A. **********BASICS FOR IV PREPARATION********************** Remember: -A program that interviews candidates is a program that wants to recruit. -First impressions are vital. In general, the first five minutes of the interview are the most important of all. -An interview is an opportunity to show your competence, education, skill and enthusiasm. -If you are not adequately prepared, whatever is on your resume will count for nothing. You have to convince the employer that you have something special to present to the program. Don’t leave this to chance – prepare and prepare well. -Go over and practice any questions you think might be tricky to answer at the interview. Keep practicing until you can express your answers comfortably. If you show any doubts about whether you are right for the position, or if the position is suitable for you, the interviewer may well detect them. With this in mind, continually seek to convince the interviewer that you are the ideal candidate. It has been observed that programs selecting the wrong candidates lose money, waste time and bleed prestige, resulting in a loss of customers. This is why any potential employer will be incredibly careful of its final selection before offering anyone a position. It is your task to convince them that you fit the bill. What is the purpose of an interview? Interviews provide the employer with information about your: -Skills -Personality -Work experience -Education -Motivation -Interests
Transcript
A. **********BASICS FOR IV PREPARATION**********************
Remember:
-A program that interviews candidates is a program that wants to recruit.-First impressions are vital. In general, the first five minutes of the interview are the most important of all.-An interview is an opportunity to show your competence, education, skill and enthusiasm.-If you are not adequately prepared, whatever is on your resume will count for nothing. You have to convince the employer that you have something special to present to the program. Don’t leave this to chance – prepare and prepare well.-Go over and practice any questions you think might be tricky to answer at the interview. Keep practicing until you can express your answers comfortably. If you show any doubts about whether you are right for the position, or if the position is suitable for you, the interviewer may well detect them. With this in mind, continually seek to convince the interviewer that you are the ideal candidate. It has been observed that programs selecting the wrong candidates lose money, waste time and bleed prestige, resulting in a loss of customers. This is why any potential employer will be incredibly careful of its final selection before offering anyone a position. It is your task to convince them that you fit the bill.
What is the purpose of an interview?
Interviews provide the employer with information about your:-Skills-Personality-Work experience-Education-Motivation-Interests
Knowing YourselfHonestly taking stock of you is the first step to preparing for an interview. Asking yourself the following questions as fully and frankly as possible will help you do so:
Your interestsWhat kind of work excites you? What type of a position do you really want?
SkillsWhat kind of skills do you have?
EducationList degrees, diplomas, certificates, etc.
ExperienceAll the positions you have worked in previously, including full-time, part-time, internship and voluntary activities.
Your AttitudeTowards yourself, other people work in general and your chosen career.
Strengths and areas for improvement:What are you good at? What do you need to improve?
Knowing your goals:Ask yourself where you want to be in five years’ time and what you want to be doing. When the question comes up in the interview you’ll able to give a considered, confident and contrary to the general preconception, the interview is not only an environment where the employer can get to know you. Use it to learn about the position and the organization.
Preparation
-Look at the interview as a verbal examination to be passed.-When getting prepared for the interview, do not forget your physical appearance. Pay attention to the state of your hair, teeth, and nails. Men should remember to shave, or trim beards and moustaches, as appropriate.-Dress appropriately for the organization you wish to join, to make a positive first impression. Women should avoid too much make-up, jewelry and perfume.-Arrive 10-15 minutes prior to appointment to ensure you are in good time for the interview. If you are going be late or cannot attend the interview for any reason, make sure that you phone as early as possible.-Be considerate and polite to everybody you see. They may provide information about you to the interviewer.-Take more than one resume with you when you go to an interview.-Collect information about the program and position you are applying for beforehand. You can use the Internet, publications. Make sure you visit the program’s website.
The Interview
Some general points to remember:
Be courteousAddress the interviewer with their title, such as Dr... Take a polite and professional approach.
Show that your are eagerMany employers eliminate candidates due to their lack of energy and enthusiasm in the interview. Being positive, interested and sociable will help you build a good impression.
Establish eye contactThis is one of the key factors for establishing a bond and building trust with interviewer.
Body languageNever underestimate its importance. Nervously waving your arms or shaking your legs is distracting and could give a poor impression. Posture is also important. Sit up straight and slightly forward, without hunching your shoulders. Do not rest your hand or arm on the interviewer’s desk.
RefreshmentsIf the interviewer wants to offer you something to drink, chose the easiest option for them, such as water.
Be a good listenerDo not lose eye contact when listening to the interviewer and show that you follow him or her by nodding where appropriate.
Be yourself:Do not try to change your personality. Try to let the interviewer get to know you for who you are.
Specific tips which can make all the difference include:
1. Pick up clues in the interview. Just as you create an impression with your style of dress, the interviewer’s office and their personal possessions like photos will give you an idea of their personality and interests. If you are able to interpret these cues correctly, you can increase your chances by using them to engage with the interviewer more effectively.2. Prepare answers to typical interview questions before the interview.3. Behave thoughtfully and be polite at all times, and introduce yourself to everybody.4. Enter the interview confidently. Shake the hand of the interviewer firmly, but not too tightly.5. Concentrate on the questions you have been asked, and give relevant, in-depth answers to questions about your education, work experiences, and any voluntary or charitable activities.6. Introduce and sell your training, skills and abilities that will be suitable and useful for the organization.7. Prepare two or three intelligent questions related to the position and organization to ask the interviewer at the end of the interview.8. If you have mentioned negative aspects of your previous or current position, make sure you
also outline a few positives. Complaining about your previous position or colleagues will give a poor impression.
Don’t forget to relax:
You don’t go to interviews every day, so nervousness before and during them is perfectly normal. Being a participant in an interview can be an unfamiliar role, so you may have to cope with a higher than usual level of stress.Rehearsing for an interview is a very good way to build up your confidence and so minimize tension. Immediately before, and during, the interview take slow, controlled breaths, stay focused and try to be calm as you can.
Dealing with interview questions:
When an interviewer assesses the candidates before them, the questions they ask will try to reveal answers to the following key issues, even if they do not asked them directly:1. Is this person capable of fulfilling this role?2. Do they have the necessary motivation and commitment to do so?3. Will this person adapt to the organization?Bearing this in mind, you need to ensure any answer you give will give a positive response to these issues.
Moreover:-Answer every question briefly, but in full, avoiding a “yes†or “noâ� € reply.�-There is no need to hurry. A short pause before the answer will be interpreted as thinking time, but try to avoid over-long silences.-If you cannot answer a question fully, say so.-Remember that some interviewers will be asking questions to get a general idea of your background and personality.-Even if you think that the interview did not go well, leave the room with a positive and cool-headed attitude.-Thank the interviewer for their time. Tell them that you found the interview very helpful and that you were very pleased to attend.
After the interview
At the end of the interview, reiterate your interest in the position and the organization, and afterwards do not forget to send a letter of thanks.
B. INTERVIEW Qs & As WITH TIPS **********************
duloxetine - 11/20/09 19:09
sb asked me for the list of interview questions. i have tried to incorporate every possible questions you
might face. some are more high yield than others. if you want to discuss any question, we can discuss here.
1. How much do you know about our program2. Tell me about yourself? 3. What motivates you? 4. Which three adjectives best describe you? 5. What are Your qualities you are proud of?6. What are your strength and weaknesses? 7. How well do you take criticism.8. If you could change one thing about your personality, what would it be? 9. What differences do you see in the health care system between your and this country?10. What do you think are the draw backs in medical system in USA from your perspective"?11. Why did you choose to be a physician12. What are the three achievements or qualities that you are proud of?13. What do you think are the most important traits in a clinician14. Why do you want to go into this speciality? Why did you choose internal medicine?15. In what subspeciality would you like to go.? 16. Why did you apply to this program. ? 17. What do you think you will contribute to our speciality/ program18. Present an interesting case. 19. What errors have you made in your patient care. 20. What was the most memorable experience in your school.21. How would you change the health care delivery system of the country?22. What is the biggest challenge facing health care delivery?23. How do you see the delivery of health care evolving in the 21st century. 24. Tell me about the patient from whom you learned the most25. What do you think of hospitals that refuse admission to patients without insurance?? 26. How well do you see yourself adapting to the American Health System?27. What do you consider the positive and negative aspects of this specialty?28. What are your expectations regarding this program?29. How do you see the health care delivery system of the country evolving?30. How have you changed since high school?31. What are the major deficiencies in your medical school training? How do you plan to get over those? 32. What medical school course or class interested you the most. 33. What problems will our speciality face in the next 10 years?34. What sacrifice are you willing to make to become a specialist35. Where do you see yourself in ten years from now? As an academician or as a community physician??36. How do you think socialized healthcare will affect medical progress?37. How will you as a physician try to curb the rising cost of health care ?38. What has shaped you the most and got you where you are at today39. What was the most difficult and trying time in your life. How did you handle it?40. What was the most important event in your life41. How do you think you can be a productive member of our residency program? 42. Why America and not your own country? Don’t your countrymen need good doctors?43. How does your roommate describe you?44. If you could be any cell in the human body, which would it be? 45. What is more imp, knowledge or imagination. 46. You are organized and structured or flexible? 47. Are you serious and dedicated or relaxed? 48. If your house was burning, what are the three objects you would save ? 49. What are your three wishes? If you have unlimited money, what would you do. 50. What is the most important thing in your life.51. If you are deserted on an island, what would you take with you?
52. What kind of people do you get along with?53. Describe your best friend.54. Who are your heroes 55. What is the last book you read?a. The God Delusion by Richard Dawkins56. How do you define success57. f you could accomplish only one thing in your life, what would it be? 58. What physician characteristics do you admire the most?59. In your med school, whose work do you admire the most and why60. What do you do in your spare time. , if you had a free day, what would you do? 61. Have you done any volunteer work62. What is the most bizarre thing you have ever done63. Where have you travelled.64. What nonmedical magazines do you regularly read65. What would you do if you found out one of your colleague is using drugs/ alcohol?66. In which situation are you most efficient?67. To which organization do you belong?68. Would you have any trouble working in this predominantly catholic hospital How important is family for you?69. If you could no longer be a physician, what career would you choose?70. Biggest failures in life and what have you done to ensure that they won’t happen again?71. How will you incorporate your research interest into your residency and future career? 72. How do you make decisions. Are you a risk taker? 73. What was the most difficult decision you had to take in your life. 74. What motivates you to study?75. What have been the biggest failures in your life? What have you done to ensure they don’t happen again76. Which type of people do you have trouble working with. 77. Describe the worst attending you ever worked with78. What kind of patient do you have trouble dealing with. 79. How do you normally handle conflict? How do you handle disagreements with colleagues or attending.80. How do you handle criticism. 81. What subject or rotation did you have the most difficulty. 82. What has been your greatest challenge83. How much of lifestyle considerations fit into your choice84. What qualities are you looking for in a program?85. What will be the toughest aspect of this speciality for you ? 86. can you stand for a long time. Are you willing to do graveyard shifts and all weekends for a month. ?? 87. Why should we take you in preference to other candidates? What makes you unique88. What Is your energy level like?89. How well do you function under pressure. 90. How well do you handle death?91. What is managed care? HMOs? PPOs? Capitation? Prepaid medical system? Deductible, copayment.92. What does a cross cultural approach to healing mean?93. What recent newsworthy medical event would you like to discuss?94. What do you think is the no 1 issue facing our specialty now?95. If a patient just stabbed your best friend, what would you do?96. What would you do if the housestaff have a job action, aka a strike?97. Should physicians be involved in active euthanasia?98. What do you think about using animals in medical research and teaching 99. Is health care rationing ethical? 100. What would u do if a colleague wanted to keep a therapeutic error secret from the patient?101. What clinical experience have you had in this specialty?102. Why is medicine called an art, or a practice?103. What do you think of physician advertising.104. Why are beer cans tapered at the top and the bottom? 105. Why are manhole covers round and not square? 106. How do you weigh a jet plane without dismembering it? 107. Tell me a joke.108. Where else have you interviewed?109. What is your stand on abortion and cloning?110. What if you don’t match? 111. What errors have you made in patient care? Sample answer
112. What is the greatest fear about practicing medicine?113. Anything else you would like to add? 114. If you were offered a position today, would you accept?115. What would you do after your residency? Will you go back to your country?116. Tell me one important research article you have read recently in a medical journal.
PD-Hello. Come on in! Have a seat. How is it going so far?
U-Hello thank you for asking its going well everybody has been very nice and I am very impressed with the hospital.
PD-Good to hear that. ( Picks up your file). Okay, tell me about your self. Why you are here today?
U-Well! As you know my name is Dr. U. I am a graduate of XYZ medical college. After graduation, I wanted to pursue a residency in USA so I passed all my steps with ___ scores. I moved to United States in year ____, and since then I have been working at ________ hospital as an _______. I am here today because I am interested in your program for residency. I have had some friends of mine who have done residency here and based on their feed back as well as what I have heard about your program from other sources including Dr. XYZ I have been working with, I was very keen to visit your program. I am glad I made that decision.
U-My interest in Family Medicine goes back to my medical school years. When I was doing rotations in US, I happened to get familiar with Family medicine. I knew I had an interest in it but I wanted to make sure that this is what I want to do for the rest of my life. To find a definite direction, I opted to work with a Family Physician. It was a very interesting experience as every day I got to see different aspects of this specialty. I still have very vivid memories of a man I met with (this is the time for an interesting case).. After that experience, I knew for sure that this is what I want to do and enjoy it at the same time as well. "---------U-
PD-Interesting. What difference did you see in medical practices here as compared to your medical school?
U-As there are geographical differences between the two areas, so the medical practices as well as disease prevalence is quite difference as well. Our hospital was one of the biggest hospital in the country with all the modern equipment. I did observe some differences though. Back home, we rely more on our diagnostic skills and as diagnostic tests are not heavily used in our setting, it was very interesting to see the role of diagnostic tests and imaging in medicine here in USA. In our system over there, medical care is not very distinguished as it is here. Physicians have a very wide scope of practice as compared to US where different teams take care of patients at different levels of care.
[Your medical school was the BEST!! Your system was as competitive as any system out there. YOU MUST PROVE THAT. You must prove that you are as competitive as rest of their American candidates.]
PD-Very interesting. Tell me about something that motivates you as a physician? Something that has helped you all this time?
U-What motivates me as a physician is that in medicine you never stop learning. and i love to keep learning. Also I will be able to practice in area of great need as the one I live in
What do you think are the draw backs in medical system in USA from your perspective"?
U-I have come from a different system. I have seen some amazing advancements in US medical system. I am very impressed by the quality of research that is being done here in different field. US has a diverse patient population, now that number of immigrants is constantly increasing. Physicians here have a broader range of experience. The only draw back that I see in the system is lack of health care for all. I think we as physicians have very limited privileges to help the entire community from all socio economic levels.
PD-How do you think you can be a productive member of our residency program?
U-I can bring a hard working, honest and dedicated resident to your program who does not shy away from his responsibilities. I get along well with everyone and as a resident I have the ability to work in a team as well as on my own. I am obsessed about learning new things every moment of my life through books and my surroundings. I have a very sharp observation and that helps me make tough medical decisions if I have to. Your program has certain strengths that perfectly match with my qualifications. As it is a busy residency program with high patient load, my back ground in Medicine will help me fit in very quickly without much time needed for training. I have been living in US for a while and I am familiar with ethics and dynamics of medical practices here. Geographically your program is an area with a diverse population. My ability to communicate both in English and Spanish gives me an edge over other applicants. I am sure you have a very competitive pool of applicants, but based on my background and qualifications, I am sure I will be a very productive member of your staff.
TIPS-[ This is your TIME when you are asked this question. This is like the final deal. What can you bring to the program. The answer should start with your strengths.
Strength 1, one wordStrength 2 , one word
After that you tell them what their program is all about.
Program quality one= matches your strengthProgram quality 2=matches your strength]
PD-What will you change in yourself if you had a chance to do so? Any regrets in your life?
U-I have some regrets in my life as I believe no human being is perfect. But rather than crying over it, I like to take actions to correct them as much as I can. My biggest regret is not taking my USMLE exams when the time was right. I think I was hasty about these exams, had too much over confidence in my abilities...If I could go back in time and correct something, I would have taken my usmle exams at a time when things were a little better in my life and there were not too many distractions. I did fail my exams because of my hasty decisions, but I didnot let it pull me down. I tried again with all my hard work and I passed it with ___ score. I am very proud of myself that I can bouce back after failures and my life does not stop there.
PD-Why should we hire you and not some other candidate with better credentials than you?/
TIPS-[Since PD already has asked about your strengths. So you dont have to be defensive at all.]
U-Well, I know your program is a very good program and you will be getting many excellent candidates who will be interested to do their residency in this program. I have told you about my strengths already. If you want me to go over them again, I can do that as well. But I really cant comment on why you should hire me? I trust your experience and judgment. I am sure you will select the best candidate.
[because I am a better fit for your program. Credentials look good on paper but I am an excellent clinician and I work very well with communicating with people and along with my ability to speak English as well as Spanish it is more important in my opinion than having very high grades on the usmle. When it comes down to it a patient wants a doctor that is understanding that they feel comfortable with and this is me.]
*if he has not asked about your strengths, then the answer will be different.
PD-Lets say a patient comes to you during your internship and you think he should be prescribed certain medication. You discuss this with your senior resident and he disagrees. He asks you to prescribe another medication. You go back, check the literature and you find that this medication can cause arrhythmia in this patient. You go back to your senior resident and he still argues to give the patient that medication. What will be your next plan of action in this situation?
U-Well the safety of the patient is always first so in a polite way I will say that I have just read that this drug can cause harm to this patient I think its a better idea that we do not give him this drug------If he still insists, you will take advice from an attending. You will never be in trouble if you intend to cause no harm to the pt.
PD-Do you have any questions about the program that you want to ask me?
U-You can ask something like this.1) How much supervision do you provide for residents in their first year?2) How accessible is the faculty for their residents?3) What is the best way to learn in your program?4) What are your expectations from your residents?5) What do your residents do usually after residency?6) How much opportunity do we have as residents to present cases in case conferences?7) What is your educational structure for Grand Rounds etc.,8) Is there anything you are working on to improve your program?9) If I am the right candidate for your program, what can I expect from now on? (Indirectly asking for prematch)10) How much autonomy do we have to manage patients?11) How accessible are the faculty?12) What do you expect of your residents?13) What do you think of these questions?
TIPS-
[1-Always prepare at least 5-6 questions that u want to ask.
2-You don’t want to ask about typical day because u already witnessed that before your interview. This is a question for lunch break
3-What if they already "KNOW ME"
Don't mention or act as if you know anything about the program already. Just add phrases like "I have seen this but I would love to ask....", "I know this happens this way but I am really interested to know.....
I have seen already that the residents enjoy independence and individuality in this program. Do you think the faculty overall believes in supervision or autonomy for the residents?"After that, when he answers this question, you may want to jump to another question like,
You have a very competitive pool of residents here. What are your expectations from your residents generally?".Once he answers that, you ask him,
Dr. XYZ, I have done my rotations here. I am sure you have excellent candidates willing to get into your program but out of all of them, I am the only one who has worked with you in a clinical setting. You have seen my interaction with patients and you are very well aware of my clinical skills. I want to take this opportunity to ask you very honestly, what should I expect from this point onwards?"]
PD-Tell me something about yourself that your friends don’t even know?
U-Usually my friends know pretty much every thing about me but the only thing that they might not know is that I do a lot of volunteer work. I usually dont like to talk about it but this question compels me to do so. I make sure that I spend atleast one week end in a month doing some kind of charity work in our mosque or free clinics around the city.
PD-Are you sure you will be happy here you know you will be far from home and friends?
U-My family 100% support my decision to join your program. They can visit me anytime. Infact my mom and dad/ wife and kids/ girl friend or boy friend is planning on moving with me here when I start my
residency. So I have no problem making this decision.
U-I see myself as a faculty in your program, teaching medical students and residents. I will be doing my research projects and may be do some research fellowships
PD-If your chief resident is studying for his exams and make you do all the work, what you are going to do?
U-Although I dont mind working hard and helping out my colleagues. I would love to help him out if. At the same time, I believe in open communication. So I will communicate openly with him if at any point I feel it is too much of a burden, I will let him know.
U-I've found that when conflict occurs, it helps to fully understand the other person’s perspective, so I take time to listen to their point of view, then I seek to work out a collaborative solution.
PD-[I have had my training experience in specialty a and npw interviewing for specialty b -- interviwers are grilling me on why would I want to change after years of experice in other specialty]How one should approach this question?
U-
TIPS-
[First of all my impression would be that you either got bored, burnt out, or lost interest because either
the schedule was very hectic, you did not like certain aspects of your specialty like insurance or taxes or you cant handle it any more because you dont have the same circumstances that favour that.
If you have spent a specific time in that specialty, you can just talk about the negative aspects of that specialty at the level of policies and structure. Something that makes it sound like you enjoyed it when you started but over the time, certain changes happened in the over all structure of the specialty that kind of repelled you.
You can also mention some personal situation that compels you to change specialties like kids, relation ship problems due to your hectic schedule.
If the other specialty is closely similar to the one you are leaving, you must mention something from the former list than the later. If there is a dramatic difference, you want to go for the later.]
PD-‘One PD made me PD and asked to design a residency program?’
U-Being unique is an advantage. always challenge the other person. I will design my own program making sure it makes sense!
TIPS-[I mean depending on the situation, in USA it is always better to just disagree very diplomatically to certain questions and this sometimes impresses the interviewer that this person has an opinion of her/his own. You are not required to say Yes Sir all the time. You can be unique and different than the rest of the crowd. I will give you an example. One of the PDs I interviewed with asked me about my weaknesses. I said I am a perfectionist. He made a comment" surprisingly all the others I interviewed were also perfectionists. We have a very perfectionist pool of applicants this year". It was embarrassing. I should have rather said I think I have a lot of them but can't think of any specific one right now or I simply have none. Its always good to be different and unique with your answers. Just be honest!!!! You will never get into trouble if you are honest]
U-1-I think my English was as fluent as it is required to practice in USA so I took a course recently and I feel I have improved a lot"
OR2- I feel sometimes I give attention to too much details and that kind of slows my over all performance but I try to prioritize my work now paying attention to most important to least important that helps me finish my task more productively".
TIPS-[What they want to know is what is your weak point and what you are doing to correct it.]
U-I believe medicine involves learning through out one's professional life and learning through my mistakes is what I believe in. Although I have not made any error that has caused any harm to any of my patients but I remember one incidence when I forgot to page my attending during my medicine rotation and tried to make decisions on my own. I was over enthusiastic when I was a medical student and had over confidence in my knowledge and ability. Never the less, I learnt through my error and now I realize that every procedure should have a structured protocol. In a hospital setting, documentation and proper relay of information through the chain of supervision is essential for proper patient care. I am glad I learnt it the hard way!!
PD-What is the greatest fear about practicing medicine?
U-My biggest fear in practicing Medicine is emotional attachment with my patients. As medical students we are taught persistently to be somewhat insensitive to make tough medical decisions. I come from a different culture. Our culture is based on emotions and sensitivity. I find it hard not to relate to my patient's pain and suffering. I feel this is my weakness and I must work on it to be a better physician in the real world."
PD-Biggest failures in life and what have you done to ensure that they won’t happen again?
U-Failures are small obstacles that help us move in the direction of our success. I have had many moments
when I didn’t achieve what I intended to do but I don’t regret those moments for once. For me, my biggest failure has been my inability to perform well on the USMLE exams. Having said that, if I look back at my life, I feel this failure has made me stronger and even more motivated to do everything possible to get decent USCE and work hard to overcome this obstacle.( I will mention my USCE in detail here). If I had not failed in getting good scores in the first step, I had not learnt the meaning of working hard for my goal that ultimately is to get into your program. I am not at all embarrassed or ashamed of my scores. I would rather like to look at where I am right now and what I have achieved after that."
PD-What were the major deficiencies in your medical school training? How would you plan to remedy this?
U-I have graduated from the top Medical school in my country. If you look through the rank list from my country, you can verify this information. I don't think my school had any deficiencies in their teaching or what so ever. The only difference might be the that it is not USA so the diseases prevalent in that part might be different. We were taught everything in English. To get myself familiar with the medical system in USA, I have done so and so(talk about your USCE). I find myself very confident about my medical knowledge and my USCE has overcome any deficiencies that I may have being a foreign medical graduate. (Remember your school is the best!!!!!)
U-I completely agree that there are certain periods when I was not doing anything significant in my professional life but I have an explanation for that and I am sure you are interested to know about that. (You explain whatever the reason was. A personal reason always works best. A family member's illness, change of location, health reasons). Try to be honest about this question because honesty here will bring substance to your answer. I have answered very honestly during my interviews" I didn’t get any opportunity but as soon as I got one, I grabbed it and now I am working at such and such hospital."
Q-Tell me about a time you didn't perform to your capabilities.
TIP-This question forces the candidate to describe a negative situation. Do so in the context of an early
career mistake based on inexperience; then demonstrate the better judgment you now have as a result of that learning experience.
A-[Ex]"The first time I had to give a presentation to our research team, I failed to anticipate some of their questions. I was unprepared for anything other than what I wanted to discuss. After that my research adviser and I brainstorm all the what-ifs in advance."
SIMPLE Qs to make you RELAX, BUT don't make a MESS, The BEST way to respond is in a short, friendly manner without going into too much detail.
1Q-Interviewer: How are you today? A-I'm fine, thank you. And you?
2Q-Did you have any trouble finding us? A-No, the office isn't too difficult to find.
3Q-Isn't this great weather we're having? A-Yes, it's wonderful. I love this time of year.
===============================================================Q- If you are asked a question that you do not know the answer to, how do you findthe answer?
TIP- Be prepared for this type of question by researching the program website (ex-links to protocols, “uptodate†websites) and other relevant materials granted you will not know all the answers but you �will have a pretty good idea about it. Remember previous hospitals where you practice may have had entirely different policies, protocols and procedures.
A [Ex]- I do spend time researching the program website and depending on how much materialthey have out there; I will have a pretty good idea and I would always go to my senior or faculty supervisor with any questions I may have.
Q-What color is your brain?
TIP-Be aware that you'll probably be asked zany questions. The point is not to stump you, but to find out what makes you tick. When the standard interview questions are asked, people are prepared, and it's harder for the interviewer to get to know the real person. There is no right or wrong answer to this type of question. In fact, the interviewer won't even really care what your answer is. The point is to see how fresh and creative
you are with current medical information and how you think and even your personality. Be sure to explain why you answered the way you did.
A [Ex]-My brain is red because I'm always hot. I'm always on fire with new and updated clinical information
Q-Was there a course that you found particularly challenging?
TIP-The interviewer will want to see how well you respond to difficult situations. Demonstrate that you won't fold in the face of difficulty, and that you're willing to put in the extra effort to meet a challenge.
A[Ex]-"Initially I was completely overwhelmed by the [any particular subject/course] that I took last year. No matter how hard I studied, I seemed to be getting nowhere. I got just above average for the first test. So I tried a new approach. Instead of just studying by myself, I asked a friend who's a [related to the particular subject/course] to help me with my studies. I also began to seek help from the professor after class. And I found that more time I spent [the new approach you had] was critical. I ended up with a A-plus in the last term course and thought I achieved a solid understanding of the material. More than that, I learned that tackling a new [particular subject/course] of study sometimes requires a new approach, not just hard work, and that the help of others can be crucial!
Q-Why didn't you participate more in extra-curricular activities?
TIP-The interviewer may be worried that if you don't have many outside interests, you may eventually suffer from burnout. Employers like candidates who are well rounded and have interests outside of work. If you didn't participate in formal extracurricular activities in college, you still may want to talk about some of your interests, such as reading or exercising, that you may have a passion for running even if you weren't on the college track team.
A [Ex]-I wanted to give as much effort as possible to my studies. I came from a high school in a very small town/your country, where I received a lot of A's/good grades, but this didn't prepare me well for higher studies/college. So I studied hard. I have, however, found time to explore the new things/city and make new friends, and I do socialize formally on the weekends.
C. THANK YOU LETTER & NOTES WITH TIPS*****************
Tips for Thank You Letters and Notes
It is important to say "thank you." In addition to being the right thing to do, every "thank you" is
an opportunity to sell your qualifications and leave a positive impression on the reader.
Send a thank you letter or note to employers, employment contacts and references whenever they have extended themselves.
The best approach, letter or note, will depend upon the circumstances, personal style and preference. The best strategy is to select the approach that best serves the immediate need. The thank you letter should follow a standard business letter format, while the note may be a simple, handwritten note or card. The situation and your personal style will determine which you send.
A written thank you letter or note should be sent after all interviews. This is your opportunity to make one more impression before the decision is made.
Points to Consider
1- Write a thank you letter or note no later than 24 hours after the interview.2- Be brief and to the point. Note the job you interviewed for, and also list the date of your interview.3- Always address a thank you letter to a person by name and title. If there are multiple people, such as a panel interview, send a separate thank you to each person. When sending more than one thank you letter, vary each letter. When thanking a potential employer, restate your interest in the position and the employer.4- Briefly include any pertinent information you failed to mention earlier. Be sure to reemphasize your most important qualifications and skills for the position, Try not to start consecutive sentences with the same word.5- Offer to provide more information if needed.6- Make it a point to tell the person when and how you will be following through.
Basic Parts of a Thank You Letter or Note
Statement of appreciationExpressions of interest in the positionBrief restatement of qualifications/skillsAn opportunity to add additional information you failed to mentionFinal "thank you"Following through
Interviewer's nameProgram nameAddressCity, State, Zip
Dear Dr [Interviewer's Last name],
Thank you very much for taking time out of your busy day to talk with me about the [title] position. I appreciated your hospitality and enjoyed meeting you and the members of your department, and I am excited about the chance to work with such a great team.
[Add a statement about the interview. Something that impressed you, or that you wish to clarify.]
A sample paragraph might include: Judging by our discussion earlier today, I believe that my prior experience in [type of experience], plus my training in [refer to training], will enable me to become a strong contributing member of your (name of team) team.The position is exactly what I'm looking for, and I'm confident that I can be a significant contributor to the success of [Program name]. I sincerely hope you agree.
Thanks again for interviewing me. If you have questions or concerns, please feel free to contact me. I look forward to hearing from you again.Sincerely,Your signature
Your NameAAMC-ID
D. HOW TO SELL YOURSELF IN MINUTES.
Use these verbs and adjectives and really sell yourself. By using this precise vocabulary and
being confident can help you make the BEST impression possible.
To describe your skills,
accurateactiveadaptableadeptbroad-mindedcompetentconscientiouscreativedependabledetermineddiplomaticdiscreet efficientenergeticenterprisingenthusiasticexperiencedfairfirm genuinehonestinnovativelogicalloyalmaturemethodicalmotivatedobjectiveoutgoingpersonablepleasantpositivepracticalproductivereliableresourcefulself disciplinedsense of humor
The most common reasons for programs to conduct a phone interview with prospective residents are:- To save time- To save money (specifically, travel expenses)- To pre-screen - To narrow down the search for potential face-to-face interviews
DIFFERENCE BETWEEN THE PHONE AND IN-PERSON?
-Method of communication.
Face-to-face communication consists of words, tone of voice, and body language. Phone communication consists only of the first two, so what you say and how you say it are most important. Your tone of voice should be enthusiastic and positive.
-Contact
One disadvantage of the phone interview is the loss of personal contact between you and theInterviewer- a vital part of selling yourself. Due to this loss of contact, you sacrifice all control over the interview because you are an ambiguous person on the phone.
-Cues
You are deprived of visual cues: Office environment, culture, and the interviewer’s attitude toward others. The opportunity to gather a sense of the program and the interviewer is lost. Keep in mind, however, that there are some advantages to the phone interview. Since the interviewer can only focus on what has been said (and how it was said), then he or she will listen to your verbal expressions more intently than in a face-to-face interview.
-Resources
The advantage of using any resources available while on the phone.
DOCUMENTS, IN FRONT OF YOUYou’ll almost certainly be asked about some of the information that appears on these documents. You might also want to have in front of you any supporting materials that relate to information in your CV and PS. You may want to email these documents to the interviewer after concluding if necessary.CHEAT SHEETMake a written assessment of your skills. Write down a few notes about the most critical points you want to make in your interview. USE HANDS-FREE PHONEThis isn’t the time to use a cell phone in spotty coverage that cuts in and out, or a cheaply made phone that makes it difficult for you and your interviewer to hear and understand each other. And please make sure your voicemail is professional because you never know when they might call.
GOAL-[The interviewer may ask himself or herself the following questions after the interview]• Did you have an enthusiastic voice?• Did you answer questions vaguely or directly?• Did you research the company well, or did you ask simple questions?• Did you express interest in a second interview?• Did you follow up with a thank-you letter?• Did you pursue this opportunity with a phone call or e-mail?• Did you send supporting material (resume, portfolio, etc.)?
DURING THE PHONE INTERVIEW
• Have a self-confident and enthusiastic voice• Smile as much as possible—the tone of a smile brings about enthusiasm• Speak succinctly so that you are not rambling• Keep the conversation going with prepared questions• Do not eat, smoke, or chew gum while on the phone• Speak directly into the phone so that you can be heard clearly• Do not take other calls while on the phone—try to turn off Call Waiting if you can• Sit in an upright position or stand while talking—your voice will sound stronger• Avoid nervous habits that will create noise• Do not interrupt the interviewer• Listen to what is said and asked and ask for clarification if needed
HOW TO END THE CONVERSATION
• Let the interviewer end the interview• Thank the interviewer for his/her time and reiterate your interest in the position• Find out what the next steps are so that you can follow-up appropriately• State that you would like to meet personally
FOLLOW UP
Send a thank you letter to the interviewer as soon as possible to show your appreciation and enthusiasm for the position. ==========================================================================
E. Some more interview questions and answers :
FIRST I WILL TACKLE THE MOST ASKED QUESTION:TELL ME ABOUT YRSELFchronological events in your life, with highlights on your strengths, is probably the best approach.
my sample answer
1. Tell me about yourself? What motivates you? Which three adjectives best describe you? Your strengths? Your qualities you are proud of?
a. SHORT ANSWER: Well, I am a hard worker with real interest in internal medicine. I love to apply things I have read to clinically relevant situations. That’s why I chose to come into medicine. I am from Nepal, and I came here to get the best possible training. I hope to specialize in nephrology after my residency, tho my preference might change with the experiences I gain during my residency
b. LONG ANSWER:
i. Well, I am a medical graduate from xxxxxx, a country in Asia. I graduated in 2008. Before graduation, I completed one year of compulsory rotatory internship in different departments of our hospital., including 3 months in internal medicine. During that period, I used to see patients independently in the outpatient clinic and the emergency room, admit patients under the supervision of seniors and take care of them in the floor, and perform different procedures like lumbar puncture and pleurocentesis under guidance from my seniors. I am a real hardworking and self motivated kind of person.
ii. I am also very efficient when working in a team. I worked as a team leader in a 3 month long residential outposting in a remote area of our country that we had to complete as a part of our public health curriculum. It was a good learning experience for me on how to work as a team.
iii. After graduation, I worked as a teaching assistant in a reputed medical university in xxxxxxx for one year. I used to teach pathophysiology to the undergraduate students. There I got to interact with people from different cultural backgrounds, from middle east to asia to Africa. It made me culturally competent- I can get along with people from different kind of cultures. I also developed deep interest in the teaching profession.
iv. After that, I prepared for my USMLE steps, and passed with good marks. After coming here, I worked as a volunteer in the Internal medicine department of xxxxxxxxxxxxxxxxxx for one and a half month. It helped me familiarize myself with the healthcare delivery system of the States, including doctor patient
relationship, patient privileges, informed consent, effective communication skills as well as giving me a glimpse of what residency in US would be like. I participated both in the outpatient clinic and the different activities in the floor including conferences and teaching learning sessions. I saw how the residents and the interns handle stress in a busy environment, which was quite inspiring. I think my experience over there will definitely help me work more efficiently as an intern in your program.
v. I have also co-authored a couple of books on medicine, and I was granted a research fund for an independent research proposal I submitted to the health research council of our country.
c. Considering all these, I think I can really be a good candidate for your program. I can bring all that experience to your program. If you would consider me capable enough for your program, then I will try to meet your expectations to the best of my ability.
d. Dedicated, thorough and hard working, (perfectionist, intelligent), can handle criticism well.
lets keep all our coming discussions in this thread- please dont ask questions in a new thread- i cant see them all. please stick to this thread if you have questions for me.
duloxetine - 10/25/09 20:32
2. What are your strength and weaknesses? How well do you take criticism. If you could change one thing about your personality, what would it be?
a. Strength: I am a hardworking and self motivated kind of person. I used to take care of patients independently in the OPD and ER of our hospitals. I am also very efficient when working in a team. I used to take care of patients under the supervision of my seniors in the floor of my hospital. I have also worked as a group leader in 2 research projects. I have a good grasp of pathophysiology of diseases, and the multisystem effects each disease can have. Teaching pathology in a reputed university of xxxxxxxx for one year really strenghthened my knowledge of pathophysiology. I have also worked with people from different cultural background, which has made me culturally competent.
b. Weakness:I cant stand people being shabby in their work. I try to do the best I can in any job, and I expect the same from others, so I really cant tolerate people who are casual, tho they might bring out the same results as me. (its better to avoid this hackneyed answer)
c. I used to be very critical of others. I can handle other people’s criticism, but I am also critical of people who are shabby and casual in their work, esp if we are on the same team.Probably that was because I always tried to judge people my way. But I have learnt to do better- I have learnt to be tolerant, to give people space, let them be. Afterall everybody has their own strong points and weak points.
d. I used to be very intolerant with patients who don’t comply with the treatment. But lately I have realized that there is always a reason behind their noncompliance, and that it is as much my responsibility to ensure compliance as is theirs, perhaps even more on my part.
e. I have to finish all my work before I take a rest. I cant relax with jobs pending, but I guess I will have to develop that habit.
duloxetine - 10/25/09 20:33
5. Why did you choose to be a physician
a. I had been a very good student throughout my childhood. I thought medicine would be intellectually challenging. So I got into the top medical school of my country after a very competitive entrance examination. Plus the satisfaction that comes with solving people’s problem is priceless. Also you get a good respectful life in return of all the hardships you endure, which is a fair compensation I think. During the first 2 years of medical school, my inquisitiveness about the human body kept me going. But after entering clinicals, then this profession really pulled me in. There is nothing that beats the charm of a clinical career.
duloxetine - 10/25/09 20:34
Why do you want to go into this speciality? Why did you choose internal medicine?
Well I have always liked the fact that internal medicine is an intellectual subject. We get to use our brain, solve the clinical complexities arising from multiple multisystem diseases and multiple medications, get to manage the patient as a whole and coordinate care with other specialities. Ever since I entered the third year clinical posting, internal medicine has always fascinated me. It’s a thinker’s job. Plus I have a good grasp of pathophysiology and I think this is the field that I can excel in. Plus internists can specialize in a wide range of subspecialties/ opens door to a wide range of possibilities, including hem/onc that I am particularly interested in. That’s because there are very few hemonc in our country, and I thought I should specialize in hemonc from a reputed state of the art hospital. That’s why I have come to this country to do my residency. During my internship in medical school, I worked for 3 months in internal medicine department. There I realized that this is what I should get into. I used to independently see patients in the OPD, ER and the GMF. Also while I was volunteering in xxxxxxxx internal medicine department, my interest was further bolstered/ strengthened. I cant think myself as doing anything else.
WHY ARE YOU HERE FOR RESIDENCY AFTER COMPLETING RESIDENCY IN YOUR OWN COUNTRY ?
I was so interested in IM that i immediately joined MD in my home country after completing my medical school. I thoroughly enjoyed my residency, the teaching learning process, and taking care of the patients. But after residency it was quite a dead end for me, due to lack of much opportunity for specialisation. i have a keen interest in nephrology (or rheum or whatever), especially because there are not many nephrology specialists in my home town. So i decided to go abroad for specialisation. And what better country to choose than US for my education. Also the working environment in the US hospitals, the level of patient care, the cutting edge technologies, the evidence based practice of medicine, the academic activities in the programs over here, I want to be a part of all these and develop myself into a fine tuned doctor, so that i can be the best at what i do. Where I work is not as important to me as how i work. And i want to be good at whatever i do. I have always been ambitious since my childhood, and i dont want to feel like i am left out on the best training available in the world. that's why i have taken so much trouble to come here. Its a very difficult transition for me, but i think it is worth it.
Also though the latest drugs and technologies were available where i studied, they werent available that widely in other places that i had to work. Plus there were other factors including affordability that always restricted the ideal practice of evidence based medicine in my country. And the lack of proper specialists adept in using cutting edge treatments like biologicals also compounded the problem. So i want to experience how medicine is practiced in the west. This will help me grow as an individual, and as a doctor too.
duloxetine - 10/25/09 20:37
15. How would you change the health care delivery system of the country?
a. Well it’s a huge subject, and I am not qualified enough to actually try and change it. But according to my limited opinion, universal healthcare covering basic services to all people regardless of their ability to pay should be implemented, something like the NHS of UK.
b. There should be an attempt to decrease the rising healthcare cost, which is almost 3-4 times more than in other countries. For that we should cut down on unnecessary investigations, which in turn can only be brought about if we can decrease the physician’s risk of litigation. Defensive medicine that we practice in the US is quite costly. We should be more focused on providing efficient and affordable healthcare to all, rather than trying to defend ourself with unnecessary investigations.
c. Medicines are also very costly due to patent rights and monopoly on market. This should be taken care of, and government should place a limit to the price hike in the pharmaceutical industry.
d. Overhead expenses have to be cut down- maybe having a single payer health system will help cut the overhead cost incurred by multiple insurance and health management organizations.
duloxetine - 10/25/09 21:21
WHAT TO ASK THE FACULTY
1. What is the program’s educational philosophy ? I wanted to know What are you looking for in an ideal candidate for this program?2. How have your graduates done on speciality board exams3. Is there much faculty turnover. Is any current staff leaving in the near future ?4. How is the faculty resident relationships5. Are there non clinical responsibilities like research, projects, writing and administration ?6. Is this program particularly well known in any special areas ?7. What are the types of clinical sites used? VA, public, private,, 8. What kind of patient population will I encounter ?9. Are there elective opportunities- I was wanting to know if there were any elective opportunities?10. Are there research opportunities ? what research projects are the department’s faculty and residents working on currently? Are there facilities, funding, time and support staff and statisticians for the job? Can we take time off? Can we take time for speciality’s national meetings ?11. Are administrative, bioethics and legal training available ? 12. Is there any mentor/advisor system ? 13. What types of resident evaluations system are used. How often.14. There is no problem with the program’s accreditation, is there?15. Have any housestaff left the program without graduating, or have transferred to another hospital? Why?16. Where are your graduates currently working? Fellowships? Academic centers, private practice, group practice, research or in administration ?
duloxetine - 10/25/09 21:23
QUESTIONS TO ASK THE RESIDENTS1. What is the housestaff officer's general opinion of the program?2. Is there a medical library close to the hospital and does it contain an adequate selection of recent books and journals?3. Is there an adequate visiting professor program with other institutions?4. How valuable are the conferences?5. Are chart rounds conducted routinely?6. What is the average number of patients for which each house officer is responsible?7. Does the housestaff receive adequate clinical experience performing procedures? Who teaches these procedures?8. What is the clinic schedule? Is there a continuity clinic?9. Is an attending physician present during each clinic?10. What does the housestaff officer think of the chair? What is the chair's background and reputation? Is the chair sincerely interested in teaching housestaff? Is the chair readily accessible to the housestaff?11. Are emergency services readily available?12. Do all wards of the institution have cardiac arrest charts and EKG machines?13. Is a radiologist available 24 hours for consultation?14. Does the hospital provide IV and blood drawing teams? Are lab results computerized?15. When do rounds begin in the morning and at what time does the normal day end?16. What is the on-call schedule? Does it change during the senior or chief year?17. Is moonlighting permitted and is it available in the community?18. Are meals provided free or at a discount for housestaff? Is there an evening meal? Is food available/provided at all hours?19. Is parking provided? If so, where?20. Are uniforms and laundry free of charge to the residents?21. Is there adequate malpractice and disability insurance, including HIV disability insurance? Does the hospital provide health and life insurance?22. What is the availability of housing and its average cost? Where do most staff live? If many staff people commute, what is the average commute time? Should there be a concern for safety in some areas?23. Is there a housestaff association and what is its relationship with the administration?
24. What are the climate and general living conditions in the community?25. What is the general atmosphere of the hospital? Is it a pleasant place to work?26. What is the housestaff officer's opinion of programs at various institutions?27. Is the stipend good enough for living in that community ?28. Does the program stick to Residency Review Committee's (RRC) regulations about to sticking to 80-hour work limits for residents ?
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duloxetine - 10/25/09 21:28
91. What is your stand on abortion and cloning?
a. Well abortion can be for medical reason, or as a personal choice. All agree that abortion for a medical reason is not to be questioned. As for abortion as a personal choice, there is no easy answer. On one hand a woman should have complete authority over her body and what to do with it, and should be able to discontinue her pregnancy if she so wishes, on the other hand terminating a perfectly viable and normal pregnancy sounds unethical. There’s no easy answer. Still I think the mother should be given complete authority to make the decision about her fetus.
b. There are different kinds of cloning. Therapeutic cloning in stem cell research by way of somatic cell nucleus transfer (SCNT) is well accepted, and shouldn’t be opposed by anybody, as stem cell research holds great promise in treating diseases as far and wide as DM to MS to phenylketonuria. Reproductive cloning, on the other hand, is again successfully done for sheep to camel to Labradors and particular breeds of horse, and I don’t see any reason to object on that. Cloning extinct and endangered species might be a good idea too. But cloning human beings is probably too dangerous, as it raises a question on the genetic identity of the individual itself. Its like the nightmare envisioned in Aldous Huxley’s Brave New world.
duloxetine - 10/26/09 09:41
PRESENT AN INTERESTING CASEGive the setting- where was the patient, ER, OPD, GMF ?then state what he presented with, what you thought is going on, but how you were wrong, or how it turned out to be something else, what you thought would be the course, but what unexpected happened, and what you learnt from the case.Eg, When i was in general medical floor, there was a patient we admitted with the suspicion of SLE- she was a young woman in her thirties with ............................................but it turned out to be.....................................she started deteriorating with the medicine.......................................finally......................................
duloxetine - 10/26/09 09:45
What do you think are the draw backs in medical system in USA from your perspective"?
I have come from a different system. I have seen some amazing advancements in US medical system. I am very impressed by the quality of research that is being done here in different field. US has a diverse patient population, now that number of immigrants is constantly increasing. Physicians here have a broader range of experience. The only draw back that I see in the system is lack of health care for all and very high health care cost which cannot be afforded by many. Many people file for bankruptcy due to their illness. I think we as physicians have very limited privileges to help the entire community from all socio economic levels.
PS- PLEASE DONT MUG THESE ANSWERS AND SAY THE SAME THING- i am only showing you how to answer, please dont take this word for word. I also have to get in somewhere, guys. I actually fear that people will start repeating the same thing, and make it hard for me.
duloxetine - 10/26/09 09:48
QUESTION : What if you don’t match?
a. I wont give up. I Will still try for same speciality next year, and will do some volunteering, externship and research in the meantime. Medicine is the dream of my life, and I wouldn’t leave that for anything.
77. What would you do if the housestaff have a job action, aka a strike?a. Depends on if the issue directly concerns me or not- if it does, then I would have to show solidarity/unity by joining the job action; if it doesn’t then I wouldn’t waste my time, I will just go on working.
this is the most honest answer
teach me sth in 5 min- teach him how to cook a dish -you can say anything, nobody will cook it anyway :) tell him how to open a beer bottle with another beer bottle. anything that you know.
#1929977 duloxetine - 10/26/09 09:49
What might give me a better picture of you than I can get from your resume?
tell him- i guess working with me is going to give you a better picture. .lol. no seriously, there is no other answer to that.
How do you feel to start as an intern ?
tell him how the rotatory internship back home is different than the internship of residency over here. so there is no question of any 'pinch' effect.
how do you keep yrself updated?
Easy answer- name some journals (and that's why you should make a habit of regularly reading atleast one journal, preferably JAMA or NEJM- most of their content is available free.)
Have you applied to other specialities ?
That's a yes/no question, and i dont believe in lying. But justify why you did that. Many PD do understand. Even AMGs do that, so dont worry.
you can draw a parrallel among FM/IM and peds, they are almost the same thing. Say you have a good grasp of pathophysiology, and you are more of a thinker, say you never really felt like surgery related field was yr cup of tea, and anything apart from that has always interested you.
duloxetine - 10/26/09 09:50
WHAT IS YOUR LEARNING STYLE
learning style- first i prioritise what to read, i get together good resources, then i scour the material once for a general overview, after that i highlight important points as i read again, and then make a shorthand note of the important points to make it easy to revise again.
when it comes to learning skills, i first learn by watching, then i practice the skill in a dummy if its a procedure or on a normal person, like a friend, if it is a clinical skill, then after a couple of trials with dummy, i give it a try under the supervision of somebody who is adept in the procedure.
Supervised autonomy and self directed learning are the core of my learning technique
60. How do you make decisions. Are you a risk taker? What was the most difficult decision you had to take in your life.a. I take very calculated decisions. I m not much of a risk taker. Probably the most difficult decision was whether to stay in my country or come to US for my further studies. My own country, is afterall, my own. But there were so less opportunities for further studies, and no any opportunity for superspecialisation that I decided to come here.
What kind of patient do you have trouble dealing with.a. Yes there are certain personality types that are difficult to handle, especially patient who don’t respect the rush we are working in and always want everything to be done then and there, have a lot of time pressure, and don’t realize there are other patients under our care too.b. but I try to act professionally with all of them, and put extra effort to make them comfortable- after all I understand everybody becomes selfish and stubborn when they are sick- its like a defense mechanism.
How do you normally handle conflict? How do you handle disagreements with colleagues or attending. How do you handle criticism.a. I don’t have problem handling criticism these days, because many criticisms can be constructive. I state whatever is in my mind, and then say I will think about it. That’s it.
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duloxetine - 11/20/09 20:01
i was asked- what difference do you see between the health care delivery between your country and the States.
this is what i said, more or less.
a. In our part, the motto is doing the greatest good to the greatest no of people. Hospitals and ER are very crowded and stressful, so are the floors. So pt rarely gets individual attention from the doctors. Here, patients are cared for individually by doctors, which is nice.
b. Definitely we are low tech in our part of the world, no interventional radiology, no fancy drugs like imatinib and rituximab. Only drugs which are being used for a long time are available, and we have to make do with them. No new investigative technologies like MUGA or PET scanning, ie no any radionuclide imaging.
c. Even those treatment and investigations available cannot be afforded by many, so we have to rely on our clinical judgement more than anything.
d. The doctor to patient ratio is very low, workload is high. e. We don’t have electronic record keeping system, and no way of coordinating care between 2 centers. f. We have less fear of litigation in our part, so doctors don’t practice defensive medicine like here. In our part, whatever doctors say is the ultimate, patients don’t question that. That’s one of the reason healthcare is very cheap in our part of the world.g. The education level of general public is also not enough for patients to be proactive for themselves, so doctors have to decide on the best course of treatment most of the time. h. There is mostly no concept of healthcare insurance, so patients all pay their own bills, but the good part is that the cost of treatment, atleast in public hospitals, are very low and significantly subsidized by the government.
duloxetine - 11/20/09 20:06
i was asked 'what do you think the most difficult part of internship would be for you in this country ?'
answer:
one thing that would be difficult for me in the beginning would be to give complete autonomy to the patient regarding their healthcare. in our part, the literacy rate isnt that good, so we could rarely take informed consent, no matter how hard we tried to explain the facts. so we had to make many decisions in the best interest of the patients. here, patients are quite educated and can make their own decisions. i would have to learn to give complete autonomy to them even in the smallest things concerning their healthcare
another answer
Toughest aspect will probably be doing the right thing, and keeping abreast of all the developments in the EBM that is changing the way we practice medicine day by day. Keeping track of new recommendations, like PPI improving COPD patients, and those unrelated and seemingly weird things, that is quite a challenge for a clinician. The standards and the recommendations keep on changing, and to be at the top of my game is really a challenge for us all.
#1956498
belibi - 11/20/09 23:56
Most difficult part of the internship is almost equivalent to the question what do you think are going to be the challenges you are going to encounter during internship:
You can add things like:1. Difficulty in balancing your private life with your professional life2. Difficulty in having to study to advance your knowledge while fulfilling your intern duty in a very busy year3. Difficulty in handling difficult and aggressive patients4. Difficulty in dealing with nurses who do not agree with your plan of care or fellow residents who might disagree with you.5. Difficulty in adjusting with a new culture, a new system which you guys touched on in your answer.
One of the keys in answering this question is to let the interviewer know that you believe you will overcome those difficulties given that you have been confronted to such difficulties in the past. Let them know that you have done clinical work on the US and that has given you the opportunity to be better prepared to deal with upcoming difficulties.
Dr. Belibi
duloxetine - 11/22/09 13:07
HOW TO ANSWER:
WHY DON’T YOU HAVE USCE ??
Ever before i came here, i tried contacting different hospitals for observership. I emailed almost 500 people in 300 different hospitals around US for an opportunity to get some USCE, but none
of them responded. some who did, wanted money. Coming from a place where my mind is my only asset, i was not in a position to pay 500 dollars a week for USCE.
If you scour the websites of different hospitals, you will hardly see any one which says they offer observership. We are not allowed by our medical school to go for externship in our school days, nor we have the resources for that.
when i started looking for the criteria during application, every website of hospitals would say '' we dont provide observerships'', and down below they would state'' we prefer US clinical experience.'' That's the hypocrisy we have to deal with.
that's why, inspite of my deepest desire, i couldnt get a chance to gain some USCE.
If you could provide me with an opportunity to gain some USCE in your hospital before i start my residency, i would be more than happy to commit ,myself. ""
if you say this much, nobody will ask you another word about USCE.f they ask why others have, tell them that's because many have connections, but i dont have, many people do unpaid research for 1 year just to get USCE, which is very difficult for me to do due to my financial background. but i am equally qualified for residency, just give me a chance, i am even willing to do an observership before my residency starts so that i can be efficient.
#1957386 duloxetine - 11/22/09 13:07
WHAT IS YOUR LEARNING STYLE
learning style- first i prioritise what to read, i get together good resources, then i scour the material once for a general overview, after that i highlight important points as i read again, and then make a shorthand note of the important points to make it easy to revise again.
when it comes to learning skills, i first learn by watching, then i practice the skill in a dummy if its a procedure or on a normal person, like a friend, if it is a clinical skill, then after a couple of trials with dummy, i give it a try under the supervision of somebody who is adept in the procedure.
Supervised autonomy and self directed learning are the core of my learning technique
* Re:INTERVIEW questions#1957389
duloxetine - 11/22/09 13:11 WHAT MIGHT GIVE ME A BETTER PICTURE OF YOU THAN WHAT I GET FROM YOUR CV?
tell him- i guess working with me is going to give you a better picture. .lol. no seriously, there is no other answer to that.
HOW DO YOU FEEL TO AGAIN START AS AN INTERN ?
tell him how the rotatory internship back home is different than the internship of residency over here. How that made you into a better clinician, and how that bolstered your interest in medicine or pediatrics or whathaveyou.
HOW DO YOU KEEP YOURSELF UPDATED?
Easy answer- name some journals (and that's why you should make a habit of regularly reading atleast one journal, preferably JAMA or NEJM- most of their content is available free.)
HAVE YOU APPLIED IN OTHER SPECIALITIES?
That's a yes/no question, and i dont believe in lying. But justify why you did that. Many PD do understand. Even AMGs do that, so dont worry.
you can draw a parrallel among FM/IM and peds, they are almost the same thing. Say you have a good grasp of pathophysiology, and you are more of a thinker, say you never really felt like surgery related field was yr cup of tea, and anything apart from that has always interested you.
duloxetine - 11/22/09 13:16
WHY H1 VISA?
Because I not only want to train here, but also get valuable work experience in a high-opportunity setting of my choice after all the residency and fellowship training. J1 will restrict my choices to low-opportunity primary care areas on the waiver job lists"
IMGs should probably NOT talk on this going-back issue unless specifically asked ..even when program directors ask the question: "where do you see yourself in 10 years" - stick to professional goals..unless very sure of heading back or if you do not mind the J1 visa
#1957402
duloxetine - 11/22/09 13:17
FROM ANOTHER WEBSITE
WHY AMERICA AND NOT YOUR OWN COUNTRY ?If it were an IMG Program Director asking you that question - your first instinct might be to blurt out : "Look Who's talking" or "If that was an issue, why invite me for an Interview" - hehe....but you gotta tone down and give an indisputable answer.
You surely want to avoid any political or personal angles that your interview might take and handling the question diplomatically will only do you good.Here are some things Non-American IMGs could use:
1. America is considered to be the highest seat of medical education in the world with the best faculty, educational facilities, technology and research opportunities.I wish to take advantage of this opportunity, learn the way medicine is done here, gain experience for some years after that and then take back what I learn back to my home country to set up a private practice, hospital, clinic. etc.
2. My country currently does not provide competent education in the specialty that I plan to pursue after this residency.
3. If asked - "But People need you back there in your home country" - you could say something like: "Yes - I am aware of that and that remains one of the most pressing reasons driving me to secure the best medical education in the world that I can achieve".
In light of the above questions, if asked 'So will you be getting back to your country ?' - I don't feel there is anything wrong in suggesting that you will, unless there are some valid political reasons like political refuge.
"Yes - after I have served in this country for a few years and put on good experience feathers on my cap, I plan to head back home to establish myself as a physician with advanced training and experience"
In all probability you might never encounter this question!
Some of you may debate that it may not be right to commit anything - but I say - when You say you will head back, it's not a legal commitment you are making. The program director is not
going to keep track of you. You are just sounding politically correct without blowing off too much steam.
duloxetine - 11/22/09 13:20
WHAT WOULD YOU DO IF YOU FIND YOUR FRIEND IS USING DRUGS/ALCOHOL
For answering this, let us cite an article by Dr. Stephen Ross posted on American Medical Association, which says:
"If a colleague is concerned that a physician has an SUD, AKA substance use disorder that is impairing his or her functioning, it is that colleague’s ethical duty to act immediately to intervene. The best approach is usually to contact a Physicians Health Program (PHP), rather than the state medical board, and to report the suspected addicted physician."So How about first Confronting and confirming from the Physician himself before taking it to the authorities ?
"Contacting a PHP can be done anonymously and is usually better than trying to confront the individual directly since most addicted physicians have high levels of denial and are usually not receptive to interventions from colleagues."Hmmm..
Note that PHP does not punish the physician, rather works with the physician to resolve the issue while allowing the physician to keep practice license. Punitive actions, license revoking, etc. after reporting the physician to the State Medical Board were the old days, the new ideology is to treat the physician for his ailment rather than punish him/her for it. Why not ? When addicted, the person is unable to control him/herself to abstain from it ..and that exactly is the ailment - and punish for a disease ?
Interestingly, the highest incidences of Substance abuse amongst physicians are seen amongst the Anesthesiologists and Emergency MedicineSince many IMGs wrote about being asked this question on the Residency interviews in primary care specialties Family Medicine and Internal medicine, it is apt to discuss this here. Besides its good for IMGs to know what mess are they getting into ;-) LOL
duloxetine - 11/22/09 13:21
from another website
TELL ME ABOUT YOUR WEAKNESS
1. "I have rather found myself impatient when it comes to teaching others - especially junior medical students. However I realize that teaching is an excellent way to reinforce my own memory. I now look for opportunities to teach as and when possible, the latest opportunity I had was when I held a rapid midnight tutorial on managing diabetic ketoacidosis for medical students who accompanied me while on call. I hope I will have ample teaching chances at your program"
2. "I usually find myself nervous and anxious while talking to a large group of people. But I have realized that sharing information on conferences is how doctors and researchers advance the science of medicine. It is an important skill to have and I have been taking every opportunity to make presentations in class, conferences, observerships. etc. I think I am getting better and more comfortable :-)"
3. "I have had a problem being organized when there are too many deadlines to meet, so I have been using my iPhone / PDA / written memos / to-do lists to keep myself on top of things...which has surely made me a better performer"A more mature and sincere reply might be "I am short-tempered when stressed, and now I exercise during my lunch hour to reduce my stress and control my emotions." Albeit, this is more risky, but also more interesting and insightful than the watered-down version
4. "I have not been able to focus my academic interests on any single medical area, I find too
many areas fascinating, which I think is a weakness that can potentially keep me from being an effective contributor. This has made me a little reluctant to decide on one choice of a specialty, though I do know that i like being in a research environment and would like to do a dedicated fellowship"
1. One terribly cliched answer that you should stay away from = "I am a workaholic...causes an imbalance in my personal life". Someday I might get to be faculty and interview the hell out of you fellas and if I hear this 'workaholic' reply, I am gonna give you the most sarcastic grin you ever saw and say - Oh Really !
duloxetine - 11/22/09 13:21
from another site again
Why internal medicine ??Internal Medicine physicians are considered and like to be considered as intellectuals, the thinkers, the problem solvers or the debunkers of clinical complexity They like to have the time to meditate on the patients problems and not be rushed over all the time - which is quiet the opposite of the Emergency medicine personality.
"What I really ended up enjoying most about internal medicine was that it required a strong grasp of pathophysiology. Granted, every field requires a certain mastery of pathophysiology, but I felt that internal medicine was the most intellectually demanding in this respect, whether you're caring for a patient with heart failure, renal insufficiency, or portal hypertension. Additionally, internal medicine is a particularly academic field and the amount of teaching and the level of discussion that occurs during the course of a typical day were very appealing to me. Finally, as much as I enjoyed my surgery rotation, I'd rather spend the majority of my day with patients who are not under general anesthesia. There is a huge variety of very different pathways you can take within internal medicine- from interventional cardiology to primary care"
- "I derive most of my pleasure in medicine from my interactions with patients in the clinic setting. I have never really felt at home in busy hospitals or Intensive Care Units, and I definitely am not called to the surgical side of the profession."- "I chose internal medicine because I liked the clinical complexity. I like the patient with five medical problems and 15 medications to figure out. I like the psychosocial complexity of trying to figure out the interaction between the disease and the underlying psychosocial issues. I like the complexity of trying to figure out how to manage patients in the in-patient and get them back to the out-patient and back to the in-patient, and make all that smooth without error"
- "I chose internal medicine for a variety of reasons. I feel that one of the distinguishing characteristics of internal medicine as a discipline is its breadth and versatility. Internists combine the attributes of a caring clinician, master diagnostician, expert in a variety of procedures, and medical consultant to other specialties. The scope of practice involves treating patients in the clinic, hospital ward, intensive care unit, in a hospice, and in a patient's own home or a nursing home. I enjoy seeing patients in these practice settings. Long-term relationships with patients are also a core feature of practice that I likewise find very rewarding"
duloxetine - 11/22/09 13:27
WHAT ARE THE POSITIVE AND NEGATIVE ASPECTS OF THIS SPECIALITY ?
a. The positive point, especially of primary care, is that we can manage the patient as a whole, with help from other specialties. We are in charge of everything that is going on in our patient, and we have to coordinate with different specialties. This is a very appealing prospect of medicine. Plus if we ever decide to specialize, there are a vast majority of subjects we can choose from, from interventional cardiology to interventional nephrology. We get to sit down and think and not rush around all the time like in Emergency medicine or surgery, which is why this specialty interests me so much.
b. The negative aspect is probably the multiple subspecialties that this specialty is divided into. Superspecialisation is like a double edged sword. On one hand, it makes us good in a particular field, but on the other hand it takes us farther away from the patient. It makes us into mechanistic beings who are taking care of one aspect of the patient or the other, without any regard for the total well being of the patient. But I guess that is what the primary care physicians are there for. …..
c. We have a busy and stressful life, with limited time for personal and family life, compared to say radiologists, pathologists or dermatologists. But I guess if we can manage our time well, we can have a pretty decent personal life. And I am ready to sacrifice a part of my personal life for the sake of a clinical career. Clinics is just too addicting to leave.
duloxetine - 11/22/09 13:28
WHY DO YOU THINK YOU CAN BE A PRODUCTIVE MEMBER OF OUR RESIDENCY PROGRAM
sample answer from another website by mikeMD so something.
I can bring a hard working, honest and dedicated resident to your program who does not shy away from his responsibilities. I get along well with everyone and as a resident I have the ability to work in a team as well as on my own. I am obsessed about learning new things every moment of my life through books and my surroundings. I have a very sharp observation and that helps me make tough medical decisions if I have to. Your program has certain strengths that perfectly match with my qualifications. As it is a busy residency program with high patient load, my back ground in Medicine will help me fit in very quickly without much time needed for training. I have been living in US for a while and I am familiar with ethics and dynamics of medical practices here. Geographically your program is an area with a diverse population. I am sure you have a very competitive pool of applicants, but based on my background and qualifications, I am sure I will be a very productive member of your staff.
#1957427 duloxetine - 11/22/09 13:33
WHY IS MEDICINE CALLED AN ART, AND A PRACTICE ??
a. Medicine is a science, but there is more to it than that. Unlike other sciences, where the subject under study always behave the same under similar circumstances, humans don’t. Patients with same disease can have such different presentation and natural course of illness that nothing can be predicted in medicine. A single presentation can be a result of many diseases, and vice versa. So the clinical judgement of a physician is very important. No matter how sound our knowledge are, humans cant be tested in a lab, or be expected to operate along certain principles. That’s why it needs a human to fix a human, and that’s why medicine is an art rather than science. Physicians practice this art, that’s why it’s a practice.
duloxetine - 11/22/09 13:34
WHAT QUALITIES ARE YOU LOOKING FOR IN A PROGRAM ?
a. Good teaching learning activity and moderate workload (don’t say this in
BarnabasïŠ)�b. Moderate level of stress, helpful ancillary staff, close contact and supervision from the attending, ie supervised autonomy.c. opportunity for direct patient care, supervised autonomy, self directed learning and friendly working atmosphere
duloxetine - 11/22/09 13:39
MOTHER OF ALL QUESTION: TELL ME ABOUT YOURSELF
i am postin this answer from a thread that i had posted previously.
Well, I am a medical graduate from xxxxxx, a country in Asia. I graduated in 2008. Before graduation, I completed one year of compulsory rotatory internship in different departments of our hospital., including 3 months in internal medicine. During that period, I used to see patients independently in the outpatient clinic and the emergency room, admit patients under the supervision of seniors and take care of them in the floor, and perform different procedures like lumbar puncture and pleurocentesis under guidance from my seniors. I am a real hardworking and self motivated kind of person.
ii. I am also very efficient when working in a team. I worked as a team leader in a 3 month long residential outposting in a remote area of our country that we had to complete as a part of our public health curriculum. It was a good learning experience for me on how to work as a team.
iii. After graduation, I worked as a teaching assistant in a reputed medical university in xxxxxxx for one year. I used to teach pathophysiology to the undergraduate students. There I got to interact with people from different cultural backgrounds, from middle east to asia to Africa. It made me culturally competent- I can get along with people from different kind of cultures. I also developed deep interest in the teaching profession.
iv. After that, I prepared for my USMLE steps, and passed with good marks. After coming here, I worked as a volunteer in the Internal medicine department of xxxxxxxxxxxxxxxxxx for one and a half month. It helped me familiarize myself with the healthcare delivery system of the States, including doctor patient relationship, patient privileges, informed consent, effective communication skills as well as giving me a glimpse of what residency in US would be like. I participated both in the outpatient clinic and the different activities in the floor including conferences and teaching learning sessions. I saw how the residents and the interns handle stress in a busy environment, which was quite inspiring. I think my experience over there will definitely help me work more efficiently as an intern in your program.
v. I have also co-authored a couple of books on medicine, and I was granted a research fund for an independent research proposal I submitted to the health research council of our country.
c. Considering all these, I think I can really be a good candidate for your program. I can bring all that experience to your program. If you would consider me capable enough for your program, then I will try to meet your expectations to the best of my ability.
d. Dedicated, thorough and hard working, (perfectionist, intelligent), can handle criticism well.
duloxetine - 11/22/09 13:40
WHAT ARE YOUR STRENGTH AND WEAKNESSES ?
Strength: I am a hardworking and self motivated kind of person. I used to take care of patients independently in the OPD and ER of our hospitals. I am also very efficient when working in a team. I used to take care of patients under the supervision of my seniors in the floor of my hospital. I have also worked as a group leader in 2 research projects. I
have a good grasp of pathophysiology of diseases, and the multisystem effects each disease can have. Teaching pathology in a reputed university of xxxxxxxx for one year really strenghthened my knowledge of pathophysiology. I have also worked with people from different cultural background, which has made me culturally competent.
b. Weakness:I cant stand people being shabby in their work. I try to do the best I can in any job, and I expect the same from others, so I really cant tolerate people who are casual, tho they might bring out the same results as me. (its better to avoid this hackneyed answer)
c. I used to be very critical of others. I can handle other people’s criticism, but I am also critical of people who are shabby and casual in their work, esp if we are on the same team.Probably that was because I always tried to judge people my way. But I have learnt to do better- I have learnt to be tolerant, to give people space, let them be. Afterall everybody has their own strong points and weak points.
d. I used to be very intolerant with patients who don’t comply with the treatment. But lately I have realized that there is always a reason behind their noncompliance, and that it is as much my responsibility to ensure compliance as is theirs, perhaps even more on my part.
e. I have to finish all my work before I take a rest. I cant relax with jobs pending, but I guess I will have to develop that habit.
duloxetine - 11/22/09 13:41
WHY INTERNAL MEDICINE ?
Well I have always liked the fact that internal medicine is an intellectual subject. We get to use our brain, solve the clinical complexities arising from multiple multisystem diseases and multiple medications, get to manage the patient as a whole and coordinate care with other specialities. Ever since I entered the third year clinical posting, internal medicine has always fascinated me. It’s a thinker’s job. Plus I have a good grasp of pathophysiology and I think this is the field that I can excel in. Plus internists can specialize in a wide range of subspecialties/ opens door to a wide range of possibilities, including hem/onc that I am particularly interested in. That’s because there are very few hemonc in our country, and I thought I should specialize in hemonc from a reputed state of the art hospital. That’s why I have come to this country to do my residency. During my internship in medical school, I worked for 3 months in internal medicine department. There I realized that this is what I should get into. I used to independently see patients in the OPD, ER and the GMF. Also while I was volunteering in xxxxxxxx internal medicine department, my interest was further bolstered/ strengthened. I cant think myself as doing anything else.
WHAT PROBLEM WILL THIS SPECIALTY FACE IN THE NEXT 10 YRS TO COME ?
duloxetine - 11/22/09 13:49
DESCRIBE THE WORST ATTENDING YOU HAVE EVER WORKED WITH ?
b. Worst attending was when I worked in internal medicine itself. He used to come late, didn’t attend the morning reports he was supposed to attend and give feedback to the residents, never did his rounds on time( we had to wait for him to come and start the round), the patients rarely saw him, he was very arrogant and abusive towards both the patients and the residents and medical students. He had a private practice, and always used to leave early for his private practice without any consideration for his patients in the hospital. He even used to refer his hospital patients to his private clinic, in front of us. He was the incarnation/ personification of what a clinician shouldn’t be like. I used to say to myself this is how I should never be.
duloxetine - 11/22/09 13:50
WHAT KIND OF PATIENTS DO YOU HAVE TROUBLE DEALING WITH ?
a. Yes there are certain personality types that are difficult to handle, especially patient who don’t respect the rush we are working in and always want everything to be done then and there, have a lot of time pressure, and don’t realize there are other patients under our care too.b. but I try to act professionally with all of them, and put extra effort to make them comfortable- after all I understand everybody becomes selfish and stubborn when they are sick- its like a defense mechanism.
duloxetine - 11/22/09 13:51
WHAT IS YOUR ENERGY LEVEL LIKE ? HOW DO YOU HANDLE STRESS ? HOW DO YOU HANDLE DEATH ?
a. Well when I was in medical school, there were too many patients, not enough physicians. So a single firm would have to see almost 30-40 patients, and we had to stand for 3-4 hours in the round, and another 4-5 hours taking care of inpatients, then we had to do nightfloats which would start at 6 and end at 5 pm the next day, almost 36 hours. I have survived that, so I feel like I will survive residency. On top of that, we don’t have crazy work hours like that in the US, atleast here, coz I have heard that this hospital strictly abides by ACGME rules. Working some extra hours a day is really not a problem for me, but very taxing schedule like in some NY programs- its really very difficult to handle. People here know that residents function poorly if they are sleep deprived. So infact I would be very comfortable working here.
a. I have worked for one and a half month in ER of our hospital in my final medical year. It was one of the most crowded, most stressful ER I have ever seen. Lack of adequate ancillary staff compounded the problem even more. We had to handle multiple patients at once, send the bloodworks ourself, open the lines ourself, insert Foleys and NG, do blind LP because there were no USG guided procedures in our hospital. So it was pretty stressful.
b. I have been though a lot of deaths in my ER postings. Initially it made me feel kinda queasy, but I got used to it later on. We start feeling mechanistic after a point, as if the human body is just the heartbeat seen on the monitor, and if we cant revive that beat on the monitor, then the person is dead. We try our best, but there is no point worrying about what we couldn’t do. The more difficult part is to make the patient’s family come to terms with it.
Questions for Attendings1. What are the strengths/weaknesses of this program?2. Is the emphasis of the program more biological or psychotherapy based?3. Do you foresee any changes in the near future? (If the chairman is leaving, it could signal trouble for the program.)4. How active are faculty members in teaching?5. Do the faculty publish?6. Are there any research opportunities for residents? Is research required?7. How do the residents seem to get along?8. What are you looking for in an applicant/resident?9. Do you have specialty clinics (eg, mood disorders, anxiety disorders, eating disorders, med/psych clinics)?10. How are the residents' PRITE/board scores?11. What do your residents do when they graduate? Fellowships? Private practice? Academics?12. How well do faculty get along with each other? With residents? With other departments?13. How are residents evaluated?14. How does psychotherapy supervision work here? Do residents get to choose their supervisors? How many
hours of supervision do they have per week?15. How diverse is your patient population? What is the socioeconomic mix of the patients?16. Do you have a journal club? Are faculty members involved?17. What are the job opportunities for my spouse/significant other?18. How many hospitals do residents work out of, and how far away are they? Which hospital do residents base their outpatient clinics out of? (It's nice if you can work in a variety of settings, such as a private hospital, psychiatric hospital, VA.)19. How well do residents do on their internal medicine and neurology rotations?20. What is the average length of stay of patients?21. Can I see a copy of your psychotherapy curriculum? Do residents gain experience in short- and long-term psychotherapy, CBT, group/family therapy, etc?22. How much ECT experience do residents receive?
Questions for Residents1. How much supervision do you have?2. Why did you choose this program? What other programs did you look at?3. What are the strengths/weaknesses of the program?4. Any regrets about your decision to come here?5. Has anyone quit? (a very revealing question - always ask why)6. Are you happy here? Do you know anyone who's unhappy here? Why?7. How's call? Is there a nightfloat system?8. How's PGY-1 morale? PGY-4 morale?9. How well do residents get along? Do you get along with faculty?10. Do you feel well-respected among other departments?11. How much teaching do you get? Conferences? Core teaching programs?12. Are didactics protected?13. How diverse is your patient population?14. How much psychotherapy exposure do you get?15. How much influence do you have on your curriculum?16. What books do you use?17. Do you have time/opportunities for research?18. How's parking/transportation?19. What's the cost of living? Where do most residents live?20. Do you have time/opportunities for moonlighting?21. How are the facilities? Library? Call rooms? Resident lounge? Computer system? Cafeteria?22. What benefits do you have � insurance, vacation, sick leave, educational leave, educational money?23. How many residents have babies during residency? How accepted is this?24. Food allowance? Laundry? Lab coats?25. Climate? Recreation? Work out facilities?26. What are the job opportunities for my spouse/significant other?27. What do residents do for fun? Do you have any free time?28. Is there low fee psychotherapy for residents?29. What are your community psychiatry experiences like?30. Would you come here if you had to choose again?
€œIt will provide more security and stability to those who have health insurance.It will provide insurance to those who don’t. And it will lower the cost of health care for our families, our businesses, and our government." – PRESIDENT BARACK OBAMA
If You Have Health Insurance, the President's Plan:
• Ends discrimination against people with pre-existing conditions. • Limits premium discrimination based on gender and age.
• Prevents insurance companies from dropping coverage when people are sick and need it most. • Caps out-of-pocket expenses so people don’t go broke when they get sick. • Eliminates extra charges for preventive care like mammograms, flu shots and diabetes tests to improve health and save money. • Protects Medicare for seniors. • Eliminates the “donut-hole†gap in c� overage for prescription drugs.
If You Don’t Have Insurance, the President's Plan:
• Creates a new insurance marketplace — the Exchange — that allows people without insurance and small businesses to compare plans and buy insurance at competitive prices. • Provides new tax credits to help people buy insurance. • Provides small businesses tax credits and affordable options for covering employees. • Offers a public health insurance option to provide the uninsured and those who can’t find affordable coverage with a real choice. • Immediately offers new, low-cost coverage through a national “high risk†pool to protect people �with preexisting conditions from financial ruin until the new Exchange is created.
For All Americans, the President's Plan:• Won’t add a dime to the deficit and is paid for upfront. • Requires additional cuts if savings are not realized. • Implements a number of delivery system reforms that begin to rein in health care costs and align incentives for hospitals, physicians, and others to improve quality. • Creates an independent commission of doctors and medical experts to identify waste, fraud and abuse in the health care system. • Orders immediate medical malpractice reform projects that could help doctors focus on putting their patients first, not on practicing defensive medicine. • Requires large employers to cover their employees and individuals who can afford it to buy insurance so everyone shares in the responsibility of reform.
A look at key points in Obama's health care speech:
1. Individuals would be required to carry basic health insurance. Those who can't afford it would get a hardship waiver. 2. Businesses would be required to offer their workers health care or chip in to help cover the cost. Ninety-five percent of small businesses would be exempt because of their size and narrow profit margin.3. Medical malpractice reform is not a "silver bullet," but practicing "defensive medicine" can lead to unnecessary costs; demonstration projects will be reviewed to see what changes to medical malpractice insurance would work best.4. It would be against the law for insurance companies to deny coverage because of a pre-existing condition.5. Promised to protect Medicare and reassured the elderly that Medicare funds would not be used to overhaul health care.6. A public option, or alternative to private insurance, needs to be available to the uninsured to "keep insurance companies honest."7. The public option would not be subsidized by taxpayers, but would be self-sufficient and rely on the premiums it collects; the Congressional Budget Office estimates that fewer than 5 percent of Americans would sign up.
duloxetine - 11/13/09 18:56
Highlights from my notes
should help in interviews.
- The most money spent on biotechnologies, with 80 % spent by private sector in R&D- NIH funds basic research only- Highest health care spending per GDP, yet highest infant mortality
- 30% goes to hospital, 20% to physicans, 23% to diagnostics, 10% to pharmaceuticals.- In 2007, the U.S. spent $2.26 trillion on health care, or $7,439 per person- The highest-spending 5% of the population accounted for more than half of all spending- Acute hospital care accounts for over half (55%) of the spending for Medicare beneficiaries in the last two years of life, tho it was found that this doesn’t improve life expectancy- prevention does not produce significant long-term costs savings. Preventive care is typically provided to many people who would never become ill, and for those who would have become ill is partially offset by the health care costs during additional years of life.- without health insurance coverage at some time during 2007 totaled about 15.3% of the population, or 45.7 million- almost 82% have insurance, 56% provided by employer, and 8% bought individually, rest by govt institutions- dental and vision care are bought separately and not covered- COBRA and HIPAA regulate insurance companies; (consolidated omnibus budged reconciliation act), allows employees to have health care even after they leave the employment. Same for Health insurance portability and accountability act.- providers (hospitals and doctors) can refuse to accept a given type of insurance, including Medicare and Medicaid. Low reimbursement rates have generated complaints from providers, and many hospitals have stopped taking Medicare patients.- Masachussetts, new jersey and san Francisco, Connecticut, have charity care to those who cannot afford.- EMTALA: emergency medical treatment and active labor act: cannot refuse emergency treatment, but ER treatment is costly than urgent clinic care- Most employee health is covered today by managed care organization, like HMO or PPO; aka health maintenance organization and preferred provider organization respectively, which negotiate with care providers and pay low prices than out of pocket prices. There is copayment or deductible involved. Capitation is the amount paid to provider every time the patient uses his care, no matter how much- this is the incentive system to persuade the provider to give less care. Primary care provider acts as a gatekeeper to decide if specialist is required. Likewise, any costly procedures usually need a second opinion before being approved. Pts going out of the network are charged extremely high. - PPOs have edged out HMOs. It is common today for a physician or hospital to have contracts with a dozen or more health plans, each with different referral networks, contracts with different diagnostic facilities, and different practice guidelines.- The first HMOs in the U.S., such as Kaiser Permanente in Oakland, California, and the Health Insurance Plan (HIP) in New York, were "staff-model" HMOs, which owned their own health care facilities and employed the doctors. They focus more on preventive aspect.- Govt run community clinics, and certain county hospitals provide free care. Child health insurance program for those who earn too much to qualify for Medicaid, but too less to buy insurance themselves.- There is no taxation on employee health service, which distorts the whole system, bcoz people who buy their own care have to do so after tax cut from their income- Medicare enrollment is increasing due to baby boomers- Health savings account is also tax exempt, but it benefits rich more than the poor- 15% of 300 million population is without care of any kind. Some say 30%. They usurp 30 billion of uncompensated care- Massachusetts has adopted a universal health care system through the Massachusetts 2006 Health Reform Statute, Health Safety Net Fund for those who cannot afford insurance- In July 2009, Connecticut passed into law a plan called SustiNet, with the goal of achieving health-care coverage of 98% of its residents by 2014- Federal Medicare and Medicaid rules forbid private healthcare providers from setting their own rates for these programs. physicians are not allowed to "opt-out" if they provide services at any healthcare facility that accepts these programs- McCarran Ferguson act allows states to control insurance policies without interference from federal government.- survival rates in the U.S. for a broad range of cancer types are the highest in the world,- the proportion of low birth weight babies may be affected by factors other than health care like Teen motherhood- mortality gap between the well-educated and the poorly educated widened significantly between 1993 and 2001 for adults- 1% increase in the unemployment rate would increase Medicaid and SCHIP enrollment by 1 million, and increase the number uninsured by 1.1 million- Many primary care physicians no longer see their patients while they are in the hospital. Instead, hospitalists are used. This fragments care.- There are hundreds, if not thousands, of insurance companies in the U.S. This system has considerable administrative overhead, far greater than in nationalized, single-payer systems, such as Canada's
- numerous causes of increased utilization, including rising consumer demand, new treatments, more intensive diagnostic testing, lifestyle factors, the movement to broader-access plans, and higher-priced technologies- cost shifting- due to low embursement by medicare, hospitals charge higher to private insurance companies, thus increasing the overall cost.- 37% reported that they had foregone needed medical care in the previous year because of cost- A lack of mental health coverage for Americans bears significant ramifications; The Paul Wellstone Mental Health and Addiction Equity Act of 2008 mandates that group health plans provide mental health and substance-related disorder benefits- An estimated 5 million of those without health insurance are considered "uninsurable" because of pre-existing conditions; people seeking to purchase health insurance directly must undergo medical underwriting. Insurance companies seeking to mitigate the problem of adverse selection; - minority groups have higher incidence of chronic diseases, higher mortality, cancer incidence rate among African Americans, which is 25% higher than among whites, DM, HIV, IMR, and cardiovascular disease- black Americans received less health care than white Americans —particularly when the care involved expensive new technology.- EMTALA is the key element in the safety net for the uninsured, but the cost is never fully reimbursed by the federal or state govt to the hospitals. EMTALA is an unfunded mandate that has contributed to financial pressures on hospitals in the last 20 years, causing them to consolidate and close facilities. emergency room visits in the U.S. grew by 26 percent, while in the same period, the number of emergency departments declined by 425. Some hospitals make pt pay by fee per service system, but many cant pay, and go into bankruptcy when hospital sues them.- the majority of the cost differential arises from medical malpractice, U.S. Food and Drug Administration (FDA) regulations- an FDA ruling went into effect extending protection from lawsuits to pharmaceutical manufacturers, even if it was found that they submitted fraudulent clinical trial data to the FDA- many other countries use their bulk-purchasing power to aggressively negotiate drug prices, governments of such countries are free riding on the backs of U.S. consumers. US consumers are thus effectively subsidizing cost for other nation’s consumers, so the lobbyists of the pharmaceutical companies say.- Bush passed an act to prohibit drug price negotiation for Medicare, thus giving power to companies to profit off the Medicare.- Democrats prefer universal health care, while Republicans don’t- the lack of health insurance among the self-employed does not affect their health, a study has shown- Advocates for single-payer health care often point to other countries, where national government-funded systems produce better health outcomes at lower cost. Opponents deride this type of system as "socialized medicine"- in 1973, the federal government passed the Health Maintenance Organization Act, which heavily subsidized the HMO business model. The law was intended to create market incentives that would lower health care costs, but HMOs have never achieved their cost-reduction potential.- Around 7500 per head per annum is spent on health care- High drug cost in the states is due to lack of government price control, and implementation of intellectual property right.- Health care cost of Medicare are rising steeply- uninsured are unfairly billed for services at rates far higher—305% in some areas of California—than are the insured; USA Today concluded that "millions of [uninsured patients] are forced to subsidize insured patients- 44,800 excess deaths annually in the United States due to Americans lacking health insurance; and almost 100,000 due to lack of medical care- Clinton signed Medicare Prescription Drug, Improvement, and Modernization Act which included a prescription drug plan for elderly and disabled Americans. Before that, medicare didn’t cover prescription drugs.- Barack Obama called for universal health care. His health care plan called for the creation of a National Health Insurance Exchange that would include both private insurance plans and a Medicare-like government run option. Coverage would be guaranteed regardless of health status, and premiums would not vary based on health status either. It would have required parents to cover their children, but did not require adults to buy insurance.- HIPAA includes electronic data interchange schemes like EDI Health Care Claim Transaction set, EDI Retail Pharmacy Claim Transaction (NCPDP national council for prescription drug programs)- Health Information Technology for Economic and Clinical Health Act (HITECH Act),- HIPAA has affected research adversely.- Proponents of health care reform argue that moving to a single-payer system would reallocate the money currently spent on the administrative overhead required to run insurance companies in the U.S. to provide universal care
- Malpractice liability has resulted in defensive medicine. Tort reform act are suggested as a way out.- Massachusetts' law forcing everyone to buy insurance caused costs there to increase faster than in the rest of the country- Eliminating the profit motive will decrease the rate of medical innovation and inhibit new technologies from being developed- Healthcare rationing- acc to age by medicare, acc to economic status by Medicaid, acc to employee status by EHS, acc to preexisting illness. And acc to how much you can pay. Other countries, by contrast, ration healthcare acc to need. In America, this rationing means there is no triage by need. Physician gatekeepers are also key in rationing.
