Residency Interviews AKA nationwide beer, food, and wine tour

I’m about a third of the way through my interviews. I’m sure other fourth years will agree when I say that the interview season is exhausting. It’s not even the stress of the interviews themselves, but rather the non-stop traveling and driving. It really starts to take a toll after a while. The nice thing is that I’ve gotten to travel to states that I’ve never been to before and have been able to explore each area and get to know the people and local attractions. I mean, I might be living there for several years so it’s important that I actually enjoy what the city has to offer. I’ve found that it’s somewhat insightful to ask my Uber driver what they like or dislike about the city. They’re a pretty unbiased source and have nothing to do with my ranking, so I like to ask them some of the more sensitive questions that I don’t feel would necessarily be appropriate to ask a program director or resident.

As for interview day themselves, they’re all set up in almost the exact same way. It always starts off with a presentation or meet and greet by a program director or someone else high up there on the academic ladder. Something I’ve noticed is that they really try to sell the program. It’s clear that they’re trying to recruit us and make sure that we rank them. I feel like when was going on medical school interviews, the other applicants and I were the ones trying to convince the admissions committee to accept us. But for residency interviews, we kind of just sit back, answer some questions they ask and the rest of the time is spent with the Program Director, faculty, and residents trying to impress us. I’m not going to lie- it feels nice.

After the introduction, the actual interviews take place. My interviews have been relatively relaxed and conversational. There have been only a couple times where I was asked an off the wall type of question, but even then they’re definitely not on the same level as some of those weird questions I got asked for medical school. The day ends with a tour of the hospital, and a lunch usually in the company of current residents and faculty. On average the day lasts probably for no more than 5 hours. My shortest interview day was 4 hours and my longest was 8 hours (yeah, I know).

For my first interview, my neuroticism forced me to prepared excessively. I read everything about the program, I reviewed my CV, re-read my entire application, the works. Then when I had the actual interview, I felt so underwhelmed that I stopped preparing so much for my following interviews. Now I just take a little bit of time the night before to read about the program and think about how to tailor my responses appropriately.

Some questions I’ve gotten a couple times that annoy me to no end are: Why medicine? Why DO school? and Why did you decide to be a doctor?

Oh I’m sorry, I thought I was interviewing for residency, not medical school 

…is what I’m thinking in my head. It takes everything in me not to roll my eyes when they ask me one of those questions. Instead, I enthusiastically nod and give my response, which is the exact same response I gave 4 years ago for medical school interviews. How groundbreaking.

Another thing about interviews: love letters. I’ve gotten some emails from either a PD or the DME with whom I interviewed with that day thanking me for visiting and that they think I will fit in well/will be a great addition to the program/that they hope I rank them highly. They also manage to integrate a specific topic we talked about during the interview, whether it was one of my hobbies or future career aspirations. It’s a nice gesture, but I take these emails with a massive bag of salt. In no way does it change my opinion of a program, or my ranking.

Anyway, I need to go send some thank you emails. Only a couple more months of interviews left…

 

-NB

Interview Invite/Rejection Season

How it feels when a program you like sends you a “we will not be interviewing you” email:

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Since the MSPE came out, I’ve received a wave of interview invites in my second specialty and a wave of rejections in my first specialty. At this point I can safely say that applying to two specialties was a good idea. I have enough interview invites in my second specialty to be considered “safe to match”, but not enough to be safe in my first specialty. I would absolutely be freaking out right now had I only applied to one. We’re still in the middle of the cycle, so it will be interesting to see what pans out for specialty #1 within the next month or so.

Time to go pray to the ERAS deities.

 

-NB

 

October 1st

I now have more interviews in my second specialty than I do in my first, which I guess goes to show that it was a good idea to apply to those programs. I’m not getting much love in my first specialty, presumably because I don’t have my Level II scores yet and because programs wait for the MSPE to be released. I also think my educational background and activities are more fitted for my second specialty, which is probably part of the reason why I’m getting interviews even though I applied relatively later.

Speaking of the MSPE, it’s recently been the center of concern for my class. For those who don’t know what an MSPE is, it’s essentially an official academic record of your performance during your first three years of medical school. It includes a blurb about what makes you a unique/great applicant for residency programs, the comments that attendings wrote in your evaluations (whether they were good or bad), along with some fancy charts and graphs that visually show programs how you stack up against the rest of your class. Basically, it’s part of your residency application and is necessary to make it “complete” for review.

Historically, the MSPE is not released by medical schools to residency programs until October 1st of the application year. Once they’re released, the residency programs review applications again with the MSPE and decide whether or not to give applicants interviews. Of course you can get an interview before October 1st without the MSPE. This obviously depends on the program, specialty, and whether the program is AOA or ACGME accredited. However, generally speaking, without the MSPE, programs will not offer interviews.

This brings us to the problem: supposedly many student’s MSPE’s had errors. Some were minor, like grammar and punctuation mistakes (although these should still be fixed immediately). However, some were huge- we’re talking incorrect grades, such as documenting a Pass when you actually got Honors, an “In Progress” grade when all the paperwork has been turned in, incorrect applicant name, and evaluations from the wrong preceptor, just to name a few. Of course, my class was furious, and with good reason. Supposedly (and this is a huge supposedly that probably depends on 1,000 other factors) some programs will auto-reject applicants if they don’t have an MSPE submitted by the time they review the application. Now, the MSPE errors aren’t the school’s fault. We were told that there was some kind of glitchy problem with the website that attendings use for submitting our evaluations. Whether this is actually true or not I’m not entirely sure, but I think my class is lucky in that October 1st actually fell on a Saturday this year. Meaning that no one in any residency program was actually working on the 1st to review applications. Therefore, there’s some buffer time to fix any mistakes and upload a 100% correct MSPE before residency programs download applications on Monday, October 3rd. At least, that’s what I’m thinking.

So to my fellow classmates that are also kind of freaking out: I think we will be okay.

Of course if I get an influx of rejections in my inbox tomorrow then I was wrong and we’re screwed.

Just kidding; I think we’ll still be okay.

-NB

I’ve got 99 problems

It’s the third week of September. The DO residency applications have been open for a couple months, but the MD residency applications have just opened for submission a couple days ago.

I feel like everyone in my class has got their application stuff together, at least judging from the non-stop influx of social media posts I’ve been getting for the past week or so. Me on the other hand, am a hot mess.

I actually decided to apply to two specialties. I guess this isn’t entirely uncommon, but the biggest problem this is causing me (other than killing my bank account) is that 1.) I have to write another personal statement from scratch, and 2.) I’m short some letters of recommendation. Since I’m limited geographically, I’m applying to both the DO and MD match. This means my DO application for my second specialty is incredibly late and this isn’t even taking into consideration how late my letters are going to be. I know people that were getting interviews in July for this specialty, and I’m going to submit an application for it in the middle of September. Why?

Because I’m scared I’m not going to match if I only apply to one specialty. I’d rather drop the money now with a later application in a second specialty than realize in November that I don’t have enough interviews and scramble to apply to more programs as a last-ditch effort. Trying to add more programs then would really be too late. The real issue I had to think about was before applying to a second specialty was, “Could I see myself in this field? Would I be happy if I matched in this instead?”. And my answer is yes, mostly because the two fields are actually similar with a bit of overlap.

The anxiety is real- I’m having some problems sleeping. I seriously considered even taking a clinical/research year and applying for the match in 2018 so I could give myself a mental break, but I don’t think it’s feasible at this point. I feel like I’m stuck in a 50 foot deep hole where the only escape is to climb out. The problem is that I keep falling back in.

 

-NB

 

Audition 1, complete

I finished my first audition rotation. I’m not sure how my fellow sub-intern and I survived a whole month of it, but we did. Honestly I think that it was one of the rougher ones that we’re going to have. I anticipate the rest of my rotations from here on out to go smoothly.

I think I ended the rotation on a good note. I tried to work especially hard the last two weeks once I got used to everything so that I could leave a positive impression. I received good feedback from the residents, most saying they hope to see me back during their interview season- hopefully a good sign. Despite how hellish the rotation itself was, I’m actually kind of sad to leave. I’m going to miss the craziness of the floor, having my own patients that I can manage, being constantly judged and under scrutiny of my seniors (okay maybe not that). I even received a compliment from Ms. Never Satisfied Senior Resident towards the end. I’d like to think that she noticed how I improved, or at least that I tried.

I also did have a chance to sit down with the Program Director and talk to him about my interest in the program. I think the meeting went well. I mentioned in a previous post that one of my top choice programs essentially rejected me before I even auditioned. This is that program. I think some people will say that I’m being too over the top/neurotic by meeting with the PD, and I probably would have thought the same thing-  but this is audition season. Sometimes you just have to do what you gotta go, even if it makes you uncomfortable. I haven’t received an official rejection from the program yet so I’m going to try to be positive and say that I still have a (teeny tiny) chance here. And as long as I have even the tiniest chance of an interview, I’m going to go all out. Not just at this program, but any program that I’m interested in.

It’s not over until it’s over.

-NB

First 2 Weeks of Auditions

Now that I’m in the thick of my audition for this month, I though I’d write a little reflection of how it’s been going.

It’s been stressful. So very stressful.

An audition rotation is kind of like a 31-day interview. You need to be at the top of your game 100% of the time. You need to assume that all the people you interact with- nurses, interns, residents, attendings- are watching your every move. If you mess up on one thing, it will stick with them for a long time and it’ll be harder to make a good impression.

For the most part, I’ve been getting along with all the residents except for this one senior. Sometimes she’s incredibly friendly and talkative with me as we discuss random non-audition related topics. Other times (maybe when she’s more stressed out) she will call me out on things I’ve done that are not to her liking by prefacing with the phrase “You know, since you’re auditioning, you have to…”. I’ve directly worked with her several times, and each time I feel like a complete idiot. I always feel regretful about something I did whenever I work with her, because she always comments about what I’m doing wrong or what I should be doing better. I talked to one of the interns who told me that she’s notoriously not good with students, usually yelling at them or publicly humiliating them until they have to excuse themselves because they start crying. He told me that if the only thing she’s done to me is give me criticism, then it might mean I’m not doing as bad as I think. Yeah, we’ll see about that. I still have two weeks of my audition left and will mostly likely work with her at least one more time, so I’m trying to really take to heart what she’s told me so that I can show her I’m capable of improvement.

In regards to working with residents, I’ve been trying to anticipate their needs beforehand and be helpful as much as possible.

“NB, I need you to see the patient in Room 1 and write the admit note. Then tell me your orders so we can review them”

“I already wrote the note and I just finished the orders for your review”

“NB, I need you to get the patient to release medical records and add them into the chart”

“I already had the patient sign the release and the records are being faxed to us right now”

I feel proud of myself for being proactive and getting things done before I’m asked, but this is really all just common sense, and all the other M4s who are auditioning have been doing the same thing- it doesn’t really set me apart.

One thing that is putting me at a disadvantage though is auditioning at a hospital I’ve never been to. Some of the M4s I’m with have rotated here as M3s, and they know how everything runs and where to find what they need. Meanwhile, my co-sub intern (who also has not rotated at this hospital before) and I feel like we were being thrown into the rotation, especially during the first week. I think the hardest part was that everyone expects a lot from us since we are fourth years; they just don’t know that we’ve never been here before and that it’s all new to us. It’s almost like we are M3s all over again.

We’ve also found that there has been little to no guidance on how to do things. We were not given a on-service orientation. During the first week when a resident would tell me to do something, I would enthusiastically reply, “Absolutely, I’ll do that right now” while simultaneously thinking, “Okay I guess I’m going to wing this too”. I really depend on the nurses, axillary staff, and more experienced M4s to help me out. There is definitely a steep learning curve, I think even bigger than the learning curve between M2 and M3 year. It makes me wonder if my core rotation site provided adequate training to my past M3 self, or if this is just an incredibly high-volume, high-stress, figure-it-out-as-you-go type of hospital. I’m thinking more of the latter. It is a county hospital after all.

Something else I did was re-introduce myself to the Program Director. My interaction with him this month is pretty limited, so I’m thinking of scheduling some kind of meeting with him. I am interested in going to this program, so I hope it goes well. It could also backfire, or have absolutely no effect on my chances of matching here.

Anyway, deep breaths. We’re halfway done.

 

-NB

Boards And Audition Rotation Woes

They say that every medical student will have at least one moment of self-doubt, one moment where they wonder if this is all going to pan out. I recently had one of these moments a couple days ago.

I had to push my board exam back, putting me at a disadvantage when it comes to my applications since now programs will not get my scores until after October 1st. To make matters even worse, I’ve essentially gotten rejected from my top choice program-one that I’m going to be auditioning at. I got in contact with the program and pleaded with them to reconsider. However the person I talked to told me that since they’re the only program for that specialty in the whole state, they get an extremely high volume of applicants and because of that they have to essentially pre-rank applicants based on COMLEX level I and level II (which I don’t have) alone. I get that it’s competitive but to not even give me a chance when I haven’t auditioned yet seems a little unfair. Plus, this ‘requirement’ is stated nowhere on their website or in any email correspondence I’ve had with them.

Now it’s too late to cancel and pull another audition rotation out of my ass, so I’m pretty much just stuck. I still need a Letter of Recommendation from that institution, so I do still need to work hard. But it’s extremely discouraging to be getting bad news so early in the cycle.

I used to wonder if some of my classmates had slipped through the cracks of the medical student selection process. How did some of these people get through the interview? But nowadays I find myself wondering if I am the one who doesn’t belong here. Lately I’ve been feeling like a fraud.

I really, really, really hope this all works out in the end.

 

-NB