In preparation for the APMLE I board exam, all attention during spring semester of second year is focused on studying and passing the test. Before students have time to catch their breath, they are required to send in an application detailing where they hope to extern the following year. This leaves little time to gather and process vital information on which programs they might want to attend. To help students get the most out of this process, we interviewed fourth year podiatric students who have recently gone through this very application process. These students are currently externing at residency programs all over the country and had the following advice to share.
Question: When applying for externships, what did you look for in a program? Since beginning your externships has this changed?
Student 1: I felt very lost when applying to externships. We had just taken boards and I felt like right away we had to try to think about residency which seemed far off but was coming quicker than I thought! I only applied to programs I could see myself at. A couple of factors influenced my decision: size of program, location of program, and experiences of upperclassman. Sadly, there is no magical way to pick programs and asking around to WesternU alumni and upperclassmen is very subjective on their experiences. However, going on the CASPR website you can find out facts such as how many residents per year, academics, which hospitals they are at, and more. You can also reach out to the programs and talk to a resident and ask questions.
Student 2: When I was looking at applications I asked people for recommendations and since then I have been looking at three main qualities. One is academics, two is social life and three is location. Also, I now look at people in the upper class that have similar personalities as me and similar goals as I do. I think it is important to keep in mind where the residents match as well.
Question: What has helped you do well in externships?
Student 1: It seems common sense, but simply working hard goes a long way. They want a resident who will put in hard work and be fun to work with. You always want to be prepared whether it is showing up early, getting supplies, reading up before a surgery, or even having scissors in your pocket. Really simple things surprisingly go a long way. They understand during residency you are there for training. They know they can always teach you areas you don’t know yet, but they can’t teach you how to be a good person or how to have good work ethic.
Student 2: Anticipation of the next step and simply being on time. Also, having the right equipment in your pockets at the right time; including scissors or a light.
Question: How did you prepare for externships before starting? Was it sufficient?
Student 1: I thought didactics were extremely helpful. I got “pimped” on many of the questions word for word and was able to recite the answers. Didactics also teaches you how to think critically. Even if you don’t know an answer, programs want to see your thought process. Reading Prism and Crozer also helped. Prism is good for a brief “how to work up” a case and Crozer is rapid fire questions that you may get asked.
Student 2: I don’t think I really prepared that much and I think I’m fine but who knows!
Question: Did you have a strategy in selecting the order of your externships?
Student 1: I really struggled with this one. The programs at the beginning I assumed I would be less prepared but putting programs at the end you might be burnt out even though you have more experience. I honestly don’t think it matters and would put them in order that makes most sense logistically for traveling. I put mine so the mid-west was first, then east coast, then west coast so I wasn’t flying or driving back and forth. I thought my first programs really understood that it was my first externship and knew I was going to learn more as the process went on.
Student 2: I ranked the programs best out of five in three different categories. One, academics (a.k.a. can I learn from this place and is their style learning congruent with how I learn?). Two, social (a.k.a. do I get along with these people, can these people be considered my family or friends during my residency years). Three, location (a.k.a. can I live here, can I deal with the traffic, can I start somewhat of a family here if I want to?).
Question: What qualities in a program have you liked? Disliked?
Student 1: There are many qualities in a program that I have been looking for. First is how hands on the program is. It is important to look at how much the residents are doing in surgeries, not how much you are doing as a student. If you are with a third year, you want to see how competent they are with working up patients and treating. Secondly, I looked at the environment. I personally want an environment that the residents all get along and hangout outside of work. Third, I am looking at how academic the program is such as if they have journal clubs, radiology, grand rounds, etc. Lastly, I am looking at where the residents go after residency. Are they getting jobs right away? Are they staying in the area? Are they going into private practice or hospital or multi-specialty?
Student 2: I personally like programs that are well-rounded because they set you up well post residency. Those that are heavily surgical do well in the surgical numbers but that’s not how you make a living. You make a living off of clinic as well as surgery, if you want to experiment in surgery. I’m looking for a place that is able to train me in low income situations, elective surgery situations, and trauma situations as well. I’ve disliked sometimes being at the very bottom of the totem pole and having no familiar face to be around. You are traveling outside of your comfort zone, you are a living outside of your comfort zone and you were working outside of your comfort zone so you really have to re-discover who you are and give yourself the time and space so you don’t go insane.
Question: What is something you wish you knew before starting your externships?
Student 1: I wished I would have been less nervous. The night before my first externship I was terrified not knowing what to expect. We are well trained and we are there to learn. The whole purpose of externships is to continue your education; they don’t expect you to know everything right off the back.
Student 2: How much I would miss my friends and family.
Question: Any other pieces of advices from your experiences thus far?
Student 1: Have fun and take time for yourself! This is a tiring process with moving, long hours, and fast learning. Reach out to your friends and stay in contact. Mental health is equally as important :)
Student 2: If you can coordinate with your close friends and your support group, or have family around, in places where you apply to externships, it would be very advantageous. You can study together, as well as hang out together and explore together without compromising loneliness and sadness and danger (especially if you’re a girl). Another thing I love is meeting really awesome people from residents to externs to attendings. Our profession has some amazing people, but it is just like a hidden gem; you have to work hard to dig and find them.