Friday, November 22, 2013

Effective Interviews - Part 2: What's Hot?

In part 1 of "Effective Interviews" we covered the basics of how to get the most out of your interview days.  In part 2 we are going to raise your interview game with a discussion of what topics are "hot" in Emergency Medicine in the fall of 2013.

While on the interview trail you are discovering the "hot topics" to talk about from your fellow applicants.  This is the default topic.  The one you go to when you are out of other questions or because everyone says you should ask about it.  For a long time this was Trauma, as in: "What is your Trauma experience like?"  For a few years now Ultrasound has usurped this spot.  This year, another shift is likely upon us: "What role does Social Media have in your education program?".  The most mainstream of EM publications, the Annals of Emergency Medicine, just published an article about Twitter.

Twitter is a great window into what is being discussed and debated in EM.  All you have to do is follow a few of the disseminators of #FOAMed (@emlitofnote, @njoshi8, @emcrit, @CriticalCareNow, @srrezaie, @precordialthump, @LWestafer, just to name a few) and you will quickly be caught up on the discussion.

But if none of the preceding paragraph made any sense to you, here are some of the big topics under discussion in 2013:

  • Social Media in Education - you should probably have an opinion or stance on this.  Many of your interviewers will.   Though you shoudl be ready for otherwise wonderful and enthusiastic educators to be very skeptical of the whole concept.  They may also be more interested in your understanding of professionalism as it relates to Facebook/Twitter/Snapchat/etc.
  • Thrombolysis for Acute Ischemic Stroke - this is being debated vigorously in EM with ACEP releasing a policy statement that has led to much consternation from many practicing Emergency Physicians.  This has recently been discussed really well on the ERCast podcast.  The LITFL blog also did a good discussion to review as well.
  • Video vs. Direct Laryngoscopy - This is being hotly debated in EM right now with very knowledgable people on both sides of the "Is direct laryngoscopy dead?" debate.  As someone about to begin your training, knowing the programs philosophy on airway management is going to be really important to your education.  What do they do?  What do they teach?  This is way more important to your eventual career than how they get Trauma experience (A comes before T, after all).

Other topics of recent discussion also include:

Transexamic Acid (TXA) in Bleeding Trauma Patients - Review by Napolitano et al.

Novel anti-coagulants and newly approved treatments - Dabigatran, Rivaroxaban, Prothrombin Complex Concentrates

And just this past week, the value of Therapeutic Hypothermia (aka Targeted Temperature Management [TTM]) in Cardiac Arrest came under renewed scrutiny.

So much to know.  Maybe you should get that Twitter handle after all...

Friday, November 8, 2013

Effective Interviews - Part 1: The Basics

The interview process is a huge expenditure of precious resources on both sides.  If you are going to go to the trouble and expense of interviewing at a residency program, you owe it to yourself to come prepared.

The Program Director will almost invariably give you some kind of overview of the program or "sales pitch".  This may even include perceived weaknesses and plans for improvement.  Even if their presentation seems balanced, they are still emphasizing the programs strengths, just as you did with your application.  You will have an opportunity to talk individually with the Program Director and other members of the residency and you owe it to yourself to dig deeper.

Since you are reading a blog about getting into EM, you have likely encountered lists of "must ask" questions.  I think there is no such thing as the "right questions" to ask.  I would much rather discuss topics that the applicant has a genuine interest in.  Answering the same questions over and over again is not enjoyable for either side.  Instead, ask about what really matters to you.  Find out if this is a place that is going to meet those needs.  If you have made it this far without deciding what really matters to you in your future training program, now is a great time to start thinking about it.

The questions you ask should be thoughtful enough that you cannot just answer them from going on the programs website for 5 minutes.  Though this is a great way to find things to discuss.  Make your question a level deeper than the website goes.  For example:  Don't ask, "What kind of rotations do the interns do?".  That is invariably on the website.  But you can ask what the experience is like on specific rotations, and if they have any concerns about the objectives being reached.

If you are going to put all this effort into coming up with good questions, you should feel comfortable asking the same questions of all of your interviewers.  You may get different answers depending on who you ask.  For example:  the Program Director and the Pedi EM Fellowship director may have very different perceptions of the EM residents pediatric experience.  You will have to decide whose opinion to put more stock in, but this information can be incredibly valuable.

One particularly important area to explore, that will not be addressed by the website is the stability of the program.  If there are changes to the size of the residency, the curriculum, the physical plant, or the program director or chairman, find out how these came about and what impact these are expected to have.  Change is often a good thing, but abrupt change is often not.  Particularly when there is not a cohesive forward-thinking plan for the future.

A few other general interview tips.  These may seem obvious, but a remarkable number of students break these "rules", usually to the detriment of their chance to match:

  1. Go to whatever they have the night before.  This is essential to getting a feel for the culture of the program. 
  2. Be on time for the interview.  In fact, be early.  Leave yourself enough time that even if you get lost, you will still have plenty of time.  Inability to plan ahead is not a sought after trait in Emergency Physicians.
  3. Dress professionally.  You do not need to wear your black or funeral-gray suit, however you also should not look like you are going tailgating or clubbing right after the interview.
  4. Be respectful to everyone, especially the coordinators.  Especially the coordinators!
  5. Be yourself.  The professional version of yourself.