Making the Rounds

Meet Your Match | Assessing program culture during virtual residency interviews

Episode Summary

Alison Schmidt, MD, a current intern who went through residency selection virtually, offers advice on how applicants can get a feel for program culture during virtual residency interviews. Dr. Schmidt is a first-year obstetrics and gynecology resident at Michigan Medicine.

Episode Transcription

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Alison Schmidt, MD, a current intern who went through residency selection virtually, offers advice on how applicants can get a feel for program culture during virtual residency interviews. Dr. Schmidt is a first-year obstetrics and gynecology resident at Michigan Medicine.

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Transcript

Unger: Welcome to Making the Rounds, a podcast by the American Medical Association. In this episode of our “Meet Your Match” series, AMA senior news writer Brendan Murphy interviews Dr. Alison Schmidt, a first-year obstetrics and gynecology resident at Michigan Medicine.

Dr. Schmidt shares her experience assessing residency programs in a remote setting, questions to ask in virtual interviews and how to determine if an in-person visit is needed.

Here’s senior news writer Brendan Murphy.

Murphy: Hello and welcome to “Meet Your Match,” a special series on Making the Rounds by the American Medical Association. I'm Brendan Murphy, senior news writer here at the AMA. Today, we are speaking with Dr. Allison Schmidt, a first-year obstetrics and gynecology resident at Michigan Medicine. Dr. Schmidt, thank you so much for being here with us. How are you today?

Dr. Schmidt: Hi, I'm doing really well. Thank you for having me.

Murphy: We are so thrilled to have you. And today we are going to talk about virtual interviews, more specifically, the process of assessing residency programs in a remote setting and how to determine whether an in-person visit is needed. To start off, Dr. Schmidt, can you tell listeners a bit about your background as a residency applicant and how you navigated residency selection without going on campuses and visiting programs directly?

Dr. Schmidt: Sure. So, I applied last cycle in the 2021, 2022, I—at that time, it was planned to be all virtual, so I knew going into it that all of my interviews and everything would be virtual. And at least there had been one year under our belt of virtual interviews. Still nerve-racking for me, though. I'll say, overall, I think the process, as similarly as it would be in person likely, was tiring but a lot of fun. You get to meet a lot of people going through the process.

Actually, I met one of my co-residents on the interview trail. And we connected over Zoom and now have ended up at the same location. So, you can still have quite a bit of fun kind of going through that process.

Murphy: Well, I think that's probably welcome news to our current listeners who are applicants that there is some fun and then you can make those lasting connections. When it comes to the decision of which programs to rank, what are some of the cultural factors that influenced that decision for you?

Dr. Schmidt: Yeah. A few things that I thought a lot about going into the process and honestly, something that I encourage everyone to take some time to try to do some self-reflection about what your core values are. As I went into the process, I knew that I definitely wanted to be at an institution where I felt like there was very much a family-like atmosphere, where I felt close to both my co-residents and the faculty and the program leadership.

It was also important to me that the program was committed to education. I think one of the things that became very obvious to me as I went through, especially the interview process, is just this idea that being a resident really is kind of a complex role where you're both a learner and an employee. And I think finding a program that at least understands that there's a dichotomy there and tries to find the right balance was really important to me.

I also really wanted to make sure that I was somewhere where I felt like it had a safe learning culture, somewhere I could ask a lot of questions, where I didn't always have to be right, that I could lean on the people around me and really lean on more of a team atmosphere and not feel nervous to ask or speak up when I don't know something. And so those were the things that I had really focused on. And I think those values kind of were honed even throughout the interview process, I would say.

Murphy: So, what questions can students ask during interviews to evaluate culture?

Dr. Schmidt: Yeah, I think there's a lot of different ways to go about it. I think for me, I knew that I wanted to ask about some specific things related to relationship with the program director, relationship with faculty. And so, I kind of had a sense of some questions going into it. And I think as you go through the process, you start to realize what questions kind of work and what questions don't. And so, you kind of have to be adapting those as you go. But what I found was that the more that I requested specific examples, I found that to be really helpful.

So, for example, wanting to know about what the relationship is like with a program director, it's helpful to ask for specific examples where there have been program changes made that were driven by residents. And what does that process look like and who are you talking to be able to make change?

And I also would ask about what type of specific examples of things that the program director is trying to improve upon for the residents. One of the things I think that can feel a little bit uncomfortable asking about is things like benefits and additional sort of day-to-day conveniences but that really do play a big role in your life as a resident. And so, figuring out ways to ask the program director on maybe what are some examples of ways that your program try to make that day-to-day more easier for your residents?

And I also think you can think about some more creative questions for some kind of challenging topics. So similar to that, if you were particularly interested in starting a family, you can think about creative ways to ask. If you don't feel comfortable flat out asking if they are accommodating of starting a family and residency, you can ask about things like how many people have dogs. How many people have long-term partners? Trying to kind of get at the answer without necessarily asking directly can kind of be helpful, in part, because you can sort of sometimes avoid the canned answers as well.

I also think almost as important as the questions that you ask are paying attention to some of the more subtle cues. So, paying a lot of attention to body language and the way that people answer questions can be really valuable, if people are somewhat avoidant of questions or don't really have good answers for some questions that everyone has thought about. So, for example, if you ask, what are things in the residency that you wish could change, if they don't have a good answer for that, then they probably aren't being honest with you. Most people have things in their program, even if they love their program that they wish would change.

And so, I think paying a lot of attention to that, paying a lot of attention to the way that residents interact with one another and the way that they interact with faculty, even over the Zoom setting can be helpful, particularly in the social events that often these interviews have.

Murphy: Can you tell us how those social events worked virtually and what you gained from them?

Dr. Schmidt: Yeah, I think there was a mix. One year into the process, I think they had gotten a little bit better but I think we are still working through some of the kinks, I would say. The majority of those virtual social events were the night before my interviews. They were on Zoom and sometimes with breakout rooms, sometimes with larger groups.

Oftentimes, it was an opportunity for you to kind of say a little bit more about yourself in a more casual environment but also get to know the residents in a more casual environment. I think that they were valuable and that sometimes you would have those kind of rare moments with a resident where you could ask your questions without feeling kind of as nervous as you might on an interview day. I really liked taking advantage of those social events to talk to the PGY ones actually at the time who are now PGY twos, and to ask them questions like, what were things that surprised you? Given that you interviewed virtually, what were things that were different for you than what you expected during the interview process? And so, you can kind of use those as an opportunity for some of those more casual questions.

I think overall, they can be a little bit tiring. And so, even though you might get tired near the end of the interview season, still paying a lot of attention to those is valuable.

Murphy: Well, who doesn't have Zoom fatigue at this point of our kind of pandemic life or our remote life? An interesting aspect of this is you had all these important cultural touchstones that you wanted to assess in a program but you weren't visiting the programs. How were you able to do that remotely?

Dr. Schmidt: Yeah, I think, in part, it's asking those questions on interview day and being strategic with the questions that you ask and making sure you kind of know those values ahead of time. In part, I also think the benefit now that we have a couple of years under our belt, I think a lot of programs have gotten better at what resources they have available online. I think that social media is a really great tool. Obviously, social media can really project maybe only the positive things but you can at least kind of see who the residents are, where they come from, what types of things they're doing together. That's kind of nice to get that little look into the program.

At least in OB-GYN, we have the ACOG residency showcase, which is one week where all of the residency programs get to kind of highlight special things about their program, which I think is really helpful. I also think that because we're in this virtual space, you kind of have to be strategic with using all of the resources you have available to you. And sometimes that might mean people at your institution who might have insight into these programs.

So, asking residents, faculty, other people who may have trained there or may know someone who trained there can be really beneficial. They can give you their experiences a little bit more firsthand.

Murphy: Having done this all remotely and not having gone on any formal program visits, did you visit any programs informally? What was the value of that if so?

Dr. Schmidt: Yeah, I never actually really visited any programs to the effect of going to the hospital or meeting any residents in person. I did, however, go to visit some cities that I was considering very heavily, particularly because at the time, I was considering a regional change. And I wanted to make sure that the cities that I was thinking about were places where myself and my partner would be comfortable and happy living in for the next four years.

And so, I did do that only with a handful of cities just to kind of get that sense, which I do think was helpful if you have the capacity to do so. I do think I was fortunate to have some time and obviously, the resources to be able to visit these cities. So, I don't think it's necessarily a mandatory thing but that can be nice.

I think when reflecting on it, I'm not sure even if I had gone into the hospitals or seen a little bit more of the campus, I'm not sure at the end of the day, that would have made a much bigger of a difference than just seeing the city itself.

Murphy: And you ended up in Ann Arbor at Michigan Medicine. Did you visit there? Or do you have a knowledge of the town and the surrounding area?

Dr. Schmidt: Yeah. I have a little bit of the benefit of I'm actually from Michigan. Although, I've spent the last decade-plus outside of Michigan. So, I was familiar with the area but I did visit Ann Arbor when I was kind of considering. So, I did come to the city. And that was really nice for me just to kind of be able to put myself in those shoes and envision myself living in this place.

Murphy: So, we've spoken offline, Dr. Schmidt, about the wisdom you've gained in your few months of residency. We kind of joked about it. But now that you are a few months into residency, what are the key points you may have overemphasized in your residency search and are there any that you underemphasized?

Dr. Schmidt: Yeah, I think, on the whole, I think the things that I really strongly valued going through the process I think really end up to be true to what I value about my current program. I do think that there were probably some things over and underemphasized. I think underemphasized as I went through these last few months, I've realized how important it is to think about the way that your program advocates for you as a resident.

Even if you're very happy with your program, there are always things that you want to see changed. There's always things in health care and medicine in general that pop up challenges that you face as a resident. And so, making sure that you have a residency program, program leadership, whether that's your program director or even up to the chair of the department advocating for. Especially in the field that I'm in, advocacy for our residents and our training has been very important in the last several months.

Things that I probably also underemphasized as I went through were—it sounds silly—but things like benefits and kind of those day-to-day conveniences. I think that can feel a little bit uncomfortable to ask about. But things like having your meals covered or parking honestly make more of a difference to your day-to-day life than you would expect as you work 80 hours a week at the hospital.

Things overemphasized. As I'm in a surgical field, a lot of the things that we think about in terms of numbers that you'll—or questions that you'll ask is in regard to maybe surgical case numbers, I think. As you find, as you go through everywhere, will publish those on their websites. Those are all GME requirements. And so, every program will at least have those. And so, I think sometimes those questions I kind of felt like I overemphasized, maybe some of those experience questions that either are pretty standard across programs or that you can pretty easily find out on the program website.

Murphy: This has been really informative. You're the first guest we've had, Dr. Schmidt, who went through the whole match virtually. So, it's going to be really helpful to our students who are doing that this year. Before we move on, is there anything else on this topic that maybe you'd like to add that could be helpful to current applicants?

Dr. Schmidt: Yeah, I think one of the things I've been reflecting on throughout this process, I'm a very—my memory very much works by a lot of sensory cues. And I think I was reflecting on the fact that as you go through this process virtually, you're really sitting in the same room with the same view. And so, you don't really have those kind of memory cues of, oh, I was in the city waiting in traffic, I remember sitting in this room talking to this person, I remember the flight to get there. And so, I think for me, it was hard to kind of keep track of interview to interview, because they were—one will blend into the other by the end of the season.

And so, my biggest recommendation honestly, is to keep very, very good notes and keep track of these interviews as you go through them, particularly how you felt, how did you feel in each interview, how did you feel interacting with each faculty member, did you feel like you connected with the residents? Those notes will really help as you come to the end of the cycle and try to actually start comparing those programs, especially because as you go through to those early interviews, you might have been blown away by an aspect of a program that as you go through the process, you realize is actually a pretty standard feature. And so, you just don't know that until you kind of reach the end of the cycle.

Murphy: That's really interesting that there's both sort of a logic aspect to it and an emotion aspect to it. And sometimes it is about how you feel during these interviews and interactions. Dr. Schmidt, I know our listeners have been so grateful to hear about your experiences and you've given us such unique insight. Thank you so much for joining us today.

Dr. Schmidt: Absolutely. Thank you so much for having me. I think this can be a stressful time but I think it's always nice to hear from people who've gone through it.

Murphy: Yes, there is a light at the end of the tunnel, right?

Dr. Schmidt: Absolutely.

Murphy: Well, before the end of the tunnel, we have so many more episodes of Meet Your Match on Making the Rounds, a podcast by the American Medical Association. I'm senior news writer Brendan Murphy. Thanks for listening.

Unger: You can subscribe to Making the Rounds and other great AMA podcasts anywhere you listen to yours or visit ama-assn.org/podcasts. Thank you for listening.

Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.