Episode 54: A rare, pessimistic moment – as Dr. Dan discusses the dark side of how you are judged during interviews.

Download transcript: medical school Interview tips

How can you AMP up your application and interview?

I certainly remember that feeling.  I think it gets seared in your brain.  It’s so hard to feel like you’re on the outside looking in.  It’s so much of a black box.  You are going to get what you pay for in life as a general rule of thumb.  I believe that, Napoleon Hill believed that, and as I’m getting a little older, I won’t say how old, I just seen it that way.  There are folks out there that want to learn how to get into medical school watching free videos on you-tube.  Maybe you have stellar grades and, it could be that you get into medical school, but you certainly didn’t earn it.  Many people float through the process not aware of how blessed they are, how grateful that they really should be, and by all rights in their personal experiences.  I’m not criticizing that they’re doing it intentionally, that’s what their experience has been.  Maybe they didn’t have a problem in high school, or college, or even getting into medical school, or residency.  They just float along as if they’re in an inner circle oblivious to the fact that there’s attritioning happening all around them.

I give you a case in point.  Last month I was around a second year emergency medicine resident trying to explain to a nurse a little bit about how our process works for going to medical school, and then residency, and fellowship.  He said, “Everybody finishes residency.”  I’m sitting in the back seat as we’re going for lunch with some work associates.  I’m sitting there in the back and I know I’ve explained to him that I didn’t finish and left the emergency medicine program, and had a bad experience and I’m now doing a second residency.  I mean, it’s kind of astounding,. There’s eight and a half percent every year don’t finish their residency.  That’s a pretty high level attrition.  It’s close, it’s a little bit more actually, than those that don’t finish medical school. Which is somewhere around five percent of those that get in.

Medical School Admission Statistics

All I’ve had to say that the biggest cut is getting into medical school.  Most of the time, the problem is that people talk themselves out of the application.  They get one C, or they get one D, or something in a class and suddenly they think, “Oh, I’m never going to make it into medical school.”  Because that’s what the, how can I say this in a politically correct way, that’s what the jail house lawyers, or the barracks attorneys, that’s what the jokers in your pre-med club think.  I ask you, how do they know?  They’ve never done it.  Talk to a doctor, ask if doctor’s have ever failed a class in college.  They’re everywhere.  They’re everywhere.  You don’t get into medical school because you give up, that’s why.  So it becomes a self fulfilling prophecy if you think your grades aren’t good enough because then you quit trying.  If you quit trying, of course, you won’t get in.  So it’s a self fulfilling prophecy.

What I want to focus on today is just to speak to you candidly about something that I witnessed today.  Today we made our rank list for folks for residency at my program.  This is a situation where, after you get into the fourth year of medical school, you apply to the residency specialties that you want to go into.  There’s an electronic application that all the places that you interviewed at, you put in a numerical order of your preference.  Well the programs do the same thing.  They set and have a meeting and put all their applicants that interviewed in a numerical order.  We had that meeting today.  I have to say, in some ways I was disappointed.  It happened last year too.  I go into the meeting having my favorites and sometimes they wind up near the bottom.  Not where I would have expected. I walk out of those meetings thinking, “That just didn’t happen the way I think it should have.”  It certainly reveals some traits and characteristics of humans in general and the human condition that are kind of ugly and kind of negative.

Don’t stand out during an interview?

One of the biggest disappointments in psychiatry is that the stigma for mental health issues, such as anxiety, stress, and depression, and difficult coping when you go through a hard circumstance.  In America, in the west anytime that someone asks for help and needs some help almost, there’s this idea that there’s something wrong with you.  That you’re not strong enough, that you’re supposed to pick yourself up by your boot straps and get along in life.  That  you’re needy.  I have to tell you that I saw some applicants being judged because they were simply being honest and telling the truth about areas of their life.  I have to say that at some point, I think it’s now, I’m going to start changing the way I counsel and coach people for interview days.  Because of what I saw today.  I just seen it enough, I’ve just studied mental health and the stigma enough to say that I used to advise people, “Just be yourself, go where you feel comfortable.”  Well guess what?  I heard numerous examples today where people had apparently done that. But we need to change our advice now and say that, “Listen, yes just be yourself, be comfortable, but you might need to take some acting lessons if you’ve ever had any stress, or needed any help, or your family isn’t some picture portrait, poster child family of strength and independence.  In other words, if you have children, and an ex, and you’re moving, there’s custody issues, and there’s social issues in your own family, don’t bring that up.  Don’t put it in your essay, don’t mention it during an interview.  You need to have other things to talk about besides personal drama.  And I hate to use that word but that’s the way it’s perceived by some people.  Sometimes one or two or three strong, bull headed people can make somebody look really bad who’s actually learned a lot from their life experiences and grown and developed.

Very often I see medical students putting together their essays and they’re talking about some of their deepest, darkest times in their life that were difficult and how they’re transforming themselves into physicians.  Folks I’m saying now, you got to kind of act as if you’ve always been a little professional.  It’s less honest, it doesn’t seem right, but if I’m going to do right by you, I need to be giving you advice that’s current and hip to the times.  Our society, if you haven’t noticed, is kind of decaying.  Unfortunately it’s made it into the ranks of medicine too and I’m very disappointed with what I see from doctors.  I’m not just talking about folks in my program necessarily but in the whole hospital the way they treat people with mental health issues.  If you don’t have the family drama I’m referring to or your own history of stress or anxiety that you’re trying to overcome or that you did overcome or anything like that, keep it legit.  One thing I talked about during an interview for medical school when I was asked,  what did I do between the year that I didn’t get into medical school until the following year when I applied and was getting that interview that day. I had taken a year off, basically.  I was doing research.  I had to have an elevator speech.  A quick synopsis of what I’m doing.  Practice your elevator speech.  I just said I took a [inaudible 08:50] course and I worked on my critical reasoning skills.  That was a fact.  I didn’t talk about the fact that I was going to get married, or anything like that, which I did.  But in the context of being grilled in an interview, I don’t bring up family personal drama.  I keep it only professional, above board, I leave out the drama.  I hate that I have to give that kind of advice but this is the day and age we live in.  Very often what I see, and I experienced it myself, I have personally had this experience.  You’ve heard me talk about the success story format before and the pain that that grew out of.  I’ve been in that seat where I’ve had difficult circumstances I needed to either explain during an interview, or on the essay, and I wasn’t sure where to mention the pieces.  Or much less if someone ask me, “Why did you switch from emergency medicine?  Why did you leave that program?”

Mentorship for Medical Careers

As I started to talk about a difficult position I was in in my life, you could just hear my enthusiasm drop, my tone of voice drop, and the more I talked, the more I was digging a hole.  I did not have an answer that was in the success story format.  No mentor had looked over my application materials, nobody had done mock interviews with me so that I could focus and really be in a hot seat and have to sweat, and really practice answering that question before the live show.  I figured some of that out on my own enough to get into medical school, but folks, it’s getting harder because of the population growth curve.  If you don’t learn anything from biology take a look at the population growth curve and look at the growth rate of medical schools.  It’s getting harder.  You aren’t going to be able to get away with not knowing the types of professional development materials that I’m talking about and that I teach inside the medical mastermind community.  Or else you’re not earning your spot in the medical school.  You might get one, but you didn’t earn it.  There’s a difference.  I’m glad to say that I have reached a level in my career now that I have time and I am going to chose a job such that I make time to mentor premedical students.  I am very excited about that.  My, it’s kind of my second rendition of coaching students again, is a program that I put together where I talk about the gory details of what I’ve eluded to today and the biases, prejudices, even racial and gender issues that are not politically correct that I cannot say on a public podcast.  I’m going to teach all that inside my get amped program.  Amp meaning A-M-P, it’s an Application Madness Program.  I am personally going to throw all other resources in the medical mastermind community, my personalized coaching, reading your essay, and doing coaching with you.  Telephone calls, you’ll have my personal cell phone only for a very small group of people and that enrollment is not always open.  It’s going to open briefly to get a few people in it and then it’s going to close right down.  I’m in the process of getting ready to open that up actually in March 2014 and it will close down as soon as enrollment.  So you can go to the medical mastermind community and check that out if you’re interested.  Otherwise, stay tuned for more exciting podcasts because the future episodes are going to continue.  The last couple of podcasts trend of going through the research and through the formative surveys that we’ve used to create the medical mastermind community to give you that MMC education that I have been starting you down that road of.