Questions to ask Residents about program at dinner

[firstdoc101]

Ok, so I want to know the best questions to ask residents while at the pre-interview dinner.... and not just the ones everyone is gonna ask..(i.e. are you happy here, would you do it again, etc). But instead, questions whose answers may change your wanting to go there for the better or worse. Ill start the list, you add if you wish...thanks in advance

1. How good is the ancillary staff at all the rotation sites? (i.e. am i going to have to spend half my day trying to get this guy a ride/place to stay bc there is no one else to do it?)

2.

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[dragonfly99]

If it's a medicine program, would want to know how many patients you'll have to crosscover (ones that aren't yours) when you are on call. 20 is good, 55 is bad!

If it's medicine, would want to ask what %age of residents who tried to match into GI and cardiology were able to do so in the past couple of years (if it's less than 80% that means they have problems matching people into competitive specialties).

Would ask if people like the program director and department chair and what their personalities are like (to see if you are likely to gel with them).

 

[jdh71]

Clarfiy what is meant by "vacation" - sometimes 4 weeks of vacation, isnt exactly what you think it is . . . at too many places a "week" of vacation means M-F, not weekends, and if weekends do not actually count for vacation see how easy it is to arrange weekends off on both sides of a vacation - this will also be a good gauge of how well the residents work with each other to make sure each other gets vacation (and if it seems superficial to ask about vacay . . . believe me, you NEED those 4 weeks of vacay)

Food - it may seem like a little thing, but in the grand scheme of it all, but if a program gets you fed, at bare minimum on calls, then you can count on that program to try and look out for its residents. Salary for residents is not bad . . . especially considering today's economy, but you know what, it helps. It reallly does. It also helps morale. And good morale = fun working environment

Home call - find out specifically how busy this is at the institution and when and where it is used. Home call mostly will not count towards work hours, and it can be abused.

I'd also ask about elective months - I didn't get one, and it's nice if you can have ONE month that's yours even if you're working.

 

[Trifling Jester]

If it's medicine, would want to ask what %age of residents who tried to match into GI and cardiology were able to do so in the past couple of years (if it's less than 80% that means they have problems matching people into competitive specialties).

Would absolutely ask this question. I'd dig a bit further too. I'd want to know if residents are able to match into their own program as well as outside programs for cards and GI, and if any positions are unofficially reserved for in-house applicants.

I'd also ask specifics about the ancillary services. Do residents ever have to place IVs, PPDs, draw labs, do EKGs, transport patients, etc? You can always do these things if you want to, but IMO you shouldn't go to a program where you'd have to do them.

-The Trifling Jester

 

[VandyMed2009]

i'd also ask about if they have paper charts or electronic recrods...and if paper, will the nurses take verbal orders? nothing sucks more than being asleep or on the other side of the hospital in the middle of the night and having to wlak all the way to a patient's floor to write an order for a tylenol.

 

[elwademd]

how are things between internal medicine and general surgery? radiology? other services? i think knowing if its difficult to get consults or very easy can make the difference when on call, and ultimiately for appropriate and timely care of your patient.

expectations for interns? pgy-2's? pgy-3s?

clinic duty? there was some talk last year of increasing the amount of clinic time for residents.

 

[gutonc]

how are things between internal medicine and general surgery? radiology? other services? i think knowing if its difficult to get consults or very easy can make the difference when on call, and ultimiately for appropriate and timely care of your patient.

Good one. This is big. I went to a med school where the services were constantly at each others' throats and you had to beg, borrow or steal to get a consult, often making it an attending-to-attending thing which pisses everybody off.

My residency/fellowship program OTOH, while there are still the classic inter-service rivalries, consults that are called get done.

It makes taking care of your patients much easier when the Urology senior will come in from home at 3am to eval a pt w/ a clotted off 3-way foley or Gen Surg will basically see any undifferentiated abd pain, mostly w/o complaining.

 

[elwademd]

Good one. This is big. I went to a med school where the services were constantly at each others' throats and you had to beg, borrow or steal to get a consult, often making it an attending-to-attending thing which pisses everybody off.

My residency/fellowship program OTOH, while there are still the classic inter-service rivalries, consults that are called get done.

It makes taking care of your patients much easier when the Urology senior will come in from home at 3am to eval a pt w/ a clotted off 3-way foley or Gen Surg will basically see any undifferentiated abd pain, mostly w/o complaining.

as an intern, i had a patient with testicular torsion... urology came in 12 hours later! of course he ended up with an orchiectomy. and had urology come in quickly, it still could have ended up as an orchiectomy, but he didn't even get the chance to have his testicle saved! granted, the guy was in his 50s or 60s, but man to man, we should be trying to protect each others balls.





but there are lots of services that will have value to you as an intern and resident perhaps on a daily basis (or call at least), that you don't think about during the interview:

cardiology- willing to come in, or consult over the phone on only mi's... what about post cabg, post heart cath... mi in the hospital, pericardial effusions...

neurology- what if you can't get an lp? what if you actually have someone with stroke symptoms who came in "on time"- will they come to administer tpa?

gi- you've got an acute upper gi bleed from the er, or on the floor... can you expect a scope within a few hours, or will it be ng tube/blakemore tube and let me know in the am if he's still alive?

pulmonary/icu- will they come if you're worried about a patient who looks like he/she is about to crash (that copd patient who isn't tolerating bipap well), or do they actually want the patient to crash before being consulted?

sometimes the timely intervention for your patients, and ultimately decision making and decision points for your patients lies in the hands of the specialists. if your specialists are dragging their feet more often than not, your patient suffers, and you may be miserable. but if they do what they're supposed to do when they're supposed to do it, you'll be happy, and ultimately the patient benefits.

 

[doc luv]

i would ask whether interns have to do discharge summaries or not. makes life a lot easier as an intern if you don't have to spend a whole lot of time on these and can focus on all the other work you have.

 

[TommyGunn04]

Having been to lots of interview dinners, both as an applicant and now as a resident, I've come to believe that applicants often get lost in details about ancillary services, average duty hours, and other such specifics, at the expense of seeing the bigger picture. Sure, it's important whether or not you'll get 4 weeks of vacation instead of 3, but if you forget to consider bigger picture questions then you're doing yourself a disservice. And an extra week of vacation won't make you any less miserable if you forget to consider other more important variables.

Most importantly, ask about the big strengths and weaknesses of a program. Residents at a dinner will usually be candid about this. Just come out and ask it...."What do you think are the biggest strengths and weaknesses of this program." And if they don't answer, ask again..."What are some negatives that you've experienced?" There's no incentive to lie...no one wants people coming to their program who don't really want to be there. You'll learn the most important things through questions like this, NOT by asking about ancillary services.

Also, remember to try to get a good feel for how residents like the city, ask about the makeup of the patient population, and how people tend to socialize. Are there lots of "private patients," where you'll have to communicate with 10 different attendings a day who don't allow you to make decisions and just dictate the course of patients' care? How much autonomy do residents have to make medical decisions? Ask specifics about what people go into, and how well they matched. Ask to see a match list. These things will make much more of a difference in your overall experience as a resident and an applicant to fellowship programs if that's in your plans, regardless of whether or not you're required to do dictations or draw blood or do EKGs. Internship will be tough wherever you go, even if you never have to place an IV.

Incidentally, a great question to ask faculty during an interview session is something like this: "What was it that brought you here, and what is it about this place that keeps you wanting to stay?" You'll learn some fascinating stuff!

No matter where you go there will be some things that are annoying, or that you think you shouldn't have to do, but that's sometimes what internship and residency are all about...someone has to do the stuff no one else wants to do, but it's only for a short time and it's educational, despite the fact that it might be annoying at times. Just remember, don't let your idea of perfection be the enemy of what might be something extremely good. Some small sacrifices here and there may be well worth it in the end, as we all learned during our pre-med years.

 

[gutonc]

Incidentally, a great question to ask faculty during an interview session is something like this: "What was it that brought you here, and what is it about this place that keeps you wanting to stay?" You'll learn some fascinating stuff!

Agreed. This was a question that I used on my residency and fellowship interviews and, like TommyGunn04, learned a lot of helpful information, both about the the program and the people that it attracted.

 

[RTrain]

Good one. This is big. I went to a med school where the services were constantly at each others' throats and you had to beg, borrow or steal to get a consult, often making it an attending-to-attending thing which pisses everybody off.

My residency/fellowship program OTOH, while there are still the classic inter-service rivalries, consults that are called get done.

It makes taking care of your patients much easier when the Urology senior will come in from home at 3am to eval a pt w/ a clotted off 3-way foley or Gen Surg will basically see any undifferentiated abd pain, mostly w/o complaining.

Yes! You don't realize how valuable this is until you don't have it.

You also want to ask how the housestaff gets along. Are they friends? Do residents make the effort to get together and see each other socially outside work? Further, are most residents married with kids, and go home and spend their down time with their families? If you have a family, it may be nice to go to a place where there can be family picnics, trick-or-treating, and not a bunch of single kids always doing things that you can't really be a part of. Conversely, if you are single and like nightlife, you may not enjoy pulling teeth to get colleagues to leave the house.

 

[emtji]

If it's a medicine program, would want to know how many patients you'll have to crosscover (ones that aren't yours) when you are on call. 20 is good, 55 is bad!

wow....we cross covered up to 121 on night float (11 per list, 11 lists) and admitted 3 patients to boot. generalyl it wasn't that many- usually only 80-90 since most people were able to discharge during the day, but still a brutal night float. never slept.

 

[eighty-twenty]

i'd also ask about if they have paper charts or electronic recrods...and if paper, will the nurses take verbal orders? nothing sucks more than being asleep or on the other side of the hospital in the middle of the night and having to wlak all the way to a patient's floor to write an order for a tylenol.

I hope this is a joke, because if this is a dealbreaker for you, I'd re-consider going into IM 😛

I think the most important question is whether or not the residents get along with each other and where the program sends it's residents for fellowship. The first question can't really be answered directly--you just have to observe their dynamics at dinner and perhaps during an away rotation.

 

[dragonfly99]

EMTJ
that is LOT of crosscover patients.
I was actually talking about medicine crosscover patients for when you are on call. We would be admitting 5 patients/night or more because we were the on call team taking all the crosscover and doing all the admits (no night float at our hospital). Crosscover would start at noon (for the postcall team signing out to you) and then about 3-5 pm for the rest of the teams' patients.

 

[VandyMed2009]

No Eighty-twenty, paper charts vs. EMR isn't a deal breaker for me. But its insulting that you think its a stupid question to ask. I think it IS important to ask about little details like paper charts vs. EMR, parking availability, do residents get free food, etc. -- because it does affect your quality of life as a resident. And if you don't ask you'll never know.

Obviously there are far more important things to consider, like how the programs places residents into fellowship, how the residents get along, etc....but if you are trying to decide between 3 awesome programs that all have top notch reputations and all match well into fellowship, then those little details might help you to make a final decision.

 

[indiamacbean]

Having been on a bunch of these from both sides it seems like the key things to figure out are:
do you like/click with the group of residents and do you see yourself being happy living in the city where the program is located. Also it should go without saying that you should be very pleasant to the other applicants and check your ego/cv at the door. I can pretty much guarantee that applicants who talk about themselves with the intention of self promotion will achieve just the opposite. We have dinged people with obvious personality issues. Also feel free to have a drink if you feel like it. we, at least at our little program in SF, won't judge you for that.

 

[dragonfly99]

having a lot of computer/EMR stuff vs. not is actually an important question I think if you do internal medicine. It ultimately makes your life easier, though I actually think it makes things harder the first month or two of internship (learning curve involved in learning how to use the computer stuff).