Thursday, November 27, 2008

A Note From the Interview Trail

I do sincerely apologize for being absent for so long. After completing some difficult clerkships, I've basically been living out of town. You see, I'm currently on the interview trail. I'm looking for a surgical residency. The current system is a bizarre one, in which I pay huge sums of money to fly around the country and try to impress people. In return, they usually put together a pretty nice looking package with which to impress me. A typical interview goes something like this.

1. Night before event- All but one of my interviews has been associated with a night before event, at which applicants meet the residents and possibly some of the program leadership. These events are highly variable. They range from being told to show up at a bar and buy your own drink to a formal reception complete with Chardonnay and Filet Mignon.

2. The Interview day- You usually come to the hospital where there will be some sort of introduction to the program. You will then attend some sort of academic conference (a way for the program to show off its academic credentials). After this usually comes some combination of talks, one-on-one interviews, and hospital tours. Then there is usually a lunch. Residents are usually invited to the lunch for one last chance to ask questions. Some programs also spice lunch up a bit. One program gave lunch against the backdrop of a talk from an eminent trauma surgeon. One program broadcast a live gastric bypass during lunch (probably the most amusing). There may or may not be an afternoon activity.

There are some variations on this, but it really is pretty consistent.

In keeping with the major theme of this blog, I'll tie a little bit of practical economics into the discussion:

This process is expensive, especially if you are applying to a competitive specialty. More competitive specialties require more interviews and are less likely to help you financially. In other words, some of the less competitive programs will partially fund flights or pay for a hotel. This is often not the case in the more competitive programs. Thus, a plan is paramount in figuring out a way to go where you need to go.

If you are applying to a less competitive specialty, a few interviews at dream programs, a couple of programs of even qualifications, and perhaps a safety school is all that is really necessary. I would recommend no less than 10 if you are applying to surgery or Emergency medicine (15 is better). For Plastics, Ortho, Derm, etc... I would take every invitation that I received.

There are two major expenses in the process.
The first is the cost of travel. With gas down to under $2/gallon, driving is often a very viable option. If you've got a bit off time off and friends in multiple places with a couch, driving can easily make your trip cheaper. If you are staying in state, it really makes no sense to do anything else. I pulled off one interview in which I drove across the state and stayed at a friend's house for under $100.

If you absolutely must fly, comparing flights is very important. Orbitz is sort of my favorite site, because it is pretty convenient to book flights and car reservations at the same time. I also find it to be a little more user friendly than Priceline or Travelocity, though these are also viable options. If possible, non-traditional carriers such as Southwest or JetBlue can be an amazing alternative. Southwest has the best service of any airline in the country. It is not close. Southwest also sometimes has some amazing flight deals online at known as "wanna get away" fares. I've actually flown across the country for $70 including fees this way. It may or may not be more expensive to link your rental car reservation to your flight, so you should check both ways. It may also be cheaper to fly into a regional center and drive to a close by program than to fly to a local airport. As an example, flying into Detriot and renting a car in order to drive to Lansing or Ann Arbor is a lot cheaper than flying direct and finding local transportation.

The second major expense is lodging. As previously alluded to, staying with friends or family can really cut down on costs. If this doesn't work, cheap hotels are a must. Many programs will recommend a hotel. With a couple of exceptions, this is usually NOT the best place to stay. Including taxes and fees, most cities outside of the biggest will have numerous hotels in the $50/night range with fees and taxes included. I made the mistake of staying at the recommended hotel once. Then I found the deals to be excellent and I never looked back.

Other price saving tips might include using only carry-on bags. Many airlines will charge fees to check baggage. If you are willing to sacrifice a bit of comfort, a suit can often be worn onto the plane, freeing up storage space. I took week long trips with multiple one-way flights while doing no laundry out of a carry on roller bag using this method. Airport food is also expensive. That being said, you may find yourself stuck in a terminal for 3 hours waiting on a delayed flight. An overpriced hamburger or drink may not be too much of an expense at this point.

For those in the early stages of medical school, I would recommend that you start putting money away early. I managed to underspend by a couple of thousand dollars each year, and that has basically funded my residency travel. Even though you'll be paying some extra interest, these loans are often deferrable, often qualify for a forebearance, and will definitely be included in any calculations of income based repayment. This makes them VERY friendly compared to conventional loans. There is an interview and relocation loan available for up to $25k. This is a private loan that requires good credit on the part of the borrower. It also comes with variable interest rates and no promise of future deferment. In other words, it is not the best loan. It's also not easy to obtain in today's credit market. All in all, it is better than not doing enough interviews to match.

It's about time for Thanksgiving dinner, so I'll be going. If anyone has any questions, feel free to post them and I'll do my best to answer them.

Happy Thanksgiving.