Important Questions For Residency Interviews

[exPCM]

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From the ABP: "Each institution sponsoring a pathology training program should develop individual sick, vacation, parental, and other leave policies for the resident. However, one year of approved training credit toward ABP certification requirements must be 52 weeks in duration, and the resident must document an average of 48 weeks per year of full-time pathology training over the course of the training program. Any additional leave must be made up. Unused vacation and other leave time may not be accumulated to reduce the overall duration of training."

The ABP gives programs tremendous latitude on how they count the 48 weeks per year of training. This leads to some important questions.

1) How much time do you give residents off for fellowship and/or job interviews?
Background: Most programs give 3 wks/yr of vacation (12 weeks total over 4 years) which would leave a total of 4wks off (1 wk/yr) for interviews/relocation. However more malignant programs will not give time off for interviews and insist that residents burn up their vacation time to interview.
2) Do you count time at CME and/or board review courses toward the 48 weeks/yr of pathology training?
Background: Again this varies from program to program. IMHO, it sucks when malignant programs make residents use vacation to take the Osler course.
3) Do you count time at the AP/CP board exam in Tampa toward the 48 weeks/yr of pathology training?
Background: Again this varies from program to program. IMHO, it sucks when malignant programs make residents burn up 3 or 4 days of vacation (including travel time to get to Tampa and then back home) to take the boards.
4) Do you give residents credit for weekends and holidays worked to offset time missed during the week?
Background: The ABP allows a program to count it as a full week of pathology training if a resident works on say Monday, Wednesday, Thursday, Friday, and Saturday and is out on Tuesday. However, some programs will not credit this as a full week and will deduct the day out on Tuesday from the residents' vacation time.

All of these issues can lead to significant variation in time off during residency which can be quite important. I have seen some residents from more malignant programs who were forced to burn up almost all their vacation time in order to interview for competitive fellowships.

 

[earmuff]

good things to think about... might feel a little awkward to ask in an interview. Perhaps asking the residents at "lunch" might be better...

 

[Pingu]

1) How much time do you give residents off for fellowship and/or job interviews?
Background: Most programs give 3 wks/yr of vacation (12 weeks total over 4 years) which would leave a total of 4wks off (1 wk/yr) for interviews/relocation. However more malignant programs will not give time off for interviews and insist that residents burn up their vacation time to interview.
2) Do you count time at CME and/or board review courses toward the 48 weeks/yr of pathology training?
Background: Again this varies from program to program. IMHO, it sucks when malignant programs make residents use vacation to take the Osler course.
3) Do you count time at the AP/CP board exam in Tampa toward the 48 weeks/yr of pathology training?
Background: Again this varies from program to program. IMHO, it sucks when malignant programs make residents burn up 3 or 4 days of vacation (including travel time to get to Tampa and then back home) to take the boards.
4) Do you give residents credit for weekends and holidays worked to offset time missed during the week?
Background: The ABP allows a program to count it as a full week of pathology training if a resident works on say Monday, Wednesday, Thursday, Friday, and Saturday and is out on Tuesday. However, some programs will not credit this as a full week and will deduct the day out on Tuesday from the residents' vacation time.

These are all excellent points to consider. Just be careful how you ask about it and once you are in the program, document everything in case it ever comes up again.

Case in point, I was asked our program director to help provide autopsy and call coverage for a fellow resident while they were interviewing for fellowships at the start of our third year. I had no problem with this and was told, in writing, that when it came time for me to interview for jobs or fellowships that I would receive the same consideration because of my cooperation.

Then our program director AND program coordinator left. Our new program director and coordinator had no clue that I had covered or had been promised anything. So during 4th year, while I'm interviewing for jobs, I'm suddenly informed that I'm out of vacation and conference days and that I'm going to have to start taking unpaid days. All I had to do was forward the email documentation and have a talk with our program director and things were taken care of. I still had to cancel the family vacations we had planned though.

Time off for interviewing for fellowships or jobs is absolutely crucial though.
Unless you are interviewing in the same city then you will have to factor in travel time of at least a day on either side and many interviews are scheduled at the whim of the program or group, so you may not get a Friday or Monday interview to allow you to travel on the weekend. Some groups may want you to spend an extra day or will arrange for you to see the city or meet with real estate agents. So only three weeks of vacation will be burned up fairly rapidly.

 

[NobleEightfold]

good things to think about... might feel a little awkward to ask in an interview. Perhaps asking the residents at "lunch" might be better...

Absolutely not something I plan to ask during an interview. Sure, it's good to find out the answer to some of these questions, but I think that would come off quite poorly.

 

[Napoleon1801]

-How many weeks of call? AP/CP coverage?
-How much for bookfund/professional allowance?
-How much allotted for poster presentations?
-Do residents in the program have time to do posters at national meetings?
-What is the cutoff time for tissue being submitted in the processor?


-What has your program changed in response to residents' critiques/suggestions?

Do residents work on weekends? (For which rotations?)
When does your day start? (6, 7, 8am)

 

[KCShaw]

I actually -would- ask some of those questions in an interview, to gain some sense of how the program is likely to treat you in regard to the other questions (vacation/time-away-from-program for training courses/electives/etc.); slapping them with all of the nitpicky little stuff up front isn't a good idea though, I agree. If they want to see this as whining about work when they don't even know you, then that's an indication of their attitude too.

Not sure if I'm missing something, but I'd ask about, y'know, the program itself too -- how they educate, lecture time, caseload, kinds of cases they get and don't get (and how they address teaching things they don't see a lot of, often bone/soft tissue & pediatric), what fellowship training their attendings have, etc. Maybe those are too obvious, heh.

 

[HbyHA]

Absolutely not something I plan to ask during an interview. Sure, it's good to find out the answer to some of these questions, but I think that would come off quite poorly.

exPCM brings up some really good questions to ask. they are definitely ones that didn't occur to me as a candidate, and i wish they had. i lucked out though. everyone focuses on the "academics" of the program, so to speak, but if you're miserable because you keep getting screwed by your program, you're not going to feel like learning very much. as far as asking these questions during the interview, i probably wouldn't ask any of the attendings other than the program director (and very carefully, of course) these types of questions. they probably won't know the answer anyway and you don't want to come off looking like a selfish tool. best to ask them of the chief (if you meet with them) and of the residents that take you to lunch (if that is part of the day.)

i interviewed quite a few people last year as chief and got a great crash course on the right and wrong ways to ask these types of questions. there were some people who focused the entire conversation on "How much call do i have to do? How much vacation do i get? How early/late to i have to be here?" It wasn't so much that they were asking the questions, it was that they seemed super concerned with spending the least time as possible at work. i'm a HUGE proponent of work-life balance, so don't misunderstand me, it's just that it's not so much fun working with people who will throw you under the bus so that they can leave at 5 every day. nothing can make your life miserable like being at a program with a bunch of people who are only out for themselves. teamwork, people... teamwork.

 

[star23]

As part of their ACGME review, programs are required to report on their programs board pass rate for the past 5 years thus they should have this information readily available to you; I would specifically ask the PD. Some programs that look OK on the outside may not have such spiffy actual numbers.

 

[green mantis]

When I was chief resident, I usually gave the lunch tours. I don't think I was ever asked about time off for boards, interviews, preparatory courses, etc. I get the feeling that candidates were more interested about the academic aspects than about non-salary benefits. In regards to call, vacation, book money, etc, I usually mentioned these things even though the candidates didn't ask about them.

I hope I'm not the only one who feels this way, but I don't think a program is malignant if they make you use vacation time to interview, take boards, go to Osler. Aside from interviews, taking the boards or a preparatory course is optional during residency. I know plenty of residents that wait until they're in fellowship or afterward to take their boards, & not everyone takes Osler. If you get 3-4 weeks off per year, shouldn't you be preparing for these things? It's not like these things are an unexpected occurrence.


----- Antony

 

[KCShaw]

Candidates in general don't seem to know or think to ask those kinds of semi-uncomfortable questions, and maybe they assume everywhere is essentially the same. I think "malignant" is in the attitude more than the isolated action; it's one thing to have a strict up front policy about vacation and another to insinuate a person is a whiny loser if they dare ask whether their situation fits the criteria. Some residents are whiny losers, don't get me wrong, but a program doesn't have to be super lenient about time away in order to be resident friendly, either.

Personally, as chief I used the "time away from the program" requirement from the ABP quite regularly, since it was one of the things most residents actually had a sense of fear about. The vacation & sick leave policies of the few programs I'm that familiar with were generally more loose than the ABP's time-away-from-program requirement, which people would occasionally bump up against, particularly after taking maternity leave. (Seems most institutions will let you leave for months when you have a baby, but that doesn't mean ABP will let you take the boards unless you have the educational time in.)

I can't recall the term we used, but there were several days (a week?) of educational time that could be used each year for conferences, without eating into vacation time. If you were presenting, that could be expanded.

Personally, I think that educational courses or conferences are within the intent of the ABP time-at-program requirement and shouldn't be counted against -that-. Whether a program wants/needs to limit that because, hey, they're paying to have residents AT their institution doing THEIR work too, is up to them.

 

[jp123ok]

While contemplating how few residency applicants actually ask important questions during their interviews I came across this old thread. I therefore think it is worth resurrecting.

Here are some more questions that applicants should be asking
(1) Does the program offer a book fund? If so, how much is offered? ($250-1000 is common)
(2) Are residents allowed to take electives? If so, how many? Does the department offer paid electives? (electives are critical for securing competitive fellowship. Some programs make it very difficult for residents to take electives and/or don't offer paid electives)
(3) Does the department reimburse residents for national/international meeting attendance (eg CAP/USCAP/etc)? Is there a limit to how much is reimbursed? Is there a limit to how many meetings residents can attend per year?

(5) Does the department pay for resident parking at the hospital? If not, how much are the parking expenses per year?

 

[Rodak]

Focus on the question, "what exactly do residents do?" Do residents learn by primarily doing what the attending would be doing as much as is legal or by primarily observing, reading, or listening to a lecture (or, god forbid, being a secretary or PA)?

3 must-ask questions:
1. Do residents write/dictate reports, final diagnoses, and comments that attendings sign out? Not just the gross. Not just autopsies.
2. Do attendings sign out reports that residents did NOT write? What percentage and in what areas?
3. Do tasks/conferences/calls from techs/docs go to attendings directly without going through the resident? What percentage and in what areas?

Another way to ask these types of questions is: how exactly do the resident's clinical duties differ from the attending's? The best answer is "the attending presses the sign button when I'm done."