SOAP/Scramble 2021 Thread

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My statement of medicine being conservative was not a political one...medicine is slow to move and still is very male centric with the idea that men have spouses that will take care of the family and the resident can focus on their job as being a trainee...your statement here shows that to be true... if you mentioned you are married with children during your interview, it would have been seen as a positive... stable and reliable because you have a family...it’s not so for women... because it’s still seen that women are still responsible for the family and it will divide her attention from training.
Is there some of that? Perhaps. But I think that you are overgeneralizing a bit, and frankly it's not very helpful. That particular reason isn't going to help her match the next time around.

Let's look at reality here for a second. She is a higher risk applicant. As NotAPD mentioned, she was a below average student in her clinical rotations. Even if it wasn't for the other factors, that's a big risk. Now you include that she is a single parent with a special needs child, entering a job that is even more demanding than clinical rotations, and it's not hard to rationalize that PD's will have concerns. If I was a PD...I'd have questions. If she had a great plan I'd be willing to give her shot....which seems to be the case, as she did receive 10 interviews (30% of her applications resulted in invites). There were tons of PD's that gave her a shot.

Regarding your last statement. She IS responsible for her family. And it WILL divide her attention from training. How can it not? She's a single mother...she is the family for her special needs child. I'd have the same concerns about a single dad in those circumstances. If she brings up the topic, I'm going to ask about her plan...any smart PD would. Again...a PD would be a complete fool if they didn't...they want to see that their residents make it through their training program and become board certified.

I'm rooting for her. The fact that she has come this far with her challenges is remarkable. It speaks loudly about her perseverance and work ethic. If she had a plan...I'd even be willing to look over the lesser clinical scores (because she had a good reason...in my opinion). But she needs a plan. She needs to get that figured out before she reapplies. Or she can just withhold the information....but honestly, I would see it as a positive if she just had a good plan laid out as far as how she was going to pull it off in residency.

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Is there some of that? Perhaps. But I think that you are overgeneralizing a bit, and frankly it's not very helpful. That particular reason isn't going to help her match the next time around.

Let's look at reality here for a second. She is a higher risk applicant. As NotAPD mentioned, she was a below average student in her clinical rotations. Even if it wasn't for the other factors, that's a big risk. Now you include that she is a single parent with a special needs child, entering a job that is even more demanding than clinical rotations, and it's not hard to rationalize that PD's will have concerns. If I was a PD...I'd have questions. If she had a great plan I'd be willing to give her shot....which seems to be the case, as she did receive 10 interviews (30% of her applications resulted in invites). There were tons of PD's that gave her a shot.

Regarding your last statement. She IS responsible for her family. And it WILL divide her attention from training. How can it not? She's a single mother...she is the family for her special needs child. I'd have the same concerns about a single dad in those circumstances. If she brings up the topic, I'm going to ask about her plan...any smart PD would. Again...a PD would be a complete fool if they didn't...they want to see that their residents make it through their training program and become board certified.

I'm rooting for her. The fact that she has come this far with her challenges is remarkable. It speaks loudly about her perseverance and work ethic. If she had a plan...I'd even be willing to look over the lesser clinical scores (because she had a good reason...in my opinion). But she needs a plan. She needs to get that figured out before she reapplies. Or she can just withhold the information....but honestly, I would see it as a positive if she just had a good plan laid out as far as how she was going to pull it off in residency.
And you prove my point.

I don’t disagree that her med school record could be a reason... but she received 10 interviews based on that record, so it wasn’t so much of an issue to those programs that granted her an interview... so it had to be something in her interview...sure the zoom/virtual interview process of this year could have had a play... hard to see the subtleties and make connections with applicants in such a setting.

but, as it’s been pointed out, these are illegal questions... asking her to make a plan based on an illegal question is inappropriate...this kid didn’t just show up... she made it through med school... not for you as a PD who can or cannot handle their personal life... and there are plenty of people who do not make it through residency and they looked great on paper.

and yes it is helpful for her to know that despite it being the 21st century, the age old perceptions and biases still exist in medicine...women, despite representing 50% of medical school enrollment, and high percentage in many residencies, still are perceived as not being able to handle balancing their personal lives of family the same as a man... that somehow men are more dedicated to the profession than women...don’t believe me? Ask a woman resident or physician...
 
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And you prove my point.

I don’t disagree that her med school record could be a reason... but she received 10 interviews based on that record, so it wasn’t so much of an issue to those programs that granted her an interview... so it had to be something in her interview...sure the zoom/virtual interview process of this year could have had a play... hard to see the subtleties and make connections with applicants in such a setting.

but, as it’s been pointed out, these are illegal questions... asking her to make a plan based on an illegal question is inappropriate...this kid didn’t just show up... she made it through med school... not for you as a PD who can or cannot handle their personal life... and there are plenty of people who do not make it through residency and they looked great on paper.

and yes it is helpful for her to know that despite it being the 21st century, the age old perceptions and biases still exist in medicine...women, despite representing 50% of medical school enrollment, and high percentage in many residencies, still are perceived as not being able to handle balancing their personal lives of family the same as a man... that somehow men are more dedicated to the profession than women...don’t believe me? Ask a woman resident or physician...

Absolutely agree that something went awry on the interviews. The committees liked her enough to bring her in. Peds is INCREDIBLY understanding when it comes to challenging family dynamics...easily the most accepting. I wouldn't be surprised if she got 30% returns on her applications because programs were genuinely interested in hearing her story. But again...the interviews must have went poorly, and I can't help but to think that she tipped her hand that she many struggle with caring for her child and being a resident. Maybe I'm wrong...but I agree, she probably should have matched (in spite of her meh clinical rotations)...because Peds isn't competitive.

My wife is a physician. So yeah.

She had <1 year old twins when she applied. But she was ready...she had very good answers to the questions about the twins and her ability to both care for them and excel in residency. She knew because she also used it as a reason why she went into the specialty of her choice. It's not illegal for a PD to ask those question when YOU BRING IT UP. And they were justifiable concerns...and those concerns were met by reality.

Her plan was that I was available and would be able to do the lions share of child care...which I did. So, the programs she interviewed knew her situation and knew that not only was she an exceptional person (much like the person we are discussing), but also had enough insight to plan ahead for future challenges. And it was a challenge...frankly, the first years of my twins lives was MUCH more difficult than internship. Not even close. Her life was infinitely more difficult than her co-residents. Just because someone is able to pull something off in clinical rotations (which let's just admit are nothing remotely close to internship/residency), doesn't mean that someone will thrive in a more challenging situation with even more isolation and even more difficult hours, such as internship/residency. With your rationale that "they made it through med school"...why even have an interview process to begin with? PD's should just randomly assign applicants to their programs. That's just not reality, and there are residents that struggle (as seen by the countless "I'm on probation or not getting renewed" posts on this forum.

My wife made it because 1) she is exceptional (probably one of the smartest and hardest people I've ever met), but also 2) we had a very good plan and I was there to help her. So I do have some insight on what the young woman is up against. It is going to be very difficult as an average-below average applicant in an even more difficult situation than our situation. She CAN do it...but it will come with significant sacrifice, planning, and hard work. I'm sure that she's aware...as I'm sure she has already faced considerable challenges.

Just what exactly do you think that she should do to accommodate for 21st century age old perceptions that may or may not have had any impact on her ability to match?
 
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I feel like I'm missing something... aren't you two both saying that she shouldn't have tipped her hand about being a single mother? Regardless of the reasoning, it seems apparent that there's just no upside to volunteering information about illegal questions in an interview setting. Wow them in the interview, get the job, THEN you'll have ~3ish months to figure out a support system that will work wherever you match.
 
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I feel like I'm missing something... aren't you two both saying that she shouldn't have tipped her hand about being a single mother? Regardless of the reasoning, it seems apparent that there's just no upside to volunteering information about illegal questions in an interview setting. Wow them in the interview, get the job, THEN you'll have ~3ish months to figure out a support system that will work wherever you match.

Honestly, that would have been the easier path. I only say that because Peds is so uncompetitive that you don't necessarily need something to stand apart in order to match. But I do think that she has a pretty remarkable story. To make it through med school unscathed and do reasonably well on her boards in spite of also being a single mother of a special needs child is pretty remarkable. That's something that would impress the crap out of me as a PD. So it is something that could theoretically help her stand apart in a good way if she played her cards right. I just question whether she did that. If she demonstrated angst over the situation then that would definitely present risk. I would probably just avoid it next time (which sucks...because her story should be told). But if she does choose to disclose it she needs to be prepared for questions about how she is going to pull it off in residency. Frankly, she needs the answer to that question even if she DOESN'T disclose it because it is probably her biggest challenge entering residency. Getting into residency is one thing...but making it through is also no lock.
 
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This may also explain the issue. Although I can't see your application, I can see MSPE's from your school so know what the grade distributions in the clerkships are. 90% of students got an A in Neuro. In general for most of the other clerkships, it was 50/50 A/B with a few C's and lower -- exception being Psych were it was 80/20. The C in surgery is the bottom 3%. So if you have all B's except for the A in Neuro and the C in Surgery, your performance is in the bottom quartile of your class. Your school doesn't call out quartiles directly, but it's easy to assess based upon your grades.

What I expect happened is that you got all of these interviews, did OK on them, but because of your relatively low USMLE S1 score (S2 was better but sounds like it came back after rank lists would have been finalized and hence not considered), you just ended up in the lower quartile of everyone's list. It's possible that your URM status increased your interview yield (programs looking to increase diversity) but overall performance still led to a lower ranking.

I also have difficulty interpreting "too authentic", and I encourage you to try to get more information if possible. I am interpreting it as "over sharing" -- it's OK to tell coworkers about your personal life in moderation, but (perhaps?) you cross that grey zone where people start to feel uncomfortable. That's unlikely to happen in your interviews, though, so doesn't explain why you didn't match in all of the other programs you ranked.
Thank you for your honesty. I am in the fourth quartile. I asked my dean about this and she said my step 1 score and grades were great. Which I knew was a lie and blamed it all on my interviewing skills. Which I think I did ok but I knew my scores and grades were low but never failed anything. I know my scores are low compared to others. There is nothing I can do about it now. I just want to be told the truth and I feel like my dean is trying to protect the program because she repeatedly said I my step score was good. Ok fine, but also help the students by not lying.
 
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Honestly, that would have been the easier path. I only say that because Peds is so uncompetitive that you don't necessarily need something to stand apart in order to match. But I do think that she has a pretty remarkable story. To make it through med school unscathed and do reasonably well on her boards in spite of also being a single mother of a special needs child is pretty remarkable. That's something that would impress the crap out of me as a PD. So it is something that could theoretically help her stand apart in a good way if she played her cards right. I just question whether she did that. If she demonstrated angst over the situation then that would definitely present risk. I would probably just avoid it next time (which sucks...because her story should be told). But if she does choose to disclose it she needs to be prepared for questions about how she is going to pull it off in residency. Frankly, she needs the answer to that question even if she DOESN'T disclose it because it is probably her biggest challenge entering residency. Getting into residency is one thing...but making it through is also no lock.
Thank you 😊
 
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My plan if I stay at home. I have my family if I have to move my kid will stay with my family. I never told them I was single though. In short, just that my son was the reason I wanted to become a pediatrician. It was in my PS and I repeated that statement during interviews. I will take it out now no need to tell them anything about it. As for step score cant do anything about them just pass step 3 before ROL and hopefully that’ll help. I will do good in my TY program. I’m excited to wow them. I’m a very hard worker as working comes easy to me.
 
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