The Mechanics of the DNR List

[JamesGleaven]

Hello SDN

I'd like to know. Can anybody here with any special insight on this, explain exactly how a candidate ends up on a Do Not Rank List? Does any faculty members, Program Directors or current residents have an specific vivid examples? If so drop them here so the masses can learn what not to do?

Thanks

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[IMG69]

I've seen you've posted a lot here because you've had a lot of drama and haven't matched for 5? years. Why don't you just learn another language and go to a country in Europe in dire need of doctors and start life there, some countries will require you to have at least done 1 year of residency so you should definitely do your research. It looks like everybody has already given you advice and that nothing will change your situation, so this may be your only real chance at ever becoming a practicing Physician.

 

[shotgunlagoon]

i'd say being dismissed from medical school and having multiple citations for unprofessional and inappropriate conduct is probably what got you on the list.... I second IMG's suggestion.

 

[operaman]

My guess is that no matter what we say here, anyone who would actually benefit from such information is to self unaware to realize they’re at risk of being unranked.

I can think of three who got DNR after interviews. Generally speaking just an abject lack of self awareness, inability to interact with other humans and, in one case, some clear dishonesty. All 3 matched at other places though. 2 of them were fired within the first 2 years and the other was apparently quite the problem child at their program. Clearly out spidey sense was pretty good on the extreme end of things!

For us, the dismissed from school or a step failure or any significant academic red flags would be enough to get the app tossed out long before the interview stage. In people smart enough to get in to medical school, such red flags almost invariably mean poorly managed mental illness and/or substance abuse issues. There are simply too many great applicants to take such a big risk on someone who may end up being a big liability.

 

[VA Hopeful Dr]

It's been a few years, but the only do not rank applicant my old program had that I remember earned that honor by trying to recruit the other applicants to the program his father worked for on interview day at our program

 

[JamesGleaven]

All 3 matched at other places though. 2 of them were fired within the first 2 years and the other was apparently quite the problem child at their program

How did you come to know this is the case?

 

[mrbreakfast]

My guess is that no matter what we say here, anyone who would actually benefit from such information is to self unaware to realize they’re at risk of being unranked.

Absolutely this. From the resident side, almost all of the DNRs I've seen/heard of (because it's exceedingly rare) occurred due to behavior that no reasonable person would engage in. Examples include:
-Arrogance to the point of braggadocio, loudly interrupting every topic of conversation to talk about themselves, while getting trashed
-Poking fun at other applicants during a zoom pre-interview meet and greet, including making a racist joke, which, thanks to zoom, was heard by every single applicant and resident
-Bad-mouthing the program during the interview/pre-interview - in addition to being a jerk in general, applicant made it clear they would be disappointed if they matched at said program
-Very bizarre political views/hobbies that applicants don't realize should not be mentioned. It's the "first date" rule - don't mention anything you wouldn't on a first date. For example, don't mention that you collect Nazi memorabilia or that you're a key part of a political movement to lower the age of consent. Sounds like I'm joking, but this happens.

It's very hard to get DNR'd; it's exceedingly rare. Keep in mind a DNR means that red flags came up during your interview that were not apparent from your application. Programs only interview applicants they'd consider ranking, so A DNR means you talked your way out of a rank spot. There's no "quick tips" to avoid it, applicants who are being DNR'd are people incapable of following social norms/cues.

 

[VA Hopeful Dr]

How did you come to know this is the case?

Certain specialties are small enough that things like that get around very easily. Like playing 8 degrees of Kevin Bacon but instead of Kevin Bacon you have sub-par residents.

 

[A-poor-student]

Hello SDN

I'd like to know. Can anybody here with any special insight on this, explain exactly how a candidate ends up on a Do Not Rank List? Does any faculty members, Program Directors or current residents have an specific vivid examples? If so drop them here so the masses can learn what not to do?

Thanks

I will be honest with you. You are a vivid example of someone that ends up in a DNR. You made many big mistakes in medical school and you don't take responsibility for it. Every post you write in SDN shows how you think people were against you. You have to take responsibility because every message shows that you think what you did was not your fault. And it was your fault. I'm sorry that you have debts and need a match. You finished medical school so we know you are smart enough to be a good doctor. But you lack a lot of professionalism. Accept your mistakes, it was your fault, and try to improve as a person that is the only way you can get a residency.

If you want to help others really tell your story and not be so vague as you did in other posts.

 

[operaman]

How did you come to know this is the case?

My field is very small so within a program of 15-25 resident, someone knows someone else at most every program in the country. You can imagine that these unaware train wrecks make for good stories, the kind that get told on various group chats and at meetings. Plus whenever you see a program put out notice that they’re looking for a PGY2 or 3, then you know someone got canned and it’s pretty easy to figure out who it was.

 

[GoSpursGo]

While I think we all can look into someone's post history and figure out that there's a "question underneath the question" here, piling onto the OP for asking a fairly innocuous question doesn't really help anyone.

To answer the question, at its core it's just a value judgement of, "Would we rather take our chances on someone in the SOAP or going unmatched rather than take this person?" In the vast majority of cases, this is because someone did something egregious in an interview as outlined above. However, there are some programs that may decide to not rank truly marginal candidates and hope they can do better in SOAP. While I would say it's a distinct minority of programs that do this, every year there are some good candidates who applied to highly competitive fields and wound up failing to match and a program could theoretically try their luck at snagging one of those applicants in the SOAP.

 

[Mass Effect]

Hello SDN

I'd like to know. Can anybody here with any special insight on this, explain exactly how a candidate ends up on a Do Not Rank List? Does any faculty members, Program Directors or current residents have an specific vivid examples? If so drop them here so the masses can learn what not to do?

Thanks

The DNR list sucks, but is a necessary evil because applicants get wild at interviews sometimes. We had one guy who was invited to interview during his away with us. The invite went out before the away though. So during the away, it was like he had it in his head he'd already matched. It was the weirdest thing, but he tried to hard to fit in to the point that he was teasing people, and even made fun of a PGY 3 for getting some question wrong on rounds. Like legit made fun of the guy when we all met up for lunch later (and the PGY 3 wasn't there so it was like this MS 4 was bashing him behind his back to his colleagues). There were other things he did during that month too, but that was the most egregious. He was good clinically, but he went on the DNR list because we all complained and program director agreed that anyone who comes in bashing one of us like that during the away will be a nightmare to work with when he's a real resident.

There was another girl who residents recommended for the DNR list but I don't know if she ended up there. She didn't do an away but when she came in for the pre-interview dinner, she had a little too much to drink, became very loud, spoke over people and had an argument with the waiter because they didn't validate parking. We offered to pay for her parking but she fought it out on principle.

 

[ohmanwaddup]

Discussions like this make me over analyze every interaction with residents I’ve had/have and wonder if I did something awful without realizing it.

Guess I’ll find out in March

 

[GoSpursGo]

Discussions like this make me over analyze every interaction with residents I’ve had/have and wonder if I did something awful without realizing it.

Guess I’ll find out in March

Did you make fun of a resident behind his back? Or get drunk at dinner?

No?

Then you’re likely fine

 

[Lem0nz]

Did you make fun of a resident behind his back? Or get drunk at dinner?

No?

Then you’re likely fine

I showed up to my interview dinner in shorts and a tshirt on a 4 hour delayed flight in a snowstorm from Vegas and got a little drunk… and matched there.

I was apparently an excellent fit.

 

[GoSpursGo]

I showed up to my interview dinner in shorts and a tshirt on a 4 hour delayed flight in a snowstorm from Vegas and got a little drunk… and matched there.

I was apparently an excellent fit.

Yeah but it’s ortho. It’s sort of expected there and for EM

 

[mrbreakfast]

Discussions like this make me over analyze every interaction with residents I’ve had/have and wonder if I did something awful without realizing it.

You haven't, because the stuff that'll get you DNR'd from a program as an applicant will get you in trouble as a medical student, i.e. it's things people are going to report you for. If you suck as a med student/person, you might get ranked lower at that program if you apply there, but generally speaking this is rare too. Also keep in mind residents work with a LOT more medical students than the reverse, and honestly the vast percentage of med students rotate through make zero lasting impression.

 

[ohmanwaddup]

Did you make fun of a resident behind his back? Or get drunk at dinner?

No?

Then you’re likely fine

Maybe I’m just super forgettable. I get stressed when residents I’ve rotated with don’t recognize me, makes me think I ticked them off.

I’m probably just my own worst enemy

 

[sloop]

Maybe I’m just super forgettable. I get stressed when residents I’ve rotated with don’t recognize me, makes me think I ticked them off.

I’m probably just my own worst enemy

People don’t get DNR’d for being forgettable. You’re only likely to get DNR’d if you’re memorable for a very bad reason.

You have to realize that somebody generally has to go out of their way to get you DNR’d. I imagine that, at most places, that’s probably going to involve whatever resident or faculty member noticed the behavior in question having a face-to-face meeting with the PD. Nobody cares that much, even about an applicant they frankly find kind of obnoxious. Somebody pretty much has to actively hate you to get you DNR’d.

 

[ohmanwaddup]

People don’t get DNR’d for being forgettable. You’re only likely to get DNR’d if you’re memorable for a very bad reason.

You have to realize that somebody generally has to go out of their way to get you DNR’d. I imagine that, at most places, that’s probably going to involve whatever resident or faculty member noticed the behavior in question having a face-to-face meeting with the PD. Nobody cares that much, even about an applicant they frankly find kind of obnoxious. Somebody pretty much has to actively hate you to get you DNR’d.

Well as the average anxious med student I kinda assume everyone hates me lol

But I see what your saying. I need to get over my "main character" syndrome and relax lol.

Thanks for the insight

 

[ortnakas]

Discussions like this make me over analyze every interaction with residents I’ve had/have and wonder if I did something awful without realizing it.

Guess I’ll find out in March

If you have enough introspection capabilities to think about this, you’re probably self-aware to not get DNR’d

 

[Matthew9Thirtyfive]

Yeah but it’s ortho. It’s sort of expected there and for EM

I think @Lem0nz did a gen surg residency lol.

 

[GoSpursGo]

I think @Lem0nz did a gen surg residency lol.

Whoops you’re right. Not sure why I got that mixed up in my head

 

[Dral]

Well as the average anxious med student I kinda assume everyone hates me lol

But I see what your saying. I need to get over my "main character" syndrome and relax lol.

Thanks for the insight

Exactly this. I like that term to describe this concept.

I just worked with a med student and introduced myself. She says "Oh, I rotated here back in the summer."

We're busy and we forget. It doesn't mean anything negative.

 

[doyouhaveaflag]

At my program, the chief actually has had a historically low threshold not to rank people. Specifically, I can remember one girl asking him why his faculty weren't more diverse. Granted, we did have an issue with low faculty diversity but it's definitely not the best question to ask the division chief (who also happens to be the only brown faculty member on staff). She was DNR. There was another girl who asked a lot about maternity leave and what accommodations were made for pregnant women and she was DNR. Illegal and discriminatory? Yes. But it still happened.

There was an applicant one year who kept going on about how he wanted to match at another program in town and how we were the backup. The residents collectively made him DNR. However, there was another person we tried to make DNR because she sniggered every time one of us got destroyed while getting pimped during conferences (among other issues). She had some really fancy research so they ranked her number one or two. Thank god she matched elsewhere.

Not at my residency program, but in my med school class there was a guy applying ortho who ran into some trouble after he was asked to draw his favorite bone during an interview. Thinking he was being funny, he drew an erect penis. I can't remember if this was the interview at my med school or if the program called the ortho chairman at my school, but our home program chairman essentially called every program he applied to and he was blacklisted. He scrambled into a prelim spot in surgery and I think is now doing a non surgical specialty.

 

[Matthew9Thirtyfive]

Not at my residency program, but in my med school class there was a guy applying ortho who ran into some trouble after he was asked to draw his favorite bone during an interview. Thinking he was being funny, he drew an erect penis. I can't remember if this was the interview at my med school or if the program called the ortho chairman at my school, but our home program chairman essentially called every program he applied to and he was blacklisted. He scrambled into a prelim spot in surgery and I think is now doing a non surgical specialty.

Wow. I have no words.

 

[VA Hopeful Dr]

At my program, the chief actually has had a historically low threshold not to rank people. Specifically, I can remember one girl asking him why his faculty weren't more diverse. Granted, we did have an issue with low faculty diversity but it's definitely not the best question to ask the division chief (who also happens to be the only brown faculty member on staff). She was DNR. There was another girl who asked a lot about maternity leave and what accommodations were made for pregnant women and she was DNR. Illegal and discriminatory? Yes. But it still happened.

There was an applicant one year who kept going on about how he wanted to match at another program in town and how we were the backup. The residents collectively made him DNR. However, there was another person we tried to make DNR because she sniggered every time one of us got destroyed while getting pimped during conferences (among other issues). She had some really fancy research so they ranked her number one or two. Thank god she matched elsewhere.

Not at my residency program, but in my med school class there was a guy applying ortho who ran into some trouble after he was asked to draw his favorite bone during an interview. Thinking he was being funny, he drew an erect penis. I can't remember if this was the interview at my med school or if the program called the ortho chairman at my school, but our home program chairman essentially called every program he applied to and he was blacklisted. He scrambled into a prelim spot in surgery and I think is now doing a non surgical specialty.

In any other circumstance that would be funny.

Not sure it was worth a specialty wide blacklisting, but neither here nor there.

 

[wysdoc]

In any other circumstance that would be funny.

Not sure it was worth a specialty wide blacklisting, but neither here nor there.

In any other circumstance the frat house that would be funny. FTFY

 

[operaman]

At my program, the chief actually has had a historically low threshold not to rank people. Specifically, I can remember one girl asking him why his faculty weren't more diverse. Granted, we did have an issue with low faculty diversity but it's definitely not the best question to ask the division chief (who also happens to be the only brown faculty member on staff). She was DNR. There was another girl who asked a lot about maternity leave and what accommodations were made for pregnant women and she was DNR. Illegal and discriminatory? Yes. But it still happened.

There was an applicant one year who kept going on about how he wanted to match at another program in town and how we were the backup. The residents collectively made him DNR. However, there was another person we tried to make DNR because she sniggered every time one of us got destroyed while getting pimped during conferences (among other issues). She had some really fancy research so they ranked her number one or two. Thank god she matched elsewhere.

Not at my residency program, but in my med school class there was a guy applying ortho who ran into some trouble after he was asked to draw his favorite bone during an interview. Thinking he was being funny, he drew an erect penis. I can't remember if this was the interview at my med school or if the program called the ortho chairman at my school, but our home program chairman essentially called every program he applied to and he was blacklisted. He scrambled into a prelim spot in surgery and I think is now doing a non surgical specialty.

Yikes. Yeah these are good examples. I would have DNR’d every last one of these too.

And it’s not illegal to DNR someone for asking about faculty diversity or parental leave accommodations. It would be illegal to discriminate on the basis of race or gender, but perfectly fine to discriminate against someone for poor enough judgement to ask such questions in a residency interview.

There are more tactful ways to get that information; posing it directly to faculty makes you look like someone who is potentially going to be a PITA and nobody has time for that, especially in a small program.

 

[VA Hopeful Dr]

In any other circumstance the frat house that would be funny. FTFY

I stand by my statement

 

[ohmanwaddup]

At my program, the chief actually has had a historically low threshold not to rank people. Specifically, I can remember one girl asking him why his faculty weren't more diverse. Granted, we did have an issue with low faculty diversity but it's definitely not the best question to ask the division chief (who also happens to be the only brown faculty member on staff). She was DNR. There was another girl who asked a lot about maternity leave and what accommodations were made for pregnant women and she was DNR. Illegal and discriminatory? Yes. But it still happened.

There was an applicant one year who kept going on about how he wanted to match at another program in town and how we were the backup. The residents collectively made him DNR. However, there was another person we tried to make DNR because she sniggered every time one of us got destroyed while getting pimped during conferences (among other issues). She had some really fancy research so they ranked her number one or two. Thank god she matched elsewhere.

Not at my residency program, but in my med school class there was a guy applying ortho who ran into some trouble after he was asked to draw his favorite bone during an interview. Thinking he was being funny, he drew an erect penis. I can't remember if this was the interview at my med school or if the program called the ortho chairman at my school, but our home program chairman essentially called every program he applied to and he was blacklisted. He scrambled into a prelim spot in surgery and I think is now doing a non surgical specialty.

damn they really fried him at every program he applied to? hardcore

 

[SurfingDoctor]

Oh all sorts of ways, but the most common is some extremely off-putting personal interaction(s) the person had with someone at the program. Generally speaking, it means that somehow, some way, that person went above and beyond to stand out among of the pile of relatively homogenous applicants, but in the most negative way possible, which actually, is quite a feat sometimes.

Some of the better examples I can think of off the top of my head in recent years: Tell everyone that you are smarter and better than them, take your shoes and jacket off during the interview and put your feet up cause I guess you deserve to "relax", unprompted talk about rape for funnsies with female faculty, hit on and try to make out with someone at the program while you are interviewing... good times.

All that being said, if someone needs to tell you not to act that way for a job interview at the age of mid-20+, that is really the least of your life concerns cause that ship has sailed like the Titanic with Leo in the cargo hold...

 

[DO2015CA]

Yikes. Yeah these are good examples. I would have DNR’d every last one of these too.

And it’s not illegal to DNR someone for asking about faculty diversity or parental leave accommodations. It would be illegal to discriminate on the basis of race or gender, but perfectly fine to discriminate against someone for poor enough judgement to ask such questions in a residency interview.

There are more tactful ways to get that information; posing it directly to faculty makes you look like someone who is potentially going to be a PITA and nobody has time for that, especially in a small program.

For the diversity question sure. It’s a pointed weird question.

But the pregnancy accommodation question? Absolutely not. These are peoples lives. They will be there for 3-7 years. That’s a good, 100% valid, and great question to ask. My program goes above and beyond for accommodations for this. We love when applicants ask this question. Plus I would want to be DNR’d at a program that didn’t value this important of a question… as a male that had a kid in residency and chose to not take paternity leave/accommodations.

 

[Lawpy]

Yikes. Yeah these are good examples. I would have DNR’d every last one of these too.

And it’s not illegal to DNR someone for asking about faculty diversity or parental leave accommodations. It would be illegal to discriminate on the basis of race or gender, but perfectly fine to discriminate against someone for poor enough judgement to ask such questions in a residency interview.

There are more tactful ways to get that information; posing it directly to faculty makes you look like someone who is potentially going to be a PITA and nobody has time for that, especially in a small program.

How is asking about parental leave poor judgement?

 

[Banco]

There was another girl who asked a lot about maternity leave and what accommodations were made for pregnant women and she was DNR. Illegal and discriminatory? Yes. But it still happened.

That's incredibly fragile on the side of the chief frankly - it's a completely reasonable question.

 

[ACSurgeon]

In any other circumstance the frat house that would be funny. FTFY

Frat house, Ortho residency, why are you splitting hairs?

 

[ACSurgeon]

That's incredibly fragile on the side of the chief frankly - it's a completely reasonable question.

Not to the chair. Maybe to other residents, HR or the program coordinator. And, at an interview you never ask a lot about anything. You try to play it cool. Being repetitive or asking a lot of detail about one thing is very annoying.

 

[operaman]

For the diversity question sure. It’s a pointed weird question.

But the pregnancy accommodation question? Absolutely not. These are peoples lives. They will be there for 3-7 years. That’s a good, 100% valid, and great question to ask. My program goes above and beyond for accommodations for this. We love when applicants ask this question. Plus I would want to be DNR’d at a program that didn’t value this important of a question… as a male that had a kid in residency and chose to not take paternity leave/accommodations.

How is asking about parental leave poor judgement?

I’m sure if that’s all it had been, they wouldn’t have been DNR. But this person apparently went on and on repeatedly pressing the issue with the division chief of all people!

An interview is supposedly when people are on their best behavior. If this person is badgering the division chief at an interview, and especially if they’re dropping legal terms like “accommodations,” I can only imagine how big a pain they would be as a resident. Even if all those things are reasonable and legally mandated, the judgement to press the issue aggressively in an interview is deeply suspect and betrays either an entitled mindset or complete self unawareness.

Look, these are good things to ask but everyone knows you ask the residents. How many residents have families? Any of them start that in residency? Then ask that person about their own experience.

 

[Lawpy]

I’m sure if that’s all it had been, they wouldn’t have been DNR. But this person apparently went on and on repeatedly pressing the issue with the division chief of all people!

An interview is supposedly when people are on their best behavior. If this person is badgering the division chief at an interview, and especially if they’re dropping legal terms like “accommodations,” I can only imagine how big a pain they would be as a resident. Even if all those things are reasonable and legally mandated, the judgement to press the issue aggressively in an interview is deeply suspect and betrays either an entitled mindset or complete self unawareness.

Look, these are good things to ask but everyone knows you ask the residents. How many residents have families? Any of them start that in residency? Then ask that person about their own experience.

I thought that was a different instance from the faculty diversity one?

There was another girl who asked a lot about maternity leave and what accommodations were made for pregnant women and she was DNR. Illegal and discriminatory? Yes. But it still happened.

Edit: ok i see, but i don't think it's wrong to ask the division chief these questions? Asking residents would definitely give a better picture but the division chief is pretty unreasonably hostile to what's an important question. Asking a lot about parental leave shows these things are in fact important for the applicant. DNRing her is unfair

 

[Bobblehead]

With covid I initially thought this was going to be a discussion about a different meaning of this abbreviation.

In the current context, as others have mentioned, don't be a jerk at your interview date. The interview date is primarily to root out sociopathy which is why having it in person was so valuable so you'd see people under some stress with travel.

 

[Banco]

Not to the chair. Maybe to other residents, HR or the program coordinator. And, at an interview you never ask a lot about anything. You try to play it cool. Being repetitive or asking a lot of detail about one thing is very annoying.

This topic has been coming up a lot from my experience, even paternity leave. I saw it brought up a few times on the interview trail for surgery. I think such a hardline stance on something so prevalent in life is unreasonable. Medicine culture in the states admittedly lags behind our peer countries with parental accommodations.

I do agree about the repetitive/aggressive thing - that would apply to any topic.

 

[ortnakas]

I did not 100% love our program coordinator, but credit where it’s due: one great thing she did was talk about how maternity leave would work when going over benefits so nobody had to awkwardly ask.

 

[operaman]

I thought that was a different instance from the faculty diversity one?


Edit: ok i see, but i don't think it's wrong to ask the division chief these questions? Asking residents would definitely give a better picture but the division chief is pretty unreasonably hostile to what's an important question. Asking a lot about parental leave shows these things are in fact important for the applicant. DNRing her is unfair

This begins to get into a level of nuance that we can't really discern on a message board. I can certainly envision a scenario where one could ask those questions and not hit the DNR level, but it's much easier to picture the many ways it could go awry. The fact they asked the division chief (aka akin to a department chair) - a senior person who probably has zero daily interface with resident staffing and family leave issues - suggests their judgement was rather poor.

There should be some measure of humility when going before senior physicians and asking them to take you in and train you. It's really a big ask, and when talking with a chair the power differential is even higher and the goal should be both to learn about the program but also to show the program why you would be a great person to train and work with daily for 5-7 years. Coming into that dynamic with an entitled mindset asking what they're going to do for you, how they plan to provide "accommodations" your family planning needs -- it suggests this resident is likely going to be difficult and problematic going forward. They're making it all about them rather than focusing on what they will bring to the program.

Who in their right mind would want to take a risk like that? Sure, everyone online trying to earn their woke merit badges decries it as unfair, but nobody in their right mind in real life would want to take on a resident that will be lighting them up with complaints and demanding that everything constantly be shuffled around to fit her needs. If she was brazen enough to pelt the chairman with questions of that nature in an interview, how much worse is it going to be after she matches and now actually has some legal standing and federal laws behind her?

It's probably worth noting that in my own program, we have matched pregnant women and others who said they planned to start families in training and we probably saw nearly half the group overall start families in training. I don't think most people have issue with doing what we have to do to care for our colleagues and help them balance family and work and we've all picked up more than our fair share of extra calls to help our colleagues.

It really comes down to that entitled mindset for me, and I'll DNR that person every single time.

 

[Lawpy]

This begins to get into a level of nuance that we can't really discern on a message board. I can certainly envision a scenario where one could ask those questions and not hit the DNR level, but it's much easier to picture the many ways it could go awry. The fact they asked the division chief (aka akin to a department chair) - a senior person who probably has zero daily interface with resident staffing and family leave issues - suggests their judgement was rather poor.

There should be some measure of humility when going before senior physicians and asking them to take you in and train you. It's really a big ask, and when talking with a chair the power differential is even higher and the goal should be both to learn about the program but also to show the program why you would be a great person to train and work with daily for 5-7 years. Coming into that dynamic with an entitled mindset asking what they're going to do for you, how they plan to provide "accommodations" your family planning needs -- it suggests this resident is likely going to be difficult and problematic going forward. They're making it all about them rather than focusing on what they will bring to the program.

Who in their right mind would want to take a risk like that? Sure, everyone online trying to earn their woke merit badges decries it as unfair, but nobody in their right mind in real life would want to take on a resident that will be lighting them up with complaints and demanding that everything constantly be shuffled around to fit her needs. If she was brazen enough to pelt the chairman with questions of that nature in an interview, how much worse is it going to be after she matches and now actually has some legal standing and federal laws behind her?

It's probably worth noting that in my own program, we have matched pregnant women and others who said they planned to start families in training and we probably saw nearly half the group overall start families in training. I don't think most people have issue with doing what we have to do to care for our colleagues and help them balance family and work and we've all picked up more than our fair share of extra calls to help our colleagues.

It really comes down to that entitled mindset for me, and I'll DNR that person every single time.

Ah ok i see now. I was under the assumption the questions were asked innocuously (maybe naive when presented to the chief), but i see how entitlement in the way the questions were raised can be an issue

 

[Mass Effect]

Not to the chair. Maybe to other residents, HR or the program coordinator. And, at an interview you never ask a lot about anything. You try to play it cool. Being repetitive or asking a lot of detail about one thing is very annoying.

I’m sure if that’s all it had been, they wouldn’t have been DNR. But this person apparently went on and on repeatedly pressing the issue with the division chief of all people!

An interview is supposedly when people are on their best behavior. If this person is badgering the division chief at an interview, and especially if they’re dropping legal terms like “accommodations,” I can only imagine how big a pain they would be as a resident. Even if all those things are reasonable and legally mandated, the judgement to press the issue aggressively in an interview is deeply suspect and betrays either an entitled mindset or complete self unawareness.

Look, these are good things to ask but everyone knows you ask the residents. How many residents have families? Any of them start that in residency? Then ask that person about their own experience.

Meh, true or not, this is the toxic culture. Will that person rank number one on my list if they annoyingly keep asking inappropriate people about any topic? No. But I wouldn't DNR for that.

 

[Mass Effect]

There should be some measure of humility when going before senior physicians and asking them to take you in and train you. It's really a big ask,

Oh man, I totally disagree with the assertion that "it's a big ask" asking programs to rank applicants. Programs need residents, maybe not to the degree that residents need programs, but going in with the mindset of "There should be some measure of humility when going before senior physicians and asking them to take you in and train you. It's really a big ask," is setting the stage for abuse to commence. There's already a power differential, but there is no reason to make residents feel like they're just pions in this game. These are grown adults applying for employment for the next 3-7 years, not Anna Wintour's protege asking to go fashion week.

and when talking with a chair the power differential is even higher and the goal should be both to learn about the program but also to show the program why you would be a great person to train and work with daily for 5-7 years. Coming into that dynamic with an entitled mindset asking what they're going to do for you, how they plan to provide "accommodations" your family planning needs -- it suggests this resident is likely going to be difficult and problematic going forward.

No it doesn't. I'm sorry but this is just bad advice. Residents should feel able ask about family planning. In some programs, that could be a problem, but that means there's a problem with that program. Nothing suggests toxicity worse than when a candidate is deemed to be problematic for asking reasonable questions about the benefits of employment. And "accommodations" is not a legal term. If that's what the program is reading into it, that's a red flag with the program.

They're making it all about them rather than focusing on what they will bring to the program.

When you apply for a job, a standard question is about benefits including salary, maternity leave and vacation. It isn't entitled to ask about these things. Come on guys. We don't have to excuse toxicity in our programs by putting up these nonsense "rules" that the rest of private industry would have to defend in court.

 

[operaman]

Oh man, I totally disagree with the assertion that "it's a big ask" asking programs to rank applicants. Programs need residents, maybe not to the degree that residents need programs, but going in with the mindset of "There should be some measure of humility when going before senior physicians and asking them to take you in and train you. It's really a big ask," is setting the stage for abuse to commence. There's already a power differential, but there is no reason to make residents feel like they're just pions in this game. These are grown adults applying for employment for the next 3-7 years, not Anna Wintour's protege asking to go fashion week.



No it doesn't. I'm sorry but this is just bad advice. Residents should feel able ask about family planning. In some programs, that could be a problem, but that means there's a problem with that program. Nothing suggests toxicity worse than when a candidate is deemed to be problematic for asking reasonable questions about the benefits of employment. And "accommodations" is not a legal term. If that's what the program is reading into it, that's a red flag with the program.




When you apply for a job, a standard question is about benefits including salary, maternity leave and vacation. It isn't entitled to ask about these things. Come on guys. We don't have to excuse toxicity in our programs by putting up these nonsense "rules" that the rest of private industry would have to defend in court.

I’d would agree with you save for the fact a training position is far more than just a job. Applicants are not just asking for employment, for a steady paycheck in exchange for work. They’re asking the faculty to invest their time and energy and reputations into making them physicians ready for board certification. They’re asking them to certify this to every future licensing board and employer. It’s far more than just a job.

I hear you on the toxicity argument, though not the word I would select. While everyone would love to see some sort of utopia emerge where these are no longer issues, candidates who test these waters with senior faculty risk only their own careers. Of course they’ll never know this was the reason; they’ll just magically drop far down the rank list or off into soap land. Maybe they can parlay their oppression into a viral medtwitter thread, but that’s about it. Advising people to be cautious then is exceptionally prudent even if it doesn’t bring us closer to some sort of liberal utopia.

There are plenty of sane and effective ways to solicit this information. Hammering the chairman with questions about it is probably not the wisest move.

 

[Matthew9Thirtyfive]

I hear you on the toxicity argument, though not the word I would select. While everyone would love to see some sort of utopia emerge where these are no longer issues, candidates who test these waters with senior faculty risk only their own careers. Of course they’ll never know this was the reason; they’ll just magically drop far down the rank list or off into soap land. Maybe they can parlay their oppression into a viral medtwitter thread, but that’s about it. Advising people to be cautious then is exceptionally prudent even if it doesn’t bring us closer to some sort of liberal utopia.

This is exactly the problem with resident education. The idea that it has to be a utopia for applicants and residents to feel like they matter enough to ask about things they’re entitled to as employees without fear of being labeled a problem and blacklisted. FFS, that’s the world building for a dystopian YA novel.

 

[VA Hopeful Dr]

This is exactly the problem with resident education. The idea that it has to be a utopia for applicants and residents to feel like they matter enough to ask about things they’re entitled to as employees without fear of being labeled a problem and blacklisted. FFS, that’s the world building for a dystopian YA novel.

I think its a matter of asking the right person in the right way.

That said, as I pointed out previously I'm not sure this should land someone on a DNR list unless it was a particularly troublesome exchange.

 

[Mass Effect]

I’d would agree with you save for the fact a training position is far more than just a job. Applicants are not just asking for employment, for a steady paycheck in exchange for work. They’re asking the faculty to invest their time and energy and reputations into making them physicians ready for board certification. They’re asking them to certify this to every future licensing board and employer. It’s far more than just a job.

You're right because in a job, you actually have rights. Let's not excuse toxic crap by making this argument. When people talk about nurses eating their young, I always want to chime in that they haven't seen doctors. And this behavior by the program cited here is exactly the kind of thing I refer to.

I hear you on the toxicity argument, though not the word I would select. While everyone would love to see some sort of utopia emerge where these are no longer issues, candidates who test these waters with senior faculty risk only their own careers.

Yes, and the fact that they're "risking" anything is what makes it toxic. Like I said, a person should be allowed to ask about the benefits that come with the job. They do in every other field.

Of course they’ll never know this was the reason; they’ll just magically drop far down the rank list or off into soap land. Maybe they can parlay their oppression into a viral medtwitter thread, but that’s about it. Advising people to be cautious then is exceptionally prudent even if it doesn’t bring us closer to some sort of liberal utopia.

Advising them to be cautious is fine. Defending discriminatory and toxic practices is not. I likely would have never responded to your post if it had stated "I know this is bad, but..." rather than defending the program for DNRing someone for such a toxic reason.