While M4s are focused on the next steps of their careers, they also have to hone the skills to be a skilled intern come summer. Dr. Meg Wolff, clinical professor in the department of emergency medicine and pediatrics at the University of Michigan Medical School, offers insight on how students can avoid getting too distracted by the Match process.
While M4s are focused on the next steps of their careers, they also have to hone the skills to be a skilled intern come summer. Meg Wolff, MD, MHPE, clinical professor in the department of emergency medicine and pediatrics at the University of Michigan Medical School, offers insight on how students can avoid getting too distracted by the Match process.
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Unger: On this episode of Making the Rounds, Dr. Meg Wolff gives advice to fourth-year medical students who are busy preparing for the Match. She talks about ways you can balance your training during this stressful stage. Dr. Wolff is a clinical professor in the Department of Emergency Medicine and Pediatrics at the University of Michigan Medical School. Here’s AMA Senior News Writer, Brendan Murphy.
Murphy: Hello and welcome to Making the Rounds, a podcast by the American Medical Association. I'm Brendan Murphy, senior news writer at the AMA. Today, we continue our Meet Your Match series with Dr. Meg Wolff, clinical professor in the Department of Emergency Medicine and Pediatrics at the University of Michigan Medical School. Medical education is one of her many interests, including interactive teaching techniques, coaching and self-directed learning. How are you today, Dr. Wolff?
Dr. Wolff: I'm good, Brandon. Thanks for having me. How are you?
Murphy: I'm great. We're very excited to have you on the show. Today we're going to talk about ways in which applicants can balance their medical training while going through the stress of the Match process. To start, can you tell us about your work with M4s specifically to get them ready for residency?
Dr. Wolff: Absolutely. So, at the University of Michigan, I direct our coaching program for medical students. And so that spans the four years of medical school. And in the fourth year, the focus really is on getting them prepared for that transition to the residency process. I also serve as a faculty career advisor for medical students who are going into pediatrics. So, I get to work with them in that space as they're preparing their applications and going through the Match process. And then finally when they're about to transition to residency.
Murphy: So, you have sort of a unique perspective in that you're on both sides of the coin of the readiness part and the application portion of the M4 year. The ideal state seems to be one in which students can entirely compartmentalize the load of the looming Match with their academic development as an M4. What's the actual state? Can you paint a picture of how things play out for M4s during the match?
Dr. Wolff: Absolutely, yeah. So, it is probably nowhere near that idealized state, Brendan. It's a really stressful year. Students are trying to figure out what is important to them as they go through the match process. They really just want to match into a residency that's going to be good for them. And in the background, they know that they're supposed to be continuing to develop their skills to help them get ready for residency. So, it can be a really overwhelming year. And I think it is the predominant thread through the whole thing is the sort of looming match process, even when they're trying to focus on their clinical skills.
Murphy: What does a student effectively balancing the time and energy required for the Match process and their skill development as an M4 look like in your eyes?
Dr. Wolff: That's a great question, Brendan. And I don't think that there's going to be one answer that's right for every student. But I think that balance really is about prioritizing different things at different times. So, when they're working through the actual putting their application together, that might need to be the focus. But once that's submitted and they're waiting for their interview offers to come in, that might be a good time to sort of start to think about what their priorities are for residency program and what kind of things that they're hoping to get out of their residency program while also working on their skill development. Students often enter a time when they start doing their interviews where that sort of becomes all consuming. And there's probably really no way around that. But after that time period is over, as they get into the sort of early spring of their fourth year, that tends to be a really good time for skill development as students are trying to consolidate what they've learned in medical school and look ahead to residency. And they're sort of in a unique place or a new time to look ahead and start to think about the skills that they need to build before they start residency.
Murphy: So, in that skill development arena, what are the most important areas of development during the M4 year?
Dr. Wolff: I think most important areas of skill development in the fourth year, really are more about the development of the student as a self-directed learner and helping sort of shift that mindset of one of being a student and focusing on grades and getting into residency and starting to transition into trying to learn so they can be the best doctor they can be. This often is a process that takes years, but I think the fourth year is a really good time to start focusing on it and focusing on the skills of, you know, being a self-directed learner and trying to become a master adaptive learner, and reflecting on what they've learned and what their gaps are. This can be hard to do on their own though, and so I always recommend that students, if they are lucky enough to have a coach to work with them with that or one of their trusted faculty advisors or mentors, can really be helpful in this space as well.
Murphy: And just a plug—the AMA has voluminous material on the master adaptive learner framework on coaching. That's all through our Med Ed team with whom Dr. Wolff has worked in the past.
How much of that M4 learning and development should be specialty focused? You talked about that self-directed piece, which is certainly broad. How do you hone in on what you need to be a pediatrician, or an OB, or surgeon as an M4?
Dr. Wolff: So, I think that a lot of M4 learning, while some of it should be specialty specific. A lot of it really is more about an approach to problems. So, things like answering pages or simulation training in responding to emergencies. Those kind of things, it might be helpful if the context is specialty specific. But I think those approaches to things that they're going to encounter in their intern year is really more important than it being specific to a specialty. I know that many schools do have residency prep courses that are available in the late part of M4 year, and if students have an opportunity to take those, I would really encourage that cause those can be really helpful in helping students prepare for interior.
Murphy: If you're feeling overwhelmed by your academic commitments as an M4, what should you do?
Dr. Wolff: That is understandable. This is a really stressful time for students, you know. They're trying to balance applying to residency getting into residency, and in the background, sort of have this constant list of things that they're supposed to be developing. So, I think it's really normal to feel overwhelmed. And I would really encourage students if they're feeling that way to talk to a trusted person in their life just to sort of process it all. And consider, you know, if there's anything that they're involved in, that that might be not essential to where they are at that point in their life right now. They might also want to consider options for scaling back or right sizing things either with a faculty advisor or coach, or maybe even a school counselor or school administrator. But I think, remembering that that it is really normal to feel overwhelmed by all of this at this time. And this is a phase in this process that fortunately will come to an end.
Murphy: What if you're feeling stressed or overwhelmed by the looming Match process? What do you tell those students? How do you manage that stressor?
Dr. Wolff: Yeah, that's a really common experience as well is just feeling totally stressed out by the process itself and you're really feeling of lack of control in the process. And so, you know, the first thing is sort of controlling the things that you can control in the process, you know, trying to do the best you can with putting your application together and talking to your faculty career advisors. But then, after you've done that, you know, just remembering to prioritize taking care of yourself. In the midst of all of this, you know things that are important to you that help you stay well, like exercise, sleep, eating well, staying connected to friends and family. You know, those things are really important too, and can help you get through this really stressful period of training.
Murphy: One thing we do like to remind our listeners is that the Match rate is extremely high for U.S. med school graduates. So that is always, at least, I'd like to think, a nugget of reassurance. It doesn't mean that your day to day is going to be easier.
Dr. Wolff: That's a really great point, Brendan, and I think bears repeating over and over again, that for the vast majority of students, they are going to be successful in this process. And the majority of students are going to end up at a residency program that they feel very excited about, and that is a really good match for them.
Murphy: So back to this topic of resident readiness, what shouldn't you do as an M4? What are the mistakes that you've seen M4s make when they're trying to prepare to be a physician?
Dr. Wolff: I think the biggest mistake that I've seen students make is that their sole focus and purpose of M4 year is on the application process, and they kind of forget about everything else. Or they don't take advantage of opportunities that their school might have in terms of preparing for residency. So, I'd really encourage students to, you know, take advantage of opportunities that are there to sort of build up their skillset, and try in the midst of all of this application process to still try to remember to be a learner as well.
Murphy: Once the Match is over, a few days after Saint Patrick's Day. Usually, I've heard that period between the Match and graduation referred to as a situation similar to senioritis. How should students be spending that time? Is there some productive exercises you've touched on potential transition curriculum that a school might offer? Are there any other ideas or thoughts you have on that?
Dr. Wolff: Yeah, it is definitely akin to senioritis for many students. You know, they've been through this stressful experience. And finally, you know, sort of have actualized their dream. They've gotten into a residency, and it is really understandable that urge to just sort of back off and completely take a break at that point.
I would encourage students during that time to use it as a time to sort of take stock of what they have learned in medical school, and more importantly, sort of what they're hoping to achieve in residency. If they do have a residency prep course, they can take advantage of by all means do that. If they have a coach that they can meet with to sort of go over their performance over the last four years in medical school, and perhaps start to identify some areas that they want to focus on in residency and also kind of identify their strengths that they want to continue building. I don't think that it needs to be a really intensive time in medical school. But I would love for students to continue to take advantage of that time they still have left in medical school before they make that transition to residency.
Murphy: In terms of taking stock, is part of this knowing what you don't know? And how do you evaluate, you mentioned, your strengths? How do you evaluate your weaknesses?
Dr. Wolff: There's a number of different ways that you can go about doing that. But I think the first thing is reviewing your portfolio from medical school. So, before you leave your institution taking a deep dive into the evaluations that you received from different rotations during your clerkships and beyond. And trying to identify if there's any themes that that several people have mentioned, that perhaps this might be an area for you to work on. Maybe it's communication skills or presentations or clinical decision making. Whatever the case may be, there is bound to be some rich data in your evaluations. If you spend time kind of digging through them a little bit. And again, if you have an opportunity to review that with somebody like a coach or a faculty advisor or mentor, they can often help you identify themes and help you sort of make an action plan, for when you start residency.
Murphy: This has all been such valuable insight to our listeners, Dr. Wolff. Do you have anything else you'd like to add on the topic, Dr. Wolff?
Dr. Wolff: I guess I would just like to finish by saying good luck, and I hope you all the best of success. And as Brendan reminded us earlier, the vast majority of you guys are going to be wildly successful with your matches and will be very happy with where you guys end up.
Murphy: Well, that optimistic nugget is as good a place to end as any. Thank you so much for being here with us and sharing your knowledge with our listeners, Dr. Wolff.
Dr. Wolff: Thanks, Brendan.
Murphy: This has been Making the Rounds, I'm AMA Senior News Writer Brendan Murphy. Thanks for listening.
Unger: Don’t miss an episode of this Meet Your Match series. Subscribe to Making the Rounds on your favorite podcast platform or visit ama-assn.org/podcasts. Thanks for listening.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.