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Pathway To Radiology Training - United States



This engaging on-demand teaching session is led by Shoy, an incoming radiology resident at the University of Chicago. The course covers a range of topics relevant for anyone considering a career in the United States radiology training pathway. Shoy provides real-world advice and experiences as to what helped him during his application for radiology and offers insightful tips for others. Further, he discusses the process for matching into radiology, factors that improve a candidate's chances for a successful match, the responsibilities and expectations of a radio trainee, and the pathways to diagnostic and interventional radiology. This interactive session welcomes participation and provides invaluable lessons that cannot be easily found online. Whether you're considering a career in radiology or are curious about the field, this session offers a wealth of knowledge and resources.
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This event will give a detailed explanation of requirements (and tips) that will be useful for junior doctors and medical students looking to apply for Radiology Training in the United States.

Speaker: Dr Omoleye Subomi

Incoming PGY-2, Diagnostic Radiology, UChicago (Prelim Internal Medicine PGY-1 UChicago)

Learning objectives

1. Understand the basic structure and requirements necessary for the US radiology training pathway. 2. Learn about the process for matching into a radiology residency and factors that may increase a candidate's chances of a successful match. 3. Recognize the typical responsibilities and expectations of a radiology trainee in a US program. 4. Gain insights about the pros and cons of a career in radiology, including personal experiences and tips. 5. Familiarize oneself with the procedures, expectations, and curriculum of an internship or prelim year at a US hospital.
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Computer generated transcript

The following transcript was generated automatically from the content and has not been checked or corrected manually.

All right guys. Um I think we should just um start the event and people can join us more. Fine. Um Doctor. OK. Um I my, my screen. OK. Can you see a full screen with the eye slide title? Yes. Yes. All right, I do. OK. Uh Hi, everyone. Um My name is Shoy. Um It's nice to be here first. I want to thank my friend Moi uh Doctor 10 for inviting me um to speak. I really love to share experiences and tips because um that's what helped me and that helped others um along the line to apply to radiology to introduce myself. Um So, you know, my name, I am I an incoming radiology resident at the University of Chicago. Um And I am also going to be doing my pre so one point is no train. I'm going to be doing my prelim uh year also at the same um um hospital and I'll explain what that means for those that don't know what the prelim year entails. Um So, the objectives um I was, I was given were to talk about, you know, the basic structure and requirements for um the US radiology training pathway. And I'm going to be sharing about the process for matching into radiology. Um try to get a sense of what factors improve a candidate's chances for a successful match. And um I'll also talk about the typically the responsibilities um and expectations of radio trainee, even as someone who is, you know, still about to start radiology proper. There's some insights that um II am able to share on that and um and just share personal experiences and tips. So I want you to be interactive. I know that the video is going to be saved on youtube for people to um refer to data, but please feel free to put questions in the chart. Um And the the slide will just serve as a guy. I'm not, you know, I'm not here to ate information that you can easily find online. I want to be as helpful and as interactive as possible. Uh So at the end of the session, um if there are any questions you have or that you had coming into this, that you feel that, you know, we can talk about, please feel free to ask. So let's talk about radiology um and keeping the black and white theme um as part of the culture um radiology in the US. Um The residency training for radiology is five years uh that's for diagnostic radiology. Um There's also integrated interventional radiology track that is six years. Um So when, when you think about the duration of radiology. Always keep in mind that first year is the internship year. Um It's also called, some people will call it a transitional year depending on how the first year structured, um or a preliminary year. Um I am doing my preliminary year in internal medicine. Some choose to do this in surgery. Some even choose to do in obstetrics and gynecology, pediatrics depending on what you want out of your first tier internship. Um Radiology does have requirements on what that first tier should entail. Um So typically people will go with internist or surgery and then the remaining four years, um we call it R one to R four. So our like radiology resident one and an R one will be APG Y two. So P gy means postgraduate year if you've had or seen that somewhere and your postgraduate year one is actually your intern year and your R one start at your postgraduate year too. While the intervention on radiology is six years. And um same concept with the preliminary year, people who are going for interventional radiology would usually choose to do general surgery for their first year just because IR is more procedure oriented. And then R one to R five would be um the um interventional radiology um proper years. Um And then, so just there are many fellowship opportunities in radiology and uh just talk a bit about what the curriculum looks like. So I said the first year is the intern year. You're not really doing radiology in the first year. Um And then I went to this is, this is a diagnostic radiology curriculum. So if you look at the spread, you're really looking at different body parts um and looking at different modalities. So with the first year, um your f the first year is more of going to be two dial imaging, some three dimensional imaging with CT. Um Most programs don't do MRI S the first year. I think that's, that's uh the second year for most programs. Uh But the, the general thing, the general concept is that the first year and moving up to the fourth year, there is greater responsibility and graded autonomy in, in doing the reads and um and whatnot and diagnostic radiology, residents also get interventional radiology rotations because even diagnostic radiology involves procedures. So um one myth is that diagnostic radiologist don't do procedures. That's not true because diagnostic radiologist, depending on what subspecialty, you think you can be doing a lot of procedures or you could be not do procedures depending really just depends on how you want to shape your practice. But there's an opportunity there are many opportunities to do procedures in diagnostic radiology for interventional radiology. Um So the training for IR is almost is pretty much identical to diagnostic radiology up to P GY four, also known as R 33 and then from R four. So you know, here this R three. This is where the end at P GY five. So for IR, for people who merch into the integrated IR track, this is the year that they start to do more IR and then there's one more year of just IR also called like an IR fellowship. There is a track that I don't appear because it's part of um it's an opportunity for diagnostic radio people that match to diagnostic radiology to specialize in IR. Basically, it looks also looks like this. It's called ESI R um early specialization in IR where usually in the R two year um radiology residents, diagnostic radiology residents who are, you know, find out there that they are interested in IR can apply for that pathway. And then when they get to their P GY five instead of doing mostly diagnostic radiology, they will do mostly IR and then they will have to look for a one-year Ir fellowship that may or may not be part of the program they are on. So the integrated IR is called integrated because that extra one year of I RR fellowship is heart COVID program. So you know that when you march into an integrated IR, you're going to complete all your Dr and IR training in the same place. Um Whereas if you march into Dr and you want you change your mind along the line that you want to do, Ir um you apply for the ES RR pathway and then your track now looks like this where you do, um IR in the R four year or P GY five and then you look for a one year fellowship that may or may not be part of the program that you are in. So the daily schedule for Dr and IR residents is pretty much the same for the first four years. Um I said earlier and the daily schedule is there by program. But um, as the, the, the, the curricular output area is just an example. This is for you again and the area of the curriculum was for Yale. Uh, but most programs have similar curricular. Um, it varies by programs. Some programs start at eight o'clock, some at 730. Um, and then some programs will start with like a morning, like morning conference or that's just go straight into work and then what you do as a resident really is you, you read studies and then you read out with the attending and then you attend the attending changes. Um, and then you basically, once you add what the attending has said and you finalize the report. Usually most programs have a mid day conference around lunch time where you grab your lunch and then you go for noon conference where, um, people present um on differ on different topics. Um and, uh, and then you go back to work and the same thing, interpret studies, read out with attendings and then, and then reports and then most programs would end at 5 p.m. like typical work day. Um, so that's, that's kind of how, um, the schedule looks like for, er, um, I obviously would be more proceed during the day and whatnot but, um, that's more dr so to the match. So, um, I'm sure we've, all, most people on this go have e have heard of the match and that's kind of some people's first introduction into UF residency and there are some names that you need to know about the match. Everyone knows that the match in March. Um and um it is um organized by the NR MPA National Residents matching program, the E CFM G. So it, it's good to know like what each of these stand for and how we fit into each of these. If, if you can think of E CFM G as the gene for international medical graduates. So, American medical graduate, American medical graduates uh also called MD Seniors. When you look at um publications from the NR NP, those um the the medical graduates from schools here um are in schools that are accredited by the nation. So there's kind of a trust system and accreditation system whereby you know, these schools can send for their products to residency training programs. And no one needs to certify the um candidates coming from those schools because there's already um the a liaison committee for Medical Education LCM E that governs basically medical school accreditation to march into a program you need to be certified by the E CFM G. Um So the E FMD is now what stands in as the me like the Dean of Im GS, what the medical schools in the US do for their um for their students and eventually graduates to match. That's what EC FMD does for us, Im GS. Um That's why it's called the Educational Commission for foreign medical graduates. Now, not all medical schools, not all international medical schools. Um I'll rephrase that. Not all grad, not all graduates, depending on the school that you are coming from, can be F MG certified because not all medical schools are recognized by F MG. So if your medical school is recognized by AFM G, then you can start the process to AFM G certification which I'll talk, talk about. Now the NR NP was talked about, that's the body that um organizes the match um between candidates and programs. Um And that's where you submit your list, what they call the rank list. Um Now that's the um electronic residency application system is owned by the AMC of, of American Medical and us is the um basically you can see A s is the body that helps you manage um applying to different programs. So it's, it makes sense because this is the of American Medical Colleges you're going into us, you create an account with us and through us, you can access, applying to different programs but when you apply, NR mps would not organizing the even match when you've applied and interviewed, right? So you understand more, but I just want um for those that don't know what those mean, those um acronyms mean. OK. Kind of like an introduction to that. So NRM P um to participate in the match. Basically, that's N RP eligibility, you need to have a medical degree, obviously, if you are not a US um medical student, um and while you don't need to have a safe certification at the time that you are registering, you need to have me requirements for a safe ification by the time that the run or that list is due, that's usually around uh in February, II will need to check um the timeline but um the, the NR NP releases the timeline every year. So the safest thing is to let all the requirements for a different certification before um you sending applications, that's the safest thing to do. Uh So you don't need to be physically present in the US to participate in the match, right? So this is the match process um that it's probably on the NRM P website that you can go look it up. So people apply for training. Um and then um you, you register with the NR NP and um you interview with programs. So that's why you sending patients to U programs, call you for interviews, interview and then you run programs, programs run to NR and might run the algorithm and then the match results come out. So that's kind of like a snapshot of the match process. So, so pain is a CT which you need to match into the program. This is a given, graduated from medical school. But the exams that you take um are the M in step one and step CK. Um SM means us medical sensing exams for those who don't know um they used to be a USM M to CS. So CK means clinical knowledge and CS means clinical skills. CS was um canceled during COVID and it's not coming back. What has taken the place of CS is um the O et occupational English test that tests your ability to communicate in a clinical setting. CF used to involve um patient encounters where there will be a preceptor that was you take your history, examine et cetera and that examined those skills also your skills indirectly. Um But now that has been taken over by O ET. So you need to satisfy requirements to be EC FMD certified and there are different pathways for AC certification. You can read more about that here. So this is the normal pathway um I in the um as in the O ET and then apply for A C FMD certification. Um The pathways will also depend the pathway you choose, will also depend on if you are licensed to practice anywhere else in the world. But go through this link. And you see um all the different pathways for a CMD certification. So for the exams that's really important to talk about because um again, um the data has shown that the step exam performance is the single most important predictor of a successful match. It used to be step one when it was scored. But now step one is pass or fail. And I think that the recently concluded match is the one that you know, period where step became pass or fail. But some people who were applying for the match were people that had scores do. Those usually were international medical record. So residency admissions committees have to um look at candidates with scores and candidates without scores. For example, I did my step one in 2021. So I applied for the match last year. I had a score and there were co applicants who didn't have scores. But I think this year there will still be, I mean, there will still be applicants who have scored every year depending on when they wrote step one. There, there are probably people who wrote step one many years ago who will be applying for the match now. But by and large that percentage is going to keep reducing. And then there'll be a point where virtually no one has a step one score and then it becomes totally irrelevant. But if you have a step one score, know that it will be looked at because the, the um usm N send, send you a transcript is going to um blur out your score as pass just because others have pass or fail. If you go, it will be in your transcript and program to see and potentially calculate into their decisions because they can see. Um So one is one day, it's a one day exam, it's eight hours long and it looks at the basic me um concepts, basic sciences that are done for medical practice. So think anatomy, uh chemistry, physiology, um from oncology. Um and also behavioral sciences, mostly psychology. And then you have some uh stat as well. So you can know more about the curriculum. Just go to the S MA website, look at what the curriculum is, a standardized curriculum and there is a uh set um percentage of questions that have to cover each of the domains that they are testing now study resource for a lot. I just think you, that's like the key. That's the, I think that has, everyone says you because it, it just works. Um So you first a pa acronym you has just over time shown themselves to be, you know, they, they've been around for a long time, they have lots of people working on them gathering um um the US tests um curriculum and what get information on what the questions are like. So you want to probably be what, you know, the, the with the result that we give you like a close representation of the step point exam, um other health resources, medical video. And I used all of these resource that I have put up here. So um they have that I can say, and I think that the way that you study will also depend on you like your study style. There's no set advice on how long should I start to study for? Step on? Because when step one used to be scored, you know, people would say study for six months. Um So people would say study for 3 to 6 months. But to be honest, there's really no set amount of time, the time you need is the time that you would need to get to the score you want. So if you just wanted 240 now it's not part of you. But again, if you just wanna pass, then there's a time you need to study. If you want to pass and understand the concept that will help you for step two, then there's also, you know, you have to factor that into your decision on how you want to prepare. Step two is now the new benchmark. So step two is more application focused, it's more clinically oriented. I'm going to see questions like what is the enzyme and what's the rate limiting step in this pathway? Uh What staining are you going to? You're not gonna probably not gonna see those types of questions here. You're gonna be seeing questions around. What's the next best step in this patient? What test would you order? What's, you know, usually what's the next best step? What, what test would you order? Those tend to be more common questions. And then you will see um drug um post as like where you have to interpret data from like drug um from my posted and whatnot. So it's a one day long e one day, nine hour long exam. The main resource for this um People will tell you is you and I agree you can also supplement with AMBOS and first aid. But personally, you was my, was my, was my uh primary resource and AMBOS I supplemented with AMBOS. Um So studying for step two, the resources are a bit more trimmed. Um but um it's not a walk in the park, you definitely need time to study for the exam. Um And again, the amount of time you devote into studying um would also depend on what your target is. And I presume that everyone here wants to apply to radiology. So if you're trying to, thinking of applying to radiology, you want to beat the average performance of typical applicants into the program, especially as an IMG. So um that kind of helps you think about what you should target for the exam. So here is data released by the NR NP for the 2022 too much. So, if you look at uh I only um picked out the one for, I just cause that's what's relevant for us. Um If you look at diagnostic radiology, the blue um bars uh represent the um the matched candidates and the green represent not matched. You can see that the average score for matched candidates for USI M GS was somewhere just slightly less than 250 for um nonmatch was slightly less than 240 for the non usi M GS. You can see that the average um step two CT score was over 250 slightly over 250. And uh the unmatched was slightly under 250. So that was like a very close margin. You can see that the non USI S have been um higher to C score um than the um US. And so it kind of tells you, you know what competition you are up against and what to target. So someone will tell you that you aim to get a 60 above for step two. That's like a safe score to have one. Step one was still there. The advice would be to aim to get it to 50 above. So just so that you are comfortably above the mean score because number one is competitive and number two, you're an I MG. So you need to beat the average if you look, look at and this, this uh this person on Twitter JB came on there. You may want to follow him if you want to follow um statistics on the match, it was really helpful um infographics um summarize the match statistics and whatnot every year. Um So definitely follow him. Um He did not ask me to advertise his handle, but I find he was really helpful in. You can see here that this step one pass rate has dropped particularly since it became pass or fail. Um It's still high, it's still above 9% but it's definitely dropped. But the takeaway there is that for radiology to look at the applicant. So the the people who are in, in programs already just 0.4 percent of residents in radiology ever failed any of the steps. So step one as someone who is, if you're thinking of writing to step of writing, step one, then aim to pass because you don't want to be in that small percentage that but let's just say that there are not many people who me into radiology who ever failed any of the steps. So if you want to optimize your chances of applying, then um aim not to fail. Step one because um apparently rates and step one have risen since it became pass of. Uh if you look at this red of candidates, so you can think of this as like from increasingly competitive to less competitive just by how many MD. So MDA means like us medical graduates do means doctor of osteopathy. Also typically from the US then IM GS here includes USI M GS and non USI M GS. The yellow means unfilled. So unfilled means that after the mesh, there were still slots available. If you look at radiology here, I think this year there was one on field sport. Uh after the match last year, there was none. Um and uh a small percentage of the people who match with radiology are IM DS. So it's really the, the summary they take it with radiology is competitive. It's more, it's becoming more and more competitive. So that's to kind of orient you into um how um to think about preparing your application in a way that, you know, reflects that, you know, how competitive radiology is. Um I also look at the minimum of appli application for applicants, average applicants into radiology up to around 73.5 programs. So that's just to also a measure of thinking, you know, how competitive is this program that I'm applying to? Um So there's something called preference signaling that's been recently that I want to explain because I think people get confused about signals. So when you apply to any specialty, be it, uh you know, when you apply to the ma you can apply to more than one specialty for every specialty that you apply to, you have a limited number of signals for diagnostic and interventional radiology. You have 12. So you, you won't have 12 signals for IR and 12 for Dr. So if you are going to radiology, you have to spread your 12 signals across both Ir and Dr. And the reason you see this yellow is that there are six gold signals and, and six silver signals and the programs will know if you signal them. A signal is like here you saw that the applicant apply to over 70 programs do say I applied to 75 and I applied to, I think I applied to 90 yeah, to 90 programs. Um You have to apply to as many as for optimize the chances at getting interviews and you have 12 signals. So the go signals and silver signals are ways for programs to know like how much does this applicant want to come into it? Because they are limited, they are 12. So for you to give one signal, if for, if, if a program sees a go signal, then that program knows that they are in your top six choice out of all the possible programs that you could have applied to, then, you know, then your top six and the silver signals will tell the programs that they your top 12, but it also tell them they are not in your top six. Theoretically, they shouldn't think that because you could choose not to use your signals, could choose not to use any of your good signals and use only silver signals. In which case a program that silver signals will be your top six but no one, most people know that you use all your, all your signals. So your program is a silver signal. They know that they are not in your top six, but at least they are in your top 12. Um Rumors I heard rumors last year that programs are not even counting the sig silver signals because of how competitive radiology is. If especially really competitive programs like think of applying to like John Hopkins and then they see a silver signal. Um Why are we not in your top? That's the question they're gonna be asking themselves. So um people advised to use the signals wisely, so apply. Yes, definitely a lot of signals to really competitive program that you really want to get into because if you don't, you're probably killing chances at even getting an interview because um I heard rumors again for people that new program directors that um signals are used to filter candidates. So um say an interview had like 100 slots before interviewing. So every program has a limited interview um quota. Most programs are depending on the number of residents slots that uh residency slots that the program has. Um then that would, you know, that would determine how many, what the quota is. So a program that has about 10 slots might have 10 residency slots might have 100 interview slots. So a 10 to 1 ratio by a program that has just two slots only have 20 the slot that, that should also inform how you apply. If you are really limited on resources as an MMG you probably won't apply to bigger programs because you have a higher chance of being interviewed at those programs because they are bigger. So they offer more interviews. Um and not surprising many programs start out by first considering um us medical graduates. And then IM GS, if you have a really competitive I MG, you can scale through some of those filters because they are there. Um And they, they are there, let's just do it that way. So for really competitive programs that you really, really want to get into, I would say definitely signal them. And then also include like programs that you have an edge that may not be as competitive. So when I see an edge, maybe you did a rotation there, um or you know, someone there, you did some research there, you already have an edge. So if you don't out them, you're kind of telling them that I don't really like you even though I know I have an age, I don't really, you know, I don't like you enough to give you one of my top 12 slots. And so that might just kill your chances. So it, it depends on how, again all of these things should be based on how competitive you think you are. There are candidates who I heard um from program directors that at, at the RNA conference that, you know, there are program directors that interviewed candidates that did not signal them. And this way, program directors are really talk programs based on the merits of that candidate. So say the candidate is just so good. Um They can still have an interview to candidate that did not signal them. The way that the N RP um the in your US, the way that they, they told programs to use the signal is it's supposed to be used as a tiebreaker. So if there were two equally qualified candidates, the signal can be a tiebreaker, but everyone goes with the part of this resistance. So it's easier to just use that the you there because most people have cardiology are very qualified. It's hard to say two candidates are Q qualified to start of time. Step three is you don't need to do step three to be safe and be certified II without step three. This is solely based on again, how you look at your application. If you are beginning, not so strong and you want to give yourself just under that edge, then maybe right? Step three would help for radiology. I don't know how much it helps because radiology starts at year two. Remember? So by the time people are coming to you to be very in step three, right? As I am D so radio program admissions probably don't look at, you know, passing a step three as important, but if you just want to give like every little bump count for competitive specialties. So that might just be the thing that makes you more qualified than someone else. So if you can write it, but people match without step three all the time and is if you have great step two scores, um it becomes less important but it might give you an edge. Um So the other thing I did mention about the steps is that the sequence you don't need to take step one before step two, you could take step two before step one. And this is, this is important because there are people who really want to apply this year. Um You could potentially take step two first because you know that that's the one with the score and then take step one. But again, just the message is there's no set sequence, you can do step two and then step one. So for the 2025 match, the rest season begins in five. So less than a month away, your season begins. Basically what that means is you can create an account with U rest and you can start putting your application together. So getting your personal statement, getting a little recommendation, you can start working on those now, like as early as June. Um and then in September 4, you can start so meeting to programs, programs will not be able to look at the applications until September 25. So that gives you like an idea of the timeline. So it means that if you're gonna get letters, we want all your letters to be submitted before, give, give it a week before because lets take time to. It's not like once the letter writer submits that it will be available. So you want to see, look on, they will tell you how many business days it takes to process a letter yourself enough time. I can't stress that, that enough. You need to give yourself enough time so that you don't feel like you're rushing, rushing your application, your personal statement, you can start now um because it takes time to write a good personal statement. Um Letter writers and letter writers. I that's like the very limiting step for most people because you can write your personal statement overnight. It would be a good personal statement, but at least you have a personal statement over night if you choose to not even be good. Um But it's probably not going to be good if you're rushing and submit. But your letter writers, you can't rush them. We can't send you replace for that uh today and say that you want it tomorrow and expect them to write a good letter for you. So tho those are the things that you need to work on early CV. You can prepare your CV. In one day, you can prepare the content of the CV in one day. So the research, the CV until like research et cetera. So if you're thinking of publications, remember that by those applications should be out um by the time that programs can assess your application, they should be on your CV. So the UR application um has fields for I would say have field for research and the research has subfield. So there's fields for research that has been published, research that has not been published conference presentations. So all of those things count especially for programs like radiology. Um So yeah, so I give like a brief overview of the NR and B ranking programs. So when you, when you apply and, and you get interviewed, then you rank programs and, and then programs rank you, I programs. Also, it should depend on like, you know, you should reflect on how your interview went and you should really think about what program you want to go to because always remember that the rank favors the applicant when you are playing and when you're making around this, just keep in mind that you should run the program that you want to go into the most first, just just take it like that. Um If you try to gain the system, then you may not get what you want. If you write the program that you like first, the algorithm helps to see if they can match into that program and if they can, they're going to your number two. So it favors you as the applicant. Um, soap is ready b when they are on field sports. But for competitive specials like radiology, there tends not to be spots in the soap. So I won't really rely on the soap. I talked briefly about what you need to participate in the match earlier. Yes, the letters apply to programs and the certification. Um So people don't really think of this when they start to apply, but you should think about Visa and immigration. So you don't need to be in the US at the time. You're applying. Programs would typically be able to sponsor AJ Visa. That's an exchange um visa um programs can sponsor H one B not all. So when you are applying to programs on AF you want to, if you're not a, a citizen or permanent resident, you want to look at what the visa sponsorship for that program looks like. Um You can look at it on a or residency explorer, you cannot look at it. Now, unfortunately, if you don't have an US account, but once you, once you open an US like June, you can start to look at all that information and then use that to decide how to um run programs depending on where you want your visa situation to be. Um Yeah, that's about, that's about these and then I put some like AQ I guess and, and I will just talk briefly about some of these um areas. You should start preparing your application yesterday, like the moment you realize that you want to apply to radiologist, that's when you should bring your because applications are, are long and tedious and you, you, you want to think about what will make me a competitive African and then start to do all those things. Um How many programs should I apply to? Also depends on, um, it depends on how competitive you are. So if you have high step scores, you have research, you have a network, you can tailor your application a bit. Um And if you also know what kind of practice you want. So if you really know that you want to be in an academic radiology program, then you should really not apply to community program because even if they interview you, unless you are really lacking for interviews, you're probably not going to run those programs. So mm you could go the safe route and apply wide just so that you can get as many interviews as possible. People advise that because it's, it's better for you to have options than for you to be constricted. Um But if, if you're also balancing that with finance, then you should really think about what kind of program I want to get into and then use that win your competitiveness to decide how many programs you apply to. Um But probably don't apply less than the mean. So last year, people on average applied to over 70 programs. So you probably want to do higher than that. Um Should I apply to backup programs? That depends on what's how competitive you are. So if, if your score is low, but you really want to theology, you can still get in. But you have to now buttress the other parts have research, have networks, have things that are interesting in your portfolio that the residency admissions committee can look at and say, oh yeah, this is like maybe have you your clinical experience. But again, having a backup makes sense if you feel like you're falling short on some of the already public statistics about what successful radio um app cancer radiology look like. Um And so the backup programs will be the less competitive programs that you can also see yourself in. The other thing to note backup programs is that your preliminary or transitional year can quote and unquote be a fallback. So if you feel like your application for radiology isn't so strong, you can actually apply to pretty much transitional programs. And before the end of your pre transition program apply to radiology. Again, I've seen people who didn't match the first time, who even had good step scores and then had so many interviews by the time they were already in a pre program. So that's something to think about. Um how can pick up mentorship and advocate for the match everywhere. So Twitter has people who tweet stuff about mentorship um conferences um program website, you could see um the residents um the list of residents if you see anyone that connected to or maybe, oh, that's a Nigerian or, or that person went to. So and so that I was also at or this person does research that I'm interested in. Don't be shy, send an email, connect some of the people that were strong advocates for me in the match where people I met, there was the one I met through Instagram that helps me talk to their program director. The so you can find advocates anywhere. Just look for what connects you with people. And that's why hobbies come in because when programs are interviewing you, they're, they're also looking at how would you fit into their culture? Are they uh are you someone that they can have an interesting conversation with? So your hobbies are not irrelevant. Your hobbies are really relevant and sometimes those are ways for you to connect with people. Um and advocates for the match. Um Your advocates, your strongest advocates may not always be the people you've worked for. The longest way. Some people are just really, they just really want to help. So even if you had a short interaction with them, like one of the letters I got was from someone I did a clinic radiation with as a medical student. Um for one month and at my interviews, people will keep talking about that letter. Oh my God, that letter was so good. And this was someone I only worked with for one month. Um So don't discount brief experience. Sometimes brief experiences are good because you can be on your a game for one month and really impress someone and get a great letter. Um How should I say like L ri right? As for radiology, you want to have at least one letter writer that is images because it doesn't make sense for your writers to be from internal medicine to radiology. That's just one easy way for your application to be put aside because you had a year or more to think about your application. And if you couldn't try to get one radiologist in it, it means you are not really strategic. And then that could be a reason for people to just exclude your, your letter or your application. Rather if you are going to diagnostic radiology, a letter from an IR physician counts because Iri R um physicians are also, you know, they, they do diagnostic radiology training identically up to a point where the so a letter from, from an IR physician will be well received by AD R um reader. And this, the reverse goes, you don't always need an IR letter for IR but it's recommended for you to have. But if you don't have at least the bare, the bare minimum is to have a letter from radiology, additional degrees on research people talk about. Should I come for a master's? And how does that help the additional degree, the extent that you can tie it into your story. I initially wanted to do a um the master's degree and then I got postop position and um, and then I was able to get research. I honestly think that people look at these things differently. Some people, some programs value that some don't. But by and large, I think what is the most important is what, what do you, what, what, how can you express how that additional degree makes you a better radiologist or radiology applicant? If you can't, then it doesn't really work in your favor. If you can, then it helps. But x-ray is always better. So you someone with two degrees always looks more qualified than someone with one degree. But then when they dig into the application, people want to know, what did you do with that extra degree? How does that tie into the story into coming like into being a radiologist? It doesn't have to be, you could, you could come with an M PH and say that you are interested in global radiology or um the very of radiology to like public health with screening and whatnot. You can come with an MSC in data science and say that you're you're interested in imaging informatics. Um you could come with just research and then your research portfolio speaks for you and for why you're interested in radiology. But everything has to make sense and has to play into your story as an applicant. Um Your primary interview starts now. So learning how to communicate with people. Um thinking about your story over and over again, just thinking about a personal statement and thinking about your CV, you should try to start practicing how you will express when they say why radiology, when people get on calls with me um about strategizing for radiology application. Cause I've got a number of that since, since the match, I always ask like, why radiology? Because that's, that's a question that we recall in your personal statement, it will record in the, in the um in the interview process as well. So you should, you need to keep thinking about that. Um letter of interest is very important. So it's important to, for programs that you're really interested in to start to try to interact with the program maybe by an email to the program director before match season saying I like your program. I'm trying to apply, you know, open houses. So programs have open house information sessions, um ask questions in those sessions. Um Let the program directors see you so that when they look at the application, the name looks kind of familiar or maybe the face they can still remember because the, the, the, the real bottleneck is that for m we, we look like uh you know, it's just a piece of paper, someone's applications on a piece of paper, someone from some part of the world that you don't even know, you look so distant when they cannot connect to you. And one way for you to bridge that is to be visible to the programs by con connecting with them, attending sessions, et cetera. Um Elective rotations always help. Um There's a point where there are de like you don't need to do. Yeah, you can do a couple of months for radiology. You won't be, be doing a lot of hands on. It would be more watching for diagnostic radiology even with the invention now, um it's hard to allow, it's hard to get hands on. So, but elective help. So if you can get it definitely and also try to get a letter from the elective. Um I talked about signaling earlier and then um people sometimes don't understand that in applying for radio, you applying to start at two, you need to apply to AP one program. So you are kind of applying to two different things at the same time. So in total, I apply to like 140 programs in total. So 50 applications for the pre and transitional year and remain 90 for radiology and premium transitional year programs can be deceptively hard to get interviews as, as as an I MG know that and also try to network those programs that to for breathing helpful resources. There's one resource that I want you to check out. It's this the radiology room that has most of what you need. Um For just general radiology as a prospective applicant um in for us for the US radiology man, please check it out. Um Twitter is a very helpful space for for these two other people. Um Just gonna ask questions. So that's about it. I will leave room for questions if there's anything that I've not took about. Thanks everyone. Um Thank you so much. Um She wrote me for very detailed and clear session. Um One question I actually had in mind and it's just because um I am in the UK and um know more about the UK pathway. So there is like a self assessment or like a portfolio that is kind of very defined and you know, like what each achievement is going to get you in terms of points compared to other candidates in the US. Is it all a big picture or is there like, oh, I mean, if I have two publications, is that fair enough or do I need to have five publications to get to a sex threshold? Like is there something like that when you are trying to apply? Yeah, unfortunately, there is no like a score sheet that you know, when going into an application, you can't really say, oh, I score 70 out of 100 possible points for how complex my application is. However, they are metrics. So the step score is, is one of the um so that's why the step scores are. So important because people know that there's no score sheet and that's the only um numerical comparison that you can apply across all applicants. So having um an a average step score is um is pretty important. Um As far as publications go, the NR NP also releases data on the mean number of publications for people who successfully match into. So and so it's o it's only a guide I've seen people match with zero publications at good radiology programs because all of these things is, you know, it's a whole, it's a holistic review. So a program director can't expect an I MG who just graduated from med school last year to have the same number of publications as an I MG who graduated 10 years ago. And 111 trap that I almost got into and a friend had to call me out and say, hey, this person that you are looking at like adequate applicant has been out of med school for 10 years. So they have, they have publications, they will have more than you. So um the the programs don't the programs actually they have a scholarship too. Some do some don't. And when the interview also have some have a standardized system but just like a holistic review of the applicant. Um Yeah. OK. Um I think Collins have put um one of the VR S have put like a link for the radiology room on the chat box. Thank you for that. Um I'm just going through the chart but I don't think I can see um other questions there. Um Does anyone have any specific question um to ask? I think it was, it was really like, quite um clear and if, if you have any queries, you can just um let us know actually. So, but on the average I would ask this one now, I, I'm an I MG, I'm just graduating from med school um to be competitive enough for radiology. Um Like what time period do you think? I'm looking at realistically as an I MG just finishing? Mm Well, so that's a good question. I don't have a straight answer to that question. Uh On one hand, when you apply the earlier, the earlier you apply, the more com any application, how do I put it years of graduation is one thing that program to get. So they want younger fresher people that helps but they also look at publications. So if you're coming with years of graduation super early, then you're also sacrificing other things that you could have built on, like building a network, building research. Some programs would actually say that they, they will not interview candidates with less than two years of dedicated research or clinical experience in the US. Um That's what so, so we will say that. So you are sacrificing on those programs for things like internal medicine. Um We menstruate on hands on, they really, really value younger IM GS. But I found that radiology tends to value what you have than how young you are because reserve is a very intellectual field. So the more experience you have obviously the better for the program. So I would say um I would say balance. So getting some trying to get some research in, if you have known it would be helpful. But I've also seen people I know someone in particular who match with our research, but he didn't match the first time. And then he matched into a pre program in a really good hospital and then was able to connect with the radiology people in the hospital eventually matched there. And when he applied the game, the the programs that interviewed again, you know, the second time was similar to the first time. So research is for radiology, I would say research is pretty important and the reason it's important, uh it, it's, it's sad but we are competing against you as graduates who have known for a couple of years. And so they were able to get mentors to get them on projects. So they have research. So as an I MG you just have to have, right? So um but uh high step scores for sure um for recent graduates, um what else letters from the field? So if you have, if you have a good step, a very enthusiastic letter like the person said that the sun shines on you and sets on you kind of later. Um He's the best person in the world, like people who want from someone that um the program directors know they work with that person. When you get that kind of letter, then you bridge so many things. So letters are also really important and sometimes the way to get that letter is having clinical experience with someone after medical school. So yeah, it's all a balance. So we we have some questions on the chat box. Um Prince is asking say what's the difference between research item and research publication as the US uses the term research item? Yeah, that's a good question. So research item and by research item, I'm not sure if you are referring to research experience. So there is research experience and then there's research publication. Um research experience is like say you were a research assistant for someone that counts as a re research item. So research experiences and publications are both research items. Um But the research experience is is basically what it is and experience. And then a publication is either a peer reviewed journal publication or a conference proceeding or a conference presentation or poster or a presentation or poster. Those are research publications and publications can also include um those that are still on that peer review. So if you submitted them for peer review, but they are still not yet published, they still count. Um OK, I just a question on Yeah, elective and clinical shadowing. Yeah. Yeah. So inactive and clinical shadowing. So one kind of overlaps the other. So shadowing is a thing. Electives are a thing. So electives are basically what you elect to do in medical school as like extra training. So clinical elective, I'm not sure what medical school you you you are from, but most medical schools will offer you uh a period where you can do anything you want. That's the highest yield thing that you can do for us. Clinical experience, get to do us clinical experience when you are still a medical student. That is more impactful than after because it's difficult to get hands on clinical experience after cause. Now you have a license liability, your liability is no longer on your medical school when you were a medical student. Does that makes sense. Um Clinical shadowing. So shadowing is also called observer. So you're shadowing, you're not really doing anything. It also counts in radiology. For the most part, you are shadowing. Even if they say it's hands on hands-on, they're not going to ask you to type reports because you probably don't know how to use the PA system and you're probably going to write really terrible reports. Anyway, so no one is going to ask you to do that. What they will ask you to do as a um someone who's shadowing who's applying is to sit with the radiologist and to ask questions and answer. So if you ever get experienced to shadow. Don't be shy, ask the dumbest questions because that's what shows that you are curious and no one expects you to know anything when you are shadowing as uh in radiology because it's a very niche field. So um helps for sure. Um If you are coming to the US for any other things. So one thing I did was um because I'm in a research fellowship, um, it doesn't allow for clinical activity but it does allow for shadowing. So II did a lot of informal shadowing with the radiologist here. And I put that in my application as I should do it. Uh It wasn't structured. I did it for so and so hours every week for so and so period of time. Yeah. Yeah. The the um colleagues uh that's the question says um will a letter of recommendation from a relative be considered by programs also, can he get a letter of recommendation from, say a radiologist? Yes. Thanks for the question, Colin. That's um that's a good question. I would not recommend getting a letter from a relative for obvious reasons. A relative will write whatever helps you as their relative. So the letter is not uh will not be viewed as objective by the admissions committee. So if you can, what a relative can do for you is advocate so, always separate. So who are my letter writers? Who are my advocates? Advocates are people that can talk to the program here? I know this guy. He's pretty cool. Look at this patient, the letter writer has to say how they know you, what you've done together and what is the basis for the recommendation. So unless that relative has worked with you and it could be an ex, if it's an extended derivative, you don't share the same surname. I would say as long as you walk to them and they assess you clinically fine. But if you share the same, so even if you are not related, I would be, I would probably not get a letter from someone that share the same story with me because uh you know, it just, it just um just think about it from the admissions committee perspective, they are probably not going to look at that. It very um strong, very, very. We just let her, I would say, I don't think that I don't think you, you, I don't think that is possible because whoever writes a letter has to be board certified. II think they have to be both certified. Um I don't know if the nurse can be both certified by, by in uh in radiology. So a nurse can be your advocate. A nurse may have friends in a program that she's worked with in the past. So use the nurse as an advocate, but I don't think she should be a because it's, it's, I mean, as a program admissions committee member, I will feel a little, I wouldn't, I mean, I wonder why a nurse is writing for you as a physician. So I probably will not, um, go that route. Wait, is there a limit to the letter of recommendation in terms of the number? I'm not sure. I like, got that part. Yeah. So that's a great question. So you can get 20 letters of recommendation on errors, but you can only submit for a program. So, so each program have, you can mix up your letters, however, you can tell 20 people to submit letters for you on era where you only end up using five of them. Um So um a safe thing to do might be have um Each program only requires, I think each program requires a minimum of three, not sticking, but a maximum of four. Um So um yes, you can't do more than four. And that might change this year. Um And then you can mix up your program, your letters however you want. Yes, you can definitely mix up your programs and your letters right there. OK. Um One last one and this 1 may be unfair. But do you? Um no, it's not fair. Um So for someone that has trained in our country and now consultant, are there alternate pathways in working in the US or you must be doing your USM le and training in the US? That is a great question. Yeah, that's a great question. And one thing I II made a note to mention I am eventually did note was that I wasn't going, I wasn't really talking about the alternate pathway because I didn't use that pathway. I know of it. So if you are licensed to practice radiologist, somewhere else, there is an alternate pathway that involves you doing, I think four fellowships. So when you do four fellowships at uh US, accredited US institutions, then you can be both certified if you can be a board certified radiologist in the US. Yes. So that is possible but like will you just be able to do the fellowships without having like background um USM L steps though? I think that you need, I think you need the USMA steps. Um I think you do need the routine and you, I think you also need to be and be certified, but I think we should um I want to confirm, prescribe that. Yeah. OK. Thank you very much for the session once again. Um for those attending. I've provided the feedback form in the chat box, please. This feedback is um very important um not just for us but also for our um guests. Um When the program ends, anyone that attended will also get an email um asking to feel the feedback and it is after you feel the feedback, you get like a certificate for this um event. So please do feel the feedback. Um just one other um announcement more of I know we did. So we did the session for the UK pathway. That was two weeks ago. Was it two weeks ago or no? Last week? My brain is it? I think it was last week. So, um some, um, attendees had asked about the ST three pathway for the UK. We, um I told you guys, I'll come back to you, like, if we're able to find a way to arrange that. So the um rega um that we talked about last week as the radiology interest group of Africa, they'll be doing an event this coming week um on that explaining that pathway. So for those that um are interested, I'll put the link on the chat box here, but I'll also put it on the group page so that you can all register and you know, attend the um event. Um I don't know if there's any last words you like to say before we officially like close the event. No. Um Thank you for having me. Um Thank you so much. Um Nothing, nothing more but feel free if you have any questions. Um You can email or message on Twitter. I just put my email in the chart. OK. All right. Thank you so much. Yeah. OK. Yeah, I think, yeah, I can, I can see it. So guys, this what I've just put in now is for the ST 31. So you can just use that name, but I'll put you on the group page. Thank you. So much and have a great evening, everyone.