If Residency Interviews Were Honest

Hey guys, sorry it's been a while. Turns out the "80 hour work week" doesn't leave much time for blogging.

This week my program hosted our first interview of the year. I attended the pre-interview social and helped with tours on the day of. I had so much fun talking to the candidates and answering their questions. It's always so nice to reflect on where I was and how far I've come. It's hard to believe it was only 2 years ago that I was flying all the over the country interviewing.

Anyway, I will have some upcoming blogs about the interview process. In the meantime, I hope you enjoy this cartoon. I started it on the plane home from one of my interviews way back when.

What Makes Med Students Happy

Click to enlarge

Why Sleep Matters to Me

Hi guys! I know it’s been a while. I’m back to discuss a very important topic to medical students and doctors: sleep. Let me preface this blog by stating that everything contained herein is my personal experience and may not apply to you.

Why Sleep Matters To Me

My personal experience has taught me that consistently getting decent sleep is THE most important factor in my overall well-being—more than relationships, exercise, diet, money, or anything else. That's why sleep is my top priority. 

If you've read my blog before, you know that I'm a surgery resident, and you're probably thinking sleep + surgery residency = ???

Obviously I don't currently, and likely never will (except maybe during research sabbatical), get 8 hours of sleep 7 days per week. But I always get as much sleep as possible. This means that sleep almost always comes before my husband, family, friends, studying, drinking, TV, and whatever else keeps me away from my bed.  (Of course there are exceptions.)

A mentor once told me, "Whenever you say 'yes' to something, you're saying 'no' to something else." Sometimes saying ‘yes’ to sleep means my life appears pretty boring from the outside. For example, when I was a 4^th year med student on my surgery sub-internship, I woke up at 4:00am every day and usually didn't get home until 7pm or later. When I got home, I ate dinner while I talked to my husband, showered, and then got in bed around 8:00pm. This was also in July, so I was actually in bed before the sun set every night.

This sounds like a really pathetic existence, but I swear I was happy. Giving up some time with my husband after work in favor of getting enough sleep was worth it because I wasn’t exhausted on my days off. I actually had energy to spend time with him. And getting enough sleep helped me perform at my peak so that I could get great letters of recommendation. I didn’t get sick once and I didn’t get burnt out.

How I Get Enough Sleep

I’m not going to rehash the 5 million articles about sleep hygiene that we’ve all read. In brief, here’s what works for me:

A white noise machine. The Marpac Dohm-DS All-Natural White Noise Sound Machine is probably that best $50 I ever spent. Available in black, white, and beige on Amazon.

My most precious possession.

A white noise playlist. For traveling and noisy call rooms.

A sleep mask. A post-call must-have.

A bedtime routine. We all know this… Try to go to bed at the same time every night. Do the same things in the same order and it prepares you for sleep.

A non-screen bedtime hobby. For me, it’s reading. I’ve also tried Sudoku in the past, but I tend to get too determined to win and it actually keeps me awake.

Benadryl. When all else fails.

Do y’all have any other sleep tips or tricks that I didn’t mention?

How to Get Rec Letters

Source: https://howtomba.com/mba-admissions/the-application/letter-of-recommendation/

Letters of recommendation are fairly specialty dependent, so I won't get into how to select your letter-writers. Instead, you should just ask your mentor who you need letters from, then introduce yourself to those people and and spend as much time with them as possible. Let them know right away that you're interested in getting a letter from them—they will pay closer attention to you and have much more to say in your letter.

When you formally ask for letters make sure you have proper etiquette.

1) Set up a meeting as far in advance as possible. Many of the people that you will need letters from probably have assistants, so you should set up this meeting through their assistant. Call or email the assistant, explaining that you will be asking for a letter and that the attending should be expecting this meeting. You can also attach your CV and supporting documents to this email, although you don’t have to if they’re not up to snuff yet. Try to meet toward the end of a rotation with the attending, so they have already had a chance to get to know you but you are still fresh in their memory.

2) Add them as a letter writer on ERAS before the meeting, making sure you have their correct name, degree(s), and title. Then print their unique LOR information sheet and bring it to the meeting. This document contains a unique number for uploading your letter, plus all necessary instructions.

3) When you meet, bring paper copies of your CV, an unofficial transcript, evaluations from relevant third year rotations, and your statement of purpose (even if it's a rough draft). You will give these to your letter writer to help them get to know you. 

4) If possible, dress up for the meeting. If you're in surgery, like me, scrubs are fine—just make sure to go through the formality of apologizing for being in scrubs. Make sure you look neat and clean. 

5) Prepare for a short interview. They will ask you how you know you want to do that specialty, what your career goals are, etc. Some of my letter writers also asked me questions like my greatest strengths and weaknesses. 

6) Ask if they feel they can write you a STRONG letter of recommendation. 

7) Say thank you!

Now the tricky part: getting them to write your letter. One of my attendings uploaded her letter to ERAS the day after we met. Another attending took about 6 weeks. He is extremely busy and had a bunch of traveling to do, so I certainly didn’t take it personally, but I did start to get pretty nervous.

To handle the latter situation, you need to be assertive and persistent but never demanding. You should become best friends with your attending's assistant and email him/her weekly. But NEVER be rude to the assistant. NEVER!

Never forget that you aren't entitled to a letter. Your attending is doing you a favor, so all of your communications should have an undertone of humility. I usually emailed the assistant something like, "Hi so-and-so! How are you doing? I'm so sorry to bother you again, but I wondered if Dr. XYZ will have time to finish my letter this week? I appreciate anything you can do to help me get the letter in by September 15th. Thanks so much!" And make sure you thank the assistant when the letter does finally get uploaded.

And if it starts getting close to the deadline, line up a backup letter writer in case they don't come through. 

Finding the Perfect Mentor

One of the greatest moments of third year is when you figure out (or confirm) what you want to do with your life. (I know this doesn’t happen for everyone, and I’ll address that topic in a future post.) Okay, so you know what you want to be when you grow up. What now? You need to find a mentor.

Found on Pinterest without source credit. If this is your work, please contact me so I can provide appropriate credit.

If you’ve read my blog before, you probably know how strongly I feel about mentorship. (My very first post was on this very topic.) But what is the purpose of this particular mentor? A mentor is an experienced and trusted adviser. Right now you need someone within your specialty to help you choose letter-writers, decide which programs to apply to, and prepare for interviews. You need someone to bolster your confidence when you get anxious about this process. You also need someone who will tell you things you don't want to hear, so that you can match into the best possible program within your chosen specialty and not end up scrambling (or whatever they call it now).

So what should you look for in a mentor? I recommend choosing someone who has expressed confidence in you, whose career you admire, and whose personality is somewhat similar to yours. Also look for someone well-versed in resident selection in your specialty or someone who has been through residency fairly recently. It's probably better to find someone who is not on the resident selection committee at your program, so that you can speak more frankly and get less biased feedback on your rank list.

For this purpose, I find it more helpful to choose a mentor I truly enjoy spending time with and respect, rather than choosing someone based solely on reputation or connections. This may be less practical in extremely competitive specialties, but you can always have two mentors: one for support and advice, the other for his/her connections.  

NB: If you can't find the perfect mentor, just find one that is good enough. Do not try to get by without a mentor.

Once you choose a mentor, set up regular meetings with him/her, starting as early as possible. Then make sure to follow your mentor's advice.

I met with my mentor a few times starting in January of my third year. I went over my current grades and Step 1 score, my Step 2 study plan, my fourth year schedule, etc. She gave me amazing advice, and I am so grateful that I followed it. For example, she told me I should do my month in STICU (shock/trauma intensive care unit) before I rotated on trauma surgery. At my program the trauma surgeons are very vocal; if they like you, you'll get a great letter of recommendation and have the chance to stay at our program. If they don't like you… it’s not ideal. As such, I was a little nervous about doing well on trauma, so I followed my mentor's advice and it worked amazingly. After a month in STICU, I knew how to insert lines and tubes, was much less intimidated by trauma patients, knew how to read chest films, etc. I did a great job, got a letter from our well-known and well-published trauma chair, and, perhaps most importantly, I had a fantastic time.

Residency Interview Prep, Part II: What to Buy

Alternative title for this post: Let's Spend Some Money!

Suit

Don't be cheap. You'll keep this suit forever (or until your weight changes significantly), so don't worry about the price tag. Buy a conservative suit that fits you perfectly (or get it tailored to fit perfectly). Check out this article for a lengthier discussion on interview attire. 

Women: the skirt versus pants debate rages on. (Especially for surgeons.) I personally opted for pants because I feel more comfortable in them, which translates into more confidence in my interviews. Plus I just can’t see myself at a program where I am expected to wear a skirt. With that being said, if I were equally comfortable in both I would actually opt for a skirt, as a skirt is technically more formal. Of course, make sure your skirt is long enough, especially when sitting down. 

Men: I would save the 3-piece suit for another day. It's a bit much. (This is just my opinion, but I've also heard some residents and attendings make similar comments.) I would also avoid bow ties, unless you've seen the program director or department chair in one. Bow ties just bring up very strong feelings and you don't want your interviewer secretly judging you for something so silly. Here's a good blog on interview attire for men.

Carry-on luggage

I just bought my first set of "fancy luggage." It's fancy to me because it was actually purchased, not inherited from my parents with a partially broken handle. I'm a nerd, so I read up on the best kind of luggage to buy and here's what you want: a hard shell spinner that's about 20" tall. The hard shell bags are much lighter than fabric bags, and spinners make navigating the airport much easier. (Spinners are those cool bags that can roll next to you or behind you.) I found my bag on Amazon for under $100.

I think carrying on is the right choice, mostly because you don't have time to deal with lost baggage. (If you must check your baggage, then keep your suit with you on the plane.) I choose to wear my suit jacket on the plane to keep it relatively wrinkle-free (Jerry Seinfeld style, with jeans and sneakers) and pack my pants as carefully as possible. 

Which brings me to my next purchase...

Travel steamer

Worth it. It is so much faster and easier than ironing.Plus, if you're not skilled with an iron, you can completely ruin your suit. (Steam can only ruin your hand by burning the hell out of it, which I consider a safer gamble, even as a future surgeon.) This is the one I bought. It's tiny and fits in my carry-on without any problem.

Comfortable shoes

You're going to wear these shoes to probably >10 interviews. (Some of you psychopaths might be wearing them to 30 interviews!) So don't make your life hell. Buy some simple, attractive shoes that are comfortable. Avoid flashy logos (I'm looking at you, Tory Burch) or anything else eye-catching. The ideal interview shoe, much like the ideal suit and purse, is one that nobody ever comments on.

Women: I recommend flats. If you're limping at the end of the tour, it looks like you aren't intelligent enough to select proper shoes. I also recommend keeping band aids in your purse for any blisters that pop up. (Pro tip: I like to put a prophylactic band aid on any area that rubs before the blister actually forms.) If you do wear heels, for the love of God, choose low heels. 

Men: I'm certainly not a men's shoe expert, but I would wear shoes that match your suit (usually black with a black suit, brown with a navy suit, and user's choice with a gray suit). I would steer clear of ultra high gloss shoes unless you are actually a member of the U.S. Navy.

Cold weather gear

(This only applies if you're from the south and will be interviewing in the north. I assume you northerners have coats, since you lived to read this blog.) Southerners: New York City in January is the coldest place I have ever been—and I've actually been to an ice castle in the arctic circle in February. (I have not been to Syracuse, Chicago, or Mars, which I understand are even colder.) This is a different kind of cold that doesn’t necessarily match the thermostat. It might be 30 degrees, but the wind bounces off all the glass buildings and gains the power to completely penetrate your body. As such, you need a coat, scarf, gloves, and hat.

Nondescript purse

Your purse (as with everything else on your body) should not have large designer logos or flashy designs. I hunted for a long time before I finally found this bag, which is big enough to fit my portfolio (see next item) and airplane snacks.

Men: I don't think you need a briefcase, but if you want to carry one the same rules apply. Choose one that's simple.

Leather portfolio

Not everyone carries one, but it looks pretty classy. Use the notepad to makes note of questions that you want to ask. Also stick some copies of your CV in the pocket to hand to your interviewers. (Make sure your CV is in good shape if you choose to do this.)

Questions? Did I miss anything? Please add your own tips in the comments section below!

Residency Interview Prep, Part I: How to Get There

This post is all about getting ready for interviews. I essentially just began interviewing, so much of the information in my next two posts will be based on advice from countless friends, blogs, and attendings, in addition to my personal experience. I’ll follow these up with a post at the end of interview season to add anything I wish I had known beforehand.

The very first step in preparing for interviews is setting up your 4th year schedule. This is based completely on personal preference and the requirements of your specialty. I took Step 2 in late June because about 30% of General Surgery programs require a Step 2 score for an interview. I chose an easy rotation in October, so that I could check my email constantly, and I am taking November and December off for interviews. Like I said, this is personal preference. Air travel stresses me out, so trying to arrange flights around an active rotation would drive me insane. I'd rather just have a rotation in April while the rest of my friends are on a beach somewhere. But the beach might be really important to you, so you'll figure out how to make it work.

As for the items below, you should start this process in September, before you actually get invited to any interviews (or even earlier if you have busy rotations in September and October). 

1. Pick an airline 

I chose Southwest Airlines because 1) their flights are cheap and they allow 2 free checked bags, should I fail to carry on efficiently; 2) they allow you to cancel your flight up to 10 minutes before takeoff for an account credit; and 3) Hobby Airport (where Southwest flies) is closer to my apartment than Bush Intercontinental. You can see that I thought this out.

2. Get an airline rewards credit card

And put all your plane tickets, hotel stays, and car rentals on that card. You may be smart enough to already have one, but if not, apply now! There’s no way around the fact that you’re going to spend a ton of money

3.  Plan strategically 

There are numerous other blogs on this topic, and it’s also intuitive. If you’re flying to Boston, try to do all your Boston interviews on the same trip. If you’re only applying to regional programs, try to book them so that you can drive from one to the other. 

Since I'm taking two months off, I don't have to be as strategic about selecting my interview dates. I don't need to do all my Texas interviews within one week, because I have the time to go on four different road trips. (Also, gas is really cheap right now.) 

4. Avoid fleabags 

And definitely avoid this!
Image credit: www.sleepinginairports.net

Cheap motels are not worth it. Just pay the extra $50 to stay somewhere clean and safe You’re already in debt. Another $50 is not going to make that big of a difference. However, sleeping well, interviewing well, and actually matching will make a difference.

Save money by staying with friends and family whenever you can. Their places are hopefully nicer than a horrible motel.

5. Go shopping

My next post will be about the travel gear, clothing, and accessories that I chose for interviews.

Please comment below if you have any other tips to share!