The Worst Question To Ask When Interviewing For Residency

What do medical students look for when they are interviewing for a residency spot? What sorts of questions should they be asking when they go on their interviews? Should they ask about the intensity of the patient workloads? Does the quality of the weekly conferences make a difference? Should they inquire about how many research papers are published by the program's residents? Or for the truly crass, should the students ask about the vacation schedule and salary?

I was walking through the hospital the other day and passed a whole gaggle of medical students coming for residency interviews. As they were being led by a current resident, she asked them if they had any questions. One intrepid interviewee then boldly asked, "Do you guys have a gym?" I almost stopped in my tracks as I heard that. It took all of my self restraint from reaching out to slap that idiot upside the head. The resident guide kept her cool and gamely replied that the hospital does not have a gym for the residents but that there are plenty of gyms nearby they can sign up for.

The gym question is so wrong on so many levels. First of all, while the ACGME has relaxed the rules for residency hours, it is still a total grind. You will be exhausted like you've never been exhausted before. You think you're tired during medical school but you haven't experienced total and complete mental and physical fatigue until you've gone through residency. What makes that person think he will have time to go exercise on a routine basis?

Second of all, if you did have the time to work out, you probably should be spending that time more wisely doing medically related activities, like reading and research. With restrictions on work hours, residents have even less time during their three to five year residency commitments to gain all the knowledge they should to become competent physicians afterwards. With the vast explosion in medical information, it is almost incomprehensible that anybody can adequately prepare to become a doctor in such a short amount of time. Going to the gym four times per week? Forget about it.

Finally, what does the gym question say about the priorities of that particular student? He is advancing his career to better understand the human condition and help sick people. But one of his main concerns is how the residency program will help him maintain his big guns and six pack abs. Though maintaining one's health is important, that is not the responsibility of the residency program. Find your own time to exercise in residency. Don't expect a program to offer five star hotel amenities. Remember, if the programs had their way they would still make residents work one hundred plus hours per week with every third night call. They couldn't care less if by the time you finish training you've shrunken down to a pale and ghostly 120 pound weakling.

Sure I knew some residents who could have it all. One of the smartest residents I ever met was in my residency class. She just blew everybody away with her intelligence and wit. She knew every question the attendings threw at her during grand rounds. She seemed to write up papers and abstracts on a monthly basis. And she always had great stories to tell about her latest activities, like kayaking around Catalina Island or surfing in Costa Rica. But I also think she was hyperthyroid and a bit manic. She only needed four hours of sleep each night, if that. So unless you plan on cutting your sleep by half during your training, don't plan on having much time for your workout regimen unless you don't mind being a mediocre resident. But at least you will look fabulous in the naked selfies you post on Snapchat.

My iPhone Says I'm A Slug

I love my iPhone 6 Plus. It's large screen and extended battery life makes it a delight to use. Unfortunately it has one flaw--it's a total nag. Why? Because it reminds me every day how sedentary my life as an anesthesiologist can be.

Anybody who uses iOS 8 has Apple's Health app on their iPhone. The annoying thing about Health app is that it cannot be turned off or deleted. It is always working in the background tracking your every movement. I discovered this a couple of months after getting my new iPhone when I happened to open the Health app out of curiosity. Lo and behold it had counted how many steps I'd been taking and how many stairs I'd climbed every day since I bought the phone.

At first I thought this is great. Who needs to spend extra money on a fitness band when my phone can already track my steps for me. Pretty soon the Health app became an obsession. I started checking it several times a day to see how active I was. Quickly it became clear that my gluteus maximus was supporting more of my body weight than my calfs.

Most days I average a little over 5,000 steps a day. Not great I know. I'm just telling it like it is. But those 5,000 steps are made very episodically. On a long, uneventful case, I discovered I sometimes take as few as 8 steps an hour. EIGHT! I take more steps than that walking from a bathroom stall to a sink. It's really pathetic that sometimes my longest walk of the day is from the doctor's parking lot to the operating room.

Since I do 100% of my own cases I have the luxury (or curse) of being involved in lengthy uninvolving procedures. If I was supervising several CRNA's I'm sure I would add a few thousand more steps to my daily routine. Since I don't, I have forced myself to go back to the gym more regularly. (One more reason why I haven't blogged as regularly recently.) I found out if I run a couple of miles on the treadmill then I will just barely edge past the magical 10,000 steps per day regimen.

Now I'm not so sure I want to get the Apple Watch anymore. I don't need another device to tell me to get up and walk around. One of the main purposes of purchasing the watch is for its fitness tracking functions. But I'm already aggravated by my phone's ceaseless stalking of my daily routines. If I wanted more nagging, I would just stay at home more often.

A Fatal Flaw In Logic

The medical profession is in a constant nagging mode to get people to exercise more. We rattle off the statistics about longer lifespans and better self esteem in people who exercise regularly in a quixotic attempt to get people off their butts. So in that spirit of exertional encouragement our hospital has decided to paint motivational sayings into the only place on the premises where people can routinely get their daily exercise, the emergency stairwell.

As you can see from these pithy quotations, they all extoll the virtues of a vigorous body, which in theory should lead to an equally vigorous and astute mind. You would think that daily words of encouragement would get more people to exercise and climb the stairs, right? Unfortunately, the hospital's HR Department has its heart in the right place but the execution has failed miserably.

It's pretty obvious the fatal flaw in logic when somebody approved the laborious task of stenciling in these sayings against the front of the stairs. The people who need to exercise the most are not the ones who walk the steps every day. They are the people least likely to see these inspirational words. I personally try to take the stairs when I don't have to go higher than three floors but I know some people who have offices on the top floor who climb all the way to the top every day. We don't need any extra support to get ourselves to exercise.

Unfortunately there are people who will wait for an elevator for five minutes just because they don't want to walk up even one flight of stairs. These are the employees who usually have a little too much junk in the trunk but can't or won't put in the effort to walk up the stairs. I look at them and  wonder why they don't bother to just walk a little further to the stairwell, which in our facility is right next to the elevators and get a little blood pumping. If they do that every workday for a year they could burn off thousands of calories. The worst offenders are the people who will wait for an elevator so they can go DOWN one flight of stairs. That just annoys the heck out of me.

So if your hospital is trying to get its employees to exercise more, by all means encourage them to take the stairs. Just try to put the motivational speeches OUTSIDE the stairs where it will do the most good, not inside.