"Tell me about an event where you did not agree with your senior or attending. How did you handle it?"
You may wonder why there would be disagreement between a medical student and the attending? This is commonly because an important piece of detail often gets overlooked or missed because of error or preoccupation with another event.
Just like the movie ‘Batman Begins’ where Bruce Wayne is asked to hurt a civilian for some wrongdoing, instead of hurting the man, he lights a fire in the league of the shadows and escapes to Gotham City. This is an example where he disagreed with this superiors. What are possible scenarios appropriate for the residency interview?
Here are two examples where the applicant was in disagreement with his or her superior.
Example #1
This is taken from an online practice interview that I performed at ed4medus.com. Click on the link below to listen to the audio clip. You can read below the transcript of this clip from the interview. (Identity of the applicant has been withheld to ensure confidentiality).
Dr Ed: ...and so certainly you were working as part of a team like you mentioned with the senior resident and attending. Was there any time you came across a situation where what the attending or what the senior resident was telling you was something that you felt was not the right thing to do. Something that was wrong and so what did you do in that situation?
GM: Well, there was one case. It was a surgical case. We were at the OT (operation theater) and my attending was performing an operation. I was the one who was assisting him. It was a neck node dissection (radical neck node dissection) and while he was operating, I could see the pleura, the pleural lining of the lung coming out of the surgical field. But he missed it. And he was about to reach it. So, I immediately pulled his attention towards it and made him stop.
At first, he didn't believe me. He never thought the pleura was a bit higher than the usual level because the patient already had fibrosis due to the previous surgery due to scars and all. And the pleura was much elevated than the usual site. But I could see it blow in and out because from the position that I was standing I could see it clearly. But he missed it because he was standing in a sideways position. So, I made him see it through my position. I cleaned the whole surgical field and made him see it clearly and he understood his mistake and apologized and he really thanked me that day for not letting him do such a mistake.
Dr Ed: Fantastic!
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Example #2
(Source: facebook.com/groups/ed4medus/)
There was this time when I just finished writing my research paper and I had a disagreement with my mentor about which Journal we should be submitting that paper to. I wanted to submit my manuscript to Circulation, a high impact journal, as I felt that would be great for my research career and it could reach a much larger audience though I did realize that Circulation is a very competitive journal and it is difficult to get a paper published in it. My mentor felt that we should submit it to American Heart Journal, a respected cardiology journal but with a lower impact factor.
I looked at the papers published in Circulation and found a paper published just under a year ago that was very similar to my study design and the question that it was trying to address. This gave me confidence and I approached my mentor with this information. I asked him for his thoughts about trying our hand in Circulation and that the worst that would happen is they would decline my manuscript and we could then submit next to American Heart Journal. He reluctantly agreed and I submitted my paper to Circulation. After a few weeks, we heard back from Circulation and the editor and 3 reviewers were willing to reconsider our paper after a major revision. Both I and my mentor were very happy about this response and very glad that we chose to submit to Circulation.
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When answering this question, make sure you are not suggesting that your senior resident or attending has a poor character or incompetent or lacks sound judgment (this maybe true but the residency interview is not the place to belittle those who contributed in whatever minute way to your medical education).
How should you not answer this question? When recounting the event, NEVER show that (1) you know more than your attending or (2) you can get away with doing things behind their backs especially ordering medications or tests (requesting additional medical or surgical input is not too terrible, though as basic courtesy, do let your attending know what you are doing).
Do share your thoughts in my facebook group and I can comment on your response. Plus, you can see other's responses too.
That’s all for now. Hope you like this post. I would love to hear your thoughts and comments. Join the mailing list or my facebook group and check out Ed4medus.com to learn more about personalized services to help you get into a US medical residency program.
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