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NBOME
Nicholas Harriel is a passionate osteopathic med student at New York Institute of Technology College of Osteopathic Medicine, and a U.S. Army veteran who served as a medic in Afghanistan.

He is a dog-parent of three raring pups and an avid advocator of osteopathic distinction and LGBTQ+ rights. Nic is focused on becoming the change that he wants to see in his community and we were so excited to hear about his personal journey on his Road to DO Licensure.

 


Why did you decide to choose osteopathic medicine as a profession?

It was my experience in military that inspired me to become a DO. Honestly, I didn’t think I could become a physician initially. I hadn’t met many people with my background—or at least didn’t know many people with similar backgrounds who had become physicians. I’d started part-time courses on a nursing track while in Afghanistan to become a registered nurse—little did I know at the time, most of the physicians I worked under were DOs.

I gravitated to them because they placed a great deal of emphasis on the whole patient and challenged me. One night, a man by the name of Col. Francis saw me studying at the clinic late (it was the only place that had Wi-Fi). He took the time to explain how he became a physician and the principles of osteopathic medicine. For the first time, I thought, “Wow, this sounds like me—this sounds like something I want to do.” I changed my major a few weeks later. Funny enough, I would go on to primarily work with DOs until I transitioned to the reserves. Those mentors I gained while on deployment and after returning to the states are also the ones who wrote my letters of recommendation for medical school.

What really inspired me to choose osteopathic medicine was my exposure through my mentors far before I ever knew I wanted to become a physician. That’s one of the reasons I push for pre-medicine programs like pre-SOMA. I think DOs are made far before they ever walk the halls of our academic institutions.

Tell us more about your experience in the military.

I grew up in a small rural town in southern Louisiana and started living on my own at 17. I worked full-time through high school, and after graduating, I started a local licensed practical nursing program. When I got out, I wanted to continue with my education, so I talked to my brother about his experience in the military, which inspired me to join the US Army as a medic.

I met my husband shortly before deploying to Afghanistan in 2013, in support of Operation Enduring Freedom. On the very night I came back to the states, he surprised me with a proposal. We were lucky to be able to get married in Illinois right before the repeal of the Defense of Marriage Act.

The following year was interesting with balancing newlywed life and a military schedule, but after making it through deployment, a hectic schedule was really nothing. This also helped prepare me for managing my time in medical school. But before then in 2015, I left active duty and joined the reserves in order to start full-time at Austin Peay State University (near Fort Campbell). I also continued nursing part-time and served as a noncommissioned officer leading small teams focused on medical training for the unit.

I had a great experience leading up to medical school that made me able to appreciate the challenges of medical leadership and administration. I was activated to stand up a 30-personnel clinic for an 8,000-soldier training mission.

Following that, I continued in the reserves in my first year of medical school, and eventually transitioned to the inactive ready reserves where I am now.

How does it feel to be the National SOMA president and how did you get here?

I have a background in service, but I’d promised myself that I would place emphasis on medical school and not get involved with anything until after I graduated. Just like most students, I was afraid school would be overwhelming. Don’t get me wrong, it has been—especially that first year. I didn’t end up keeping that promise to myself. I saw all the good things that SOMA was doing for the community and I was hooked.

I became invested in SOMA at the national level; I wanted to continue helping my peers make an impact on the communities our chapters serve. I campaigned to become a region trustee so I could help other students lead their chapters. After a lot of deliberation, I decided to run for president.

Being the SOMA president is amazing. I get to advocate for and serve our members—medical students from various backgrounds—on a multitude of different issues. I get to work alongside an amazing leadership team to push for real change. While I advocate for more than 15,000 members on the national stage, I am also answerable to those I serve. That and our amazing 51-year legacy can, at times, come with pressure. Still, I couldn’t imagine myself doing anything else. I am very, very thankful for the confidence others have given me to serve them in our organization.

From a holistic viewpoint, having taken COMLEX-USA, how does osteopathic medicine stand out to you personally?

You know, this is a great question. What is osteopathic medicine? How do we give ourselves, as students, an identity and how do we own that?

At present day, I believe osteopathic medical education emphasizes patient-centered care through a collective view of factors that impact those we care for. Our institutions focus on the whole person, and that influences our education from the first day we enter school. This includes mind, body, and spirit, but also the interrelatedness of systems in the body; social, environmental, and behavioral health determinants; accessibility to care; as well as physician-patient relationships. We pair this amazing emphasis on medical education with approaches to care that allow the body to better heal and ensure our students are well-equipped for modern care practices within clinical environments. Osteopathic medicine stands out because of our approach and emphasis within medicine, and I think that is evident when DO students work with patients and clinical staff.


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Dina Tsourdinis, MSA, CPA, joined the NBOME as vice president for finance & chief financial officer, effective October 5. She will provide oversight of the organization’s fiscal operations and work to ensure its strong financial future.

Most recently, Tsourdinis served as associate vice president of finance for Adler University. In that role, she oversaw the operations of accounting, finance, and student finance, including financial statement preparation, budgeting, internal controls, cost management, regulatory reporting and financial analysis.

Prior to that, she held several financial leadership positions in the non-profit and education sectors, including ChildServ, SOS Children’s Villages, Dr. William Scholl College of Podiatric Medicine and the University of Illinois.

For 20 years, Tsourdinis has served as an adjunct instructor of accounting for graduate and undergraduate students at St. Xavier University Graham School of Business in Chicago. In this role she also trained and hired more than 60 students as part of an accounting internship program she developed.

“Dina’s well-documented track record of success as a leader in finance, accounting, and business operations, and as a strategic visionary in the higher education arena, makes her an ideal fit for this position, and for the NBOME,” said John R. Gimpel, DO, MEd, president and CEO.

Tsourdinis received both her bachelor’s and master’s degrees from the University of Illinois at Chicago. She will be based in the organization’s Chicago office.

The NBOME’s vision is to be the global leader in assessment of osteopathic medicine and related health care professions. DOs and DO students are generally able to provide the COMLEX-USA licensure series as a credential that is recognized across the continuum by stakeholders to help them to realize their professional goals.

While its primary and intended purpose is for use in applying for medical licensure for DOs, COMLEX-USA is widely regarded as the valid and reliable assessment for other secondary uses for osteopathic students and physicians. So it’s disappointing when we occasionally hear students or others say or write, “COMLEX isn’t as good of an exam as USMLE,” or “We should only take the USMLE.”

The more than 100,000 professionals who choose to study and practice osteopathic medicine are unique; they are more likely to choose career paths in primary care (roughly 56 percent of DO graduates practice in specialties that comprise primary care) and historically tend to practice in areas of greatest need. Not only that, global recognition of osteopathic medicine continues to grow.

DO students learn to integrate the unique osteopathic principles and practice of medicine. DOs assess each patient through their osteopathic lens, which is developed through mentoring, assessment, practice, and an integrated curricular program leading to the DO degree.

Unique individuals learning a traditionally unique way to provide care for patients should have a unique way to measure those skills.

Nursing students are shaped and assessed by the nursing examinations, law students take the bar exams, and optometry students sit for national board exams in their unique field. So too are MD students, in part, credentialed by the USMLE exam, and DO students by COMLEX-USA.

And this is why numerous authorities across the medical profession recognize the substantial body of evidence for the validity, reliability and quality of COMLEX-USA. For example:

The Federation of State Medical Board’s House of Delegates’ official policy is that the evidence for the validity of COMLEX-USA is exemplary, and every state licensure board uses (and a number require) COMLEX-USA for medical licensure of DOs.  The editor-In-chief of the FSMB’s Journal of Medical Regulation, complements the NBOME in her forward (October 1, 2018): “COMLEX-USA…provides a good example of how medical examiners can update their assessment systems to stay ahead of the curve of change [and] help medical regulators make sound, balanced decisions as they continue their work in protecting the public and ensuring quality in medical practice, keeping our patients safe.”

In November 2018, the American Medical Association’s House of Delegates adopted a new policy to promote equal acceptance of the USMLE and COMLEX at all US residency programs. The AMA also called for education of residency directors to better understand and use COMLEX scores.

The Graduate Medical Education community also endorses COMLEX-USA, as the ACGME accepts COMLEX-USA and USMLE equivalently. In August, the Undergraduate Medical Education to Graduate Medical Education Review Committee (UGRC) of the Coalition for Physician Accountability released a series of recommendations for improving the transition to residency, and calling for the mitigation of bias in all forms—specifically against DO students and their COMLEX-USA credential, which the committee called a “comparable examination with a different scale.”

Kenneth B. Simons, MD, senior associate dean for GME and accreditation at the Medical College of Wisconsin, is another passionate advocate for DO students and for COMLEX-USA. Dr. Simons serves as chair of the Federation of State Medical Boards and is a former leader of the National Resident Matching Program and the ACGME.

“The AMA says [COMLEX] is equivalent, the ACGME says it’s equivalent, the FSMB says it’s equivalent,” he says in this video from 2019.

“I would tell program directors who are uncomfortable with DO students or with COMLEX that they need to get comfortable with both. These young men and women are under tremendous debt and they don’t need additional debt placed on them because a program director doesn’t know how to interpret COMLEX.”

Internationally, the COMLEX-USA series is also highly regarded. Most recently, in September 2020 the Medical Board of Australia established a new competent authority pathway for licensure in that country, which includes COMLEX-USA for US-trained DOs. This decision was based on a recommendation from the Australian Medical Council, its accreditation authority, who performed a comprehensive, two-year review of the COMLEX-USA program and found the exam series to be a valid and reliable assessment for licensure/registration to practice medicine in Australia.

While most international jurisdictions require their own country’s national standardized assessments for physician licensure, COMLEX-USA was the first such physician licensure assessment program in over 15 years to receive this designation in Australia, another seal of approval for U.S. DOs and COMLEX-USA.

Leaders across the house of medicine endorse COMLEX-USA as a valid, rigorous, and trustworthy method of assessing competencies for osteopathic medical practice. What’s more, our profession and its distinctiveness continue to gain popularity; the number of practicing DOs has grown by more than 80 percent over the past decade, and roughly 25 percent of current medical students in the US are enrolled at a college of osteopathic medicine.

Patients like the osteopathic approach to care; a 2019 study found that osteopathic physicians were perceived significantly more favorably by their patients on the measures of interpersonal manner and empathy. An aligned assessment program, linked to this unique education pathway and practice, contributes to high-quality osteopathic medical care for patients and communities.

Robert Frost’s famous poem, “The Road Not Taken,” celebrates seeing things from a different perspective. Today, highlighting the value of different paths traveled and different viewpoints is more important and perhaps more relevant than ever.

While some both inside and external to the profession may struggle to reconcile the uniqueness, spirit, and competencies of osteopathic medicine with their need to assimilate in a number of ways, the fact is that DOs, MDs and IMGs each have their own rigorous and valid pathways to becoming a physician in the U.S.

In diversity there is strength—and a diversity of pathways interacting together helps to broaden the educational milieu in the GME learning environment–and ultimately strengthen health care in the U.S.

For our part, the NBOME, along with the AOA and AACOM, continues to work to educate program directors and other stakeholders to increase their understanding of COMLEX-USA, what is measures, how to interpret its scores. We will continue to advocate for the inclusion of the COMLEX-USA credential when assessment for DOs is considered. We also support the U.S. Department of Education-recognition of COCA accreditation of US DO-granting medical schools, and almost universal acceptance of AOA board certification in 27 different medical and surgical specialties.

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In celebration of GME Professionals Day, we recognize the GME coordinators, managers, and administrators who work tirelessly to make residency programs a success. We took this opportunity to highlight the incredible accomplishments of Philadelphia College of Osteopathic Medicine (PCOM)’s GME Coordinator, Brenda Hoffman. Hoffman has been with PCOM for three years and is the coordinator for Hospice and Palliative Medicine and Geriatric Medicine. During that time, she was instrumental in getting both programs certified with the ACGME for Osteopathic Recognition. We had the chance to sit down with her to discuss her accomplishments and talk more about the importance of osteopathic distinction in GME.


 

What changes did you notice during the shift to ACGME’s single accreditation system?

I actually started working at PCOM right at the start of the application process for ACGME accreditation for the two fellowship programs for which I am the program coordinator: geriatric medicine and hospice and palliative medicine. It was a whirlwind of learning ACGME guidelines at the same time everyone else was, while also learning my new job! In the end, it was beneficial for me to not have a ‘before’ reference. The application process was actually a great opportunity to learn the ins and outs of both programs.

 

Does your program rely on score reporting for filtering applicants or are you adopting more holistic reviewing processes in anticipation of COMLEX-USA Level 1 going Pass/Fail?

Our program has always had a more holistic approach to reviewing applications in that we strongly consider many other attributes in candidates.

 

What other key attributes do your program directors look for to determine whether a candidate is a  good fit for the program?

My program directors focus highly on the personal statements, letters of recommendation, activities, and volunteer work. There is an emphasis on service to older patients that goes beyond merely treating their medical complaints, so fellows must embody the characteristics of compassion and care.

 

How early in single accreditation did your program gain ACGME Osteopathic Recognition (OR)?

The programs became ACGME accredited in 2019 for the 2018-2019 academic year and received OR in 2021.

 

How does OR set your program apart from others in this specialty?

Most geriatricians and palliative medicine physicians who are trained osteopathically apply OMM principles throughout their entire assessment. It gives a more integrated approach to patient care. While osteopathic manipulative treatment is not appropriate for every patient, seeing the body as a self-regulating unit is a key OR principle seen in both geriatric and palliative medicine.

 

What is some advice you would give to COM students who plan to apply to an OR program?

You already have all the tools and knowledge that you need to succeed in any OR program! When interviewing for any program, make sure you are interviewing the program as well as letting them interview you.  And most importantly, be extra nice to the program coordinator! They have more say in things than you might think.

 

What do you most enjoy about your role as a Program Coordinator?

Because I work with much smaller programs, I love that I get to work with each fellow very closely.  We have the opportunity to cater the program to meet the needs and wants of each fellow, within reason. I enjoy helping to maintain a meaningful and impactful experience for every doctor that decides to spend a year in our fellowship programs.

 

Anything else you’d like to share about being a PC?

Program coordinators are such a key element to any residency or fellowship program. There is so much behind-the-scenes that goes into it to make sure programs are running as smoothly as possible and it could potentially go unrecognized. I am fortunate to feel appreciated in my programs and I work with an incredible team at PCOM! Go thank your PC today!

 

We have been a tireless advocate for reducing unnecessary barriers and increasing awareness of osteopathic students and their qualifications.

You watched the incredible resilience of the Class of 2021 as they navigated a match cycle during the pandemic. Everything they had been told to expect, changed. And now you find yourself in a similar position as the process continues to shift. While your Match season will be fundamentally different, rest assured that the community has come together to provide plenty of resources and support to help you navigate one of the most important transitions of your academic and professional careers.

You have overcome incredible challenges to get here, and we have great resources to help you as you take your next step on The Road to DO Licensure.

2022 Match Timeline

 

June 2021 | Open for Business

ERAS opened in June, and if you have been approved by your COM to enter the upcoming Match, you can access  MyERAS, and begin working on your applications. Check out the NRMP Intro to Main Residency Match page to learn about what’s new for this upcoming application cycle.

As a reminder, the following key Match dates occurred in June and July:

Military students automatically registered for Army/Navy/Air Force Match

 

September 2021 | Off to the Races

Keep in mind that you do not need to submit all of your applications on September 1; you have plenty of time to complete and submit your applications. If you’re still researching programs, the AAMC’s Residency Explorer Tool can help you find programs that are a good fit for you.

 

October 2021 | Putting Yourself Out There

Most residency program interviews will be held between October and December. Some specialties will continue to rely on virtual interviews. Double-check the websites for the programs you have applied to, and see what they have planned for this interview season. And make sure you’re ready to ace your virtual interview with these important tips.

 

December 2021

 

January 2022

 

February 2022 | Ranking Opens

It’s that time – once you’ve registered with the NRMP, you can now submit your Rank Order Lists.

 

March 2022 | This Is It

*The 2022 SOAP schedule shown below is an estimate; the official schedule has not been posted yet.

 

May 2022

 

 

For osteopathic med students getting ready to participate in the 2022 Match cycle or those who have not started their 4th year yet and want to prepare early, there are a number of key resources available. The following is a brief rundown of the latest Match resources crucial to crafting a successful application strategy.

The American Association of Colleges of Osteopathic Medicine (AACOM) has put together a Match Resource Center to help COM students as they embark on the UME to GME transition. It includes interviews with key leaders, tips on interviewing and managing social media during the application cycle, and help for those who don’t match. With over 5,000 students attending the last Virtual Residency Fair, it has proven to be a great resource for applicants seeking to learn more about residency and fellowship programs—and it’s free! Best of all, AACOM has launched a new site which provides residency programs with a platform to share available positions with COM students. Check out Available Residency Positions here.

Alongside AACOM, the Assembly of Osteopathic Graduate Medical Educators (AOGME) have great transition resources. Available webinars can provide key insights into understanding residency contracts or optimizing the transition from a COM student to a PGY-1. Connect on the AOGME Membership Discussion Forums to share perspectives and get guidance from other colleagues in GME.

As the gatekeepers of ERAS, the Association of American Medical Colleges (AAMC) offers a number of in-depth resources like the AAMC T2R Tools for a Successful Residency Application webinar. Though the session went live in June, the recording is freely available, and provides an overview for the application process itself, helping to facilitate application strategies. The webinar includes an overview of the Careers in Medicine microsite, Diminishing Returns data, the Residency Explorer research tool, and ERAS guidelines.

Careers in Medicine is a multi-resource deep-dive into physician career options, tips on preparing for residency, and insight into 135 specialties and subspecialties. The Specialty Insights section is especially useful for COM students who want to see how their COMLEX-USA scores stack up against those who have already matched.

Apply Smart for Residency provides data and resources which helps candidates shape their application strategy and cover topics, such as managing finances, interviewing, and understanding the application process. In addition, COM students who are looking to enter Internal Medicine, Dermatology, and General Surgery can find details on the supplemental ERAS application specific to these three specialties. The supplemental application spotlights candidates’ prior experience, interests, and indicate their program preferences.

Residency Explorer is a tool that allows applicants to review and compare programs in 23 specialties. The platform can weigh student’s profiles with other applicants who have successfully matched. Users can also compare using metrics like applicant type, standardized exam scores, peer-reviewed publications and research, and volunteer and work experiences. Residency Explorer is supported by verified data which includes contact and demographic information, such as the number of filled resident positions, program characteristics, application requirements and trends, program selectivity, and resident opportunities. Users should be very aware that some elements depend on program input (e.g. if a program has failed to update their application requirements, candidates may find conflicting information on the program website).

As we gear up for the 2022 Match cycle, it is important to know that there is a wide-range of knowledge available for COM students. The application process is stressful, but finding the right resources can help reduce that stress.

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Brittany Ladson is a fourth-year osteopathic medical student from Michigan State University College of Osteopathic Medicine with plans of going into Emergency Medicine. Throughout her career in medical school, she participated in many study abroad programs and mission trips—including Doctors without Borders.

 
Her efforts working in under-resourced areas were able to give her a well-rounded view of medicine. During her time there, she relayed that critical thinking was imperative in order to maintain a patient’s future health. Her experience in providing care without technologies physicians would typically have at their disposal allowed her to see the value in preventative treatment and gain a newfound appreciation for osteopathic medicine. We were fortunate to be able to interview her on her experiences and acquire insight into her personal journey on her Road to DO Licensure.



What inspired you to become a DO, specifically? Tell us your story.

Initially, I thought I had wanted to go into business and accounting—that’s what my whole family does; there’s not a single healthcare provider in my extended family. I thought I’d just follow suit, but I quickly learned during an internship where I had to sit at a computer desk all day that it wasn’t my thing at all. I like having more energetic, personable interactions with people—over the phone just doesn’t cut it. That’s why I think physicians are the foundation of the service industry because during a very vulnerable time in a patient’s life—maybe even one of the worst days of their life—they must still be able to give themselves wholeheartedly to serve their patients. To be able to provide emotional support, social support, and of course, the physical medical help patients need is no easy feat. By combining all these aspects together, I felt that it’s the perfect way to be able to help someone. I couldn’t see myself doing anything else—I’d always be missing something.

We often hear the phrase “osteopathic distinctiveness” used across the profession. What does that phrase mean to you personally?

What I believe sets us apart is the osteopathic philosophy of providing the public with preventative healthcare. Yes, it’s important to see someone in an acute situation and serve them at that moment, but the impact that preventative healthcare provides for a community is part of what makes osteopathic medicine special.

On top of that, there is also the unique value that osteopathic medicine adds to an individual’s patient care in that we look at their body, mind, and spirit. And although a lot of other physicians are starting to recognize that as integral to their practices as well, it’s part of the foundation, groundwork, and philosophy instilled in all DOs. The way we see patients is very unique from the start, and I couldn’t see myself doing anything besides serving patients with an osteopathic mindset.

When you’re in your third year of medical school as an osteopathic student, and you’re seeing patients who are seeking help, you start to come out of the textbook and appreciate the real aspect of addressing a whole person. In starting my clerkship education during the pandemic, we saw more patients come in with acute mental health issues. They need that in-person patient interaction—they need their hand held, they need a hug, they just need help. And that’s when I really started to appreciate how much the mind can affect the body.

Looking back at how you prepared for your most recent level of COMLEX-USA, would you have taken a different approach to studying? What advice do you have for other COM students who are preparing for COMLEX-USA?

What I found really helpful was having a daily schedule where I would have a dedicated period of studying. I’d keep to the same pattern—waking up at the same time, having coffee, sitting down to study—and then following dinner, I’d have the evening to myself. Around six or seven at night, I’d be able to decompress or hang out with my friends.

I also found it really important to go outside and get sunlight, especially because studying adds extra tension. Taking walks and breathing in the fresh air and feeling the sun on your skin is so much more rewarding than just sitting in front of your desk the whole time. I even got an Apple Watch that would tell me when I was sitting for too long, just to remind me to get up and go to the bathroom or grab a drink of water.

Something else that I would recommend when studying for COMLEX-USA is taking a layered approach. I’ll start off with a block of questions and see how I scored—and I’m not judging myself or being hypercritical of how I did. Instead, I am looking for specific themes or concepts that I’d commonly missed. Then I’ll go into the source material I’m studying to review the content as if I was seeing it for the first time. Following that, I’d do another block of questions to determine if I improved. I’d continue on that way, layering on new material so as to not forget the old. I found it very helpful for me in retaining the information.

The Road to DO Licensure has many unexpected challenges that I’m sure you’ve experienced, including burnout, stress, and anxiety. Tell me some of the major challenges you’ve faced while taking COMLEX-USA and some advice on how you personally overcame them.

Burnout is real, and unfortunately, when you reach that point, there’s not a whole lot you can do in that immediate time period to recover from it. It’s very hard to come back from. Personally, when I got burned out, it took me several weeks to feel like I was back to normal. I dedicated a whole three months to studying, underestimating how exhausting that would be because I thought if I went to bed when I needed to and napped when I wanted to, that it would be fine. But even with that mindset, I was still liable to become burned out by the end of that period, and that’s actually when you want to be at your peak. There’s no magic cure to say, “Okay, burnout is done;” it’s a challenge you have to mentally and physically go through.

The most important thing you can do is plan to prevent burnout before it happens. That way when exam day rolls around, you are at the top of your game, and not on the tail-end. To do this, I think scheduling is essential—not planning too much time per day, per week, or per month to study. Pace yourself. You don’t need to learn every single thing, and you’re never as behind as you think you are. It’s all just a mind game that you have to play with yourself. I would even extend this concept to any point in your medical education. If you can get to that peak and then take a break after that, I feel that would be the most efficient way to get studying done, especially for things as important as COMLEX-USA.

What are you looking forward to the most in the next stage of your journey?

I am mostly excited to audition, since interviewing seems kind of intimidating and scary. I look forward to meeting other physicians in the field I want to pursue and to experience different emergency departments and how they operate. I think it’ll be especially interesting to see the current fourth-years go into that internship role in the emergency department that I will be rotating into. Seeing how their perspectives have changed and picking their brains for advice is something I’m really excited for.


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There is no more exciting a time than when we are welcoming a new incoming class to our colleges of osteopathic medicine. Three organizations have come together to produce a welcome video for new osteopathic med students. We wanted to give a brief introduction to each organization and illustrate how we work closely together to give support throughout their Road to DO Licensure.

Working in collaboration with specialty leadership organizations: Alliance for Academic Internal Medicine (AAIM); Association of Professors of Dermatology (APD); and Association of Program Directors in Surgery (APDS), the Association of American Medical Colleges (AAMC) is piloting a potential solution to address the need for a holistic review of residency applicants. The challenges of adopting new review processes beyond academic qualifications have long been a point of conversation. However, recent changes in academic healthcare have underscored the need for direct action.

The National Resident Matching Program (NRMP) reported 42,508 active applicants in 2021, a 6 percent increase from 2020. According to AAMC ERAS Statistics, the average number of applicants per program in 2021 was 505.77 (Dermatology), 3,383.28 (Internal Medicine), and 1,186.45 (Surgery). As the COMLEX-USA Level 1 and USMLE Step 1 transition from reporting three-digit numeric scores to Pass/Fail, program directors will no longer be able to rely on score filters to differentiate qualified candidates who are genuinely interested in a given specialty or specific program.

The supplemental application will provide applicants with the opportunity to share information about themselves, their education and their experiences in medicine in ways they are not currently able to through the original ERAS application. New dimensions will include geographic data, information regarding their most meaningful experiences (volunteer, work and research), and an indication of their top program choices. While the supplemental application will be mandatory for applicants of the three specialties, participation by residency programs is voluntary.

Applicants for these three specialties will be invited via email from the AAMC to complete the application, which will open on September 1. At the end of the Match 2022 cycle, the AAMC will evaluate the effectiveness of the new application components, building off of research undertaken throughout the year. The data collected for this study will not be shared with program directors. Additional information, including a list of participating programs, is available on the AAMC Supplemental ERAS application (for the ERAS 2022 cycle) webpage.  

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Brysen Keith, DO, MS, PGY-1 is a recent graduate from the A.T. Still University School of Osteopathic Medicine in Arizona (ATSU-SOMA) and is beginning an internal medicine residency with the University of Miami/Jackson Memorial Hospital Internal Medicine Program this month.
  Brysen Keith, DO, MS, PGY-1 is a recent graduate from the A.T. Still University School of Osteopathic Medicine in Arizona (ATSU-SOMA) and is beginning an internal medicine residency with the University of Miami/Jackson Memorial Hospital Internal Medicine Program this month. He serves on the Special Commission on Osteopathic Medical Licensure Assessment, which was formed to review the current COMLEX-USA exam and explore new, evidence-based ways to evaluate and verify fundamental osteopathic clinical skills and other competencies as osteopathic medicine, medical education and healthcare continue to evolve. We were very excited to get the opportunity to sit down and interview him on his Road to DO Licensure thus far.

What inspired you to become a DO, specifically? Tell us your story.

I didn’t take the typical route into medical school; my background is actually in biomedical engineering. I loved what I was doing but I really enjoyed working with patients more than anything, which is why I made the switch into medicine. Why I chose to become a DO came from my foundation as an engineer in that the idea of body, mind, and spirit with the addition of OMT seemed so naturally rooted in the idea of structural medicine. Therefore, going into osteopathic medicine just made sense to me because there was that understanding.

How does it feel to be part of the Special Commission? Tell us your thoughts.

I’ve spent a lot of time both before and in medical school working in advocacy; it’s something I enjoy and am passionate about. Being my school’s student government association (SGA) president and working through the council of osteopathic student government presidents was very rewarding. Part of what drove me towards pursuing innovation, particularly in medicine, was my history as an engineer in a past life. To be selected for the Special Commission was not just an honor, but has also been very enjoyable.

In the Special Commission, there are a lot of people who have been involved in medical licensing for a long time—so I try to push the boundaries for innovation in medical assessment as far as it can stretch. That’s what I see my role as, but I also want to make sure that the student voice is heard, which is very important because it’s the students who are being tested. I love it and have enjoyed it so far, but overall, I’m very touched and excited to see what comes out of it.

We often hear the phrase ‘osteopathic distinctiveness’ used across the profession. Having taken COMLEX-USA, what does that phrase mean to you personally?

Having taken COMLEX-USA Level 1, 2-CE, and PE, what I think defines the distinctiveness of osteopathic medicine is how we approach our patients. I love it, and it’s something I’ve seen a lot of in clinical; DOs really take a hard look at the person. I know we often talk about treating the patient as a person and focusing on the whole body, but that makes such a huge difference when you’re actually having those one-on-one conversations with a patient and their family.

I love that I was taught to balance clinical medicine with social medicine. Being able to have those human-to-human conversations and interactions is what brings the osteopathic touch to medicine. It’s extremely powerful—just taking a couple extra minutes to have a conversation with someone. For example, in internal medicine, a single patient may see upwards of six different physicians, so I always take the time to explain to them who their team is and who is in charge of their care and how I fit in that role. They always appreciate that. Especially in today’s healthcare, that connection is something that is often lost, but it’s also something that I want to make sure we continue to instill in our graduates—it’s something that I am very proud to carry forward.

Looking back at how you prepared for your most recent level of COMLEX-USA, would you have taken a different approach to studying? What advice do you have for other COM students who are preparing for COMLEX-USA?

This is a tough question because the approaches I took to studying for COMLEX-USA Level 1 versus studying for Level 2 are very different. When I was preparing for Level 2, I definitely did a lot more practice questions versus overall content review because when you’re taking Level 2, you’ve already seen all the content at that point. The preparation involves refreshing your brain a lot more on clinical aptitude.

The advice I would give to COM students is to make sure you program in days or even a half a day every week to take some time for yourself. There is a lot of anxiety involved in board licensure and exams, and it’s really easy to fall into the trap of getting burnt out. It starts with thinking that you need to do everything right now, and that isn’t true.

When prepping for my Level 2 exam, I allowed myself to take a day when I needed it. I know it’s something people say a lot, but I think we also don’t realize how important that is. You can say it all day, but actually doing it and putting it into practice is something else entirely. I literally had it written in my calendar [to] shut my phone off. In all honestly, I think shutting my phone off was one of the most helpful things because then you’re not even thinking about it.

The Road to DO Licensure has many unexpected challenges that I’m sure you’ve experienced, including burnout, stress, and anxiety. Talk about some of the major challenges you’ve faced while taking COMLEX-USA and how you personally overcame them.

What I had a hard time battling was the anxiety around boards, and thinking that this is one thing that will either make or break my career in medicine. For example, after getting up every morning and doing a 40-question problem set and not performing as well as you’d like, it’s hard not to fall into the thought process of questioning your abilities. “Am I ready for this? No, I’m not—what am I going to do? Do I need to push my exam back?” That anxiety and imposter syndrome starts setting in, and it’s really hard to get yourself out of that rut. I think what helped me through that was having a really good friend group who were all going through it at the same time. We’d compare notes with each other and also be reminded that we’re not the only ones who have those feelings and are going through this—we’re not alone.

Everyone has off days, especially when you’re doing boards. I had a really good friend during mine, and we would always keep each other accountable—talk each other off the ledge when we were freaking out about things. In medicine, when you hear about others doing so well, you start to think, ‘Oh, crap, I’m not doing that.’ So having those people—maybe even a couple years older than you—with similar study habits can help you take a deep breath and move to the next thing.

Did you only take COMLEX-USA and why?

I only took COMLEX-USA. I had debated taking USMLE, but I knew early on that I wanted to go into internal medicine, therefore I didn’t need to take it. For other specialties, it’s said to be more important—this is an issue that is being addressed.

I definitely will say that I think something we as DOs can work on is recognizing that there are still specialties where programs require USMLE along with COMLEX-USA. The level of anxiety and money that students have to pay to make sure they are competitive in that space is something that we need to look at really closely. That said, it is nice to see—at least in my tenure in student leadership—that a lot of programs are doing better in no longer requiring USMLE for DO students. We still have a long way to go.

Change is slow—especially good change. I am appreciative to have the 30,000-foot view that I have because it allows me to see that change is happening—it allows me to talk to other students and give them hope. It’s easy for them to say, “Why is this not happening right now?” But unfortunately, that’s not how policy change works. We are heading in the right direction, and I’m happy to see the progress we’ve made collectively as a profession over the last few years.

What are you looking forward to the most in the next stage of your journey?

I’m excited for the learning aspect of residency, but I’m also really nervous—like how I mentioned imposter syndrome earlier. Even though you’ve been told so many times that you shouldn’t be nervous for residency and you’re going to do great, you still can’t help the feeling. I also can’t wait to be in a space where I have the flexibility to learn and to also make mistakes. I feel like I’m going to become competent very quickly with the program I’m going into because they do a lot of teaching. I can’t wait to have students under me that I can help guide through the same path that I took a few years ago. I think I bring a good world view, especially when rotating and in third-year where there’s a lot expected of you. I am excited to help mentor students through that.

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The National Board of Osteopathic Medical Examiners (NBOME), founded in 1934, is an independent, nongovernmental, not-for-profit organization whose mission is to protect the public by providing the means to assess competencies for osteopathic medicine and related health care professions.

 

There is little that COVID-19 hasn’t impacted in our daily lives—everything from special events like weddings, funerals, the birth of a baby, to routine daily activities like going to work, class, and getting together with friends. If you’re entering your 4th year of medical school, that likely also includes applying for residency. We sat down with AAMC staff: Amy Mathis, Senior Director at ERAS and Michele Oesterheld, Director of Client Services at ERAS, to talk about some of the key changes in this year’s application season.

There is little that COVID-19 hasn’t impacted in our daily lives—everything from special events like weddings, funerals, the birth of a baby, to routine daily activities like going to work, class, and getting together with friends. If you’re entering your 4th year of medical school, that likely also includes applying for residency. We sat down with AAMC staff: Amy Mathis, Senior Director at ERAS and Michele Oesterheld, Director of Client Services at ERAS, to talk about some of the key changes in this year’s application season.

How has the COVID-19 pandemic changed the Match or the ERAS registration timeline—were there any changes to the 2021 ERAS Residency Application Cycle?

The Coalition for Physician Accountability’s Work Group on Medical Students in the Class of 2021: Moving Across Institutions for Post Graduate Training made recommendations on major issues facing applicants and training programs as they prepare for the 2021 residency application cycle. In the wake of coronavirus (COVID-19), the Coalition recommends a delayed opening of ERAS for residency programs and a delayed release of the MSPE with a shared date for both. After much consideration for everyone involved and in collaboration with AAMC affinity groups, specialty organizations, and the ERAS Advisory Committee, ERAS has determined that on Wednesday, October 21, 2020, residency programs will gain access to applications and MSPEs will be released to residency programs. This delay gives applicants five more weeks to finalize their applications before submitting to residency programs. These date changes are reflected on the ERAS 2021 Residency Application Timeline.

Are there any other changes to the normal application process?

The COVID-19 pandemic has caused significant disruptions to medical education across the country and has drastically changed the usual application process this cycle. To draw attention to these changes, ERAS communicates with the program community through different channels (emails, community sites, webinars, training, special workgroups, etc.) during the application season.  Several specialties have released guidance for applicants around their application cycle. Please visit this page for additional details.

How can applicants stand out in a virtual setting?

The AAMC has posted several resources for residency applicants on conducting interviews during the coronavirus pandemic.

Prep for Success in Your Virtual Interview

Programs may be conducting live virtual interviews or incorporating an asynchronous/on-demand virtual interview into their process. This webinar will help you prepare for success in your virtual interviews by identifying a suitable environment, preparing and practicing with technology, and preparing for and responding to interview questions. It discusses how to address possible challenges you may face with virtual interviews and possible steps you might take to overcome them. These resources are also available in PowerPoint slides (PDF).

What key resources do you recommend for 2021 applicants?

ERAS encourages applicants to utilize the guides and worksheets listed below to assist with submitting applications.

What advice do you have for 2021 applicants?

Research programs. To help you determine which programs best fit your interests and skills, programs may provide additional details about their selection criteria and application requirements. This information is provided on ERAS 2021 Participating Specialties & Programs webpage and within ERAS, a blue informational icon will appear next to the name of programs that have provided additional information.  The AAMC has curated a series of resources that explain the process and ensure that the residency program you select is the right fit for you. Your likelihood of securing residency training depends on many factors – including the number of residency programs you apply to. This diminishing returns data is provided on the Apply Smart: Data to Consider When Applying to Residency website.

You can also research individual residency programs across 23 specialties and compare yourself to previously matched applicants at those programs using the Residency Explorer Tool.

Prepare your application.

Check your application. Please review your application before certifying and submitting. Once you certify and submit, you will not be able to make any changes to your MyERAS application except to the “Personal Information” section – which includes the ability to upload and assign new documents after submission.

What are some of the other major questions or concerns you are receiving in relation to the 2021 application cycle?

The ERAS FAQ page for ERAS Residency Applicants contains many of the concerns we are currently hearing and will be updated throughout the ERAS 2021 season. Some of these include questions in regards to which programs will be participating in 2021, editing MyERAS Documents, application deadlines, and more.


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We understand how uncertain the times are right now, but know you are not alone in navigating it. Due to the pressures of the changing climate, we wanted to put together a resource to assist DO candidates with the 2021 Match season. While it will be fundamentally different because of the COVID-19 pandemic, there are still plenty of resources available to make it easier to get through the Match application season successfully.

We understand how uncertain the times are right now, but know you are not alone in navigating it. Due to the pressures of the changing climate, we wanted to put together a resource to assist DO candidates with the 2021 Match season. While it will be fundamentally different because of the COVID-19 pandemic, there are still plenty of resources available to make it easier to get through the Match application season successfully.

Looking past the many changes brought on by the COVID-era, there are many reasons to be optimistic about the 2021 Match season, especially for DO students.

The ERAS 2021 Residency Timeline and the 2021 NRMP Main Match Calendar are great resources to help you stay on track as you take your next step on the Road to DO Licensure.

2021 Match Timeline

June 8, 2020  |  Open for Business

ERAS is now open in advance of the 2021 NRMP Main Match! A token from your dean shows you are approved by your COM to enter the upcoming Match, enabling you to register with the NRMP and in MyERAS, and begin working on your applications. Check out these NRMP FAQs to learn about what’s new for this upcoming application cycle.

September 1, 2020  |  Signed, Sealed, Delivered

At 1:00pm ET, you can begin to submit your applications to residency programs!

Keep in mind that you do not need to submit all of your applications on September 1st. Programs can’t begin reviewing applications until October 21, so you have plenty of time to complete and submit your applications. If you’re still researching programs, the AAMC’s Residency Explorer Tool can help you find programs that are a good fit for you.

September 15, 2020  |  Don’t Miss a Step

The 2021 NRMP Match registration is now officially open! While it is not required for you to have an NRMP ID to submit your program applications, applicants must be registered in the NRMP’s system to participate in the Match.

October 21 – December 31, 2020  |  Crunch Time

Residency programs can begin reviewing applications at 9:00am ET on October 21st. Most residency program interviews will be held between October and December.

Many specialties have recognized the unique situation caused by the pandemic this year and have changed at least some of their expectations from previous years. Find out what your desired specialty has planned for this interview season. And make sure you’re ready to ace your virtual interview with these important tips.

February 1, 2021  |  Ranking Opens

It’s that time – once you’ve registered with the NRMP, you can now submit your Rank Order Lists. You have until March 3rd to figure out where you’d like to train – and remember, registering establishes your eligibility for SOAP (the Supplemental Offer and Acceptance Program) in this year’s Match.

March 3, 2021  |  Last Chance for Rank Order List

The final days are here! If you haven’t already finalized your rank order list, you have until 9:00pm ET to do so – here are some tips from the NRMP on how to do it right. (And don’t forget to verify your COMLEX-USA scores too!)

March 15 – 18, 2021  |  We’re So Excited

It’s finally Match Week! Your match status becomes available at 11:00am ET on March 15th, and SOAP begins for eligible, un-matched and partially-matched applicants to unmatched positions.

Good news for those of you that haven’t heard – the NRMP has added a fourth offer round to the 2021 SOAP process to alleviate some of the uncertainty caused by the pandemic.

March 19, 2021  |  Drumroll Please

It’s Match Day! Celebrate with your classmates at your COM’s 2021 Match Day celebration. Match results will be made available at 1:00pm ET.


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NBOME caught up with Sydney Miller on Zoom to talk about her experience with COMLEX-USA, her new role as Student Director on the NRMP Board of Directors, and what’s next on her Road to DO Licensure. Originally from Commerce, MI, Sydney is a third-year medical student at Michigan State University College of Osteopathic Medicine, which has recently become a satellite testing center for COMLEX-USA. She just started her clinical rotations a few weeks ago and is currently working in a family medicine clinic.

 

NBOME:  What inspired you to become a physician and what drew you toward becoming a DO, specifically?

SM: I had a lot of different interests as an undergrad, but I finally decided I wanted to become a doctor because I wanted to help patients, not only as a physician treating their conditions, but also serving as a teacher, advocate, and overall coordinator of care. I wanted a career where I could use my love of science and my soft side too, which is why I chose osteopathic medicine. We don’t just treat patients’ medical conditions, but we also try to discover what in their community is contributing to their health. What makes the person who they are—I was really drawn to that. I also like public health, and felt as a physician you can pull some of that in, especially as a DO. I want to be a doctor that my community can rely on.

 

NBOME: Looking back at how you prepared for COMLEX-USA Level 1, would you have done anything differently or taken a different approach to studying? 

SM: I just took COMLEX-USA Level 1 in June and one thing that was crazy about my prep was that my exam was canceled multiple times.  I had to become more adaptable. I had a set plan where I was going to study XYZ for this many days and take these specific practice tests leading up to my exam, but when I found out it was canceled, I had to be even more flexible.

Overall, I wouldn’t change too many things about how I studied. During the two years leading up to my COMLEX-USA exam, I used a few resources consistently. One thing I’d suggest is trying to blend learning the specific details with understanding the bigger picture. It’s important to make sure you aren’t losing sight of what a patient might actually present with—if someone comes in with these symptoms, what are some things that would be on your mind?

 

NBOME: As a medical student in the midst of a pandemic, do you feel this experience is helping you be more flexible or do you feel as though the stress is holding you back? 
SM: It’s a little bit of both. I try to look at it as, ‘okay, this is a new challenge.’ It also puts into perspective that COMLEX-USA is just another step in the road to becoming a doctor, which helps to lessen the pressure of performing super well. It’s true, you want to do well, but COVID-19 helped prove that there are elements you can’t control—like when you take the exam.  You have to learn to be more flexible, do the best you can, study hard, and achieve what you can the day of your exam.

Something I saw over the last two weeks of working in my family medicine clinic is people are scared—they are so stressed. They come to their doctor not just for things like ‘can you refill my blood pressure medications,’ but for, ‘I just need to talk to somebody. Can you just hear me out because I have these concerns?’ Even just talking to a doctor who knows their medical history and their family can help a lot of people get through this crazy time.

It took time for me to adjust to doing all of this differently too, and we have to realize not every day is going to be perfect. Some days I was very stressed. Moving into clerkship, a lot of original plans at the hospital had to change, but that’s the case right now in every field. You just have to take it day-by-day.

 

NBOME: Was that the most difficult part of preparing for COMLEX-USA in the middle of a pandemic?

SM: The hardest part was just being in isolation. I’m a busybody—I like to be out and about and I normally study at a coffee shop or at school because I like to have other people around me. I’m not much of an at-home studier, so I learned to study really hard and then take breaks, go outside and do fun things in between. Not being able to be around people while trying to keep a positive mindset in the midst of so much uncertainty was the hardest part for me.

 

NBOME: Part of managing stress is definitely continuing to do the things you love. How have you managed to fit in time for your hobbies and other activities while studying?  What else did you do to help keep your stress levels in check?

SM: Though I couldn’t play beach volleyball with my classmates, I’d still go for a walk almost every day, and force myself to take an hour or two off, no matter how stressed I was or how much I had to get done. I’d just schedule it into my day—40 questions in the morning, some educational videos, another 40 questions, then an hour off. There’s not too much hiking where I am, but I’d go for walks and try out new recipes to keep myself entertained. It’s important for me to put time-off into my schedule to go listen to music, lay in the hammock, catch some sun, and do things outside.

It took me some time to figure out what works for me and what doesn’t. Find something that helps take your mind off of studying, something that makes you feel at peace. For me, it’s being outside and being around other people. Talking to people both inside and outside of medicine has helped give me perspective.

Especially during the first two years of school, find ways to take time off and develop coping mechanisms. At my college, we have a counseling department that’s there for just medical students. Using resources like that early on, before you start studying for COMLEX-USA and start feeling anxious or depressed, can really help support your mental health.

 

As President of your class government, you serve as a liaison between students and administration/staff across all three MSU COM campuses. How do you find balance? 

SM:  I am very lucky that the other students I work with on class government have been amazing, and I have mentors and our administration who have been so supportive. I always have people to turn to if I need help.

It was an adjustment, timewise, though—‘how do I manage having three meetings today and an exam in four days to study for?’ Yet, I know when I have meetings, it makes me appreciate the time I have by myself to study. When I’m bored of studying, then I have the meetings. They each make me appreciate the other a little more.

 

NBOME: I’m sure you’ve encountered some challenges in this role—what were they and how did you come up with solutions?

SM:  It’s almost impossible to come up with solutions to problems that work for everyone. We can’t fix everyone’s problems, and there’s no single solution that everyone’s going to be happy with. I try to listen to feedback from my classmates and advocate for changes that will do the most good for the most people.

I have mentors and staff at MSUCOM who are receptive to feedback, so if something comes up that I don’t know how to deal with, I immediately run down to their offices and say ‘please help me, how do we attack this?’ I listen to feedback from them and the students so together we can make useful changes and a positive impact.

 

NBOME: Congratulations on your new role as Student Director on NRMP’s Board of Directors too! We understand you’ll be providing NRMP with an osteopathic student perspective on current initiatives and brainstorming ways to help improve the residency match process. What drew you to this role?

SM: Thank you! I was interested in this position first of all because it’s a national position dealing with problems across the country for medical students. As president of my class, I was focused on the problems my immediate community faced. I wanted to take it to a bigger scale to learn more about the process and advocate for DO students to have a seat at the table now that we have a single match.

As a medical student, the one thing you know you want at the end of your four years is to match into a residency program—it’s the biggest step in your professional career.  I wanted to learn more about that process and contribute to it in a way that helps all students, DO students especially.

There’s a lot of mystery in what being a DO student is like and I’m excited to share that with the board and talk about my experiences. There’s a new wave in medicine of ‘how can we improve this–how can we do better?’ I thought this would be a cool place to get involved.

 

NBOME: What are some of the topics you would like to explore further with the NRMP? 

SM: I was thinking of ways residency program directors can look at applicants more holistically, taking into account all parts of the individual—not just their scores. I want to help come up with a streamlined process that allows them to better analyze the thousands of applications they get each year. I don’t have a perfect answer for what should be important, but I want to work with RPDs or directors of medical education at hospitals and students to try and come up with a holistic process. It’s important for RPDs to select students based on more than just a score.

With respect to licensing examinations going to a Pass/Fail format: there are positives and negatives to Pass/Fail. Some students have shared that they worked hard to do well on this exam and want their score to reflect that. How can we come up with a middle ground that benefits both students and RPDs?

There is also the issue of students not reporting Match violations by programs. So if they are at an interview and the interviewer asks the student where they rank that program on their list, students feel afraid to report it for fear of potential backlash. I want to be part of developing a process that enables students to report these violations without fear of retribution.

 

NBOME: You’ve had the opportunity to explore so many different specialty areas through your rotations. Based on this, do you have a plan for zeroing in on a specialty?

SM: Because I have to do rotations in a lot of different areas and have so many interests on top of that, there are very few things I’ve encountered that I’ve felt weren’t for me. Right now, I’m leaning towards family medicine, internal medicine, or emergency medicine because you see a little bit of everything. I’m trying to keep an open mind and go into every rotation acting as if this is exactly what I want to be doing, all while asking myself, ‘Could I see myself doing this? Do I fit in here? Do I feel like I could contribute?’

I’m hoping to figure it out by going there, experiencing the day-to-day, and seeing what being a resident in that field really looks like. I also need to think about what my lifestyle looks like so I can find a field that matches those needs. I’m trying not to think about it too hard, but in the end, I’ll have to go with my gut.

 

NBOME: What advice would you give to COM students following in your footsteps?

SM: Find ways to make yourself happy outside of school, and try to develop coping skills for when things get tough—because things will get tough. Studying for long hours isn’t fun. Working long hours as a student or resident isn’t always easy, but if you can figure out ways to minimize your stress, you can succeed.

Work to get to know the people around you and form relationships with the people in your class. Medical school is a unique experience and the people who understand that best are your classmates. The best part about medical school is the community I’m so lucky to have. Having other people I can call on when I need them is what helps me get through stressful times when I’m feeling overwhelmed.

Some people want to study all the time and not take breaks. That’s what works for them, but that’s not what works for me. It’s taken me a little bit of time for me to confidently say, ‘this is how I study and this is how I’m going spend my time off.’ Not doing the same thing as everybody else doesn’t mean it is wrong.  Find what works for you and stick to it. That will take time and that’s okay. You don’t have to have it all figured out right away. Take it day-by-day and do your best.


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To just say that mental health and the effects of stress and anxiety have a direct impact on academic success would be an understatement. Mental health issues have never be in a brighter spotlight than they are right now—both for medical students, as well as for the general public. Many who have never experienced serious stress and anxiety previously are suddenly in the middle of something that feels completely foreign and unexpected.

According to the CDC, 1 in 5 Americans experience mental health issues every year.  Yet, we continue to talk about it in hushed tones, quietly labeling those who are struggling as weak or inferior. This stigma is very real and the feeling of being judged or deemed unfit is often what prevents people from addressing their problems or getting help. In a profession where, in order to even gain admittance to its educational institution, you have to prove you are the “best of the best,” the perception of weakness can only compound anxiety.

Even though physicians face more scrutiny when disclosing mental health issues or treatment to licensing boards, we need to help ourselves and work together to break the stigma.

Mental health issues can permeate every aspect of our lives—from how well we sleep, to the health of our relationships, to how we perform on COMLEX-USA. But these issues are also present in more subtle ways, like mood swings, changes in eating habits, our ability to push ourselves intellectually, take chances, and feel emotions. These discreet changes can compound over time, leading to more serious issues, so it is important to recognize them as they surface, acknowledge their importance, and put a plan in place to address them.

 
Tune-in and listen.  You can’t fix something you don’t know about. It’s easy to turn a blind eye to what your brain and body are trying to tell you as you push yourself towards your goal of becoming a DO. We’re not suggesting anything elaborate, just a quick, daily Q&A with the most important person in your life (you). How are you feeling? How’s your brain? Sleep well? Ready to take on the day? Now listen to your answers. Does anything seem off?

Now that you’ve successfully inventoried your headspace, your sleep, eating patterns, and your personal relationships, we can talk about what triggers your stress and anxiety. Everything can be going along fine and all of a sudden, emotional whiplash is upon you. But why? What happened that disturbed your mental homeostasis and how can you improve your understanding of the issue so you can better master your response the next time?

 
Find your solution. Unproductive worries and rehearsing disaster can build up like cobwebs in your mind and be hard to shake out, but you can train yourself to experience those recurring thoughts in a different way. Implementing emotional well-being practices can help restore and protect you—both mentally and physically.

Practiced Meditation can assist you in letting go of those distracting thoughts, giving them less power over you. And while yoga, deep breathing exercises, repetitive physical activity, and open communication are all effective as well, continuing to do the things that you love—those that bring you joy and relaxation are just as important.

In choosing to pursue osteopathic medicine, you’re no stranger to stress and personal sacrifice, but there ARE limits. While stress can be a crucial element in keeping you motivated and on track towards achieving your DO goals, extending yourself past your limits helps no one, especially not your future patients. You can’t provide quality care to others if you aren’t able to provide quality care to yourself. Burnout is real. Know your limits and be confident when you chose to strategically say no.

 
Help reduce the stigma. Becoming an advocate for others who are also struggling, even while you’re working to manage your own mental health and anxiety issues, can be extraordinarily rewarding and even help deepen your own self-awareness and understanding. Become a more active and engaged member of your own support system of friends and family or find strength in numbers by joining or starting a group at your COM or as part of your Residency Program to help fight the stigma of mental health issues.

Raising awareness about mental health and reducing the stigma associated with it continues to be incredibly important, as is promoting help-seeking behaviors and emotional well-being practices. Your mind, body, and spirit takes care of your patient’s mind, body, and spirit. To do that successfully, you need to find a mental balance for yourself first.

Be strong during a crisis, be adamant in the calm, and stay firm in the storm.


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We’ve all been the kind of busy and stressed out that makes us accidentally miss a meal (and in some cases, not even be hungry for one). However, missing those meals prevents you from giving your body the nutrition and hydration it needs to power through and operate at full capacity. For busy medical students, it’s important to remember that you have to take care of yourself before you can successfully take care of others (i.e. your future patients). If you get into the habit now of not just eating regular meals, but also healthy ones, you’ll likely be able to carry these habits through to residency (when you have even less time to dedicate to eating and drinking the right things). Ensuring you get sufficient nutrition, can dramatically improve your mood, immunity, energy, and focus—all things necessary for preparing to be a physician.

We’ve all been the kind of busy and stressed out that makes us accidentally miss a meal (and in some cases, not even be hungry for one). However, missing those meals prevents you from giving your body the nutrition and hydration it needs to power through and operate at full capacity. For busy medical students, it’s important to remember that you have to take care of yourself before you can successfully take care of others (i.e. your future patients). If you get into the habit now of not just eating regular meals, but also healthy ones, you’ll likely be able to carry these habits through to residency (when you have even less time to dedicate to eating and drinking the right things). Ensuring you get sufficient nutrition, can dramatically improve your mood, immunity, energy, and focus—all things necessary for preparing to be a physician.

Not sure how to cram nutrition, and hydration, and everything else into your already super-packed schedule? Keep reading!

WATER

How much water do I need?

80% of our water intake comes from fluids, and only about 20% from the foods we eat. This makes drinking water all the more essential. When you are even mildly dehydrated, this can cause physical stress on your body, and make it difficult to concentrate and even perform physical tasks.

How do I drink more water?

With so many things on your plate right now, you forget about the glass of water sitting right next to it. Technology can help! Hydration apps and smart bottles provide reminders to drink your daily fill.  You can also up your intake of water-rich foods:

FOOD

How do I eat healthier?

Stop. Skipping. Breakfast. We hear you.  By the time our feet hit the floor in the morning, we’re already go-go-going—with many of us putting little to no thought into jump-starting our day (and our metabolism) with breakfast (because we already jumpstarted it with a million other things). When a leisurely brunch is not on your menu, here are a couple of easy grab-and-go ideas:

Pre-portion your snacks.  Looking for a better way to avoid stress-eating and/or over-eating? Portioning out your snacks ahead of time with baggies or bowls can be a lifesaver. Plus, it helps you plan your limits (before your mouth craves more). When it’s gone, it’s gone.

Upgrade old favorites to healthier versions.  We’re not suggesting you stop eating your favorites like mac and cheese (gasp!) or hamburgers (nooo!). Just give them a little refresh with some healthy swaps and additions.

How do I pull this off with my busy schedule?

Virtual Shopping with grocery apps.  Skip the store with apps, such as Amazon Fresh, Instacart, or Peapod. These allow you to shop from wherever you are. Instead of investing time going to the grocery store, wandering around aimlessly, and suddenly finding yourself holding a family-size bag of chips instead of a head of broccoli, this method can help you save some serious time, and if you’re smart, some money too.

Save prep time by going frozen.  Best part? It’s already prepped and chopped for you. And some studies show that frozen vegetables are packed with even more nutrients than the fresh stuff because they are frozen before your fruits and veggies start to break down. Frozen also costs a LOT less than fresh too.

Prepare meals for on-the-go.  Make the most of your weekend study breaks. Pop into the kitchen for a few minutes here and there to bag some snacks for the week or blend smoothies to freeze (find some of our favorite recipes here). Another study break gets your virtual grocery shopping taken care of too.

When you’re busy, it’s hard to make space for nutrition (or even meals in general), but doing so will help to increase your focus, lower your stress, and save you time in the long haul. Focusing on diet and nutrition doesn’t need to slow you down!


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Residency Explorer is a resource for rising 4th-year medical students from MD-granting and DO-granting medical schools in the United States and international medical students and graduates who are applying to residency programs in 2020. It allows applicants to research individual residency programs in 23 specialties and compare themselves to applicants who previously matched at those programs as well as explore program characteristics across many areas of interest.

Residency Explorer is the only resource with original, source-verified data from the 9 national organizations involved in the transition to residency. While Residency Explorer does not tell applicants where to apply or predict where they may match to a residency program, it can help applicants research and develop a list of programs for further investigation. Last year, 9 out of 10 applicants said after using Residency Explorer, they felt more confident about which programs to apply to and felt more informed about the characteristics of programs of interest to them.

NBOME is a sponsor of Residency Explorer along with other national organizations involved in medical education: Association of American Medical Colleges, Accreditation Council for Graduate Medical Education, American Association of Colleges of Osteopathic Medicine, American Medical Association, Educational Commission for Foreign Medical Graduates, Federation of State Medical Boards, National Board of Medical Examiners, National Board of Osteopathic Medical Examiners, and National Resident Matching Program.

If you have questions about Residency Explorer, please consult the FAQ and Help sections at https://www.residencyexplorer.org.


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What do you picture when you think of meditation a person standing under a waterfall or someone sitting in full lotus chanting “ommm”?  With so many stereotypes following meditation around, and so many perceived restrictions, it’s not surprising that it prevents many from practicing it; however, it is important to keep in mind that meditation is simply a vehicle with which to still your mind. Practicing meditation belongs to you and does not involve any right or wrongs. There are no pressures and there is no try with which to feel as though it is too hard. To put it simply, meditation isn’t inclusive of sitting down and doing nothing for extended periods of time. Let’s face it, as a medical student or resident do you have time to do nothing while studying or preparing for licensure exams?

While sitting meditation is its own kind of practice, it doesn’t have to be your practice if you don’t have the time for it. We all have our unique ways of getting to a clear, stress-free mind. What’s yours?

WHY MEDITATE

As a future physician, and someone whose job is to heal, you will inevitably see a lot of suffering, and there will be times that are difficult to get through. With this in mind, you’ll need to find your own strategy to get through the hard times and prevent those situations or leftover feelings from eating you up inside. All doctors have acquired learned behaviors to help them cope with the feeling of burnout. Meditation is one of them.

Imagine you have to tell someone they have cancer and they only have a certain amount of time left to live. Not all specialties will encounter situations this severe, but the mental fortitude to ‘reset’ yourself and be present for your next patient is important no matter what specialty you choose. You’ll have to let the emotional baggage go, move on quickly, and continue to function.  When you are stressed out, when you are anxious or nervous, and facing something that feels impossible—the only real choice is calm.

Meditation can help you find that calm and develop a different response to stress by refocusing your thoughts when you fall into a negative thinking pattern. It’s a practice that will help strengthen your mind and learn how to be with yourself—deeply with yourself, and your darkest thoughts—while you watch them pass by like ships on the water, silently observing, and then letting that go too. As a future physician, you can take the practice of meditation with you anywhere and apply it to all aspects of your life.

HOW TO MEDITATE

Face the Difficulty
Your mind is your worst enemy.  Whenever you start something new, there’s always a level of uncertainty. And that’s okay. It’s normal to feel challenged when meeting with yourself. Don’t let you discourage you. This is an open dialogue—a forever conversation with yourself, and it will take discipline and commitment to follow through—just like your commitment to becoming a DO.

Find the Time
There are many kinds of structured meditation that follow forms, such as Zazen, Qigong, or Yoga. These types of meditation involve making time in your schedule. And if that’s possible for you, that’s wonderful! However, we truly know, and appreciate, how frenetic and time-crunched the schedule of a busy medical student or resident is. Not everyone can spare the time to essentially get nothing done. In which case, they will need to take their practice into their own hands and find portions of time in their schedules to meditate or at least be meditative.

Start with counting your breaths and keep letting the thoughts roll away. Let what you’re doing become your mantra, and keep reciting it.

Learn to Focus
Stop for a moment—stop wondering about the results of your last COMLEX-USA exam or how one of your patients is doing.

  1. Take a moment to focus inwardly.
  2. Make yourself comfortable.
  3. Check-in with your body and keep your back straight.
  4. Don’t move if you can help it.
  5. Keep your eyes still and about six yards in front of you, soften your sight.
  6. Breathe diaphragmatically from your core.
  7. Start to count each of your exhales until you get to ten.
  8. Start over from one and count your exhales again—rinse, repeat.
  9. Keep bringing your mind back and avoid wandering down that rabbit hole.
  10. Be the observer. Let it pass and don’t try to catch it—fish without any bait.

Keep Consistency
It’s better to meditate for just five minutes every day than to try and clear time for larger chunks of meditation twice a week. The consistency and repetition of your practice are essential to perform maintenance on your mind like you would on a computer. Keep at it!

WHEN TO MEDITATE

Meditation isn’t a prescription. It’s not like taking an ibuprofen that will make your headache go away—it’s more like the reins on a wild horse you need to learn how to tame. With this in mind, don’t just meditate when you’ve had a stressful day; meditate when you’re also having an amazing day. Sit with your happiness as often as you sit with your distress.

WHERE TO MEDITATE

Sitting
As mentioned before, there are so many different forms of meditation. While many of them involve sitting formally and doing nothing, that isn’t to say you can’t enter the same headspace in a different setting—like sitting on a park bench or in the car. The restrictive and often painful ‘do nothing’ structure is conjured to help you focus on the here and now, but you can also achieve that same experience in other ways:

Walking
Meditation isn’t just limited to stillness. There are forms of moving meditation that can enable you to sink into a focused state without having to stop moving. “Walk it off” had to come from somewhere, right? Sometimes just taking a beat internally, can help to move you through a stressful space and into calm. And there are so many ways you can fit this into your daily life:

Doing
Meditation is also not limited to any action and can exist anywhere within you. Meaning, even when you are doing something, your mind is free and unbound from it. With any type of repetitive motion, you can enter a meditative state:

In the medical profession, meditation can be a practice that helps you sculpt a clean bill of mental health. It’s easy for anyone to have unproductive worries, but if you can train yourself to experience those distracting thoughts differently without giving them too much power over you, then you can avoid rehearsing disaster and stressing too much over the uncertain. Meditation will root you in the moment and help you be present not only for yourself but also for your patients.


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We stand with you as we bear witness to the unjustified deaths of black Americans at the hands of systemic racism running rampant in our nation.

George Floyd
Breonna Taylor
Ahmaud Arbery

Just a few of the names—among so many more—whose shocking and senseless deaths have left our communities reeling and enraged.

We are with you.

As our nation continues to endure this global pandemic, we reflect on the inequalities that remain alive and well in America. This civil unrest has yet again helped bring to light a long-overdue conversation that we will continue to have with you, using our platform to speak of love, support, respect, and community. While peaceful protesters search for answers, we continue our belief that empathy for one another can fuel positive cultural change.

We support you.

We refuse to stay silent when innocent lives are sacrificed in the throes of senseless brutality. In line with our mission to protect the public, we choose to speak out against hate, violence, and injustice against all people. We must all rise together to address these issues as we build a framework for future generations, founded on trust, equality, and support for our fellow human being.

We stand together.

We call on everyone within the osteopathic medical community to help heal not just the body, but also the heart of our very broken nation.

 

COVID-19 can’t dampen the excitement of graduating from a College of Osteopathic Medicine and earning the title “DOctor” Let’s celebrate your achievements virtually — Include #DOProud2020 in your posts!

Make it Count Monday

Now is a great time to give back in your hometown – whether it’s a couple of cans donated to a local food bank or shelter, volunteering your time with a worthy cause, or helping to support your local blood bank — every little bit counts!

Take Us Back Tuesday

Let’s rewind to your first day of medical school and then fast-forward to your last.  Share your best side-by-side pictures on social media.

Write It Wednesday

Who has been your biggest champion or influenced you the most during medical school? Take a moment to write and share five quick notes with professors, staff, colleagues, or friends and show them how important they have been on your #RoadtoDOLicensure.

Throwback Thursday

What was your favorite COM memory? Share a social media post of your story with the DO community – make sure you tag your classmates, your COM.

Fresh Start Friday

What are you looking forward to the most in residency? Share your list with others on social media.

 

Best of luck from NBOME! Extra points if you use our logo.

 


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Stories from the Road - GME Professional’s Day – Interview with Brenda Hoffman

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Katelyn Wray is a second-year medical student at Chicago College of Osteopathic Medicine on her #RoadtoDOLicensure, and she admits that she doesn’t have it all figured out. There just isn’t a set formula for success that DO students can use to plug-and-play. Even so, she has still managed to find an approach that works for her–one that balances her time so she can incorporate all her requirements into her schedule without robbing from either her physical or mental health.
Katelyn Wray is a second-year medical student at Chicago College of Osteopathic Medicine on her #RoadtoDOLicensure, and she admits that she doesn’t have it all figured out. There just isn’t a set formula for success that DO students can use to plug-and-play. Even so, she has still managed to find an approach that works for her–one that balances her time so she can incorporate all her requirements into her schedule without robbing from either her physical or mental health.

“It’s important to keep in mind that we are studying for the patient, not for the exam.”

Katelyn Wray is a second-year medical student at Chicago College of Osteopathic Medicine on her #RoadtoDOLicensure, and she admits that she doesn’t have it all figured out. There just isn’t a set formula for success that DO students can use to plug-and-play. Even so, she has still managed to find an approach that works for her–one that balances her time so she can incorporate all her requirements into her schedule without robbing from either her physical or mental health.

Having a balanced schedule like that is also possible for you, which is why we would like to share her experience. We’re excited to be able to relay Katelyn’s spirit, attitude, and unwavering determination to figure out how to accomplish her dream—even after not getting into medical school on her first try. It is that determination that we would like to pass on in the hopes that it will help inspire others to do the same—be confident in the pursuit of your dream, enjoy the present, and try not to stress as much we know you do. We are all human and no one is perfect.

Katelyn’s schedule won’t work for everyone either—in truth, it may only work for Katelyn. However, we hope that it may help you craft your own study schedule—one that is focused on the importance of your own wellness and mental health.

I wish I could start this off with an exciting story from my medical school life. I envisioned telling you a breathtaking encounter resembling a TV sitcom about how this past week I performed a lifesaving resuscitation in the emergency room or researched a rare syndrome, making a diagnosis no one had been able to make before. But the reality of medical school is that it’s extremely mundane. My days are long, filled with lots of exams and studying, and most recently, saturated with preparation for COMLEX-USA.

For me, a typical day starts at 5:15 AM. I live with two other second-year medical students. One of them gets up with me each morning, we get ready, eat breakfast, and head to the library together. I’m currently preparing to take COMLEX-USA Level 1 at the end of May 2020. In the mornings, I study for two to three hours: practice questions, watching review videos. I had been completing sets of 5-10 questions periodically prior to winter break, however, my exam prep has really increased since returning to school in 2020.

I attend class in person versus watching a recording of my classes. I feel that just watching recordings could isolate me, plus, attending class lets me work on my interpersonal skills and ask questions live. Because of that, my school day usually starts at 8 or 9 AM. Our curriculum has a lot of repetition, which has been very helpful to me in learning concepts and retaining them. For instance, we’ll learn a concept in anatomy during first-year, then during the clinical skills course in second-year, we’ll have the same concept presented in another way. This is different than a systems-based curriculum, which many schools utilize. This approach covers everything related to, say, the kidney, including the anatomy, pathology, pharmacology, and clinical correlations, and then moves on to the next system. For me, the repetition I get from our curricular approach has been very useful and works well with how I learn.

A typical day for me consists of about five hours of class and lab time. After that, I usually take a break. Sometimes I work out, I eat dinner, and I recharge. Then, I study my course content. Our curriculum is ‘exam heavy’ so we have about 1-2 exams per week and 2 quizzes per week.

The upside is that it holds you accountable for knowing the material and puts less value to each point.  The downside is that there is always an exam to prepare for.

My day ends at 10 PM when I go to bed and get ready to do it all again.

One of the most interesting parts of med school has been watching all the different ways that students can successfully DO medical school. For instance, I wake up early, study, and attend class. My other roommate sleeps in, watches lectures online, and stays up late studying. Some students study lecture packets, some use online flashcards, others utilize board prep materials, copiously annotating in the margins. During my first year, and honestly to this day, it was extremely difficult to feel comfortable and confident in my own approach to studying. This seems to be a common theme amongst my classmates. It’s so easy to doubt yourself when you see someone else successfully employ a totally different study strategy. And in a world with an overabundance of resources and information, you can find yourself burdened with the desire to study everything and learn everything all at once. At the end of the day, time is limited, so pick a study method and make the most of it—quality of studying over quantity.

Despite the repetitive nature of my days, each day is filled with learning that brings me one day closer to fulfilling my dream. I’ve had the opportunity to volunteer at a Community Health Clinic throughout med school, and as I’ve progressed, it’s been exciting and rewarding to witness my medical knowledge grow and expand, which has increased my ability to provide quality patient care. I’m currently in the process of selecting rotation sites for my third and fourth year, and experiences like these are what bring the patients on the pages of textbooks to life and bring excitement and passion to my more mundane days.   These experiences allow me to refocus and direct my energy toward studying while enabling me to eventually achieve my dream.


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For NOM Week 2020, NBOME joins others in the profession to help raise awareness of the distinctive care DOs provide, and further, extend our heartfelt thanks to frontline workers in all communities large and small.

 

NRMP #Match2020 Results. 90.7% match rate for DO Seniors. Up 2.6% over 2019. Up 13% over 2016.

               


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Here’s what you need to know about residency programs, Osteopathic Recognition and board certification.

A valuable guide for RPDs (and others) to better understand COMLEX-USA scores and usage.

Medical College of Wisconsin’s DIO, Kenneth B. Simons, MD discusses how residency program directors can utilize COMLEX-USA scores for DO applicants as part of a holistic admission review process.

 

Kenneth B. Simons, MD , Senior Associate Dean for GME and Accreditation at the Medical College of Wisconsin discusses holistic approaches for residency programs and COMLEX-USA for DO applicants.


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More than 9,916 fellowship positions filled through NRMP Specialties Matching Service.

 

Even though Match 2020 events have been canceled to contain the spread of COVID-19 and help flatten the curve, that doesn’t mean you can’t still celebrate this huge achievement in a big way. Let’s keep the wave of DO support and #MATCH2020 positivity going this week! Here are some ideas:

 

  1. Take your celebration online. Post an Instagram story of your at-home letter-opening ceremony and use the cool frames provided by @AACOM_DO. To be seen and found, make sure you hashtag #VirtualMatchDay #DistanceMatch #Match2020 #MatchDay2020. And don’t forget to tag @NBOME for a repost!
  2. Get everyone together. Gather your extended family and friends online and video chat them about your huge accomplishment – they’ll be thrilled to get the chance to celebrate alongside you!
  3. Find your friends. Identify hashtags related to the specialty you matched into and join the conversation! #VirtualPathMatch, #PsychiatryMatch2020 #VirtualEmergencyMedicineMatch, etc.

 

We’re excited to see your posts and stories in the coming days. If you want to share a quote and a picture with us to be featured on our website and possibly in our social campaign, please email it to us at: komalley@nbome.org!


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Sleep is usually the first to fall to the wayside when your time is limited—even when you do manage to carve out the time, it’s not always in the cards. However, sleep challenges are to be expected when you’re trying to fit in time for class, studying, and 4,026,527 other things. Your sleep hygiene is what determines your energy reserves and endurance, your ability to focus on the material you’re learning, and even your stress and anxiety levels throughout the day. For busy medical students like yourself to keep functioning at 110%, getting better sleep is essential on the road to DO licensure.
Sleep is usually the first to fall to the wayside when your time is limited—even when you do manage to carve out the time, it’s not always in the cards. However, sleep challenges are to be expected when you’re trying to fit in time for class, studying, and 4,026,527 other things. Your sleep hygiene is what determines your energy reserves and endurance, your ability to focus on the material you’re learning, and even your stress and anxiety levels throughout the day. For busy medical students like yourself to keep functioning at 110%, getting better sleep is essential on the road to DO licensure.

Sleep is usually the first to fall to the wayside when your time is limited—even when you do manage to carve out the time, it’s not always in the cards. However, sleep challenges are to be expected when you’re trying to fit in time for class, studying, and 4,026,527 other things.

Your sleep hygiene is what determines your energy reserves and endurance, your ability to focus on the material you’re learning, and even your stress and anxiety levels throughout the day. For busy medical students like yourself to keep functioning at 110%, getting better sleep is essential on the road to DO licensure.

Regardless of age, everyone is wired a little differently—some function best at the crack of dawn, while others channel their cognitive energy more effectively in the middle of the night. No matter what category you fit into, you can benefit from some improved sleep hygiene—here’s how:

1. Keep a Consistent Schedule

You should be aiming for the same bedtime and wake time every day—yes, even on the weekends. This regulates your body’s sleep-wake cycle to help you fall asleep and stay asleep. And sadly, there’s no playing catch-up on those lost hours either. Losing sleep on Thursday and sleeping-in on Saturday doesn’t mean you’re back to zero—you’re just confusing your body.

Instead of squeezing in study time by dipping into your eight hours of allotted sleep, try and plan ahead. Use your early wake time on the weekend to get some preemptive study time in. This will help prevent you from losing sleep on weeknights and sleeping-in to try and make up for it. Of course, things like concerts, parties, and other fun events come up and throw off your beat, but if you try not to change your schedule by more than an hour on weekends, you’ll be set.

2. Design Your Sleep Space

You will spend approximately 30% of your life in your bedroom, so you should make it a place that meets the conditions you will need for a good night’s sleep.

Clean

A cluttered room is a stressful room. Organization is what can help you avoid that creeping anxiety caused by a pile of dirty laundry you were supposed to wash two days ago—just when you’re trying to fall asleep.

Cool

Sleep usually begins when the body’s temperature drops, so a colder room will encourage sleep faster. Aim for between 60-67 degrees Fahrenheit to avoid the tossing and turning.

Comfortable

Is there anything better than a comfy bed? You’re looking for one that is not only less than ten years old, but also supportive and paired with an allergen-free pillow that works with your unique sleeping position. Flatter pillows usually provide better neck support for back or stomach-sleepers.

Quiet

Make sure your bedroom is free of any noises or distractions. Jolting awake at 3 AM from a car horn is in no one’s best interest. Try ear plugs, white noise, or ambient sound machines if you live in a particularly loud area.

Dark

For all those night owls or anyone who doesn’t rise with the sun, blackout curtains or quality shades are your sleep-inducing companion to block out unwanted rays of sunshine during exam week.

3. Manage Light Intake

Circadian rhythms determine a lot when it comes to daily sleep patterns. They naturally program us to be awake when the sun is up, and ready for sleep when the sun goes down, all while cueing other physical, mental, and behavioral changes. What can throw that off, however, is how you manage your overall light intake.

Blue light from electronic devices will trick your brain into thinking that it’s still daylight even when it’s not. Try changing your device’s color temperature or limit screen time an hour before you plan to go to sleep.

Reversely, make sure you’re getting adequate natural light during the day. Letting in some sun when you first wake up can help you stay alert for your classes or study sessions throughout the day. For short winter days or night owls, light therapy boxes can also provide an assist.

4. Exercise Regularly

Exercising on a daily basis is the best science-backed way to improve your sleep and wellness, and there are many ways to find the right, time efficient activity for you—from attending yoga classes to just a short walk. Body movement and physical exercise can cut the amount of time it takes you to fall asleep in half (so long as you aren’t exercising right before you go to bed, as the release of adrenaline can also make sleeping hard).

See our blog on how exercise can not only help you sleep better, but also help reduce stress and anxiety.

5. Shut It Down

Just like you power down your computer, you also have to power down your brain! The more overstimulated your brain becomes during the day, the harder it is to unwind when you are going to sleep. Plus, if you are always checking your phone, emails, or notes from class, your brain will learn to continue seeking fresh, new stimulation—even when you don’t want it to.

Racing Brain

Let’s face it, there will be nights when you just can’t turn it off—so keep a notepad on your nightstand just in case. You’ll avoid the bright light from your phone and be able to download your thoughts to paper so you can leave a memo for your future self. You can also try reading—not your Anatomy textbook, but a good, old-fashioned fiction book. This will help distract your brain while take advantage of the repetitive eye movements that help slow you down.

Appetite

Give your body at least two to three hours to digest before going to bed. Also, don’t go to bed hungry either. Both hunger pangs and digestive activity will be uncomfortable and keep you from catching some quality Z’s.

Substances

Avoid anything like caffeine, alcohol, or nicotine late in the day. As you’re likely aware, they will stimulate your body and keep you awake.

Napping

Irregular or long naps can confuse your internal clock, making it harder for you to initiate sleep or creating a disruptive sleep. Remember too, there’s no catching up on that missed sleep!

Planning for eight hours of sleep each night can certainly benefit your life—from reducing the risk of obesity, heart disease, and type two diabetes, to helping you stay awake during the day to study for your next COMLEX-USA exam. If you aren’t sleeping well and none of these suggestions seem to work, talk with your doctor to see what other solutions can be offered.


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Where all the #Match2020 tweets live from Twitter.

Exercise may be the last thing you want to add to your plate this winter—why take it on when you’re already worried about your other responsibilities? With all these challenges, why would you further stress yourself out by tackling a new exercise routine on top of it?
Exercise may be the last thing you want to add to your plate this winter—why take it on when you’re already worried about your other responsibilities? With all these challenges, why would you further stress yourself out by tackling a new exercise routine on top of it?

Exercise may be the last thing you want to add to your plate this winter—why take it on when you’re already worried about your other responsibilities? With all these challenges, why would you further stress yourself out by tackling a new exercise routine on top of it?

Surely, you’re wondering how you’d fit it all into one day. Well, the good news is that there are lots of ways to integrate it into your daily routine. You can listen to lectures or recorded notes while you walk, run, or even during a workout. Though after a while, you may even find that you want to just unplug the biochem and turn up your favorite band.

Despite the obvious physical benefits of getting fit, exercise also has significant mental health benefits that can improve your quality of life. That’s right, exercise can take the stress factor out, so you don’t have to worry about it. Not only can it reduce your stress and anxiety levels, but it can also make you healthier overall—find out how.

Increases the production of “feel good” endorphins

During exercise, your body produces endorphin neurotransmitters that send positive, blissful signals to your brain while also acting as an analgesic to reduce feelings of pain. This is the coveted ‘runner’s high,’ which gives you a sense of euphoric well-being. Engaging in even a short 30-minute walk can work to chemically change your state-of-mind.

Boosts your self-confidence

The phrase #LookGoodFeelGood most certainly comes from a place of wisdom. If you’re in it to get fit or just want to start engaging in a daily walk, you’ll begin to see changes in yourself (both mentally and physically) based on the work you’ve put in. Self-confidence can also go a long way in those motivational pre-exam pep talks with yourself! Your self-image will grow as you meet your goals, build strength in your muscles, and stand at the top of the mountain you built with your own efforts.

Helps you balance mind and body movement

Most exercise involves repetitive motions that, once learned, cease to involve any strenuous mental engagement. It becomes a form of moving meditation that your body remembers and performs while your mind relaxes into a state of stasis or even mental nonbeing. Have you ever felt so stressed that you just wanted to hit the pause button? This type of exercise naturally helps guide you into a rhythmic ebb and flow to lose yourself in. Jogging, swimming, cycling, walking and even several types of martial arts, like Aikido or Tai chi can bring up this state-of-mind. Get out there and find the sport or activity that works for you.

Creates opportunities for social interaction

There is nothing more valuable than a friend you can help pull along, while they help push you forward.  this goes for exercise as well as your road to DO licensure. Having strength in numbers is one thing, but having a friend, significant other, child, or fellow DO candidate, enables you to create positive and collaborative experiences to help remind you of life outside of this journey. Especially when it comes to exercise, having a workout buddy or engaging in a group class can help you blow off more steam than you ever would alone.

Improves your overall health

Future doctors: we’re pretty sure we don’t have to tell you that your health is important. Juggling exercise alongside everything else may seem like a trying task, but it will help you sleep better at night, literally. On the flip side, it can also help boost your energy reserves. Movement of your body helps to improve blood circulation, boost levels of good cholesterol in your blood, lower your blood pressure, and strengthen your immunity. Movement is life, and exercise can be your ticket to help keep you actively pursuing your health.

At the end of the day, there is no downside to trying your hand (or feet) at a new exercise regime to help decrease your stress and anxiety levels, especially during these extra challenging times. We know that you are working hard toward your DO goals, and with that, comes a tremendous amount of stress. That is why we want to encourage you to take a moment to stop toiling over what you cannot control and focus inward on what you can do to help yourself feel good. Exercise can assist in guiding not just your body, but also your mind to keep you balanced and keep you focused on pursuing your passion.


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We’re guessing you don’t necessarily believe everything you hear or read these days, especially on the internet. While knowledge sharing is one of the best ways to help students and colleagues exchange ideas and best-practices related to COMLEX-USA, the high-stress, high-stakes environment you’re living in is a tangled grapevine of mysterious myths and misconceptions.
We’re guessing you don’t necessarily believe everything you hear or read these days, especially on the internet. While knowledge sharing is one of the best ways to help students and colleagues exchange ideas and best-practices related to COMLEX-USA, the high-stress, high-stakes environment you’re living in is a tangled grapevine of mysterious myths and misconceptions.

We’re guessing you don’t necessarily believe everything you hear or read these days, especially on the internet. While knowledge sharing is one of the best ways to help students and colleagues exchange ideas and best-practices related to COMLEX-USA, the high-stress, high-stakes environment you’re living in is a tangled grapevine of mysterious myths and misconceptions.

Our latest blog series is designed to help dispel some of the more popular (and more entertaining) myths and rumors about COMLEX-USA and the #RoadToDOLicensure. From things we’ve found on the internet to things we’ve experienced first-hand, what follows are some of our favorites from over the years, specifically related to Level 2-PE.  From the straight-forward to the completely off-the-wall, let’s set the record straight.

You have to pass X number of encounters to pass COMLEX-USA Level 2-PE.

The score for the PE exam is compensatory across the day, which means that passing is determined based on your performance throughout the day, not just on each individual encounter. Fun fact: there is no passing standard for each individual encounter.

We fail 10% of students each year…just because.

All levels of COMLEX-USA exams are based on standard passing scores determined by an independent group of national educators, practicing physicians, and state licensing board representatives. To pass the exam, you must meet the passing standard. Passing rates aren’t based on a curve or a pre-determined number of failures.

One Standardized Patient didn’t like me, so I failed the exam.

Having one bad interaction with a Standardized Patient doesn’t automatically determine the end result. Conversely, Standardized Patients have a lot to keep track of following each encounter, including the case they are portraying. AND they do it 12 times daily. Truly, they don’t have enough time to determine if they “like” you or not; they are simply too focused on their role, documentation of their encounter, and the assessment duties of their job.

Stay tuned for next month’s blog just in time for #MATCH2020 where we’ll share some of the latest myths and misconceptions related to applying to residency.


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“I love taking tests,” said nobody, ever. And we agree.  We want you to know that we truly understand the extraordinary level of stress and anxiety that comes with COMLEX-USA—preparation, scheduling, taking the exam, and (the hardest part), waiting for your scores to be released.

“I love taking tests,” said nobody, ever.

And we agree.  We want you to know that we truly understand the extraordinary level of stress and anxiety that comes with COMLEX-USA—preparation, scheduling, taking the exam, and (the hardest part), waiting for your scores to be released.

It takes a lot of dedication, perseverance, and hard work to pass the COMLEX-USA exam series (we know they’re really difficult. It’s that way on purpose). As we all are aware, the stakes are high—these exams play a huge part in determining whether or not you become a practicing physician. As such, the pressure is even higher than normal. Completing these exams really means something—it means you know the material, you’re competent, and you believe in protecting the public—and that’s why you chose to become a DO in the first place, right?

To address this very special brand of stress and anxiety, we’ll be exploring a variety of wellness topics in a blog series during the coming months. In them, we will be talking about the important role that Exercise, Sleep, Nutrition, Mindfulness, Mental Health, and Doing What You Love plays in helping support your overall health, (both mental and physical).

On the surface, these may sound like topics you already know and are fully aware of, but when applied the right way—that’s the powerful part.  You will learn what you can do, what you can do better, and even more importantly, what NBOME is doing to help you on your #RoadtoDOLicensure.

Stay tuned for our first blog in the series!


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