In which Amazon realizes that I’m not a student anymore

It couldn’t last forever, and so today is the end of a personal era: Amazon figured out that I’m not a student anymore. Which is too bad, because now I’ll have to pay full price for Amazon Prime. I spent the last year of medical school (and two bonus years to hit three of the maximum total of four) thoroughly enjoying/using the “Amazon Student” service, which is Amazon Prime for half the cost, including their (nowhere near as good as Netflix) bundled video streaming service, free Kindle books, and tons of two day shipping. I first signed up for the six month free trial when I needed some holiday gifts quickly, and I haven’t cancelled since.

Upon receiving the email notification that my student membership was expiring and that I was going to be automatically “upgraded” to Prime, I immediately checked to see if there was a way to use an .edu address or student ID to continue being a student. My choices to confirm my “student” status were:

  • A transcript or class list for the current term (must include the date/term)
  • A copy or picture of your student ID (must include an expiration date or term)
  • A tuition bill for the current term (must include the date/term)
  • An official acceptance letter for the upcoming term (must include the matriculation date)

Er, so yeah. They thought this all out. None of that is going to happen.

Amazon may have some questionable/bizarre hardware efforts, but on the retail side, they figured out long ago that if they get you to sign up for prime, you get hooked/spoiled by unlimited two day shipping and then buy basically everything through Amazon.

Residency Consultants (and a big discount for Game Set Matched)

I get emails all the time asking for residency application advice. A lot of these come from IMGs, which isn’t surprising: applying to residency in the US from the outside is stiffly competitive, and the support/advice from home isn’t always sufficient. To profitably fill that void are the “residency consultants” and their ilk, like the folks who wrote The Successful Match who would also love for you to be their client on not one but two (ugly) consulting websites. A lot of these guys are former associate program directors in fields like internal medicine who applied to residency themselves in a different era. In many cases, the nitty gritty details and current application climate are probably better known by recently matched fourth years and residents in your specialty of choice, and being involved in interviewing and selecting candidates in one field at one institution doesn’t necessarily make you an expert in the whole process. Great consultants probably exist, but the credentials they spout are a red herring.

I don’t think US allopathic students who are thoughtful and reasonably competitive for their respective fields generally have a significant need for a comprehensive application review. Depending on how supportive and useful your student affairs department and faculty advisors are, many US MDs who are reaching a bit (but flexible) are likely doing just fine on their own for the most part. But for others, particularly IMGs, a service and all-around helping hand to go over every nook and cranny of your application, help you fix your mistakes and take the right angles, polish your personal statement, and prepare you for interviews is obviously of value. Given how much you have to pour into ERAS, traveling costs, etc–shelling out for a residency consultant may be too much insult to injury, even for those students who are among those who would benefit the most. While I’m generally suspicious of a lot of “advice” (and you often get what you pay for), but there’s no doubt that the perspective, experienced editorial services, and advice you get from qualified people who don’t know/like/love you is going to better approximate the things that will help you when the same sorts of strangers review your application or interview on the big day.


Game Set Matched is a residency consulting company with a polished online package. It’s a team of people with a network of contacts and not one random guy in one random place. So if your application requires unique expertise, they have additional folks who’ve matched in multiple fields in multiple places (and from multiple countries) who they can tap for additional knowledge. You create an account on website for free and then fill out the forms with your ERAS information including demographics, CV, personal statement, etc and then (once you pay) the folks at GSM respond to your application point by point. They edit your personal statement. They ask you interview questions, review your online answers, and then critique those too. When you have questions throughout the process, they will answer them. The whole package normally costs $999 (you can buy the components separately for $399), which–while entirely reasonable–is more than I would have ever considered spending from my loan coffers as a medical student.

Since the interview season has already begun, they reached out to me this past week with an offer for the readers of this site, $399 for the whole package by using the coupon code BW399 at checkout (good until rank order lists are due, 2/25/15). But better still, when I then asked if people could sign up now with the discount to use for next year’s application cycle, they said yes. 1

So if you sign up and are applying this year, they’ll help you prepare for your interviews. They’ll review your application and help you figure out how to communicate with programs and present yourself on the trail. If you don’t match, you can use it again next year.

But if you’re an MS3 or IMG who is planning on applying next year (2015-16) and think you could use all the help you can get, then this is the time to sign up, because $399 will get you a team of physicians working with you on everything from day 1. As a cost comparison, professional editing for personal statements runs around $150 on the lower end (and is not normally done by physicians, who are the actual intended audience). So while the deal for this year is good, the deal they’ve agreed to for next year is excellent. You have until the official end of the interview season, February 25, to buy GSM using BW399 at checkout.

And if you do sign up and use their service (or even other competitors!), please come back or send me an email to let me know how it goes. 2 The reason I began writing about medicine on this site was what I felt was a lack of reasonable information online when it came to medical education, and there’s still not enough.

  1. Full disclosure: “they” is actually a senior resident at my program, who is an employee of the company; I’ll also get a few bucks for referring you if you sign up, and you’ll get a warm feeling inside for supporting this site in the process.

  2. I’ve never used a residency consultant, and reviews for any of services/consultants out there are essentially nonexistent. I’ll update this post and/or write others when I get some more data!

Ebola Reading

The current Ebola scare and the growing story of its mismanagement made me remember two excellent books:

  1. The Hot Zone, the nonfiction thriller about Ebola that I found highly disturbing in middle school. For an even scarier read, try its spiritual sequel, The Demon in the Freezer (in which Preston details how much bioweapons grade Smallpox the former Soviet Union may have misplaced). I don’t know if Preston invented the nonfiction biomedical pageturner, but he was extremely good at it.
  2. The Stand. Stephen King’s magnum opus was re-released uncut and unedited (1200 pages!) in 2012. Viral apocalypse literature at its finest. It’s no spoiler to say that the government does neither a great nor honest job when faced with a deadly virus.

SPEAKING OF: Richard Preston reprises his old role to breakdown the current Ebola outbreak in the New Yorker.

The resident gender pay gap?

When people talk about the very real gender pay gap, they’re talking about women and men being paid different amounts for doing the same work. There is a pay gap in medicine, and that’s a problem.

What’s so odd then is this discussion of the gender pay gap in the most recent Medscape Resident Salary and Debt Report:

Salaries for women in residency are lower than those for men ($54,000 and $56,000, respectively). The gender disparity in residents, however, is only 4% compared with a disparity of 24% among all physicians, according to the latest Medscape Physician Compensation report. The much smaller difference among residents is most likely due to their work in the hospital setting, where salaries are consistent. But disparity seems to be a continuing problem.

And later:

Over three quarters (76%) of male residents work at least 51 hours per week in the hospital compared with 68% of women. Such a discrepancy might be one reason for the slight income disparity between male and female residents.


  • Resident salaries do not actually vary by gender.
  • Residents cannot bargain for salary increases on an individual basis.
  • Residents are salaried (stipended) workers who do not get paid by the hour as residents (moonlighting aside).

I can think of a few more plausible explanations for the small resident gender pay gap in this totally nonrandom sample of 1279 residents from different fields not accounting for seniority:

  1. Out of survey respondents, men were more likely than women to choose specialties with long residencies. This is a general trend which has been demonstrated previously. Resident pay is graded by PGY level. If you are a resident longer, you will eventually get paid more. So a male PGY6 neurosurgery resident gets paid more than a female PGY3 pediatrics resident.
  2. Out of survey respondents, the men who answered had a slightly higher PGY level on average than the female respondents, and this wasn’t controlled for. Same logic as above.
  3. Out of survey respondents, slightly more men lived in geographically expensive areas with consequent larger salaries thanks to CMS.

I would argue that given the classically terrible methodology of Medscape surveys, that the above explanations or more likely than a nefarious but hitherto unknown hidden systematic gender pay gap among resident physicians. The real problem lies in landing that first job after residency and continues from there.

I’ll leave John Oliver to weigh in more eloquently: