Returning to residency... questions about the match from a GP

[Timmythemic22]

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Hey All,

Moderators, please feel free to redirect this thread to a more appropriate one, I wasn't sure where to post. My unique situation is I'm applying for family med through the match after working as a GP doing locum tenens work for the last two years. I'm officially 5 years out of medical school and have one year of pediatric and one year of surgery training. I have my first interview in a few weeks and I'm hoping you all may have some ideas on what kind of questions I should prepare for given my unique circumstances. Barring that, any resources to a general list of residency interview questions would be incredibly helpful (I've been out of this game for so long, it still feels so strange).

Other notes... I have no blemishes on my record, no withheld medical licenses, malpractice, or anything else on my record that would be cause for concern other than me leaving two residency programs because I wasn't finding the right fit for me. I loved aspects of surgery and peds, but I want the all-encompassing patient population family medicine brings. I would be glad to talk more specifics if that helps.

Thank you all so much. It's been a long time since I've been a regular on SDN but I have always found the posters to be knowledgeable, helpful and kind.

 

[the argus]

Hey All,

Moderators, please feel free to redirect this thread to a more appropriate one, I wasn't sure where to post. My unique situation is I'm applying for family med through the match after working as a GP doing locum tenens work for the last two years. I'm officially 5 years out of medical school and have one year of pediatric and one year of surgery training. I have my first interview in a few weeks and I'm hoping you all may have some ideas on what kind of questions I should prepare for given my unique circumstances. Barring that, any resources to a general list of residency interview questions would be incredibly helpful (I've been out of this game for so long, it still feels so strange).

Other notes... I have no blemishes on my record, no withheld medical licenses, malpractice, or anything else on my record that would be cause for concern other than me leaving two residency programs because I wasn't finding the right fit for me. I loved aspects of surgery and peds, but I want the all-encompassing patient population family medicine brings. I would be glad to talk more specifics if that helps.

Thank you all so much. It's been a long time since I've been a regular on SDN but I have always found the posters to be knowledgeable, helpful and kind.

Family med interviews aren't going to have many gotcha interview questions. It's mostly gonna be them trying to get a sense of your personality and whether you will be a good fit in their program. Interviews haven't changed in the last 5 years, whatever you did then will be fine for now. I would think the main question you better have a good answer for, and I'm sure I don't have to tell you this, is,

You have already dropped out of 2 residency programs. You have proven twice already that you have no problem leaving a program in a bind. Even if you didn't like the specialty, why didn't you feel an obligation to honor the commitment you made? Why should we take a chance on you? Can we trust you?

I think your chances of matching will almost solely rest on your ability to address this issue.

 

[Timmythemic22]

Family med interviews aren't going to have many gotcha interview questions. It's mostly gonna be them trying to get a sense of your personality and whether you will be a good fit in their program. Interviews haven't changed in the last 5 years, whatever you did then will be fine for now. I would think the main question you better have a good answer for, and I'm sure I don't have to tell you this, is,

You have already dropped out of 2 residency programs. You have proven twice already that you have no problem leaving a program in a bind. Even if you didn't like the specialty, why didn't you feel an obligation to honor the commitment you made? Why should we take a chance on you? Can we trust you?

I think your chances of matching will almost solely rest on your ability to address this issue.

Absolutely. I absolutely will be addressing that and have been planning it out. In fact, the majority of my personal statement discussed my circumstances. It will still be an uphill battle of course. Thank you for being frank.

 

[typhoonegator]

How does funding work for this situation? Haven't you used up two years of medicare funding already?

 

[Law2Doc]

As mentioned, for you the obvious questions are all going to relate to your prior residencies/history and why they didn't pan out. You aren't going to get the fluff canned standard interview questions and if you do they will be the easy things asked.. So expect something like - Why were the prior two residencies not good fits and why do you think family med would be better? How come you couldn't stick it out-- like lots of unhappy residents do? By now you could be a boarded doctor In something. Why should we believe you are going to stick it out this time? Why didn't you try a third residency rather than two years of "GP"? how many times have you done the match? What would your prior PD say was the reason you didn't stay on? What went wrong in your GP practice that you are now looking for more training? Do you think it will be hard going back to training after having worked for a while? Do you think your age/experience is going to create issues when dealing with young attendings and senior residents who might not have that many more years out of med school than you? Why should we take you with your red flags over someone with none?

And all of your answers to these may lead to follow up questions.

That's what I would want to ask you so I expect you'll see some stuff like that rather than generic fluff interview questions. Besides you've been through the interview process before (probably more than once) so I don't think there's much we can add here.

 

[Crayola227]

How does funding work for this situation? Haven't you used up two years of medicare funding already?

Yes. But there are threads on how much that matters to a program. Some programs are funding the spots themselves hence the Medicare funding attached to the resident matters not at all. This happens more commonly with surgical specialty residents as those departments are happy to have more surgeries being done by poor bastards, as we all know reimbursement is better for procedures even those by residents. Happens less often with primary care fields because even with Medicare dollars and cheap residents those departments are a money drain to the hospital (in fact the hiring of cheap ass subsidized residents in that case is one way to stem the tide...)

If the PD is smart, they are aware that this applicant has had former training, likely used up Medicare dollars (hm, unless maybe they were in one of those separately funded spots by the hospital to begin with...) in which case if they are interviewing this guy then I cannot imagine that is a huge barrier. Although it has happened that someone showed up to the interview, whereupon that was when the PD decided to tell the applicant it was a waste of time due to the funding issue.

OP, look at some of the old threads to see if you can find the post where someone brought this up. I believe they were advised at the point of preparing for interview to be sure the program had considered their medicare funding status. This isn't something that you are going to slide past them in the long run even if the have overlooked it in offering you this interview, and you don't want to be post hundreds of dollars of travel to be told "we forgot about that, thanks but no thanks."

TLDR:
Usually if a PD is interviewing someone with prior training and maybe has less funding, then it's not a big deal or they wouldn't be interviewing. A PD could make a mistake and waste both your time. You may want to look into talking with PD about it after being offered interview but doublecheck that.

 

[Crayola227]

OP one thing I do is google questions PDs ask residents, med schools put out resources like that, even specialty specific ones
Hopefully your alma mater med school is supportive, you could reach out to them for help potentially. Theoretically they have an investment in how you appear in perpetuity since what school you graduated from will always follow your name in your practice and reflect on them, at these program interviews for example.

 

[Timmythemic22]

As mentioned, for you the obvious questions are all going to relate to your prior residencies/history and why they didn't pan out. You aren't going to get the fluff canned standard interview questions and if you do they will be the easy things asked.. So expect something like - Why were the prior two residencies not good fits and why do you think family med would be better? How come you couldn't stick it out-- like lots of unhappy residents do? By now you could be a boarded doctor In something. Why should we believe you are going to stick it out this time? Why didn't you try a third residency rather than two years of "GP"? how many times have you done the match? What would your prior PD say was the reason you didn't stay on? What went wrong in your GP practice that you are now looking for more training? Do you think it will be hard going back to training after having worked for a while? Do you think your age/experience is going to create issues when dealing with young attendings and senior residents who might not have that many more years out of med school than you? Why should we take you with your red flags over someone with none?

And all of your answers to these may lead to follow up questions.

That's what I would want to ask you so I expect you'll see some stuff like that rather than generic fluff interview questions. Besides you've been through the interview process before (probably more than once) so I don't think there's much we can add here.

Thank you! Those are excellent, and I'm going to craft a reply to each one. These are the hard questions I need, and though I know there is always the 'correct' way of saying something, I want to maintain honesty at all costs and let them know who I am. I'm not about to present a false presentation especially when a good fit is needed not just on their side, but mine.

 

[Timmythemic22]

Yes. But there are threads on how much that matters to a program. Some programs are funding the spots themselves hence the Medicare funding attached to the resident matters not at all. This happens more commonly with surgical specialty residents as those departments are happy to have more surgeries being done by poor bastards, as we all know reimbursement is better for procedures even those by residents. Happens less often with primary care fields because even with Medicare dollars and cheap residents those departments are a money drain to the hospital (in fact the hiring of cheap ass subsidized residents in that case is one way to stem the tide...)

If the PD is smart, they are aware that this applicant has had former training, likely used up Medicare dollars (hm, unless maybe they were in one of those separately funded spots by the hospital to begin with...) in which case if they are interviewing this guy then I cannot imagine that is a huge barrier. Although it has happened that someone showed up to the interview, whereupon that was when the PD decided to tell the applicant it was a waste of time due to the funding issue.

OP, look at some of the old threads to see if you can find the post where someone brought this up. I believe they were advised at the point of preparing for interview to be sure the program had considered their medicare funding status. This isn't something that you are going to slide past them in the long run even if the have overlooked it in offering you this interview, and you don't want to be post hundreds of dollars of travel to be told "we forgot about that, thanks but no thanks."

TLDR:
Usually if a PD is interviewing someone with prior training and maybe has less funding, then it's not a big deal or they wouldn't be interviewing. A PD could make a mistake and waste both your time. You may want to look into talking with PD about it after being offered interview but doublecheck that.

My god, thank you. This is something I would have never considered. I only have one interview at this point but I will be sure to inquire. Things are at quite a lull right now, haven't heard from any programs since mid-October, and I'm still waiting on 25 programs. My biggest fear is that they have already all discounted me. It has been long enough from this process that my inner-neuroses have firmly taken hold that this is a futile endeavor. Sorry, I don't mean to turn this into a venting thread. This information has been wonderful.

 

[Timmythemic22]

Haven't used the search feature in a while... any particular key words to look up the topic at hand? I've tried 'returning to residency' or 'residency hiatus interview questions' haven't come up with much yet. Each year that passes I seem to be less tech savvy... durn yung-uns'...

 

[Crayola227]

try "resident medicare funding", post history by @aProgDirector because posts where resident dismissal, re-hire where he shows up is where I learned the most


http://forums.studentdoctor.net/sea...edicare+funding&o=relevance&c[user][0]=118297

this was that search term as applied only to aPD and it pulled up enough threads to get you started I think

and @gutonc gave you some good advice

definitely read all you can about resident termination, dismissal, resignation, transferring, legal stuff on this board because all of that info can help you understand the system at large and the concerns on both sides, plus those life imploding threads also have a lot of info on how to rebuild

 

[gutonc]

Thank you! Those are excellent, and I'm going to craft a reply to each one. These are the hard questions I need, and though I know there is always the 'correct' way of saying something, I want to maintain honesty at all costs and let them know who I am. I'm not about to present a false presentation especially when a good fit is needed not just on their side, but mine.

I'm going to point out that, given what you're dealing with, you don't really get to choose a "good fit". The best fit for you is a program that will interview and rank you.

You say that you have 1 interview and haven't heard from 25 programs. I assume that you applied to every single FM program in the country and got rejections from the rest.. If you didn't, you gravely miscalculated.

I'm not saying this to be a jerk. But beggars can't be choosers and you sir/maam, are a beggar. You claim no red flags, but you have at least 2, possibly 3 or 4. To enumerate...you quit not one, but 2 separate residency programs (and you don't mention if you successfully completed either of them, although I assume you did at least one if you have a license, hopefully you have glowing LORs from those PDs); your YOG is 5 years ago; you've been "a GP" for the past 3 years...(why didn't you re-enter the Match right away?)"; the funding thing".

I typically minimize the funding issue, but in your case, it's significant. PDs will often overlook the fact that applicants don't come with full funding (non-full funding is somewhere in the 75% range depending on the program) for a good applicant. But you're not a "good" applicant. You may be an amazing physician and would do any residency program proud. But you have enough other red flags to make a PD wary of spending extra cash (actually asking the institutional GME office, or the Dept. Chair to do so) on you.

So tomorrow you need to call those 25 programs you haven't heard from and ask what's up. Then on Wednesday (or tomorrow if you have time), you need to apply to every other FM program in the country that you haven't already applied to and is still open for applications.

 

[Timmythemic22]

I'm going to point out that, given what you're dealing with, you don't really get to choose a "good fit". The best fit for you is a program that will interview and rank you.

You say that you have 1 interview and haven't heard from 25 programs. I assume that you applied to every single FM program in the country and got rejections from the rest.. If you didn't, you gravely miscalculated.

I'm not saying this to be a jerk. But beggars can't be choosers and you sir/maam, are a beggar. You claim no red flags, but you have at least 2, possibly 3 or 4. To enumerate...you quit not one, but 2 separate residency programs (and you don't mention if you successfully completed either of them, although I assume you did at least one if you have a license, hopefully you have glowing LORs from those PDs); your YOG is 5 years ago; you've been "a GP" for the past 3 years...(why didn't you re-enter the Match right away?)"; the funding thing".

I typically minimize the funding issue, but in your case, it's significant. PDs will often overlook the fact that applicants don't come with full funding (non-full funding is somewhere in the 75% range depending on the program) for a good applicant. But you're not a "good" applicant. You may be an amazing physician and would do any residency program proud. But you have enough other red flags to make a PD wary of spending extra cash (actually asking the institutional GME office, or the Dept. Chair to do so) on you.

So tomorrow you need to call those 25 programs you haven't heard from and ask what's up. Then on Wednesday (or tomorrow if you have time), you need to apply to every other FM program in the country that you haven't already applied to and is still open for applications.

Acknowledged. I respect it's coming from a direct place. I've no regrets on any of my choices as they've made me who I am now. I've found a way to thrive despite every hardship incurred. My significant other also plays a role. It has to work for her as well, and if that means I don't find a place then I'll find a way to succeed regardless. I can think of a few places that I haven't reached out to however, and I'm going to reach out. Thank you, you aren't a jerk.

Though I suspect we may approach life differently ha.

 

[Timmythemic22]

I apologize for flooding my own thread... I'd be curious to hear more about your discussion on asking 'What's up? I'm at a loss for a delicate way to ask if they're even considering me... or perhaps you meant something different?

 

[Timmythemic22]

Just updating...

Thank you for the advice everyone. Not meaning for this to sound like a blog, but I wanted people to know I'm taking their advice. I spoke with a few people in faculty and because of my background funding will not be an issue (confirmed from multiple sources thankfully). I've applied to 15 more programs today, and I'm going to try and do more but honestly I'm running out of money, and this is the crux. I may have to try my luck with 50 programs. I'm sending out emails today and over the next week to programs. I hope this will pay off but I thank you just the same for your help. If you have any more insight please proceed, but I'll probably update this thread if I have any news.

 

[Crayola227]

Thank you and yes, please update us.

I hope you are successful and that whatever you learn we can all use to help people return to residency in the future as needed. Godspeed.

 

[deleted547631]

Wishing you luck that you gain a few more interviews and overcome this challenge to successfully match.

 

[evilbooyaa]

Dude. You NEED to apply to WAY more than 50 programs. Seriously. Every FM program in the country that you would be OK matching at should get an application. I agree with gutonc - you cannot be picky right now.

I understand money may be tight, but if you're staring at one interview (for FM) in late November, things may not end well for you.