Session 101 Dr. Patrick Myers joins us to talk about what he looks for as a fellowship program director, what makes a good neonatologist, and his own unique journey to this specialty. Out of training for about eight years now, Patrick also shares what they’re looking for in candidates if this is something you’re interested in. Meanwhile, be sure to check out all our other episodes on Meded Media. [01:30] Interest in Neonatology and Real-Life Experience Patrick realized he wanted to be in Neonatology until after his entire residency class matched into Neonatology. He spent a year being a peds hospitalist as he experienced a ton of deliveries. He thinks the fellowship match is helpful in terms of streamlining and getting everybody a chance to get their application out to several people.  A big downside is if you decide you want to do something else when you're already two years in.  For residents taking an extra year to figure things out to become a better applicant, Patrick thinks doing a chief or hospitalist year is great. Being to able to work with other people in an actual, real setting allows you to understand your work skills. In fact, Patrick considers having this kind of real-life experience as a gold mine.  This shows programs that these people really love the field and they're going to have so many more skills than people who just went straight through. Patrick started medical school when he was 29 years old. He was a Theater major. He just got married at that time and had to work. Desire is another thing he looks for in applicants. [05:55] Traits that Lead to Becoming a Great Neonatologist The ability to solve problems is very important so you really have to love problem-solving. Especially in Neonatology, there is a variety of illnesses so you always have to be solving problems.  Other essential traits include exceptional communication skills and empathy. Moreover, you'd be working with a lot of other specialties. You should know how to negotiate and pull divergent views together and still come up with a really good plan. [07:45] Common Cases in Neonatology Except for rheumatology, all of medicine is in neonatology. In NICU, the kids are sick and a lot of them are ventilated and unstable.  What differentiates it from PICU or Neuro ICU or medical or surgical ICU is that a lot of their really sick kids stay for a long time. It's not unusual for kids to stay at their unit for 100-200 days. Some of their kids have even stayed with them since birth to a year. The hardest thing to manage is children with underdeveloped lungs so there's that balancing act. Either help the lungs and keep the kid alive, but mechanical ventilation for 10 to 100 days is actually bad for you.  [10:10] Letters of Recommendation To figure out whether an applicant for residency is a good communicator, Patrick explains they try to 2-3 very open-ended questions to let people be comfortable and talk. He personally evaluates how people treat his support staff. These are his section administrators, the people touring you, the fellows. Patrick also highly values letters of recommendation from fellowship directors you have a personal relationship. He further shares this tip to ask a director if they could write you a really good or superior letter of recommendation. If you get any hint of body language that it isn't an equivocal, enthusiastic yes, then do not take that letter. There's medical literature on interviews that talk about a lot of the code phrases in letters of recommendation. It tells you of phrases that program directors look for. Already two years as a program director, Patrick admits it took him a while to write good letters. Because you want these people to go out, be successful, and get a really good fellowship.  But sometimes when you're selling somebody the way you want them to, you actually aren't. You could say one thing but others may read it in a different way. So it takes a bit of skill to get this down. Nevertheless, the letter of