Dr. Waitt and I worked together at the same institution and we met when, on her first day on the job, she jumped in to help with the anesthesia OSCE. She is also a WSU grad and a terrific person with whom to work. She has insight into the equine veterinary world which I don’t have which she shares during this episode.
Your application is compelling enough for a program to spend the time interviewing you- congratulations! Many residency programs conduct interviews, and it can be a significant variable in the decision making. Sometimes these are by phone, sometimes by video, and sometimes in person. Obviously, you should follow the general guidelines for each of those interview types as well as prepare so you can present your best self. More specifically, here’s how to make the most of your residency interview experience.
This is not only a chance for them to learn about you but for you to learn about them. If you get matched for a program but will be miserable, you may not finish. Every year there are residents who drop out of their long-dreamed-of specialty because the program wasn’t a good fit for them. You need to make sure this is somewhere you can be happy for three or four years. Here are some questions to ask the program directors or existing residents to help you decide:
Both program directors and existing residents:
- What’s it like to live here? What do you like about it? What do you dislike about it?
- What are the students/interns like? What are the interaction with them and the residents?
- What are the responsibilities of the residents? Do they do general ER duties or call or only do specialty emergency duties?
- What is the interaction with other specialties like?
- What is the strategy for ensuring residents successfully complete a research project? Are there opportunities to do more than the required project?
- Are there opportunities or requirements to teach in lab or classroom or rounds room? What kind of support is available to help nurture resident teaching skills?
- If you could change anything about the program, what would it be?
- What do you do to ensure resident success?
- What are the plans for program improvements?
- What have you learned from previous residents that has caused you to change the program?
- What have been your challenges with this program? What did you like about it?
- Would you have chosen this program if you knew then what you knew now?
- What would you change about this program?
Asking incisive questions will ensure that the program knows you are serious and engaged. What else can you do to impress them during your short interview time? Remember, their goal is to determine if you will be successful in their program. You want to assure them you are competent, dedicated, and enthusiastic.
You need to have examples from your experience that demonstrate your best characteristics. Are you willing to come in odd hours- tell a story during your clinical year or internship when you did and had a great time. One of my best days in vet school was 22 hours long and started with a hemilaminectomy and ended with a GDV. The resident on duty said excitedly, “Well, what else would we be doing on a Friday night?” and I was in enthusiastic agreement. Just saying, “Yes I work hard and I would love to be your resident” is not enough. Demonstrate you have those characteristics with stories.
Each residency program is different, but characteristics that are generally looked for include (in no particular order): curiosity, willingness to work hard and long hours (no laziness or cutting corners), detail oriented, compassionate, humble, teachable and willing to accept and use feedback/criticism, able to handle setbacks, good at managing stress, pleasant to work with/positive, ethical, good critical thinking skills, knowledgeable, effective at communication, enthusiastic, dedicated, and cooperative and helpful.
The residency interview is a difficult experience to navigate. You need to get information to make sure you would be happy there while assuring them you would be happy there and a great catch for them in a very short amount of time. Have a plan ahead of time. If you fumble asking questions or coming up with examples of how you’re awesome, you’re sunk. It’s a fairly high stakes experience. You spent undergrad, vet school, and maybe an internship to get here. You can’t just hope it will work out. You must prepare.
Dr. Diehl and I worked together at the same institution and enjoyed discussing and engaging in research. Since I left, we have continued to work together and have some great collaborations. Dr. Diehl talks about the unique circumstances of finding and obtaining an ophthalmology residency as well as what she looks for in candidates and how she likes to help students be successful.
The letters of recommendation for a residency are key. These people will hopefully not only write you a letter but advocate for you in the residency selection process. Fortunately, the strategy for this letter is simpler than the strategy for letters of recommendation for an internship. I really have only two guidelines:
1) All of your letters should be from someone in the specialty to which you are applying unless it violates (2).
2) At least one of your letters MUST be from where you are currently working. If you are doing an internship, all of your letters can’t be from your student days. If you are doing a specialty internship, all of your letters can’t be from your student or rotating intern days.
My recommendation is therefore as follows:
At least 1 letter from a specialist in the field at your current institution. The more the better.
If you do not have a specialist in your field at your current institution, get a recommendation from someone in a core discipline (internal medicine, surgery, emergency/critical care).
The balance of letters can be from specialists not at your current institution.
The reason you need a letter of recommendation from someone at your current institution, even if they are not in your specialty, is to demonstrate that you are not a monster. If I were to read an application from someone from a private practice internship- which did not have an anesthesiologist- and they had 4 letters of recommendation from anesthesiologists from where they went to school, I would wonder, “Did they peak in vet school? Is there NO ONE working with them now who can vouch for their medical competence? Anesthesia includes knowledge of information from all kinds of disciplines- if they can’t do basic medicine, will they be a competent anesthesiologist?”
In general, more letters from people in your specialty is good. If you have your choice of specialists, those more well-known or connected may be slightly preferable. But a great letter from just any surgeon is probably better than an OK letter from a renowned surgeon. If at all possible, those writing for you should already be boarded and have a lot of experience writing letters of recommendation. If this is not possible, unboarded people in your specialty will have to do.
Dr. Patterson was my supervisor at one of my academic positions, and she was a very inspiring, positive, wonderful boss. She has a massive wealth of experience in academic veterinary medicine and mentoring students and faculty. She is compassionate and will also tell you what you Need To Hear in a positive way to make you a better veterinarian. Dr. Patterson talks about raising a family during training, how to progress successfully through an academic career, and what is great about internal medicine.
Links to topics brought up in this episode:
I wanted to be a surgeon. Specifically, I loved orthopedic surgery. I wanted to just fix something and not manage a chronic illness for years like internal medicine does. It was not to be for me, though, and my life turned out grand. I have reviewed applications from people who have done THREE specialty surgery internships, and it makes me sad because they seem to be throwing themselves at an impenetrable wall. Obviously, you can’t choose what you want to do for the rest of your life based purely on numbers, but let’s start by looking at the numbers.
For the 2018 Match, the specialties with the worst match rate (i.e. most competitive) that routinely participate in the match were exotic/wildlife (2.9%), zoo med (6.6%), and avian medicine (10%). You would not believe the number of vet student applicants who have told me their life long dream is to be a zoo vet. I feel so bad for them. Their dreams will almost surely be crushed. If you plan to do zoo med, you need a backup plan.
The specialties with the best match rate were lab animal, emergency/critical care, and anesthesia. Lab animal often pays quite well and allows you to do diverse interesting things. E/CC can be challenging and complex, but be sure to review the specialty board pass rate for the institution- some of them do not train their residents very well. Anesthesia, of course, is great- you don’t have to talk to crazy clients or haggle over money with clients and you can do small animal, large animal, or both.
Small animal surgery is actually higher than I thought- 20%! I have heard some programs receive 190 applications for one small animal surgery position. But the overall statistics don’t seem terrible for small animal surgery.
Obviously, the match rate includes _every_ applicant, even those who are clearly not viable candidates. So your odds are probably much better, assuming you are reasonably competent and pleasant to work with. You may be able to improve your odds by having a great application packet and doing an interview well, with which this blog will help you.
So what to do with this information? Well, I would suggest analyzing your future career considering the statistics. Are you SURE the only thing you could be happy doing would be surgery or zoo med? A lot of other clinical specialties offer a similar quality of life, intellectual challenge, and freedom.
The evidence indicates that people can be happy leading life one of three ways – seeking pleasure, doing your best work, or helping others. You can do your best work doing a lot of different things in veterinary medicine. If you don’t match the first time for a residency, maybe re-examine your future and consider other alternatives before you waste years of your life pursuing an impossible dream.
You applied through the match for an internship or residency- great job! Now, 8am on match day has come… and gone, and you are without a matched position. You still want to do an internship or residency, and there are programs which did not fill all their positions. What do you do now? Now you Scramble.
The Scramble is the informal term for the process following 8am on match day. All unmatched applicants scramble to find good positions while programs with unmatched positions scramble to find good applicants. It is an absolute mess and a travesty of a system. Pharmacy has a two-step matching process to avoid the chaos of a scramble, but veterinary medicine, as always, lags behind.
It can be an emotional blow to not get matched, but realize that not matching does not mean you are a bad applicant. The vagaries of the match mean that good programs and good candidates go unmatched every year. Scrambling to pick up an open position is a normal part of the process. Heck, I scrambled after I didn’t match for a surgery residency and ended up having a terrific career. If you decide to scramble, you can maximize your success with six steps.
Step One: Be Prepared. I’m sure your application packet is superb because you have followed the advice on this blog. Nonetheless, the match is capricious, and even the best candidates may find themselves unmatched if they didn’t find a good fit or were too restrictive in their selections. Be ready for not successfully matching by answering these questions:
- Do you still want to do an internship/residency? If you are disheartened by not matching where you wanted to go, are you still excited at the prospect of going SOMEWHERE? Decide this beforehand- don’t be wishy-washy in the middle of the Scramble.
- Are your materials ready and updated? Is your CV and letter fully up-to-date? Can you send them off today with a high degree of confidence they reflect your current state of mind, ideas, and experiences? If not, get them ready.
- Have you looked at all the programs to which you didn’t apply but would consider? If there’s a position unfilled somewhere, do you have to do research to find out about that position or are you poised and ready to go?
- How do you feel about going into a program that is not quite what you wanted? If you wanted to do a surgery residency, would you ever consider something else for a year which may position you better to apply next year?
If you are prepared mentally and practically, then you may be successful with the Scramble.
Step Two: Don’t wait. Email programs with open positions at 8:10am on match day. You can get this list from your institution’s VIRMP administrator. If you wait a day or, god forbid, a week, most open positions will be filled.
Step Three: Be decisive. Contact programs with open positions and attach your letter and CV in that initial email. Tell them why you are reaching out to them. Not just because they have an open position, what you would be excited about if you got to work there? If you get an offer, you need to be prepared to accept or decline it on the spot. Programs won’t wait for you to decide, because their second choice may be gone by the time you decide to decline.
Step Four: Cast a broad net. Don’t just send your materials to the top 2-3 places you want to go. They may fill up with someone else, and by the time you look around, your top 4-6 places may be already filled, too. Send a message to every open position where you would be happy immediately after the match results come out. Realize that, at this point in the process, there is no more official ‘ranking’. Just as with the match, though, you need to be prepared to accept any program which gives you an offer. If you get an offer from a place you’re willing to go, but not excited to go, go back to planning in #1.
Step Five: Be attentive. Don’t send an email and fail to follow up. If you don’t hear back, a polite follow-up the next day is appropriate. Most positions get filled in the first few days after the match results come out. If they reply with, “Thank you, we will be in touch in the next 2 days”, send a follow-up on the second day. You need to be present without being pushy.
Step Six: Be at peace. The Scramble is frustrating, intense, and emotional. Be prepared for the possibility of not finding anything. Be prepared to commit to a program and have them back out at the last second. Have contingency plans laid out so you are ready whatever the outcome.
It’s always frustrating to fail to match. I failed to match for a surgery residency and scrambled. I even applied for transfusion medicine fellowships and similar programs. Ultimately I thought, “I can go do anesthesia for a couple of years (residencies were 2 years then) and then go into surgery!” Here I am 20 years later, perfectly content in anesthesia. As always, the key is to be honest with yourself.
Dr. Moran and I worked together on a terrific research project which led to a publication in JVECC while she was a veterinary student. I wrote letters of recommendation for her and have been so excited to see her be successful in surgery. Dr. Moran talks about why academia is awesome, particularly when studying for boards, why surgery is fun, and developing relationships.
How do you sum up everything that you are and do professionally in a short span of time? This is the premise of the elevator speech- a few lines of dialogue which encapsulate your professional experience, approach, and future. We don’t use them often in veterinary medicine, but I think it’s useful to have one ready. Let’s look at who the elevator speech is for, some uses for the elevator speech, and how to make a great one.
Use #1 – Talking with non-veterinary types. Although most of the people you engage with during an interview are in the veterinary field, you may encounter some who are not. Maybe you have a meeting with a Senior VP (for higher-level positions), maybe you have time with a basic sciences researcher or someone from a different college. These people need a purchase to stand on and enter a conversation. Your elevator speech gives them a starting point.
Use #2 – You may get asked regardless. Particularly in larger group interviews, you may get asked to give a quick summary of what you do. Hopefully, everyone has read your CV and letter, but those don’t necessarily answer this question. If you don’t have an answer prepared, you can flail around looking for an answer. This question may come up as, “Do tell us about yourself” or “I’ve read your CV- give me some insight into your overall approach.”
Use #3 – Priming your brain. Similar to a mission statement, having an elevator speech helps to crystalize what you do and why you do it. This can inform any professional interaction you have, even if you don’t actually say your elevator speech. You can refer back to it and ask, “Is this still true? Do I want it to be?” You can even ask, “How would this project fit into my image of myself, given my elevator speech?”
Now that we’ve decided it’s useful, let’s work on crafting one. Here are the few short, sweet suggestions:
1) The most important rule is to keep it short. One to three sentences- what you could say to someone as you ride an elevator to the next floor.
2) Give some context for who you are now and what you do.
3) Provide an example.
4) Make a conclusion. Or not. I like to leave the ending opening for a question. You can see that in my elevator speech:
“I’m The Vetducator, I’m a Professor of Veterinary Anesthesia at the University of Wherever. I look for improvements in systems- teaching, research, service, policies- using an evidence-based approach. For example, I measured how students performed on quizzes of varying length over the years to arrive at the best amount of time to balance efficiency with student performance.”
Let’s look at how it hits the four points above:
1. It’s short- 3 sentences. It takes about 18 seconds to verbalize. 2. The context is I work at this place in this role. Since people may not know what a professor of anesthesia does, I expanded on what I do on a fundamental level. Saying “I anesthetize pets and research animals” doesn’t add much to “I’m a veterinary anesthesiologist.” Also, it doesn’t really encapsulate my whole professional approach and philosophy. 3. There’s an example of my research. 4. I don’t give a conclusion because I want to leave them with something to ask. Hopefully, this gives the other person an easy next step in the conversation: “What did you find in your study?”
My wife’s is: “I’m The Pharmducator; I’m a PharmD and PhD at the University of Wherever. I teach pharmacy and other healthcare topics and I research natural products. The project most people are most interested in is my research on the phenolic and antioxidant content of craft beer and its ability to inhibit some of the processes by which diabetic complications arise.”
Let’s look at how it hits the four points above:
1. It’s short- 3 sentences. It takes about 16 seconds to verbalize. 2. The context includes her degrees, which is important- she can do both clinical and basic sciences work. She specifies what exactly in pharmacy she does. 3. She gives an interesting publication. 4. She doesn’t include a conclusion, but beer and science are always intriguing to people, so giving them an example, which will make them curious, leads them to asking about it.
The elevator speech is not often found in veterinary medicine, but I think it’s a good tool to have ready, just in case. I believe it also helps to cement what you are interested in professionally, which can affect your global thinking.
Interviews are tiring events for everyone. The interviewee has to be ‘on’ all the time. But the interviewers are taking time out of their busy schedule to meet with you. Academics always feel overwhelmed and time-stressed. Staff are often underappreciated. Thank you notes acknowledge the time and energy dedicated to your interview.
Should I Send Thank You Notes? Yes. You won’t be cut from the shortlist for not sending a thank you. But you DO appreciate people’s time, don’t you? Why not show it? This reflects a level of class and professionalism. Who wouldn’t want to hire the classiest, most professional applicant?
Should I Send a Thank You Note to Staff? Yes. I always send a thank you note to the staff who helped arrange the interview. I have gotten reports from my admin during faculty interviews ranging from, “She seemed really nice. She asked me questions and was interested in the area” to “We drove in silence the whole way.” Staff can subtly alter the perception of your visit- let them know their hard work is appreciated.
Should I Send a Thank You Note to Faculty? Maybe. I recommend sending one to anyone you spent a significant amount of time with. These will be the individuals who directly interviewed you. If you had a large session with 20 faculty for an hour, I wouldn’t send a note to all of them. But if you had lunch with 2 faculty, a note to each is suggested.
Should I Send a Thank You Note to the Hiring Managers/Committee? Yes. If applying for an internship/residency/faculty position, you should send thank you notes to the decision-makers. For faculty positions, this is the search committee and the department chair, possibly to include the Dean. For internship/residency positions, this is whomever is in charge of those programs, assuming you met with them (Intern Training Committee, group of specialists for residencies, etc.).
What Should I Say? I recommend personalizing each note as much as possible. If you can remember a specific topic discussed with that person, mention it in the note. If not, you can make it generic. It does not need to be long- 3 sentences are plenty. Begin with “Dear Title Lastname,” and end with “Salutation, Yourfirstname Yourlastname”. Do not use your title in your salutation. Respectfully, sincerely, with thanks, and regards are all good salutations.
What Form Should the Note Take? This is up to personal opinion so I will not be prohibitive here. Your options are email and a physical thank you card. I personally prefer to send a physical thank you card, but an email in this day and age is acceptable. I feel a physical thank you card is a little classier and more consistent with my professional image- I am a little bit old school and a little bit formal. It can also be hard to find email addresses for some individuals. If you are concerned about a physical card arriving after the decision-making group meets, an email may be preferable. Decisions are rarely made less than a week after an interview, though, giving plenty of time for a physical note to arrive.
What Happens if I Don’t Send a Thank You Note? Probably nothing. For vet school, those who interview you may not be on the selection committee. In this case, after the interview is over, they have no say in your selection. For internships, residencies, and faculty positions, those who participate in interviews will probably have varying levels of influence on any hiring decisions. I’ve never heard anyone say, “Well, that person didn’t send a thank you note, so I think we should put them lower.”
Does a thank you letter change them from a “no” vote to a “yes” vote? Unlikely. In the event of two equally qualified candidates, does getting a thank you letter cause them to vote slightly higher for that candidate? Possibly. It is a very low-cost action to take which may ever so slightly improve your chances of success. Why not send a thank you note?