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Friday, January 23rd 2009

Interviewing For Residency

My last residency interview was a couple of days ago. I’ve rarely been so relieved to be done with something. Walking out after hours of being holed up in a hospital conference room and of talking with faculty and researchers, I felt a real big weight leave my shoulders.

Interviewing for any job can be stressful. Residency interviews may be on a whole different level.

Residency has been caricatured by shows like Grey’s Anatomy and Scrubs. It is that time in a physicians life after they have graduated after they have graduated from medical school and gotten that M.D. after their name; when they are getting training in a medical specialty.

Can’t Wait For Graduation Day & The Diploma

But getting from where I am now, to where the characters of Grey’s Anatomy are requires navigating the residency interview and match process. It isn’t quite like any other job search out there. Although most of my interviews were get-to-know-each-other type of affairs I was, at times, ‘pimped’ on clinical scenarios, asked to read CT and MRI scans, and even had my dexterity tested. All more than fair. But except for select technical jobs – say engineering or computer programing work as examples – not exactly the type of oral test most job applicants face.

Those type of clinically relevant questions are important and not wholly unique. What may be more unique and grueling is merely the length of the whole process. Last year, in the specialty I’m trying to enter, the average medical student went on more than 14 interviews. Like for in many job interviews, each residency interview is a full day, often a multi-day affair. 14 job interviews is a lot. Perhaps more telling, it isn’t unheard of to talk with 15+ individuals at a single interview.

Let’s say the average number of faculty you interview with at any program (this is specific for the specialty I’m trying to enter) is 7 or 8. Let’s say 7.5. That seems like a reasonable number from my experience. If you went on 14 interviews you would’ve talked with more than a 100 people by the time the interview season was over.

That’s answering the same questions 100 times. That’s asking the same questions 100 times. That’s the same small talk 100 times.

Don’t get me wrong, it is important. This is your future as a graduating medical student. This is their future as a program. And the interview is often a very narrow window to get a feel of where you want to spend the next several years of your life. But boy, I think everyone can imagine how draining such a process could be.

And you do get such a small window of what programs are like. If my future was working in a cubicle, I could get at least a sense for the day to day mechanics of a corporation, of it’s bureaucracy, of what a typical day is like during a couple of days of interviewing. Residency interviews can rarely afford you that. Ten applicants, crammed into a day of interviewing cannot go spend time down in the clinic or go scrub into the operating room or round with the residents.

True, many programs, especially in some of the surgical specialties, encourage ‘second looks.’ They encourage interested applicants to come back and see how their residency program runs in a real day situation.

But there’s another kicker with that. The entire interview process, including any potential second looks, is largely self funded. Applicants applying to competitive specialties and going on many interviews can easily spend upwards of ten or fifteen thousand dollars. That is borrowed money and in actuality will end up costing the applicant much more than that.

It’s an investment in your future of course and so I think most applicants take the debt with grace. And most medical students are used to debt; another $10,000 is just something to shrug at…unfortunately. Still, it is a little eyebrow raising.

I’m done though. Now I merely wait. You see, the final difference between interviewing for residency and your typical job interview is that residency programs don’t really offer applicants positions.

Unlike interviewing for that cubicle job, there was no chance I was going to walk out of a residency interview and a couple of days later get a call offering me a position.

Instead, all applicants and residency programs are bound by contract to go through the residency match.

Applicants have to rank the programs they interviewed at. Residency programs have to rank applicants they interviewed. It all goes in a mysterious box and out comes the results, telling you where every applicant ended up (if they matched at all). In reality the algorithm used to match residency applicants to residency programs isn’t too complicated. Why it is done this way is a matter of history. The match is certainly not without it’s detractors; but that is for another post.

At the least, the match makes for a trying wait. From now until match day is approximately 2 months.

My interviews though are over. That sounds like an excuse for a celebratory beer.