- Career Choices
- Balancing Priorities
- Residency Interview Tips
- Second Look Interviews
- Research and the Resident Application Process
- Preparing Your Final Rank List
As you are beginning to think about your career choices more seriously, consider this algorithm to you to help in the decision-making process:
First, try to decide on the basic distinction between a medical specialty and a surgical specialty.
Then, if you decide on surgery, consider issues related to lifestyle, competitiveness of the specialty, patient gender focus (i.e., ob-gyn –>only women patients), age focus (i.e., pediatric surgery is age-limited) and your individual competitiveness. Those considerations should help you narrow your choices.
If you decide on a medical specialty, then consider the basic issue of no or minimal patient contact (pathology, radiology) vs extensive patient contact (all other medical specialties). Then think about continuity of care vs no or minimal continuity of care. If you prefer the latter, then specialties such as PM&R, Anesthesiology, and Emergency Medicine seem most appropriate. If continuity of care is extremely important to you, then Family Medicine, Pediatrics, Psychiatry, and Internal Medicine seem most appropriate. Finally, consider the issue of a procedurally oriented specialty (Emergency Medicine, Anesthesiology, subspecialty areas in Medicine and Pediatrics) vs non-procedurally oriented specialties (Family Medicine, Psychiatry).
During orientation week for each of your classes, I spoke with you about the importance of striking the right balance in your life. In my opinion (speaking as the father of 4 grown children, a physician, and an educational administrator), at this time in your life, I think you should have three major priorities:
- Preserving your own emotional, spiritual, and physical health
- Caring properly for your loved ones and friends, and
- Doing as well as possible in school.
Depending upon circumstances, the relative importance of each of these priorities will need to change from time to time.
Important, but definitely secondary priorities, include participating in extracurricular activities such as Equal Access; AAMC, AMA, AMWA meetings; student interest groups; and intramural sports. If you are “in balance” with respect to the priorities listed above, I think it is fine to pursue these secondary priorities. However, if you are having difficulty in any of the 3 areas (health, family, schoolwork), you need to re-establish balance. All of the altruistic activities in the world (admirable though they may be) will not compensate for a “failure” in school, loss of your good health, or deterioration in personal relationships.
If you are experiencing difficulty in any of the three key areas of your life, please take advantage of the many resources available to you. All of your basic science professors are intensely interested in your education and will do everything possible to help you succeed academically. Please also know that Dr. Dede, Dr. Fantone, Dr. Harrell, and I are here to assist you in any way we can with personal and academic issues.
Residency Interview Tips
If you pay careful attention to these few practical suggestions, I think you will have a more enjoyable experience with this exciting, but unsettling, process.
- If you must cancel an interview, please be sure to speak directly to a responsible person. DO NOT rely on message recorders or e-mail. Please try to give the program as much advance notice as possible so that your interview position can be filled by another candidate.
- Please schedule your interviews thoughtfully. Try to complete your travel in the early afternoon on the day prior to the interview. Please do not rely on late-afternoon and evening flights that may well be delayed (flight delays build up as the day progresses) and get you into an unfamiliar city late at night (or not at all)….fatigued and hungry. Many programs, if not most, have some function on the evening before the interview, and these informal sessions are a great opportunity to meet the residents and ask them detailed questions about the education program.
- If the program at which you are interviewing has a social event the night before, or the night of, your interview, you should make every effort to attend. This is your key opportunity to meet the residents on an informal basis (and vice-versa) and to learn a great deal about the day-to-day reality of working in the department. I realize that, in some cases, your airline flight may not allow you to arrive in time for the social event. However, whenever possible, make sure you attend these social events. Failure to attend the event may be perceived as lack of serious interest on your part.
- BE ON TIME FOR YOUR INTERVIEW. Do a “dry run” on the afternoon before the interview so that you know exactly how to get to the room where the orientation session is held.
- Dress appropriately for the interview. Men should wear a conservative suit or a blue blazer and grey slacks. Women should wear comparable attire. Flashy or immodest clothes or unusual jewelry or hair styles will attract just the wrong type of attention.
- Do your homework beforehand. Be able to explain in detail exactly why you chose the program — i.e., suggestion of your adviser, national reputation, recommendations from recent graduates of that program who are now house officers at UF, unique training opportunities, job opportunities for your significant other. Do not just say you chose a given program because you like warm weather, have a relative in the area, or like the proximity of the program to the ocean or to an attraction like Disney World.
- Have a list of questions that you ask EVERY faculty member who interviews you. Toward the end of the interviews, do not just say, “I guess I have no questions because they already have been answered.” It is fine to ask the same questions of many different faculty members and residents. If their answers vary dramatically, that may be a red flag that something is amiss.
- KEEP YOUR ENERGY LEVEL UP THROUGHOUT THE DAY. When I reviewed the interview performance of over 200 students who applied for our ob-gyn training program in the last 5 years, the single biggest reason for a low interview score was ” did not appear interested, no spark.”
- BE ON YOUR BEST BEHAVIOR THROUGHOUT THE DAY. Do not be rude to administrative personnel who you may perceive as “unimportant” in the interview process. Avoid too great a sense of familiarity with the residents. Do not curse. Be wary of drinking ANY alcoholic beverage even though the residents may “imbibe.”
- As the interview concludes, ask the program director what is expected in terms of future communication. Some program directors will want you to stay in touch and indicate that your interest in the program is sustained. Others will not expect you to contact them again. In turn, they will probably not contact you again prior to the match, and you should infer nothing negative from their silence.
Second Look Interviews
The official position of the AAMC and this office is that such interviews should NEVER be required of a student as a condition for demonstrating sustained interest in a program. Second-look interviews should ONLY BE FOR YOUR BENEFIT, that is, to reassure you and/or your significant other that a given program should be at the top of your list. You should regard the second-look interview as an informal opportunity to spend more time within the department, meet additional residents, and re-assess desirability of a given geographical locale. If you do a second-look at all, I recommend that you limit the number of such visits to a maximum of 2.
Research and the Resident Application Process
A number of students ask about how research might influence the residency application process. Please carefully consider the points outlined below.
- First, with rare exceptions, most residency programs will not regard research experience as a “deal breaker” or “deal maker.” Some very highly competitive specialties clearly prefer that their candidates have research experience, ideally in that particular field. However, unless you already know for sure what you want to do with the rest of your life, it will be hard to tailor a research experience between years 1 and 2 that will be ideally suited for enhancing your chances for a particular residency.
- When you do engage in research, you want to make sure that it is a SUBSTANTIVE project that leads to a final work product (abstract for presentation at a meeting and publishable paper) and that you get to play a meaningful role in the conduct of the investigation, analysis of the results, and preparation of the abstract/manuscript. “Doing research” but playing no meaningful role in the investigation is not going to be a worthwhile use of your time.
- When all things are considered, what most influences your chances for selection for the residency of your choice are: USMLE Step 1 and Step 2 scores, clerkship evaluations, letters of recommendation, and the interview. Other things being equal, substantive research experience may give you the nod over another applicant. However, short-term, low-yield research in which you play no meaningful role is not going to be a decisive factor in your selection for a residency program.
Preparing Your Final Rank List
Please remember that these are simply guidelines, not absolute rules. However, I think you will find them helpful as you try to make these exciting decisions.
- Be certain that you have included an appropriate number and mix of programs based upon your degree of competitiveness and the competitiveness of the specialty for which you are applying. I recommend a minimum of 10 programs (3 to 5 more for a couples match). I also recommend that, for those of you who must apply for preliminary or transitional programs, that you include at least 7 programs to ensure a match.
- Do not rank any program in which you would not like to train. If you are unsure about a program, ask yourself this question, “Would I rather go unmatched than train here?” If your answer to the question is “yes,” do not rank that program. Please remember that entering into the match program is equivalent to signing a contract. You are obligated to live up to your end of the contract which is to “honor the match outcome.”
- Rank programs entirely according to your preferences. Please do not try to “guess” how a program will rank you or to negotiate a quid pro quo agreement ( that is, you will rank the program first if it ranks you first). Efforts to guess your possible ranking are fraught with uncertainty and often lead to major disappointments.
- Do not be misled by a program that seems to “show you more love.” If that is not your first choice, do not make it your first choice just because the program seems to “court” you more than your true first choice. No program will know how you rank it. You lose nothing by sticking with your own first choice. For example, if you like program A the best, list it first, even if program B is putting on a bigger recruiting pitch than A. If you match at A, you have achieved the ideal outcome. If you fail to match at A, but B truly has you at the top of its list, you will then match at B even if you listed it second on your list.
- Trust your basic “gut instinct.” It is more reliable than any numerical rating system you could devise.
- Remember that interview day is the “best” a program will ever look. If you have some reservations after your interview, those doubts are likely to be amplified when you actually work in that department.
- If you are applying as a couple, please remember that you can prepare your rank lists based on both individual medical centers and city of preference. You maximize your chances for a desirable match if you list different programs in the same city.