Friday, November 28, 2008

Dr. Goatee

In searching the internet for possible residency interview questions, I stumbled upon some other 'tips' about interviewing. Most notably, one site from Rush University offers the following prescription for a successful personal presentation:
Dress should always be conservative, tasteful, neat—and comfortable.
Have the appearance of a successful, mature physician, not a medical student.
MEN should wear a suit, not sport coat or khakis.
  • Navy or gray, solid or pinstripe.
  • White or pale-blue shirt.
  • Conservative tie: solid, stripes, or small pattern (red or navy).
  • Keep jewelry to a minimum.
  • Short hair, preferably no goatees.
It's not just the Chicagoans at Rush that offer this advice. I found websites penned by schools from LA to Boston arguing for a clean shaven face. But there are other things I noticed about these suggestions:

Dress should always be conservative, tasteful, neat—and comfortable.
Okay, I buy this. Comfortable helps when you're running to catch your next flight, too.

Have the appearance of a successful, mature physician, not a medical student.
I think I have this down, what with being older than most of the residents at some programs; in five interviews (three schools, so far), I've received the follow-up question, "How old are you?"

Men should wear a suit, not sport coat or khakis.
Okay, I'll give here. Although when I interviewed at UW for the MD/PhD program, I wore khakis and a tie - no jacket. Look where that got me!

Navy or gray, solid or pinstripe.
Evidently black is out?

White or pale-blue shirt.
Whoops again. I don't own white or pale blue.

Conservative tie: solid, stripes, or small pattern (red or navy).
My real goal here is: not ugly.

Keep jewelry to a minimum.
Nickle allergy keeps this in check for me.

Short hair, preferably no goatees.
Does a shaved head count for short hair? Maybe shaving up there will cancel out the apparent transgression I make with this:

I did end up shaving, but it was the top of my head...

Thursday, November 27, 2008

EM Interview Questions

There are a number of standard residency interview questions that candidates are asked in the interview circuit. A Google search will provide you with some stock questions you should be prepared to answer. For various reasons, I tend to take advice from those sites with a grain of salt. So here are some actual questions I've been asked on my emergency medicine residency interviews.
  • How did you decide to apply to our program?
  • Where will you be in 10 years?
  • You've a different background than many applicants. Describe your trajectory in deciding on emergency medicine.
  • What have you been reading?
  • What is Wunderkammern? (A hobby I listed on my application.)
  • So! What do I need to know about you?
  • Which of your letter writers do you admire the most?
  • What questions about our program can I answer for you?
  • How would you respond to (insert complicated ethical dilemma here)?
  • What are you doing the rest of the year?
  • What are your plans for the holidays?
  • What courses are you enrolled in this year?
  • Why emergency medicine?
  • Where else are you interviewing?
  • Why (insert city here)?
  • What will your first book be about?
  • How have you responded to a situation of personal conflict?
  • What areas of emergency medicine need the most work?
  • Do you want to go back to Seattle to practice EM?
  • What do you do to relax?
I'll give periodic updates to this list. I've only interviewed in three places. Do any of you co-applicants have any additions?


A few weeks ago, I shared what would I thought could make a good title for a book. I still like it a little while later, but am thinking that catchy isn't the only requirement for a title's success. The content has to be interesting, too.

My recent extravagance in carbon expenditure - also known as residency interviewing has triggered some interesting publication ideas. Of course, the best idea has already been acted on by another frequent flier. Fortunate to get window seats in the exit row for my past 3 flights, I could concentrate on the view below rather than avoiding broken patellas or DVTs. And I got to thinking that the maps in the back of the airlines' magazines hardly provide useful information for the curious window-sitter.

So why not publish a guide to the most trafficked flight corridors that explains where you are, the topographic formations, and cloud formations from 35,000 feet?

One good reason is that other folks have already thought of this. A title printed in 2004 (Window Seat: Reading the Landscape from the Air) and one in 2007 (America from the Air: A Guide to the Landscape Along Your Route) look to be complementary resources for the curious traveler.

Both look interesting, so I put them on my Amazon Wish List. Maybe there is still room for my ideas, but the core concept has already been done... One author even thought about providing an interactive CD for use in your laptop! (My idea was to adapt my book for a handheld computer.) So much for my business plan! I should stick with medicine.

Wednesday, November 26, 2008

Inner Viewing

You can expect my posts over at The Differential to focus on interviewing for the next few weeks. After I finished my interview at the UCSF residency last week, I jotted down a few tips for future interviews. The article is now up over at the MedScape blog.

Stay tuned for more tips. Both here and there!

Thursday, November 20, 2008

Obama Lit 101

In real life (i.e. not on this blog), I'd been pretty critical of John McCain's medical history of melanoma so was pleased when he released his medical records, limited that they were. Back in the early primaries, I was equally critical of Barack Obama's smoking habit (correction: smoking addiction). That issue just faded away. Where is it now? Evidently, Obama may still be smoking. Michael Kinsley of the Washington Post thinks it's okay that he's fibbing about quitting. I'm not so sure I agree with that, but I am sure about it not being okay that the next president smokes. We need some health advocacy groups to jump on that (if it's true).

What have you heard about the next president lighting up?

Today is the Day

Today I interview at UC San Francisco for a spot in their emergency medicine residency. It is the first interview of many for me, but is one of my very top choices. I've spent the last month working in San Francisco General Hospital, and really like the place. Granted, it's the only academic ED I've worked in thus far...

Well then... Here goes!

Sunday, November 16, 2008

back to days

brain is jelly.

granted, it's spicy cranberry jelly.

jelly none-the-less.

perhaps returning to daytime shifts will help me out!

Sunday, November 09, 2008

This is What I'm Signing Up For...

Several of my friends have suggested I respond to Pauline Chen's recent article in the New York Times about the treatment of medical interns during the first year of residency. Her article is provocative, and I am planning to offer a response (from a soon-to-be intern), but am still digesting it. Stay tuned.

Saturday, November 08, 2008

Really Tough Stuff

Lately, I've been complaining about the residency application process on this site and elsewhere in the non-digital world. It's been nice to be on rotation and have daily reminders of why you are going through the cumbersome process. Sometimes however, giant "reset" buttons come your way. Gianter (grammar intentionally misused) then catching a DVT or sewing a laceration, and not quite like the reset weekend to help me switch from day to night shifts that I wrote about this morning.

The reset I'm referring to tonight is more important. Today I visited a blog that I had not been to in a while. It's Ben Towne's online journal.

Ben is the three year old son of one of the pastors at the church I attend. He was diagnosed with an aggressive neuroblastoma last August (2007). Ben and his family have endured ups and downs of treatment and remission, hospitalization and time at home. They have had a large body of supporters, many of whom may have never even met Ben. I count myself as one of the folks who first heard about the family's story in a pew and have followed it by periodically reading the blog.

Much of the art of medicine is related to empathy with patients and families we encounter them in the hospital or clinic. It's a gift to be able to achieve this emotional skill, and it's one that can always find a new place in the physician's toolkit. There is even more to learn from witnessing non-medical aspects of patients' experiences. Some people go into medicine because of these experiences: a grandparent who may not have received the best care, a sibling who couldn't be saved from a disease, or a friend who was paralyzed in a car accident. I was not one of these people. That's why it has been a privilege to follow along with the Towne family's trials. Their web journal also makes it easier for me to think about and pray for them.

After aggressive radiation and chemotherapy, Ben's tumors are back with a vengeance. There is little that medicine can do for him except control his pain. The family has taken him home from the hospital and will pursue comfort care for him. By any account they have a tough road ahead of them. Yet, the journal reports this week that:
Many times last night Ben told [his mom] not to worry and that he loves her.
If you are inclined to pray, meditate or reflect about Ben and his family, I am sure that the Townes would appreciate it.

Fog Horns

It's a reset weekend.

After doing mostly 6AM to 2PM or midday shifts, my schedule necessitates my transitioning to an inverse circadian rhythm. After two days off, I have one 2PM to 10PM shift, and then five 10PM to 6AMs. Just like flying across country there are a couple of tricks for adjusting that I'm trying to follow. Today, I:
  • Slept until 9:00 AM
  • Plan to have a late breakfast
  • Am contemplating each toot of a distant foghorn
  • Will take a midday bike trip (via BART) to my parents in the East Bay
  • Plan to eat dinner as my second meal
  • Anticipate catching up on my writing late into the night
Tomorrow, I plan to:
  • Sleep in even later
  • Wait for the (forecasted) morning rain to cease before returning to San Francisco
  • Take an evening jog
  • Eat lunch, dinner and a late night snack
  • Study some topics in emergency medicine
  • Sleep from 1AM to 9AM (Monday)
Then I'll have to figure out where is the best place to sleep during the day...

A similar plan worked for me when I flipped from 12 hour day shifts to the converse while working at Harborview. Stay tuned for the outcome.

Friday, November 07, 2008



The stress of the interview season is still crescendoing for me. I've a couple of rejections, a fair number of invites (see column at right) and a couple of programs I still haven't heard from in cities where my wife is very interested in training. Now that she is heading off for her first trip (New York, Baltimore, St. Louis, Boston, Chicago in two weeks), I'm of course antsy. Trying to fit in a couple interviews in each of the cities she likes is maddening! Especially when there are optional but strongly recommended social activities the night before or after the interview, making logistics quite painful. And I haven't even started to purchase airfare!

So it goes. I am glad to be in San Fransisco learning more emergency medicine and seeing how a residency works. Being from a city without a residency program is a real handicap in terms of knowing what to look for and assessing for fit. I'm having a great time here in spite of the stress of organizing a travel agenda. Any readers out there having the same struggles?

Thursday, November 06, 2008

Health Care PRN

Will all of our pre-election excitement be lost to follow-up?

Now that there's a new guy headed to the White House, it's time to put some of those ideas about improving access to health care on the line.

I ramble about this and other topics over on The Differential today. Thanks for reading.

Wednesday, November 05, 2008

My First Rejection

The University of Pittsburgh declined to interview me for their residency program, but there are a couple of others who have extended an invitation (see running panel at right). I'm still playing the waiting game for the other 20 programs...

And I'll still root for Pitt basketball and football...

It is Finished

And so it came to pass that on Nov. 4, 2008, shortly after 11 p.m. Eastern time, the American Civil War ended, as a black man — Barack Hussein Obama — won enough electoral votes to become president of the United States.
Read the rest of Thomas Friedman's editorial here.

Tuesday, November 04, 2008


Good for health care
Good for peace
Good for science & innovation
Good for education
Good for the environment
Good for a better society

I guess those are the main things I care about when I go to the polls. My remaining hope is for:
An Obamaslide

Make your own logo at Logobama.

And no matter your political preference, make sure you vote today.


How would you feel if after being treated for a traumatic car accident, the ER doc comes back to tell you there's probably a tumor in your lung?

Sunday, November 02, 2008

The Daily Commute

or, "How Biking in San Francisco Reminds Me of Rugby"

After a week of commuting between San Francisco's Haight-Ashbury neighborhood and the Mission by bicycle, it occurred to me why I'm having so much fun going to and coming from work: it reminds me of rugby! Some readers may know that I played rugby for three years at the University of Pittsburgh. It was a club sport and I played on the B-side for all but the last 4 months or so, but I stuck with it because it kept me in shape, I was always learning new strategy and it was certainly a good way to release stress during difficult semesters. After I realized the other night that commuting by cycle provided the same thing for me here, the similarities just kept piling in. Here's my running list:
  1. Both are excellent sources of aerobic exercise.
  2. Biking safely in SF requires the hyper-alert mental status that keeps a rugger from getting clocked.
  3. Ruggers and bikers must remain aggressively protective of their space.
  4. This is the first time since rugby I've consistently worn stretch pants.
  5. I get up really early to ride.
  6. I work out late at night.
  7. Showers twice a day in odd locations.
  8. Climbing Haight St. kind of reminds me of running stairs.
  9. Avoid taxis at all costs.
  10. "Why are all of my clothes sweaty?"
  11. There are some rules that must always be followed and there are others that you can get away with breaking most of the time.
  12. There will always be folks who are much faster, in better shape, have more skill and are harder core than I.
Well, that's all that comes to mind for now. The bottom line is that I'm having a great time in SF, even if it's mostly consisting of working long hours, staying in to study and commuting between the two. By the way, I found this excellent website that plots a course between A and B on a bike that takes into account hill grade, total distance and more.