<p>"there is a huge regional bias when it comes to interview invites (you will be interviewing at a lot of places close to your med school or close to family). "</p>
<p>-Very usefull info. Thanks.</p>
<p>Son is currently at an interview. Just thought I’d post about how unique it is. He was told no suit or tie, just to bring comfortable shoes. He was to report at 6AM at which time he would change into scrubs and spend the day in surgery. What better way to interview a candidate for a surgery residency than in the OR while participating in various procedures?</p>
<p>He was very psyched about the day. Hope he feels the same way afterwards.</p>
<p>22 interviews scheduled and most of the Cali programs still haven’t given out any. I’m pretty much capped. I will be cancelling 1 interview for every interview I schedule from now on. </p>
<p>I did 3 interviews this week. All pretty laid-back. At this point, scheduling interviews has become more stressful than doing interviews. I received an interview invite to a place I wanted to go to yesterday. I was doing an interview at another place but called right after (roughly 1.5 hours after receiving the invite). By then 6 out of the 7 interview dates had been filled.</p>
<p>S got an invite today from one of his top 5. He’s been in an interview all day on the West Coast. He just found out while on a break and is praying that the slots don’t fill before he has the opportunity to respond. I’m praying it hasn’t filled because it’s one of his top choices and in one of his top locations as well.</p>
<p>Gosh! The interview rounds at residency seem to be far more stressful than the med school rounds of interviews. On ophth threads, I see students applying to nearly 40 places. Good luck to you all.</p>
<p>I think the residency programs are in control of the entire interview process up until the actual match. The actual matching algorithm favors the applicant. It attempts to maximize applicant satisfaction at the expense of the programs’ preferences. </p>
<p>For example, there’s probably a really stellar group of 30 applicants to radiology with 260+ USMLE scores, AOA, 5 pubs. These 30 applicants likely interviewed at most top 10 radiology programs. Let’s assume they’re great at interviewing and are ranked among the top 30 applicants that these programs interview. Well, the 30 applicants have their own preferences. Some may prefer WashU for radiology, some may prefer UCSF, some may prefer Mass Gen, and some may prefer Johns Hopkins. In the end, even if all 30 top-notch creme-of-the-crop applicants choose to go to top 10 programs, on average each program is only going to receive 3 of these applicants. Yet, each program has now gone through the top 30 in its rank list and has only filled 3 out of the 10 or so spots available at each program. This means the other 7 residents at each program is likely to come from the bottom 50 on that program’s rank list (radiology programs interview ~80 total applicants each year). So, while each individual applicant likely received his top or 2nd choice in residency programs, residency programs, on the other hand, have to dip often into the 2nd half of their ranklist to fill their spots. Despite the fact radiology applicants routinely interview at 15-20 places, 60% of all applicants match at one of their top 3 preferences, which isn’t too bad. The number is as high as 90% matching into their top preference for specialties like internal med or family med. </p>
<p>This new algorithm was instituted not too long ago (~15 years ago) as the previous one favored the programs and the NRMP was actually sued. This is also the reason why programs engage in all kinds of match violations (including telling applicants where they’re being ranked, flat out LYING to applicants about where they’re being ranked, and all kinds of other posturing). They are really at the mercy of the applicant come match time and they want to retain the best applicants. The radiology program director at my home program flat out told us that we can’t trust anything he says to us on our interview day.</p>
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academic centers where residents do most of the off-hour readings [/q;uote]</p>
<p>With new payment rules, staff now have to read off-hour for payment and regulations and 80 work week for residents. Alot of the review is done at home though does it make any differance to awake all night at home or in your office at the hospital.</p>
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<p>The new work hour rules have very little impact on radiology residents because most of them didn’t come close to the limit in the first place. The new rules seem to impact internal medicine and surgery residents a lot more. At most academic programs and some of the community programs I’ve seen, off-hour readings are done by residents. The residents may or may not be overread by attendings depending on if the hospital chooses to have 24-hour attending coverage or not. At my home program, for example, there is no attending coverage overnight by design. This means that the resident’s prelim read is the only read until an attending staffs it in the morning. This is to get the residents to grow some balls. At other institutions, there is an attending there at all times and the residents’ reads are finalized almost immediately.</p>
<p>Norcal
Are we talking a county hospital (where surgical residents still operate without attending skin to skin)?
At academic hospitals the rest of the med staff would demand attending reading as does risk management</p>
<p>lol This is an academic hospital and a pretty good one at that ;)</p>
<p>You would be surprised at the number of programs that does this. I see the advantages and disadvantages of both systems. </p>
<p>Even during the day, I would say that clinicians are grateful for a read, even if it’s a resident read (knowing an attending will not staff it until the late morning or afternoon). I think how much the clinicians trust the residents depend on what kind of experience they’ve had with them in the past. From my experience of observing readouts for 2 months, the senior residents (2nd-4th year radiology residents) are pretty spot on in their reads.</p>
<p>They have actually done studies on this. Subspecialist attendings reading studies that are outside their field of specialization (ie a neurorads attending reading a body CT) have error rates similar to that of senior residents. Thus, having a 24-hour attending doesn’t actually ensure greater accuracy.</p>
<p>Both academic centers I’ve personally worked at have not had 24 hour staff coverage, so resident reads are the norm overnight. I’ve definitely seen plenty of ER callbacks in the AM after staff overreads. Of course, the added layer is that all pediatric films are essentially a subspecialty field (NCG - whatever you do, never tell the peds resident calling you at 3:30am to answer a question that you hate reading pediatric films…it’s not going to go over well for you). And most of the places where I interviewed for fellowship only had resident coverage overnight.</p>
<p>Of note, I find the specialization argument interesting because the pediatric radiologists are specialized, but they end up being body system generalists for the most part (we do have one radiologist who has done neuro and peds fellowships and so is super-sub-specialized). It’s a similar construct for the pediatric surgeons, who over the course of the day may end up doing 4 or 5 different procedures that in adults would have gone to 4 or 5 different subspecialties. As one of the peds surgery fellows told me, peds surgery is the last place where you really get to do the expanse of what surgery has to offer.</p>
<p>I think it’s about practice. Peds radiologists don’t specialize per se in a body part since they read imaging of the entire body. Thus, their skills remain sharp because they read imaging of the head, thorax, abdomen, etc. on a daily basis. Whereas a board certified neuroradiologist will only read head imaging 99% of the time. They’re on call once every few weeks and that’s the only time they get to read a body CT or an extremity x-ray. </p>
<p>I think it’ll be interesting to see how 24-hour attending coverage works at community hospitals. At academic centers, there are usually plenty of subspecialists and generally everyone only reads films in their area of specialization. At smaller community hospital radiology programs, there may not be enough subspecialists and thus everyone is a “jack of all trades” radiologist. This does not bode well for day-to-day training since you want to be trained by a specialist but these generalists may be more useful on call since they’re used to being versatile.</p>
<p>Must have different places. Have worked at 4 University Hospitals (Ive League to State School) and one County. Only the County had residents. All of the academic ones had staff reading - especially in this day of risk management. The senior resident might have read or done the exam – but his staff read digital copy within several hours.</p>
<p>I believe that will be the norm now. Our radiology residents don’t even take more than one night of “night call” due to the 80 and soon to be 60 hour work week.</p>
<p>I’m not really sure why this is so shocking. In internal medicine, overnight admits are done by residents (often interns) and aren’t staffed until morning. If you have quality residents, you will trust them.</p>
<p>Princess’Dad: What about the work week for surgical residents (general, ortho and neuro)? Does your institution limit every week to 80 hours or is “compliance” an average for the year?</p>
<p>I have not read this entire thread so please excuse my confusion as I do not understand what is meant by regional bias for interviews. Medical students have a huge bias as to where they want to continue their training. Generally it is close to either their medical school or their home. On the other hand if one wants a competitive residency location may become a secondary matter. While there may be residencies that prefer “local talent” I am not aware of any. Indeed, if there is a surplus in the field near the residency it might be an advantage not be be local.</p>
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<p>I think what they’re saying is that residency programs tend to have a bias towards students either from med schools in the region or who live in that area/state. The latter is especially true of desirable/popular locations like CA, where being a CA resident (even if you did med school out of state) is considered an advantage for CA residencies. The former likely because the PDs tend to know more about med schools in their area and will more likely know the people who are writing LORs from that school (i.e. the department chair in that specialty).</p>
<p>As icarus alluded to, there are many reasons for regional biases including the PD being more familiar with local med schools, with local letter writters, etc. In general, PD’s want residents they think will be happy because an unhappy resident is a bad resident. For example, WashU may have a lot of great programs but a PD will want to be sure that the applicant is willing to live in St. Louis for 4 years (or more). Someone who already attends med school in St. Louis is going to be a lot more familiar with the area than someone who’s never lived outside of California in their life.</p>
<p>At every interview, I’ve been asked either about my familiarity with the area (or any ties to the area) and/or my willingness to live in the area long-term (ie after residency). There is some degree of regional bias as well for med school although much less. I went on double digit med school interviews but no one asked me many questions about what I thought of the city or if I planned to live in the area long-term.</p>
<p>Rank order lists are due tomorrow at 9pm EST…I’m more anxious than I expected, even though I certified my list 2 weeks ago and haven’t touched it since. I sent emails to to my top 3 choices a couple of weeks ago, and got immediate (<24 hours) responses from my top 2 choices but even after a couple weeks did not hear from choice #3. From what I know, I’d be shocked if I fall below my #2 choice but it’s still a nerve wracking process. Match Day is the 30th…</p>
<p>There is usually not a bias perse unless you are going to a family practice program in a very rural area where they may want you to stay.</p>
<p>So why does it appear to be so.</p>
<p>First. Residencies still are “an old boys (girls) club”. Every day during this time, I get or give a phone call from/to someone saying that Suzie is walks on water. Often it is a “I’ll take George” and “you take Susie”. We know where most of our good kids are going way before the match (if the kids tell us “the truth” about where they want to go).</p>
<p>Second. Kids from the medical school usually have the upper hand on other kids. Why, because we know them. If we know a kid will be good because of how he did on our clerkship, we will take him over an unknown.</p>
<p>Third. If you want to go someplace else, that is why we recommend that you do a fourth year clerkship there. Then they know you.</p>
<p>Finally, I know people at schools from through out the country. So just because San Francisco is “up the road” does not mean that I am more likely to know the chair there than I am at Harvard. It is a small world and we have many meetings together. I know most of their wifes as well as alot of their kids (who have grown up with mine).</p>
<p>I would expect the above holds true for law, banking, etc. Icarus. I think you are wrong otherwise about being a California Resident as the make up of their programs (at least Surgical) don’t demonstrate that other than as noted above</p>