Your Residency Application: What Do Program Directors Really Want?

Imagine that you're a program director (PD) going through scores of ERASes and interviews. What questions would you ask yourself as you assessed 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, extra curricular activities that demonstrate teamwork, and - if asked - hobbies and reading materials that demonstrate your personality. For the latter, highlight research projects in the specialty, sub-internships, and knowledge about the program and city. 

Making sure the PD knows you are not going to cause him/her trouble is at least half the battle.

Don't Let Other People Freak You Out

I started Insider Medical Admissions over a dozen years ago, so I've been in admissions consulting for a while. I'm pretty good at spotting trends. Every year about now I begin to get emails from clients saying they're worried about their lack of (or minimal number of) medical school and residency interview invitations. (Yes, even as early as mid- to late-September folks are concerned about residency interviews.) They report they have a classmate who says he's gotten an interview invitation or they read online that others are being contacted with invites.

Sure, some people are getting early interview invitations. But that should not affect your confidence. After all, according to Amy Cuddy, whom I've referenced before, confidence is the name of the game when it comes to interviews.

So, minimize conversations about interviews with others and simply stop checking online. If you are in the thick of the season and you still haven't gotten any interviews, then you'll need to reassess and act. But for now, put in ear plugs. This process is so very stressful; you certainly don't need to seek out more anxiety-provoking information (and who even knows if it's accurate anyway!).

Check out these Medically-Related Podcasts

Creepy, but juicy. That's how I'd describe a podcast I just finished called The Shrink Next Door. It's a fascinating series reported by Joe Nocera (of New York Times fame) about an East Coast academic psychiatrist who manipulates at least one patient into sacrificing control of his finances, social connections, and business for decades. For medical folks like us, it brings up monumental issues of professionalism, ethics, and oversight.

Another one to listen to (but be prepared for nightmares) is Believed. This podcast chronicles Larry Nassar's decades of sexual abuse of patients within and beyond his role as the USA Gymnastic national team doctor. It's a chilling description of how even well-meaning adults can have blinders on when it comes to a physician, based on his perceived social status. 

And please feel free to listen to my guest spots on the White Coat Investor Podcast, the FeminEm Podcast, and the Hippocratic Hustle Podcast, although they are admittedly less captivating than The Shrink and Believed :). Use the links included in this entry or download them directly from your favorite podcast app.

Medical School Interviews: How to Strategically Confront and Address Weaknesses

Not everyone has a 3.99 BCPM or a 99th percentile on her MCAT. In my recently-published Student Doctor Network article, you'll learn how to acknowledge your candidacy's deficiencies, while providing persuasive evidence that you've overcome obstacles. These techniques work well for residency and fellowship interviews also. 

Four Ways to Save $ in the Medical School and Residency Interview Processes

1. If you are ambivalent about an institution, schedule your interview later. By late-season you may decide not to interview there at all, saving you some money.

2. Group your interviews geographically. If you think this is impossible, consider this: There is nothing wrong with calling an institution you are waiting to hear from and politely letting the assistant know you have been invited to interview at a nearby school/program. Let him/her know you would like to save money by flying out to the area once, and ask if the admissions committee/ residency might be willing to let you know now if the institution will be offering you an interview. Believe it or not, this technique sometimes works.

3. Check out travel web sites daily or better yet, set an alert on Kayak, Hopper, or Google flights. Occasionally, a low price is available only if you catch it quickly.

4. Consider staying with students/residents if the institution offers. Hotels can be expensive, and sometimes you can gather useful information about the school/program this way. Just beware that anything you do or say may be repeated to the admissions committee/residency. (Make sure to write a thank you note.)

How the Show ER and New Residency Programs Change the Economy of a Specialty

Here's an interesting piece called "Are There Too Many Emergency Physicians?" by Thomas Cook MD, an emergency medicine program director. Dr. Cook chronicles the growth of emergency medicine residency positions from a total of 1821 in 2015 to 2488 in 2019. This rapid growth in the field may lead to an oversupply of emergency physicians.

The paradox here is that only recently there was a shortage of emergency physicians. And back when I graduated from medical school in the mid-1990s, almost no one was applying for emergency medicine. In my class of around 150 students, there were three of us. As the popularity of the show "ER" waxed, the number of applicants to the field swelled. Then, years later, the field contracted again. 

Other fields have also recently seen a boom in the number of residency spots, including family medicine, psychiatry, and anesthesiology. Of course, opening up more residency positions is a good thing for medical students (especially international medical graduates) and patients, but the growth in certain fields may lead to a change in the economy of those specialties. It will be an interesting experiment.

Mom and Dad May Think You Have Good People Skills, But That's Not Enough When It Comes to Interviews

Every year I am hired by re-applicants for medical school and residency who tell me that the year before they received multiple interview invitations, thought they performed well on interview day, but then were left with no offers in the spring. 

This is the truth: Interviews are hard. You need to strategically respond to criticisms of your candidacy, showcase the strengths of your application, be prepared for awkward or even - sometimes - illegal questions, all while seeming fresh and enthusiastic.

There are applicants who spend months studying for their MCAT or Boards, but don't spend even an hour practicing for their interviews. It's a naive disconnect. 

If you can mock interview with someone who has been on a medical school admissions committee for years or a faculty member who has strong experience with residency applications, go for it. If not, check out my mock interview services here. Don't rely on a friend or family member with no experience.

Here is a funny, less-than-one-minute, stop-motion video to guide you on this topic. 

The Week I Spent 138 Hours in the Hospital

During my internship, on my surgical rotation, I once spent 138 hours in the hospital in one week. If you think this isn't mathematically possible, I will tell you that I was on call from Monday morning to Tuesday evening, from Wednesday morning to Thursday evening, in-house on Friday, and then on call from Saturday morning until the next Monday morning. (I had to stay in-house that Monday until evening rounds were over too.) As you can imagine, I was barely human by the end. How this schedule was good for patient care is beyond me.

I thought of that ghastly time recently when reading this article in the New York Times called "How Job Stress Can Age Us" written by Dr. Dhruv Khullar. The author reports on a study, "Physician-Training Stress and Accelerated Cellular Aging" that assessed the DNA of 250 first-year medical residents around the country. Researchers examined the saliva samples of these residents, focusing on their telomeres - the bumpers at chromosome ends that prevent DNA damage - before and after the first year of residency. Researchers found that the DNA of first-year residents aged six times faster than normal. 

Six times faster.

I found this both shocking, upsetting, and validating. Residency training is as hard as we think it is. 

What I would strongly recommend is that you compare residency programs' hours before you create your Match list. Strangely, many applicants don't even consider this important issue when making decisions about their next three to five years. Also, many residencies support physician wellness programs and night coverage. Especially in the setting of severe burnout among doctors, your happiness should be a primary factor in your career choices. If you're not sure, consider your shrinking telomeres. 

Managing Difficult Medical School Interview Questions: Rehearse Your Elevator Pitch Now

An important key to preparing for tough medical school interview questions is realizing that a) interviewing is a skill and b) practice improves performance. Every year too many medical school (and residency, fellowship, and dental school) candidates expend tremendous energy assembling fantastic applications, only to undermine their chances by approaching the interview with twisted laws of entropy and enthalpy: They prepare for it with maximum randomness and minimum energy.

Once you’ve done adequate groundwork, the medical school interview represents your opportunity to distinguish yourself and impress your interviewers as the type of candidate they’d love to have at their institution.

That’s not to say every interview will be full of hugs and puppy kisses. Like the story of the interviewer whose window was nailed shut, there may be uncomfortable moments and even illegal questions. With a bit of preparation, you can learn to hit these curveball questions out of the park. Let’s explore an example that has come up in the not-so-distant past.

Rehearse Your Elevator Pitch

While most interviewers take the time to read your application materials in advance, don’t be offended by the faculty member who did not prepare, is blankly flipping through your application right there in front of you, and who asks open-ended (and dreaded) medical school interview questions, such as “Tell me about yourself” to be brought up to speed. View it this way: These faculty members are offering you the opportunity to define how you’d like to be remembered.

Your goal should be twofold: 1) to persuade them how much you’d add to their institution and 2) to make their job easier by giving them the bullet points they’ll need to persuade their peers about your candidacy’s worthiness. When your interviewer sits around a table advocating on your behalf, steer her to use terms that will be germane to your candidacy. Are you the, “global health advocate who volunteered with Mother Teresa and ran his school’s homeless food program?” Or perhaps you are the “first generation college graduate who held premier leadership positions in medical school?” Help your interviewer help you.

In the end, difficult interview questions are less intimidating if you both prepare well and have an attitude that they are an opportunity to clarify and further your candidacy. For help, secure your Mock Interview slot with me. I'm booking a few weeks in advance, so sooner is better than later.

“Unhappy is He Who Depends on Success to be Happy" - Alex Dias Ribeiro, Former Formula 1 Race Car Driver

Age-related professional decline is the last thing many doctors want to think about. Those who have just finish years of arduous training can't imagine that they have only 15 years until they will deteriorate (statistically true), and those of us in middle age don't want to think about our impending, cognitive retreat from medicine. And yet, this fantastic piece in the Atlantic "Your Professional Decline is Coming (Much) Sooner than You Think" by Arthur C. Brooks is a fascinating, well written article about happiness, gifted and accomplished people, and personal relevance with multiple interesting celebrity examples. Brooks also proposes some quasi-solutions (or at least some work-arounds). I strongly recommend this compelling piece for physicians of all ages and stages.

Are you a Residency Candidate Applying in More than One Specialty? Read this.

If you're planning to apply in more than one field, you have a challenging road ahead of you, and you should strategize accordingly. Remember that, although your ERAS activities cannot be individualized to different residency programs, your personal statement and letters of recommendation can. Demonstrating commitment to each field through your essay and letters will be a challenge, so take time to write thoughtfully, and make sure you speak candidly to your faculty recommenders.

Above all: Ensure that you assign the correct specialty-specific documents to the correct programs!

Be an Adult: Don't Accept Helicopter Parenting

Check out this hilarious (and sad) piece in 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?)

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 a winning strategy.

Reading this Article Could Make You Wealthier than Working Long Hospital Shifts

Work smarter, not harder. Read this funny, informative Student Doctor Network article by CrispyDoc on financial literacy for the newly minted physician. Have little idea what an "alternative asset class" really means? Don't know which is a bear- and which is a bull-market? This piece is for you. Learn that do-it-yourself investing is not that hard with the technological tools now at our finger tips and start saving so that you can gain financial independence early and avoid burnout. 

Also, make sure to check out CrispyDoc's awesome blog for tips on financial independence and finding your mojo in and out of medicine. 

The Difference between Lazing Around and Laissez-faire

When I was in medical school, I was talking to a friend who was an avid fiction reader. I, too, love to read, but I remember feeling like I couldn't find the time. I told him that I didn't think I could get through medical school successfully if I were reading regularly. I remember he told me kindly, "I don't think I can get through medical school successfully if I'm not reading regularly." 

That comment really sunk in, and I think of it often when I'm focusing on conventional productivity. There's a great, recent New York Times opinion piece by Bonnie Tsui that reflects this idea: We need to relax and have fun in order to be creative and successful (although she points out that fallow time should not be seen as just another life hack; there is great importance in recreation apart from its ability to boost our productivity). Take a peek at her piece here. It's especially important for those entering the demanding career of medicine. 

Brevity is the Soul of Wit -William Shakespeare

I've been editing a lot of medical school, residency, and fellowship essays over the last few months, and I want to give a shout out to the importance of brevity. I focus on a word count of 750 or fewer for my advisees for a few reasons: 

First, I've found that that number is just the right balance of content and streamlining: Over 750 words for an admissions essay lends itself to meandering writing.

Second, your reader is likely stuck reviewing tens or even scores of applications in a short period of time. S/he is looking to spend as little time as possible on your written materials, while still getting a good flavor for your candidacy. Don't burden your reader with verbiage.

Having trouble being brief? Here's a helpful trick: Imagine AMCAS or ERAS is charging you $10 per word. How would you keep costs down?

Looking for Podcasts to Spruce up Your Summer Workout?

I'm a jump roper and stair climber, so podcasts are an excellent way for me to keep my mind occupied while I exercise. (I also swim but listening to a podcast underwater is hairy.) Check out my guest spots on the White Coat Investor Podcast, the FeminEm Podcast, and the Hippocratic Hustle Podcast. You can also download them directly from your favorite podcast app.

Other podcast favorites of mine are Serial (especially season 1), S-Town (genius), In the Dark (first season), Wait Wait...Don't Tell Me, and Slow Burn (second season).

 

Enjoy!

The Ins and Outs of Choosing a Specialty: The Generalist vs. The Early Committer

For many third-year medical students, this is a tough time of year. Preparing an ERAS application can be daunting, but it's even worse if you do not know what specialty you want to practice. Here's a short piece I wrote with my colleague David Presser MD MPH called "Choosing a Specialty: The Generalist vs. The Early Committer." And recently, I read a complementary, but non-medical, New York Times article called "You Don't Want a Child Prodigy" that seems like a good follow up to our piece. 

Urgent, Urgent, Urgent, Emergency?

The AMCAS open-for-submission date came and went, and the question I'm getting now is: Should I panic if I haven't yet submitted my AMCAS?

The answer is no - and depending on where you are in the process - yes. Submitting on Day 1 precisely is not worth losing your mind over, so if you didn't do so, please don't kick yourself. On the other hand, submitting very soon is to your advantage because of rolling admissions.

So, if you are wrapping up your work and have your written materials in a superior state, just keep moving and get your application submitted promptly. If you are behind the eight ball and don't feel that you can craft outstanding written materials speedily, consider waiting a year to apply. Every season I encounter re-applicants who, during the previous application cycle, submitted their AMCASes in August or September...thus making them re-applicants :(. 

So... on your mark. Get set. Go!

AMCAS Tips (and Particulars): How to Best Draft Your Work/Activity Experience Description Section

I've had a few clients recently who were confused about the AMCAS Work/Activity Experience Description character limits and how the Most Meaningful Experiences fit in. 

Please remember that AMCAS Experience Descriptions can have up to 700 characters (not words!), while the Most Meaningful Experiences max out at 1325 characters. (Note, then, that the Most Meaningful Experiences are separate from the Experience Descriptions.) 

Here's a short blog with AMCAS Work/Activity Experience Description writing tips and another with Most Meaningful Experiences guidance. Good luck!

How to Use the MSAR to Your Advantage

The Medical School Admission Requirements (MSAR) is an online database that allows users to search, sort and compare information about U.S. and Canadian medical schools. (I hate to date myself, but when I was applying to medical school and used the MSAR, it was a hard copy book.) The 2019 MSAR came out last month, and if you are applying to medical school, I'd recommend purchasing it ($28) because it provides so much information about schools and their admissions statistics. The MSAR allows you sort and compare schools by median MCAT scores, AMCAS GPAs, and other criteria. 

You should use the MSAR to help determine which schools are in your range and which are "reach" schools. While it's fine to have a lot of "reach" schools (if you can afford it), it's critical to ensure you are applying wisely to schools that match your numbers. The advantage of the MSAR is that you can make evidence-based decisions. I've found some applicants have eye-opening experiences when they thoroughly review schools' statistics and either realize that their numbers are low and that they should apply accordingly or, happily, that they have numbers that match with top schools. Either way, reviewing the data is critical to good decision making.