On The Trail

Holy crap, interviews.

The first thing you should know about medical school interviews is that your medical student is supposed to go on a lot of them, and that they all blend together into one big Vitamix of tours, catered lunches, and Powerpoint presentations.

Actually, that’s a lie. The first thing you should know about interview season is that it is the most GLORIOUS WONDERFUL TIME THERE IS. I have zero medical school responsibilities besides some extracurricular things unrelated to science. I have no clinical workload, no classes to attend, no emails to answer unless they contain the word “INTERVIEW,” and no grade to attain. It is the greatest stretch of medical school. To those of you behind us in school: there is a light at the end of the tunnel, and it is a beautiful and luminous light.  Glory, hallelujah.


Besides going on interviews, my principal responsibilities include binge-watching Netflix, inducing my liver enzymes, and sleeping. This taxing schedule is often interrupted by timely naps.

Anyway. That said.

I’ve only been on four interviews so far, including my home school, and despite my best efforts I have already begun to forget what makes each program special. This is at least in part due to my own priority list for Things I Care About In A Residency Program. Before I tell you what that list is, you should know that everyone cares about different things. Some people really, really care about things that aren’t even on my radar, like having big-name faculty or a fellowship in their desired career. Others are limited by geography or are trying to match with another person (‘couples matching’ is a whole different story I can’t get into here).

With that disclaimer in mind, here’s my list:

Things I Care About in a Residency Program

1-15: Fit: are the residents cool? Do I get along with them? Could I spend three or four years working with them? Are they medicine robots with the personality of a toaster oven? Are any of them potential serial killers or axe murderers?

16. Location: If the program is in rural Montana, no thanks. (The winters are too long.) The rest of it is harder: do I care deeply about the differences between a medium-sized city and a big city? A town? (hint: not really.)

17. Diversity of training sites: in emergency medicine, spending all your time at one place isn’t the best idea since there are many different practice settings. The best programs for me are the ones that have good tertiary center, county hospital, and community hospital exposure.

18. Curriculum: I’m honestly not sure how much I care about this one (hence its position as #18 on the list) but I suppose whether the program is a 3-year or 4-year program makes a difference. Also, not doing “floor months” on a general medicine or surgery team is a nice perk, because rounding is evil and I hate it.

Why 18? 18 is a lucky number for us jews. I have no idea why, but it is.

As you can see, I have no idea what I’m doing and everything is based off my gut feeling. The problem with using gut feeling is that everyone is friendly, relaxed, and has a good sense of humor (at least so far). I’ve gotten a positive gut feeling everywhere.

I have yet to discover where all the maximum-stress “A High Pass Indicates The Imminent Apocalypse” people from medical school go, but it must be into a different specialty. I know from firsthand experience that they exist, but they aren’t anywhere I’m interviewing.

Hence, everything starts to blend together. A typical interview day looks like this:

The night before the actual interview (or sometimes, the evening after), the residents usually hold a social event – whether that’s beers at a local bar or a dinner at someone’s home. It’s a chance to get to know the residents so you can figure out that all-important “fit” – and a chance for the residents to identify which applicant isn’t capable of taking off the medical hat and talking about something other than medicine for a couple of hours.

While most people I’ve met on the interview trail can easily do this (probably because EM intrinsically draws people with outside interests), a couple fellow applicants have unfortunately stuck out for their inability to turn it off. Just speaking generally from four years of medical school experience, these people are less than fun to be around. Specifically, they suck the air and life out of a gathering. They’re the medical version of Dementors, and are to be avoided at all costs.


Edits mine. Anyway.

The interview day itself is pretty standard. Wake up early, put on the ridiculous costume called a suit, go to continental breakfast and awkwardly converse with other applicants/competition. Make friendly conversation about traveling without asking about other interview locations as this is slightly forward.

After the breakfast, listen to a Powerpoint presentation by the program director and sometimes other residency administration people. In this talk, listen to the highlights of the program and understand how they are different than other programs.

(I never remember this for longer than the duration of the interview day, perhaps because I have the attention span of a goldfish and perhaps because for the most part, residency training is pretty similar everywhere.)

At some point, there are a series of (usually short) interviews, where you are asked why do you want to attend this specific program and what kind of vegetable would you be, if of course you had to be a vegetable.* Because emergency medicine physicians like to move fast and have made up their mind about you by the time you sit down in the chair anyway, the interviews are usually short.

*No one actually asks this question, although I have been asked some pretty bizarre questions.

At some point there is a tour. At some point there is lunch, usually with residents. Some programs will also have you attend a lecture, or sit in on their conference to see what that’s like.

Then the day is over, and the real work begins: info-dumping everything I can remember about the interview day into a Word document before it erases itself from my brain. I usually do this in the airport while awaiting my (always-delayed) flight.

It is astounding to see, days later, what I write. For one program I wrote in, “Very strong, shiny program.” What the hell does shiny mean? I went on to add “Modular curriculum with modules,” and “? Ultrasound.” I have no idea what the question mark-ultrasound means.

Finally, it’s time to crash. Interviewing is somehow exhausting; I suspect this is related to my theory called the Reservoir of Nice. My reservoir is… well, let’s say “limited,” so I crash and burn pretty hard after going from holding a smile all day to dealing with frantic people paradoxically moving at a snail’s pace while boarding yet another Southwest flight.

Note: that was humor, if you are a residency person reading this.

The bottom line is that for many of these programs, I’ll be splitting hairs when it comes to ranking them in order of where I’d like to go. It will come down to “fit,” whatever that means, with maybe a little bit of location and curriculum and training sites thrown in. Then it all gets thrown into a computer and our fates come down to an algorithm. Welcome to 2016. If only our presidential elections were as sane.

I’ll write more as the interview season gets later to avoid identifying any specific place….

2 thoughts on “On The Trail

  1. is that tiller looking stunning in the surgical cap?????

    nathan, you make me laugh and for that i thank you. i particularly like items 1-15 on your list. am sending you 18 brownies(chai) to wish you good luck in your search. does it say in the bible ,chai means only money???? love, grandma

  2. Pingback: Tail of the Trail | STATUS HAZMATICUS

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