Fast, Easy Healthy – A Couple Cooks

One of the keys to wellness for medical students, residents and physicians is to cook. Sorry, but it’s the truth. Eating nothing but fast food, pizzas at conferences and “free” food in the hospital is just not good for you!

I developed the “pizza rule” years ago for myself and my trainees. It’s important to cook food at home … but who really has the time? I realized that we had to find recipes that took less time to cook than it takes to order a pizza.

This week I discovered A Couple Cooks– a great website by Sonja and Alex, a couple who taught themselves to cook together and now share their recipes and ideas for others.

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Enchilada skillet

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Tropical Mango Salad with Creamy Cilantro Dressing and Grilled Shrimp

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Lasagna Stuffed Zucchini

Words of Welcome and Advice to New Medical Students: The DeBakey Scholar Convocation Address

“Whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is gracious, if there is any excellence and if there is anything worthy of praise, think about these things.”

It’s so good to be here with you—what an exciting day.  I was asked to share some thoughts that might be relevant to you all as you get started on this incredible ride.  I’ll get back to the Paul in a moment—just to say here that, from a purely literary sense, there’s something to admire in his lists, their cadence and directionality.  Most of the rest of what I’ll have to say is from Greek pagans but they just can’t compete with this poetry, so I put it first.

I remember sitting where you are now on my first day.  The woman who is now my wife was halfway across the country; I was in a new city, sweating profusely, with a slowly dawning perception that I didn’t actually know what I was getting myself into.  Over time I found a place, some solid friends, some good study habits.  We all helped one another through.  I’m sure you will do the same.

What I wanted to share with you today, though, is something that I think is pretty important you know up front.  Here it is: You are all about to devote a tremendous amount of time and energy over the next four to…fourteen years…on something that is not enough.  I’ll say it again: a tremendous amount of time and energy will go to something that isn’t enough.  Medicine—the science, the practice—won’t get you through.  It can’t sustain you on its own, through all through the hard days, the specter of burnout, nor can it sustain the lives we will cultivate with others while we are here in school.  There’s a temptation sometimes to think it will, or at least to slip into the illusion that the whole world is just a somewhat distracting corner of medicine, instead of remembering that medicine is really just a small part of the world.  But we can’t forget that—and our patients, if we listen to them, won’t let us.

For us, medicine is (or will soon be) a way of life.  We’ll eat and sleep in the hospitals—and sometimes, we won’t eat or sleep, but we’ll still be in the hospitals.  But for the patients we serve, their days are anything but normal.  They—often regardless of how sick they are—are in extremis.  This day that you just walked into represents to them disorientation, rupture, interruption of their story and sense of self, reckoning with an unseen, threatening force.  We would do well not to forget that.

Narrative theorist Arthur Frank writes of what he terms ‘spaceship ethics,’ named after a physician’s anecdote of leaving his home and imagining his car a spaceship, carrying him to a distant world where “terrible things happen,” all the while refusing to acknowledge that his planet and the planet of the hospital are one in the same.  The problem here is that the physician is isolated—from his patients, his role, and even from himself.  What Frank proposes instead is to invest deeply in stories–essentially, being willing to be open to the ways that stories are the first inroads to a more personal and specific way of being-toward-the-other. Others have picked up his argument to strongly argue that we as clinicians need also to look outside of medicine, and toward things like living traditions, authentic relationships, good art, the natural world–not just to relate to our patients better or to help ourselves recharge but also to help us do the work that, ideally, we’re trying to do.  Medicine—the science—pushes us to efficiency, effectiveness, near-perfection.  There is a lot of power in that.  But healing—I hesitate to call it an art because it is more than that, more than artifice and closer perhaps to a way of being—healing sometimes requires inefficiency.  Hesitation.  Our wounded nature encountering another wounded nature, and stopping long enough to witness their suffering and, even if we cannot take it away, being willing to be changed by it.  How?

I promised you pagans.  Aristotle said, “the virtue of a man…will be the state of character which makes a man good and which makes him do his own work well.”  There is a sense, in his writing, that virtues—from virtus, excellence, worth, developed through habit—are the raw materials for a well-favored life in which work is integrated into a greater and more important pursuit of being a good human being.   Philosopher Craig Irvine at Columbia wrote, “I must care for my hands, if I am to lift the fallen; my heart, if I am to love the stranger; my mind, if I am to cure the ill; my eyes, if I am to find the lost, and my soul, if I am to guide them home.” I would challenge you to find a few ways to sustain yourselves that are not simply disconnected from medicine, and to avoid the slow gravity toward “spaceship ethics”—but instead to look to each other to begin to cultivate those strengths—humility, courage, charity, patience—that can sustain us as we remain human in the face of the suffering we will inevitably see.

Baylor has given me a tremendous education.  Now in my fourth year I can almost feel the first little shoots of competence poking up over the vast freshly-fertilized fields of my inexperience.  Thomas Merton said, “The world is made up of people who are fully alive in it: that is, of the people who can be themselves in it and can enter into a living and fruitful relationship with each other in it.”  Education, then, should be one of the ways that we learn who we are, what we have to offer, and how to make that offering valid to the contemporary world.  Baylor has provided that type of space for me while laying a solid foundation, and I have confidence that the faculty here will do the same for you.

As I look ahead, there’s one particular virtue that I would personally like to cultivate, that seems especially fitting especially after this last month at Texas Children’s Hospital with patients and families who are uprooted from home.  Here’s a long quote from Henri Nouwen from his book called “The Wounded Healer,” and then I’ll wrap up.

“Hospitality is the virtue that allows us to break through the narrowness of our own fears and to open our houses to the stranger, with the intuition that salvation comes to us in the form of a tired traveler…Paradoxically, by withdrawing into ourselves, not out of self-pity but out of humility, we create the space for others to be themselves and to come to us on their own terms…But human withdrawal is a very painful and lonely process, because it forces us to directly face our own condition in all its misery as well as all its beauty…[W]hen we have finally found the anchor place for our lives within our own center we can be free to let others enter into the space created for them, and allow them to dance their own dance, sing their own song, and speak their own language without fear.  Then our presence is no longer threatening and demanding, but inviting and liberating.”

Enjoy this time—it is fun.  Study hard, and try to do it for someone else.  Be good to one another, to your patients, to yourselves.  I wish you all the best.

The address given by the Mark Kissler, MS4, the 2014 Debakey Scholar of Baylor College of Medicine on July 30, 2014 at convocation for the class of 2018.

Learning to Run Meetings

Whether you are a college student, medical student, resident, faculty member or physician in practice, you can’t get around the need for meetings. Having watched some masters (and some “masters to be”) I thought it would be worth a little research on what makes a meeting work well. Here’s 12 ideas to help learn the skill of running a great meeting.

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1. Start on time, stay on schedule and end on time. “Set the ground rules – meeting does not equal chillaxin in a room with a big table” from the MIT meeting Primer

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2. Don’t use PowerPoint.

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3. Make meetings as short as possible. Just because Outlook defaults to an hour doesn’t mean a meeting has to be an hour. I’m a fan of 30 minute meetings (max).

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4. Never have a meeting without a clear purpose. If it’s just “getting together” to talk, it’s not a meeting. (Face to face time is important socially, but don’t confuse the two). That being said, a little social interaction at the beginning of the meeting is important to set a collegial tone.

5. Invite the appropriate people. Nothing is worse than sitting through a meeting about a topic that doesn’t apply to you. Limit the number, too – more than 8-10 people limits the ability of the group to interact effectively.

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6. Make an agenda and send it out before the meeting. If you are using Outlook to schedule your meetings, you can include the agenda (or add it later) with the invitation. The best agendas use the DRI approach adopted by Apple. Every item on the agenda should a) have a time limit for the item b) lead to an action item, and c) should list the “Directly Responsible Individual” for that item.  If it’s a smaller meeting, a formal agenda may not be necessary, but setting goals (and letting everyone know in advance) is still crucial.

7. Share documents with the team. Create folders on a shared drive, SharePoint or use Google (or other) apps. Otherwise, make sure these are shared by email.

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8. Include “brainstorming” as an action item at the end of every meeting. When people bring up items that aren’t related to the task being discussed, stop them, write it down and bring their idea up during the brainstorming session.  Reinforce that there is no judgement in brainstorming – this is where the great ideas come from!

9. If you are running the meeting, control the conversation without stifling the creativity of the group. If one person seems to be dominating the conversation, gently (but firmly) steer the conversation to the other people. Go around the table to ask for opinions. If it’s a controversial issue, ask people to write their decision/opinion on a piece of paper and “pass the hat”. You can then read what are essentially “anonymous” responses to the group.

10. No texting, emails or other technology during the meeting. If it’s an hour long meeting, think about a 5-10 minute “bio break” to let people check their phones mid way.

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11. Send an email within 24 hours summarizing the action items, deadlines and DRIs. Alterantively, you can send the  the minutes instead (but do it within a few days, not just before the next meeting so people know their responsibilities)

12. Kindness matters. These are your friends and colleagues who are all trying to do a good job and help.

 

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Seven Steps to Running the Most Effective Meeting Possible

How To Run Your Meetings Like Apple and Google

University of Wisconsin-Madison guide to running good meetings

MIT Meeting Primer

Top 10 ways to survive (and maybe even enjoy) being on call

Like our residents (but not nearly as frequently), my group has started taking “in house” call.   For every one who is currently or has been a resident, this is an experience we all know…. and one that’s hard to describe to those that haven’t experienced it.   Spending 24 hours on call in the hospital can be emotionally and physically draining, but it has moments that make it a special experience, too.

There are ways to make the experience easier.  Here are my top 10 ways to survive (and maybe even enjoy) being on call:

1. Drink water. Put a water bottle in the lounge refrigerator, drink from every water fountain, put your water bottle next to your computer, or come up with other ways to stay hydrated. If you want more flavor, bring a zip-lock with cut up lemons or limes to put in your water or add a splash of fruit juice.

2. Be kind. No matter how stressed or busy you are, knock on every patient’s door and enter their room with the intention to help. Sit down or put a hand on their arm when you are talking to them. Smile.

3. Take breaks. On purpose. No one really expects you to work non-stop for 24 hours and it’s not good for your patients. Deliberately stop to do something else every few hours, even if it’s just for 5 minutes. Go outside for a few minutes for a short walk to catch some natural light and breathe some fresh air. Get a good cup of coffee or tea, listen to some music or just sit. If you want something more active, climb a few flights of stairs, stretch, or even do a light workout.

4. Eat well and eat often. Do not rely on fast food or the hospital cafeteria. By far the best plan is to bring really good food from home. You need to have “comfort” food on call. If you don’t cook, buy really good prepared food that you can look forward to. Make sure you have “plan B” ready if your call day gets completely out of control by having an energy bar (my favorite is Kind bars), peanut butter sandwich or other “quick” food in your white coat pocket.

5. Be part of the team. Notice and encourage the unique camaraderie you share with everyone else who is on call. It’s a small “band of brothers” who find themselves in the hospital at 3am. Be kind to each other, help each other, and use this unique opportunity to get to know someone you might otherwise not get to know.

6. Wear good shoes. If you are in house for 24 hours, bring a second pair that’s completely different (clogs and running shoes for example). Ditto socks. Buy really good socks and change them after 12 hours if you can.

7. Use caffeine wisely. It’s practically essential for many of us at the beginning of the day, but beware trying to “wake up” with caffeine after 2pm.   Not to mention that if you “caffeinate” all night, you’ll have that sickly post-call-too-much-caffeine feeling in the morning.

8. Take naps. Any sleep is good sleep on call. If it’s possible, 20 minutes will make you more alert and effective in your work.

9. Make your beeper a “Zen bell”. Use your pager or phone as a tool for mindfulness. When it goes off, take a deep breath, relax the muscles in your face and shoulders and be present.  This is a proven practice to decrease stress – try it, it works!

10. Learn. Take advantage of the unique educational opportunity of being on call. The fact that there are fewer people around at night and on the weekends has a real impact on how and what you learn on call.   If you are a student or junior resident, you are more likely to be the first person evaluating new consults and admissions. You are also more likely to have one on one time with your senior resident or faculty as you care for patients together.  If you are further along in your training,  the “down time” on call (if there is any!) is a great time to catch up on reading.

 

 

Celebrating Match Day!

Yesterday was Match Day.  At noon EST, just over 17,000 4th year medical students simultaneously found out where they will go for their residency training this July.

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Medical training is punctuated by ceremonies like convocation, the White Coat ceremony, the donor ceremony (to acknowledge the “silent professors” in anatomy) and graduation.  But of all the ceremonies, the one that is pure joy is Match Day.

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I truly believe that any physician disillusioned with their work, or even suffering from burnout should be “prescribed” attending a White Coat ceremony, donor ceremony and/or Match Day.  I’m serious!  These moments of ceremony allow us to remember the reasons we choose the profession of medicine and the joy of practice. If you are part of a medical school faculty, make a point to attend one or all of these ceremonies next year.  I promise, it won’t feel like an obligation, it will feel like a gift.  If you are not in a medical school, contact the Dean of Student Affairs at your alma mater or a school close to you – we’ll help make it happen.

During the five long days of waiting between Monday, when they find out that they matched and Friday, when they open the envelope to find out where they are actually going, many fourth year students often wish this process would be replaced with an email notification…. until they experience the celebration of Match Day…

 

Congratulations to all medical students graduating this year –  and to your families, friends, and professors!

 

Photos and video from Baylor College of Medicine

 

 

 

 

Why You Should Take a Sabbatical

With all the concerns about “burnout” in physicians, allowing a colleague time to rediscover the excitement of his or her career may just be “just what the doctor ordered.”

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I’m ending up a month long “sabbatical” to work on a writing project.  I’ve become convinced that this is something most, if not all, physicians should include in their professional life.  I’m also sure that the data about sabbaticals are true – the “return on investment” for a practice or university is well worth developing a policy to encourage and support sabbaticals.

The concept of a sabbatical is traced to the Old Testament, but in recent times it has come to mean “any extended absence in the career of an individual in order to achieve something.” The corporate world has learned the benefit of these planned breaks and an impressive number of companies not only support the concept, but pay their employees to take sabbaticals.

Here are some concrete suggestions for taking a sabbatical, based on what I did (and some things I learned to do… and not to do).

Have a Mission.  A sabbatical isn’t a vacation.  It’s supposed to push you to learn something new, but it should be related to your work.  Think carefully about where/what/why you want to do, but don’t be afraid to choose something challenging.  Ideally this should be something that takes you out of your comfort zone into a new way of thinking.   It may be concrete, like learning a new skill in the laboratory, or a new procedure… but take advantage of the time to explore other fields and other ways of thinking.

Advance Planning is Key.  I picked a month that was the closest to “off peak” for my clinical and administrative responsibilities as possible.  I went to my associates six months before the sabbatical to make sure they were ok with the idea, and to give them time to work out any coverage plans that needed to be put into place.

Let People Know.  It’s not a good idea to just “disappear.”  It’s really ok to talk about what you are going to do and why.  I put an out of office message on my email 2 weeks before I left, explaining that I would be “out” for the month in order to avoid surprises for other people who were trying to find me.

Be prepared for pushback, but don’t be surprised if there is none.  Not only was everyone supportive of my plan, numerous people congratulated me on being a good role model for my colleagues.

Decide how to pay for the time away.  Many universities pay for some or all of your time away, so if you are in an academic setting, the first place to start is to learn about your institution’s sabbatical policy. Some non-academic practices also have policies to provide a part of your salary if you are on sabbatical.  If there is no policy, you may have to finance this another way.  You may have accrued enough vacation to cover the time away from work.  Another strategy is to put aside money specifically to support you for the time you are away.  A word of caution, if you take an unpaid leave, make sure your benefits are still in place. Finally, unlike other occupations, physicians have the option of locum tenens work to finance a sabbatical.

If at all possible, disconnect completely.  This is the one thing I would do differently next time.  My initial out of office message told everyone I would only read emails on Fridays, but was otherwise unavailable.  There were, however, a few events that happened during the month that I (and others) thought I needed to handle, and I let them take over some of my time away.  It didn’t detract from the overall goal of the month, but I think the experience would have been even more rejuvenating if I had been able to really leave work behind.

Coffeehouses (and tea houses) are great places to write.  I know that many of my students and residents routinely study in coffeehouses, but I never “got it”.  Now I do.  A good coffeehouse has just enough background activity that you have to focus to work… but not so much that it is distracting.  You are also protected from the day to day distractions of your office or home.  One of the great secondary gains of my month was learning about the great coffeehouses and teahouses in Houston!

From Pre-Med to Med: Making the Transition to Medical School

Making the transition from college to medical school is one of the biggest academic “leaps” a student can make.  I was recently asked to address the Texas Association of Advisors for the Health Professions on how to best advise students getting ready to start medical school.

There are more details in the slides I presented (Here’s a link to the slides:Transition to medical school), but the following are the “top ten” pieces of advice I passed on during my lecture:

1.  Arrive a week early (at least).  It’s important to build in time to move into your new home and make it a space you enjoy.  Make sure your electricity and cable are working.  Meet your neighbors, find a gym, stock your kitchen with healthy food.  It’s tempting to stay with your family (or add to your trip to Europe), but don’t – the time you spend getting ready to start medical is time well invested.

2. Buy a good computer (and the appropriate software).  Check on line to see if your school has specific requirements and make sure you meet them.  You’ll want a laptop, not a desk computer – you’ll be taking notes in class and carrying your computer around to study.  You’ll also be taking National Board exams on your own computer.  Most medical students at Baylor organize their notes with One Note (PC) or Growly (Apple).  You might want to buy the software and get used to it before you start.

3. Set up your study space before the first day of class.  You’ll be studying hard from the first day, so don’t put this off.  Most students buy two monitors and hook their laptop to the monitors to study (usually with a supplemental keyboard and mouse, but this is optional). Buy a really good chair for your desk.  If you listen to music while you study, invest in good speakers for your computer.  Keep your desk organized. Put some reminders on your desk of why you are doing this for the times it’s not so easy.  Consider a standing, walking or biking desk for your primary desk – or as a alternate desk.

4. Learn about active study skills and apply them from day one. Your study style in medical school will be different than what you used in college.  You have to learn all the material, as in really learn it.  It all builds on itself, so you can’t skip parts that aren’t interesting.  You’ll never cram for another test in your life – it’s all about learning, reviewing and repeating.  To get ready, learn about methods like the SQR3 method of studying as well as other systems.

5. Go to class (and be really present).  Unlike college you’ll need to use class time as active learning time.  Review the notes before the lecture and make notes during class.  Ask for clarification during class.  Most medical schools record the lectures as streaming video so you can review them later.  It might be tempting to skip going to class but don’t.  It’s easier to stay actively engaged if you are in class.  You’ll be able to ask questions about the things you don’t understand.  And, most importantly, if you don’t go to class you’ll miss out on the social benefits of being with your classmates.

6. Start with studying 1 hour for every hour of class.  Adjust up if needed.  The amount of material you cover in a semester of medical school is the equivalent of 30+ hours of undergraduate courses.  Medical school as a 60 hour a week job.  Schedule your “work” on a calendar to make sure you make your 60 hours.  When you tackle your hours of studying, use “study reps” – 45-50 minutes of all out studying followed by 10-15 minutes of absolutely no studying.

7. Exercise at least 30 minutes every day.  The real goal should be an hour a day, but the minimum should be 30 minutes.  You can “multitask” by riding your bike or walking to school.  Daily exercise is a great way to decrease stress, help prevent future work related injury and prevent the medical school equivalent of the “freshman 10”.

8. Plan your day so you can sleep 8 hours a night.  No sleep = poor synapse formation.  Poor synapse formation = no learning.  It’s that simple.  Don’t believe yourself or anyone else who says they “don’t need” 8 hours of sleep.  It’s just not true.

9. Eat real food.  Good fuel is necessary for your brain to make the synapses that are necessary for learning.  Eat well and often enough (every 4-6 hours) to keep you blood glucose stable.  Shop on the outside of the store (where they real food is) and learn to cook!  If you don’t cook, at least make conscious choices to buy prepared food that is healthy.

10. Make friends and work to maintain those friendships.  Social connections are one of the strongest antidotes to the stress of medical school.  Make friends among your classmates (because they really understand what you are going through) and maintain your friendships out of medical school (for the perspective they will give you).  Your significant other is your most important friend – so pay special attention to the time and effort you put in to supporting him/her.

Gratitude, Thanksgiving and Being On Call

Thanksgiving week is here. Our families will gather together to eat our traditional meal, swap stories, argue about whether cornbread or white bread dressing is better and nap on the couch while watching football. I’m in charge of the corn bread (my great grandmother’s recipe) and the corn bread dressing (my grandmother’s recipe).  It’s a great time to recharge and to be thankful for family, food on our table, and the many gifts in our lives.

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I’m not on call this Thanksgiving, but I have been in the past.  I have a fond memory of Thanksgiving when I was the Chief Resident in our county hospital Emergency Room.  I bought the traditional dinner, including a large turkey, for my team… and then realized we didn’t have enough microwaves to heat it up properly.  I won’t go into the details of how we handled the problem…. but it turned out that the rarely used autoclave in the ER was big enough for a turkey.  We were grateful for ingenuity and a hot dinner!

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I will be thinking of the physicians, in practice and in training, who will sacrifice time with their families this year to take care of others.  To the physicians, nurses, hospital staff, police officers, fire fighters, soldiers, clerks and anyone else who spend this holiday helping others – thank you.  We are grateful.

“Gratitude can transform common days into thanksgivings, turn routine jobs into joy, and change ordinary opportunities into blessings.”  William Arthur Ward

The Secret to Medical School is Practice

The first official event for new students at Baylor College of Medicine is Convocation.  One of the highlights of the ceremony is when a rising fourth year medical student is named as the DeBakey Scholar. The DeBakey Scholar Award was conceived by the Baylor College of Medicine faculty in 1973, as a tribute to Dr. Michael E. DeBakey, one of the founders of the Texas Medical Center and a medical icon, who was revered throughout the world as the most famous surgeon of the 20th century.  It is awarded by a select committee of faculty at the college’s Convocation Ceremony to a currently enrolled medical student, who has completed all but their last year of medical education. The recipient is considered to be “living model of excellence” in residence for the incoming freshman class and the other underclass students and is chosen because of demonstrated excellence in scholarship, integrity, academic leadership and service.

This year’s award winner, Nader Zamani, delivered an inspiring talk to the entering class which he called “ The Secret to Medical School is Practice”. I asked his permission to share the text of his speech with you here.

 

I’ve been asked to speak with you briefly this morning to tell you what I wish I had been told during my own orientation. Though I am hardly in a position to impart any advice, I can definitely tell you about my experiences over the last 3 years and what has been beneficial for me. And let me be among the first to acknowledge that the emotions of excitement, anxiety, intimidation, and even fear that you may be experiencing right now are normal.

They are normal because you know that medical school will not be easy. Yes, you will be pushed. You will experience physical and emotional challenges. And at times, your patience, and even your compassion may be tested.

However, through it all, you will thrive. And when you succeed, not only will you appreciate the journey that much more, but you will also realize how much you have accomplished.

Given the challenges of medical school, you are here because you deserve this opportunity. Though I completely understand that this in itself may be intimidating to know that you are now among a class of incredibly bright and driven students, this is actually one of the best parts of medical school. And to help calm some of your anxiety, please recognize that doing your best does not mean that you have to be the best in any one subject. Doing your best is simply an obligation to yourself to set realistic goals, to ignore the external concept of ranking, and to realize that it is acceptable to say “I don’t know.” In fact, this is only in this way that you will continue to learn and to adapt to the challenges that you may encounter.

Over the next few weeks, you will receive great advice from upperclassman and our wonderful faculty about how to do well. And over the next few months, you will develop study habits that allow you to digest and process the material that you are being taught. You’ll learn how to seek out opportunities that supplement your interests, and to collaborate with faculty mentors to develop a balance in your lives that not only fulfills the demanding aspects of medical school, but also caters to your own health. As I quickly realized, taking care of yourself is one of the most important aspects of medical school, and as you will see, we are lucky to be in an environment that not only realizes that, but makes it a priority.

I have heard many times throughout the course of medical school that to be successful as an academic physician, one needs to devote 1/3 of their day to reading, 1/3 to writing, and 1/3 to thinking. And most recently at the Department of Surgery’s Inaugural Research Day, Dr. Malcolm Brock of Johns Hopkins University told us that it is the thinking part of this formula that ultimately results in the quality research and discovery that has the potential to impact our practice of medicine.

The formula for medical school, however, has to be a little bit different. From my experiences, the 3 factors that would have to be in the formula are:

1) Studying – which includes actively keeping up with the material, asking questions, reviewing, really thinking about what you are learning, and trying to apply these concepts to a clinical setting.

2) Taking care of yourself – which includes eating well, exercising, trying to get enough sleep, and maintaining your social support systems.

3) And one of the most important factors — Service.

Similar to the thinking part of the equation of a physician’s day, the service part of the student’s formula can easily be deferred, especially considering our academic priorities. But I want to use this opportunity to urge you that this is the part of the formula that ultimately makes the difference. Taking time to reach out to others has provided me with the motivation to continue through this journey when it is easy to get bogged down by the stress associated with being in medical school. Whether service to you means working at a clinic, spending time at a shelter, tutoring, or helping your classmates, each one of us can serve our school and community by volunteering our time.

But as with anything else in medical school, you don’t have to do it yourself. By learning to work together with the amazingly talented people around you, you will grow as not only individuals, but also as a class. You will become a community with a sense of obligation toward each other, which is essentially a responsibility to help one another manage the trials that lie ahead. Ultimately, our life experiences may shape our practices, but it is our interaction with others and our service for our community that molds our profession.

I’m lucky to have attended DeBakey High School, because it was while I was there that I first became impressed by Baylor’s community outreach initiatives. Whether Baylor is working to eradicate disease on an international stage, supporting its relationships with undergraduate institutions throughout the state, or enhancing education throughout our local community, it is clear that many of our paths have led us here because of Baylor’s very own outreach programs.

It is in this very sense of community that I urge you to give back as well. You’ll be surprised at not only the inspiration, but also the perspective that you will receive as a result of your efforts. You will realize why you are spending so many hours studying, and you will begin to reevaluate what is truly important to you. In fact, your defining moments in medical school may very well be those in which you actually take a break from studying to reconnect with others.

It’s that very kindness and compassion required in medicine that truly makes our profession an art, one that requires a lifetime of practice. And it is this PRACTICE of medicine that demands so much of us. If there is a secret to doing well in medical school, it is to always keep practicing – practice your studying; practice asking thought-provoking questions; practice your self-care; practice your kindness; practice your service.

The Irish poet John O’Donohue wrote that with inspiration, we are able “To enter each day with a generous heart. To serve the call of courage and love.” We are all truly lucky and fortunate that we are here. We have been given an opportunity to learn not only how to help, but also how to heal. Despite the challenges that lie ahead for all of us, please remember that the road we are on is a privilege…so take advantage of it!

Congratulations, good luck, and we are all excited for you and for what is to come on your journeys here!

Applying for Your Residency

The following guest post was written by Daniel Fox, MD with the help of other residents in ENT  for medical students applying to otolaryngology.  I thought it was so outstanding that I asked his permission to publish a minimally edited version that would apply to all medical students applying in the NRMP match. 

The application process starts with knowing and understanding the rules.  The following are the websites that will help in this process:

Match Statistics hhttp://www.nrmp.org/data/index.html This will give you an idea about the qualifications of candidates that match into each specialty.

ERAS https://www.aamc.org/students/medstudents/eras/.This website is for applying to residency programs.

NRMP http://www.nrmp.org/.This website is for submitting your rank list.

FREIDA https://freida.ama-assn.org/Freida/user/viewProgramSearch.do. This website gives some very basic information about individual programs, but overall is not very useful.

Residency Program Director Survey (38% response rate) http://www.nrmp.org/data/programresultsbyspecialty2010v3.pdf.  This gives you an idea about what program directors value.

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Applications (in General)

  1. Talk to as many individuals as possible (MS4s, residents, and faculty) about the field you are thinking about.  This will help you obtain the most accurate overall information.
  2. Get ERAS completed and submitted the first week it opens (September 15th).
  3. You are able to resend your transcript when you get rotation grades back.
  4. You are able and should update schools on your AOA status.
  5. When you are invited for interviews is really dependent on the specialty.  For example,  ENT programs typically have a later timeline so you might only have 3 interviews at the end of October while one of your friends applying for pediatrics has 15.  They will come in time!
  6. Ask around the department, both at your own medical school and on your aways, to help find out which programs you should apply to.
  7. For competitive programs, an average applicant can probably expect interviews from 15-25% of the programs to which they apply.  The very good applicant may receive 50%, and the outstanding applicant may receive interviews from 75-90% of the programs to which they apply.  If you are applying in on of the very competitive specialties, recognize that many applicants applying have taken an entire year off to do ENT research, have a 270+ Step 1, have an additional degree (MBA, PhD), are former Rhodes Scholars, Olympic medalists, etc.  Don’t overestimate your qualifications as an applicant.
  8. There is no rhyme or reason to interview selection.  Even if you did an away at a program and were told that you would have an interview, this does not mean that you will have an interview.
  9. It is very hard to get interviews with schools in California. Most require Step 2 scores to apply (which means you need to take Step 2CK no later than the 1st two weeks of August)
  10. You should utilize program websites to construct a list of desired interview dates prior to being contacted by a program.  It is not a bad idea to have preemptive emails written to each potential program with your desired interview date, so that you can respond promptly when offered several interview dates.  This sounds entirely unnecessary and neurotic, but if you do not respond within the first couple minutes of receiving the email, your preference and possibly spot may be gone.  If you have a logical flow of interviews based on location, this can also save you a lot of money when coordinating travel.  Some programs do offer more interviews than they actually give, so if you don’t respond immediately, you may be wait-listed.  During the months of October-December you should not go anywhere without immediate access to email during the hours of 7am-8pm.  Be conscious of when you schedule Step 2 CS/CK as well because I know applicants that were not able to respond while in the exam and did not receive an interview as a result.
  11. I definitely recommend checking your “Junk Mail” box from time to time as one of my colleagues happened to check it one day and found an interview offer that they would have never seen otherwise!  An alternative to this is to change the settings on your “Junk Mail” folder temporarily so that every email goes to your inbox.
  12. Regardless of your personal competitiveness, be sure to apply broadly to programs. Don’t rule any programs out as being “above you” and don’t rule a smaller or medium sized program out as “below you.” Even your instincts on location may steer you wrong and you might be surprised by places you thought would be “too big city” or “too small town” for you. Exactly who various programs choose to interview is a strange process with strong applicants sometimes seemingly randomly being refused interviews at less competitive programs and moderately-competitive applicants landing interviews at those same programs. Often, it comes down to the “intangibles” of your personal statement and/or LoRs that may tip a program toward or away from offering you an interview.

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ERAS

  1. Extracurriculars are important in ERAS, and you can put anything that you did into the CV section.  Some college activities like research are acceptable, but mostly put medical school activities.  Please note that there is some disagreement on this topic.  I actually put nearly all of my undergraduate activities on ERAS.  You can also just choose a few that required that were especially impressive, time-consuming, or representative of your overall character.  Remember, if anything you have done can be positively spun in a way put it on ERAS, but don’t misrepresent your activities.
  2. You need to have an actual CV and not just what ERAS generates.  Ask for help with the format and appearance of your CV.  It’s important to start making the transition from a “student resume” to a “professional CV”.  Away programs and LOR writers will want your CV.  Also carry a copy of your application with you to interviews.  Though very rare, there are cases where the interviewer changed at the last minute because the intended interviewer was stuck in the OR.

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Personal Statement

  1. Have several people read your personal statement, including an attending.  Also have a non-medical person read it.
  2. Have it done in time to give to your letter writers.  Start early and revise multiple times.  This was something that a few of us wished we would have had done earlier to make it easier for our letter writers.
  3. This is a very, very important part of your application that can help set you apart from the other applicants.  Remember, for competitive specialties, program directors receive 200-300 applicants who all have mostly Honors on clinical rotations, mostly Honors in Basic science courses, and 235-250 Step 1 scores. Your personal statement is your opportunity to talk about what is important to you and what differentiates you. The goal is for the program director to finish reading your personal statement wanting to meet you.  However, do not exploit trite writing techniques (e.g. “I knew I wanted to be an ENT as I climbed that mountain peak in the Rockies”). If you play an instrument, talk about it and how it has improved your manual dexterity.  If you’re a parent, talk about how it has challenged you to be a team player and balance work and personal life; etc.  The ideal is to mention some personal things that demonstrate something positive about you.
  4. The personal statement is also a place where mentioning what you are looking for in a program is appropriate.

Letters of Recommendation (LORs)

  1. Ask the faculty member in person.
    1. All faculty members know how painful and difficult it is to ask for an LOR, so don’t be bashful in asking.  The consensus is that you should generally work with the person for the better part of a week before asking.
    2. A suggestion of how to ask: “I have really enjoyed working with you…Would you be able to write a strong letter of recommendation for me?”
  2. Give the letter writer a packet of information, including:
    1. Cover letter telling them about yourself
    2. Transcript
    3. USMLE Step 1 scores (probably not mandatory, but some will want it)
    4. Personal statement-It would be ideal to have your personal statement done as early as possible because your writers will ask you for this.
  3. Send everything electronically to both your letter writer and his/her administrative assistant.  The assistant will make it happen.  Thank them with something appropriate – a thank you note, a small gift like chocolate, a Starbucks card or a small bouquet.
  4. It is probably best to have a mix of LOR types.  Ideally you will have at least one nationally well-known writer and at least one that is very personal and speaks toward your character.  Every field expects variations on who should submit letters, so make sure you understand these expectations.
  5. Residency directors like to read letters from other residency directors.
  6. Any faculty member who knows you very well can write a personal letter.  Senior faculty will always have more “impact” than junior faculty for an equivalent letter.
  7. Away rotation residency director/chair.  If you have an away early enough and can procure a letter, it is a good idea because programs like to see that you impressed people outside of your institution.  It is not the end of the world if you don’t get a letter an your away though.  The organization of away rotations can make it impossible to obtain a letter.  If you want to get a letter, it is very beneficial to set up a meeting with the appropriate faculty member or chairperson at your away rotation during the 2nd or 3rd week of your stay and make your interest known that you would like a letter of recommendation.   Ask what you can do to facilitate this.  This will allow you to schedule time to work with him/her if you haven’t already so that they can decide whether or not to support you in your application process.
  8. Letters should ideally be uploaded by September 15th when ERAS opens to the programs.  Every program knows that some faculty procrastinate.  Don’t hound the faculty (although one or two gentle reminders are ok).  Programs will decide to interview you even if all the letters aren’t there when they are making their interview lists (mid to late September).
  9. All schools require at least 3 LORs.  You can submit up to 4 at most programs and should try to get 4 if you can.  You have to individually assign each LOR to each program, so you can use any combination of LORs you wish for a given program.  The same is true for personal statements, if you desire to write multiple personal statements.

Away Rotations

  1. Try out programs you think you might like.  It is a chance to unofficially audition before interviews; You can either impress them or destroy your chances for an offer, so work hard!
  2. Do away rotations early so you can get letters and try out programs before interview season, which centers around November-December. Be cautious about doing two aways in a row.  Even if you think that you are a machine, you will be very tired by the end of these 2 months, and that can come across poorly to programs.
  3. Aways are not required, but can help your chances at a program if you do well during your stay.  Aways, however, will not help you with any program other than that one.  In fact during interviews, you may be asked why you did an away at one program and not where you are currently interviewing.
  4. Keep in mind that doing an away rotation does not guarantee you an interview with that program.  If that is important to you, look for programs that automatically offer you an interview.
  5. If you know you want to get out of your state, do an away rotation far away.  It will show programs that you are an applicant who is mobile and could really be interested in their program.  You’ll be surprised on the trail how large of a part the “How interested are you really in coming to join us?” factor plays.
  6. Get your VSAS info in ASAP, and make sure you know what each program requires; VSAS is the website used to apply for away rotations.  Some programs have very complicated requirements like having titers drawn and drug tests, and they will not consider your application until you submit all of the necessary info.  Some of these processes take time (i.e. you may have to have 2 negative PPDs 7-10 days apart.)

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What to Look for in Programs

This is a very individual decision but here are some brief suggestions (not in any order):

  1. Location, cost of living
  2. Resident-faculty relationship
  3. Friendly, happy residents and faculty.  One way to assess this is talking with chief residents who have little invested interest in which applicants match.  If a chief is still a strong cheerleader for his or her program, that is a strong positive.   Keep in mind that these are the people you’re going to be working with day in and day out and will probably become you’re closest friends, especially if you’re moving to a new location.
  4. Faculty covering all sub-disciplines in your field, particularly if you think you will be interested in subsequent fellowship training.
  5. Faculty that love to teach and are dedicated to their residents.  Getting jobs and fellowships is very dependent on who you know and how willing these faculty members are to support you in pursuing career goals.
  6. Surgical or procedural volume; clinic volume; exposure to a breadth and volume of complex patients.
  7. Adequate autonomy afforded to residents.
  8. Fellows vs. no fellows.  There are pluses and minuses to both.  Doing an away at a place with fellows might help you determine your preference.
  9. Budgets for books, loupes, meeting travel.
  10. Clinic/OR locations.  Are you going to have to travel to cover multiple hospitals at night?  Are there away rotations?
  11. Mission trips.  Many residents have the opportunity to go on trips with faculty members within or outside their program.  Will you have to use vacation time to do this?  What about funding?
  12. Significant, quality research and faculty willing to mentor you with research projects.
  13. A place that will provide reasonable benefits.  THERE IS A LOT OF VARIATION IN BENEFIT PACKAGES SO READ CAREFULLY.  Also, there are many states that do not have a state and/or local income tax.  Family health insurance can vary from almost free to more than $6000/year.
  14. “Moonlighting” possibilities. Moonlighting counts in your 80 hour limit on weekly duty hours and must be approved by your program director.  That being said, within those parameters, it’s something that is possible in many programs.  Most students are afraid to ask this question.  Only ask residents about this and not faculty members.  If you ask, you will find that about 75% of the programs allow moonlighting.  You can find some of this information in the resident compacts posted on department websites.  For the most part, a lack of moonlighting is not a big deal for single residents, but can be important for applicants with growing families and a spouse that stays home.
  15. Program stability.  Looking at past department newsletters that have faculty listings can give you a good idea about faculty turnover.
  16. Home call versus in-house call. Home call isn’t necessarily better, especially if you are frequently up all night and don’t get to go home early the following day.  Also, how many hospitals are you covering?  Are they in the same location or spread throughout the city?

What Programs Want

Try to figure out what you would want in an applicant and be able to give examples of how you display these qualities.  Always be yourself though.  It is not beneficial to anyone to be a chameleon and take on whatever role you think the interviewer wants you to play.  You expect programs to put their best foot forward but also want transparency and humility.  Likewise you want your personality to come through so that they can evaluate you.

Some components of the “perfect” applicant are as follows.  Clearly, this comes from an applicant perspective, but after doing 100-150 individual interviews, you will develop sufficient insight into the interview process.  There aren’t many people outside medicine that do this many interviews in a career.

  1. Intelligent-don’t emphasize this in interviews.  Everyone granted an interview is intelligent.
  2. Excellence-someone that has a built-in desire for excellence in all areas of life and doesn’t need external motivation to excel.  Try to demonstrate this by giving examples outside of medicine.
  3. Team Player-someone that can work will with others. You will be asked multiple times about an experience where one member of a team was dysfunctional and how you handled it.
  4. Self-sacrificial-someone that recognizes that medicine is not about them but the patient.
  5. Learner’s spirit-you will be asked multiple times about a mistake you’ve made in the past and how you’ve learned from it.
  6. Thoroughness/Organization-this can be demonstrated by mentioning something about the interviewers background indicating your prior research about the program/interviewer.
  7. Personable-if this is true, it will come across in the LORs and interviews.
  8. Good Hands (for procedural or surgical fields)- a faculty member told me about a resident that made purses as a hobby and conveyed manual dexterity through this story.
  9. Mature/Responsible-evident through life experiences and decision-making processes.
  10. Contributor-someone that contributed to their medical school or a department and wasn’t simply a consumer.
  11. Initiative-be able to give examples of how you take initiative and are self-directed.
  12. Leadership-you will be expected to be a community leader.
  13. Interest in educating others- The root of the word “doctor “ is “to teach”
  14. Honesty-this is almost assumed, though you may be asked to tell about a time that you lied.
  15. Work experience-residency is not only a training experience but also a job.  Past work experiences can show a willingness to work hard, how to submit to superiors, and knowing how to fit into a team.  Programs will want someone that is a hard worker and hasn’t been given everything on a silver platter.
  16. Good communicator: practice responses so that they are succinct.
  17. Self-reflective-applicants that know themselves well, can articulate goals, personality.
  18. Attitude-someone that is positive, enjoyable to be around, and not an Eeyore.

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Travel/Expenses

  1. Look for alumni of your medical school (particularly recent graduates who just went through this process) that would be willing to house you for interviews.  If they do, take flowers, chocolate or memorabilia from your medical school as a thank you present!
  2. Stay with family and friends in surrounding areas.
  3. Take advantage of family member’s frequent flier miles.
  4. Develop a strategy to increase flexibility and decrease cost for your airline travel.  Look for flexibility in buying and changing tickets.  Many of your interview dates will be changed at the last minute.  Southwest airlines is probably the most flexible about this (and has no change fees).
  5. Use priceline.com’s name your own price for hotels and rental cars.
  6. Most hotels offered by programs are overpriced.  You can priceline the same hotel recommended by the program for half the price.
  7. Look into whether your car insurance and credit card provides collision, loss of use, and liability insurance.  Most should not have to buy the supplemental rental car insurance.
  8. Rather than flying directly into your destination city, consider flying into nearby cities and getting a rental car.  If you have the time, you can save significant amounts of money.
  9. Check out MegaBus, train schedules or other mass transit (more prevalent in some parts of the country than others)
  10. Consider asking family members to help you drive.  This can cut down on the number of flights you have to take.
  11. Be strategic about which suitcase you have (and make sure it’s not shabby) and how you pack it. Never check any bags when flying.  You get 2 carry-ons (suitcase and interview clothes).
  12. Use the same packing list.  Make sure to include:
  13. Printouts on program/residents
  14. Maps/Directions to campus, hotel, airport
  15. Umbrella
  16. Keep a travel expenses log to get more federal loan money.  There is some debate about whether you can deduct travel expenses for tax purposes, but several CPAs I have spoken to say you can.

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Interviewing Tips (General)

  1. If wait listed, write an email indicating your continued interest.  This actually works!
  2. Email the residency coordinator about places residents live.  This will show genuine interest and will allow you to evaluate the area. Exploring each city not only gives you full disclosure but also shows the program that you would seriously consider moving to their city.
  3. You should probably buy an interview portfolio and a nice pen.
  4. Make sure your clothes are professional and appropriate.
  5. Carry a toothbrush and mints on you.
  6. Allow for time to iron clothes.
  7. Don’t forget to get your hair cut and to clean your fingernails.
  8. Concise replies that answer the question are usually better than rambling.
  9. Ask clarifying questions when presented with uncomfortable questions
  10. Have $25-50 in one dollar and five-dollar bills so you have easy cash access to pay tolls when driving through big cities or for parking at hospitals if it is necessary.  Not all programs will validate parking. If there is a parking attendant, remember how little money they make and think about leaving them a little something for a cup of coffee, too.
  11. Obtain a schedule of the interview day beforehand when possible.
  12. Maximize the “down time” to see other aspects of the program. (i.e. cafeteria, library, resident rooms)
  13. Plan to be at each program 1-2 hours later than expected.  Interviews often go long.
  14. Know the entire faculty by name prior to meeting them.
  15. Know in general faculty research interests.
  16. Google them, look up their publications on PubMed, etc.  Don’t flaunt this, but if the door opens to use this information it will make you look great.
  17. Have a bio printed out (or at least notes) with you on each faculty member!
  18. Know all the residents by name and medical school/undergraduate.  This may seem like overkill but the residents will remember that you took a specific interest in them.  It will also serve as a conversation starter.
  19. Know what the program is proud of and be enthusiastic about those points.
  20. Know how to pronounce the name of all those with whom you interview.
  21. If you’re given a question that you can’t answer easily, you can always say that you’ll have to think about that.  Can we come back to that later?
  22. Bring several copies of your research work if published.
  23. Bring copies of written core evaluations to counter any questionable grade.
  24. Many interviewers will ask why you don’t have an honors in the major core rotations, particularly if its in your chosen field.
  25. Reflect on each interview day
    1. What went well?
    2. What could have gone better?
    3. What do I still not know?
    4. Did I sell myself?
    5. Make notes the day of the interview – it’s too easy to forget the details if you wait.
  26. Plan to send an email or written note after you interview that emphasizes the following:
    1. Thank you for opportunity to interview
    2. Strengths of the program
    3. How you fit into the program and why you would be an excellent choice

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Questions you are Likely to Be Asked During Your Interview

These questions are compiled from both actual interview questions and possible questions.  Many of these questions you will never hear, but going through this list will help you know yourself better and be able to more fully communicate it.  You should practice the answers to questions with another person listening.  Also, one crucial skill is to figure out why an interviewer would ask a question.

Introductory questions

  1. How are you today?
    1. Great, glad to be here, great program, great area, great people GREAT!  It is very clear who is interested in a program and who is going through the motions.  If you spent hundreds of dollars on an interview than you should be enthusiastic.
  2. Tell me about yourself
    1. Brief biographical outline
    2. Strengths
  3. What makes you stand out from all the others?
  4. WHAT ELSE WOULD YOU LIKE TO KNOW? Don’t ramble and don’t guess what the interviewer wants to know—ASK.

Background Questions

  1. How did you choose undergraduate, medical school?
  2. What are your three biggest accomplishments?

Medical School Questions

  1. How did you do so well as a medical student?
  2. What kept you from doing better during medical school?
  3. Why did you do an away at … and not here?
  4. What did you like about the program(s) you did away(s) at vs. your home program?
  5. Why didn’t you get letters of recommendation from your aways?
  6. What is your favorite surgery/patient/day at work?
  7. Tell me about the most interesting case/patient you’ve seen.
  8. Tell me about a particularly satisfying or meaningful experience during your medical training.
  9. Why don’t you have any publications?
  10. What is the greatest sacrifice you have had to make to get where you are?
  11. Tell me about your research—often a specific project.
  12. Why did you get not get an honors in surgery/medicine/pediatrics/etc?
  13. Which patient did you learn from the most?

Values/Personality Questions

  1. Tell me about your strengths and weaknesses.
  2. Strengths-see above and give in the context of a story.
  3. Weaknesses-focus on something that is an “acceptable” weakness
  4. Tell me about a time that you failed at something?  What did you learn?
  5. Tell me about the most difficult challenge you’ve faced in your life?
  6. Tell me about how you’ve grown and changed as a person during medical school.
  7. How have you been able to maintain a work-life balance?
  8. Three adjectives that best describe you?
  9. How would your best friend, parents describe you?
  10. If I gave you $5000 what would you do with it? $50,000? 1 year?
  11. What is your energy level like?
  12. How well do you function under pressure?
  13. Tell me a story about yourself that best describes you.
  14. Tell me about an obstacle that you’ve had to overcome.
  15. What would you want on your tombstone?
  16. Tell me one thing that I wouldn’t know about you from this packet?
  17. What was the most difficult decision in your life?
  18. What is the most difficult stand you’ve ever had to take?
  19. What have been your biggest failures in life?  How do you ensure this won’t happen again?
  20. With what type of person do you have trouble working?
  21. How would you handle a situation where a senior resident or attending asked you to do something you thought was wrong?
  22. Give me an example of when you have disagreed with a superior and how you handled it.
  23. Most useful criticism you ever received?
  24. What did you do to prepare for this interview?
  25. How do you make decisions?
  26. If your house were burning down, what three objects would you grab?
  27. If you could have 3 wishes, what would they be?
  28. What in your life is most important to you?
  29. Who are your heroes?
  30. What is the last book that you read?  You will be asked this question 10+ times.
  31. What is your favorite movie?  You will also be asked this question repeatedly.
  32. What do success and failure mean to you?  How do you measure these?
  33. Interests outside of medicine?
  34. If you could do anything for a day, week, month, what would you do?
  35. What’s on your bucket list?
  36. Describe your best friends?
  37. Single most valuable thing that you have ever learned?
  38. Life goals?
  39. What was the most important event in your life?
  40. Why do others see you as a leader?
  41. What has been the most difficult thing you’ve ever done?
  42. How have you changed since high school? College?
  43. What might give me a better picture of you than your resume?
  44. Pet peeves?
  45. How well do you take criticism?
  46. What motivates you?
  47. Tell me a joke.  You will definitely be asked this so have a quick, clean, funny joke on hand.
  48. What has been the most traumatic event in your life?

Specific Questions about your specialty

  1. Why [specialty]?
  2. Why surgery over medicine? Medicine over surgery?  Children over adults?
  3. Do you see yourself in academics or private practice?
  4. Do you think you’ll do a fellowship?
  5. What do you want to accomplish as an [specific specialist]?
  6. Career Goals?
    1. 5 year
    2. 10 year
    3. 20 year
    4. 30 year
    5. 40 year
  7. Most enjoyable part of [specific specialty]?
  8. Toughest aspect of [specific specialty]?
  9. If [specific specialty] didn’t exist, what would you do?
  10. If medicine didn’t exist, what would you do?  You will be asked this many times.
  11. What will be the biggest issues our specialty faces over the next five/ten years
  12. Do you play a musical instrument?  Did you play on a competitive sports team ever?  These are 2 of the 3 “predictors” for who will be a good surgeon per a recent paper.  The third is the quality of medical school attended.  Don’t put too much weight on this if you don’t play an instrument or weren’t on a sports team, but several interviewers will ask about this if you are going into a surgical specialty.

Program Questions

  1. Where else have you interviewed?
  2. How would you describe each of those programs?
  3. Other than here, what program has impressed you the most and why?
  4. What are you looking for in a residency program?
  5. Why did you want to come here?
  6. What one thing do you want conveyed to the residency committee?
  7. What if you don’t match?

Why Me Questions?

  1. Why should we pick you over the other applicants?  What will you contribute?
  2. What one characteristic qualifies me more than any other candidate?

Residency Questions

  1. How do you plan to succeed as a resident?
    1. Academically?
    2. Clinically/Surgically?
    3. What are your plans for research as a resident?

Odd Questions

  1. Give an example of a problem you solved and describe how you went about solving it.
  2. Teach me something in 5 minutes.

You will often be asked if you have any questions as the last part of the interview.  Be ready!

Questions to ask faculty

  1. For each faculty member, ask why he or she went into academic medicine.
  2. Where are your recent graduates?
  3. What percent of graduates enter a fellowship?
  4. In what ways do faculty members help residents obtain jobs/fellowships?

Questions to ask program director

  1. What is the program’s educational philosophy?
  2. What is the best example in the program of faculty dedication to resident education?
  3. Where do you see the program in 5 years?
  4. What changes have been made in the recent past based on resident feedback?
  5. In training exam scores?
  6. Percentage of residents passing oral and written boards first time?
  7. Mentoring system?
  8. How many residents go to academic meetings?
  9. Do you expect any curriculum changes in the near future?
  10. What does this program see in me and why was I offered an interview?
  11. May I have a copy of this month’s didactics schedule?

Questions to ask residents

  1. Would you choose this program again?  Ask different residents, and look for the blink reflex.
  2. Which parts of the program do you like the best, least?
  3. How would you characterize faculty-resident relations?
  4. For key faculty members, give me 2 positives and 2 negatives about working with them.
  5. Have any residents in the near past left prior to graduation for any reason?
  6. Moonlighting policies, opportunities, and participation?
  7. If a 4th year resident announced his/her intention to pursue private practice, how would faculty view this?
  8. How many times have you been to a faculty members home in the past year?
  9. Have any faculty members been recently added?  How long do you expect the chair and program director to be in their current positions?
  10. Access to books?  Online?  Textbook money?
  11. Do you have time to read?
  12. Midlevel providers (NP, PA) help?
  13. Percent of in house vs. home call?
  14. Percent of time you come in when on home-call?
  15. Taught by residents or faculty members?
  16. Past case numbers (for surgical specialities)?  This is changing to a competency system but past numbers can give you an idea of volume.
  17. Approximate number of hours for each PGY level per week?
  18. Call schedule?
  19. Benefits package: obtain from Graduate Medical Education Office though residents will know too.