This residency interview season: Be the rebel


Ours is a chaotic and overburdened medical system. As a senior resident, there is every temptation to seek in our incoming classes more obedient interns and junior residents who would obey my orders as their senior without question. I challenge that we must do the harder thing.

The explosive growth in the health care industry has seen a shift in priorities to traumatic, urgent and emergent care. And we see profits in our health care system which we have never seen before. Without any corresponding expansion in the fields of primary care, those of us in family medicine with a longer view see an impending and growing danger for those most disadvantaged patients who we care for daily. They are a costly lot, and to care for them in a profit-driven system will not win us any popularity contests with the administration or the taxpayers. This was the mantle we chose to carry. We care without exceptions. We must seek out those who would question us — the rebels.

I chose to join this field. I am immensely proud of being a family medicine physician. Living in the South, where our numbers are few, I sometimes find myself in the position of being an “ambassador” of sorts, introducing patients and sometimes my colleagues in the medical field to who we are and what we do. I like to say that we are the “Swiss army knife” doctors — flexible, adaptable, with a wide range of experience and training. Often, we work at a discount relative to others doing the same job. This is not the field for those seeking wealth, prestige and the social standing of the higher classes. Ours is a field of true service, and our dedication is to our patients. I can think of no better example than the AAFP’s swift response to executive actions taken by our president, an excerpt below:

The children originally detained at the southern border remain held apart from their parents, some as far away as Michigan, New York, and South Carolina. The administration is silent on its plans to reunite these families in an expeditious and humane manner. Further, while we assume the children’s physical needs are being met, with each passing day apart from their families, the mental and emotional toll taken on these children continues to mount.

My heart swelled that morning, to see my field rising to respond swiftly and yet with the constraint of our collective professionalism; no extraneous claims or political finger-pointing, but a statement in matters of fact which could not be ignored. Undoubtedly, many would take great issue with that statement. To make this statement so boldly and unequivocally, surely it was known that we would be angering wealthy and influential donors across the nation. Yet our leadership did not hesitate. The health of families is our purview, and we are unafraid to be the vocal “troublemakers.”

So now, as we seek our new class of incoming family physicians, I invite that we pay particular attention to those troublemakers. As I have talked to candidates, I take notice of those who take a stance — any stance — that flies in the face of the majority opinion. Even more impressive are those who are comfortable enough with conflict to disagree with me amicably. Conflict avoidance and subjugation to the majority opinion by brute force of likes and internet commentary has become a growing and troublesome characteristic in our generation.

Let us find the doctors that hold some “unlikeable” opinions. Millennials who like movies that are rated as “rotten” online and unashamed that they enjoy them when the critics decided we shouldn’t. When the whole interview dinner table is gloating over the pigs in a blanket, this would be the one doctor who doesn’t like them and is unafraid to say so. The one ordering last but going for a beer when everyone else is drinking soda and water (but hopefully just the one or maybe two beers, save the binging for Supreme Court justices).

Maybe even someone who would disagree with the statement I stand so proud of above. The secret sauce of diversity is the bit of conflict it forces us to live with and overcome.

So this interview season, root out the rebels. Rank them highly. We are building a base.

Bryan Pardo is a family medicine resident.

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