Friday, October 31, 2014

Boo! Making trick or treating not so tricky: Halloween for pediatricians

This holiday just screams of us pediatricians working hard to prevent or avoid: Not trying to put a damper on things. But there are ways to encourage healthy halloweening. Like dressing up as your favorite historical figure, athlete, or book character. Like raising money for organizations that provide children worldwide with health care, clean water, nutrition, education, and emergency relief. Like giving out crayons, coloring books, stickers, toothbrushes, and card games instead of candy. Like participating in dentist candy buy back programs that send it abroad to thank our troops. Like getting some exercise (minus the candy) by walking around your neighborhood. 

Then, perhaps your trick or treating won't be so tricky. Boo! Here are some tips from the AAP and the CDC.

Tuesday, October 7, 2014

Like speed dating, but instead it's the "multiple mini interview" format

She presented me with a scenario, asked me a question, and then I had about 8 minutes to discuss... to give my answer, my response as to how I would address that situation. I hope she likes me and what I have to say. And then the bell rings and I move on to the next station for another interviewer and another scenario. In the process, I aim to make a case for why I would be a suitable match, that is, why that residency program wants me in their new intern class.

It could happen.

Some programs use this "multiple mini interview" format with a series of brief structured interview stations where your non-cognitive traits are assessed. While found to be useful in undergraduate medical school admissions as kind of a "people skills test," it has also been demonstrated to be a reliable and acceptable way to assess residency candidates. If a residency program is using this format, they will surely inform you on the interview day, if not before.

For the "looks good on paper only" applicant, the MMI (or any interview) could be difficult. But don't be that person.

Fortunately, at programs using an MMI interview format, you (the applicant) will have multiple opportunities to interact, communicate, and demonstrate your humanity and empathy. And, you will likely be able to showcase your social skills and problem solving skills and reasoning abilities during the MMI.

Regardless, you want to show who you are and put your best self forward. The real self, the person they want in their residency program. Remember the tips:
  • Have a strong one liner about yourself! What do you want them to know, if you had the chance to simply tell them?
  • Know everything that you've listed on your own ERAS application/CV.
  • Make sure you have a few key points that you want to convey about yourself during the interview, then you can work those in at some point during the interview.
  • But here's another tip, for the MMI or otherwise, do pay attention to the question asked or scenario presented, don't just talk, or just talk about yourself! Remember, you're in this to help other people (probably infants, children, and young adults).
Interviews at the pediatric residency program here at Children's National start today!

Sunday, September 28, 2014

Spotlight on our team at Children's Health Centers at Good Hope Road and MLK

"And you know, we're on each other's team," sings the young New Zealand singer-songwriter Lorde.

Drs Cara Lichtenstein, Terry Kind, and Elshadey Bekele
Here we are (that's me in the middle), posing for the camera, but working hard every day on behalf of the children of southeast DC

What a team!  It takes a village (and listed here in no particular order, though nurses quite deservedly come first!):

They are all my colleagues.  We are all dedicated to serving our young patients and families.  In this medical home.

Monday, September 8, 2014

How will you apply yourself?

Apply yourself... to residency programs where you will have an opportunity in training to learn, teach, serve, conduct research, advocate, thrive, be well and promote wellness, make critical decisions and care for those with critical conditions, use clinical reasoning, use technology well, and prepare for the future of medicine, now.

The Electronic Residency Application Service (ERAS) opens in 1 week (Sept 15th).

Apply with some letters of recommendation (or make sure they are going to be in soon)

Apply with a heartfelt personal statement - make sure it says something about who you are that augments the rest of your applications. Without typos!

Apply to a range of programs that offer what you are looking for in a location where you could see yourself living, where you may have supportive friends and family (or somewhere near the beach/mountains/city), include some "dream" or "reach" training programs, and include some where you'd be "just okay" with training there (i.e. those you'd be okay with training at rather than at no place at all).

Apply with a CV in ERAS format that is accurate, complete, and helps inform your story.  You get to list (or describe) your hobbies too!

Your medical student performance evaluation (MSPE, aka deans letters) is also a component of your evaluation, coming on Oct 1.  And then on to the interviews.  And the match itself.

Make your application strong, but make sure to apply yourself to getting the most out of 4th year of medical school!   And through it all, keep calm and see your advisor.

Tuesday, August 26, 2014

The Ask (part 2)

More on asking for and obtaining stellar letters of recommendation.... (see "The Ask" part 1 here) 

Remember, every pediatrician at some point needed a letter of recommendation to get where he/she is now (note: Dr Seuss is not actually a physician). And we want to help. Just ask. We'll take a sincere approach to help enhance your success. And what if you learn that a program of your liking needs a "departmental/clerkship director" letter? Your clerkship director is happy to assist you in this way (with a letter highlighting your strengths) and throughout the match process to help make it indeed that, a proper match. 

Students sometimes wonder whether their letter writers need fancy titles (Founder of the Pediatric Universe, etc). If Don Berwick actually knows you well, ask him.*  Otherwise, go for a faculty member, can also be a private practitioner who you worked with (who would likely have a faculty appointment with your school anyway). Preferably someone who has worked with students before. Perhaps someone who can honestly write that you are one of the top 5 students he or she has worked with in 5, 10, 20+ years on faculty. Would not ask a resident or fellow - though of course we value their skills and contributions to medical education highly! Almost always should be someone with an MD/DO or PhD.... and maybe some writing skilss-- that is, skills.

Your prospective pediatric program director or residency selection committee chair will wonder if you have NO letters from pediatricians. It would be concerning, if not just downright improbable, if not a single pediatrician got to know you and thought highly enough of you and your performance to write a letter of recommendation on your behalf.

But 1 or even 2 of your letters can certainly be from other fields... it's ultimately all inter-related. So, for example, a letter from someone in internal medicine, OB-GYN, surgery, primary care, or family practice would be okay and still speak to your skills as a comprehensive, cool under pressure, clinical reasoner who goes that extra mile for his/her patients. Even geriatrics has its similarities to pediatrics if you think about it (hmmm, sounds like a future blog post in the making). These non-pediatric letters could show your breadth and other strengths.
Ultimately, ask people who know you well (or could get to know you even better this summer with 1 or 2 additional meetings) and can attest to the qualities in you that would make pediatric residencies want you in their program.

Not all your letters need to be in at the precise moment that you submit your ERAS application (for pediatrics that's usually mid-September nowadays). You might have 1 or 2 in at that time, and the others can follow shortly thereafter.

Special circumstances:
  • A possible 4th letter (if the prospective program allows more than 3) could come from a non-clinician /non-researcher, if this person can add something meaningful about you as a person and your skills as a future pediatrician.
  • Could include a letter that "balances out" some difficult academic experience that you have had. Example, you performed poorly on the outpatient portion of the pediatrics clerkship but there were extenuating circumstances that one of your preceptors or other faculty member can attest to.
  • Do meet with your dean/mentor/clerkship director for individual advice about these and other special circumstances.
Of course, you will also have a personal statement to allow the residency selection committee get to know your strengths and unique qualities... where you get to play "show and tell" about yourself. Better to show than tell though, as you help them understand what makes you the outstanding person you are. And aim to make both the statement and your recommendation letters say more than a mere recitation of the items listed on your CV.

*Unless he's your uncle. No aunts/uncles/relatives/best friend letter writers please.
Comment below or email with additional questions or tips

Tuesday, August 5, 2014

Tip Tuesday: Do you have any questions? Or, instead...

As an esteemed pediatric colleague of mine suggests, instead of asking (patients, parents, students), "Do you have any questions?"

we should instead say,  "What questions do you have?"

A subtle but very important difference.  Try it.

There may be unanswered questions, and unlistened to answers.   But let's avoid unasked questions, if they should be asked, and could benefit our patients, our learners, our profession, our society...

So tell me, what questions do you have?

Tuesday, July 22, 2014

The Ask

"I was wondering if (or hoping that) you would...

A) interested in writing a letter of recommendation."
B) ...have time to write me a letter of recommendation."
C) ...have time to write me a strong letter of recommendation."

Ah yes, you are used to taking multiple choice tests. All of the above might be acceptable, but of those choices, which is the
best answer?

Let's make it
boldly clear (don't you wish all tests did that?).

"I was wondering if you would have time to write me a strong letter of recommendation."  Why choice C when A and B are also fine? Asking if they have time gives them an "out" if need be (you'd rather they not write it if it isn't going to good). And they might even effusively say I will make time to write you a glowing letter! Add the word strong so they get that this is not just any random letter, but one to get you in the door of your favorite hospital for a pediatric residency. And again, you'd rather they not write it if it's not going to really sing your praises. 

What else might be part of the ask?An offer to update the prospective letter writer on what you've been up to. That you are indeed applying for a residency in pediatrics. A hello, hope you have been well. A question or two to pick their brain about pediatric residency programs. A thank you... perhaps for past teaching or for possibly writing you this recommendation letter. Logistically, have those materials that they'll need readily available (essentially, the LoR cover sheet with your AAMC ID number and the FERPA waiver that you waive the right to see the letter, and the address of your dean's office) to make it easy for them to submit the letter. 

How to ask?
A) text message
B) a tweet
C) email
D) phone
E) in person
F) via STAT page
G) don't ask, just assume they will offer

A?  Have you ever texted each other before? Assume you need something more formal, more official, more... old school.
You don't need to make it so public and recorded by the National Library of Congress, for that matter.
C or D? 
Sure, either by email or phone would be appropriate, if you have in fact emailed before, that would be a fine choice. And when calling or emailing, do at least offer to set up an in person meeting to follow up.
Sure, in person would work, but you might have to schedule the in person ask, unless you just happen to come upon your prospective letter writer or are seeing him/her anyway. However, in person you aren't really able to give the prospective letter writer an easy "out" if it isn't going to be a strong letter. On the other hand, at least in person you can remind them who you are!
It's not urgent, would be better to use a different method, as you might be paging them in the middle of a code or other important patient encounter.
Perhaps if someone has offered, during your research or advocacy time together or at the close of your clinical experience during 3rd (or early 4th) year, then yes that is a really good sign. But don't assume! Ask.
For your pediatric residency application, do all your letters need to be from pediatricians?
No!  See "The Ask part II" coming soon...