Interview season

[sandiego1]

Anyone have general advice for the interview season with regards to keeping track of programs and pros and cons for each? Anything to look at in each program (ie number of shifts worked, amount of peds experience, etc.)? Anything you wish you had known at the beginning of interview season?

I have heard about keeping a list of pros and cons and an excel sheet but not sure what I would put in that excel sheet.

Would appreciate any advice from anyone whos been through the process

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[HoosierdaddyO]

Strong thread topic!!

 

[Fox800]

If you are a member of AAEM, you get access to EMSelect which does exactly that. It's nice.*

*said in a Borat voice

 

[HumerusBaker]

The NRMP has an app called Prism. You can input interview dates and do rankings and notes.

 

[Cinematographer]

Another vote for the Prism app. Let's you assign a score to programs based on preset strengths/weaknesses such as geographic location, faculty, curriculum, work/lifestyle balance, size of class.

 

[racerwad]

I used Prism as well which was handy. On my excel sheet were things like: shift length, food stipend, whether they allow moonlighting or not, pay, and a section about why a specific program should be where it is on my ROL (on top of basics like pro/con, etc). The question helped to clarify why or why not the program deserved to be ranked higher or lower based on my own biased perception of it.

Take good notes and answer for yourself what specifically you're looking for in a program (not just "will other ppl be impressed?"). You'll be surprised how little you remember, how some programs seemed good (or bad), but you can't put a finger on why, etc. I found that the top and bottom of my list were easy, but sorting out the middle was really difficult for the above reasons. I think the Prism app is helpful in this regard bc it asks fairly objective questions and the list it makes can be different from the ROL in your head.

 

[barnacle]

After each interview write down a few notes on the subjective stuff like general impression, people, fit, etc... Try not to get bogged down with spreadsheets and what not.

In regards to your question of what to look at in each program, everyone has different priorities and there have been threads on this. I would put emphasis on a few things:

1. Location (probably ends up being the top factor for most applicants)
2. Fit (this is important, but can be hard to judge unless you rotated there, you'll have to go with your gut on this one)
3. Niche/Fellowships (ie if you want to do XYZ fellowship, you want a program that has strong emphasis on XYZ, faculty interested in XYZ & affiliation w/ XYZ fellowship program would be a +)

The rest doesn't really matter.

 

[deleted720339]

I think shift length is a really important consideration. I rotated at a place that did almost all 12's and the residents were miserable. Now rotating at a place that does 8's (+1 for charting) and everyone seems much happier and has a life outside work. You can do A LOT with 3 "extra" hours a day.

 

[barnacle]

And you can do a lot with 5 extra days off... (15 - 12's vs 20 - 9's)... I think you are looking at things from a narrow perspective from your one experience. Not all places that do 12's are miserable. I worked 10's & 12's as a resident and I was happy. I rotated as a student at a different program that only did 12's and their residents were happy. I wonder if the program you talk about had more systemic issues at play that you weren't seeing?

Happiness of the residents is important and falls under fit/culture/subjective stuff that can't be measured. All I'm saying is that I personally wouldn't rank one program over another due to shift length. You have to look at the whole picture and see if the place is right for you.

 

[sandiego1]

thanks for the input everyone.

And you can do a lot with 5 extra days off... (15 - 12's vs 20 - 9's)... I think you are looking at things from a narrow perspective from your one experience. Not all places that do 12's are miserable. I worked 10's & 12's as a resident and I was happy. I rotated as a student at a different program that only did 12's and their residents were happy. I wonder if the program you talk about had more systemic issues at play that you weren't seeing?

Happiness of the residents is important and falls under fit/culture/subjective stuff that can't be measured. All I'm saying is that I personally wouldn't rank one program over another due to shift length. You have to look at the whole picture and see if the place is right for you.

From what I have seen so far from looking at programs it doesnt seem like programs with 12's work that many fewer shifts if at all. If your experience is actually more common then great but from what I've seen, most 12 hour programs work about the same number of shifts as programs with 8's. Can anyone comment on this?

 

[FallingFromSpace]

From what I have seen so far from looking at programs it doesnt seem like programs with 12's work that many fewer shifts if at all. If your experience is actually more common then great but from what I've seen, most 12 hour programs work about the same number of shifts as programs with 8's. Can anyone comment on this?

It's very much program dependent. One other thing to consider- some programs have 4 week blocks, other programs have 1 month blocks. Sounds similar, but it's an extra 2 days of work. So a 21 shift/month program is essentially the same as a 19 shift/4-week block program in terms of days on/off.

 

[barnacle]

Hours per mo/block depend on each program. Most programs work fewer total hours as you progress.

Again, all I'm saying is don't discount a program cause they work 12's or a lot of hours/mo. I think it is more important to look at overall environment, culture, resident wellness/happiness/ satisfaction, etc... I would rather work a few more hours per mo, in a place that I'm happy, than fewer hours in a place that I'm not. If the residents are miserable, then yes that should be a red flag.

As someone that has been through residency, I can tell you, you will have to put in time & make sacrifices (regardless of the program). EM & residency is a team sport. If your program is the right fit/team for you (location, people, academics), then this other stuff, shift#, food stipend, parking, etc... doesn't matter.

Residency is a means to an end. Your focus should be which program fits you the best, so you can maximize your education. Everyone has different priorities and needs to achieve this. For me it was being around good people that worked hard and helped each other out.

 

[Cinclus]

I rotated at a place that did 8's, a place that did 12's, and a place that had a big 'ol mix of shift lengths. Resident happiness did not seem to correlate very well with the shift lengths. I think the place that did 12's had some of the happiest residents I have seen; these folks were fun to work with, too, and the shifts flew by.

 

[Porfirio]

I rotated at a place that did 8's, a place that did 12's, and a place that had a big 'ol mix of shift lengths. Resident happiness did not seem to correlate very well with the shift lengths. I think the place that did 12's had some of the happiest residents I have seen; these folks were fun to work with, too, and the shifts flew by.

My experience was the same. I would only add that it might be important to have 12's during your training to see if you want to work 12's as your first Attending job.

 

[racerwad]

Hours per mo/block depend on each program. Most programs work fewer total hours as you progress.

Again, all I'm saying is don't discount a program cause they work 12's or a lot of hours/mo. I think it is more important to look at overall environment, culture, resident wellness/happiness/ satisfaction, etc... I would rather work a few more hours per mo, in a place that I'm happy, than fewer hours in a place that I'm not. If the residents are miserable, then yes that should be a red flag.

As someone that has been through residency, I can tell you, you will have to put in time & make sacrifices (regardless of the program). EM & residency is a team sport. If your program is the right fit/team for you (location, people, academics), then this other stuff, shift#, food stipend, parking, etc... doesn't matter.

Residency is a means to an end. Your focus should be which program fits you the best, so you can maximize your education. Everyone has different priorities and needs to achieve this. For me it was being around good people that worked hard and helped each other out.

I think it's a little short-sighted to decide what is or isn't important for other people. I agree that fit is definitely the most important thing, but there are factors that are individual to each person and their context that may affect their concept of fit.

The op asked for input on what sorts of insights people had gained through the process. For you, it turned out that shift length was maybe not as critical as you thought prior to residency. That is important information. What may be of less utility is having you decide for them what is best.

Fwiw, my program does 13 4-week blocks with 18 9hr shifts during ED months. Chiefs do less. It's not why I chose it, but it is a factor to why I love it here.

 

[barnacle]

If I came across as telling people how to make their decision, I apologize. I was simply providing my opinion of what was important to me after having gone through the application process and residency. Saying nothing else matters was purposely made as an overstatement, to emphasize the importance of keeping the big picture in mind. I remember being a medical student and how it easy was to focus on the minutiae. And yes, what I consider minutiae, may not be minutiae for you. As I stated in all 3 of my prior post everyone has different priorities.

 

[barnacle]

To the OP,

In regards to shift length, one question to ask is how much overtime you do on average? If you are spending hours after each shift you will get worn down regardless of shift length.

In regards to PEDs experience, it kind of depends on setup and whether your primary hospital sees kids. Most programs do 2-3 mo of dedicated PEM experience. I found PICU to be the most important peds rotation, it really solidified things for me.

One question I would consider asking, is the involvement PD & Chair in post-residency job application process. It may help you gauge faculty support. It is very nice to have faculty that will go out of their way to help you get the job or fellowship you want.