Leaving the Medical Workforce

Beware: The article I'm about to recommend has a bitter tone, but it's important for those who are considering the medical field to hear all perspectives. Plus, many of the issues this anonymous writer brings up - understaffing, corporate medicine, twisted financial incentives,  lack of fulfillment - are on point. 

Here's the piece.

Surgery Without Anesthesia

As we look forward to Thanksgiving, I recommend this short NYT piece by AJ Jacobs on gratitude. It’s a few years old, but it's still relevant, fun, and reflective.

How to Evaluate an Institution: Consider Your Happiness and Trust Your Intuition

A few medical school and residency applicants have asked me how to evaluate institutions, especially since interviews are virtual. This is a huge topic, but here are some thoughts:

• To me, geography is one of the most important factors – at least equal to the reputation of the institution. You want to make sure you are in a location that will make you happy – near community, family, friends and/ or the ability to enjoy your hobbies.
• Cost is sometimes a deal breaker when it comes to medical school. There's not much more to say here except that most institutions are extremely expensive.
• Of course, didactics and academic opportunities are critically important for both medical school and residency. However, many medical schools of similar caliber have equivalent curricula and programs. You likely could be happy at many different medical schools. With regard to residency, it's important to ensure you are getting a lot of hands-on experience and to look at what fellowships are available, with your interests in mind.
• Faculty is hard to assess because – like anything – there are good and bad ones. Also, faculty come and go. Having said that, if you are applying to residency, the program director is very important (understanding that he or she could leave).
• With regard to residency, call schedule and overall work hours are important to consider. Certain programs within the same specialty require a lot more hours and scut work than others.
• One of your best bets is to talk to current students at medical school or current residents in a training program. Oftentimes they will be very honest about the pros and cons of their institution.

Once you've assessed all of the above - narrowing down your list by geography and quality - I would analyze the vibe you have. If this sounds too touchy-feely, remember that intuition is not a magical assessment; it's based on major and minor facts that you consciously and subconsciously analyze.

Remember: If you're a medical school applicant, consider yourself fortunate if you have more than one option to choose from. Earning admission to medical school is getting harder every year. It's a great problem if you need to struggle to decide among multiple schools!

Your Residency Interview: What Do Program Directors Really Want?

Imagine you're a program director (PD) going through scores of ERASes and interviews. What questions would you ask yourself as you assess each residency candidate to avoid big headaches?

1) Can this person do the job? Is s/he competent?

2) Will this person "play well with others" and not create complaints from patients, faculty, or other services.

3) Will this person stick with the program and not leave prematurely? (A PD does not want to scurry around to fill an open call schedule/ residency slot.)

As you approach your interviews, consider how you can demonstrate your competence and collegiality, as well as your commitment to the field and the residency program. For the former, ensure you showcase academic successes, extracurricular activities that demonstrate teamwork, and - if asked - hobbies and reading materials that demonstrate your agreeable personality. For the latter, highlight research projects in the specialty, sub-internships, and knowledge about the program and city.

Simply making sure the PD knows you're not going to cause him/her trouble is at least half the battle.