Feb 5, 2018
After the success of Brandon Dyson and TLDRPharmacy.com's interview back and forth, I was able to connect with a graduate of a PGY-1 Pharmacy Practice Residency and a PGY-2 Critical Care Residency at the University of Illinois at Chicago (UIC), Sean P. Kane, PharmD, BCPS, who is now an Assistant Professor of Pharmacy Practice at Rosalind Franklin University in Chicago. He is also the host of the HelixTalk podcast.
He received his Doctor of Pharmacy degree from Butler University in 2010 and during his time at UIC, Dr. Kane acted as Chief Resident, precepted IPPE and APPE students on clinical rotations, lectured in a variety of educational and professional settings, and participated in an on-call overnight program. He's launched an evidence-based clinical decision support website, which provides a practical toolkit and an educational resource for clinical pharmacists, residents, and students.
Currently, Dr. Kane is a critical care pharmacist in the intensive care unit at Advocate Condell Medical Center and serves on the Admissions and Strategic Planning Committees at the university. His areas of interest include septic shock, pharmacokinetics in critically ill patients, and IT-based clinical decision support.
Welcome to the Pharmacy Leaders Podcast with your host Tony Guerra. The Pharmacy Leaders Podcast is a member of the Pharmacy Podcast Network with interviews and advice on building your professional network, brand and a purposeful second income from students, residents and innovative professionals.
Welcome to the Pharmacy Leaders Podcast. Today I have Sean Kane foreign DBCPS, an assistant professor and critical care pharmacist at Rosalind Franklin University. He's a graduate of Butler University College of Pharmacy and he has completed a PGY-1, PGY-2 and gone on to secure a role in academia as a critical care pharmacist and professor. So I wanted to bring him in to talk more about how, what his road was as he got into PGY-1 and PGY-2 and get his good advice. So Dr. Kane welcome to the Pharmacy Leaders Podcast.
Hey Tony, thanks for having me.
Alright great well, I want to open it up. Normally I would ask about your leadership road but what I want to ask for you now is what is the road that students should take, they're getting their interview offers right now, they're trying to figure out how they're going to afford maybe four or five trips around the country and they're going to have interviewed days. Can you just first from a very, you know, 10,000 foot perspective what's the first thing you'd do besides maybe celebrate a little bit if when you get that interview email?
You know, I think that you really have to be, A, grab those dates early on. So if they're offering you specific dates try to reply as quick as you can because those dates are going to go quick depending on how the program kind of organizes the logistics of the interviews you don't want to be trying to either not do an interview because you can't make a date or something like that. Then of course if you're on an Appy rotation which most p-force would be at that time a mess around break, coordinating your interview schedule with your Appy preceptor as soon as possible. Just be super open about it and say, you know, these are my dates, is this okay for me to go? If you have an Appy preceptor who understands, you know, the logistics of the residency interviewing hopefully they'll be willing to work with you and that's super important to just be upfront and as punctual as you can. As an Appy preceptor myself I don't want to hear the day before oh by the way, I have an interview and I can't come tomorrow. It really needs to be more proactive than that. So logistics is the number one thing to think about when you're figuring out what to do when you get that awesome email if you have that interview opportunity.
Okay let's say, you have, and let's use this just, we'll kind of make a fictitious experience. Let's say you applied to eight, I think the average is somewhere around there and you got interviews for four, you're given a number of dates. Let's say you have enough flexibility to pick the order. Where would you put the interview that you want the most, would you put it in the middle or at the end?
You know, I think for me I would probably put it in the middle but I think it's going to depend on the person. I think for the most part you probably don't want to have your first interview be the kind of Holy Grail.
No, definitely not the first, it's like doing critical care as your first Appy. No, just no.
I think that there's no harm in doing it at the end. You might start getting kind of burned out a little bit at that point especially if you have a lot of interviews. So maybe somewhere in the middle might be a sweet spot between enough experience but you're not getting burned out with the process at the same time.
Okay so, maybe we can just pretend you're the residency applicant and I'm going to be the residency program director and I'm just going to ask you a couple of questions and what I want is not only an answer but kind of your rationale behind it. So the first thing that Brandon Dyson from TLDR kind of recommended is to remember that as soon as you meet a person the interview has started. So when somebody just says hey, how's it going? What would you say?
So, you know, I fully agree that the interview starts as soon as you park your car and as soon as you meet the first person. In terms of the how's it going I think positivity and smiling goes a really long way. So even if you got stuck in traffic, even if you spilled coffee all over your pants, be positive about it. They want people who are going to have a positive attitude who are interested in being there, who are personable and sociable. So no matter how bad your morning was this is not the time to go over every negative detail it's the time to talk about how excited you are and how much you're looking forward to the interview process, not how nervous you are and things like that.
Yeah, no that's definitely good advice. So the first kind of questions they have tend to be very general, you know, tell us a little bit about yourself. Well, where do you start that? I've seen CVs from 15 pages to 6 pages. What part of the CV do you start with or do you start with something a little bit maybe about your personal life?
You know, I think that the big pitfall for that question is that you talk for 10 minutes and again kind of a general principle for any question is danger to just talking, talking, talking and not having a conversation with that interviewer. So for something as simple as tell me about yourself, I think that should be like a 30 second a little bit about, maybe your path to what got you into pharmacy school and why you're interested in residency or something unique about yourself. Anything like that but for sure like anything more than 30 seconds for a very open-ended question like that is going to kind of drag on the interview and it isn't going to be helpful for that interviewer because they probably have ten targeted questions that they want to ask you and if you spend all the time on this very open-ended thing you're not going to get the value out of that interview that the interviewer wants to have.
Okay, so let me ask you the question and then answer it as if you're back here in your PGY-1. So hey, how would I refer you, I guess as a student because you're Dr. Kane as a professor so I kind of.
Sean is fine.
Sean hey Sean, you know, how was your trip, you know, tell me a little bit about yourself and, you know, just I want to get to know you a little bit.
Yeah, so my trip was excellent. I was a little concerned about the Chicago traffic coming from a small town where I grew up but everything worked out great, parking was wonderful to be here, you know, I'm completing my Appy rotation in critical care right now and it's going really well and that's kind of prompted me to pursue such as this residency that really helps me delve deeper into that specialty and that's really why I'm here today.
Okay and so you've kind of held true to the 30 seconds or 40 seconds and you've made clear that, you know, there's an end point to what you want, okay. So let's do some of the questions that are real traps for students.
What was your least favorite Appy? Give us the good stuff tell us what, you know, you really want, you know, what you really hated about it?
So and clearly you're getting to another key point is at no point from the time that you park your car to the time that you leave should you out really be super negative about an individual, an experience or any aspect of a rotation that you've had. There is always a silver lining and even if you didn't have a great experiment, if you had a bad experience really you really need to paint it in a way that shows that you aren't a pessimist about experiences and things like that. So to your question, a bad experience I might say something like, you know, probably the rotation that I had the least enjoyment out of was XYZ rotation and it really wasn't because it was bad it was just that I didn't feel challenged on the rotation and I didn't get a lot of value out of it. So for that reason I feel like that could have been a better rotation for me and I wish I would have gotten ABC rotation and I had heard that that may be offered a lot more value but I did get some enjoyment out of it. It just could have been a little bit better.
Okay, so if you could just tell us maybe about a leadership time that you had a struggle and then you overcame that struggle. So was there any organization that you led or a group that you led and you really ran into a wall but you managed to get through that wall somehow?
Yeah, so before I answer that Tony I think one of the best interview tips I can give your audience is when you respond to an open-ended question like that it's always helpful again trying to keep your answers concise to have kind of an introduction, kind of a body statement and then a conclusion. And that conclusion is probably the most important part because what sometimes happens is when students answer a question they don't know when to stop and because they don't have that concluding final statement and there's like this silence, they get nervous and then they just keep talking and talking and talking and then they end up with a five minute answer and they aren't really taking control of, you know, that session. So for example, for a challenging leadership opportunity I might say, you know, in terms of the intro I did coordinate a health screening event at my university. It was the first one ever and the biggest challenge we had was actually funding it and that was really difficult. In terms of the funding the university wouldn't provide us, you know, any funding for it. So we really had to seek external sources then I might go through maybe 30 to 60 seconds of who we talked to, how we ended up securing that funding and then at the end in terms of my interview answer I might say so, you know, clearly that was a big challenge to get the funding I'm glad that we finally were able to secure it and that was absolutely one of the challenges that I had in a leadership scenario.
Okay well, I'm going to lean into you on your, just because of your role as a critical care pharmacist would you be able to put together a case study that maybe would be a challenge for the students because I think what students are getting are the ones that I'm talking to right now they're saying, I feel like I've learned what I need to learn but I've never been challenged under pressure with a case study. Could you put together a case study that, you know, maybe a student could learn from and then how to answer it? And I'm not asking you as a student, I'm asking you as professor, you know, Dr. Kane give me a little bit of a critical-care case study that would be appropriate for someone that who is just graduating PGY-1 residency applicant.
Sure, yeah absolutely. You want, Tony you want one now or?
Yeah, yeah, yeah just go for it.
So, let's say that we have, you know, in our ICU we see a lot of sepsis patients in septic shock and drug shortages are a huge issue right now. So a scenario might be that we have a patient who is in septic shock who needs to have epinephrine and unfortunately that drug is now on backorder and we can't get any of it. What is your process in terms of either an alternative agent or where would you go to seek out that information to figure out what the best alternative for an epinephrine would be in that patient?
Okay and so before you answer the question what rationale are you hoping that this person is going to answer with?
So, you know, many students don't get a ton of critical care and many of the niche topics. So I don't expect every student to answer with a perfect answer but what I'm looking for is some amount of critical thought of when I do what they want to do and the other thing I'm looking for is do they have a good basis for looking up drug information questions. Because really, you know, it's the fishing pole or the fish problem. I want to potentially interview and hire someone who has the fishing pole to figure out how to go out and get all of these DI answers. I don't know that they need to have all of the fish, all of the answers at one time but they need to be able to figure out how to go get them. So to me resourcefulness and drug information background is super important to be able to be an effective pharmacist and so I'm kind of looking for what process would they go through. So for example if they say, well I probably start with Google. That interview is not going to go very well.
Yeah, I understand. So tell me a little, let me ask you to do two answers. One answer where you've had a critical-care Appy and they know that on the CV. So they've seen that you've had a critical-care Appy and then another one where the critical-care Appy actually came after and because of the lottery system they didn't get their critical-care Appy until after this interview.
So the first one is they should be knowledgeable because they have an Appy?
Sure, so a reasonable answer would be, you know, I would probably decide based on their heart rate. Something like a dopamine is a typical alternative but based on the soap to trial it looks like the risk of rhythm easel is a lot higher with dopamine versus norepinephrine. If they're a very tachy-cardic or prone to arrhythmias I might consider phenylephrine. Even though it's not a preferred therapy that would be a reasonable alternative depending on the patient and then clearly based on the response would dictate, you know, further therapy at that point.
Okay and so some people are saying, oh gosh I wouldn't have had that answer. I'm going to fail, this is going to go so badly, I didn't have my critical care Appy. So maybe if what answer could you expect from someone that has had about five residents or five Appy experiences or six Appy experiences but just hasn't had a critical care when maybe they've had internal med but their critical care because of the lottery is coming in March.
So another reasonable answer could be, you know, I'm earlier with the surviving sepsis guidelines specifically but I can tell you that norepinephrine and works primarily on the little bit on the beta one receptor. So a drug like dopamine probably would be similar but I'd have to look that up.
Okay so again really just not I think students are like oh my gosh, I'm going to forget what the answer is but that's really not it at all.
In our last interview we talked about being practice ready. So let's maybe have a question about being practice ready because that seems like what we're trying to evaluate. So tell us Sean so we'll have the two entities Dr. Kane and Sean. So Sean, how would, how have you worked under stress either in your Appy rotation or at a job that you've had during pharmacy school?
In terms of stress I would say that time management can be stressful and then in terms of, you know, my Appy rotations that I've had with time management it's working up your patience in an efficient manner that you're ready to go in rounds when started. So for me time management is always something that has been challenging. So for example, when I was on my ICU rotation I was very cognizant not just about the patient that I was working up but how I was working up the patient and always thinking about, I asked my preceptors how they're able to work up 20 patients before rounds and, you know, get all these great interventions and, you know, so for me one of the challenges that I've experienced is definitely that time management especially with patient workup and I think that I've done a good job of addressing it and getting better over time.
So it sounds like you're doing the, okay tell us something that you really struggle with but you turn the negative into a positive.
And you have to be super careful about the negative into a positive thing. All too often like the typical example of this Tony is, you know, what is your biggest weakness and then a student who cops out will say something like, oh I work too hard or I'm too dedicated to my job. Those are ridiculous, don’t do that. Because it's not and everyone knows that you're just making it up. So instead take something that you truly did struggle with and even if you're not great at whatever that thing is that you've been struggling with show improvement or show that, you know, you've taken the steps to get better at that. That's what I'm looking for not the fact that you work too hard that's irrelevant.
Yeah when I was at ASHP this year I saw a group of residents and then when I was in kind of my cohort the group of residents tend to kind of act as a pack not a mean one or a bad one but more like I think, you know, if we had somebody do that in front of the five or six of us, we'd be like boo, you know, we'd boo, you know, answer the question, answer the question. So we wouldn't, I don't think we would let something like that go. But tell me a little bit about the one thing that I think another concern that students have is their presentation. So what recommendations do you have Dr. Kane for making sure that your presentation is it's going to be maybe five ten minutes. I talked to Brandon and I had pictures of, you know, people with their tubes from like ASHP because that's kind of ubiquitous, you know, on the plane and, you know, tubes on the plane and, you know, they're bringing it to this interview but how do you, how do you choose a topic if they don't give one to you, what was your experience with that getting in front of people and just presenting a case? How much can you get away with in terms of, you know, content, you know, you can't do a whole trial, what part of a trial do you take, things like that?
So Tony in your experience are students typically doing PowerPoint presentations or more like a verbal five to ten minute thing that they're reading off of a paper?
I'm hearing that they're being asked to send their PowerPoint to the residency director and that they'll make a presentation of five to ten minutes and that, you know, people are going to be coming in and out and, you know, X number of people are supposed to be there and then other people are going to try to be there. So let's say we have a room of five people, there's going to be a couple interruptions but you're going to be giving an eight-minute presentation on a clinical case.
Cool, so the number one thing that students need to realize is that when you review off your slides or you read off your notes you lose the audience and it's horrible for engaging that audience. So the best way to not do that is to what I call detextify your slides. So just have less text and there's a bunch of different like rules of thumb like a seven by seven or a four by four rule in terms of four lines of text with no more than four words per text. It doesn't matter what the rule is but the less text you have on your slides the more you're going to have a conversational tone, a better delivery, you're going to engage the audience they'll be watching you and listening you instead of reading your slides because you've included like a paragraph of text on your slides. That's the number one mistake that many students make and if they fix it it's also the number one easiest thing to do to make.
Okay, so I guess when in terms of nervousness how did you control your nervousness at the most important interview that you had? So some of them they're going to be not as nervous because they have one in their heart that if this would happen and they got this residency then their life would be complete. How do you control that nervousness or how do you work with that anxiety?
So I think that one, you have to think about why are you so nervous or anxious with the student presentation. For me as a student my anxiety probably came mostly from what if they asked me something I don't know or they call me out as something that I present something incorrectly something along those lines. And for something like that the best way that a student can respond to that kind of a challenge is to say, you know, that's a really good point I'd have to look more into that. And they know that that's kind of a cop-out answer but it's by far the most professional answer. You don't want to be arguing in terms of well that's what the article said so that's why I put it there or something like that. You need to be incredibly professional and if they do ask you something that you don't know or they disagree with something you said you have to have some way to basically say, you know, that's a great point I need to look more into that to be able to fully answer that question or to address your concern that you're bringing up. In terms of everything else in terms of anxiety I don't have a magic bullet here, you know, if it's the program of your dreams and you're finally there, you know, I guess just a, you know, words are one thing but being confident is really what it comes down to. So be confident in your skill set, be confident that you're a good match for the program and vice versa. That confidence is what's going to hopefully help with some of that anxiety for you.
Okay well, is there anything that I didn't address that you think that a potential PGY-1 student should know in preparation for their big interview days?
So I think the other thing is be thinking about what questions you want to ask your respective interviewers. So you let's say you have five different interviewers throughout the day. They're going to expect that you ask some number of questions again it depends on how long the interview is and how in-depth you get with that interviewer but it kind of shows that you're not interested in someone or in that program if you don't ask a question here and there. It's engaging, people want to talk about their program and about themselves. The trick here though is that you should not ask questions that are readily available on their website like, how many required rotations you have, you know, something like that, not a good question. The best questions are questions where you're asking that person about how they interact with the residency, what their impressions of XYZ are, maybe, you know, how they've been involved in residency research projects. That's always kind of a hot topic because there's a lot of heterogeneity in terms of the quality of the research process and the projects and things like that. But again don't be asking questions that are kind of obvious questions or super open-ended questions like what is the biggest weakness of your program, not a great question. But something like, you know, what has your involvement in the residency research projects been, probably a better question.
Okay, well Dr. Sean Kane thanks so much for being on the Pharmacy Leaders Podcast.
Thank you Tony.
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