Archive for the ‘How to get residency?’ Category

How to perform on the residency interview

December 14, 2010

As I watch a few hundred students come into Jamaica Hospital for residency interviews, I realize how little opportunity there is for feedback to improve performance. For instance, the US graduate who did not bother to shave. Perhaps he had not re-filled his prescription for psychoactive pharmaceuticals.
Or the applicant who did not like being interviewed by a resident and an attending. We do it to show partnership with residents and real authority in the program. The applicant was stupid enough to actually say out loud ‘why am I being interviewed by ONLY someone as low as a resident’. ON interview, even if you do not like what the program is doing, do NOT say it! Unless you have not interest.

Or the guy last week who bit his nails CONSTANTLY through the whole process. Here is what to DO:
1. Look interested
2. SIt up straight
3. Always have some ‘safe’ questions like ‘what do you like best about your hospital’ or ‘what unique opportunities are there here’or “How is the teaching’
4. Never tell a faculty member or interviewer if you are applying in two specialties and the program is a ‘safety’ for you. They cannot handle the ambivalence. I hear it from attendings ‘he has no direction’ . this is AMAZINGLY unfair,but unfortunately, do NOT tell them
5. come early. Leave late. Ask to come for a ‘second look’
6. Smile and make eye contact
7. NEVER NEVER NEVER criticize ANYTHING.
So, each year I get comments like ‘so you are telling applicants to LIE!!!” actually..,,, yes, withold your real feelings. Do NOT be completely honest about things you see as negatives.
If you don’t understand, you are an idiot.

2011 Match: The Game has Changed, but the Players didn’t notice

November 20, 2010

There are three more medical schools graduating their first class this year in the United States. The existing schools expanded their classes four years ago and some are coming out now. But this little fact has escaped most of the applicants. People who go unmatched are often like those who die of cancer. You figure it is really sad, but it won’t happen to you and in any event, at least not today.

Yet, yesterday, I had to pare down those we were inviting for interview because we have already seen a LOT of people and the program director is getting fatigued. We chopped off all IMG with scored below 90 and chopped off all US grads who ever failed or had scores below 80.

What does this mean? It is getting harder and people don’t know.

Limited Time from school to make interviews

October 18, 2009

QUESTION:

Is there a way to learn more about how happy people are at a given residency program without going on the interview? My school strictly limits the amount of time I can take off for interviews during each rotation. As a result, I need to make some choices about which interviews are more worthy than others and am unsure how to proceed.

Thank you for all of your guidance! Your personal statement series helped me to make a statement that truly reflects me!

ANSWER

Your interviews are the MOST important thing you can do! I do care if they ‘Only give you a certain amount of time.”  You MUST make the time. this is MUCH more imporantant than any arbitrary limit of time on your interviews from schools. As such. to hell with their rules. Protect yourself.

You are the one who is going to have to live, for a  long time, with the outcome of you interviews’

1. Explain it to the local clerkship director

2. Generally he/She will agree.

3. IF they do NOT agree, then YOU must take the situation into your own hands and do as many interviews as you see fit.

Seriously, what a bunch of assholes@!

It is not at if you were going to the movies or something

Contemplating the number of Interviews you have

October 17, 2009

It is a weird time in the interview process. Even for the people who have many interviews, there has been a strange level of dissatatisfaction. You think you should be happier. I understand.

You will have to start from where you are. You can grow and learn enough medicine ANYWHERE. I am fully convinced of this.  Now, there is a difference in where you can get to later based on the name of where you are, but name only makes it easier. Not automatic. Not impossible.

When you are looking at your programs that you are going to for interview it comes down to two things:

-WHat is the location?

-Do people seem happy?

Be careful about what people promise you on interview

October 13, 2009

“You are great Conrad, we will see you here in July”

“You are exactly what we have been looking for”

“You are ranked high enough to match here”

I heard all these things when I was preparing my rank list. I was not exactly lied to. I remember the excuse I heard to this day “We put you at position 17, we alway go to position 20-25 on our rank list. We could not have predicted we would only go to position 12”

I was heart broken. I now, in retrospect, see what a disaster it would have been to have matched in my first choice. I matched at my fourth choice. A preliminary spot in medicine.

Later, I switched to categorical medicine, and because the chief resident.
How could I have known?

Living with disappointment about your interviews

October 13, 2009

I have received many notes about anxiety concerning the number of interviews you received. I know it must be very frustrating, however, you only need ONE place to match. I also think you can start from anywhere. It depends on your goals of where you want to eventually end up. You can ascend more later.

I did NOT match into my first or second choice. I could not have imagined where I would end up today, based on my rank list. However, I DID end up in the right place for what I needed to do.

What do you say if you are asked if you applied to other specialties?

October 8, 2009

Bobbylight writes:

If an interviewer flat out asks, “Did you apply to other specialties?” How do I handle this? It feels so unfair to be put in that situation. Everyone knows most applicants will apply to many specialties, either for “cushions” or simply because they are uncertain or like multiple fields. (The latter applies to me.)

 FISCHER RESPONDS

It is NONE of their business if you applied to other specialties! Tell them “NO” .   Ask them if they were a virgin when they got married. Ask if they have ever cheated on their spouse. Ask them if they have ever been arrested.

YOu tell them “NO”. You are allowed, legally and ethically, to apply, interview and rank other specialties and figure it out on match day.

Maybe you are not sure.       MAybe you only got ONE interview in a more competitive specialty.

Maybe it is just a whim. You do NOT have to embarrass yourself, or THEM by saying :”Yes, I really DON’T want you or your program, Your are just a safety”

Ouch!!!!!   By the way, I propose the same solution if you are on a date as well.

“Oh Yes BABY!!!!! YOU are the ONE!!!!”

What should you tell them? “Actually, yeah, I went out with your sister last week, she was busy tonight  so I called you”

Question on Finding residency for an IMG

September 30, 2009

Dr. Fischer,

I was one of your students who is currently looking for a Residency Position  in Internal Medicine. I am a US Citizen(national) who is an IMG. In what program would I have the best chances? I do have US Clinical experience but it has been a couple of years since graduation, but I understand it would not matter for the NY State licensing board when I graduated.

Regards,

A

ANSWER:

With over 30% of PGY 1 positions going to IMGs, the question of which programs will take IMGs is a little vague. the answer is THOUSANDS  (there are 8,000 separate programs in the united states) . As for the year of graduation, you are correct that this has no effect on licensing. It does, however, have some impact on your marketability for program directors who may not want to take people graduating >5-10 years ago.

That is why the only way you can make yourself competitive, is often a higher score on Step 3 or something like that

On Faith

September 29, 2009

Making efforts without seeing results is difficult.  Un-requited love has a certain pleasure in the pain of the inability to connect, but struggling for our goals, making efforts, working and not seeing it go closer is more denervating. There is no heart lacerating endorphin surge with that effort.

I have been contemplating the thousands of students and doctors I have been meeting in my travels around the outer geography of this American Civilization. America, you must remember, is an idea, more than it is a place. Because of the nature of my position,  an enormous amount of anxiety flows my way from people. It lacerates me like a cold wind on a loveless day.  People want reality to be different than reality. Some other answer than  work hard, score high, apply wide, get your work double checked.

Last night a woman comes to me apopleptic with paralytic fear “Should I take Step 3 now?”  her fear comes across to me in an instant like a fragrance or perfume, I smell the fear and feel my own muscles tense.

Turns out she has a 99 on BOTH step 1 and step 2.

Everyone has fear.  Our futures, mine too, are uncertain. Yours with USMLE and residency and mine with my book ‘Routine Miracles”.  I am in the same boat as you, so I encourage you to have faith. If my number one goal is a mere external like book sales, then I will be anxious. If my goal is the beautification of this Civilization through the ideas of my book, then I am free.

Faith: Making efforts in the direction of your dream in the absence of tangible results in front of you.

When you are on your mission to find your residency, if your highest goal is simply a match, you will have more fear, less satisfaction. If you have faith, that an effort is NOT wasted if it is to make the world better, to heal the sick to relieve suffering and to cleave to HOPE and HEROISM then you will relax.

I am in the same circumstances as you. Making efforts, not always seeing results.  Let us renew our faith, originating in the beauty of the impulse that we started this voyage with, and know that we will come to a destination, even if we can’t see it at the moment.

Do NOT worry!

September 28, 2009

At this time of the interview season, I know that many of you are anxious. You have spent years in school, college, Med school and it is now all coming to fruition.

This is a time of extraordinary opportunity to realize the fruits of your labors, to practice your art and to follow your calling.

Ask not, ‘How will I be safe”  or ‘How do I get my first choice?” but ask “Where am I MOST necessary?”  “Where does the world need me?”

I myself, did NOT get my first choice in the match. But, I DID end up where it was right for me.