Don't Accept Helicopter Parenting

Check out this bizarre (and sad) article from the New York Times about helicopter parenting, and note that two of the anecdotes are physician related. (Can you imagine interviewing for an attending position with your dad present?)

Along those lines, I'd recommend the New York Times best seller How to Raise an Adult by Julie Lythcott-Haimes for any parents who read this blog. (Disclaimer: Julie was one of my frosh resident assistants at Stanford.) Julie gave a great interview on Fresh Air last year. 

My policy at Insider is to work exclusively with applicants (not parents or spouses) to maintain confidentiality, avoid redundancy, and ensure candidates assume primary responsibility for their work. It's been a winning strategy. 

Optional Secondary Essays: Are They Really Optional?

I've recently received several questions about optional secondary essays and their necessity.

The beauty of an "additional comments" section is that it is intentionally vague. It's your chance to provide details, context, or qualifications that the structure of the application didn't allow you to present. For that reason, I lean toward using that space to both highlight who you are and any exceptional aspect of your candidacy that you'd want a reader to know before making an interview decision.

So, one good option for these essays is to pick something completely nonmedical that distinguishes you and is nowhere else to be found on your application. In this case, the essay can actually be fun to write.

Of note, sometimes people use this type of a prompt to explain one major deficiency in their candidacy. I only recommend that if there's a big elephant in the room: In other words, in general I tell applicants – throughout the process – to avoid highlighting weaknesses. The goal is to demonstrate distinctiveness and worthiness, so negatives are usually left out. But sometimes someone has a big problem like a low MCAT score that is an anomaly that's worth addressing head on.

Bottom line:  Since an interview isn't guaranteed, don't save your best material for an in-person meeting. Get your foot in the door. And as always, make sure that your essay is substantive and not fluffy.

15 ERAS Tips to Boost your Residency Candidacy

It's July, which means it's time for residency applicants to start thinking about their ERASes. Here are tips I've cultivated for crafting the best application:

1. Include relevant pre-professional accomplishments from college. If you conducted research, for example, list and describe it. Do not include high school achievements unless they were truly unique (worked at the White House, sang on Broadway, published in Nature).

2. While you want to include many strong achievements, you do not want your ERAS to be so long that your reader is tempted to skim it, so avoid small activities (like an afternoon health fair). 

3. Keep your descriptors to approximately five to seven sentences. Fewer can look lazy and more can look self-indulgent.

4. Use full sentences. It’s a formal application, and you want to make your written materials as readable as possible.

5. Avoid abbreviations. Ones you think are common might not be familiar to the reader.

6. Avoid contractions; they are too informal for an ERAS. 

7. Make sure you spell out your accomplishments clearly. If your reader doesn’t understand an activity, you won't get “full credit” for what you’ve done. Make no assumptions - not even that the reader has reviewed the experience's introductory information (location, name of activity). 

8. Write about yourself and your role – not an organization. For example, don’t use the space to discuss Physicians without Borders. Use it to discuss the specifics of your role at Physicians without Borders.

9. Use numbers to be persuasive. Saying that the conference you organized had 500 participants says a lot.

10. Unless your PI won the Nobel, avoid using supervisors' and/or doctors' names in your descriptors as they will be meaningless to the majority of your readers.

11. Do your best not to leave the "Medical School Awards" section blank. Even if you have to simply include clerkships in which you obtained honors (or high honors), fill that section out.

12. If you have not already, consider joining your specialty's national organization and listing it under the "Membership in Honorary/Professional Societies" section. If you are applying in two fields, take this advice, though. 

13. Try to end your entries with a sentence about how the experience you just described will help you as a future specialist. Making that connection for the reader furthers your candidacy. 

14. As with all good writing, avoid redundant language. Having the word "research" three times in two lines is distracting and demonstrates a lack of originality. 

15. Get help. Don't submit your residency application without having it reviewed by someone with a lot of experience. You do not want to put forward suboptimal materials for a process that is this important and competitive.

Understaffing is Affecting Patient Care

I am only middle aged, and yet, so many of my cohort, including myself, have recently left clinical medicine. There are layer upon layer upon layer of reasons: Even before the pandemic, burnout and discouragement about the current healthcare system were big problems amongst providers. Then, COVID facilitated more departures because of the need to stay home to care for children or even illness and death, sadly. Finally, the national workforce shortage and economic cuts have led to a real crisis in our medical system.

See this piece by Dr. George Hyde, a pediatric resident at Harbor UCLA, as he describes how understaffing is directly harming patient care.