S01E06 - First milestone, who does the interviewing, and LORs

The Myers Hurt Method Podcast

Milestone:

We crossed 100 downloads! Combined total of the first 5 episodes, still, an exciting milestone, and I hope you guys continue to find some value in this format. If you have a free second please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.

We are ramping up our website over at the Match Gurus, so check the website soon to add your e-mail to our mailing list. We are primarily a consulting group, and work with individual clients to identify strengths and weaknesses in your application and hone your interview skills - so check out our website for the specific services we offer.

Any of you looking for a consolidated guide on how to approach to interview season - my book is titled “Getting In” - available on Amazon in both kindle and paperback format - currently the lowest price book on the market for residency interviews - I know how books add up in med school and am making a conscious effort to keep that product at a reasonable price point so you get more bank for your buck.

Residency timeline update: Hope you are all working on your personal statements, and working hard in those rotations and Sub-Is to get glowing LORs - remember if you are struggling with your PS we can help - drop us a line over at theMatchGurus or DM us on twitter

I want to get into our first topic today, and that is knowing who will actually be interviewing you.

Who will be interviewing you:

Short answer - everybody. THIs is not a figurative expression either. Literally everyone you encounter from the second you receive an interview invitation has a say in your future. As we mentioned previously in our who’s who sement - most if not all of your pre-interview communication will be through a program coordinator. Treating them with respect goes a long way. No need to go overboard and send them gifts or anything, they won’t help position of candidates on a ROL directly, but they can absolutely turn any candidate into a DNR with any evidence of disrespect or poor communication skills.

More formally, you will generally be interviews by two groups of people - residents and faculty. Traditionally, 2-3 junior residents and interns attend a social event, or pre-interview dinner the evening before your actual interview. These are people who have just now made the transition you are about to - great opportunity to ask them about their process in choosing the program, how they are experiencing their first few months, things they wish they had asked, or things they thought were important that turned out were not, etc.

Very informal, very social, your chance to ask practical questions in a relaxed atmosphere. Good examples would be typical cases they see, typical hours, curriculum for interns for didactics. Even things like parking, day care, housing, transportation - more day to day practical questions are good for the residents and especially these dinners, and less so for the faculty.

Essentially a “Getting to know you” or “meet and greet” session that is less formal Q&A interview, and more “can we work with this person. This is of course, part of the whole interview package, and don’t confuse “informal” with “unprofessional.” You are very much on display and these people have an incredible say in who gets ranked and ultimately hired.

Interview day is typically reserved for senior level or chief residents and faculty. Faculty can include MDs, DOs, NP and PA involved in resident education, PhDs, educators or behaviorist. Programs are starting to integrate people who can evaluate the more “soft skills” required to train in medicine.

These are the people with the best info about fellowship placement, careers of recent graduates, current faculty strengths, future department goals (as a lot can change in 7 years - while an outgoing chief is thinking about next 6 months) Building new hospitals, clinic, getting new equipment either specifically for resident training, or treatment.

Do your homework and look into the interests of those who will be interviewing you. A little will go a long way, and you’ll be able to make conversation outside of the expected, obvious questions.

The second topic of the day involves our question of the day - and this weeks question comes to us from Travis:

Question of the day:

Does it look better to get a letter from the program director or a department chair?

Classic question, thanks for asking Travis. This comes up all the time - and the reddit medschool forum, SDN forums, ValueMD forums all have versions of the same answer - the best letter comes from the person who knows you best.

We all know these pillars of medicine in our own institutions - big names with hundreds of articles, book chapters, grant dollars, caseloads, etc - anything that is seen as god-like in medicine, and hope that by getting a letter with your name at the top, and their name at the bottom is a golden ticket.

That can absolutely be true. However, you would have to spend a significant amount of time with that attending, and they would have to be a good letter writer.

Ask the recent graduates now in their intern year (your ex-upper levels) who was open to writing a letter, and who seemed to have good letters.

Ask the secretaries / administrative assistants who writes good letters - they usually dictate them and upload them to ERAS - they will have unique insight into who writes quick one-liners vs who tells personal stories of strong recommendation.

No need to feel intimidated, you are not the first person to ask for an LOR - in academic medicine, faculty expect to write these things monthly. They can always say no - and don’t confuse that with the worst thing that can happen - it isn’t. The worst thing that can happen is they say yes, then write you a sub-par letter. Impersonal, generic, cookie-cutter letters absolutely scar an application.

Best way to approach it is to lead off with your intentions. Usually during AIs and away rotations, the implied understanding is that you are there to impress and are at least interested in the field, as well as that specific program. There is nothing wrong with stating your intentions once you arrive that you would like to work hard for the time you are there in order to produce a strong LOR. Let your upper levels on the team know, let your admin assistant contact know, and let the attending know. Volunteer yourself up front for anything above and beyond. Show up early, stay late, do the grunt work, there to learn and there to impress.

Towards the end of your month, not 6:30pm on the Friday your rotation ends, touch base with your letter writer and phrase your question in a way that gives them an out. “Dr. soandso, as you know I’m looking to go into Radiology and really enjoyed my time here. Do you think you know enough about me and my work ethic to write a strong letter of recommendation?”

I love it - as a faculty member on the receiving end of questions like “Can you write me a letter” I would always say yes, and generate a good letter, but sometimes had to struggle to find good aspects I would want to highlight.

Often times, faculty will offer to write letters for outstandingly strong students - never say no, as those will likely be some of your strongest.

Waive your right? I understand some of the bias, but I know plenty of people who give samples to the students as well. My personal policy was you waived your right, but I want you to also be praised and proud of the work you put in, at the very least send it home and make your parents proud.

Longest possible answer to your question, Travis - and I could go on - but to summarize - letters are often used after certain objective benchmarks are met, cutoffs are passed, and departments are teasing out who would be a better fit with a team. I read hundreds of letters, and personally written dozens - there are PDs who have reads tens of thousands. Bad ones are usually outstandingly bad - no matter whose name is at the bottom - “Jimmy is a great students, he was on time every day and always read his assigned articles. Patients really liked him.” tells us nothing. Stories about a specific patient interaction, well thought out research, outstanding clinical and critical thought - these things speak volumes, regardless of who they are from - and the content is what you should be primarily concerned about. Get as many as you want, ERAS lets you pick and choose which letters you send where, no harm in collecting an excess. Better to have the problem of which to choose vs scrambling at the end to piece one together from an old preceptor.

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