AMA Alliance President Nancy Kyler

The AMA Alliance is the largest organization representing the family of medicine in the United States. It is organized in 40 states and more than 400 countries throughout the world, placing it in a unique position to serve the interests of medical families as no other single organization can. The Alliance network of physicians and physicians’ spouses represents all stages of the medical lifestyle, from the training years to retirement. The Alliance’s 2009-2010 President Nancy Kyler, a medical malpractice defense consultant from Stanton, Virginia married to a radiation oncologist recently took time away from her hectic schedule to talk with Student Doctor Network (SDN) about the Alliance’s services and programs.

Who makes up the membership of the AMA Alliance – is it limited to physician spouses/partners and families, or are others encouraged to join?

The AMA Alliance is a membership organization made up of medical students, medical student spouses, residents, resident physician spouses, physicians and physician spouses.  We have the unique perspective of the physician family and can offer support and guidance along the way.  We partner with a number of organizations such as Student Doctor Network,  American Medical Association, American Medical Association Foundation, American Medical Association Political Action Committee, National Council on Violence Prevention, American Psychiatric Association Alliance, Internet Keep Safe Coalition, American Legacy Foundation,  American Heart Association, American Lung Association, and Partnership for a Drug-Free America.

The Student Doctor Network membership consists mainly of pre-health and health professional students.  Why should they or their partners consider joining the AMA Alliance?

The Alliance serves the interests and meets the needs of physicians and their partners at all stages within the medical family—students, residents, practicing physicians and retirees. The AMA Alliance particularly recognizes that medical school and residency are stressful for physicians in training, young physicians and their families.  The AMA Alliance has resources to provide support for partners of physicians in training, as well as assistance in finding an Alliance in your area.  We invite you to join us at our national meetings where we provide practical guidance and information on thriving in the unique relationship of the family of medicine.

The AMA Alliance also provides a “Physician-In-Training” Host Program which is an opportunity for fourth-year medical students to receive free housing as they interview for residency programs. The program was created to help cut down on interviewing costs, get to know the community surrounding potential residency programs and introduce them to the local medical society and Alliance.  Through the Physicians-In-Training Host Program, students can expect a one-or-two-night stay in an Alliance member’s home.  To request a host and download an application, go to www.amaalliance.org

Also available on the Alliance Web site is an active blog written by our young members for young members!

Do you have any activities and programs that are targeted specifically to pre-health and health professional students and their partners?

Log onto our website and take a look at all the activities and opportunities to get involved at www.amaalliance.org.  The Alliance has everything from community health projects to national programs such as “Screen Out” promoting removing smoking from children’s movies; and “Faux Paw” focusing on Internet safety for children.  The AMA Alliance also has a long history of raising money for medical student scholarships through the AMA Foundation.   This is a tangible benefit to students and their partners in helping to alleviate the financial stress of medical school tuition today.   We are also involved in advocacy on behalf of physician families on a local, state, and national level.

What trends do you see for the families of new physicians and physicians-in-training?

Physicians of today look different from physicians of 20 years ago in terms of gender.  Over 48% of students entering medical school today are female.  The younger generation’s career expectations are different from those entering the workforce 10 to 15 years ago, which is not unique to medicine.  Gone are the days of a single career family and also the notion that the mother would stay at home while the father works.  Our members are stay at home dads or moms, working dads and moms, dual career families, married and single physicians.  Research from the independent sector has shown that younger volunteers today are more likely to create their own volunteer activities instead of being mandated what activities they are to do.  That is the beauty of the AMA Alliance and our younger members involvement.  We do not mandate what activities our members should do.  Instead we give our Alliance groups and members the autonomy to be involved in whatever ways best fits their lifestyle.

What do you think the greatest challenges are for physician partners and families right now?

Time poverty appears to be one of the greatest challenges for not only physician families, but people in all walks of life.  Historically, physicians have put in long hours, leaving little time for their family, not to mention themselves.  Many physician families have dual careers, sometimes both doctors or professionals, also adding to the stress for the family.  Our newly completed strategic plan, which will guide the Alliance through 2012, focuses on the physician family and ways in which we can take care of the family of medicine through education on work/family/life balance, healthy lifestyles, time management, managing the medical family and managing the business of medicine. As a result of our work on the strategic plan, we have refocused our resources and offerings on our core constituency—individual members.  This has brought us back to our roots with an emphasis on work/life balance and wellness.

What role do students play in the leadership of the AMA Alliance, if any?

Two years ago the Young Member Connect Task Force was created in an effort address this issue.  The Task Force is made up of medical students, medical student spouses, resident physicians spouses as well as young members, many of which are students.  Their role is to address and promotes ways in which young members will have a greater voice in our organization.

What do you see as the role of the AMA Alliance in the current debate on health care? How is the AMA Alliance working to impact the debate?

The AMA Alliance feels our voices need to be heard so that we may impact the change going on around us.  We recognize the need for health care reform; we know there is heated debate on how this should be accomplished.  The AMA Alliance is serving as a portal to a voice on this issue.  We are gathering feedback and sharing the views of our members with the AMA through the members-only AMA Alliance Facebook page and Presidents blog.   We are providing this information to the AMA as it works to meet the challenge of health system reform.  The Alliance is posting up to date advocacy updates from the AMA on our Web site as well as links to the AMA’s health system reform bulletins.  We are offering a side by side comparison of health care reform proposals from the Kaiser Family Foundation as well other health system information from reputable media outlets.

How can SDN members learn more about the Alliance?

The Alliance is a one-stop-shopping source for help, answers and opportunities.  The best way to learn more is to visit our Web site at www.amaalliance.org.

Roy Ziegelstein, MD

Dr. Roy Ziegelstein is the Executive Vice-Chairman of the Department of Medicine at the Johns Hopkins Bayview Medical Center and a professor of medicine at the Johns Hopkins University School of Medicine. For many years, he served as the program director of the internal medicine residency program at Johns Hopkins Bayview Medical Center. Presently, he is one of the associate residency program directors there.

In 2007, his article ”Rocking the Match” was published. In the article, he offers sage advice “from the perspective of someone who regularly mentors students through this process and as someone with years of experience as a residency program director evaluating prospective interns.”¹ Recently, Dr. Ziegelstein was able to share with us some of the wisdom gained from his extensive experience mentoring students.

Studies have shown that, while medical students recognize the importance of mentors, many students don’t have one.² In your article, you write about the importance of finding a mentor and describe ways to initiate a mentor-mentee relationship. Once established, what can students do to make the most of this relationship as it relates to the residency application process?

I think that there are several things that can be done by students to ensure productive mentor-mentee relationships with respect to the residency application process.  The most important thing is to try to get to know your mentor(s) and vice versa.  People have limits on their time, so you may want to use e-mail for much of your communication; most faculty read e-mail regularly.  You should also schedule quarterly meetings – even if only for 15-20 min at a time – so that your mentor knows how you’re doing, what your goals are, and how he or she can help.  About six months before the whole application process starts, schedule a longer meeting to discuss specifics: what field you’re going to apply in; whether your mentor feels there are others on faculty you should also meet with; what programs you should consider applying to; whom to ask for letters of recommendation; and how to approach your personal statement.  As interviews get closer, schedule time with your mentor(s) for practice interviews.

In a recent survey of 71 internal medicine residency program directors inquiring about the importance of applicant selection criteria, grades in required clerkships were the # 1 academic selection criterion.³ Some have questioned the appropriateness of using clerkship grades in residency selection, citing the significant variability that exists in grading from one institution to another. How do you view clerkship grades and their role in the selection process?

I think clerkship grades are very important.  Whether or not I agree, I believe the findings of the study you refer to are absolutely correct.  Many program directors recognize that the grading system of some schools is much harsher than the system used in other schools, but not all program directors do.  Most faculty who evaluate applicants rely heavily on the Dean’s Letter, now known as the Medical Student Performance Evaluation (MSPE).  Often, the MSPE contains figures or charts that provide information on how the grades were distributed in the applicant’s class.  Sometimes, the MSPE indicates a class rank, or if the applicant just missed an Honors grade, it may indicate “near Honors” and indicate why.

It is often said that audition electives are not necessary for students applying to internal medicine. Under what circumstances should students consider doing an audition elective?

I think by “audition elective” you mean an elective at the program the student is applying to.  I think these are unnecessary, but they may be helpful if the applicant wants to learn more about the program or if the applicant is confident that his or her clinical performance will be impressive enough that it either reinforces an already strong application or demonstrates strengths that may not be apparent from the application alone.  I have heard it said by some students that they were advised NOT to do an elective at an institution they were particularly interested in because it might detract from their application. I disagree.  I have seldom seen an applicant hurt by an “audition elective” but I have seen many applicants helped.  I do want to emphasize that I think that the most helpful “audition elective” is a subinternship.  It allows you to really see what it would be like as a house officer at the program and it allows the program to get some sense of what you would be like as an intern or resident there.

In reviewing residency applications over the years, we’ve found that some letters written on behalf of excellent candidates were brief or vague. Is there anything that students can do to help their professors write effective letters that are most useful to residency programs?

I would focus on three things: First, when an applicant asks for a letter, I think it’s best to say “Do you feel you know me well enough to write a strong letter of recommendation in support of my application?”  Brief or vague letters are often written because the professor doesn’t really know the applicant.  In fact, I think they are often the result of a student asking a professor at his or her school who has a well-recognized name to write a letter of recommendation thinking that it will be of great help, even though the professor really doesn’t know the applicant. I think these letters are often viewed as “prizes” by applicants, but they may, in reality, hurt the applicant rather than help.

Second, when a student asks for a letter of recommendation, he or she should come prepared with a complete and up-to-date CV and, if possible, with a personal statement.  Also, the student should ask the professor for a letter in a formal meeting rather than in a chance meeting in the hallway or cafeteria.  In the more formal meeting, the student can tell the professor something about his or her goals, objectives, background, etc., if the professor doesn’t already know the student well.

Finally, the student could offer to compose a few paragraphs about his or her background, goals, objectives, interests, etc., for the professor.  The student is not really offering to “write the letter for the professor,” but by writing a few paragraphs like this, the student may make it easier for the professor to put things in the letter that are important.  I think these “tips” should help avoid the perils of the brief or vague letter of recommendation.

For many students, the personal statement is often the most dreaded aspect of the residency application. As someone who has read thousands of statements, what makes a statement memorable to you?

I can’t for the life of me understand why the personal statement is so dreaded, but I certainly know it’s true for most students.  Remember, no one is asking you to write an essay on how the principles of the Gettysburg Address influenced politics in the Eisenhower era, and you’re not being asked to solve a complex mathematical equation.  You are being asked to write about yourself, and you should be able to do that relatively easily.  In fact, you should relish the opportunity; this is your chance to tell people something about you before they meet you and to make them look forward to getting to know you better.  If you can communicate what is special about you (without sounding overly self-promoting or arrogant) that is not already evident in your application, you have created an effective personal statement.

Why should I want to meet you?  Let me know in the personal statement.  Remember that the personal statement is also often used as the basis for your faculty interviews, so make it something interesting.  One important point though: a “memorable” personal statement (the word you used in your question) is not necessarily the goal.  I can tell you of many personal statements that were “memorable” because they seemed outlandish or silly or because they made the applicant appear “scary” or weird.  Please show your personal statement to others (e.g., a faculty advisor who has experience reading them and evaluating applicants) before sending it out.

Many surveys of program directors have shown that the interview is the most important factor used in the ranking of applicants. You’ve had considerable experience conducting interviews. Why do some applicants stand out?

Applicants who stand out in the interview are able to communicate confidence without arrogance; sincere interest in the program that does not appear disingenuous; good speaking and also good listening skills; and an enthusiasm for medicine.  Applicants stand out when they make me feel that the interview flew by rather than dragged.  Applicants stand out if I can envision them taking care of my patients when they need to be hospitalized and/or if the interview leaves me feeling eager to teach and work with them.  As I mentioned above with respect to the personal statement, I would advise practicing interviewing with a faculty member who has experience interviewing and evaluating applicants.

The quality of questions asked by an applicant is important to many interviewers. In your experience, how often are you impressed with questions asked by candidates? How can applicants learn to ask meaningful questions?

To me, “meaningful questions” are those that seem “meaningful” to the applicant.    Just be yourself.  Don’t ask questions because someone told you that those are the questions you should ask.  Ask the questions that are important or relevant to you.  Also, come prepared – read about the program before your interview and try not to ask a lot of questions whose answers should be known to you before you visit the program.

References

¹Ziegelstein RC. “Rocking the match”: applying and getting into residency. J Natl Med Assoc 2007; 99(9): 994-9.

²Aagaard EM, Hauer KE. A cross-sectional descriptive study of mentoring relationships formed by medical students. J Gen Intern Med 2003; 18: 298-302.

³Green M, Jones P, Thomas JX Jr. Selection criteria for residency: results of a national program directors survey. Acad Med 2009; 84(3): 362-7.

By Laura Turner
SDN Staff Writer

The Student Doctor Network, in coordination with the Student Osteopathic Medical Association (SOMA), is pleased to announce the winner of the first annual SDN Scholarship in Community and Preventive Medicine. The inaugural winner is Tamar Nazerian, a first year medical student at Western University College of Osteopathic Medicine.

Scholarship Winner Tamar Nazerian

The scholarship was launched earlier this year to provide support for students that plan to enter the field of community and preventive medicine.

Lee Burnett, physician and co-founder of SDN explains, “As a nonprofit charitable organization we have a responsibility to the greater community.  Our goal with the scholarship is to provide support to a student that also feels that sense of community responsibility. Tamar Nazerian has worked extensively in the area of preventative care. It is wonderful that she is the first recipient of this scholarship.”

Prior to matriculating at Western University, Ms. Nazerian served as the Project Coordinator for the University of Southern California/Childrens Hospital Los Angeles University Center for Excellence in Developmental Disabilities, working on two federally grant supported projects. The first was called Project Access for Pediatric Epilepsy, which used telemedicine to bridge the communication gap between pediatric primary care physicians and pediatric subspecialists in rural areas. The second project focused on providing children with special health care needs who are transitioning into adulthood with information to enable them to find appropriate medical care. She also worked at the UCLA Lili Claire Family Resource Center as a Program Coordinator.

Ms. Nazerian completed a Masters in Public Health at the University of Southern California, with a focus on Child and Family Health. She received her Bachelors of Science in Physiological Science from the University of California, Los Angeles, with a Public Affairs minor with a Social Welfare emphasis.

“I am thrilled and humbled to be the first recipient of this scholarship,” Tamar Nazerian said. “As I wrote in my application essay, I have found that the strategies that are most effective at improving the overall health of a community are not those that rely on individual behaviors or access, but instead focus on improving society’s collective health and wellness. My goal is to serve as a Pediatrician and focus on early intervention to improve the health and well being of children and society as a whole.”

A complete text of Tamar Nazerian’s application essay is available here.

“We look forward continuing to support students that are focused on community and preventive medicine with this and other scholarships in the future,” said Lee Burnett.  The annual SDN Preventive Medicine Scholarship was offered as two awards, one for SOMA and the other for the AMA-MSS.  SOMA chose to start the scholarship with the 2009 academic year.  In 2010, annual scholarships are planned for additional healthcare professions.

by Laura Turner
SDN Staff Writer

U.S. health care reform is shaping up to be a key activity for lawmakers in 2009. The Obama administration is mobilizing its volunteer base from the campaign to lobby Congress for change. Politicians on both sides of the spectrum are putting forth their vision for the future of medicine.

In order to provide our membership of future health care providers with the latest reform ideas, the Student Doctor Network will be publishing a series of articles on health care policy. These articles will include interviews from policy makers and details on technical and structural innovations aimed at reducing costs and improving outcomes.

Previously, SDN interviewed Dr. John Geyman, author of Do Not Resuscitate, who espoused a need for a single payer nationalized health care system.

Additional articles in the series, to be published in the coming months, will include the following:

• Interview with Dr. David Sundwall, who served as President Reagan’s Director of the Health Resources and Services Administration at the U. S. Department of Health and Human Services
• The role of health information exchanges in improving health care delivery

We invite our membership to submit ideas for other articles in this area. Please provide your comments below.

For St. Patrick’s Day 2009, I’m shaving my head.  And so are many of my friends and classmates.

And no, vast quantities of Guinness have nothing to do with it.

We are participating in a St. Baldrick’s Foundation event to raise funds for childhood cancer research.  Participants will either shave their heads or donate their hair to make wigs for a child in need.

Since its inception in 2000, St. Baldrick’s has raised more than $50 million and grown into the world’s largest fundraising event for childhood cancer. Worldwide 160,000 kids are diagnosed with cancer each year and despite tremendous progress, cancer remains the top disease killer of children in the U.S. and Canada.

My medical school class at Tulane University School of Medicine has the goal of beating last year’s event, which raised over $63,000. We’re well on our way, but we need your support.

The Student Doctor Network is currently sponsoring SDN membership for those who donate to the St. Baldrick’s foundation.  To get an SDN subscription, you will need to donate that subscription amount or higher to St. Baldrick’s.  For example, Gold status is $45 for one year or $75 for two years, so if you make a $75 donation to St. Baldrick’s, you will get a two year Gold status membership to SDN.

The link to donate is here (click on photo on the page): http://www.stbaldricks.org/participants/shavee_info.php?ParticipantKey=2009-64188

In order to obtain your SDN membership, please email the receipt you receive from St. Baldrick’s to Anna@studentdoctor.net.  You must request an email receipt at the time of donation.

While battling cancer, children may lose not only their hair, but years of their childhood, and sometimes their lives. In comparison to their struggle, cutting my hair is a small sacrifice, and the money raised will make a difference for children with cancer now and in the future.

Beyond the money raised, my medical school class is banding together for this cause to show solidarity and support for the children and families affected by childhood cancer here in New Orleans and across the country.

So, I am asking you to help me raise as much money and awareness as I can for the foundation to fund as much research as possible!   Please donate now.

Recognizing the direct and far-reaching value of community and preventive medicine, the Student Doctor Network (SDN) has committed a portion of its 2009 and future revenues to creation of an annual scholarship program for medical and pharmacy students that plan to enter the field of community and preventive medicine.

Lee Burnett, physician and co-founder of SDN explains, “As a nonprofit charitable organization we have a responsibility to our members and the greater community.  Part of our mission is to encourage students to look at those areas of healthcare which provide the most reward, both to their careers and to the world.”

It is hoped that the scholarship will encourage students to take a closer look at the field of community and preventive medicine.  Specialists in this field often have dynamic careers in government, academic or research and make decisions that affect thousands or millions of people.

Details of the scholarship will be available shortly.