Hi everyone,
Just a brief note today because literally all I’m doing right now is breathing and reading residency applications. I have 200 lined up for today, and the plan is to send out invitations next Friday (hopefully).
So, just a few observations as I look up for a second:
- AI doesn’t help: This year, I thought AI would save me hours sorting through grades and publications. It turns out AI can’t figure out grades—let alone clinical performance—any better than I can. On most readouts, AI wrote “see transcript,” meaning the grades were indecipherable. And while AI can quickly count publications and tell you how many are first-author, it doesn’t distinguish Nature papers from those in the journal Pay Me and I’ll Publish Your Case Report. So, I still need to read applications as I always have, one line at a time.
- Signaling Doesn’t Save Time: In theory, signaling should save time by highlighting truly interested candidates. Signaling does decrease the number of applications to review, since I don’t spend much time on candidates who didn’t signal us (i.e., we’re not in their top 15). But among signaled applicants, the talent pool is deeper than ever: most have strong grades, leadership, and scholarship. Each merits a careful read.
- I Like Grades: Many schools have shifted to Pass/Fail, presumably because they think eliminating grades allows students to focus on learning medicine without having to worry about being judged. But ultimately, we program directors have to know who’s ready for internship, particularly at a program like ours where we give interns lots of responsibility, caring for large numbers of sick, complex patients. In the absence of grades, we’re forced to divine meaning from text pasted from performance evaluations, including a profusion of adjectives (“enthusiastic!”, “engaged!”, “polite!”) and random observations (“came in early!”, “took ownership!”, “responded to feedback!). If a student showed “steady growth over a rotation,” is that a positive thing? Does it signify a growth mindset, or does it mean that they had lots of growing to do? If a student is described as “excellent,” is that praise, or is that a way of saying they were less than “outstanding?” I’m not always sure. What do you think? Bring back grades!
- Oh, The Inconsistency: Some schools and departments provide performance summaries (“She met expectations”) while others advocate (“She is destined to transform the practice of medicine”). And you wonder why AI can’t figure this out?
- Hundreds of Emails: This year, I’ve gotten hundreds of emails endorsing applicants. Some come from candidates themselves, while others come from friends, acquaintances, mentors, and even family members. Some emails are helpful, particularly those from trusted sources, highlighting information I wouldn’t otherwise know. But most are just pleas to pay attention, and with each email, I have to remind myself that most candidates don’t have special sponsors to advocate for them. Ultimately, the only letters that matter are those in the application.
Which reminds me, I need to get back to reading applications. Five hundred to go!
Have a great Sunday, everyone. Stay dry!
Mark
P.S. What I’m reading and listening to:
- Who Deserves an Organ? The Dilemma of Severe Mental Illness. By Daniela Lamas
- Crowded Emergency Rooms and Other News On Health & Veritas with Howie Forman and Harlan Krumholz
- Applications