First interview and rash of rejections

I recently had my first interview. I had a great time, residents and faculty were both very nice. The interview was pretty low stress. One thing, though, surprised me. The institution that I interviewed at is well known for its research, but I had no comments made about my research and when I asked about research opportunities, each faculty member replied with a quick "yeah, we've got research" and seemed to not be so interested. The tone of the response of one faculty member almost made me feel like I asked an inappropriate question. I understand that in residency it's fairly difficult to work on a real research project and I have no intentions of working on a PhD level project, but I expected at least some acknowledgment of their research strengths.
I feel that most residency programs want a token amount of research in your background, but would rather not have your clinical training soiled with research. As such, someone with a background like mine actually has a big disadvantage. With average grades and boards scores my strength is in my productive research (and recommendations). This leads to a strange situation in which some mid-/lower- tier programs decide not to offer me an interview (I assume because they think I will go to a research heavy institution) and many upper-tier programs decide not to offer me an interview (I assume because of less than stellar grades/boards score). I end up with a small number of fairly random interviews with some of the best and some mediocre programs. Of course, maybe I'm just trying to rationalize a (essentially) random process. Anyway, another week or two of potential interview invitations, but I'm feeling a bit more pessimistic now than I did a few months ago.

People are stupid

It amazes me how millions of people can be convinced to vote against their self interest. Healthcare? Who needs that? What America needs is a tax cut for the rich. Also, get rid of the estate tax (even though it only applies to people who make millions and I only make $20,000 a year). Oh, and extending unemployment benefits is unamerican (even though I'm unemployed and collecting unemployment right now).

Rural Hospitals

I recently did a surgery rotation at an outlying hospital. It was labeled a "rural" hospital, but in reality it is only a 30-minute drive from where I live. It was a great experience. Without residents, I actually felt that I was a useful member of the team and in the OR actually got to do more than hold something that I can't see. The hospital only had something like 30 beds and I expected that any patient requiring more than a minimally complicated procedure would make the 30-minute hop to the giant academic center nearby. To my surprise lots of patients there would rather have their complicated multi-organ bowel surgery at the small 30-bed hospital (with only 4 ICU beds). Their main reasoning was that they felt comfortable in a place with familiar faces, where they knew the staff as friends or families of friends, something that they preferred over a giant maze of a hospital where you're known as a diagnosis or a room number. Also, I quickly figured out that the quality of care was the same (if not better, in some respects) than the giant academic center. True, you couldn't get a transplant or brain surgery, but for most procedures that general surgeons (or orthopedic surgeons) do, they're just as good. What's more is that things happen amazingly fast at this small hospital. There were several patients that came in with suspicious breast lumps and within a week had a partial mastectomy with pathology results in and an oncology appointment made. Scheduling several procedures across four different specialties is pretty much not possible in a large hospital. So, even though there's a lot of "outside hospital" bashing in academic centers, for the most part, they're just as good.

Checking email

Still checking my email for possible residency interviews. It's a very anxiety-provoking process. I check my email something like 20 times a day (I thought having a smart phone would be great, but it turns out to distract me more than help me). It's getting to be a crazy obsession. The plus side is that I've gotten two radiology interviews and four intern year interviews. It's somewhat reassuring, but it hasn't stopped the anxiety (and I did get one rejection from an intern year program).

One thing I'm really glad I managed to do was to take a large chunk of time off in December and January (prime interview season). With the number of interviews I hope to get (and an equivalent number of intern year interviews since I want to be in the same city for both), I will be traveling all the time. Our school only lets us take off one day per week of class for interviews and (by my calculations) I would have to break that rule to fit in the number of interviews I hope to get. Some classmates who don't have the time off are wondering how to deal with this dilemma. Since the med school administration always strictly adheres to their rules (and no amount of logic will let them change it), the best option is to either call in sick or ask your resident/attending and not bother with the administration. Nonetheless, the administration may find out and you'd have to deal with their fury.

Tips to any future medical student:
1. It's best to plow through 3rd year and free up 4th year for easy rotations/research/time off so that you could focus more on residency applications and interviews.
2. When it comes to needing time off, follow the old adage: It's better to take the time off and apologize afterwords than to ask for permission and not get it (because you won't get it).

PLoS One: Not a real science journal

I love the open-access concept for scientific journals. There is no reason why someone should have to pay $35 to read my papers. PLoS is one of the first and largest open-access science journals out there. Some of their journals, like PLoS Biology, are very prestigious places to publish and have put out many amazing studies. They also have a vigorous peer-review process. Unfortunately, to subsidize publication in their premier journals, PLoS pretty much lets anyone who's willing to pay a couple of thousand dollars to publish anything in their barely peer-reviewed journal PLoS One. Their argument for minimizing the peer-review process (and ignoring the scientific merit of their papers) is that it is reviewed by the global community. Unfortunately, all it does is get a bunch of non-scientists make a big deal of a crappy study for being published in a scientific journal. Don't get me wrong, there have been some nice papers I've read in PLoS One, but they also let in a lot of crap (70% of what's submitted is published), like this recent one about a model for Moses parting the Red Sea, that has absolutely no scientific merit. Because of this, PLoS One made it to my Fake Science list.

The waiting game

My applications are in for residencies. Now I play the always-fun waiting game. Actually, with radiology, an intern year in either an internal medicine, surgery, or transitional (short rotations of everything) program is required, so I've got twice the applications and (hopefully) twice the interviews. The two programs are essentially independent of each other, so all of this is further complicated by the fact that I would like to stay in the same city for all programs. With radiology being so competitive, I've got a lot of programs on my list. I'm happy to say that I've got one interview already, although it's only an intern year interview... nonetheless, it seems like all that effort I put into applications is actually producing something.

Just for those that don't know (and for me when I look back at all this craziness), the whole residency application process starts with completing an application at a central computerized program, uploading a personal statement about why you want to go into the field you chose, and uploaded grades, national boards scores, letters of recommendation by your medical school. The application goes out to any program you want to click on. This makes it really easy (but pretty expensive) to apply to a lot of programs. Once the you choose the programs, the waiting game involves waiting for them to download your application, go over it, compare it with other applicants and decide to send you a short e-mail that they like you enough to see you in person. This process can take from a few days after submitting for some programs to several months for others (which results in applicants agonizing over whether they got interviews all through the fall and into the winter). Next, you interview at the programs that choose you. Then, by sometime in February, you make a rank list indicating where you want to end up the most from the programs that interviewed you. Finally, on March 17th (this year), the "match," based on your rankings and the rankings of their applicants by the programs you interviewed at, decides where you'll end up for residency. I still don't know how the match exactly works, but (like almost everything in med school), I'm sure I'll figure it out when I get to it).

Stay tuned...

Wanna look stupid?

Burn books.

Edit: Make that, if you wanna look stupid, give attention to a nut that wants to burn books. Seriously, that guy not only just increased his influence about 1 million times, but there will be hundreds of copycat nuts out their trying to get their 15 min. I don't care that it's the Koran, it more that the media and the government has elevated this guy's voice to an international level. A simple "who the hell are you" and "who cares" would have shut him up easily.