Friday, November 16, 2007

Some People: The Interview Process

I've been interviewing for residency positions over the past month all over my home state. I've met quite a few individuals on the trail, and all I can say is "Some People!"

Interviews for residency are interesting. You are there obviously bowing before the altar trying to get a job from these people - although they can't officially offer you anything outside "the match". And they are trying just as hard to sell themselves to you. I consider myself lucky in that this year anesthesia programs are doing quite a bit to woo their applicants. Most are paying for hotels the night before. Most are providing us with extravagant dinners or lunches at fancy restaraunts. Several hand out SWAG bags when you leave. I've gotten pens, t-shirts, coffee mugs (they did their research on that one, huh?), snacks, and the obligatory school folder.

Each morning there is an introductory power point slide show (if the chairman/director is tech savy enough to figure out how to power up the projector and computer) that shows off their program. One program, which notably lacked the fancy dinner/lunch and SWAG, spent most of their presentation talking about unbuilt hospitals that they are pouring money into and how great their program is going to be. Others go on and on about their benefits, which frankly is what I want out of them, while others spend the hour showing you pictures of the town and of their residents out partying together at "journal club". Then you go off to interview.

Interviews so far have ranged from 2 to 6 interviewers for about 30 minutes each. When there's just two, you pray that you get someone high up on the chain of command while with 6 you die just trying to come up with original questions to ask each interviewer and to continue to look interested as they sell their program to you by giving you the same information the last 5 have.

And the whole time you pray you don't have a situation like I had at the aforementioned school-who-sells-you-unbuilt-hospitals. I walk into the interviewers office which happens to be noticably bare of any decoration. That's a red flag that whoever this is is new to the faculty and can't tell you much or not very involved with the main faculty. Turns out this interviewer was the later. The interview starts and I notice right away that this interviewer also doesn't say much. And then the fun starts. They asked me about my step 1 score. It by no means is anything that would blow you out of the water, but it is one I'm proud of and feel like was an accomplishment. They specifically ask what I did to study for it. I tell them all about the 3 week course I took and how it helped and they start writing down details on a sticky note and then put it in their pocket. Weird. Finally they give me something to grasp at and tell me their daughter is about to take her step and they just wondered what kind of courses were available to help. Fine - I think. Then I made a big mistake. I asked what their daughter was going into. The answer was she wants to go into XX-non-anesthesia-program. Without any further interaction on my part I then get a story about how this interviewers spouse was a high up faculty for this speciality at a near by hospital and then died of cancer 4 months ago. And then the interviewers eyes started welling up with tears. Not exactly what I signed up for.

Anyway, usually while part of the interviewees are interviewing, the other half are off in a room trying to make stifled conversation. Some people are great and are people I wouldn't mind working with in the future. And some, especially those who come from big name schools, act very guarded. They ask probing questions of you and offer very little information in return. They like to hear all about every other school and even go as far to ask where you want to end up, but when you ask them in return you get a quiet, "I don't really want to talk about it." Cut throat gunners! One girl I interviewed with today was just that person. She tried very hard not to divulge any iformation even about where she had applied. What's worse is this was at her home institution so she knew all the residents and faculty well so was off gossiping with them and even had the gall to take over on part of the tour of the facilities. She was very snooty about this particular school and inferred that no other school in the state was good enough for her. I hate cut throat gunners. Fortunately none of the other residents in that program came off that way, but she seriously drove me up the wall. Some people!

Saturday, November 10, 2007

"Ambulatory" "Medicine"

This month I'm on a 4th year required core rotation - ambulatory medicine. Essentially what that means is I'm supposed to be at just a regular run of the mill internal medicine clinic. Not in the hospital.

So I entitled this post the way I did because of what I'm actually doing. "Medicine" because it's actually more like "interventional cardiology". The attending I'm working with is a cardiologist, and a pretty well respected one at that. My friends are all treating diabetes and hypertension and "chronic pain" and whatever else it is regular doctors do. I'm seeing people who have all sorts of crazy messed up heart disease. SVT of pregnancy, s/p quintuple CABG (coronary artery bypass graft, or "cabbage" as we lovingly call them for short), or nectrotic foot ulcer limb slavage (necrotic = dead tissue). It's also interesting considering the number of health care professionals we see and treat. Nothings stranger than doing a history and physical exam on a patient who also happens to be a doctor at the school you attend.

"Ambulatory" because >50% of this month we're actually in the hospital and not in clinic. We have clinic two mornings and two afternoons a week. The other 3 days worth of time is actually hospital time. We round on patients in the CVIMU, CCU, and CVICU. We do lots of endovascular procedures in the cardiac cath lab. I think I've been wearing lead in the cath lab more time this month than I've spent in the clinic. Procedures after all is where the money in medicine is.

Oh yeah, and I think on average I'm working 3 days a week for the whole month. 4th year is everything I dreamed and more.

Wednesday, November 7, 2007

Note to Self [update 1]

No "disco dancing" while intubating. Or putting in lines or anything else. Especially if I ever have the opportunity to be using an extremely high powered drill that CUTS BONE while cutting bones in the face. Read more here:

The real issue here is what do/should doctors and other health professionals do if (read WHEN) they screw up. Clearly not do what this guy did. I'd write more about it, but it's late.

[update 1]: I fixed the broken link, in case any of the 3 people who read this actually wanted to read the stem article.