Residency Interview A

So, today was my first residency interview. I am thinking of keeping track of these interviews and program characteristics here, because we don’t rank programs until February, and I doubt I’ll be able to keep these programs straight without some sort of log. I should develop some sort of systematic way, I think.

Briefly: the rank list is a way for residency applicants (who are generally 4th year medical students like me) to order their preferences out of the programs where they interviewed. The residency programs also rank the people that they interviewed, and then the two different rank lists go into a complicated program with some mathematical algorithm that I could probably try to understand but don’t care enough to, and one magical day in March is Match Day, where residency applicants across the country find out where they will be going for the next three to seven(!) years, depending on the specialty and the specific program. Obviously, the rank list and Match Day are fraught with craziness, anxiety, and angst. (And I promise, this is not just if you’re me. Maybe a little more if you’re me, because I seem drawn to the Crazy, but hey, everybody’s got their thing.)

Uh, where was I? Oh, right, rank list and Match. When it comes to the Match, it’s not like applying to college, where you get acceptances and you just pick one of the colleges before a certain date to commit yourself to. When it comes to the Match, you rank all the programs where you applied, and the magical mathematical algorithm matches you with just one program and assigns you to it. And wham, that’s it. I mean, that’s not always it, because you could not match and have to participate in the Scramble, but I choose not to think about that right now because it’s an alarming thought that I don’t need to worry about.

Why I Applied
Residency Program A is a program at a private, non-profit hospital somewhere in the Mountain time zone. I applied to it originally because I’ve always had a fascination with the area, and I thought I should check it out. Also, Residency Program A is purportedly in the 6th largest city in the United States (though I think it’s an exaggeration), so it’s urban without being one of the big three (which I consider to be LA, NY, and Chicago. Maybe DC? San Francisco? Whatever.). After taking this course in college, I thought I really wanted to live in a second city, which is an urban development that has all the benefits of a larger city without so many of the problems (sprawl, ridiculous prices for living actually downtown, crime). These are the reasons why I applied to the program.

The program is fairly academic without being completely devoted to churning out academic physicians. The mentality is to do research and to publish, but I didn’t sense that there was a publish-or-perish mentality, nor did I think that it was frowned upon to end up as a community surgeon. This would probably be helpful in keeping more avenues open for me, in case I started off wanting to do community and ended up becoming academic (though the reverse is probably more likely at this point). The program is unique in what I’ve seen in that the teaching is done in an apprenticeship manner — generally one resident to one attending. Other surgery programs (in fact, all the surgery programs that I’ve seen) involve larger teams consisting of a chief resident, senior resident, and junior resident running the team and answering to the attending physician. I wonder if being one-on-one with the attending can be lonely, without other residents around to be part of your team.

The thing I really liked about the program setup was the chief year. At other programs, the chief residents are the team leaders of certain services. At this program, the chief residents were treated more like junior faculty members. They had their own clinics, their own patients, and ran their own surgeries with only minimal supervision by senior faculty. I think this would be a great asset as a graduate, because I will have been essentially running my own practice for a year by the time I graduate and actually start practicing on my own.

There are some rotations that are done at off-site hospitals, including all of the pediatric months. Clinics are usually at the hospital.

Secondary concerns
– The hospital is very new and very nice. I think the institution is financially secure, so I wouldn’t have to worry about the place losing accreditation or its funding for residency education.
– The support staff and the ancillary services seem awesome. No drawing my own labs or wheeling my patients down to get x-rays.
– Call schedule seems pretty manageable and, dare I say, easy, especially compared to other programs out there. There are programs out there where call is q3, which means every 3rd day. For example, if I were on call on Monday, I would stay in the hospital all day and night on Monday, go home Tuesday around noon, come back Wednesday morning and work a regular day, and be on call again on Thursday. Lather, rinse, repeat, cry. They were talking about q6 call for interns. That sounds like vacation to me.
– The program is pretty small. They take 3 residents per year. I think they could take 1 more and still be okay, but I think they’re not interested.

The hospital is an easy flight from Southern California (my criterion for “easy flight” = anything shorter than 5 hours; admittedly low standards). This isn’t a huge deciding factor, but being able to pop back to see my family for a weekend would be great. Oh, and the program has a slightly different weekend schedule, where you get actual weekends, as in Saturday and Sunday are not spent in the hospital at all, about 3 out of 4 weekends a month. The flipside of that is, though, that a weekend call lasts from Friday night to early Monday morning. Ouch.

The People
Wow, that town is white. Very white. There was 1 other Asian person interviewing on my day, and one girl who looked half Asian. Two and a half Asians out of 11, which I guess is representative of the Asians in the general populace. I guess. I have to say, that my first impression of the house staff (= residents), the patients, the faculty, and the general population around Residency Program A’s city was, “…But it’s so WHITE.” Nothing against white people, but… I’m not white. And I’d like the city I live in to at least somewhat reflect the person I am. Oh, that reminds me. I need to Google around to see if there is a 99 Ranch or something nearby. ALSO, just a tip: It’s “99 Ranch,” not “Ranch 99.” When you want to impress your friends with your Chinese people know-how, at least say our market right. If you really want to impress, learn it in Chinese. It’s not hard to say, actually.

The Bottom Line
It’s not at quite as big or as academic a program as I’d imagined myself training in, but then again, my assumptions about what I want might be totally off. I can’t help thinking that going to a program that is somewhere closer to being community than academic, at a posh hospital with insured old white people as my primary patient population is kind of like… putting myself out to pasture. Before age 30. I mean, I like taking old lady walks and going to bed kind of retardedly early, but still. A line must be drawn! And it’s so white. In a sentence, I would say that I like the program and how it’s structured, that the institution is well-regarded, and I would end up being a very good physician out of it. But I have some reservations about how well I would fit in with the rest of the crew and the surrounding location. I would be going there for the program, and not for the surroundings.

Despite it being my first interview and not having seen other places yet, I think it will end up somewhere in the middle, when I eventually rank.


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