I am totally on the sideline too. Fir the little that I happen to know, I have the impression it is more “random” this round as compared to UG or med school admission. I learned from SDN that usually very few applicants got IIs or acceptances (do not remember which one is referred to as being random) from, say, every top program (say, top 6) unless that applicant is really head and shoulder above almost everybody. This could be true for almost all applicants (or interviewees) from a given med school.
I do not think that there is such thing as “acceptance”, I am not sure if the applicant will ever know which residency programs ranked them high or low. At the end, your got the match to one program. So, you assume that this program ranked you relatively high. There is no other information available. You are in complete dark until the match day. Some mentioned here that an applicant received “love” from certain program(s). No “love” was received by my D. in any kind of shape or form from any of the programs that she had interview.
I am not sure what standing “head and shoulder above almost everybody” means in this process either. Some have excessive number of away rotations that suppose to result in an interview. Some have tons of publications. And these may result in more II. However, none of these facts will result in higher ranking of the applicant at the specific program. I do not believe there is such thing as being better in general. It looks that programs and applicants are looking for the best fit. Maybe the best fit is what makes a certain candidate to be “head and shoulder above almost everybody” at certain program, which for the same applicant may not be the case at other programs.
In comparison, the residency application was the only stressful cycle (very stressful!), UG and med. school applications were fun for my D. But she never had any aspirations to chase Ivy’s / top Med. Schools, so acceptances to top 20 Med. Schools happened because they were desirable locations.
From your description, it seems that for the residency application, it is more stressful and the soft factor like “fit” is more important, than the same factor in UG and med school application. Glad that I am at a further distance from the actual application details now (due to both my ignorance there and DS’s more independence.) Not knowing could be a blessing because, if we know too much, we may be itching to provide “unwelcome” inputs to the process, making him even more stressed.
Our job was supposedly done when we sent him to college! (Well…except for the tuitions and living expenses parts. We are still trying to lower, or pretty soon, likely only “freeze”, the amount of his student loans. Even a little bit efforts on this front on behalf of him while he is still unable to do so could help.)
Agreed. I tried my best to back off when it came to giving input during her residency applications but my daughter no doubt thinks I didn’t do a very good job of it.
D is part way through year two and finishing up five weeks of nights. Though in theory she does well when having to shut down during the day, I don’t know if you ever fully adjust to being a night person. Once or twice a week I get a text in the early morning because she is jazzed with the outcome of a particular case. She had emergency surgery a couple of months ago. At the time her co-residents stepped up and filled in for the four days she was out. They were very kind by not making her feel she had to apologize for something out of her control, merely reconfirming D’s belief that her residency program fosters a particularly supportive environment. She will repay the shift coverage but these people work big hours and all have their own responsibilities. It was done in the spirit of we-all-help-one-another-out. Not all residencies are like this and I was impressed. She was operated on in one of the ORs where she works daily so H and I got to observe the structure of her work life for the couple of hours we were at the hospital. I get why she feels this program is a good fit for her.
Her vacation starts soon and she will be heading off to warmth, sun and surfing camp. She has mentioned looking forward to reading a non-medically related book…any book.
I know I can and I suspect that many other people who post here can relate stories about how one coworker for many reasons can be very destructive to a workplace environment. Who wants to work alongside such a person for perhaps 3-5 years. And unlike UG and med school apps, PDs have a tool (ie MSPE) that may provide them with greater insight especially from firsthand third year clerkship evals about a potential future coworker’s personality, work ethic, etc, (aka fit). So yes fit IMO does become more important as to residency because of the evidence that may be available to PDs.
What kind of questions should the student ask during the interview to be able to make a more meaningful ranking? Are there areas where for the same specialty, programs differ a lot? What are the main differences when you compare a program with a small number of residents with one that has many times more? Do programs have large differences in things like how independent the residents will be, the amount of call, etc.? Are there other opportunities that one should ask during the interview? (D is applying for Peds)
In regard to questions at interview.
First, I do not think that applying to Peds will be very stressful and I am sure that there is a high chance at matching if applying smartly. I would not worry too much. Second, the most important thing at ANY interview (I had sooo many in my life), any school interview, residency, job is to remain YOURSELF, never ever pretend to be somebody else, it will not come across positively at all. So, I would ask whatever applicant wants to ask. I can tell you one story about myself, non-medical, IT person. I was interviewed for certain responsibilities that had a certain name (acronym of 3 letters). I had never worked with it before so I blankly asked at interview what this means, what 3 letters represent. I was hired with almost 50% increase in comparison to my previous job. And I actually did very well there.
So, just ask what is important to you personally. D. said that some applicants were practically drilling the residents during pre-interview dinners and it came out as very annoying (from my D’s standpoint). Do not underestimate the fact that your applicant will also have to rank the programs. So, the applicant should make sure to have their own impressions of the program, put some notes down while everything is fresh in the mind and do not hesitate to ask what is important to you personally.
The reason that I know a lot is that I actually was involved this time very closely, I had to. I was my D’s back up to watch for her Invites when she could not and I actually caught one of them when she was not accessible and let her know. D. applied to a selective specialty that also interview later than others. I was not involved that closely for UG and Med. School, except making the lists on D’s request.
Keep mind that D will often be “interviewed” in 2 settings. It’s very common on say night before interview day to have some informal get together with current residents (eg dinner). The residents get a chance to see if D would be someone they would want to work with for next several years. So likability with showing a positive interest in program with some questions about hours, facilities, etc. would probably go a long way with residents. I don’t think drilling residents is a great idea as most of them will have just finished work, may be tired, and are there primarily for a free dinner and drinks. As a note S reported that one of these dinners ended around 8:30PM. The next AM at a 9:30ish interview with PD, she had the resident’s report of S based on previous night’s dinner on her desk. I think you want to have the resident’s report that is something along the lines of D is personable, likeable, seems eager (not over eager) to work here, etc. Hopefully residents bottom line assessment: D will fit in just fine, she’s a keeper. D should also use experience to get a sense if residents come across as people she would want to work with and keep notes afterwards
As to interview day itself S reported that questions, opportunities to ask questions varied from interview to interview and from interviewer to interviewer. As there can be an ebb and flow to an interview if D is asked a question she probably wants to be responsive, in a non rambling way and not go off into some preset list of questions she has. Perhaps wait until she’s asked if she has any questions or just like any conversation there can be lulls where D could ask a preset question or bring up a new topic. She should have a preset list of topics for these lulls. D should always keep notes and impressions about programs after interview is complete as in S’s case the top 3 or 4 were easy to rank, but when you get to bottom it can be hard to remember some of the details and the bottom of list is important because you never know.
As to creating a meaningful rank list: I think in large part the answer to what’s meaningful will be different from applicant to applicant. First of all I’d say there is no perfect program as there always will be positives and negatives about every program which often you won’t find out until after you start. What’s important to D? In S’s case, he grew up in CA, but attended med school OOS. Returning to CA was number one consideration, so geography was the driving force in ranking. Although his top 3 picks were CA programs, he actually thought a TX program was the overall the best program but ended up 4 on rank list. Does D have some non program issues (geography, SO, family, etc) that she might cause her to overlook a negative(s) in the program when considering rank list? I don’t need an answer, just rambling…
Every program has its own “feel” and culture. Your D will start to notice the differences after the first couple of interviews. Programs in the same specialty are often very different in how they approach things like rotation scheduling, hours, moonlighting, sick leave, support staffing etc. as well as the residents’ and attendings’ attitudes. Some places are much more intense than others; some are more laid back. Some are more structured; some offer the residents a great deal latitude and independence. It’s absolutely true that different programs within the same specialty will have different emphases of subareas/subspecialties within the larger field. Your D should definitely write down notes on her impressions about each program immediately after her interview is over because after 4 interview in 10 days, it all starts to get jumbled together.
Your D may also want to take note of the social scene of the locale, esp if she isn’t in long term committed relationship. D1 was single and she interviewed at one program which was quite small (5 resident per class and almost all of them were married as were most of the other residents in other specialties) and was in smallish city with very limited dating opportunities. (D1 chatted up the young female bartender at the restaurant after the residents’ dinner was over to get the skinny of the local dating/social scene.) While she liked just about everything about the program, the lack of dating opportunities was a black mark against it.
While the resident dinners are important, sometime things (like weather, scheduling) make it impossible to attend. The residents’ dinner can be not terribly important to extremely important, depending on the program. At some programs, the current residents get final veto power on interviewees-- no matter how good their scores and grades were and how much the PD liked the interviewee.
Creating rank list is a real balancing act. Your D will need to weigh the pros and cons of each individual program as well as her own internal values and needs. D1 attended an instate med school and really would have liked to stay in the Rockies/West–so that went into her decisions when she created her rank list.
D1 said the ranking the first 4 was really easy and the bottom 4 was easy, it was ranking the middle of her list that was hard and was something she was constantly adjusting right up to the last minute.
D. had exactly the same experiences as in posts 909 and 910.
Yes, it gets “muddy” in the middle of personal ranking, personal notes will help. She knew her #1 and #2 from the days she was rotating there, she knew her #11 and #12 (the last ones) right after she had interviews there and it was no surprise that both of them were in NE, she knew beforehand that her personality of the typical Midwesterner will not fit there very well, so she actually was surprised that she found one of the NE programs very well fitting, but not 2 others. I can only add one thing, D. was absolutely ready to go to any place that would take her, from her #1 to her last ranked. She actually “prepared” herself for any outcome, repeating it over and over again. And “geographic location” was D’s criteria #1, no doubt. But it may not necessarily be for another applicant. Some were chasing absolutely highest ranked, but again, were ready to go anywhere.
Best wishes for this cycle applicants!
I was delighted to have DD call me after each interview visit, usually on the drive to the airport. She led with a stream of consciousness report and I jotted notes on a Google Doc, at ranking time she reviewed all those notes.
It was great! I was helping her, but I selfishly also got to hear all about it & I included my comments on her apparent interest or not. As WOWmom said, top & bottom-not too hard, middle of the list-a struggle to rank
DD has completed four interviews and has many more to go. One of the issues that we hadn’t given much thought to before came up - how does one factor in the size of the program? Today’s took in fewer than ten new residents a year, while one of the earlier ones had well over twenty. Is bigger better with more opportunities, or does the smaller one provide more mentoring and personal attention? What’s the impact on call time, etc. Any thoughts on the pluses and minuses?
I think those features are really program dependent and aren’t always related to the size of the program.
D1 interviewed at programs that ranged in size from 5 interns (small) to 18 interns (huge for her specialty) and ended up at program that was in the middle w/r/t size. Opportunities seemed to be more dependent on how busy and how well funded the hospital was than the size. Mentoring/personal attention seemed more to depend on the attending/PD/ program “culture” than the size of the program. (For example, at the huge 18 intern program, interns were divided into 3 groups of 6 that rotated together through 3 different and very busy hospitals in the same city. This seemed to mitigate any potentially impersonality due to size.)
Clarification, please, about a big test MS4 students take—It’s an all-day test given in only 4 or 5 locations in the country and only 4 or 5 times throughout the year. Student sees 12 ‘patients’—20 minute appointment with 10 minutes to write notes and repeat…
What is the test called and how is it graded/what is it’s purpose? How important is the test? Is it comparable to Step 1 or 2??
BFF’s son (ortho resident hopeful) is taking it this week and she tried to explain it to me. Sadly, her explanation left a lot to be desired. Can you say, “Clear as mud?” LOL I can always count on this forum to clarify things for me!
I heard that a long time ago, this kind of test was not needed for an American med school student. It is expensive and some complained about its cost. It is rumored that such a test is meant to screen out those students whose English or people’s skill is not good enough for a practicing doctor but I do not know whether this is true.
I heard it is a P/F test, and less important than Step-1.
Step 2 CS (clinical skills)-- the student sees and examines a series of standardized patients (specially trained paid actors who simulate symptoms). I think they see around 10 of them during the day. Student takes a history, conducts a physical exam, orders tests/x-rays and gets results of those tests, makes a diagnosis, develops a treatment plan and writes the notes for the EMR/patient record. The whole process is videotaped and reviewed by a panel of examiners who grade it.
It’s a test of professionalism as well as people skills, making sure the future doctor is ready for prime time. (IOW, not just good at book knowledge, but at the actual treating of patients.)
As mcat2 says, it’s pass/fail and is usually considered “easier” than Step 1 or Step 2 CK. However, not passing the CS is a black mark (especially for an American med student) and will damage residency chances.
And yes, even US med students sometimes fail the CS.
