Tips and tricks for the match. By 林宗贤

Dear colleagues,

As the saying goes, “To assist others is the fountain of happiness.” These are what I just learned from the ACAP convention this May. However, always read critically with a grain of salt. Any constructive feedbacks are welcome.

Every program has cut-off scores for step 1 and 2. Higher scores can help one get interviews. However, the decision makers look at the whole package, not just scores, for example: scores, USCE, LORs, graduation years (<5 years), interview performance (analogous to a speed date), English proficiency, interpersonal and communication skills, research experience and publications, connections, no gap, and etc.

PHD is good for applying fellowships. Many university based programs (highly competitive and stress clinical research) love candidates with related research experience and publications. Still, some think that it may take too long and the clinical hiatus may be of concern. MPH is favorable to some programs as well because MPHs are oftentimes considered as statistic whizzes. Community based programs relatively care less about research.

USCE is almost a must in this day and age! Get them by all means (better more than 1 month). Aside from getting the Letters of recommendation (LORs), one needs to be familiar with the US medical system since it is very different from the Chinese one and be competent in the US clinical settings working with many experts of various fields. The USCE should be done recently within 2 to 3 years. One can be asked, “When was the last time you drawed a blood gas or did lumbar puncture?” Obviously, it would not be convincing if one replies, “in year 2000.”

Many program directors do not know if an externship is applied through commercial agency or not. If you are doing such, it’s a good idea not to mention that it’s commercial unless they ask, rather emphasize positively on what you did during the USCE. For instance, history taking, PE, procedures, SOAP notes writing, case presentations, and etc.

LORs should be written by someone who knows you well, best be written by US MDs and the content should be clinically related. Although it’s fine to have stellar LORs from your US PHD advisors. However, it’d be better to have at least one of the total 3 to 4 LORs that are from a US MD. The longer the LOR, the better. However, one should avoid letters with negative comments. One way to avoid that is by asking “Would you be able to write me a strong LOR?”. Waiving the right to read the LORs will definitely make the LORs to weigh more (Do so when you’re confident that the letters are strong).

Keep personal statements short (1 to 1.5 pages most) and impressive. There are thousands of applications for each program, there is no time for PDs to read all of them. Spend some quality time to write them and revise many times. It’s good idea to have them polished by professional editors. An impressive personal statement should be able to reflect one’s life experience completely with vivid and in-depth examples. When one is applying more than one specialty, one should always prepare at least one PS for every specialty (Please note, it is not a good idea to bring up that you’re applying more than one specialty during the interview unless they ask). Be realistic, assess your CV honestly, and have a plan B, when your first choice is too competitive (very high incomes or very comfortable lifestyles or very high reputation). Competitiveness of specialties changes over time.

Any gaps present on CV/CAF should be well explained. For instance, I understood the importance to do the usmle very well that’s why I took one/ two years off to prepare for them, meanwhile have been volunteering in a hospital or a lab. Yes, I understand that the MPH may sound like a gap for you; however, I’ve been doing statistics intensively in clinical research. Therefore, I can be a true asset to your program (programs that tend to have a lot of research going on). It’s really about how you say it, always put it as positive as possible. For instance, never say I’m an old cmg. Instead, say something like a mature CMG with variety of life experience, and elaborate further.

Connections! Connections! Connections! For instance, your PHD mentor makes a phone call for you, or delivers your credentials to the PD, offers you an observership position (when he/she is an MD), etc.

Good communication skills! Be humorous as appropriate, blend into the American culture, work on your English skills, or even be multilingual. Know how to break the bad news to the patients and family and so forth.

Be responsible, professional, and a team player. Don’t want to mess with the nurses, or else you’ll have a miserable life.

Be humble and don’t show off on the ward. For example, directly answering questions that the senior or junior resident doesn’t know in front of many people can make the resident look bad and he/she might hate you thereafter. Instead, keep a low profile, and when it’s appropriate respond it indirectly by asking good questions. Shine as appropriate.

Fewer programs sponsor H1B visa because H1B are costly (Residency program pays about 5 k per H1B visa yearly, I don’t remember the exact figure) . Most CMGs without Green card or US citizenship do their residency on H1B. Those on H1B are subject to 6 year limitation of their stay in the US. Therefore, many try to get Green Card from employer or family-based sponsorship in order to stay beyond that time.

J-1 Exchange Visitor Visa opens more doors to good programs. Theoretically, J-1 is not out of the question for CMGs since there are successful cases done lately. Nevertheless, it has a track record of not being readily available for CMGs till recently. Those on J-1 visas have to return to their home country for a minimum of 2 years before applying for re-entry unless waived. A common example of waiver is to work in medically underserved area (rural area, inner-city, etc) for 3 years. At the end of that, the participants may be eligible for Green Card status. For more information about J-1 waiver, please visit

“Chance favors the prepared mind.” Good luck!


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