Advice for Applicants

[smellycat]

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This is just what I personally felt was important about residency training and how to find the right one. Others with experience, please feel free to add.

1. When you interview, make sure you talk to the residents that are there. Both junior and senior. Ask them questions about what they liked and especially what they didn't like about their program. If you don't meet residents...that's a very bad sign.

2. Make sure that you get ample teaching time. Yes, you will be grossing, putting in billing codes, dictating, and such. But make sure that the attendings sit down with you and go over cases at the scope. Make sure the residents are getting this experience. Also for the most part you should be previewing your cases. It is invaluable experience. Get in the habit of writing down what you think it is (diagnosis, why?, how would you work it up, immunos and such). See if the residents at the programs are doing that.

3. Feedback from the attending is also very necessary. Both immediate and after certain time points (6 months). I know for the most part they have to be doing this for ACGME but it doesn't always happen. Especially the immediate feedback.

4. It would really be nice to go to a program with multiple fellowships (derm, heme, surg, cyto). You will see later down the line that when you apply for fellowships, many of them will be filled by internal candidates.

5. Where did the residents go? Did they end up doing a fellowship? Did they take a job in the area? Did they go to the place where you would like to end up?

6. Board pass rates. They vary, but I usually asked the PD what the rates were just to get an idea (past few years).

7. Elective time. You will see elective times vary in each program. Some will give more elective time because they feel their program can't train you in all of the things you need to be trained in. Others will give you nearly no elective time because they want the residents to cover a particular service year round. Personally, I think 3 months is a minimum. You will need that time to rotate at other places (fellowships) and also to see how other pathologist sign out cases. You may even use the time for "research" when studying for the boards.

8. Surrounding area. I think this is really, really important. You will be much happier if the place you live has things to do.

9. Current residents. You will hopefully get a chance to meet some of them during lunch. See how they are and see if you think you would fit in. Having good classmates is a MAJOR plus.

Good luck!

 

[yaah]

Good advice, thanks for posting 🙂

 

[KeratinPearls]

Ask questions to the residents. We had an applicant today who maybe asked one question.

One question I like to ask is what type of program are you looking for? That will tell me if that person is a good fit or not. Each program has their own culture...we here tend to be friendly with each other, help each other out..if you come across as someone like that and we can tell you sincerely want to be at our program, that's a huge plus.

 

[Patho2009]

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[Gene_]

This may sound really silly, but whenever someone comes for an interview and expresses an excessive amount of interest in the program, they are always viewed favorably compared with those that just show up, interview, and go home. Bottom line: 1. be engaged during the interview, and 2. flattery works.

Note: You can easily take the above too far, and make everyone think you're a doofus.

 

[KeratinPearls]

This may sound really silly, but whenever someone comes for an interview and expresses an excessive amount of interest in the program, they are always viewed favorably compared with those that just show up, interview, and go home. Bottom line: 1. be engaged during the interview, and 2. flattery works.

Note: You can easily take the above too far, and make everyone think you're a doofus.

yeah, be sincere when expressing interest, we can detect fake interest a mile away.

 

[yaah]

Ask questions to the residents. We had an applicant today who maybe asked one question.

One question I like to ask is what type of program are you looking for? That will tell me if that person is a good fit or not. Each program has their own culture...we here tend to be friendly with each other, help each other out..if you come across as someone like that and we can tell you sincerely want to be at our program, that's a huge plus.

These are good points. It is always amazing to me how many people show up for interviews looking great on paper but yet turn out to be complete clutzes, antisocial, or borderline deviant when in discussion. Some go overboard into being too friendly and forthcoming. But the ones who remain stoic and silent often get bumped down in the rankings. Programs like residents who are going to be good team players, work hard, and not create problems for other residents or for the program.

 

[HbyHA]

These are good points. It is always amazing to me how many people show up for interviews looking great on paper but yet turn out to be complete clutzes, antisocial, or borderline deviant when in discussion. Some go overboard into being too friendly and forthcoming. But the ones who remain stoic and silent often get bumped down in the rankings. Programs like residents who are going to be good team players, work hard, and not create problems for other residents or for the program.

i agree. i'm sure we've had some excellent candidates that were not highly ranked simply because they barely opened their mouths at interview day. pick some other time to be shy and quiet!

 

[mlw03]

These are good points. It is always amazing to me how many people show up for interviews looking great on paper but yet turn out to be complete clutzes, antisocial, or borderline deviant when in discussion. Some go overboard into being too friendly and forthcoming. But the ones who remain stoic and silent often get bumped down in the rankings. Programs like residents who are going to be good team players, work hard, and not create problems for other residents or for the program.

agree with everything people have been posting. would also suggest that if you're genuinely interested in a program, ask the residents and faculty how they like living in that city. to me, that says, "this person is really considering ranking us highly and wants to know if they'll enjoy living here for at least 4 years." plus, it helps show you're a normal person socially if you ask about normal things young adults tend to care about, like parks, sports, arts, music, etc.

 

[exPCM]

This is just what I personally felt was important about residency training and how to find the right one. Others with experience, please feel free to add.

1. When you interview, make sure you talk to the residents that are there. Both junior and senior. Ask them questions about what they liked and especially what they didn't like about their program. If you don't meet residents...that's a very bad sign.

2. Make sure that you get ample teaching time. Yes, you will be grossing, putting in billing codes, dictating, and such. But make sure that the attendings sit down with you and go over cases at the scope. Make sure the residents are getting this experience. Also for the most part you should be previewing your cases. It is invaluable experience. Get in the habit of writing down what you think it is (diagnosis, why?, how would you work it up, immunos and such). See if the residents at the programs are doing that.

3. Feedback from the attending is also very necessary. Both immediate and after certain time points (6 months). I know for the most part they have to be doing this for ACGME but it doesn't always happen. Especially the immediate feedback.

4. It would really be nice to go to a program with multiple fellowships (derm, heme, surg, cyto). You will see later down the line that when you apply for fellowships, many of them will be filled by internal candidates.

5. Where did the residents go? Did they end up doing a fellowship? Did they take a job in the area? Did they go to the place where you would like to end up?

6. Board pass rates. They vary, but I usually asked the PD what the rates were just to get an idea (past few years).

7. Elective time. You will see elective times vary in each program. Some will give more elective time because they feel their program can't train you in all of the things you need to be trained in. Others will give you nearly no elective time because they want the residents to cover a particular service year round. Personally, I think 3 months is a minimum. You will need that time to rotate at other places (fellowships) and also to see how other pathologist sign out cases. You may even use the time for "research" when studying for the boards.

8. Surrounding area. I think this is really, really important. You will be much happier if the place you live has things to do.

9. Current residents. You will hopefully get a chance to meet some of them during lunch. See how they are and see if you think you would fit in. Having good classmates is a MAJOR plus.

Good luck!

Good post.
I would add two very important questions:
1. I would expand on the question given above and ask how much time do the residents get to preview their cases before signing out with the attending?
2. How supportive is the program on allowing the residents to take time off to interview for jobs and fellowships?

 

[HbyHA]

Good post.
I would add two very important questions:
1. I would expand on the question given above and ask how much time do the residents get to preview their cases before signing out with the attending?

agreed. a program may say that you get to preview your slides, but that may mean at starting at 11 pm (if you can still see straight after being worked all day long) vs a program that give you a half or full day of "PROTECTED" review time. both programs will say yes you get to review your slides, but only one will actually contribute a lot to the learning process. unless you like doing your learning at 11pm...

 

[raspberry009]

I also want to add:
Preview time is great. But how is the volume? do you get the morning to review 20 cases? or 40?

Some programs will give you the whole day to preview, but the volume just isn't there. Other programs will slam you with so many slides that you don't feel like you get enough time to learn from each case.

Which leads one to consider another question: Do you learn best by seeing or by reading?

With programs that have high volumes, you learn by repitition and you will also get to see some of the odd birds. Other low volume programs will give you more time to read.

 

[BierstiefelAndy]

All good points above. Another underappreciated but important factor has to do with the presence of nationally/internationally renowned faculty who are actively involved in helping residents find jobs. It really helps if you have some altruistic faculty members who will take the time to pick up the phone on your behalf and also advise you when it is time to negotiate a contract. Unfortunately, not too many people like this exist but if you can find a program that does, take that into serious consideration.

 

[2121115]

I also want to add:
Preview time is great. But how is the volume? do you get the morning to review 20 cases? or 40?

Some programs will give you the whole day to preview, but the volume just isn't there. Other programs will slam you with so many slides that you don't feel like you get enough time to learn from each case.

Which leads one to consider another question: Do you learn best by seeing or by reading?

With programs that have high volumes, you learn by repitition and you will also get to see some of the odd birds. Other low volume programs will give you more time to read.

If you are not getting the opportunity to preview 40 cases in a morning (and aren't expected to get them all thoroughly worked up and prepared to sign out) then the program isn't preparing you to join a busy practice. Speed is crucial to keeping up when you first join a busy practice. Do not underestimate this factor.

 

[mlw03]

If you are not getting the opportunity to preview 40 cases in a morning (and aren't expected to get them all thoroughly worked up and prepared to sign out) then the program isn't preparing you to join a busy practice. Speed is crucial to keeping up when you first join a busy practice. Do not underestimate this factor.

i think the above could be a bit misleading. what does working up a stomach biopsy entail? or a endocervical curetage? i agree being able to get through cases quickly is valuable, but there's a big difference between biopsy and reg cases. regs do need to be worked up (review history, determine what the main diagnosis is, assess margins, assess lymph nodes, consider immuno stains if necessary, write report like case is yours) vs a small biopsy (give diagnosis, maybe with a comment).

programs vary in their structure. i think the more important question for applicants to ask residents is whether they're able to preview the majority of their cases prior to signout. of course, if you're gonna be a blood banker (or one of the other minority of pathologists who don't do surg path as their main thing), just get through your surg path rotations and try to learn the material.

 

[raspberry009]

mlw has a good point, however, "busy-ness" is always subjective. Some residents just work faster than others ect. Where I did my medical training, you asked those residents, they would say that they were busy, however, where I am now in residency, the specimen load dwarfs what I saw previously. My definition of "busy" has changed dramatically.

So really all you have are numbers.

To get an idea of large specimens maybe ask how many ORs feed surg path. Is there a biopsy rotation that is separate or are those numbers included with the surg path review day.

 

[raspberry009]

Can I offer another word of advice?

I would recommend not wearing perfume. I think deoderant is more than enough. Just imagine if the person that was interviewing you was allergic or nausiated by the smell. Bring the deoderant with you if you need to reapply halfway through the day.