Jan 17, 2018
In this episode, Jackie Boyle, PharmD, MS, MBA, BCACP, BCPS Assistant Professor for Community Pharmacy Innovation at Northeast Ohio Medical University (NEOMED) comes back to help us with residency interviews and advice from residency invitation to ranking the programs.
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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 again to the Pharmacy Leaders Podcast. I know a lot of you guys are thinking about interviews and hoping for some good news in your inboxes from residencies around the country. So I've brought Jackie Boyle in to help us out tell us her road. She did PGY-1 and PGY-2 and is in academic position at Neo-Med in Ohio. So welcome to the Pharmacy Leaders Podcast, Jackie.
Thanks Tony, thanks for having me.
Okay well, let's get started right away. My wife and I did scramble so our journey is completely different than probably what you went through. But what I wanted to do is kind of get your perspective, we've gotten Brandon's perspective already on it but your perspective on, you know, you're here in January, what was it like the January that you were starting to get those interview notices that yes there were residency sites that were excited to bring you in?
Oh gosh, so that feeling is both thrilling and terrifying. Because you've worked so hard and students I know if you're listening you've worked so hard so give yourself some credit for getting this far because it's a lot of work and a lot of time and effort to prepare for residency and even just the application process. So back in the day when I applied, it was paper applications. So believe it or not we sent our applications through snail mail and that was a little bit scary because you just hoped and prayed that your application actually made it to the RPD. And knowing how slow sometimes hospital mail transport can be you wanted to know that it got there in time. So start this process as early as possible. I realize we have forecast now but the holidays, if you want to spend some time with your family get into forecast as soon as it opens. Get that application done and then come January you start to see those emails rolling in.
So tell me about that. Tell me what actually happens though? Now I know your system was a little bit different with forecast but how are you advising the students now or are you working with the students like, hey let me know as soon as you get an email and then we can start talking about the process, how do you support your students at Neo-Med with these types of things?
Yeah, so when I was a student I actually went to Neo-Med as well. When I was a student we had, we did not have any dedicated resources to helping students prepare for residency training. My mentor and now colleague Tim Albrecht started during the end of my third professional year and he was the new dedicated resource to residency. So while we didn't have any courses or preparation at the time we all kind of flooded his office and thank you Tim for everything.
Okay.
Now that we've developed our programming much more we have a elective track that students can opt into that prepares them from residency from their first year through their fourth year. We also have a third year residency elective course that helps the students prepare most of their materials for forecast and also make some good networking connections with local programs in Northeast Ohio. Because we find that a lot of our students actually end up staying in the area. So those resources are invaluable. Students please take advantage of and I'll use that word, take advantage of your faculty and their network that they've built, the skills that they've had. They've likely been in contact with residency directors in the area and especially if you have any dedicated academic programming towards residency preparation I use that to your advantage because that can really help you take the stress off of this time of year in the application process. And then you can reach out to your mentors and faculty when you do start receiving emails. We don't have a mandatory process to say that students need to contact us when they start getting notifications but we do have several of them that ask us about how to navigate the process as its happening. So for example, you're probably going to get notification from all of your programs within the second or third week of January. And you have to decide then how you're going to schedule these interviews. So what if there's an interview at two different places on the same day and you have to pick between those two programs.
Oh my gosh, that's a terrible choice to have to make.
And that doesn’t happen often. I'd say more often it's programs offer three or four days for interviews and some of them conflict with three or four days that others have offered, so how do they prioritize which program to interview with first. But I have seen maybe one or two situations where they only offered one interview a day, another program also only had one day left, for example and the student did have to select between those two programs which is really unfortunate.
Okay so tell me a little bit now about the actual travel plans, getting things together. We, my wife and I were a pair as we were applying for residency or we were a couple in the scramble. Made complete turnaround in terms of we were going to do DC Baltimore area or she was going to do DC Baltimore then we decided to do Midwest. tell me a little bit about how that happens, how you, you know, you get the emails and you start plotting out your trip around the country, you know, you're free to move around the country as they say?
Yes. Well firstly, it's good to notify your Appy preceptor that you are in this process depending on what rotation you have in late January, February and even early March sometimes interviews can happen. You'll want to let them know that you are going through the residency process and you may need to request some days to go interview. If you are traveling out of the area you'll likely want to budget at least one day for a travel depending on where you're going and you'll need to know when you need to be there. So some programs do have a dinner the night before or some commitment the day before your interview that they'll want you to be present for. And they will let you know that way ahead of time. I will say I did, personally I did have one situation where I was notified pretty late. I think it was the last week of February about an interview offer and getting close to, you know, ranking time I was debating. It was out of the area I didn't know if I wanted to fly the flights were astronomical because it was, you know, a week before I had to actually go to this interview. My parents were very supportive and said hey we'll help you out with this, you know, we will help you fund this trip because this is the only time you're going to interview for residency. So anyway I ended up going on a short turnaround and it was definitely worth, you know, going on that flight. So budget, money wise as well so, you know, as you're looking at your financial aid or your personal budget for these next couple of months, if you're going to be traveling you have to think about the hotel stay, the food, what if you need to uber or get a taxi to go somewhere. You're likely going to need that or if unless you're driving for some reason counting on how far it is. So think of all these financial implications as well when you're making your final commitments to selecting interviews.
Okay so, you've decided on your interviews let's say you have landed at one of your interviews. Take us through that day, tell us the story of that day because I think many students are like they hear about residency and they hear about the actual what's going on and they see residents but they don't actually see what a residency day looks like. So they wouldn't be in on, you know, residency hiring process or something like that or the residency interview process.
Right.
So tell me about the interview day and some the tips that you have for succeeding and making it through what I believe is an exhausting process.
Yes, so can we talk about the day before?
Oh yeah I didn't, so I'm kind of naive to it because we did the scramble so it was just come on in with the RPD, have food.
Yeah.
Meet the residency sites and go back. So what was yours like?
Yeah, oh no problem, for those places where I went out of town or on a flight. The day before was and even in town I guess as well was my preparation day. So I would recommend not scheduling residency interviews on back-to-back days if at all possible. One, from a exhaustion standpoint but two, from a preparation standpoint. You want to have a hundred percent of your energy focused on that residency program. So while you're on your flight or even the day before if you're local and you're staying some, you know, close. You should be finishing all your final research and detailed questions for that program the day before. So look at the preceptors you're going to be interviewing with, you know, see if they've published any new articles or changes that they've made to their program or precepting responsibilities if you can find that available. Because you can have some really impactful conversations during your interview if we have these specifics to talk about and while I did not know I would be asked about this while I was interviewing I was asked by a few interviewers, you know, have you read my recent article in this journal? What do you think about it? And thankfully I had but I didn't know that that would be a question at any point. So having done that research I think was extremely helpful. The day of the residency interview is definitely exhausting, you want to have a lot of more sleep than you think you need the night before because this day will be eight ish hours of you and you're 100% energy into talking and thinking and reflecting throughout the whole day. So usually a residency interview is all-day process, you'll arrive anywhere from 8 to 9 in the morning usually when a residence or other person from the program would greet you. You'll likely have, it depends on the structure of the interview. But you'll likely have several interviews with preceptors, current residence, staff, the residency director, may be the pharmacy administrator of the departments and you'll want to have questions that are tailored to each of these groups of individuals. I know something that was a little bit surprising to me was how much time during the actual interview day I had to ask questions. There was one interview I had where half of each block of my interview time was dedicated to me asking questions. So now, half of that half hour was 15 minutes of questions to me and then half of that time was reserved for me to ask questions. So if I didn't have any questions available that would have been a really awkward 15 minutes. Other parts of the interview day might include a clinical case. So this could be either on your schedule or it could be a surprise and really what the preceptors are looking for there is your thought process and how you rationalize your recommendations. You may have to present something whether that's pharmacy related or not and that should be told to you way ahead of time. How much time you'll have available, usually it's only 15 minutes to present your topic and then sometimes you'll have a tour of the institution. I'd say one thing that really varied from my interview process was individual one-on-one interviews versus group interviews. Which we can probably do a whole another discussion about because the dynamics in each of those types of interviews is very different and you can really do well in each of those settings or you can maybe not shine as much especially in the group interview.
Well I guess what I'm concerned about is that kind of fatigue as you go through the day you may hear the same question over and over again, you know, there's, you know, you can't really stop to say hey, I just need to get a couple of 5-hour energies or, you know, and so I guess they don't you kind of have that afternoon kind of downtime or whatever it is. What did you do to keep engaged or was it just, did it just fly by?
That's a good question. I think it was so fast that I realize, you know, what time it was the days while they are jammed, you know, while they are exhausting, they are jam-packed with stuff you're basically just going back to back to back to interviews. And even during the lunch process I forgot to mention that they will go on a lunch likely with the residents. You probably don't have time to eat a whole lot. So try to get as much nutrition as you can during that time because you might not have that much time to eat. But honestly, getting that that full night's rest is super important and they might offer you coffee at some point throughout the day although if you're too nervous that might not be a great idea because we all know what caffeine does to us.
No absolutely, absolutely. Well tell me how it works afterwards. So, let's say you had four interviews. You've gone through four interviews you like one, you decided that maybe that third one that you did wasn't really a good fit after all. How does the match work? I really don't actually understand the process itself. After maybe let's say, I got four interviews and I went through four interviews and I definitely know I want one really bad. I definitely know I don't want this one all of a sudden and then the other two I would take and I would be happy enough with them. How does that work?
Yeah so, you will get, and this sounds very cliché, but you will have a gut feeling about where you're number one and probably your number two programs are. And I think that decision is probably the most difficult is one versus two, you know, it kept me up at night several times and I even had a nightmare that I submitted my friends rank list instead of mine, so.
Oh my gosh.
I called her and I'm like Christie, I think I submitted your rank list. Anyway that didn't happen but the programs that use, you know, maybe you thought that it was a good fit when you first met with them but then the interview wasn't what you thought it was going to be. If you can't see yourself being there for an entire year, you know, 42 question-mark hours amount of week. You don't have to rank all the programs that you interview with just like the programs don't have to rank all the candidates they're going to interview with. So the match will favor the candidates' preferences, so remember and, you know, it's hard to keep this in mind throughout the process but you are interviewing the programs just as much as they're interviewing you. Now at the end of the day the program is likely going to match a resident but you need to match with the residency that fits you best. So figuring out after each interview I went through a process where I put, you know, my new rank list in order and really took them a couple of hours at least to reflect on what just happened. You know, how did I feel throughout that interview, what did I really like, what didn't I like as much, how were the current residents feeling about the program itself and that gut feeling and that intuition will really help you rank your programs at the end of the day. If you don't have the gut feeling I would say talk with your mentors. Sometimes they can ask you some hard questions to help you really identify where you're thinking you'll end up.
Okay, so now you've got the good news. You've got, you match with a program. What happens next? There's a long time between graduation and match day which I think is March 4, 2018. I feel like there's people listening to this right now they're like, of course it's March 4th everybody's waiting for March 4th. What time that day, you know, so what is that like what like, what happens afterwards? Do you get like, here's your residency success instruction booklet maybe a little grief booklet for not matching. Or how does it work?
I think, I'm trying to think of what it is. It's right after APHA this year so I think it's the 20th.
Oh maybe I am wrong. Okay so maybe I'm off by three weeks, that's bad.
That's okay. I think ranking is due sometime that first week of March.
Okay.
That first week and I believe it's the 20th this year which is a Tuesday, which is interesting because they usually have it, you know, at the beginning or the end of a week but that Tuesday it's kind of odd. Anyway you, so you find out your match results which is very anti-climatic, Tony.
Really?
Well it just, it's very exciting but it comes in the form, have you, when you went to there through the scramble you probably didn't get this. You get an email from the national matching service that says one line of congratulations, you match with and then your program name and that's it.
No, no, we just got a call from the residency director who just ended up being kind of like a friend because its Midwest nice like, you know, in the Midwest we're just like hey yeah so we'd love to have you.
Yeah.
Okay we'd love to be there and that was it. Yeah so I guess I have to tell you a quick story about anti-climatic.
Yep.
And I really let my wife down. So we were infertile for two years, you know, waiting for children and all of that. 4:00 in the morning she comes over and tells me hey, we're having babies and I say okay, and I fall back asleep. So I feel like it's kind of like I let her down like, I should have had it prepared like some kind of yes, yes, you know, and I really blew it there.
And by the way it's triplet.
Yeah, yeah by the way it's three, you know. That news came a little later. But I guess, so, you've worked for, you know, you've been in school for 18 years or something like that.
Right.
And you've got in the residency, you know, you of course are going to be posting on Facebook on Instagram and letting everybody know, you know, but I guess, what is the next step? Because you got this email so, cool.
Yeah.
I have somewhere to go July 1st but now what do I do?
Right and when I might want to set the anti-climatic I meant, the email was. The actual opening of the email finding out the results that's one of the best moments of my life that I'll remember forever. It was just funny that it came in the form of like a one-liner. Anyway, so you're in this weird period right and usually something I definitely didn't anticipate was that you will have to do some sort of interview slash formal process with HR at the institution. So you will have to, you know, formally apply to the position even though you've matched there which is awkward. But it's not difficult at all you just, you know, put your CV there like a regular application. You might have to have, I know I had a phone interview with the HR for maybe a half an hour about how my value is lined up with institution values. No more difficult for sure than the residency interview process and then from there you're really in, you know, Naplex and MPJE prep mode. So making sure that you can pass the boards and take that residency position. I know most programs are looking at either August 1st or around that time to make sure their residents are licensed by that time. But otherwise you'll likely, you know, hear from the RPD. You might have to go to the hospital to meet and greet with everyone or attend some sort of orientation a couple days before you start your official residency job. So it is a little bit of a job process even after you go through all this matching but definitely not nearly as difficult or stressful as the residency process.
Yeah Brandon talked about that. How it's a job, they're hiring you for a job and we keep maybe have the misunderstanding that we're still going to school but no it's a job it just happens to be a place where you're going to learn a lot. Well maybe let's transition now to something which is a little more straightforward. Getting a PGY-2 but not having to go through the match. I talked to residency director at the University of Maryland who does a PGY-2 and psych or she's in charge of a PGY-2 and psych and, you know, sometimes you they have, you know, a student or a PGY-1 and then that carries over but I don't understand what that is. What does that mean to not have to go to the match for PGY-2?
Yes, so if you're at an institution that has a PGY-2 in an area of interest that you're interested in. You can do, you can go through the process that's called early commitment where you essentially take that spot ahead of the match even happening. So basically it is a little bit formal in the sense that I know I had to submit a letter of intent to my own PGY-1 director who I worked with, you know, every day and knew very well what my intentions were. But from again, from an HR standpoint there needs to be some formality to this process so that they have documentation that you actually applied to the job and you're interested etcetera, etcetera. So expressing interest to your residency director and your preceptors as you are in the first half of your residency year can seem a little bit rushed at times but if you have a clear understanding of where you want to be at the end of PGY-1 then sometimes that helps you identify maybe I do want to early commit to this second year program. Now you can only do that at an institution that has a PGY-2 to early commit to and I should give one caveat not all PGY-1 programs that have a PGY-2 available will go through and early commit. So it's definitely an important question to ask as you're approaching PGY-1 interviews. If they have a PGY-2 let's say in am care that you're interested in, that might be a question as you get either get to the residency interview or even beforehand to say, you know, have your PGY-1 residents been able to early commit to that second year program because I'm very interested in it. And if they tell you no, that's a good thing to keep in mind. If they tell you yes, that's also a good thing to keep in mind because then you can anticipate October or November applying to and early securing that program if possible.
So the early commit doesn't follow the January, March calendar.
Right.
The early commit is literally early July, August, September, October. That means you're four months into your residency where you could commit.
Yes, usually it's around October or November where the actual commitment happens because something else that can happen too is, let's say there's three PGY-1 residence and only one PGY-2 spot well what if all of the residents want that same spot. You know, and a lot of programs will actually end up going through the match in that case and they have that option to continue to the match process, you know, the traditional schedule if they so choose or if they have no PGY-1s that want to early commit then they would also traditionally go through the match.
That's something that I know a number of students were concerned about is, am I applying to a program where they may already have somebody that they really prefer. Is there any way to know or is that just kind of luck of the draw where maybe there are three PGY-1s like you said for that PGY-2 but since it's open to the full match there might be other people trying to apply for it from the outside. You would never really know that their internal and external. It's just, you know, you've applied to this program or I guess you could intuit that oh well, this is a program that has both and then choose to go through the match. I guess I know a lot of students are concerned that like, well am I going to this program when they know they're going to probably pick someone else. Is there any advice you could give that way?
So you're thinking about, you're talking about PGY-2.
Yeah PGY-2 where you have that internal structure but they've opened it up to the match. Are you really at a disadvantage coming from the outside?
Maybe and I say that because I've seen some scenarios where the PGY-1s are not interested in the PGY-2.
Oh okay,
That's there. So, you know, if the program's going into the match then likely either their PGY-1s haven't demonstrated a strong commitment to the PGY-2 or they're in that other scenario where all three of them want it.
Okay.
And you wouldn't know unless you have good, unless you have a connection, you know, to those PGY-1 individuals. So if your network is big and then you might be able to find out what's going on with that program but it could be one of those two scenarios. There's probably another scenario that I just thought of because I heard about it from another program lately where the PGY-1, one of the PGY-1s was unsure and then decides late that they want to pursue that second year and early or not early commit but they'll have to actually go through the match because they missed the early commitment.
Okay.
You know, so they have, they probably have the internal first year advantage because likely the program likes them.
Right.
If they're there for their first year but again you might not ever get to know those details. So I would just recommend, you know, pursuing what it is you want with a passion and the match will work out the way it's supposed to.
And then as far as a recommendation when and I'm going to go back to retail then I'll talk a little bit about residency. In retail you don't get hired as a manager at the store that you were a technician or you don't get hired as a pharmacist at a store you're as a technician. It's just awkward for somebody who was, you know, a subordinate to now be a super-ordinate or a boss or whatever, you know, manager. So is it better to do PGY-1, PGY-2 at different places or now that, you know, the EHR and now that you kind of know some people you've just gotten your feet under you, is it better to be at the same place? We know what decision you made but can you give us pros and cons for each?
Sure, yeah I think, you know, pros of, I'll start with my more familiar zone of being at the place that I did my PGY-1 is exactly what you mentioned Tony, you know, there's not really a transition time where you're going through orientation again. You already have good relationships with everyone at your site hopefully and there is a familiarity with the program. Perhaps the drawback is that you aren't, you won't grow from learning another system or maybe miss out on developing new relationships at another program that could have been beneficial for the rest of your career. So now that you could definitely weigh that as you're deciding depending on if you go to a program outside let's say a PGY-2 outside of your PGY-1 institution. There may be more opportunities, you know, a benefit of going outside could be more variety of rotations if it's a larger institution, those new networking connections that you'll make after that year-long experience. The downsides again would be the transition time perhaps it wasn't as good of a fit as you thought it was or, you know, you may not have had time to travel as much during PGY-1 to get to network and know places as well as you did when you were a student. So there could be some drawbacks that I could see with both of those situations too.
Okay, well I want to make sure that we keep these episodes around 20-30 minutes I may need to split this one but maybe next time we'll talk a little bit about your road from PGY-2 to an academic career. I know a lot of students are hoping to do the PGY-1, PGY-2 into academic career but just as a maybe a teaser to better understand what your road was, did you go straight PGY-1, PGY-2 or did you go into some kind of clinical practice first? What was the road, what did it look like?
Yeah so I did PGY-1 and then I early committed to PGY-2 and then took my first academic slash practice-based position right after PGY-2.
Okay awesome. Alright well, Jackie thanks again for giving us all your insights and being on the Pharmacy Leaders Podcast.
Thanks for having me Tony.
