Radiology Faculty--Answering Questions/"AMA"

[reslife56789]

A word of warning to applicants. Benign programs will act this way, but there are programs that use the pre-interview dinner to evaluate and even eliminate candidates. I remember one program that would gather its residents together after the dinner and the residents would basically vote people off the island. It made me a little sick. One person was dropped way down the rank list because one of the residents at the dinner didn't like the candidate's hair. I kid you not. For some reason the PD thought this was a good way to evaluate candidates.

SO... I imagine most programs are like RadiologyPD's and screen only for psychos, but not all programs are benign and residents can be unbelievably petty with their comments. If the residents at the pre-interview dinner tell you that they are not evaluating you (which they should), then I would trust them. If they do not tell you this, then be on your better behavior.

That is interesting. So will the smartest thing to do is just to not attend the dinner then?

---

Members don't see this ad.

 

[ValleyRad2018]

A word of warning to applicants. Benign programs will act this way, but there are programs that use the pre-interview dinner to evaluate and even eliminate candidates. I remember one program that would gather its residents together after the dinner and the residents would basically vote people off the island. It made me a little sick. One person was dropped way down the rank list because one of the residents at the dinner didn't like the candidate's hair. I kid you not. For some reason the PD thought this was a good way to evaluate candidates.

SO... I imagine most programs are like RadiologyPD's and screen only for psychos, but not all programs are benign and residents can be unbelievably petty with their comments. If the residents at the pre-interview dinner tell you that they are not evaluating you (which they should), then I would trust them. If they do not tell you this, then be on your better behavior.

I can't speak to the malignant scenario described above, but I will say from my experience the pre-interview dinner can matter. I have personally been involved in a resident meeting where we evaluated applicants. We were told essentially the applicant's ranking from the program's perspective and then asked if we had any additional input. Many of the comments that were made were based on interactions during the pre-interview dinner.

There were many positive comments, like, "She was very nice and friendly etc" but a few negative ones as well. The negative comments definitely hurt the applicant's chance of being ranked highly. My advice would be to proceed with caution. I think attending the pre-interview dinners can be important at some programs, as in it's not good for no one to know who you are during these meetings, but there is also the risk of hurting your chances if things do not go well.

As someone now switching specialties, I plan to attend as many pre-interview dinners as possible. For what it's worth. I think it helps you learn more about the program and also gives you added visibility when it comes time to rank applicants, particularly if residents are involved in this process.

 

[ValleyRad2018]

Keep in mind my experience is based on applying to a different specialty, but in general the most common negative comments I heard included being "too intense, awkward, arrogant, obnoxious."

Don't assume anything. Be yourself, and be kind to everyone.

 

[Gadofosveset]

That is interesting. So will the smartest thing to do is just to not attend the dinner then?

I would definitely go to the pre-interview dinners, just be on your better behavior. You can gather a lot of useful information at the dinner as well.

The situation I described is definitely an extreme. Just don't assume that because residents aren't reporting back to their PD at one program that no one does it. It definitely happens.

 

[harambe4ever]

A word of warning to applicants. Benign programs will act this way, but there are programs that use the pre-interview dinner to evaluate and even eliminate candidates. I remember one program that would gather its residents together after the dinner and the residents would basically vote people off the island. It made me a little sick. One person was dropped way down the rank list because one of the residents at the dinner didn't like the candidate's hair. I kid you not. For some reason the PD thought this was a good way to evaluate candidates.

SO... I imagine most programs are like RadiologyPD's and screen only for psychos, but not all programs are benign and residents can be unbelievably petty with their comments. If the residents at the pre-interview dinner tell you that they are not evaluating you (which they should), then I would trust them. If they do not tell you this, then be on your better behavior.

Can you let me know what program this is so I can avoid interviewing there? PM would be fine as well. Thank you.

 

[sunnysnow7]

Hi, RadiologyPD.

Thank you for all of the info! This thread has been incredibly helpful.

Quick question: is averaging the Step 1 and 2 scores commonplace in radiology? I was under the impression that many programs only consider Step 1, but Step 2 CK appears to be a relatively important factor at your program.

Thanks again!

 

[SamuelTesla]

Thanks for your time RadiologyPD.

At the end of every interview with a PD/attending there is always the "do you have any questions?" There are lot of memorized questions to choose from, but are there any specific questions that are especially important or you are impressed by?

 

[RadiologyPD]

Quick question: is averaging the Step 1 and 2 scores commonplace in radiology? I was under the impression that many programs only consider Step 1, but Step 2 CK appears to be a relatively important factor at your program.

I honestly don't know.

It's been so long since I took these exams that I can't even remember the differences in material, other than a perception that step 1 was more basic science and step 2 was more applied stuff. Because not all students take step 2 prior to application/interview decisions, I suspect that some programs rely only on step 1 as a differentiator of "book smarts" or study skills. But I know that some medical schools seem to do a better job preparing their students for step 1 outperformance. As I've mentioned, I assign a step 2 to anyone that doesn't take step 2 (previously we have added 5 points to step 1, but this year we've just assumed step 2 = step 1--this underestimates the true step 2 for most, since our average applicant scores 7 points higher on step 2 than step 1, but it seem only fair to give a minor boost to the applicants that went ahead and took step 2 instead of those who chose not to risk it). This allows me to determine a combined step 1 + step 2 score. Somewhere in my past I remember somebody saying that step 2 scores are more correlative with residency performance as compared to step 1.

Bottom line is that I don't want my residents to have any problems with standardized tests, even if they are terrible predictors of a good radiologist. It just gives me more to worry about if I have a resident who isn't a good test taker, since radiology Core exam now is another standardized test. I like to give applicants "2 cracks" at showing me that they are sufficiently good at taking tests vs. have issues taking tests.

As a differentiator between candidates, USMLE performance is a terrible metric. I know that the student who got 265/265 on step 1/step 2 isn't more likely to be a better resident than the student who got 245/245, even though the score is almost one standard deviation higher. That's why my system basically gives only a slight nudge to the 265/265 person over the 245/245 person, the degree to which is easily overcome by a better clinical clerkship record or better interview assessment. On the other hand, if we are going to rank the 225/225 student above the 265/265 student, that 225 student had better impressed me in other ways. The 205/205 student is just too much of a risk for me. The 205/245 student tells me that they can pass the standardized test not exclusively testing basic science stuff, and maybe that they've learned how to take these standardized tests. That's why I want to see step 2.

At the end of every interview with a PD/attending there is always the "do you have any questions?" There are lot of memorized questions to choose from, but are there any specific questions that are especially important or you are impressed by?

I hate this whole notion that interviewers are "grading" how good someone's questions are (though I have heard of this) and that interviewees feel like they have to have an arsenal of "good questions". I catch myself asking interviewees if they "have any questions" and I feel stupid the minute that phrase comes out of my mouth because I know they think I want them to ask a question, when the reality is that I just wanted to make sure they didn't leave that day with any unknowns. So I'm the wrong person to ask about this whole "question" charade.

What I've been trying to do recently is start the interview by saying, "At the end of our short time, I might inadvertently ask you if you have any questions--what I mean by that is simply if my presentation in the morning and your discussions today have left you with anything of importance that remains unclear--do not feel compelled to make up any questions, I am not assessing you with that query." You have to understand that as an interviewer, we know we are in charge of the flow of the interview--sometimes due to fatigue our minds hit a blank--we don't know where to go with the interview--so we blurt out "do you have any questions?--it's a crutch for us. We're really asking you to save us from this awkward place where we have 3-5 more minutes for the interview but we don't know what topic to explore next.

When you get asked that question, it's probably best to explore a topic that is truly meaningful to you and to state the question in a way that makes it clear that it is important to you. Example: you are truly interested in developing leadership skills--state that you are truly interested in developing leadership skills, so how are chief residents selected?. Example: you are truly interested in doing an international elective--state that you are truly interested in doing an international experience in your R4 year, is that possible at the program and how? Example: you are truly interested in neuroradiology--state that you are truly interested in neuroradiology, how many prior residents have done fellowships in that area, where, and are any now junior faculty at academic centers? Example: you are truly interested in further developing quality improvement skills--state that you are truly interested in further developing quality improvement skills, so is there an opportunity for residents to be involved in departmental QI projects, and have any residents done so in the past? Example: you are truly interested in organized radiology--state that you are truly interested in organized radiology, so is there a way for residents to become active in the ACR in the program. The purpose of asking a question about something of true interest to you is that you actually seem interested in the answer--I absolutely can't stand it when someone asks me a question and I get the sense the only reason they asked me the question is because they thought it would be a good question to ask. It also helps you understand if this is the right place for you--does the program inspire you to be the best version of what you want to be (see post #21).

 

[SamuelTesla]

Thank you for the awesome answer RadiologyPD.

I am in a unique situation. I am a PGY2 general surgery categorical resident who saw the light in IR and is now switching. Most of my scheduled interviews are in DR programs or programs with ESIR. Only one integrated IR interview. If you were interviewing me as a PD of a DR program are there anything specific you are looking for?

 

[RadiologyPD]

What I look for in any candidate does not seem to change for me (see post #41).

What do I care as a PD if you choose to go into MSK vs. Neuro vs. Abdomen vs. IR vs. Breast vs. Nukes vs. combinations of 2 or 3 vs. whatever? So your intention of doing DR and then essentially what used to be called a fellowship (and in the future will be called an independent residency, with or without a preceding ESIR year) doesn't really matter to me.

I actually don't even care if you are "open" to the idea of doing a fellowship in DR or are dead set on doing IR. I've seen enough people who get their eyes open to what their particular talents are during residency to know that things can change.

Having said that, having now been introduced to SDN and having read a number of random comments from medical students who somehow can't stand DR but want to do IR and will tolerate DR only as a pathway to an "exclusive IR" position not only makes me chuckle but also makes me realize that I have to be sure I don't get one of those people as a DR resident. Your ability to be really valuable and innovative in IR is related for many people (admittedly not all people) on your aptitude for many of the principles that you'll learn and use in DR. You have to be open to trying to be the best DR person you can be even if you want to go into IR.

I'll agree that there are some amazing IR people who probably would have been just as good if they'd never learned any DR--but my guess is that isn't the case for most people. There is an imager's mindset that informs your approach in IR. If you think I can't know what I'm talking about because I'm not an IR trained person, let it be known that I have done a hell of a lot of what passes for IR in most practices--biopsies, nephrostomies, fluid aspirations, ablations--though admittedly no intravascular work since residency. So I'd rather not have to deal with someone who sees the DR residency as something to suffer through on their way to interventional heaven.

When I was a medical student, my medical school roommate briefly dated an undergrad who insisted she was going to be a cardiothoracic surgeon. After they stopped dating, we often chuckled about it, shaking our heads. Sometimes I get that feeling when I read some of these posts from the "I'll suffer through DR to get to IR" crowd whose sole exposure to DR was watching someone read out films and who got to hold and maybe push some catheters in the IR suite.

Don't come across as that person if you want a spot in my DR program.

 

[DrfluffyMD]

What I look for in any candidate does not seem to change for me (see post #41).

What do I care as a PD if you choose to go into MSK vs. Neuro vs. Abdomen vs. IR vs. Breast vs. Nukes vs. combinations of 2 or 3 vs. whatever? So your intention of doing DR and then essentially what used to be called a fellowship (and in the future will be called an independent residency, with or without a preceding ESIR year) doesn't really matter to me.

I actually don't even care if you are "open" to the idea of doing a fellowship in DR or are dead set on doing IR. I've seen enough people who get their eyes open to what their particular talents are during residency to know that things can change.

Having said that, having now been introduced to SDN and having read a number of random comments from medical students who somehow can't stand DR but want to do IR and will tolerate DR only as a pathway to an "exclusive IR" position not only makes me chuckle but also makes me realize that I have to be sure I don't get one of those people as a DR resident. Your ability to be really valuable and innovative in IR is related for many people (admittedly not all people) on your aptitude for many of the principles that you'll learn and use in DR. You have to be open to trying to be the best DR person you can be even if you want to go into IR.

I'll agree that there are some amazing IR people who probably would have been just as good if they'd never learned any DR--but my guess is that isn't the case for most people. There is an imager's mindset that informs your approach in IR. If you think I can't know what I'm talking about because I'm not an IR trained person, let it be known that I have done a hell of a lot of what passes for IR in most practices--biopsies, nephrostomies, fluid aspirations, ablations--though admittedly no intravascular work since residency. So I'd rather not have to deal with someone who sees the DR residency as something to suffer through on their way to interventional heaven.

When I was a medical student, my medical school roommate briefly dated an undergrad who insisted she was going to be a cardiothoracic surgeon. After they stopped dating, we often chuckled about it, shaking our heads. Sometimes I get that feeling when I read some of these posts from the "I'll suffer through DR to get to IR" crowd whose sole exposure to DR was watching someone read out films and who got to hold and maybe push some catheters in the IR suite.

Don't come across as that person if you want a spot in my DR program.

For applicants with an aspiration in IR, it’s absolutely vital to keep an open mind and heart. Do recognize that expertise in diagnostic imaging is what set IR apart from other procedural specialists.

With that being said, it’s absolutely OK to not want to do any diagnostic work, just keep that sentiment to yourself during DR interviews. I’ve personally would never take a job with any significant diagnostic component, as it’s just something I don’t enjoy. Keep in mind that the entire professional society of IR more or less is supportive of folks who want to do 100% IR and those jobs are out there (mostly academic though).

Just keep your head down, learn diagnostic well, and recognize that you are fundamentally different from a diagnostic radiologist.

 

[servingtheunderserved]

MS1 here with a question.

How is someone with a few years of work experience in a radiology department viewed? For reference this was someone who was not taking x-rays and CTs, but was helping with getting patients ready, as well as assisting radiologists with some common procedures such as fluoroscopy and biopsies. Will this help, hurt, or not really have an impact on a residency application?

Thank you.

 

[RadiologyPD]

That experience is mildly positive to your application.

 

[medicalschool123]

Hello RadiologyPD,

Does your institution (or radiology programs in general) require Step 2 CS to be completed for ranking? I currently have my exam scheduled in December, and I'm worried that my score may come back too close to rank list submission. I've also heard of programs finalizing their rank list weeks before the due date - is there any truth to this?

Thanks!

 

[RadiologyPD]

We don't require Step 2 CS for ranking. Not sure about other programs.

We do finalize our rank list well in advance of the due date. We try to complete this as soon as possible after interviews are completed, since we have a final review meeting where we finish the ranking and my selection committee will forget their impressions of candidates if too much time elapses from the end of interview season. Remember, at my program, your Step scores get you your ticket to the dance, along with your clerkship performance, and with some other stuff at the margins (see post #9)--once you interview, it's the other stuff that gets prioritized for ranking.

 

[spruntable]

Hi RadiologyPD, thank you so much for your time and your insights. This has been tremendously valuable to a lot of students!

I was wondering if you would offer your thoughts on having a faculty member in an applicant's home radiology department reach out to your institution on the candidate's behalf, either in trying to help the candidate secure an invitation to interview or trying to help improve the candidate's position on the rank list. You've detailed a scoring system with some wiggle room built in, so I guess I'm wondering: 1) whether this tends to actually have a positive effect vs. being neutral/bothersome and 2) assuming this can indeed bump a borderline candidate, when is the optimal time to have a faculty member reach out?
Thanks again!

 

[ValleyRad2018]

Hi RadiologyPD,

I appreciate all of your insight, and I know you have already detailed extensively your applicant evaluation process. One question I have is do you have any insight into how regionally biased programs are throughout the country. This application season has been very strange for me. I have plenty of interviews and overall am very pleased with the response. However, it has been completely unpredictable as far as which programs will offer me invites.

I have received several 'top tier' invites (like top 5 on doximity), but have been waitlisted at a number of other academic programs in particular areas. One example is an interview at Northwestern and U Chicago but rejected by Rush. There are other similar examples. I'm not complaining because I have plenty of interviews and statistically will likely match, but there are certain programs I am very interested in that have seemingly taken a pass, while others that I believed to be 'reach' programs have offered me invites.

There doesn't seem to be a method to this madness.

 

[recycledpaper]

I mean, if some Chicago programs are interviewing you and others are not, that doesn't really sound like REGIONAL bias to me. Either way, that's a #humblebrag post if I've ever saw one.

 

[Rads4lyfe]

Hi RadiologyPD,

I appreciate all of your insight, and I know you have already detailed extensively your applicant evaluation process. One question I have is do you have any insight into how regionally biased programs are throughout the country. This application season has been very strange for me. I have plenty of interviews and overall am very pleased with the response. However, it has been completely unpredictable as far as which programs will offer me invites.

I have received several 'top tier' invites (like top 5 on doximity), but have been waitlisted at a number of other academic programs in particular areas. One example is an interview at Northwestern and U Chicago but rejected by Rush. There are other similar examples. I'm not complaining because I have plenty of interviews and statistically will likely match, but there are certain programs I am very interested in that have seemingly taken a pass, while others that I believed to be 'reach' programs have offered me invites.

There doesn't seem to be a method to this madness.

I had a similar experience when applying. My guess is that bigger named programs expect people to come from all over the country to their program. However, smaller/community programs will sometimes overlook stellar candidates who have no geographic ties, since it would be a waste of time to interview that person, since he/she is unlikely to rank the program high. Just my guess.

It is pretty random at times too though. I was talking to my coresidents, whom mostly have similar stats, and we all got some invites that others didnt(similar tier programs). For example, one resident got invites at program A but not program B. While another resident got invite at B but not A. We all pretty much had a few interview invites like that.

 

[ValleyRad2018]

I mean, if some Chicago programs are interviewing you and others are not, that doesn't really sound like REGIONAL bias to me. Either way, that's a #humblebrag post if I've ever saw one.

Not at all trying to brag. As a non-traditional candidate, I am far from the days of caring what people think or trying to win a pedigree contest. I tried to use Chicago as an example, but perhaps it was not the best one. My point was I have gotten some very good interviews, for which I am extremely thankful, but there are certain programs that I was particularly interested in going into this process (because of location, family ties, prior experience, etc.) that aren't typically considered in same caliber as a U Chicago (some community programs, etc) that haven't given me the time of day.

 

[RadiologyPD]

I was wondering if you would offer your thoughts on having a faculty member in an applicant's home radiology department reach out to your institution on the candidate's behalf, either in trying to help the candidate secure an invitation to interview or trying to help improve the candidate's position on the rank list. You've detailed a scoring system with some wiggle room built in, so I guess I'm wondering: 1) whether this tends to actually have a positive effect vs. being neutral/bothersome and 2) assuming this can indeed bump a borderline candidate, when is the optimal time to have a faculty member reach out?

A personal reach-out to the PD from a faculty member at your institution's radiology department is pure gold to your application. Totally positive. Optimal time depends on what is needed. If the applicant needs to get an interview, then the optimal time is before interview decisions are made. If the applicant really wants to match there and has already been offered the interview, then the optimal time is after the interview and before ranking decisions are made.

I appreciate all of your insight, and I know you have already detailed extensively your applicant evaluation process. One question I have is do you have any insight into how regionally biased programs are throughout the country. This application season has been very strange for me. I have plenty of interviews and overall am very pleased with the response. However, it has been completely unpredictable as far as which programs will offer me invites.

Programs get 70-150 applications for each position they have, depending on whether the program is huge or small. Even if you weed out the applicants that really aren't qualified or just aren't in the ballpark of credentials for that particular program, you are talking about at least 30-50 qualified applicants for each position. This is because everyone applies everywhere these days. I personally think the application system is broken in this respect. I almost wish there was an "early decision" system in which applicants could apply to that person's "top choice" if that person has already established top choices. Make it so early decision happens by mid November, get these applicants matched up to their favorite programs, and get them out of the system, and then let everyone else interview in December, January, February. Since maybe 40% of applicants match to their top choice in the end (can't remember the exact number), this alone would save tons of time in the interview process.

That's an aside related to your question. Especially in urban areas where applicants sometimes have to stay due to significant others, programs that aren't considered at the top of the urban area have a problem, especially if they are smaller. Often the same cohort of applicants will apply to all the programs in that urban area. Each program only has the bandwidth to interview a fraction of the applicants, so some programs are going to favor personal experience with resident applicants (aways) and other factors over traditional "academic" metrics in which they may not compete as well against the bigger dog in their area. Also, there isn't a straightforward set of metrics that predict who is going to be a "great radiology resident". So there is bound to be some variability in how each program sees your application in relation to their estimation of whether you will match to their program.

I had a similar experience when applying. My guess is that bigger named programs expect people to come from all over the country to their program. However, smaller/community programs will sometimes overlook stellar candidates who have no geographic ties, since it would be a waste of time to interview that person, since he/she is unlikely to rank the program high. Just my guess.

I agree.

there are certain programs that I was particularly interested in going into this process (because of location, family ties, prior experience, etc.) that aren't typically considered in same caliber as a U Chicago (some community programs, etc) that haven't given me the time of day

If this is the case, then I would say you didn't do a good job convincing those programs that you were really interested in them. Take the time to tailor the personal statement appropriately for that program, and reach out separate from the application (via direct communication) to express your genuine interest in that program, with a well articulated rationale why you would consider that program highly in your Match considerations.

 

[kim873]

A word of warning to applicants. Benign programs will act this way, but there are programs that use the pre-interview dinner to evaluate and even eliminate candidates. I remember one program that would gather its residents together after the dinner and the residents would basically vote people off the island. It made me a little sick. One person was dropped way down the rank list because one of the residents at the dinner didn't like the candidate's hair. I kid you not. For some reason the PD thought this was a good way to evaluate candidates.

SO... I imagine most programs are like RadiologyPD's and screen only for psychos, but not all programs are benign and residents can be unbelievably petty with their comments. If the residents at the pre-interview dinner tell you that they are not evaluating you (which they should), then I would trust them. If they do not tell you this, then be on your better behavior.

I know you are switching specialities. May I ask what speciality practiced this form of weeding applicants.

I only ask because, I also am switching specialties. And this vaguely sounds like in/gyn or surgery.

Also I have really frizzy curly hair, and am worried of interviewing with my natural hair, and am considering straightening it for the entire interview season.

 

[Jfandango]

When is a good time to reach out to programs to express interest? Is it still too soon? Some other applicants got rejections from programs I still haven't heard back from, so I'm hoping no news is good news, but if it helps I'd like to sent emails to program coordinators to express interest. I just don't want to jump the gun and hurt my chances.

 

[ValleyRad2018]

When is a good time to reach out to programs to express interest? Is it still too soon? Some other applicants got rejections from programs I still haven't heard back from, so I'm hoping no news is good news, but if it helps I'd like to sent emails to program coordinators to express interest. I just don't want to jump the gun and hurt my chances.

Hey, I'm no expert on this, but I've reached out to a few programs (several weeks ago) and received a good response. I did the same when applying for a different specialty 2 years ago and it worked out well. In fact, one of my co-residents at prior program was not scheduled for an interview, reached out to the program, and ended up matching there. At this point I'm not sure there's too much harm in reaching out. Just my 2 cents.

 

[RadiologyPD]

Also I have really frizzy curly hair, and am worried of interviewing with my natural hair, and am considering straightening it for the entire interview season.

Candidates want to put their best foot forward in terms of hygeine/appearance during the interview, and you know better than anyone what does and doesn't resonate about your appearance with others when you interact with them...BUT significantly changing your preferred hairstyle because some people don't like curly hair makes me feel sad about the state of humanity--

When is a good time to reach out to programs to express interest? Is it still too soon? Some other applicants got rejections from programs I still haven't heard back from, so I'm hoping no news is good news, but if it helps I'd like to sent emails to program coordinators to express interest. I just don't want to jump the gun and hurt my chances.

Not too soon. Its only too soon if they aren't in application review mode--trust me, all PDs have started (and some nearly completed) reviewing applications. If they have rejected others but not you, it's the perfect time...do not delay. Having said that, there should be a reason for the reach out...something that aligns you with that program that wasn't obvious from your application. If you study in the Northeast and want to express sincere interest in a smaller program on the West coast, that makes sense as the program might not want to "waste" an interview on you thinking you aren't really interested and you are just trying to get your 10 interviews--I would have done that with a personalized personal statement but if you didn't, then express the interest. If you are reaching out to the program across the street, or to a brand name, or any program and all you are saying in the reach out is that you really really like the program because of x, y, z--but you are not addressing a reason the program might not yet given you an interview, then it won't work, and can backfire.

 

[Gadofosveset]

I know you are switching specialities. May I ask what speciality practiced this form of weeding applicants.

I only ask because, I also am switching specialties. And this vaguely sounds like in/gyn or surgery.

Also I have really frizzy curly hair, and am worried of interviewing with my natural hair, and am considering straightening it for the entire interview season.

?

This is a Rads program.

Don't get hung up on hair, or teeth, or clothes, or whatever. Just use your good sense and realize you can't control what everyone thinks about you. The important point was that if the residents don't tell you explicitly that they aren't evaluating you, then there is a chance that they are.

 

[radiologay]

I was wondering if you have any experience with military applicants? I have a good amount of interviews at programs I am very excited for, but I am worried that my military status could be a detriment to matching.

There are two major paths I am allowed to pursue civilian training through; these are civilian deferred and civilian sponsored.

- Civilian deferred: I would separate from the military during residency/fellowship and be paid by the civilian training institution that I match to before again joining the military and finishing my commitment.

- Civilian sponsored: I would remain in the military, but would be training at the civilian institution I match at. The military would pay my salary and the civilian institution would have zero financial obligations to train me. Similarly to deferred, I would be working for the military after residency/fellowship.

My question is, are the places I'm interviewing at going to care which path I am doing? I am doing civilian deferred and I have heard I will be less likely to match because interviews may have been extended to me under the assumption that I would essentially be "free labor" for 5 years.

 

[kim873]

?

This is a Rads program.

Don't get hung up on hair, or teeth, or clothes, or whatever. Just use your good sense and realize you can't control what everyone thinks about you. The important point was that if the residents don't tell you explicitly that they aren't evaluating you, then there is a chance that they are.

I understand the point of residents evaluating me in the dinner.

But it has been mention in my few interviews why I switched my hairstyle since my photo didn't match my person that day. But as a URM female with frizzy curly hair (let's not forget when a certain us female gymnastic Olympian got so much hate for her hair being slightly out of place while competing) my concerns are actually valid.

If I had non frizzy hair that would be one less thing I have to care about, but yea appearances matter. And frizzy hair may make people think I didn't care about putting my best foot forward. Just my two cents.

 

[RadiologyPD]

My question is, are the places I'm interviewing at going to care which path I am doing? I am doing civilian deferred and I have heard I will be less likely to match because interviews may have been extended to me under the assumption that I would essentially be "free labor" for 5 years.

Yes, it makes a difference and some programs will care. This should be obvious.

If you are civilian deferred, you will be ranked compared to other competitive candidates. Your chances of matching are based on how well you stack up against others. You have no advantage or disadvantage based on your military status.

If you are civilian sponsored, meaning the program does not pay your salary/benefits, then you will be ranked based on whether or not you can add value to the program. Your value to the program is a function of your potential as a radiology resident AND anything the residency might be able to do if they don't have to pay your salary/benefits.

For some programs, that money "savings" does not really go back to the program or department, but rather the institution--in that setting, your candidacy does not really have any "extra" tangible value to the program beyond your potential as a radiology resident--in that case, your chances of matching are based on how well you stack up against others (same as above).

For some programs, your salary/benefit savings could translate to an extra resident, or extra fellow, or extra research intern, etc. for the department and/or the program--for 4 years. For those, programs, you obviously have more value to the program than just your potential as a radiology resident. For those programs, your chances of matching are HIGHER than the standard applicant, whose value to the program is limited to their value as a radiology resident.

 

[reslife56789]

Hello RadiologyPD! From the selection committee stand point, what is the perception of post interview thank you letter? In addition, do we write a thank you letter to everyone that we interviewed with? And will it look bad if we use the same template for interviewers from the same program? Thank you!

 

[loshun]

Hey there @RadiologyPD. Question about the lucky waitlist applicants that receive invites. If we're invited to a waitlist interview to a top program, and personally it's clear I didn't quite make the #'s cut the first time around -- at this point -- does interviewing well hold more weight than my numbers?

It's hard because I imagine most interviewees pretty much interview all the same, fairly well with good answers. I wonder what the selection committee really looks for in these instances that might make a waitlist candidate really stand out or be worth ranking highly.

 

[RadiologyPD]

Hello RadiologyPD! From the selection committee stand point, what is the perception of post interview thank you letter? In addition, do we write a thank you letter to everyone that we interviewed with? And will it look bad if we use the same template for interviewers from the same program? Thank you!

I tell applicants at the end of our interview day that I don't care if they send a thank you letter or not, that it won't help them or hurt them if they do. Anyone on the selection committee that is relatively new usually thinks a thank you note implies a heightened level of interest in the program, and they sometimes forward them or send them to me thinking that the applicant may have only sent it to them. I know all too well that these mean nothing. It truly does not matter to me that a candidate sends me a hand-written note on personal stationary. I cannot say if that is true for others. Some people still send thank you notes even after I tell them that they don't affect their standing in any way, and I don't think it matters if they use the same template.

Hey there @RadiologyPD. Question about the lucky waitlist applicants that receive invites. If we're invited to a waitlist interview to a top program, and personally it's clear I didn't quite make the #'s cut the first time around -- at this point -- does interviewing well hold more weight than my numbers?

It's hard because I imagine most interviewees pretty much interview all the same, fairly well with good answers. I wonder what the selection committee really looks for in these instances that might make a waitlist candidate really stand out or be worth ranking highly.

I don't think programs consider whether or not the candidates who interview were "first cut" vs. "second cut" vs. "waitlist". Remember, typically the selection of who interviews is done by a much smaller subset of the selection committee--in my program, just me--so the selection committee/interviewers usually don't know that you were a wait list person or first cut person. Secondly, I think the interview impressions usually substantially outrank the initial metrics in the final decision (see my earlier posts regarding the process at our place--interview is at least 50% of the final "score" and my selection committee often doesn't really even follow the score, many people are heavily influenced by their "blink" assessment of candidates during the interview. As someone who favors data and objectivity, I find that a little short-sighted but I understand it.

Bottom line--most interviewees do NOT come across the same in interviews and the answer to the question "do I want to work with this person for 4 years" often reflects assessments that have nothing to do with relative USMLE performance or even relative clinical clerkship scores (which are so hard to compare from school to school anyway). To the extent that the invitation to interview is often heavily influenced by those metrics, you can see that there can be a complete disconnect between the "rank order" of candidates pre-interview and the eventual rank order of candidates.

 

[recycledpaper]

Hi RadiologyPD,

Having been on two interviews so far with a third in a few hours, are there any suggestions to honestly gauge how your interview performances go? Obviously, you will be better at describing certain things, more comfortable etc as you do more interviews, but on a program-by-program basis, anything I should be looking out for that would either indicate a successful/memorable interview vs an unlikely to be ranked high interview? It would also help me change up my approach to certain questions/scenarios so that I can get better at interviewing.

Thank you for your time!

 

[RadiologyPD]

Sorry, no special advice here, other than to go with how you feel. It sort of depends on your emotional intelligence--if you have it, then you'll know to some degree how the day went, and honestly it won't matter--the interview is over. If you are saying you have the ability to adjust how you behave/come across so that you'll get vastly different responses from people, then by all means put your best foot forward from the beginning--no need to see if your "B game" was good enough.

If you don't have any EQ, then I'm not sure I can explain all the non-verbal clues that might help you understand how you did.

 

[Oops_I_Messed_Up]

I'm an M4 who was set on applying to ENT but have realized (unfortunately late) that it is not the specialty for me. Had a radiology elective in October and I really liked the field and would like to apply to it. My school won't let me delay graduation so it seems like I have to scramble, apply to a prelim spot, or sit this cycle out and apply next cycle. Due to personal reasons and my goal to get into a good academic program I would like to avoid scrambling. I think sitting out this cycle is my best option so I can focus on research and working with faculty to get good LORs but my school is pushing for me to grab a prelim spot (or scramble). I was wondering if you had an opinion on someone in my position. Would I be at a big disadvantage withdrawing this cycle and applying to the next one? (my personal statement would state what happened that led to this decision)

 

[RadiologyPD]

I think your plan is better. If you grab a prelim spot now, you effectively cut yourself out from all of the categorical program slots (the ones that have the internship built in). You would have to interview during your internship, which can be difficult. Granted, there may be spots in SOAP but this year it seems less likely that there will be great residency spots open given the increase in US grads interviewing for rads. If you were competitive for ENT, you'd should have a good shot at good programs. If you can afford to sit this cycle out, I think that is your best bet.

 

[RadsApplicant1]

Hello @RadiologyPD - Thanks for doing this, we really appreciate all your insights into the application process. Just wanted to ask a question I've gotten conflicting advice on: Is it possible to defer matriculation for a year once you've already matched?

If so, how exactly would that process work, how would they be able to fill the spot you left for categorical radiology programs vs advanced radiology programs vs prelim programs, and how supportive/unsupportive would programs be if someone asked to do that?

 

[RadiologyPD]

No, not possible to defer. No way that could work.

 

[pandh83]

As I have yet to describe, our program gives more weight to factors we try to glean from the interview. As you might imagine, not all of our 7 selection committee members see these factors exactly the same way when evaluating any one candidate. The "uphill battle" is that every one of the selection committee members balances their interview assessment against the "perception" card, and I know from seeing this play out that the IMG candidate's stock goes down, especially given the recent past in which more radiology programs have had to turn to the SOAP--my committee is justifiably worried about perception. Like it or not, it is a real issue. Since I see this all the time, why waste my committee's time presenting them with candidates that they are going to ding due to perception? As a result, I am increasingly hesitant to bring most of the IMGs in for an interview, because I don't want to waste their money or time. The 3 candidates chosen were all US IMGs with super high step 2 scores, great clerkship performance, with great letters. They also clearly explained in their application how and why they ended up going abroad for school in what came across as a sincere life circumstance issue. I think they are going to do fine in the Match--as others we've interviewed in the past have done--but it's just tough at my program. Again, being honest. They also clearly explained in their application how and why they ended up going abroad for school in what came across as a sincere life circumstance issue. I think they are going to do fine in the Match--as others we've interviewed in the past have done--but it's just tough at my program. Again, being honest.

I was wondering how would someone explain this in someone's application about going abroad in for med school? I went abroad(Caribbean) at age 17 because becoming a doctor in 6 years(+cousin matching in Cleveland clinic IM 7 Years ago) seemed great while in hindsight I had no idea how much of an uphill battle it would be. I have noticed attendings perspectives change a lot for better when I mention I went straight from high school vs them assuming I went after doing undergrad. Understandably being an IMG will be a huge ding on an application but I want to maximize my chances at matching in a field I really want to go into.

I was also wondering if getting a 2nd radiology letter a necessity for a good application or having 1 rads+3 IM(one chair) sufficient.

 

[RadiologyPD]

You could address head on why you are at the Caribbean school in your personal statement, which would provide some insight, but sounds like you will then also be battling the "not enough life experiences" stigma. Personally I know many outstanding physicians/radiologists who have done the 6-7-8 year BA/MD programs from the US (Brown, UMKC, GW, etc)--even they have some haters related to the fact they went straight into medicine from high school.

Look, you have to understand that many PDs know that there are outstanding IMG students--outstanding. The problem is two-fold: (1) perception--if a program can fill with seemingly good/great US grads, they are going to do that, because it helps them recruit in future years...if you look at SDN threads everywhere, the assumption is that a program that routinely fills with IMG candidates could not attract US grads for some reason; (2) hard to figure out who the diamonds in the rough are coming from IMG schools, since the clinical clerkships tend to be at less academic places, the opportunities for research experiences are lower, and the letter writers are unfamiliar.

Your best bet is to do clinical rotations or research experiences at places and impress the hell out of them as a way to get into their residency, or at least get you stellar recommendations from academic people. 2nd radiology rec is not a necessity--but you can help your cause by impressing some radiologists who work at academic centers.

 

[Obama123]

Hey RadiologyPD,

I appreciate all the feedback you've given. I was wondering if you had any insight on the implications of a failed Step 2 CS on matching into fellowship.

To give a little background, I passed it with ease the 2nd time. I otherwise have high board scores, AOA, all clinical honors in med school, and am attending a top tier residency. I had matched before getting my CS score back. Step 2CS was kind of a blip in my record and has been haunting me since.

Based on your experience, how will this affect my chances at landing a more competitive fellowship at a desirable location?

Thanks again!

 

[RadiologyPD]

Should not affect your chances, since you have many years of history after this to vouch for your abilities. Fellowship selection is less about USMLE metrics and more about residency prestige/performance/LORs.

 

[reslife56789]

Hello Radiology PD. Will really appreciate your advice for this, recently received my step 2 ck score and instead of improving, my score went down a bit compared to my step 1 score (high 240s). I am in a good position in terms of interview invites, but wondering what should I do in this situation in order to maximize my chances of matching into my top programs. (whether I should release my score now or after my interviews, will this impact my chances of matching into a good program significantly, etc,.) Thank you so much!

 

[RadiologyPD]

No need to release the step 2 score unless required by any residency at which you interview. To be honest, once you make it to the interview stage, it’s doubtful that a slightly lower step 2 will even be looked at by the program. Of course, if you failed it or massively underperformed and the program is aware, it could hurt. At my program, we actually don’t go backward to get that data, but maybe that’s because we have penciled in and assumed a step 2 number if we didn’t have it when we made the selection for interview. It’s possible the programs that don’t make an assumption about your step 2 will actually go back and get it. However, I don’t think programs do it that way. I actually think that most programs have a mini ranking session immediately after the interview that roughly determines your general position and that any final meetings will only serve to tweak that slightly.

 

[speedyxx626]

I haven’t seen this asked yet, and you don’t have to answer if you don’t think it’s appropriate. Would you be able to comment on what percentage of applicants that send you #1 letters were actually ranked to match in your program? I know it will vary greatly based on institution, but a ballpark number would be be intersesting to see...

 

[RadiologyPD]

I’m not the best person to answer, because I explicitly tell applicants at the end of the interview day that we don’t attach any weight to “love letters” and we don’t send out any rank to match communications. I’m pretty clear to the applicants that them telling us that we are their number one choice won’t affect their chances at all. My guess is that this decreases the number of love letters that we get. Even so, we still get a few—more often than not they are not “ranked to match”—and we don’t change their rank based on the letter. We have had a few candidates who happened to be ranked to match telling us or implying that we were their number one choice, who then did not actually match with us. I end up remembering these people in a negative way for a long long time. It’s really a stupid bonehead move if you ask.me.

 

[SpartanWolverine]

I haven’t seen this asked yet, and you don’t have to answer if you don’t think it’s appropriate. Would you be able to comment on what percentage of applicants that send you #1 letters were actually ranked to match in your program? I know it will vary greatly based on institution, but a ballpark number would be be intersesting to see...

Not sure if this helps answer your question but, broadly, around 50% of applicants who match do so at their top 1 rank. >80% match in their top 3.

As to your specific question about letters it seems to vary widely. I've had a couple PDs tell me to shoot them an e-mail at the end of the season if I remain highly interested in their programs. Others, as @RadiologyPD is an example of, explicitly said that no letters or cards were necessary or weighed for/against us.

 

[ValleyRad2018]

Not sure if this helps answer your question but, broadly, around 50% of applicants who match do so at their top 1 rank. >80% match in their top 3.

As to your specific question about letters it seems to vary widely. I've had a couple PDs tell me to shoot them an e-mail at the end of the season if I remain highly interested in their programs. Others, as @RadiologyPD is an example of, explicitly said that no letters or cards were necessary or weighed for/against us.

When I applied previously, I was very surprised by how much post-interview interaction there was. The same has occurred this cycle. I think RadiologyPD has discussed this topic previously, but it is interesting because, at least in my case, these interactions DID influence my ranking decision.

But I thought it was a given not to tell a program they are your number 1 when that is not the case. Medicine can be a small world, and I can't imagine the thought process behind doing something like that.

 

[speedyxx626]

When I applied previously, I was very surprised by how much post-interview interaction there was. The same has occurred this cycle. I think RadiologyPD has discussed this topic previously, but it is interesting because, at least in my case, these interactions DID influence my ranking decision.

But I thought it was a given not to tell a program they are your number 1 when that is not the case. Medicine can be a small world, and I can't imagine the thought process behind doing something like that.

When did you start receiving communication from programs? Was it more towards January/February?

 

[ValleyRad2018]

When did you start receiving communication from programs? Was it more towards January/February?

I received the "ranked to match" emails mostly in January/February, but there was additional communication, even as early as a few hours after an interview, between October - February. I received letters in the mail as well.