Important things to find out during your residency interviews

[fyfanatic]

Since interview season is coming up I thought I would share some insight from my first few months as an intern on some important details to find out during residency interviews. These are things that I never thought to ask because the typical questions that come up are things like, "what are the attendings and ancillary staff like?, or how strong is the education in this particular program? how is the camaraderie between residents?"
Yes these questions are all well and good, but I have realized that there are details about a program that people don't ask but that can make the difference between being miserable or tolerable. Here are a few examples of things you should find out from current residents....

What is the cap on how many patients you carry?
On what days do you take new admissions; are these days spread apart so you can actually get to know your new patients before being bombarded with more new ones? Is there a certain time after which you will not get any more admissions, for example an hour before you are supposed to sign out?
Do the current residents feel constantly rushed to discharge their patients as soon as possible so that when its time to be on call, they have enough room to get more admissions?
How much paperwork is there? For example, if there is an H&P written for a pt that day, do you still have to write a progress note? Or on the day that a pt is getting discharged, do you have to write a progress note on top of the discharge paperwork? Are you allowed to cosign progress notes written by med students?
How does cross-coverage work, especially on weekends?

Feel free to add any other important information to get on interview day...

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[kc222]

great thread!

Other questions I would ask -

What's the earliest you can sign-out? Is there a day cross cover or do you have to wait for night float to come before leaving?
If you do get to leave, until what time are you expected to answer your pager?
What happens to "rocks," are you expected to see them daily? Or are they attending only?
Do you have 1 attending per team at a time? Or are there multiple attendings for the different patients?
I want to echo that asking about admission caps, team caps, and intern caps are important. Also the importance of what it means to be on long call vs short call or medium call. And whether or not it's different if short or medium call falls on the weekend.

Good luck to those applying!

 

[Law2Doc]

While all of these things are important to know, all of them could rub an interviewer the wrong way. Best to ask them privately to med school alumni who are residents or other non-official channels.

 

[Bartelby]

While all of these things are important to know, all of them could rub an interviewer the wrong way. Best to ask them privately to med school alumni who are residents or other non-official channels.

Unfortunately I think this is true.

Caps seem key to me (I had a cap of 8 on IM and felt like it was a lot).
Also, how many months do you spend on wards/nightfloat/ICU versus electives and ambulatory months? Lots of learning takes place on wards/nightfloat/ICU, but so does lots of work.

 

[FutureInternist]

great thread!

Other questions I would ask -

What's the earliest you can sign-out? Is there a day cross cover or do you have to wait for night float to come before leaving?
If you do get to leave, until what time are you expected to answer your pager?
What happens to "rocks," are you expected to see them daily? Or are they attending only?
Do you have 1 attending per team at a time? Or are there multiple attendings for the different patients?
I want to echo that asking about admission caps, team caps, and intern caps are important. Also the importance of what it means to be on long call vs short call or medium call. And whether or not it's different if short or medium call falls on the weekend.

Good luck to those applying!

DO NOT ask these Qs...
Earliest sign out?
Rocks?

Like in most situations in life, you can think whatever you want but do not say them.
Quickest way to get to the bottom of the Do Not Rank list

 

[Law2Doc]

DO NOT ask these Qs...
Earliest sign out?
Rocks?

Like in most situations in life, you can think whatever you want but do not say them.
Quickest way to get to the bottom of the Do Not Rank list

Absolutely. All of your questions need to hint that you love to work hard, stay late, and love working with patients. Doesnt matter if its true, but thats the ideal candidate they want to rank highly. You don't want to come off as the guy who is worried about and focused on how hard he has to work, how many patients he will be burdened with, how much scut he will have to do, and how much call will he have to endure.

 

[drizzt3117]

It also depends if you're applying to a categorical or prelim/TY. I would say 90% of TY interviewee Qs are simply to find out how Cush the programs are, and the PDs are only too glad to tell us.

 

[SouthernSurgeon]

Here are a few examples of things you should find out from current residents....

Agree with others that asking these questions can look very bad.

But that doesn't mean you can't find out the answers to a lot of them. Go to the resident dinners...find a social group of residents...and listen. If they start talking to each other about work, the answers to a lot of these questions, and their general attitudes about the program, will come out.

 

[Law2Doc]

It also depends if you're applying to a categorical or prelim/TY. I would say 90% of TY interviewee Qs are simply to find out how Cush the programs are, and the PDs are only too glad to tell us.

Nah, the TY PDs still want folks who come off excited about a broad learning experience, not the guy who asks how little he can get away with doing. If pDs volunteer that it's cush, that's great, but you really shouldn't be asking.

 

[drizzt3117]

Nah, the TY PDs still want folks who come off excited about a broad learning experience, not the guy who asks how little he can get away with doing. If pDs volunteer that it's cush, that's great, but you really shouldn't be asking.

That's nice. I did and matched at my top choice.

 

[Winged Scapula]

Moving to ERAS/Match forum...

 

[Law2Doc]

That's nice. I did and matched at my top choice.

N=1. for every person like you there are a dozen who dug their own grave. That you dodged a bullet doesn't mean it isn't bad advice. It is.

 

[VisionaryTics]

It also depends if you're applying to a categorical or prelim/TY. I would say 90% of TY interviewee Qs are simply to find out how Cush the programs are, and the PDs are only too glad to tell us.

I think the difference is that your CV is so unbelievable that any PD in the country would be salivating to land you. For most people, they need to put on a good show during the interview to be ranked highly.

 

[drizzt3117]

N=1. for every person like you there are a dozen who dug their own grave. That you dodged a bullet doesn't mean it isn't bad advice. It is.

Doubtful. Almost everyone I talked to on the interview trail was basically asking PDs how many electives there were, what the call schedule was like, etc. it's a TY. They know you're doing it because its easy. It just is what it is.

 

[akhim]

are you being sarcastic?? or trying to screw everyone else over?

great thread!

Other questions I would ask -

What's the earliest you can sign-out? Is there a day cross cover or do you have to wait for night float to come before leaving?
If you do get to leave, until what time are you expected to answer your pager?
What happens to "rocks," are you expected to see them daily? Or are they attending only?
Do you have 1 attending per team at a time? Or are there multiple attendings for the different patients?
I want to echo that asking about admission caps, team caps, and intern caps are important. Also the importance of what it means to be on long call vs short call or medium call. And whether or not it's different if short or medium call falls on the weekend.

Good luck to those applying!

 

[kc222]

Not trying to screw people over - this thread was originally in the internship forum, geared to prelims/TY's. I asked these questions to get a sense of the program since there's a wide spectrum of programs where it's obvious that interns are overworked vs. having a balance. It was important for me to find out the structure of each program too.

 

[kc222]

While all of these things are important to know, all of them could rub an interviewer the wrong way. Best to ask them privately to med school alumni who are residents or other non-official channels.

I forgot to mention and people are right about this - I directed my questions to prelims/TY's during tours or lunch and not to interviewers.

 

[Law2Doc]

I forgot to mention and people are right about this - I directed my questions to prelims/TY's during tours or lunch and not to interviewers.

I'd still keep it out of the interview day, and ask this through side channels, preferably to residents with whom you have a nexus (especially alumni or your med school, friends of friends, etc)who are less likely to be debriefed by the PD. The guy enlisted for the tour, lunch often are asked to weigh in, so your line of questioning gets known.

 

[Law2Doc]

Doubtful. Almost everyone I talked to on the interview trail was basically asking PDs how many electives there were, what the call schedule was like, etc. it's a TY. They know you're doing it because its easy. It just is what it is.

Again, it's still not necessarily good advice even if it worked out fine for you. Ive seen the other side of the process and have seen this kind of thing rub certain people the wrong way. Many PDs feel that there is a right way and a wrong way to get certain information. Private settings away from the interview process and PDs would be the right way to get this info.

It's like raising the issue of salary in an initial job interview -- it's considered gauche, even though obviously it's hugely relevant to your decision. Some people will still get the job, but many won't due to this lack of etiquette.

At any rate, it's not the kind of blanket "advice" that you want to post on a public board for those who may be at lot closer to the cusp than you apparently were, and for whom a few mild blunders of etiquette could make a real difference. You could say " it didn't hurt me" but I'd really shy away from saying it's totally accepted (because frankly it's not).

 

[SouthernSurgeon]

N=1. for every person like you there are a dozen who dug their own grave. That you dodged a bullet doesn't mean it isn't bad advice. It is.

There's always this phenomenon among some of the folks applying for TY years who like to brag about how easy it is going to be; the types of comments you're responding to are typical of this. And as you said, the advice is still bad. I'd also be surprised if the majority of people making these claims were as cavalier during their interview days as they act here on SDN.

Along with this attitude comes the similarly themed claims that the reason TY years are so easy is that the superior applicants are just better at getting the work done than their lowly counterparts in traditional medicine or surgery intern years.

 

[calico5]

Moving to ERAS/Match forum...

Now that this conversation is hanging out in the main ERAS forum... any general advice for those of us NOT applying for TY?

It seems as if much of the advice regarding interview days boils down to "a lot of the things you kids ask about doesn't really matter, and the things that do matter you can't ask about... so just go with your gut!"

(I know there are many similar threads from past years, many of which I have read, but always curious if anyone has anything new to add!)

thank you!!

 

[blue2000]

There's always this phenomenon among some of the folks applying for TY years who like to brag about how easy it is going to be; the types of comments you're responding to are typical of this. And as you said, the advice is still bad. I'd also be surprised if the majority of people making these claims were as cavalier during their interview days as they act here on SDN.

Along with this attitude comes the similarly themed claims that the reason TY years are so easy is that the superior applicants are just better at getting the work done than their lowly counterparts in traditional medicine or surgery intern years.

Also, I will never forget working with a resident who had completed a year at a "cushy" TY program who was rotating through the ICU in his advanced program. He. Was. Terrible. Like dangerously terrible. I hate to sound like an old person, but intern year does serve a purpose. And learning some clinical skills is actually a good one.

 

[darksideone]

great thread!

Other questions I would ask -

What's the earliest you can sign-out? Is there a day cross cover or do you have to wait for night float to come before leaving?
If you do get to leave, until what time are you expected to answer your pager?
What happens to "rocks," are you expected to see them daily? Or are they attending only?
Do you have 1 attending per team at a time? Or are there multiple attendings for the different patients?
I want to echo that asking about admission caps, team caps, and intern caps are important. Also the importance of what it means to be on long call vs short call or medium call. And whether or not it's different if short or medium call falls on the weekend.

Good luck to those applying!

When interviewing as a medical student I asked similar questions to get a feel for the program. However I asked these questions during the dinner with the residents and away from any faculty. Residents were completely opened and were happy to answer the questions.

- what an average call night is like in terms of admission
- what services are run and how many residents (senior/junior) per service
- caps for admissions
- backup for call nights
- what typical day is like with rounding/admissions/consults...etc.


Had no residents state those questions were off limits or give the impression they were uneasy answering them. If anything, I would be weary of a resident/program not willing to answer those questions. Everything is fair game for interviews.

Now fast forward to residency, I actually appreciate it when medical students ask those questions. Shows they are interested in the program and how it runs. Also is fair to them as it provides a comparison to what they have experienced and gives them an idea of how things are run here and what to expect. It would be dumb for them to think of these questions and be afraid to ask them since it breaks some "unspoken etiquette" that is an antiquated tradition. Incoming residents should get the best possible exposure to the program and best understanding of how things are run. I am most scared about the medical students who ask the same old questions about electives, % passing boards, questions regarding faculty, if I would pick the program again...etc. Much of those questions are fluff.

However I agree that this questions are not appropriate to ask the PD or other faculty during the interview process. Leave them for the residents.

 

[scarletgirl777]

Now that this conversation is hanging out in the main ERAS forum... any general advice for those of us NOT applying for TY?

It seems as if much of the advice regarding interview days boils down to "a lot of the things you kids ask about doesn't really matter, and the things that do matter you can't ask about... so just go with your gut!"

(I know there are many similar threads from past years, many of which I have read, but always curious if anyone has anything new to add!)

thank you!!

And who wants to move to a 1-year program in another part of the country based on "gut feeling?" There needs to be SOME kind of benefit in order to make that effort to move twice, otherwise people should just apply to prelims in their home town.

 

[drizzt3117]

I'd still keep it out of the interview day, and ask this through side channels, preferably to residents with whom you have a nexus (especially alumni or your med school, friends of friends, etc)who are less likely to be debriefed by the PD. The guy enlisted for the tour, lunch often are asked to weigh in, so your line of questioning gets known.

I think someone asking about the call schedule is just being practical. What else are they going to ask the residents?

Again, it's still not necessarily good advice even if it worked out fine for you. Ive seen the other side of the process and have seen this kind of thing rub certain people the wrong way. Many PDs feel that there is a right way and a wrong way to get certain information. Private settings away from the interview process and PDs would be the right way to get this info.

It's like raising the issue of salary in an initial job interview -- it's considered gauche, even though obviously it's hugely relevant to your decision. Some people will still get the job, but many won't due to this lack of etiquette.

At any rate, it's not the kind of blanket "advice" that you want to post on a public board for those who may be at lot closer to the cusp than you apparently were, and for whom a few mild blunders of etiquette could make a real difference. You could say " it didn't hurt me" but I'd really shy away from saying it's totally accepted (because frankly it's not).

We'll have to agree to disagree about this. My experience is that people applying to TYs are trying to find the best possible situation for themselves. I saw plenty of questions even asked in open forums like "what is the call schedule?" "How are you adapting to the new intern work restrictions?" "What is the schedule like on electives?" In fact this happened at every TY interview I was at. The tours and lunches were TY residents falling over themselves to explain how Cush their programs are.

There's always this phenomenon among some of the folks applying for TY years who like to brag about how easy it is going to be; the types of comments you're responding to are typical of this. And as you said, the advice is still bad. I'd also be surprised if the majority of people making these claims were as cavalier during their interview days as they act here on SDN.

Along with this attitude comes the similarly themed claims that the reason TY years are so easy is that the superior applicants are just better at getting the work done than their lowly counterparts in traditional medicine or surgery intern years.

Oh really? How was the attitude during your TY interviews? Oh wait... I didn't say a thing about categorical medicine interviews because I didn't apply or interview for it so I have no knowledge of the process. I'd welcome your insight into the TY application process from the vast knowledge and experience you seem to have.

Also, I will never forget working with a resident who had completed a year at a "cushy" TY program who was rotating through the ICU in his advanced program. He. Was. Terrible. Like dangerously terrible. I hate to sound like an old person, but intern year does serve a purpose. And learning some clinical skills is actually a good one.

Yep learning how to call social work will come in very handy for those of us doing derm, rad onc, pm&r, and rads.

When interviewing as a medical student I asked similar questions to get a feel for the program. However I asked these questions during the dinner with the residents and away from any faculty. Residents were completely opened and were happy to answer the questions.

- what an average call night is like in terms of admission
- what services are run and how many residents (senior/junior) per service
- caps for admissions
- backup for call nights
- what typical day is like with rounding/admissions/consults...etc.


Had no residents state those questions were off limits or give the impression they were uneasy answering them. If anything, I would be weary of a resident/program not willing to answer those questions. Everything is fair game for interviews.

Now fast forward to residency, I actually appreciate it when medical students ask those questions. Shows they are interested in the program and how it runs. Also is fair to them as it provides a comparison to what they have experienced and gives them an idea of how things are run here and what to expect. It would be dumb for them to think of these questions and be afraid to ask them since it breaks some "unspoken etiquette" that is an antiquated tradition. Incoming residents should get the best possible exposure to the program and best understanding of how things are run. I am most scared about the medical students who ask the same old questions about electives, % passing boards, questions regarding faculty, if I would pick the program again...etc. Much of those questions are fluff.

However I agree that this questions are not appropriate to ask the PD or other faculty during the interview process. Leave them for the residents.

I don't think it's inappropriate to ask the PD how your rotations are structured. How is that possibly an issue?

 

[Winged Scapula]

Yep learning how to call social work will come in very handy for those of us doing derm, rad onc, pm&r, and rads.

Obviously someone thought that a GS/SICU rotation *was* important for a TY program. You even have one later this year, as I recall.

blue2000's comment was made in observation (which we have all seen - including southernIM, who is Surgery, not IM) that *some* of the TY interns are looking for the easiest way to finish out the year and often have no interest in gaining any skills. I have no beef with that except when it comes to rotating on my service. It may not be important for you to learn how to do a microvascular anastomosis for your future career, but recognizing how to take care of sick patients is a good skill any one needs. You may argue that point as well, but my response would be, "take it up with your PD who has you rotating on GS <or insert other speciality that some TY interns think is unnecessary>." It is not my job to provide you with an experience that benefits your future career, but if I can, I will try and do so.That however does not translate to allowing off service interns to sit around, gripe about the work and let patients go uncared for. You are treated the same as every other resident on service.

And while I have no interest in getting into an argument here, my sense is that if you think a SICU resident's job is to " call social work" rather than take care of patients, then you are misinformed.

 

[drizzt3117]

I am done with icu/sicu. I actually liked it but that's not surprising as it's a very procedural rotation and I'm doing IR. I actually have liked a lot of my internship too, although not the generalized scut that characterizes most of IM. I have a month of GS later, which I think I'll also enjoy. I did two surgical electives in my TY because I think it's interesting and like being in the OR and procedure suites. I don't, however, like dealing with placement and social issues and I would say that's 2/3 of what my medicine ward months consist of. Minimizing that and maximizing my ability to do interesting rotations was one of my biggest priorities in selecting a program and despite my disdain for some of the work I can't say I can really complain that much and am generally happy even on medicine (which I'm on now). The same can't be said for some of my co-residents, though, who generally just hate clinical work with a passion. I personally don't think that's a great attitude but w/e.

Obviously someone thought that a GS/SICU rotation *was* important for a TY program. You even have one later this year, as I recall.

blue2000's comment was made in observation (which we have all seen - including southernIM, who is Surgery, not IM) that *some* of the TY interns are looking for the easiest way to finish out the year and often have no interest in gaining any skills. I have no beef with that except when it comes to rotating on my service. It may not be important for you to learn how to do a microvascular anastomosis for your future career, but recognizing how to take care of sick patients is a good skill any one needs. You may argue that point as well, but my response would be, "take it up with your PD who has you rotating on GS <or insert other speciality that some TY interns think is unnecessary>." It is not my job to provide you with an experience that benefits your future career, but if I can, I will try and do so.That however does not translate to allowing off service interns to sit around, gripe about the work and let patients go uncared for. You are treated the same as every other resident on service.

And while I have no interest in getting into an argument here, my sense is that if you think a SICU resident's job is to " call social work" rather than take care of patients, then you are misinformed.

 

[Winged Scapula]

I am done with icu/sicu. I actually liked it but that's not surprising as it's a very procedural rotation and I'm doing IR. I actually have liked a lot of my internship too, although not the generalized scut that characterizes most of IM. I have a month of GS later, which I think I'll also enjoy. I did two surgical electives in my TY because I think it's interesting and like being in the OR and procedure suites. I don't, however, like dealing with placement and social issues and I would say that's 2/3 of what my medicine ward months consist of. Minimizing that and maximizing my ability to do interesting rotations was one of my biggest priorities in selecting a program and despite my disdain for some of the work I can't say I can really complain that much and am generally happy even on medicine (which I'm on now). The same can't be said for some of my co-residents, though, who generally just hate clinical work with a passion. I personally don't think that's a great attitude but w/e.

Fair enough.

I admit I was suprised at what I thought your attitude was about GS/SICU since I'm aware that you will be going into IR.

Placement and social issues are a problem on ALL services but it appeared that you were relating that to TY interns on SICU/ICU rotations (which is what blue2000 was going on about).

 

[drizzt3117]

Fair enough.

I admit I was suprised at what I thought your attitude was about GS/SICU since I'm aware that you will be going into IR.

Placement and social issues are a problem on ALL services but it appeared that you were relating that to TY interns on SICU/ICU rotations (which is what blue2000 was going on about).

No I meant internship in general.

I think it's less of a problem in some fields than others; certainly non-admitting services have to deal with it less.

 

[drizzt3117]

Fair enough.

I admit I was suprised at what I thought your attitude was about GS/SICU since I'm aware that you will be going into IR.

Placement and social issues are a problem on ALL services but it appeared that you were relating that to TY interns on SICU/ICU rotations (which is what blue2000 was going on about).

No I meant internship in general.

I think it's less of a problem in some fields than others; certainly non-admitting services have to deal with it less.

I like surgery and actually like ICU too. No d/c summaries or placement issues in the icu is awesome, patients leaving celestially, less so.

 

[Law2Doc]

...
I like surgery and actually like ICU too. No d/c summaries or placement issues in the icu is awesome, patients leaving celestially, less so.

death certification papers take about as long as discharge summaries, and you have many more of them in the ICU than elsewhere. And I've discharged people directly from the ICU to rehab, nursing homes and other facilities on many occasions, so I think suggesting that there's no discharge summaries or placement issues from the ICU is not particularly accurate.

Also at least at the hospital I'm at the IR folks direct admit many of the TIPS and ablation patients, so you might find you are dealing with this in IR even more than you did as an intern.

 

[drizzt3117]

death certification papers take about as long as discharge summaries, and you have many more of them in the ICU than elsewhere. And I've discharged people directly from the ICU to rehab, nursing homes and other facilities on many occasions, so I think suggesting that there's no discharge summaries or placement issues from the ICU is not particularly accurate.

I discharged 0 pts from the icu; at our hospital we always step down to medicine. Yes death summaries are rough but unless the death is really unforeseen it's less pored over than a d/c summary to a NH.

Also at least at the hospital I'm at the IR folks direct admit many of the TIPS and ablation patients, so you might find you are dealing with this in IR even more than you did as an intern.

Lmao.

In any case, that's what midlevels are for.

 

[SouthernSurgeon]

Oh really? How was the attitude during your TY interviews? Oh wait... I didn't say a thing about categorical medicine interviews because I didn't apply or interview for it so I have no knowledge of the process. I'd welcome your insight into the TY application process from the vast knowledge and experience you seem to have.

My post was an observation of behavior frequently seen on this forum...

I don't think it's inappropriate to ask the PD how your rotations are structured. How is that possibly an issue?

It's definitely appropriate to ask about rotation structure, call schedule, etc. But I would suggest that for most people, the PD is not going to be the person you should ask. At most programs you will have multiple interviews, information sessions, tours, all of which would be appropriate places to get those questions answered.. Why ask these nitty gritty questions to the PD? - you should probably be spending that interview selling yourself.

 

[45408]

I think someone asking about the call schedule is just being practical. What else are they going to ask the residents?



We'll have to agree to disagree about this. My experience is that people applying to TYs are trying to find the best possible situation for themselves. I saw plenty of questions even asked in open forums like "what is the call schedule?" "How are you adapting to the new intern work restrictions?" "What is the schedule like on electives?" In fact this happened at every TY interview I was at. The tours and lunches were TY residents falling over themselves to explain how Cush their programs are.



Oh really? How was the attitude during your TY interviews? Oh wait... I didn't say a thing about categorical medicine interviews because I didn't apply or interview for it so I have no knowledge of the process. I'd welcome your insight into the TY application process from the vast knowledge and experience you seem to have.



Yep learning how to call social work will come in very handy for those of us doing derm, rad onc, pm&r, and rads.



I don't think it's inappropriate to ask the PD how your rotations are structured. How is that possibly an issue?

There was a much less toolish way of saying all of this.

 

[Dr. USMLE]

.

 

[drizzt3117]

There was a much less toolish way of saying all of this.

Perhaps, but I'm not partial to the peanut gallery chiming in on a process I went through and they didn't.

 

[Law2Doc]

I discharged 0 pts from the icu; at our hospital we always step down to medicine. Yes death summaries are rough but unless the death is really unforeseen it's less pored over than a d/c summary to a NH.

[/b]

Lmao.

In any case, that's what midlevels are for.

LMAO. Please.
Sounds like you were at a very atypical hospital if nobody in the ICU ever got discharged from there to another facility. And depending on the state, ALL death certificate documents get "pored over". And sometimes sent back if the hospital finds them inadequate. Sorry but once again it sounds like you had a wildly atypical and sheltered experience and are trying to extrapolate that onto every one else. Kudos to you for finding a place which bucks the trend, but perhaps you should refrain from giving advice based on an outlier experience. And in most hospitals, the availability of midlevels on nights and weekends is pretty nonexistent -- as the IR resident or fellow YOU are going to be the midlevel. Good luck with that my friend.

 

[Law2Doc]

Perhaps, but I'm not partial to the peanut gallery chiming in on a process I went through and they didn't.

Honestly it seems like those of us you call the "peanut gallery" had much more typical experiences. Also in this thread technically you chimed in with a differing view subsequent to several of us, so that technically makes you the peanut gallery (as that term is defined) here.

 

[drizzt3117]

LMAO. Please.
Sounds like you were at a very atypical hospital if nobody in the ICU ever got discharged from there to another facility. And depending on the state, ALL death certificate documents get "pored over". And sometimes sent back if the hospital finds them inadequate. Sorry but once again it sounds like you had a wildly atypical and sheltered experience and are trying to extrapolate that onto every one else. Kudos to you for finding a place which bucks the trend, but perhaps you should refrain from giving advice based on an outlier experience. And in most hospitals, the availability of midlevels on nights and weekends is pretty nonexistent -- as the IR resident or fellow YOU are going to be the midlevel. Good luck with that my friend.

I've been at six major medical centers and haven't found it atypical that ppl from the ICU go to the floor prior to discharge. As far as death summaries go (not certificates, and in my state, interns can't do death certs anyways). my experience is that they're not as time-consuming as d/c summaries.

I fully expect IR months to be busy during residency and especially during fellowship; as an attending though, most centers I've seen have midlevels to manage your hospital patients (or medical/surgical services depending on the center)

 

[drizzt3117]

Honestly it seems like those of us you call the "peanut gallery" had much more typical experiences. Also in this thread technically you chimed in with a differing view subsequent to several of us, so that technically makes you the peanut gallery (as that term is defined) here.

I meant people in other specialties that didn't do TYs. If you're saying you had DIRECT experience with the TY interview process feel free to comment, otherwise it's just noise.

 

[Winged Scapula]

Not that I care to get into the petty back and forth here...

I've been at six major medical centers and haven't found it atypical that ppl from the ICU go to the floor prior to discharge. As far as death summaries go (not certificates, and in my state, interns can't do death certs anyways). my experience is that they're not as time-consuming as d/c summaries.

My experience was the same as yours; patients tended to be discharged from the ICUs to a step-down unit, the floor or perhaps Rehab. Didn't you have to do a Transfer Summary? I found those incredibly painful as it was difficult to condense months of SICU stay into something that didn't take all day (then again, maybe with EMRs you don't have to do those anymore?).

I fully expect IR months to be busy during residency and especially during fellowship; as an attending though, most centers I've seen have midlevels to manage your hospital patients (or medical/surgical services depending on the center)

L2D may practice at an institution where IR admits and manages their patients. I never saw that in residency, fellowship or now out in practice. They are admitted to Med or Surg, and while they round on them, the calls and the day to day management is not done by IR. I understand more and more IR programs are becoming "clinical" (as one user in the Surg forum likes to talk about) but without significant medical training, is that in the best interest of the patient? In my world, IR is a consult team.

 

[drizzt3117]

My experience is consistent with the below.

Not that I care to get into the petty back and forth here...

My experience was the same as yours; patients tended to be discharged from the ICUs to a step-down unit, the floor or perhaps Rehab. Didn't you have to do a Transfer Summary? I found those incredibly painful as it was difficult to condense months of SICU stay into something that didn't take all day (then again, maybe with EMRs you don't have to do those anymore?).



L2D may practice at an institution where IR admits and manages their patients. I never saw that in residency, fellowship or now out in practice. They are admitted to Med or Surg, and while they round on them, the calls and the day to day management is not done by IR. I understand more and more IR programs are becoming "clinical" (as one user in the Surg forum likes to talk about) but without significant medical training, is that in the best interest of the patient? In my world, IR is a consult team.

 

[shan564]

Silly me, I opened this thread expecting to read about "important things to find out during your residency interviews."

 

[Law2Doc]

...


L2D may practice at an institution where IR admits and manages their patients. I never saw that in residency, fellowship or now out in practice. They are admitted to Med or Surg, and while they round on them, the calls and the day to day management is not done by IR. I understand more and more IR programs are becoming "clinical" (as one user in the Surg forum likes to talk about) but without significant medical training, is that in the best interest of the patient? In my world, IR is a consult team.

Maybe it's regional, but at the multiple places I've been IR is both a consult team for inpatients and has direct admits of it's own outpatients. They see patients in clinic, and schedule them for procedures. Around here, this is the emerging model, particularly as IR pushes to become it own independent specialty. This is perhaps not true for places where IR departments are basically glorified line services, but is for the IR departments which hold themselves out as alternatives to vascular surgery for real procedures. Around here, if you schedule an appointment for eg a non emergent TIPS, you get admitted to IR after the procedure. The nurses page the IR resident for patient issues overnight. And if it falls on a weekend, or if midlevels are scarce, someone like drizzt gets to deal with the discharge papers and social issues during fellowship, just as if he was a surgery intern. This is how ive seen it, and how IR seems to want it based on their push for direct pathways and for becoming a free standing specialty. I think drizzt is in for a surprise if he thinks discharge papers are in his rear view mirror. But whatever.

 

[deleted103644]

It also depends if you're applying to a categorical or prelim/TY. I would say 90% of TY interviewee Qs are simply to find out how Cush the programs are, and the PDs are only too glad to tell us.

Still think these Qs are better for current prelims/TYs and not attendings. (And yes, I interviewed at TYs.)

PDs are aware of why people look for TY programs, but that doesn't mean they want lazy interns.

Save the questions that might reflect poorly on your work ethic for the residents.

 

[drizzt3117]

Maybe it's regional, but at the multiple places I've been IR is both a consult team for inpatients and has direct admits of it's own outpatients. They see patients in clinic, and schedule them for procedures. Around here, this is the emerging model, particularly as IR pushes to become it own independent specialty. This is perhaps not true for places where IR departments are basically glorified line services, but is for the IR departments which hold themselves out as alternatives to vascular surgery for real procedures. Around here, if you schedule an appointment for eg a non emergent TIPS, you get admitted to IR after the procedure. The nurses page the IR resident for patient issues overnight. And if it falls on a weekend, or if midlevels are scarce, someone like drizzt gets to deal with the discharge papers and social issues during fellowship, just as if he was a surgery intern. This is how ive seen it, and how IR seems to want it based on their push for direct pathways and for becoming a free standing specialty. I think drizzt is in for a surprise if he thinks discharge papers are in his rear view mirror. But whatever.

The only academic centers with that kind of model are MCW and Miami (FL) and in some sense Hopkins. The center I'm training for rads at certainly doesn't.

 

[darksideone]

I've been at six major medical centers and haven't found it atypical that ppl from the ICU go to the floor prior to discharge. As far as death summaries go (not certificates, and in my state, interns can't do death certs anyways). my experience is that they're not as time-consuming as d/c summaries.

I fully expect IR months to be busy during residency and especially during fellowship; as an attending though, most centers I've seen have midlevels to manage your hospital patients (or medical/surgical services depending on the center)

This has been my experience as well.

Maybe it's regional, but at the multiple places I've been IR is both a consult team for inpatients and has direct admits of it's own outpatients. They see patients in clinic, and schedule them for procedures. Around here, this is the emerging model, particularly as IR pushes to become it own independent specialty. This is perhaps not true for places where IR departments are basically glorified line services, but is for the IR departments which hold themselves out as alternatives to vascular surgery for real procedures. Around here, if you schedule an appointment for eg a non emergent TIPS, you get admitted to IR after the procedure. The nurses page the IR resident for patient issues overnight. And if it falls on a weekend, or if midlevels are scarce, someone like drizzt gets to deal with the discharge papers and social issues during fellowship, just as if he was a surgery intern. This is how ive seen it, and how IR seems to want it based on their push for direct pathways and for becoming a free standing specialty. I think drizzt is in for a surprise if he thinks discharge papers are in his rear view mirror. But whatever.

This is definitely not how things are done where I did medical school or where I am currently. This is not the norm and must be the exception.

 

[drizzt3117]

You're also in a location of the country where interns draw blood on their patients and nurses do nothing. PDs of relatively rural community programs are recruiting people on interviews whereas NYC area programs sell themselves.

Still think these Qs are better for current prelims/TYs and not attendings. (And yes, I interviewed at TYs.)

PDs are aware of why people look for TY programs, but that doesn't mean they want lazy interns.

Save the questions that might reflect poorly on your work ethic for the residents.

 

[deleted103644]

You're also in a location of the country where interns draw blood on their patients and nurses do nothing. PDs of relatively rural community programs are recruiting people on interviews whereas NYC area programs sell themselves.

Honestly don't know what you're talking about, and I interviewed at TYs outside of NYC.

It is never a good idea to come across as a lazy dick in an interview, I figured this was just common sense.

If the PD starts talking about call, by all means ask for details, but it still looks bad if you are the one to bring it up.

 

[45408]

Perhaps, but I'm not partial to the peanut gallery chiming in on a process I went through and they didn't.

You may have been through the process, which gives you a unique perspective, but it's still an intern spot. We've all matched. I've worked with and evaluated TYs as their senior resident. I know their program director and I know my program director. We had a TY last year who tried to get away with doing less than the bare minimum. My PD, his PD and he all had a "Come to Jesus" talk that straightened him out. I'm pretty sure that if the PD knew he was a lazy sh-t at the outset, he would not have ranked him.

Therefore, choose your questions wisely at an interview.