Interviews 2020- A Reflection

Well folks, we made it. 2020 is over, the sky is blue, birds are singing, and everything is back to normal!

One thing I can say for sure, however, is that 2021 will be a year of lots of changes for me and my family, regardless what course the pandemic, social distancing, masking, and other life-altering rules take. I graduate in 144 days, relocate to start my first doctor job a few weeks after that, and start building a new community in the town we move to.

I’ll write a couple separate posts on how The Match works later. The Match, or National Resident Matching Program (NRMP) is how we medical students gain access to residencies. The whole process is confusing, even to students, and the best way I’ve found to summarize it is to compare it to The Sorting Hat from Harry Potter.

But before Match Day, every medical student has gone through a long, arduous application and interview process, balancing rotations, travel, wearing suits, smiling so much our faces hurt, and general schmoozing with people we just met, but from whom we desire employment.

Obviously, this year has been very different than a “normal” year, but it hasn’t been without its challenges. Back in October of this year, I penned a post describing the upcoming interview process and some of the challenges 2020 would bring. And unfortunately, many of the predictions I made came true.

But I’m getting ahead of myself.

How did this interview cycle go for me? Well, overall, I’m fairly pleased with how I faired interviewing for PM&R programs.

Applications went live on October 21st, meaning residency programs were able to look at them at that time. On our class Facebook group, some classmates were announcing or asking advice on how to respond to interview requests within an hour of them going live, all while my inbox sat silent. Programs are just taking their time and looking at all the applicants before making decisions. It’s not me. This is fine, I told myself. And while I’m sure this was the case, I couldn’t help be nervous as many of my friends got their first interviews before me, especially since I was on an academic rotation and could sit at my desk obsessively refreshing my email while most of my classmates were off at work.

My first interview offer came in at 7pm on the second day. That was such a long time to wait. Plenty of hours of self doubt, no sleep, excessive worry, and fear that I’d somehow messed up my applications. To my relief, that first interview offer was for the following Friday, which I gladly took in a heart beat.

In the week before my first interview, I scheduled another three or four, which helped boost my confidence and bring me back to reality that many programs were simply sifting through the unreasonably huge number of applications they had received.

That first interview day was… interesting. The program did a great job dealing with the circumstances, but my setup was, for lack of better words, awful. If you’re familiar with the Pacific Northwest, you know two things are true up here- first, weather is bipolar (sunny one day and gloomy the next), and second that it only rains once per year- starting in October and ending in June. Well, the day before that first interview, I had ample natural light and had planned on using that to light my face during the interview. The next morning, however, was the darkest, gloomiest day to that point in the fall.

The interviewers couldn’t see me at all, and there was nothing I could do about it. I tried moving my setup between interviews, adjusted lights, turned up my camera’s sensitivity, everything I could to be better seen to no avail. That afternoon, I went out and bought new lights and asked my mother-in-law if I could borrow her office, which has better lighting than any non-bedroom in our house.

The next five interviews went a lot better. I was doing two, sometimes three interviews a week for those first three weeks. When I went back on rotation, I spent more time at home interviewing than I did in clinic. On the one hand, I knew that was okay as I’d get plenty of experience in residency, and missing one clinic day as a med student was worth having a job come summer. On the other, my days in clinic were spent obsessively double checking my phone, sitting out of clinical encounters to get paperwork to programs before end of workday for an east coast program (so, lunch time-ish), and the like. I didn’t feel present. The learning wasn’t great (me, not them). The stress of balancing work and interview was enough of a distraction that I felt inadequate for both.

At least I didn’t need to fly across the country in addition to all this.

How do medical students do this in a normal year? Those November and December “rotations” are jokes. Students spend so little time onsite, any review of their ability would be tainted (if seen by anyone at all, as those grade won’t come out until after graduation), what they learn would be minimal at best, and (as mentioned in the other post) may be detrimental to the student’s ability to even get an interview.

Anyway, by Thanksgiving week, I had scheduled almost all of my interviews, which stretched at least one a week until the second week of December. I took vacation in December hoping to fill the month with more interviews, but that ended up not being necessary. At that point, I had 8 PM&R interviews and 1 preliminary medicine interview. I was near my goal of 11 rehab interviews, but grossly short of my goal of four prelim interviews. I had applied to an additional 30 or 40 programs, and only one of those bit.

Just as I was wondering if there was a problem with me or my application (again), a representative from the American Academy of Medical Colleges (AAMC) sent a letter to her colleagues expressing concern over application trends this year. In the letter (which has been publicly shared online), she admits that they are seeing discrepancy in distribution of interviews, with the top tier applicants receiving more and releasing less interviews than in previous years, leaving middle tier applicants short on interviews. I hope this wasn’t a surprise to her or anyone at the AAMC, as there were plenty of medical students who expressed this very concern (yours truly included).

Anyway, what was the AAMC’s official recommendation on how students should deal with the current situation?

Apply to preliminary programs.

I applied to almost 50 preliminary programs and got TWO interviews… Were they serious that this is the “best” solution to this situation? There is a gross miscommunication between students’ experience and leadership’s proposed fix.

And who pays the price for this miscommunication? Middle and lower tier applicants who may need to apply to unnecessary preliminary programs or give up on specialties they desire and would succeed at just because concerns expressed back in the summer went unnoticed.

As an aside, there has never been a correlation between how good of a doctor a student becomes and their test score, class rank, or school grades. And yet, these are the metrics many of the most competitive specialties use to weed out “unworthy” students. There must be other ways to evaluate whether a student will be a good resident or physician within a certain specialty.

So where am I now?

I have one more interview in two weeks, at which point the 2020-2021 interview season will be officially over. Then I will reflect on my experiences, compare programs, and rank my preferred programs from best to worst. Then, on March 19th, we’ll learn the results of the sorting hat’s decision.

Academically, I have 12 more weeks of rotations. As all my interviews are done, my grade or performance on these rotations is arbitrary. In a way, this frees me up to be able to relax and learn rather than feel some need to perform for the grade. While I may enjoy acting, it’s a lot easier to portray a character on stage for a few short scenes than to perform at a high caliber for 200 hours over four weeks. It will be nice to just go to work and learn rather than putting on an act to earn an attending’s favor.

Oh, and who has a spare COVID shot to share?

Until next time.