Medicine From The Trenches

Experiences from undergradute, graduate school, medical school, residency and beyond.

Residency Interviews and Choosing a Residency Program

Introduction

At this point, most people have completed most of their residency interviews. Many programs tend to go on “interview hiatus” until after the holiday season. At that time, there isn’t much time left to interview because rank lists will be submitted. Here are some things to consider if you have an interview coming up or you are trying to make a decision as to how to rank programs.

Interviews (What’s important and what is not important)

Once you have interviewed, you should make a point of sending out thank-you notes to the program director and the administrative staff that made your interview day a success. It takes a bit of planning and work to make sure that everyone gets interviewed and everyone gets a good experience. Be sure to let the staff and program director know that you appreciated their efforts on that day.

The next thing that you need to consider is if you want to go back for a “second look”. This may be most important because one has to remember that on interview day, your schedule is largely governed by the person(s) who organized the day. Sometimes it is good to have a look on a day that isn’t so organized. It’s also good to try to see what the department is like on a “regular” day especially conferences and educational items. These become vitally important as in-service exams are going to be coming up rapidly once you get settled into your program. All good programs will extend an invitation for a “second look” where you can get a chance to spend some long hours with the residents because they will be your colleagues.

Things to consider from your Interview Day

It’s wonderful for folks to rave about where they “scored” an interview and most of us are no exception to wanting to let everyone know that a high-powered residency program is interested in us. The first thing to think of is not so much the reputation of the program but your feelings about the program as you went through your interview day. How does the faculty and residency staff get along with each other? Do the residents look overwhelmed, especially the PYG-1 folks? Remember, you will be in their shoes in a few short months and looking weary at this point in the year is not great. People may be tired especially post call but they should not be exhausted and frustrated. That is a harbinger of a non-supportive environment.

Make sure that you look at some of the places that residents from your program of interest live. The program may be great but you have to have a safe and secure place to live and sleep. There are fabulous programs in older and larger cities but if you are in constant fear of your car being vandalized/broken into or your possessions being stolen, you are not going to perform your best in your residency program. Make sure you have a good idea of housing and its costs because your life is going to be the hospital and your home for the most part during residency. You won’t have much money for much entertainment other than sleeping in your own bed which needs to be secure and comfortable.

How did you fit in with the rest of the residents especially the folks who will be the chiefs next year? This is vitally important because you will be learning so much from your more senior residents. If you are not a good fit (you should have met some of them during your interview), then you won’t be a good match. Besides providing much of your day-to-day education, your more senior residents will become your colleagues and your friends. You want to make sure that you are a good fit with the rest of the crew so you can pull together for each other and help each other. Residency is hard enough without having to deal with personality disorders and problems getting along with your chiefs.

Your vital education

Yes, you made it through medical school but as most of us know, it will be your residency that determines your style of practice. You want to make sure that your environment is educationally supportive and conducive to learning as much as possible. Is there protected time during conferences? Are the conferences well organized and informative? (It would be good if you had a chance to attend some of the conferences during your interview).

If you observed that the residents spend too much time taking care of patients and “extending” the attending physicians, at the expense of their education, then you may want to consider ranking another program. The best programs make sure that residents have ample opportunities and support for educational activities (good library and protected time during conferences) as well as good resources for research (vitally important if you are interested in fellowship).

Your professional development

A good residency program will have faculty that is interested in your professional development. It’s great to have an assigned mentor and supportive faculty. I can say that my assigned mentor had very little in common with me during residency but I found plenty of “unofficial” mentors in the faculty that were priceless. A mentor does not have to be in the same area of your main interest but it helps to find at least one faculty member that can guide you along with your chief residents. Usually the best faculty members for mentors are the new faculty who are close to their training. They have the latest information and educational strategies, thus it is good to seek them out for guidance.

You want to look at where graduates of a specific program wind up. There should be a good mix of general practice folks and fellowship folks from your program. Not everyone wants to enter a sub-specialty but the option should be there should you find that this is your aim. You should have spoken with the folks who are the present chiefs so that you can get an idea of where they will be headed next year.

Consider how you were received by the faculty that interviewed you. I can tell you that one person who interviewed me, spent most of my interview time on the phone dealing with a personal matter. This is not a good situation and I requested to be interviewed by someone who wasn’t so distracted. I thanked him for his time but I also felt that if he couldn’t give me his attention for a majority of my interview time, then I needed to be interviewed by another person. Fortunately for me, that program was not high on my list of places that I wanted to match.

Some final words…

If you are at this point and you don’t have at least 10 places to rank, you will likely have a difficult time matching. Remember that many people will go unmatched because the number of medical school graduates has increased but the number of programs has stayed static. If you find that you don’t have enough places to rank at least 10, then you need to have a solid plan for getting a job if you don’t match. Now is a good time to work on that plan because there just isn’t much interview time left before the rank lists go in.

You also need to look at the Supplemental Application Process (SOAP) which is not a “scramble”. You should not rely on this process for finding a job as the number of places that you can apply to is limited. Have a back-up plan should you not find a position in the SOAP or match outright.

Be sure to consider your competitiveness within the context of the people that interviewed with you. It’s great to shoot for a “dream” program but make sure you realistically rank programs where you would be a great fit.

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10 December, 2014 - Posted by | academics, applying for Residency |

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