​Tips for Applying for Categorical Cardiothoracic Residency Training

1. When you write a thank you note for the interview, don’t do it on tasteful letterhead stationary.  Just email it.  It lets the interviewer forward the email to the rest of the faculty.  Therefore, don’t send the same note to everyone in the same program.  As soon as you walk out of the interview, one note to take:  Some memorable point of conversation that you can refer to in the note so that it accentuates you in the interviewer’s memory.
2. Just before the interview, scope out the faculty on the website.  Look for points of commonality between you and them.  Where did they train?  Do you come from similar backgrounds?  If you are interviewing in their office, is there something there that can serve as a conversation piece?  Look for things you have in common.
3. Seldom has a personal statement turned the tide in favor of an applicant.  If it is something that really makes you stand out, mention it.  If you are bashful about bragging, get one of your mentors/letter-writers to mention it in their letter.  If it is a bad thing that you really feel you need to explain and want to make excuses about it, have your mentor make the excuses.  If you have creative flair, fine let us have it.  But make sure you show it to other people first.  It must be grammatically correct and have correct spelling.  Typo means carelessness.  Should you really be doing that anastomosis if you can’t spell anastomosis?  Spellcheck will betray you.  Read it aloud.  Have someone else read it aloud to you.
4. Start explaining to your program director and your fellow residents that you will need to go to MANY interviews.  Make it up to them any way you can, but attend as many interviews as you can.  
5. If there are conflicts with interview dates, try to figure out which program you value more highly, and select accordingly.  Try to figure out if there is an internal candidate, and if the program truly has an open position.  Other applicants on the interview trail may know the answer, sometimes your program director can scout this out telephonically.  If there is a conflict, ask the program whose interview you declined if there is an alternate date.  It usually won’t go as well as interviews on a true date, but something is better than nothing.  Bethany Harpole adds “Remain organized. Have an easily accessible method of keeping track of offered, accepted, and potentially needing to be rescheduled interviews.”
6. Issa Rezzek says, “Apply for TSA Pre if possible. I know some applicants who missed flights because of long lines at the high season and that didn’t reflect so well on their interviews.”
7. Publish something.  It demonstrates commitment to the field, and shows a program that you are able to comply with the the ACGME required academic productivity.  Bring a copy of your publication to the interview.  Be prepared to discuss your research.  Steer conversation towards your research.
8. Letters of recommendation exist on a spectrum.  On one end, a Nobel prize winner writes a single paragraph that says you have a pulse and that he’s heard of you.  At the other end, somebody unknown to the world writes a three page paean to your abilities, and relates some personal anecdotes about you including that time you pulled him from a burning building.  The latter end of the spectrum is better.  Key phrases in letters of recommendation; “we would like to hire him/her when he/she is done with training,” “superior technical skills,” “excellent teacher to students and junior residents,” “amongst the top x percent of all the residents I have ever trained,” and “I would trust him/her to take care of my own family.”
9. Don’t ask someone to write you a letter of recommendation unless you are SURE they will write enthusiastically about you.
10. Issa Rezzek says, “Prepare to apply, and request letters, quite early. Some surgeons take a very long time to get the letters written.”
11. You aren’t limited to three letters of recommendation.  Get at least four.  Anything over five starts looking a little flaky.  There is no law that confines you to letters uploaded to ERAS.  Do you have a faculty member who knows you and has a personal connection to a specific program?  Send it by the US mail instead of ERAS.
12. There is a growing number of programs that are making skills testing part of their interviews.  Brush up on your anastomotic skills.  Do a few robotic/laparoscopic simulation drills.
13. Have somebody go over your CV who knows you.  Did you forget something?  Membership in some hospital or residency committee?  Intern of the year award? AOA?  Congressional Medal of Honor?  Eagle Scout?  Not kidding about Eagle Scout.  I pay attention to that.
14. Is it unfair that in-service training exam scores carry such weight? Yes.  Are they predictive of how good a resident or how good a surgeon you are going to be?  Not at all.  But it’s a number.  Is it the end of the world if your percentiles aren’t that hot? No, but your journey will be harder.  So, study for the exam.
15. Never too late:  most applicants  get their most recent inservice exam scores between interviews and the match deadlines.  If your scores are good, or at least show significant improvement, this is a good time to email your programs with the information while you express further interest in them.  Scores worse?  Forget I said anything.
16. Can you do any elective time during your general surgery residency on the cardiothoracic service or on the cardiothoracic service of an outside program?  Not only does it let you audition for that program, you can decide whether the program is worthwhile, and maybe get exposure to an influential figure in the world of cardiovascular and thoracic surgery that can write you that killer letter of recommendation.