Hi everyone,
At 1:30 this morning, I finally decided who to invite for residency interviews. The decision culminates more than two weeks of non-stop reviewing. My eyes are barely hanging on.
Forty-nine hundred candidates applied- 3980 to the categorical track, either alone or combined with the physician scientist and/or preliminary tracks. Among the categoricals, 45% attended U.S. medical schools, 45% are women, and 15% belong to underrepresented groups. Thirty-seven percent signaled us: 9% gold and 28% silver. Forty-seven percent prefer to train in New England.
We have to fill 66 intern slots. Of these, 10 are for preliminary neurology, 5 preliminary ophthalmology and 3 "general." Eight slots are for physician scientists, leaving 38 categorical slots to fill, which is my focus now.
Given the number of signals allowed, we assume each applicant is considering at least 14 other programs. Interview slots are precious, so we have to figure out who would thrive at Yale and who is sincerely interested.
Here’s how I decide:
- Signals: I mostly focus on candidates who signaled Yale as well as a handful who didn't signal because they assumed incorrectly that we would not choose them. All else being equal, I prioritize gold over silver, since that means we’re starting the season in the candidate’s top three- though we aim to persuade everyone that Yale’s the perfect place to train.
- Division Preference: I slightly prioritize those interested in New England unless they're clearly heading to Boston (“I hope to join my spouse who is a surgery resident in Boston”). I do assume candidates with “no geographic preference” are interested in Yale, but I also assume that candidates prioritizing other regions are less interested. I also look for Connecticut ties, for example if they grew up, went to school, or worked here.
- Clinical Performance: Here’s where I spend most of my time, given the clinical demands of our residency. Some schools helpfully share milestones and objective measures in letters and MSPEs. Other schools are inscrutable, leaving me to decipher a hodgepodge of adjectives and reams of unedited text, seeking signs of clinical excellence while digging for evidence of clinical struggles. For example, “taking feedback to heart,” “showing interest,” and being a “good residency candidate” are probably red flags.
- Step 2: Absent reliable clinical performance data, Step 2 takes on more weight. While we don’t use an absolute cutoff, the average Step 2 score of viable applicants is 260. I generally hold off on inviting candidates who haven’t submitted scores yet (if you’re a medical student reading this, please take Step 2 before applying to residency).
- Honor Societies: It helps to know a candidate was elected to AOA or the Gold Humanism Society, and it’s especially impressive if they were elected to both. This information is only so useful, though, since many schools don’t have AOA or Gold chapters or don’t elect members until next spring.
- Scholarship: Training academic physicians is one of our core missions, so we seek candidates who engage in research and publish, keeping in mind that publishing is also a measure of opportunity, and many students who would flourish at Yale attend schools with fewer resources.
- Diversity: Last year’s class was the most diverse ever, and we want to repeat the magic with an intern class that reflects New Haven's diversity.
- Distance Traveled: I’m impressed by candidates who've overcome obstacles such as poverty, war, illness, and discrimination. Their resilience in the face of adversity marks them as ready for residency.
- Leadership: We train academic leaders, and our program depends on the engagement and contributions of residents, so I look for candidates who lead interest and advocacy groups, student clinics, and professional societies.
- Endorsements: I appreciate the input many of you have given me about candidates you know. Most candidates have no prior connection to Yale, so endorsements by their mentors are essential.
- Couples: If both members of a couple apply, I treat them as a pair. If I invite one, I invite the other.
- Essays and hobbies: To be honest, I don’t have time to read many essays at this stage, though I did glance at some to supplement my review. The deep dives will happen at interview time when I’ll also review hobbies and interests outside medicine.
Interview invitations should go out this afternoon or early evening. If past is prologue, the slots will fill rapidly. There are many more talented applicants than we can possibly interview, so we’ll maintain a waitlist, and more candidates will be invited as slots open in the weeks ahead. PSTP invitations will take a few more days as applications work their way through the academic sections.
Our first interview day is October 25. All residents are invited to join the applicants for pre-interview dinners, and if you’re a faculty member or fellow who would like to interview, please let me know!
Enjoy your Sunday, everyone. After I send the list to Brett, I’ll be headed out for a bike ride, followed by dinner tonight with my daughter Gabrielle.
Mark
Here's what I'm reading and listening to:
- TV Medical Dramas Are Not Like Real Life. Maybe They Should Be
- How Do You Forgive the People Who Killed Your Family?
- ‘Are We Not Humans?’
- Let's Go Mets!