Making the Rounds at UNLV School of Medicine

Making the Rounds

January 5, 2021 Issue 267

Friends & Colleagues,

In today’s newsletter, we focus on Monica Rose Arebalos, Damien Medrano and Kristina Cordes, three members of our inaugural 2017 class who are looking forward to a day less than three months from now that becomes one of the most significant milestones in the life of a physician -- Match Day. It is on that day, the third Friday in March, when fourth year medical students across the country learn where they’ll spend as many as seven years in specialty residency training -- another big step towards turning them into fully-trained, independent physicians. The match process is based on an algorithm that pairs students with residency programs nationwide. Even in this tragic Age of COVID-19, the Match remains the culmination of 4 years of medical study and deciding on a medical specialty. This feature should give you a better sense of the importance of Match Day and how a deadly virus has brought changes to this year’s process.

Marc J. Kahn, M.D.

Dean, UNLV School of Medicine

Medicine By The Numbers

Residency Match

The 2020 Main Residency Match was the largest in National Resident Matching Program history.

A record-high 40,084 applicants submitted program choices for 37,256 positions.

The 2020 Match represented the first time that all allopathic (MD) and osteopathic (DO) applicants participated in one matching program.

Source: https://www.nrmp.org/2020-press-release-thousands-resident-physician-applicants-celebrate-nrmp-match-results/

‌

In Home Stretch of Medical School

Members of Charter Class Pursuing Residencies

Damien Medrano

Monica Rose Arebalos

Kristina Cordes

Fourth year medical students, including Damien Medrano, Monica Rose Arebalos and Kristina Cordes, are in the process of applying to residencies in Nevada and around the country, where they will receive training in their chosen specialties while also helping treat patients.

A theater background doesn’t hurt. Be ready to share memorable patient encounters. Mock interviews are essential prior to the actual interviews with medical professionals.

So go just a few of the observations of Monica Rose Arebalos, Kristina Cordes and Damien Medrano -- three fourth year UNLV School of Medicine students, all with strong ties to Nevada, who are undergoing the taxing interview process that culminates in Match Day, the third Friday in March when graduating medical students learn where they’ll spend, depending on their chosen specialty, between three and seven years of residency training.

While in medical school, a student chooses a specialty and later enters the grueling process of applications and interviews with as many as 20+ residency specialty programs across the country. Unfortunately, because of government funding issues, Nevada still doesn’t have all the specialty and subspecialty training programs that some students seek.

Medrano, like Cordes and Arebalos, is a member of the medical school's inaugural 2017 class, where each student, courtesy of gracious donors, received a full tuition scholarship. He credits his undergraduate minor in theater at Loyola Marymount University for helping make his interviews with hospital and medical professionals go smoothly. He says the kind of concentration required for him at Loyola Marymount to hold down a leading role in the play, ”Topdog/Underdog,” by Pulitzer Prize winner Suzan-Lori Parks was advantageous in his interviews as he shared, among other things, the reason he decided to become a radiologist.

“The interview process is both physically and mentally demanding,” said Medrano, who’s been an extra in several TV programs, including "Grey’s Anatomy."

“Sometimes you’re in interviews for four to six hours in a day where you have to be constantly on, where concentration and the energy it takes is critical to making a great first impression,” he said. “ You not only have to be aware of what you’re saying, but you have to be aware of your body, of how they’re seeing you, the lighting, the camera lens... It’s definitely not easy.”

Medrano didn’t always plan on becoming a radiologist: “Before medical school, I saw myself as a pediatrician because of the enjoyable interactions I had with my own pediatrician. I would have never guessed radiology would be the perfect fit for me and my interests but it goes to show the importance of keeping an open mind and embracing the unexpected. The most memorable encounter in radiology was seeing a patient with a liver tumor receive treatment from an interventional radiologist using fluoroscopy, chemotherapy, and a catheter. Radiology was very appealing to me for the anatomy, pathology, technology, procedures and opportunity to communicate with many different specialists and patients.”

Like it’s done with everything else in the U.S. since February, 2020, COVID-19 has thrown a wrench in the matching process. Medical students nationwide have generally had to deal with delayed timelines, paused rotations, postponed exam dates and virtual, rather than in-person interviews. Still, students find positives in the experience, pointing out that clinicians have to always adjust and bounce back when the unforeseen occurs.

“Although we weren’t in clinic or the hospital our first two months of fourth year (because of COVID), I used the time to go through an online ultrasound curriculum, study for exams and also volunteered to deliver food to families in the community,” said Cordes, who is applying for a family medicine residency. “Our options for fourth year away electives were quite limited, but I was able to spend a month doing primary and urgent care at the Yosemite Medical Clinic in Yosemite National Park. While I was there, I had the opportunity to work with officers in the Public Health Service and go out with the search and rescue team.”

“Sometimes you’re in interviews for four to six hours in a day where you have to be constantly on, where concentration and the energy it takes is critical to making a great first impression. You not only have to be aware of what you’re saying, but you have to be aware of your body, of how they’re seeing you, the lighting, the camera lens... It’s definitely not easy.” -- Damien Medrano, 4th year medical student

Fascinated by the interview procedure, Arebalos, who is applying for an emergency medicine residency, has started a blog -- https://monicarose.me/interviews-1/ that offers advice and reflections on the process: “I think the most difficult part this year is just the fact that the interviews are on Zoom rather than in person. It’s hard to fully feel that person to person connection in-person interaction provides while looking at a computer screen...My resident-mentor advised me to talk to myself in the car or when walking the dog just to hear how my answers to common questions sound -- that has...been helpful.”

Arebalos said like most students, she and a friend also prepared for the interview by frequently going over 60 common interview questions suggested by medical professionals. In her blog she also suggested that applicants for specialties be able to reflect on their medical school journey in several areas, including: memorable experiences with patients; challenges that have been overcome; favorite and least favorite experiences; positive changes that could have been made and how a medical specialty was chosen.

Arebalos wants to go into emergency medicine.

“The opportunity to be the first physician to stabilize the patient, to start to figure out their story and their presentation is so exciting to me,” she said. “I’m drawn to the unique connection that emergency physicians form with brand new patients each shift. It’s a unique kind of compassion that ER docs share with their patients and their families when they are in such a vulnerable place, and it’s exactly what I pictured growing up wanting to be a doctor someday."

Cordes, whose goal is to one day be a medical officer for the Centers for Disease Control and Prevention or a member of Doctors Without Borders, said she has applied for a family medicine residency because her “underlying goal in becoming a physician is to work with those who are most vulnerable and at-risk, particularly in remote settings. When I thought about the populations I want to serve and what they will need from their physician, family medicine seemed the best way to provide that care.”

She has found the preparation for her desired specialty very helpful.

“The residents and faculty within the Department of Family Medicine were a great help in preparing us for interviews,” she said. “They held mock interviews to help us get used to the virtual setting and provided feedback.”

As with so many medical students, Cordes found a silver lining in virtual interviews.

“Although there can be technological challenges with virtual interviews, in some ways the overall logistics are easier,” she noted. “When we don’t have to take time to travel it’s possible to interview with programs across the country on back to back dates, which wouldn’t really be feasible otherwise...It’s obviously not as expensive...The most difficult part of virtual interviews is not being able to get a sense of the community and clinical environment. There are so many good programs where residents receive excellent training that a big part of the choice comes down to finding a program that is a good fit, where you will love working with the people for at least the next three years. Although we couldn’t travel to see the sites, I found that all of the program faculty and residents worked really hard to get to know applicants as individuals and provide a good sense of the program environment.”

If you think about it, the residency matching process is a little like speed dating, though in slow motion. Once the application and interview season finishes (generally October through January each year), training programs create a rank list of their desired applicants, and all applicants create a rank list of their desired training programs. Because of the intensely competitive nature of the process, students don’t divulge their wish lists prior to Match Day, if then.

The “match” is actually determined by a Nobel Prize-winning computer algorithm managed by the National Resident Matching Program. The algorithm sorts through each medical student’s list of residency programs they’d like to attend, and aligns their preferences with the students chosen by the directors of residency programs. The Match process also has a special feature called a “couples match” that Medrano and his wife, fourth year student Lauren Hollifield, hope works in their favor. Even more complicated algorithms balance the training objectives of married students -- Hollifield wants to be an anesthesiologist -- who want to end up in the same city for residency programs.

At precisely 12 p.m. Eastern Time on March 19 -- 9 a.m. at the UNLV School of Medicine -- the nation’s medical students will open an envelope with their name on it that reveals the name of the residency program where they’ll do their graduate medical education. About 75 percent of graduating medical students receive one of their top three choices.

Though Arebalos says each specialty interview she’s had has made her less nervous in the interviews that followed, she still has some anxiety over the process.

“I’ve always gone through life telling myself all you can do is your best, so just keep doing that until you fail,” she said. “I’m currently just so humbled and thankful that my best was enough to get me where I am today. But I’m admittedly still holding my breath a little until I officially match in March.”