Before
the clinical years, I had volunteered and precepteed under several
good family doctors and really enjoyed the wide variety of patients
we encountered-from kids to pregnant moms to veterans, you never
really know who would walk through the door. Still, I wanted to
keep my options open, and in my 3rd year rotations, I also found
pediatrics and internal medicine to be really appealing, and briefly
considered Med/Peds. However, I am more of a "clinic person" than
a hospitalist, and just felt that family practice (FP) encompassed
all the things I like about medicine: the diversity of patient
age, background, and illness; the opportunity for patient interaction
and continuity; and the chance to incorporate psychosocial issues
and preventive care into my practice of medicine.
How
did you prepare yourself for application to your chosen specialty?
I did
one 4 week elective/sub-I at a Kaiser facility (since my core rotation
in family medicine was at a community hospital), to compare Kaiser
to the community setting. I also went to the American Academy of
Family Physicians Conference in Kansas City at the end of my 3rd
year-they had a lot of information for students about applying
as well as residency booths of different FP programs (to ask questions,
get info).
Who
wrote your letters of recommendation for your application?
Some
FP programs require 3 letters of rec's from 3 different fields
(i.e. medicine vs peds vs surgery etc). In the end, I got 4 letters-2
from family practitioners, 1 from an internist, and 1 from a pediatrician,
and just sent 3 out to each program (depending on which fields
they required). It's probably a good idea if one of the letters
could come from a higher ranking person of that field (i.e. chair
of pediatrics or residency director of family practice), but I
honestly don't know if plays a major role in the end. It's more
important to ask people who really know you on a somewhat more
personal level as well as professional level, as opposed to an
attending who you had superficial contact with for your 4-or- so-
week rotation.
Which
programs did you apply to and why?
I applied
to 18 programs total, all in Southern California because that's
where I want to live. Mostly I applied to community hospitals and
Kaiser hospitals, because I am more interested in those settings
than in an academic facility.
What
kinds of questions did programs tend to ask you?
For the most part they asked the typical questions:
Tell us about yourself, your family. What brought you to choose medicine
as a career? Why did you choose family medicine? Why did you apply to
our program? What can you add/bring to our program? What do you see yourself
doing in ten years? Some other questions: What is the hardest thing you
have had to overcome? What is the hardest question you've had during
these residency interviews?
What
would you have done differently in applying?
I would've
applied to fewer programs. All 18 programs granted interviews,
but I got too tired and started cancelling on the ones I was less
interested in or offered interviews to me later. I think I landed
out going to 9 interviews total.
What
was the most difficult part of the application process?
Probably
the hardest part was writing the personal statement and thinking
of who would write my letters. Friends who had been through it
already had told me to start thinking about the letters as early
as the beginning of my clinical rotations, but it wasn't until
a little before the application process when the letters fell into
place. I had a hard time thinking of what I wanted to say in my
personal statement, since I wanted to show my enthusiasm for FP,
but I couldn't honestly convey the same naêve "gung-ho" attitude
about medicine that I had when I first entered med school.
What
should I look for on my interview and tour day?
The
interviews all become a blur after a while-I don't really remember
how each hospital looks, what kind of call schedule/rotation/benefits
each one offers. The big thing is the general feel of a place,
especially from a resident's point of view: How do the residents
like their program? How do they interact with each other, do they
hang out together outside of the hospital? Are these people you
can fit in with and work with everyday for the next few years?
Are the attendings approachable and people you can respect, yet
feel free to ask "dumb questions"?
What
questions should I ask of residents, faculty, and program directors?
Definitely
get the scoop from the residents-they are generally pretty frank,
and can tell you from what they do and don't like about the program,
to the details of things such as how they (the residents) get along,
what a typical day is like, which rotations are good/bad, which
ones are hard, what call is like on a specific service, how the
food is like. Questions to consider asking the program directors:
Is there a strength or emphasis on any specialty (i.e. some programs
are particularly strong in peds or OB)? What changes are you planning
to make in your program (i.e. moving the clinic site or improvements
in the curriculum)? What do you look for in an applicant? Strengths
and weaknesses of your program?
How
did you form your rank list?
Because
I applied to only Southern Cal programs, location was not as much
of an issue as it was for a lot of people. The top programs I ranked
were places where I felt I would be able to work well with mostly
everyone and feel at home at- I didn't need to be best friends
with all the residents, but I wanted my residency to be as enjoyable
(oxymoron? J) as possible; I'm kind of timid when it comes to speaking
up, so I didn't want to be completely intimidated by fierce attendings.
Other things I took into consideration were the patient demographics,
how stable and reputable a program was, how close it was to my
family.
What
other advice can you give seniors applying in your specialty?
The
FP programs are generally more relaxed, and a lot of times it felt
like I was interviewing them rather than they were interviewing
me (unlike job or med school interviews). Find out what you are
looking for in a program by asking about the things you are most
interested in, and really look to see if you feel like you can
fit into the place. Another thing to consider is to schedule some
time apart between your interviews (more than 2 interviews consecutively
is tiring and confusing to remember which program had what). If
possible, for local interviews, find an easier rotation that will
give you one day off a week and with attendings who are understanding
about interviews. (I had dermatology where all Wednesdays were "independent
study", plus they allowed a few more days off for interviewing).
Save your chunks of time off for flying out to other interviews
or just for vacationing and traveling. And finally, enjoy your
4th year and do some traveling while you can still fit it in!
