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Want to apply for Radiology? here is McGill’s program director’s opinion!

chankowsky

Our first guest in the website is Dr.Chankowsky. He is the program director for the Diagnostic Radiology Program at McGill University. We had a very interesting interview and we discussed many aspects of the application process.

Interviewer: Dr.Chankowsky, I welcome you as a guest on our website. Thank you for accommodating us within your busy schedule.

Dr.Chankowsky: You are most welcome.

I: Could you tell us a little bit about yourself?

Dr.C: I am the program director for the Diagnostic Radiology Program at McGill University. I have been the program director for eight years. I am originally from McGill, I am a McGill student, a McGill medical graduate, and a McGill residency graduate. I did my fellowship in the United States and have been a staff radiologist for 15 years. My involvement with Middle Eastern candidates began many years ago, before even there was a very organized relationship between different universities and your hospitals and our hospitals. At the beginning there were candidates from some Middle Eastern countries like Bahrain and then almost a decade ago we started to have a much more organized system with respect to the Middle East.

 

I: How is the candidates yearly selection process organized?

Dr.C: In radiology, every single year we take a certain number of candidates from the Middle East. The number we can take depends on how many Canadian candidates are we going to take at that year. We have a critical mass of ten positions that we can afford in the program so we have an enough space for rotations. So if I have seven CARMS candidates on a year I can have three Middle Eastern ones on that year. If I have six CARMS candidates I am going to take four Middle Eastern candidates. We advertise the positions each year through the Faculty of Medicine and we get the candidates files through them. Then, a selection committee is formed which reviews all the files. We then invite the candidates for the interview. The ratio of the candidates to the position is approximately one to five. So if we have two positions we interview ten candidates and if we have three positions we interview 15 and so on.

I: How does the interview process go?

Dr.C : The interview is composed of two panels. In each panel there is a staff radiologist and a resident. There is always a Middle Eastern resident so there will be some sort of cultural connection. The candidate is exposed to different interview processes in each room, one room is much more clinical and the other room has some Radiology. What I mean by that it is not an exam process but the goal is to know if the candidate have true interest in Radiology. Because if you are interested in Radiology, you would have looked at Radiology images already and you would know what you are talking about. We know that from your reaction to certain questions we ask during the interview. The other room is much more like a clinical scenarios as we assess your clinical skills. After that the committee meets and discusses the candidates and then we offer our position.

I: So I understand from what you are saying is that you do not ask the traditional interview questions like: Tell me about yourself, what are your strengths and weaknesses..etc?

Dr.C: We do. Each interview is 15 minutes and you have to go through two interviews. In each room there is going to be 10 minutes dedicated to the traditional interview process, where you are going to introduce yourself and going to tell us why you choose Radiology and so on. We just get a feeling about you in the first seven minutes then both rooms change.

I: Based on your personal opinion, what makes a good candidate? What makes you say: I am going to take this candidate?

Dr.C: I think the first step is how to get in the interview. Why do we have 25 applicants but take only 12 for the interview for example? I think one of the key things is a very high scores on qualifying examinations. We put a large value on that. An average score is not enough. We like to see better than average. So if you see one of these exams reports you can find your score, the average scores and the scores required for passing. The minimum score is 250. So if you just passed we do not think you are much of an academic candidate and we are not likely to take you. So you do have to have a reasonably qualifying score. It does not have to be 350 for example but it has to be reasonable. We use the score as a discriminator of whether we are going to interview you or not. We also look at your CV….What I am going to tell you honestly is that most of the letters of reference that we receive are too generic and impersonal, and that is detrimental to an applicant. The letters sent by former McGill trainees on the other hand will often be more appropriate, as they have a better understanding of what we like to read in a letter of reference. I write almost 75 letters of reference each year. Because I am a program director and I write them for everybody all the time. I have become an expert on this and I have 250 of them on my desktop that I can play with. But I guarantee to you that I spend half and hour on each one tweaking it to your personality, written with your CV next to me, written with your letter of intent next to me so I can make a letter that sounds like you and sounds like I know you. The letters that we usually get cannot tell us about the person because they say: He is respectful, he comes on time, he is intelligent. But there is nothing about you on a personal level. You can easily know the marks of the person. But on a personal level you need to know that, for example, this is a good person, this a person whom you can trust, this is a person who is responsible and works really hard to make your life easier not things like he is respectful he comes at time for his work. That is why the odd person who gets a letter about someone that really tells about him, that person gets on the top of the list, Because their letter is personal.

I: For someone hearing you, and I am thinking from the standpoint of a candidate. Someone may say then I should come here and do electives or do research or a master’s degree and have recommendations from Canadian doctors or from you personally. What do you think about that?

Dr.C: Ok, in general, we do have a lot of people that try to come here to take an elective so they can be known and they know us before the interview process starts, and the smart ones will do this! The smart ones will come on October, November, or December just before the interview so I will be able to recognize them. If you do it a year before, for example, I will not be able to recognize you. The smartest ones will arrange for the elective just before the interview so I will for sure know this guy as he was with me last month. That is the guy who has the best organization skills. So ideally an elective should be a few months before the interview process. Almost all of them will ask for a letter of reference from a local person here and it will be heavily weighed. You cannot ask for the letter from the program director because it will be like I am writing the letter for myself! So it is a good idea to have an elective and ask someone from here to write for you. On the other hand, the resident should choose the right person to ask to write the letter for him. You should go to someone that you worked with for a while, he will write a good letter for you. It is not important who is this person and what is his status in the department. What is important is that he writes for me that I worked personally with this man, he is an excellent candidate, he cares about his patients, I see him on a daily bases coming to work early and leaving late. That is the difference. We really care about the personal aspect of the letter.

So the MCCEE scores are very important as well as the letters of reference. Also your personal letter is very important. It needs to be reviewed by someone who knows English very well. You can tell by reading some letters that they are not very well polished. I realize that it would be difficult to write in another language that is not your original one. That it is why it should be checked by someone who is good in English.

I: So now I got into the interview, what would get me accepted?

Dr.C: Well, we are very sensitive that there may be going to be a cultural shock. The interview is in the middle of the winter. We try to make the candidates comfortable. That is why we invite Middle Eastern residents to these interviews so you can see a familiar face that you maybe would recognize. So after going through the interview process that I explained before. And because in radiology we are more of an expressing specialty so we write reports all the day, English is very important. Therefore there is an English test and there is a radiology test. What we basically do is that we have lunch after everybody finishes his or her interviews. So we have halal lunch in the conference room with all of our residents. After that you go into a different room and you write an English essay. It gives us an idea of whether or not you can write in English and whether or not you or someone else wrote your personal letter. Also there an OSCE exam, which is basically a PowerPoint presentation, composed of 15 slides that show different radiological diagnoses, simple things like pneumothoraxes and fractures. The idea here as I told you if you are interested in Radiology you would have spent some time gaining basic skills in reading radiology. So it separates someone who takes zero on the exam from someone who takes 100%. This guy has never seen Radiology before but that guy has spent sometime learning about Radiology. The first one is maybe applying as a back up to another specialties.

We do know actually know if you applied to other specialties by the way. So when we examine for Radiology we just want to see how interested is the candidate. If the candidate has never seen a pneumothorax for example he is not interested and he is most likely applying as a back up.

I: OK; now I am thinking from a perspective of an applicant. Based on what I heard I should have a clinical experience of one or two years before applying?

Dr.C: I think yes. The chances of getting in the program immediately after finishing your medical school are low because you would only have few months of clinical experience.

I: Some programs think that if they saw the candidate multiple times, like if they interviewed him two or three times, they would give the chance to other candidates and do not give him an interview. So based on that do you recommend someone to apply multiple times or wait until he has a strong CV?

Dr.C: There are very few who have made on the first time. One of the applicants was a fresh graduate and he was a brilliant guy. It was evident from the first time we interviewed him and we took him right away. But he would be the only person that we took in this way. This was not the case for all the others. We will not look seriously at your CV until you have at least one year of clinical experience in the field in which your are applying, and the year of internship does not count as an experience in this field, because you are competing against other candidates who have a least one or two years of clinical experience. And let us add to the pot that Saudi Arabia is a big country and has many medical schools, and let us add to the fact that there are other Gulf States like Oman. All of the candidates from these countries compete for the same spot. Also, many universities support their candidates and speak to us directly so we take their candidates. They meet with us and say that their candidates are the best ones prepared for Canada. So there is competition between these countries and even competition between the universities in the same country.

So everyone gets an equal chance when they go to the interview but in the back of the mind of the program director is the people who came and tried to push for their candidates. So advocacy for your candidates is important. I will always remember when representative from certain countries come to me and tell me they only send their best candidates. They are limiting the applications to certain candidates while other places send all their candidates. I am not saying they are right or wrong. What I am trying to say is that they are good at advertising themselves.

I: Since you mentioned Master’s and PHD, do you think it would be good for a candidate to do these degrees before applying?

Dr.C: I do not think it would make a difference for us. We basically are looking into having a good clinical resident who is going to do a good job. We are not interested in the academic part.

I: What about research? Is it important to have research experience?

Dr.C: It is important to have research experience. But it is not something that we weigh a lot.

I: I think we talked about many aspects. Do you think that there is something that we did not discuss?

Dr.C: I think many of graduates went back home. And some of them became program directors in their programs there. And some of them became so in a short period after their return. And that is because they trust them there. I think Saudi Arabia in particular has the ability to develop their programs and start to get things go on their on and they actually started working on that direction. I still think that demonstrator programs need more development. I see some demonstrators come here and they spent two years and still they need to work more on themselves. The system needs more organization, but I think with the years passing now and some of our graduates going back home and participating in the programs there, I think there is an improvement in this aspect. All what I can say is that we will continue this relationship. We enjoy having the Middle Eastern candidates in our program. We have the deepest relations with Saudi Arabia but we still have our relations with the other Gulf Countries as well.

For those who are worried about cultural shock, you know that there are preparatory two weeks before starting the program. Also you will find more than 250 Middle Eastern candidates at McGill at any given time. So you have your own little community in the hospital. Some people are concerned about religious aspects like time to go to pray and Ramadan, all the accommodations are made. So if I am working with a guy and it is Friday afternoon and he looks at me I will understand immediately and tell him go! We do not have any issues with this and we all understand each other. And I think you may not get this if you go to other places that do not have many Middle Eastern candidates.

I: Here at McGill, since we are in Quebec, some put huge emphasis on French language. What do you think about that?

Dr.C: Well, although McGill is an English institution. Each year, I get five to ten complaints that some patients were unable to be serviced in their language of French. So apologies need to be given for those patients. We are an English institution but we are a bilingual hospital system. The patients should be able to be spoken to in the language of their choice. It is a big challenge to acquire the language but I think there should be an effort to acquire at least the basics while someone is here. It would be perfect to take some courses before starting residency. It would relieve much of the stress for Middle Eastern candidates when someone is called at the middle of the night for example and the patient speaks only French. Then, the resident will need a translator and everybody in the room will be anxious, because the doctor is not speaking directly to his patient. And I have seen this myself.

I: Would you like to add any other thing?

Dr.C: I think McGill and the Radiology department are very happy to have you here, not only as residents, but also as fellows. Some people do not realize that if you did not do radiology residency here, you can do a fellowship. From out point of view it is a multicultural experience so we like having it. We also suffer from chronic lack of government man of power. The government does not offer enough CARMS positions so we rely on Middle Eastern missions to have a program with 10 people for example. I think for sure my life has been enriched by the process, because of break down of cultural barriers for example. I will tell you one interesting story. One of our Saudi graduates, when he finished his program, and in the graduation ceremony he said I would like to make an announcement. He then talked with one of the doctors here and told him you are like a brother to me. Everyone in the room was touched because of the break of cultural barriers. So we have this culture here where everybody can work with each other regardless of their backgrounds. Also, I will be honored if one of the graduates asked me to come as a visiting professor when he goes back home.

I think we learn things from each other’s cultures on regular basis.

I: Dr.Chankowsky, thank you very much for this interesting interview.

Dr.C: Thank you very much for having me today with you.

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