Rank Advice

Tomorrow I can enter in my rank list for residency programs. Hurrah, it’s almost there! Even though I have 2 more interviews to undergo, I already know my rank list and plan on entering it just as soon as I can. These interviews are more formalities – I already have seen what they have to offer outside of the dangerous interview day and an extra day isn't going to change anything.

For what it’s worth I found interviewing a struggle. How can you honestly determine a program’s worth for you based around self-aggrandizing statements, sweetened webpages, and residents who tell you that: “It’s awesome here! I would do it again!” Perhaps, but still…something’s not right.

So, with that in mind, here is a list of some items that I’ve come across that tipped me to some redflags which pushed a program low on my list:

1) Residents not being able to get out to their assigned dinner meeting with applicants because there’s no one to cover for them. Hey, if they can't even go meet their potential applicants because they're stuck, how do you think you're going to get treated?

2) Mention of the word “probably” when asking a resident if they’d rank their program #1 or come back as a resident. Yeah, I'd probably want to get reamed again too...if I forgot how bad it was.

3) Program directors or chairs who aren’t at your interview day and never talk to you. Seriously here, if one of them can't be at the interview (expecially the PD) then how likely are they going to be there for you when you're having some issues or need to talk about the program? Major red flag.

4) The feeling that “there’s nothing that needs to be changed” when asking someone where they feel the program will be heading in the next 5 years. Really? Nothing? Just like anything, you can always improve.

5) Students from programs that tell you they hated, or the residents hate, the program. Additionally, if they state that they’ll be placing their own school’s program low on their list – you better dig more. These are the best source of information, but can also be very devious since they're interviewing for the same specialty as you. I was asked about one of my school's residency programs and was honest. Some people will tell you accurate info while others lie. Take it with a grain of salt.

6) Program where you feel a nauseated feeling after leaving – something’s not right, but you’re not sure what…trust that instinct. Unless it's food poisoning from the fish the night before.

7) Less than forthcoming program director when questioned about ACGME troubles or a low cycle year. They should tell you what they were cited for, their improvements, and where they hope to be when they get reevaluated. If they can't, they're hiding something bad.

8) Dirty and run down hospital setting. Look, I know a lot of hospitals aren't pristine, but I’ve already dealt with this for 4 years and I want to work somewhere that I have pride in being at day to day. Worrying whether the ceiling tile will fall on my head is not beneficial.

9) Environment where you’ll work – is it run down, nasty, scary? If you don’t want to work with certain populations (perhaps having to speak ebonics more than english at any one time) come early and watch whose walking around the hospital.

10) Residents who tell you “don’t come here”. Yeah, you might want to avoid that one altogether. Didn't actually hear that, but some people have and I actually cancelled an interview after learning a co-applicant was informed that by the residents.

Just a few hints that I picked up while out on the trail. I personally am grateful to have run into students from various areas in order to get a better appreciation – because I honestly think you get the wool pulled over your eyes a great deal during this process.