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Why do I say that? Attrition rate = 20% Top-ranked resident attrition = 35% The ones that pursue you the MOST rabidly are the first to drop out and go to business school or enter a psychiatry residency!
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KAREN DEVENEY, M.D.OREGON HEALTH & SCIENCE UNIVERSITY
Mistakes I Have Made...and What I Have Learned from Them.
Residency Selection Issues
Lesson #1: Don’t go for the
thoroughbreds-look for Clydesdales!
NO YES
Why do I say that?
•Attrition rate = 20%•Top-ranked resident attrition = 35%•The ones that pursue you the MOST rabidly are the first to drop out and go to business school or enter a psychiatry residency!
Moral of the Story:
Be careful what you wish for-you may get him/her!
Corollary: Don’t be fooled by flattery, beautiful thank-you letters, and second visits!
Look below the surface for quality people who really want
to be in your program!
Lesson #2:It’s better to STAY out of trouble than GET
out of trouble!*
Look more closely for RED FLAGS hidden in the Dean’s
Letter, C.V., or recommendation letters of
applicants.
*Old surgical adage
Applicant
file
What do I mean?
•They’ve been a member of every “interest group” on campus: Family Medicine, Emergency Medicine, Pediatrics, Surgery•They have multiple interruptions in the progress of their education or life course •Their letters of recommendation are from non-surgeons and very junior people•”Code words” imbedded in Dean’s Letter
THEY are the 5% that will occupy 95% of your time!
Lesson #3:Try to avoid dealing with ICE* in the era of
the “War on Terror”
*Immigration and Customs Enforcement
Why would I say that?
Am I an ultra-right-wing xenophobic nationalist? I’ve been accused of being a LOT of things, but never THAT!
BUT...I’d like never to relive the summer of 2002!
Delays in visa processing led to late starts of 3 preliminary
interns, one as late as November!
And then there was December 2009...
Tip for Program Directors:Do NOT let a resident with a
Muslim-sounding name and a J-1 visa that needs annual renewal
travel back to his home in a small Caribbean country for a family
wedding on Christmas Day 2009!
Lesson #4:Develop a hard shell.
George
Why is that?
You must avoid having your feelings hurt on Match Day when the applicant who said in thank you letters and follow-up emails that you were his/her top choice doesn’t appear on the list and you discover he/she matched at your rival in the next state. You’re better off without him/her!
Residency Management Issues
Lesson #1: You can please some of the residents some of the time, but you can’t please ALL of
the residents ALL of the time.
•Don’t promise one resident a certain schedule, rotation, vacation, etc. The others will expect their preferences to be accommodated or accuse you of “playing favorites.”•Learn how to balance competing interests by developing a POLICY for EVERYTHING THAT YOU CAN THINK OF...and follow it!
Lesson #1 continued
Don’t sweat the small stuff-and it’s all small stuff!
Lesson #2
What do I mean by that?
You can lie awake every night from 1:37 a.m. until 4:40 a.m. worrying about your latest screw-up, but then the problem magically solves itself three days (or weeks...or months) later!
PULLING RABBITS OUT OF HATS IS WHAT PROGRAM DIRECTORS DO!
