A little preparation can go a long way to showing your interest, this was provided by one of the fourth year students:
General Questions
What is the structure of didactic curriculum?
Is there time allotted for electives?
Do the residents have a high operative volume?
How busy is the ER? Level 1 trauma center? What types of trauma?
Do residents attend national conferences? Is it funded?
Where do the graduating residents go?
Questions for Residents
What are the strengths/weaknesses?
Did you ever consider leaving the program?
How many facilities do you cover? How do you like that? A lot of driving? Any required rotations in different cities?
Do fellows take away from learning experience?
What is call schedule like? How are the call rooms? Do you sleep while on call?
Do you have ample time to read?
How is the balance between autonomy and supervision?
How is ancillary staff? Are they helpful and pleasant to work with?
Is there a lot of scut work?
How is your relationship with the staff?
How do the residents get along? Do you hang-out outside of work? Are there any sports teams that you play on?
Do the residents get along with other residents in the hospital?
How do you like the city?
How are the benefits? Parking? Meals paid for?
Do you have moonlighting opportunities?
Questions for Chairman/PD/Attendings
What are your plans for the future?
How do you see the program changing in size or structure over the next five years?
How long have you been here? Do you plan on staying at this program for the next 5 years?
What is the status of the programs accreditation?
How highly do you emphasize resident education?
How do you feel the relationship is between the staff and the residents?
What are the research opportunities like? Is it required? How is it funded?
How are the residents evaluated?
How do the residents perform on OITE? Boards?
What do you look for in a candidate? How many people do you rank?
Thursday, May 7, 2009
Some Tips From the 4th Year Students on Getting Into Orthopedics
Some notes from our 4th year panel last night:
1) Ways to get around your school's limits on away rotations
a) Do a “research” month somewhere you want to go
b) Use weeks off to get a feel for the program, just contact the people at the program beforehand
2) Get a blackberry, iPhone or other smartphone. When it comes time for interviews, hospitals will send out an email to 100 students, the first 80 students to schedule an email will be interviewed the rest won’t
3) How do you have a chance to match out west/east etc (a region where you aren't in medical school)?
a) Rotate in the region
b) Better chances if you are from out there
c) “I like the weather” is a bad answer if they ask why you want to come here
4) Be prepared for crazy questions on interviews
a) Tell us a joke
b) Do puzzles while answering questions
7) Letters of recommendation
a) Most places only want to look at ortho letters
8) Step 1 advice
a) Average nationwide is 231 for those who matched
b) People from have matched with a 217 on Step 1…and a 250 on Step 2, can use the Step 2 to make up for a low Step 1
c) Vastly different views on how to prepare, do what’s best for you
One just read = 256
One did all questions = 255
d) Once you get an interview, all the scores go out the window and everyone is on an even playing field
9) Interview trail
a) Rank all programs that you would rather go to than sit around for a year if you don’t match
b) Don’t rank multiple specialties unless you would be happy doing either, there are lot’s of miserable radiologists that really only wanted to do ortho
c) Be ready to answer the question, “What would you do if you didn’t match this year?”
10) Your school's alumni
a) Contact people for free places to stay, i.e. many doctors will put you up for a month in another town for free during your rotations, the school has a directory
1) Ways to get around your school's limits on away rotations
a) Do a “research” month somewhere you want to go
b) Use weeks off to get a feel for the program, just contact the people at the program beforehand
2) Get a blackberry, iPhone or other smartphone. When it comes time for interviews, hospitals will send out an email to 100 students, the first 80 students to schedule an email will be interviewed the rest won’t
3) How do you have a chance to match out west/east etc (a region where you aren't in medical school)?
a) Rotate in the region
b) Better chances if you are from out there
c) “I like the weather” is a bad answer if they ask why you want to come here
4) Be prepared for crazy questions on interviews
a) Tell us a joke
b) Do puzzles while answering questions
7) Letters of recommendation
a) Most places only want to look at ortho letters
8) Step 1 advice
a) Average nationwide is 231 for those who matched
b) People from have matched with a 217 on Step 1…and a 250 on Step 2, can use the Step 2 to make up for a low Step 1
c) Vastly different views on how to prepare, do what’s best for you
One just read = 256
One did all questions = 255
d) Once you get an interview, all the scores go out the window and everyone is on an even playing field
9) Interview trail
a) Rank all programs that you would rather go to than sit around for a year if you don’t match
b) Don’t rank multiple specialties unless you would be happy doing either, there are lot’s of miserable radiologists that really only wanted to do ortho
c) Be ready to answer the question, “What would you do if you didn’t match this year?”
10) Your school's alumni
a) Contact people for free places to stay, i.e. many doctors will put you up for a month in another town for free during your rotations, the school has a directory
Saturday, May 2, 2009
Book Review: Hot Lights, Cold Steel
Although I've mentioned this book in prior posts, I thought it only fitting that one of my all time favorite medical books is given a post all to itself. First I'll include a summary, followed by my review and a link to where you can buy it off of Amazon.
Hot Lights, Cold Steel: Life, Death, and Sleepless Nights in a Surgeon's First Years
by Dr. Michael J Collins
Hot Lights, Cold Steele is a firsthand account of what it is like to be an orthopedic resident at one of the busiest and best hospitals in the nation. For the unindoctrinated, the Mayo Clinic is generally thought of as the best program to get into in terms of the training experience for orthopedic residents. I've heard that getting in is so difficult, that medical students who scored below a 240 on the USMLE need not apply because they will not even look at your application (a 240 and above includes only the upper 4% of test takers or so). In other words, aside from being a very interesting story in its own right, it shows what it is like at the best orthopedic training hospital in the country.
Interwoven through Dr. Collins story is the theme of choices. The story opens with a dilema as to whether he should try to save the arm of a boy who nearly had it ripped from his body when it became intangled in a combine, or amputate the arm immediately. The choice to moonlight at another hospital, or get some extra sleep. The choice to go to church with his family, or use that extra time to relax.
At once both lighthearted and introspective, Hot Lights, Cold Steel challenges the reader the reader to put themselves in the shoes of an orthopedic surgeon (which is why I loved it). It tells the story of one of the most loved patients he saw, a patient who all the nurses talked about and kept tabs on once she left the hospital, and you can't help but experience the hurt when he later finds out that she died a few months later.
During the lighter times, I found myself laughing at the similarities to my own life. When he talks about going from one clunker to the next, I'm reminded of my own experiences with cars (I've been getting in the passenger door and climbing over for the past 10 months). When he talks about making choices between medicine and family or medicine and faith, I think of all the similar choices I've had to make.
In summary, this is a book that will make you laugh and make you cry, and I don't think that you have to be a medical student, or a budding orthopedic surgeon to love it.
Hot Lights, Cold Steel: Life, Death, and Sleepless Nights in a Surgeon's First Yearsby Dr. Michael J Collins
"If he didn't feel overwhelmed before the Mayo Clinic senior orthopedic surgery resident lobbed a beeper at him with the nonchalant order, "Cover for me," 29-year-old ex-cabdriver, ex-construction worker, and, at the time, brand-new resident Collins certainly did then. It was his first day on the job, and
instantly he began fielding calls from staff nurses requesting orders for patients he hadn't laid eyes on. If it hadn't been for his innate sense of humor--brilliantly demonstrated in this memoir of his Mayo residency--and a sense of perspective derived from that experience, he might have failed. He didn't, and here he honors those who helped him along the way and those whom he helped. As a man who recognizes that he, too, makes his living with his hands, Collins anguishes over the options available to a carpenter who had severed four fingers. After assisting at a young cancer patient's leg amputation, only to learn later that she had died within months, anyway, he agonizes over what drew him to his profession in the first place and what could possibly keep him on course. "I wanted to be the guy who confronted the arbitrariness of life and strangled the unfairness out of it." Instead, while honing his craft, he learned from a Vietnam vet that the main thing patients deserve is compassion. If Collins' scalpel is as sharp as his pen, his patients are in capable hands, indeed."
Hot Lights, Cold Steele is a firsthand account of what it is like to be an orthopedic resident at one of the busiest and best hospitals in the nation. For the unindoctrinated, the Mayo Clinic is generally thought of as the best program to get into in terms of the training experience for orthopedic residents. I've heard that getting in is so difficult, that medical students who scored below a 240 on the USMLE need not apply because they will not even look at your application (a 240 and above includes only the upper 4% of test takers or so). In other words, aside from being a very interesting story in its own right, it shows what it is like at the best orthopedic training hospital in the country.
Interwoven through Dr. Collins story is the theme of choices. The story opens with a dilema as to whether he should try to save the arm of a boy who nearly had it ripped from his body when it became intangled in a combine, or amputate the arm immediately. The choice to moonlight at another hospital, or get some extra sleep. The choice to go to church with his family, or use that extra time to relax.
At once both lighthearted and introspective, Hot Lights, Cold Steel challenges the reader the reader to put themselves in the shoes of an orthopedic surgeon (which is why I loved it). It tells the story of one of the most loved patients he saw, a patient who all the nurses talked about and kept tabs on once she left the hospital, and you can't help but experience the hurt when he later finds out that she died a few months later.
During the lighter times, I found myself laughing at the similarities to my own life. When he talks about going from one clunker to the next, I'm reminded of my own experiences with cars (I've been getting in the passenger door and climbing over for the past 10 months). When he talks about making choices between medicine and family or medicine and faith, I think of all the similar choices I've had to make.
In summary, this is a book that will make you laugh and make you cry, and I don't think that you have to be a medical student, or a budding orthopedic surgeon to love it.
Friday, May 1, 2009
Discussion on Orthopedics and What it Takes to Get Into an Orthopedic Residency
Here's a video discussion about orthopedics in general and what it takes to get into an orthopedic residency program.
How To Do Well in Your 3rd Year Surgical Clerkship
Here is a form on the internet from Vanderbilt University detailing how students
are scored on their surgical clerkship.
are scored on their surgical clerkship.
My Lecture May Be Awful, But At Least I Have Travel Pictures To Show
Have you ever noticed that some of the dryest presenters put pictures of all their travels in their presentation. It always seems to be the dermatology people--it's like they want to rub it in your face that they have tons of free time and are making money hand-over-fist.
Wednesday, April 29, 2009
Advice on Getting An Orthopedic Residency
Here's a bit of advice I got from an Orthopedic Surgeon on what are the important things to consider when trying to get into an orthopedic residency, it's valuable because it speaks to things other than just the typical "get good Step 1 scores, do lots of research etc.":
"I would tell you that scores on tests are important, but that they would a given, that I would expect excellent scores. There is no doubt that a recommendation by a friend known to me would count highly, but a rotation at the program would count the most. That has always been the case. So, if you spend a month at a program and are knowledgeable, tireless, eager, nice but not an obvious brown nose, competent at procedures, first to arrive and the last to leave, can quote articles from JBJS, you will be a shoo-in."
"I would tell you that scores on tests are important, but that they would a given, that I would expect excellent scores. There is no doubt that a recommendation by a friend known to me would count highly, but a rotation at the program would count the most. That has always been the case. So, if you spend a month at a program and are knowledgeable, tireless, eager, nice but not an obvious brown nose, competent at procedures, first to arrive and the last to leave, can quote articles from JBJS, you will be a shoo-in."
Friday, April 24, 2009
First Year Haiku
Anatomy
Welcome to Med School!
Did you buy your scalpel yet?
Dead bodies are here
Welcome to Med School!
Did you buy your scalpel yet?
Dead bodies are here
Clinical Medicine
Your first real patients
Except they are just actors
They think they're great
Tests
Gauge how good you'll be
Life is multiple choices
Oh wait that's not right
Specialty Choices
Most are rational
Except the bug-eyed, creepy guy
Loves pediatrics
Email Listservs
Some department fights
Are best disseminated
To all four classes
Biochemistry
You won't need this again
Continue the illusion
Undergrad mattered
Physiology
How many times can we
Tell students about GFR
Before they go crazy
Pretending to be Interested in OB/GYN To Get Free Food (or An IUD at an OB/GYN Party)
Sorry about the dearth of posts in the past few months, second year is much more time consuming than first year, especially once you get closer to Step 1 season. (This is going to be a very "rusty" post)
A couple of days ago I received an email saying that there was going to be an OB/GYN interest group meeting and that there would be some free food involved. I was starving, so I decided to see if people interested in OB/GYN were actually human.
I walked down to the conference room where the meeting was being held, and the first thing that I noticed was that there was one of the staff members guarding the door to make sure that nobody came in, grabbed food, and left. Clearly they knew that there wasn't going to be a lot of interest in OB/GYN today.
So I put on my best "I can't wait to deliver babies for the rest of my life" face and confidently walked past the food police to sit down at the conference table, as if I didn't even come for the free food. And it must have worked because all of the other OB/GYNites seemed to accept me as one of their own.
As I began to look around at what kind of people would actually want to go into OB/GYN, I was struck by the fact that they seemed normal, on the outside at least. (I was also struck by the fact that they didn't have any food). Clearly, I was the only second year student at the meeting, but I did my best to act like a first year while deftly avoiding their conversations about the neuroanatomy test that they had coming up.
The food finally arrived (baked potatoes, chili and broccoli--not great but better than going hungry) and I took as many of the chocolate chip cookies that I could reasonably fit on my plate, which didn't seem to bother any of the other 8 obstetrics lovers, their stock was rising.
So what kind of people go to an OB/GYN meeting? One was a mother, the other women couldn't wait to be, and the two guys that were there seemed to be a little to excited to be around this many women (as evidenced by their laughing at anything that was said). Needless to say, the topic of conversation was babies--which I love, but I don't need to spend lunchtime for the rest of my life discussing every bit of infant minutia.
When the doctor finally arrived who was heading up the meeting, everyone quieted down and waited for him to begin. But before I continue, a brief quiz:
Which of the following is a group of OB/GYNs and which is a group of orthopedists?
A)
(don't let their smiles fool you, they're miserable on the inside)
B)
Back to the story, so the OB/GYN doctor talks about his life in medicine, how he came to be doing what he's currently doing etc. There really wasn't anything especially interesting or unique to his story, aside from the fact that he mentioned he worked in rural Arkansas for a few years after finishing his residency, and though I hate to admit it, he actually seemed pretty normal.
Then came the questions, someone asked, "I heard that OB/GYN is awful and getting worse" or something to that effect.
To which he responded that things weren't necessarily getting worse, but that those who had spent a lot of time in practice were noticing that OB/GYN had changed dramatically from what it was when they started as doctors; less individuals, more groups, doctors who were more concerned about lifestyle than just seeing a lot of patients.
Someone else asked a question about malpractice (OB/GYN's have to pay for malpractice insurance 18 years after they're done practicing!), and then a few questions later and it was over.
As I walked out, I was struck by the fact that those interested in OB/GYN are actually quite normal, as long as by normal you mean that they enjoy the thought of putting thousands of dollars towards paying malpractice and talking about children and women's reproductive organs 24/7.
A couple of days ago I received an email saying that there was going to be an OB/GYN interest group meeting and that there would be some free food involved. I was starving, so I decided to see if people interested in OB/GYN were actually human.
I walked down to the conference room where the meeting was being held, and the first thing that I noticed was that there was one of the staff members guarding the door to make sure that nobody came in, grabbed food, and left. Clearly they knew that there wasn't going to be a lot of interest in OB/GYN today.
So I put on my best "I can't wait to deliver babies for the rest of my life" face and confidently walked past the food police to sit down at the conference table, as if I didn't even come for the free food. And it must have worked because all of the other OB/GYNites seemed to accept me as one of their own.
As I began to look around at what kind of people would actually want to go into OB/GYN, I was struck by the fact that they seemed normal, on the outside at least. (I was also struck by the fact that they didn't have any food). Clearly, I was the only second year student at the meeting, but I did my best to act like a first year while deftly avoiding their conversations about the neuroanatomy test that they had coming up.
The food finally arrived (baked potatoes, chili and broccoli--not great but better than going hungry) and I took as many of the chocolate chip cookies that I could reasonably fit on my plate, which didn't seem to bother any of the other 8 obstetrics lovers, their stock was rising.
So what kind of people go to an OB/GYN meeting? One was a mother, the other women couldn't wait to be, and the two guys that were there seemed to be a little to excited to be around this many women (as evidenced by their laughing at anything that was said). Needless to say, the topic of conversation was babies--which I love, but I don't need to spend lunchtime for the rest of my life discussing every bit of infant minutia.
When the doctor finally arrived who was heading up the meeting, everyone quieted down and waited for him to begin. But before I continue, a brief quiz:
Which of the following is a group of OB/GYNs and which is a group of orthopedists?
A)
(don't let their smiles fool you, they're miserable on the inside)
B)
Back to the story, so the OB/GYN doctor talks about his life in medicine, how he came to be doing what he's currently doing etc. There really wasn't anything especially interesting or unique to his story, aside from the fact that he mentioned he worked in rural Arkansas for a few years after finishing his residency, and though I hate to admit it, he actually seemed pretty normal.
Then came the questions, someone asked, "I heard that OB/GYN is awful and getting worse" or something to that effect.
To which he responded that things weren't necessarily getting worse, but that those who had spent a lot of time in practice were noticing that OB/GYN had changed dramatically from what it was when they started as doctors; less individuals, more groups, doctors who were more concerned about lifestyle than just seeing a lot of patients.
Someone else asked a question about malpractice (OB/GYN's have to pay for malpractice insurance 18 years after they're done practicing!), and then a few questions later and it was over.
As I walked out, I was struck by the fact that those interested in OB/GYN are actually quite normal, as long as by normal you mean that they enjoy the thought of putting thousands of dollars towards paying malpractice and talking about children and women's reproductive organs 24/7.
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