I'll just add one thing, like having the elective experiences in those places, that could also be helpful sometimes. Like if you're in DO school, wanted to get in particular residency that have more MDs, so showcasing your talent over there, like getting an opportunity to work with the residence faculty over there. But reviewing the applications, honestly, we review all MDs, DOs, non-US altogether. It's just like where you see the fit, and sometimes you end up getting more MDs versus DOs. So I don't see that should be a big problem, but that could be another way if you're interested in one particular program. So in my training, we had MDs and DOs together. There was absolutely no difference. We were all good, clinically sound, did all the rotations together. The attendings didn't see a difference. No one asked, oh, but you're good, but did you do an MD or a DO kind of training? I do want to, again, highlight what the speaker said. There are actually a lot of med student opportunities. So it depends on perspective. So if you take anything from this session, we always walk into like a residency session thinking about, oh my god, I've got all these things to cover. These questions, how do I get all these problems answered? Let's take a different approach today. It's a matter of perspective, right? Take a strength-based approach, saying I'm going into this session with all these problems, so today I walk out thinking about all the strengths I have in my application that resonated with all these things that the presenter said. And you check off all the strengths, not the things you need to do. And then your to-do list becomes smaller, and you feel more confident going back. And then you can kind of problem solve on the things you really need to do to enhance your application. Thank you. Hi. I'm Dhwani. I'm a med student from Bangalore, India. Firstly, thank you so much for a lovely session. I think I really appreciate the very specific pointers, lists of themes, and everything like that. It really demystifies the process that can remain ambiguous despite having a lot of resources out there. So I have a two-part question about signals. The first part of the question is, in your opinion, what would be the role of the informal letter of interest now that there is a formal signaling system in place? And the second part of the question is probably a little bit more hypothetical. I don't think that it's something that any of us are really going to be messing with. But as program directors, do you see the formal signaling system eventually changing the landscape such that the number of applications that the applicant puts forward would reduce, almost closing the gap between the number of signals and the total number of applications that the applicant sends out? I can go. So for the second, I will answer your second question first, that it is definitely helpful to have signals right now. We're going to have 10 this year. I don't know. We don't have enough data how it's going to impact overall in the future. So it would be nice to have more candidates that are really interested in your program rather than have 1,000 that may be not everybody is interested. So it gets hard on our end as well. So I'm hoping that would be a step in the right direction. And so that's my take on that one. And the first one, you asked about formal letter of intent versus signal. What would be the difference? So signal is more so done in the beginning, that you are interested in the program. It's basically, I see it as a kind of winking to the program. Hey, look at my application. I'm here, that type of thing. So it's like your application has a higher chance of get seen, but it doesn't guarantee you an interview. Have to keep in mind. So you have to utilize your signals judiciously. It's only 10. You want to make sure that where one is, if you are highly interested because of certain number of reason in that program, signal that program. Secondly, you want to use your signal where you feel that, if you are signaling to really, really high yield programs where you know that your application may not be that competitive, even if you signal, you're not guaranteed that interview is going to come. So you want to make sure that you signal where you feel you are the fit also. And letter of intent people send afterwards, after the interview process is done. As Dr. John was talking about, your initial application is only 30%. Then what happens in the interview makes a whole lot of difference. We do receive letters of intent from many candidates, but that does not impact the rank list. It is our rank list is always made by faculty who will program selection committee together. So I don't see any difference that you can still send the letters of intent that if you are interested in program. I don't see any much connection with the signal that it would reduce in any way because of the way it works, the process. So overall, informal letter of interest, I think, has low yield. But it can help you if you are waitlisted at a program. So when we sent interviews yesterday, we just sent in, not yesterday, last year, we sent all in one wave. And then we waitlisted roughly about 15 people in there. So if there are cancellations, you are waitlisted, you may get bumped up. But because I have a waitlist, there is very less likely chance that I'm going to pick someone who I'm not planning to interview early on. So it does help a little bit with the waitlisted, but you're never going to know whether you're waitlisted. But at the same time, don't over bombard with letter of interest. Don't message people on LinkedIn. Ask, I think, an email would be fine. Maybe two to three times spread over the match session would be OK. And write enough that if I'm riding an elevator, I can read all in that elevator. I'm sorry. I confused with the letter of intent that's sent at the end, like you were talking about formal letter of interest. Yeah. That's about three, five. But I think these questions are really important. So we'll take the two questions if the respected guests in line, if the presenters are OK, and don't have to be at the next session. So Dr. Mali and I will be stepping away. Thank you all. But the next two questions, please proceed. OK. Thank you all. Hello. You have been working in a psychiatric clinical experience, or is it? Oh, no. OK. So my question is, since I know different specialties have different formats for a letter of recommendation, and also in terms of, let's say, are there setting qualities itself that relate to psychiatry? I know there's some form of overlap. Is there any setting qualities that relate to psychiatry that could be mentioned within? I know communication skills is very important. There's an overlap. I think, as psychiatrists, what we definitely value is one's capacity to feel empathy for the patient. So compassion, empathy, capacity to have good interview skills. So it doesn't matter which specialty, to interview a patient very well. And then level of accountability, which means that you've done your really best for the care of the patient. And if you've been in a very active clinical setting, like a residency, we like to see how you navigated the whole part of clinical reasoning and documentation, how good are you in your diagnostic acumen. And for psychiatry, if you're psychiatry specific, there are aspects of interaction with the patient which could be under a broad category of what we might call psychotherapeutic skills, empathizing with the patient, practicing early supportive psychotherapy. So those are the areas, if your letter writer could focus on, it might resonate with us. I will also say, when you're writing your personal statement, link your clinical experience, how did they help you develop those skills along the way. For example, I read this personal statement of this person. Actually, a US MD created an elective on empathy for physicians. So that was in medical school elective. So if you can give an example that you can relate that how that helped you grow that skill, I think that can be helpful. OK. All right, thank you. Last word, I think the next round speakers are here. I'd like to ask, in your opinion, how valuable it is to have the USMLE step three on the application. Like, if I need to make a decision right now, whether I'm investing my time in the step three or doing something else that will contribute to my experience or because I just need it, you know, because we all need to make a living and can't only be busy with investing in a unfortunate way. I think it's a great question because it sort of looks at how to pass out how we're going to do the next six months, whether we're going to focus on the application or study for step three. My sense is that it is very much program dependent. Some programs value your performance step three as a way of ensuring that you're going to do really well in your offside rotations. Some programs sort of don't even look at it because they are mostly interested in how they see every other candidate. So it's difficult for me to say I really don't look at step three, but some programs may insist or can give you signals that that's very important to them. Very few programs actually request step three when I looked at all the requirements. But I was thinking, you know, how there is a significant additional value in having it on my application. Yeah, in reality, no program is going to ask you for step three because then that means that they don't want you as MDs and DOs in their residency program. So because they cannot take step three out of before residency. So I think just from the general standpoint and from where I am, step three helps if, you know, your year of graduation is, you know, is longer than most traditional, most applicants. So usually it's taking two to three years for IMDs to appear in the match. But if someone has been out of medical school for five, ten years, I would prefer that they have step three. If someone has a failure on previous exams or low scores, that's where step three will help. Third thing would be if you want to go for H1 visa compared to J1 visa, that's when you need step three. In some countries, you know, J1 can go to admin processing and that can be tougher. So in those cases, H1 might be easier. Okay, thank you. So as you can see, we all have a little bit of a difference of opinion. My take would be, yes, go for it. And I'll, you know, I think it's really critical for an IMG, in my opinion, especially as all the training directors for if you're going to PGY-3, you need typically a USMLE step three pass. So as a training director, you're seeing it as, okay, this person has already taken that limitation out. And like, you know, Dr. Navid said, if there has been a, you know, difficulty passing another exam or, you know, the two, three points he elicited, I think it's even more critical there. But if you have an opportunity, I would knock it out of the park right away. That's my personal take. So, we'll keep you in a dilemma. So just- I think it's a good addition. Yeah, everything helps. So for our eight incoming residents, I think only two or three have done step three, if that helps. Thank you all. Thanks for joining. Safe travels.

residency applications

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personal statement

letters of recommendation

program signaling

program directors

interview process

emotional intelligence

psychiatry

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