Landing a Pharmacy Fellowship

Fellowships are hard to get. Typically, less than 15% of fellowship applicants land a position, according to the best statistics that we have, and those are likely generous. Compare this to the historical residency match rate of about 70%; in 2017, of the candidates that matched: 58% matched with their first choice and 80% matched with one of their top two ranked programs [detail]. To put this in perspective, there were approximately 1.5 applicants per available PGY1. Although there is certainly variability here for both residencies and fellowships (more at some programs and less at others), a typical fellowship program will receive 9+ applications per position, sometimes even hundreds.

Having now seen both sides of this recruitment process, I have updated a post I originally authored for the University of Michigan P4 blog with additional information about how to find success as a fellowship applicant, from the perspective of someone who has sat on both sides of the interview table, and that will culminate in a discussion of offers and negotiation.

I don’t expect you to know anything other than “maybe a fellowship might be interesting!”

Okay ready? Let’s go!

Building a Foundation

I. When to Start

The realistic answer to this question is always “the earlier the better.” The sooner you start exploring alternative career paths for pharmacists, connecting with current and past fellows, building your network, and getting questions answered, the better prepared you will be for the formal application process. That said, starting when the application process formally opens in October absolutely does not put you out of the running. If you made the decision to pursue a fellowship a little later. We will discuss networking later, don’t worry.

That said, before you do anything else, you must first:

II. Ask Important Questions of Yourself

This is the single most important step of your preparation by a significant margin and the critical first step in developing your story–the cohesive narrative that illustrates why you want to do be doing this. Your story is the confluence of your experiences, skills, and interests that will ultimately inform how you approach the rest of the this process. Notably, your story will serve as the foundation of your applications and will inform the decisions you make about your curriculum vitae (CV), cover letters, answers to interview questions, questions you ask, what programs you apply to, and where you ultimately end up.

Small aside: What is your story, anyways?

I will refer to your story and narrative throughout this series. This is not something you write our word for word and memorize. This is instead a loose mental grouping of your accomplishments, motivations, goals, skills, interests, and experiences that come in to play when you are considering how to approach a problem.

You will use your story to inform how you tackle this process, write your CV, select programs to apply to, and answer interview questions. Your story is not an answer, it is not your elevator pitch, it is a tool you will draw on to build everything else.

The first, and most important question is this:


Why am I doing this at all?

This question is deceptively simple. This is not an easy process. You will probably lose sleep, have your fair share of anxiety, and spend an enormous amount of time preparing. If you do well, your reward is more anxiety and some long plane rides to on-site interviews. So ask yourself, is this worth it? Why am I going to go through this?

To illustrate, let me share some real answers to related questions that I and my team received during the recruitment process that indicated that the candidate did not adequately answer this question for themselves. As a consequence, they lacked a cohesive narrative that communicated a lackluster motivation for pursuing a fellowship at all, let alone why they felt they would be a good fit for my program. As a bonus, these answers are extremely not memorable!

  • “I hate my job/retail/clinical pharmacy”
  • “Industry seems cool”
  • “I don’t have any other options”
  • “I heard you can make good money”
  • “My friend/roommate/second cousin is doing this”

Even if any and/or all of these were true, these are the kind of answers that demonstrate–at best–surface-level effort. Now consider the following potential thought processes for someone who the first bullet above is their truthful reason for pursuing this career option.

  1. I hate my job –> I need to get out –> this is anywhere else
  2. I hate my job –> I need to get out –> what are my goals and interests –> what kinds of jobs match this –> where could I do those things –> here is a place that matches this kind of work –> now how do I get there

When an interviewer inevitably asks you “Why are you pursuing a fellowship?” and “What appeals to you about our program specifically?” consider the difference in the quality of the responses based on the second line of thinking versus the first. The first results in the answer above and tells me that it doesn’t matter what you do as long as it isn’t that thing you are running from. It tells me that here is as good a place as any.

The second, on the other hand, tells me that you have thought through what your interests and goals are, considered the type of work that would be a good fit, that you have done the legwork to know that this program/position/company is a place that will allow you to reach your goals, and that we can have a mutually beneficial relationship.

Who would you rather hire?

Finding a positive answer to this question that speaks specifically to you, your experiences, and your goals will inform everything you do and help you find a program that is a good match for what you really want. Presumably, you don’t want just any job; you want one that you will enjoy. Even if you just really, really hate your job, I hope you’ll think about what you want to do instead and why. What is interesting to you? If you don’t know yet, start doing your research (we’ll discuss this later).

Answering this question for yourself is the first step in developing your story–one that you will need to land a fellowship.


 

What are my goals, and what would an ideal program offer to get me there?

A fellowship is not simply a means to an end; done right, there is significant value in the program itself. Finding one that affords you the opportunities you need to grow in your career will pay dividends. This comes with the added bonus of dramatically improving your odds of finding and landing a position that you enjoy!

Below is, more-or-less, my roughed out parameters  going into the application process when I was applying for fellowships. You’ll notice that I do not state a specialty (i.e. regulatory or medical affairs or drug safety etc.) as I was open to a wide range of specialties. I am still a firm believer that opportunity is far more important than job title or labels (check out Section III for more):

I want to be somewhere that allows me to exercise these strengths but also provides ample opportunity for horizontal development. I am a big picture person and work best when I have a holistic understanding of the system I am working within, tailoring my output to the needs of the next step in the chain. The program should be open to innovation and new ideas and be forward thinking. Ideally, I would be working with or supporting oncology products, my area of interest given my family medical history.

A mission and vision that I can support: this is critical--the mission and vision of a company drives everything that it does at a high level. If this is not something I can get behind it will be difficult to highly engage in my work (Note: this was a deal breaker for several programs).

Professional development opportunities in conference travel, tuition support, leadership opportunities, mentorship, or other that supports the above goal of horizontal development.

I have no geographic restrictions; location agnostic, as programs few and far between, especially given these other requirements. My girlfriend, pursuing managed care residencies (another relative rarity) will have even less control over where she ends up.

One year over two years, wherever possible: I would like to avoid being away from my girlfriend for longer than necessary. Possibly excepting the case where the program is degree-granting or offers a significant benefit for the increased length (not just a teaching certificate).

Specialty is less critical but should be considered. Team, flexibility, and opportunity take precedence.

Compensation: student loans are a real consideration. While I have spent the last four years making significant sacrifices to keep my balance down, avoiding a significant pay-cut where possible would be appreciated (but not required of) a one year program. Two-year programs at this salary level would be significantly de-prioritized unless there was a compelling reason otherwise.

While your parameters don’t necessarily need this level of detail, putting my ideal program in writing allowed me to be deliberate in identifying programs that were most likely to have these characteristics.


What makes me stand out as an applicant?

The unfortunate truth of the 15% statistic is that there are a lot of well-qualified people going for a small number of available positions. Most, if not all, of these candidates are soon-to-be-PharmDs with similar student organizations, clinical rotations, an industry internship, leadership experience, etc. etc. etc. The resulting homogeneity in applicant experiences can make it difficult for both recruiters to confidently differentiate between and consequently, remember you as a candidate. Therefore, it is important to not only find those things about you and your experiences that make you both memorable, but apply that knowledge to your narrative deliberately. When a recruiter is deciding between two otherwise identical candidates those seemingly small, interesting things matter.

These things aren’t necessarily even pharmacy related! That said, these unique aspects of yourself should be a part of your story. Think about how these skills or experiences set you apart in how you approach and solve problems, or how they are relevant to your goals and interests. Tying these experiences and skills together into that narrative will dramatically improve your ability to stand out. For example, here is a list of qualities that, often mentioned off-hand as part of an otherwise run-of-the-mill interview question that can make a big difference in differentiating yourself:

  • Teach for America, Doctors Without Borders, or similar
  • semester/year/other experiences abroad
  • later return to school for PharmD
  • sport scholarships
  • competition wins
  • hobbies (knitting, judo, climbing, etc.)
  • graphic design; video or music production
  • computer programming
  • non-traditional pre-pharmacy undergraduate degree (e.g. non-STEM)
  • many, many others!

This isn’t to say that your student organization or leadership experiences cannot be differentiating! However, the bar here for accomplishment here is much higher simply due to the nature of this kind of experience and the likelihood that others will share those particular traits.

Small aside: using leadership as a your stand-out experience
Leadership experience is an important component of any application; however, many recruiters simply look that it exists. Holding leadership positions should not be the experience you draw on, rather, focus on accomplishments gained during your tenure. This is another key reason why I encourage accomplishment-based communication in CVs and in interviews.

Find your hook. Don’t think you have one? You do; think hard!


How can I tell if I am a strong applicant or not?

Part of the benefit of finding your hook and focusing on your differentiating experiences is the benefit of further standing out as an already strong applicant and leveling the playing field a bit if you are not so lucky. Later on, when you are deciding how many programs to apply to, you will need to take an honest assessment of your strength as a candidate.

Making this determination requires an honest, really honest, assessment of your strength as a candidate. This is hard; the entire spectrum from imposter syndrome paranoia on one end to I-met-the-program-director-once cockiness on the other must be minimized. No matter whether the results of your assessment are good or bad you need to strategize and prepare based on this information.

Mind that none of these attributes are need-to-have (when I am recruiting at least) but that different programs will weigh some attributes differently. With that in mind, these are intended merely as part of a heuristic to estimate your strength as a candidate, not as a checklist! The strongest candidates for our positions tended to have:

  1. one or more pharmaceutical industry or other non-traditional (e.g. managed care) internships, rotations, or other experiences
  2. one or more leadership positions in a student organization(s) with several related organizational accomplishments
  3. one or more relevant personal or research projects

Do grades matter for fellowships?

Certainly less than residencies! Generally, stronger fellowship candidates had stronger academic qualifications as well; however, this is correlation, not causation. Many programs do not care to check so long as you graduate and if a program has a GPA minimum, they are typically generous.

While the degree to which GPA is weighed may certainly vary from program to program, academic strength is usually very low on the list of qualifications fellowship recruiters are looking for, especially since we would typically not receive a transcript until you have been invited for an on-site interview. At this point we are only looking to ensure you aren’t imminently failing out of school.

If you are concerned about your academic qualifications, don’t include it on your CV (see Section V for more) and don’t bring it up in interviews. Most will never even think to ask about academics, but think beforehand about how you might answer that question if you get it, especially as it relates to time management-type questions that are more common (see Section VII for more on this).


III. Doing Your Research

A significant amount of your success will hinge on simply having some idea of what you are getting yourself into. The fellowship is a non-traditional path that culminates with most former fellows staying in jobs that represent <5% of all employed pharmacists. The work environment and responsibilities diverge significantly from what most of our training covers and the reality is that most schools don’t offer any information on these kinds of positions.

Not only will you inevitably be asked about why you are pursuing the specialty of the position at hand, you’ll also learn about specialties that you may or may not have an interest in–helping narrow your search. This is one area where starting the pursuit earlier can be beneficial.

How do you learn more? A few ways that I recommend:

  • use your school’s alumni network. If you have a Career Center or Advancement Office they may be able to connect you with some people who have pursued this line of work
  • find people on LinkedIn and message them. You won’t always get a response, but I did fairly frequently and had some great conversations
  • look at program websites; many post names or current or past fellows. Email them and ask to chat
  • organizations like the relatively new Industry Pharmacists Organization has some free resources, including a program directory
  • ask your professors and preceptors; it is virtually guaranteed that one of them has a classmate or friend that followed a non-traditional path

Chances are you’ll meet some cool folks, have some good conversation, and learn mountains about the various available roles. Always end a conversation with “who do you think I should talk to next?” and ride the wave. Don’t be afraid to check in every once in a while–especially with current fellows to ask how their program is evolving. As an added bonus, these conversations may pay dividends if you choose to apply to their program later.

This information will help you work out what specialties you might be interested in (or in my case, open up more possibilities to pursue); here is a brief list of common fellowship foci to get you started:

  • medical affairs (including medical information, medical communications, and other sub-specialties)
  • regulatory affairs
  • marketing
  • health economics and outcomes research (HEOR)
  • drug safety
  • clinical development

IV. The application process and Personnel Placement Service (PPS)

By now you are probably wondering how this entire process works in the first place. The vast majority (not all) fellowship programs recruit at the ASHP MidYear meeting at a special session called PPS. Registering for PPS costs a little extra and you must be registered for the main MidYear meeting. Practically, attending PPS is a requirement to obtain a fellowship, for better or worse.

Why? PPS is essentially a mini job fair that lives inside the MidYear meeting. Although the majority of programs there are looking for future fellows, many residencies, health plans, and companies recruit through the PPS platform as well.

Here is the floorplan for PPS 2017 as well as a list of exhibitors, for reference.

What happens at PPS?

These programs are at PPS to recruit future fellows and they aren’t beating around the bush about it. Each program is there to interview candidates, usually in 30-minute blocks. There are often multiple rounds, receptions, and possibly other requirements, though these can vary widely by company (so pay attention, as these are generally communicated very clearly). Most programs are looking to determine who they will be bringing for on-site interviews at their company campus.

How do I apply to programs through PPS?

Small aside: applying to programs through PPS
The use of the PPS portal is documented extensively on the PPS website itself, so I will not spend a lot of time discussing this. I encourage you to look there for more specific information about the technical particulars.

You can register for PPS when you register for the MidYear meeting and the initial list of available positions becomes available in late October. Keep in mind that positions are continually added over the following month, so you will want to check back every so often to review new additions.

Through the same online portal you can then apply for an interview to one of the positions that you are interested in. The company will review your information and potentially request to schedule an interview with you. If granted, you get a time to interview. If you do well, there may be additional rounds of interviews or other requirements. Generally, you only need a CV to apply for an interview (though this does vary so again, be sure to read the job description thoroughly). I hope you are now realizing the importance of a polished CV now, as that is often the only tool that reviewers have to make an interview determination.

Roughly, the application timeline looks like this:

  1. September: register for PPS
  2. October: the list of available positions first becomes available late in the month
  3. November: identify programs of interest and begin applying for interviews (earlier the better). Interviews are scheduled.
  4. December: PPS begins

On-site interviews generally take place anywhere from the week following the MidYear meeting through the end of February, though most take place in January. More discussion of this later.

What are my odds here, really?

We have already seen the 15% figure–but to give you an idea of my experience as a recruiter for my own position last year:

I had 18 first-round interview spots and 10 second-round interview spots, based on the time my team was able to be there. We had 105 applications for an interview at PPS. I phone screened 56 people (an absurd number, in hindsight).

Immediately, the math is obvious: about 1 in 5 people who applied for an interview would ultimately get one at MidYear. About 1 in 10 would get a second-round interview. We interviewed 3 on-site (a typical number; about 1/30) and ultimately selected 1 candidate for the position.

Our other positions were similar and based on my conversations with other recruiters, this is likely a conservative number as my company is a relative unknown compared to many of the ‘Big Pharma’ programs like Eli Lilly; doubly so for those offered through Rutgers and MCPHS.

Lesson: even receiving an interview at PPS is an accomplishment! Is it an uphill battle? Sure! When in doubt refer to Section I.

Second Lesson: the significant importance of a thoughtful consideration of your story and using that as the foundation for your application materials. Be the 15%.


V. Preparing Application Materials

In general, you will only need a CV to apply through the PPS online portal and request interviews. However, most programs will eventually require the following by the time you are at the on-site stage (all of these will be discussed in detail below) and should all be ready by the time you leave to PPS:

  • updated and polished CV
  • letters of recommendation (at least 3, typically)
  • program specific cover letters
  • official academic transcripts

Programs are increasingly interviewing in the weeks immediately following PPS, before Christmas. It behooves you to have your materials well in order beforehand to ensure you are prepared for this possibility. Plus it is just less stressful.


Your Curriculum Vitae, or: How to Make a Good First Impression and Not Shoot Yourself in the Foot

Small aside: resume versus curriculum vitae

The overwhelming majority of companies expect a CV from prospective PharmD fellows while going through this process. Always read the job description carefully for any information to the contrary.

I have read a lot of CVs; honestly, I kind of enjoy it. For many programs, cover letters at the interview application stage though PPS are optional. In this case, your CV is the one item that reviewers can determine whether or not you receive an interview (outside of networking, see Section III).

What is amazing, then, is the poor overall quality of CVs that many applicants send out. About 15% of the CVs that I received were clearly never given a second read, with multiple prominent misspellings, unintelligible phrasing, or general poor grammar. Many recruiters will reject these out of hand, no matter how qualified you may otherwise be for the role. Don’t give them that chance!

Although in-depth CV advice is beyond the scope of this article I have written extensively on the subject; click here for an in-depth look (coming soon).

Like I advised you in Section II to step back and ask some important questions of yourself that will inform the rest of the application process, developing a quality CV requires keeping a few key facts in mind:

  1. Time is against you. Reviewers typically give you less than 10 seconds to decide whether it is worth looking further. That time is valuable. Use it wisely.
  2. If you don’t think it is interesting, no one else will. Every word should have a purpose and that purpose is getting you an interview. Brevity is the soul of wit.
  3. Think about your eyeballs. Draw them where you want them to go so they see what you want them to see. Be precise.

No matter what: proofread your CV. Have someone else proofread it. Have a third person proofread it. Seriously.

Don’t be afraid to ask for feedback. They will think of new, potentially interesting ways to say things. They will keep you from saying things that make absolutely no sense. They will make your CV better. Many schools have programs for CV review; worst case (as in Section III) just start asking people you respect. If they say ‘it’s fine’, thank them and then immediately ask someone else.

Small aside: taking feedback on application materials


You will likely receive feedback--constructive and not--from many individuals throughout this process. Be sure to weigh it against their point of view and experience and remember that every piece of advice you will receive is an opinion and that you can take or leave any or all of it. Ultimately, your CV is a reflection of you and your experiences and if you are not comfortable with including a suggested change then simply don't. It is likely that you will get conflicting advice; in nearly every case there are multiple 'pretty good' ways of doing something. Use the one that appeals to you.

That said--this is not a shield. Any advice is likely given in good faith. Carefully consider any you receive.

More on this in my CV-centric articles here (coming soon).


Letters of Recommendation

Most programs will require that you provide 2-4 letters of recommendation, usually at the on-site stage following PPS. Again, I recommend that you have these ready before PPS begins. Programs often will ask for recommendations from specific types of individuals (e.g. clinical preceptor, industry preceptor, and professor); however, most only expect that you provide a certain number. Be sure to check the job description for details.

Regardless, you should have a variety of possible letters available to you. I contacted 5 individuals (industry preceptor, intern manager [managed care], professor, clinical preceptor, student org advisor) to have those available and had the luxury of choosing which letters were best suited for each program and gave me some redundancy in the event someone was not responsive.

Obtaining a letter of recommendation can be as easy as simply asking. Your managers, preceptors, professors, research or student organization advisors, etc. are all good options. Have a particularly good rotation? Ask them before you leave! I have seen many people panic about this step: chances are you are underestimating yourself. Give careful consideration to who best to ask but if you’re torn, just ask both!

Begin getting recommendations nailed down 6-8 weeks before PPS.


How do I usually get the letters of recommendation to the program?

Unlike the residency application process where there exists a standardized form and a centralized system–letters of recommendations for fellowships are usually e-mailed directly to a representative at the program.

If you are at the on-site stage with a program, you will generally have an excess of guidance (detailed more later). When prompted by the program, simply ask your writer to e-mail the letter to them directly with any guidelines they have laid out. If you have these ready to go in advance, this is a low-stress event. Don’t be afraid to ask for confirmation of receipt!


Program-Specific Cover Letters

There are two distinct phases of cover letter writing that can take place during the fellowship application process:

  1. a letter sent in with your interview request (phase 1)
  2. a letter sent in with your formal application at the on-site interview stage (phase 2)

As detailed previously, a cover letter at the interview request stage is usually optional (check the job description for specifics). At this stage, a good cover letter can help you just as much as a bad cover letter can hurt you. They are rarely read (though I read all of the ones I received); do not worry about not including a cover letter with your applications.

That said, they serve as a great framework to build your program-specific cover letters for the on-site stage. Read more about cover letters in this post (coming soon).


Academic Transcripts

Contact your registrar for instructions on how to obtain these. Many schools provide electronic versions (easy), others might require that the office mail them to addresses you specify (more annoying). You generally will not need these until the on-site stage, but make a point of checking in to get an electronic copy early.

If your program requires a physical copy be mailed to them, contact your registrar’s office the same day to start this process–the stress of waiting for someone else to mail a transcript is not worth procrastinating until the last minute and depending on your institution, may take much longer than you expect.


VI. Targeting Your Applications and Requesting Interviews

After registering for PPS in September (register early for the discount), it was not until October 24th that the online system opened up and I could actually see the programs available. I had my profile set up and CV uploaded and ready to go.

Small aside: Rutgers and MCPHS. I did not apply through nor have I recruited for Rutgers or MCPHS for a variety of reasons (feel free to contact me). Ample information on their application process exists online. Preparation as detailed here is entirely transferable to preparation for Rutgers or MCPHS programs.

After filtering Rutgers out about 100 fellowship programs remained. After spending about 2-3 hours weighing each of them against my requirements above, I identified 10 programs to pursue further.

Small aside: read the job description already.

I have emphasized repeatedly the importance of reading the job description. Turns out it will contain valuable and important information about the position, including application deadlines and other special requirements. My program set an application deadline a few weeks before PPS to allow time to phone screen and make final candidate selections. The deadline date was stated in bold at the very top and the very bottom. We received (in addition to the above number) an additional 15 applications after the deadline as late as the day after PPS began.

From here, I reached out through my network (see III. Doing Your Research) to see if I could connect with current or past fellows at these programs to ask questions.

Ultimately, I requested interviews from six programs as soon as possible with three sentences in the message box about why, specifically, I was interested in the program.

Small aside: messages along with your interview request.


The relevance of these messages will vary so widely among companies that there simply is not one right answer to the question of whether or not you should be sending something. They might never get read, they could be triaged by someone not affiliated with the program, or they could be a sanity check.

My approach: it can't hurt to write something brief. Be specific and succinct. It took 2-3 minutes per application to write a few sentences (max); it might make a difference and it might not.

Regardless: this is not a cover letter. Keep it short. I received several that were >500 words. Let your carefully crafted CV do the work.

How many programs do I apply to anyway?

This is a highly individual question. In part, please review “What are my odds here, really?” above. In short, the numbers are against you, no matter how qualified you are; I need not re-emphasize the importance of not phoning it in with your application materials.

Use what you thought about in Section II to help make this determination.

The results of my very unscientific survey has suggested that most people apply to between 4 and 8 programs, which I recommend breaking up across 3 “tiers” based on the self-assessed likelihood that you could land a spot based on your strength as a candidate:

  1. aspirational programs that are highly competitive. These are your “reach” programs that should be at or beyond what you think would be reasonable for you to apply to based on your strength as a candidate. You have a small chance of getting these but it would be really awesome if you did.
  2. matched programs. These are programs comparable to your strength as a candidate and you have a decent chance at landing a spot and you would still benefit personally and professionally from participating in.
  3. safe(r) programs. These are solid programs that are newer or less competitive (perhaps in more niche focus areas) that you have a relatively high chance of landing a position.

While I have seen some applicants put in as many as 21 (!) applications, unless you are the world’s weakest candidate I do not believe that this will ultimately help your chances. The reality is that overloading on applications is actually detrimental, as it:

  • decreases the care you take with and lowers the quality of each individual application
  • reduces your ability to properly prepare for each interview and lowers the quality of each individual interview
  • decreases the likelihood that you will have any time to breathe between interviews increasing the likelihood that you are late, out of breath, or unprepared (see Interview Scheduling as a small aside below)
  • dramatically increases the workload and stress level of this already hectic period, which increases the likelihood that you make a stupid, avoidable mistake
  • increases the likelihood of burnout and reduces your ability to focus on the programs that matter most
  • increases the likelihood of interview or reception scheduling conflicts with other programs

What many candidates fail to realize is that each application may come with as many as 3-4 interviews, a reception, and potentially even other activities that may be required. With 10 applications, a typical candidate might have 15-20+ individual interviews; much beyond this you inevitably begin to have significant logistic challenges getting places, scheduling interview times, and simply avoiding burnout and bringing your “A-game” to the interviews that matter.

Even considering that most programs are selective about offering interviews at PPS, these are all more reasons to start applying as early as possible once PPS opens. As invitations roll in (or don’t!) you can adapt and apply to more places throughout the cycle if needed, prioritizing those programs that are most important to you.

Work smarter, not harder! Give your self the best chance of success by not overloading yourself so you can bring your best self to each interview.

Small aside: interview scheduling

Try to avoid back-to-back interviews whenever possible. Time slots have 0 minute gaps. Candidates were frequently late or flustered at the very least, attempting to run from one interview to the next and the interview area is larger than you would expect.

When you get a new interview mark the 30 minute time slot on either side of the interview as unavailable on your schedule. This allows you to decompress, prepare, have a snack, go to the bathroom, and get to your next interview early. This was wonderful; I did 5-7 interviews a day with no logistic issues.

Depending on the number of programs you are apply for you may need to allow for some interviews back-to-back; however, the earlier you apply the more likely it is that you are granted an interview when the schedule is wide open.

VII: Interviewing at PPS

Alright you’ve made it this far! Honestly, now we’re getting to the fun part, interviews! If you have spent time with the rest of what has been written here, you have your story, done your research, and you’ve spent time understanding your experiences, motivations, challenges, and successes, this may be fairly straightforward for you.

From here

Two weeks before PPS I re-reviewed all available programs as new ones occasionally appear. None of the new ones interested me so I stuck with the six:

  • Two I was very, very interested in and hit all of my requirements (one-year programs)
  • Two that were a good fit, hitting most of my requirements (one year, one two-year)
  • One that I would be happy with (two-year)
  • One “backup” that I would do well at if I received an offer and felt confident about my ability to make it to the onsite phase (two-year)

This was a risky but calculated approach given my strength as a candidate and the availability of strong plan B and C options.

As an example, my “thesis”–below–supported by a ream of experiences and projects to illustrate

Use my programming and computer science background, marrying clinical training and technical expertise to fill gaps and find unique opportunities.

How can I apply that specifically to an industry career?

Thankfully I already had specific examples of using this in practice in my PDI and at Blue Cross Blue Shield of Michigan. Big data is a big thing, tying my experience here into business and clinically relevant outcomes were fairly straightforward.

MidYear

I was at MidYear solely for PPS and no other reason. While I did go to some residency showcases just to chat, see Peyton Manning, and go to various CE sessions, my focus was entirely on PPS and my interviews. After checking in to the conference your name badge will have a symbol indicating that you are registered for PPS that people at the door will check (which caught me off guard). There is a small waiting area inside the hall but outside the interview area with tables to rest, recoup, and wait for in-between interviews. Food nearby is expensive (it was Vegas + conference hall after all) so I brought snacks (peanuts, protein bars, etc.).

Prior to the meeting I frequently heard the advice that you are there to get a fellowship and screw everyone else. Personally, I enjoyed many conversations and stories with fellow candidates in the waiting area which I felt helped me be conversational and relaxed in the interview setting. I made a point to stop by the UM booth every day and just walked around a bit to get a lay of the land and located each of my booths before my interviews started each day.

The Interviews

All of my interviews were far more relaxed and conversational than I had anticipated. I got a handful of situational/STAR questions but the vast majority started with “tell me about yourself” or “why us” or “why industry” and branched from there. I was careful to emphasize my experiences and what made me stand out (all of those important questions above!) in each of those initial questions and tried to have fun with it. People reflect your energy and enthusiasm in the vast majority of cases and if you know yourself and what you have done things generally flow pretty well. Try to enjoy yourself! Show off a little! I developed software that generates clinical trial abstracts so I brought copies to show my interviewers. Moves like this helped me not only set myself apart but take control of the interview by talking about something I knew well and was comfortable with. Plus it guided follow-up questions!

I made a point to get the business card for each of my interviewers.

It goes without saying that you should have a baseline familiarity with the company, their pipeline, recent events that affect them (subscribe to FiercePharma), not because they will necessarily ask questions about these things (though I have heard that) but because incorporating these into your responses to questions or just in conversation is a big plus! I included mission and vision statements in my responses whenever I was asked “why us” or similar questions (remember that this was a critical part of targeting these programs in the first place!).

All of the STAR/other questions I can remember getting (paraphrased):

  • You have made a mistake on a project that you delivered to a client. It would be embarrassing to you and the company to bring it up but could affect their work. What do you do?
  • Walk me through the timeline you would use for developing a big presentation due in one month.
  • What are your time management strategies?
  • What are you proud of that is not listed on your CV?
  • What do you do to relax/for fun?
  • Are you open to relocating?
  • Where do you want to be/what do you want to be doing in 5 years? 10 years?
  • Tell me about a time where you
    • struggled to balance short and long term goals
    • improved the efficiency of a process
    • dealt with conflict on a team
    • worked well with a team
    • managed a big project
    • made a mistake/failed
  • What was the best team you’ve ever been on?
  • Why not managed care or informatics? (specific to my interests, what I was talking about with computer science as these are plausible alternative careers)
  • What are you looking for in a program (and why do you think we have those qualities)?
  • Tell me what you know about medical affairs.

Invitations for second round interviews were either by phone, text, or email (always have your phone on you and not on silent except when in an interview for this reason.

All programs that did second round interviews invited me to one. In each case they were more of the same with different members of their team and generally were more relaxed/conversational than the initial round (about 50% of people get cut at this stage). Usually, about 50% of the interview was time for me to ask questions. This conveniently brings us to:

Asking Questions

While my first round interviewers usually made 3-5 minutes for asking questions, my second rounds were much more focused on my receipt of information about their program (it really is a two-way street). It goes without saying that logistic and compensation questions (how long, where, how much, benefits etc.) are off the table. These are either basic or answered in the PPS listing, online, or are simply off the table as appropriate questions. Focus on questions that let you learn about quality of life, where past fellows have ended up, mentorship and leadership opportunities, and subjective questions that each interviewer can respond to, including:

  • Who makes up the team I would be working with?
  • What kinds of cross-functional work might I be doing?
  • What are some stand out qualities of past fellows?
  • Tell me about a time someone in your program blew you away.
  • Will I have the opportunity to precept students?
  • What would my relationships with leadership and management look like?
  • Does this program aim to retain fellows? If not, where do they go?
  • What appeals to you most about the work that you do?

And the list goes on and on. Ask follow-up questions. Honestly not thinking too hard about this helped me a great deal. My goals were to assess the openness of the company to new ideas, its innovative spirit, the opportunities for horizontal development, and what cross-functional work looks like. Reading between the lines on the answers to any question will tell you more than what the response is–it is pretty easy to tell when someone is simply stating the party line and when someone is genuinely excited about what they do. Think about what is important to you and come up with half a dozen questions that will help you assess that (go back to the qualities of your ideal program!); the rest will work itself out!

Thank You Cards

I did not send thank you cards after PPS. I went back and greeted whoever was around the booth and chatted very briefly thanking them for the great interview (with specific things that we talked about) and how excited I was to hear from them again. Some people deliver cards onsite, others mail them following PPS. Considering how fast the turnaround is for getting onsite interviews it seemed more sensible to me to go chat in person wherever possible. I specifically avoided emails at this stage on the advice of friends who had successfully navigated this process and interviewers who said that these generally get deleted immediately. Engage to your comfort level.

VII: On-site Interviews

Hearing About On-site Interviews

Generally, you will hear about onsite invitations within 24-48 hours of PPS ending, earlier if a program stops interviewing earlier or you are stand out candidate. Of the six programs I applied to, I received five onsite invitations, three of which were by phone before I got on the plane to come home. One was by email the next week; the last was by phone the following week. Many programs will email you to let you know that you were not selected to continue, but this is not common. I did my best to not hold my breath too hard (though it is hard not to be nervous!).

I should note that none of my programs had selective receptions that I was waiting on invitations for, unlike most Rutgers programs. For those programs if you do not receive a reception invitation by the second or third day of PPS you are generally out of the running.

Completing Any Additional Applications

A handful of programs (not all), having made it to the onsite stage, requested a formal application, letters of recommendation, transcripts, or other documentation. These were all due the week following PPS and were not time consuming or stressful provided that you have your letters of recommendation ready to go. Most of them were online (either emailed or through an HR portal). Clear instructions were provided for all steps so no worries there!

Scheduling On-site Interviews

Each program that I was invited to sent an email with additional details within a few days of the invitation, detailing available days, times, and other relevant information. You will generally have 2-3 days to choose from for scheduling interviews and things can get fairly cramped as there can be overlap between programs. In my experience, everyone was willing to work with me to fit everything in.

This brings up an important point: if you have made it to this stage of the process with a company they are very interested in you. You are one of their top 5-10% of candidates! Do not be afraid to ask if there is a scheduling conflict or other issues that arise. They understand that you are pursuing other opportunities! Everyone that I worked with was wonderful and bent over backwards to make sure everything worked out schedule wise!

All of my travel, hotel, rental cars (when needed), meals, and incidentals were paid for by the company I was visiting. Flights were arranged through an agency that I was instructed to call in each case (they already had my information!) that allowed me to select my preferred airline and provide my frequent flyer information. Hotels were prearranged and specific instructions for reimbursement for other expenses were provided in each case. Even though the company is paying for it, you are expected to provide a credit card when checking out a rental car or checking in to a hotel.

In each case I was given an itinerary for the day listing each person that I would be meeting, for how long, details on the presentation I was expected to give, and any other logistic information about the day.

Preparing for On-site Interviews

In addition–while there are no rigorous statistics to support this–I estimate that a typical successful fellowship candidate receives between 2-5 onsite interview offers. What might be surprising is

Keeping in mind that anyone interviewing you onsite (and spending $1,500+ for the privilege) is interested in you, it is doubly important to show the same courtesy. I found any information I could about each interviewer listed on my itinerary, made sure I knew in depth about the company’s mission, vision, ongoing trials, products I would likely be supporting, and other details. I had enough thank you cards packed for each person (not prewritten!), copies of my CV, and plenty of mental preparation. I made sure I fully understood the logistic arrangement for the interview day (is there a shuttle? Am I driving? If so how long does it take to get there? Parking? Where am I getting breakfast in the morning?) and baked in extra time for potential problems.

I took the time to reach out to current fellows by email (remember those business cards?) to ask questions and get a better feel for the program overall. It is the holidays, so don’t freak out too much if they do not respond or cannot set up a time to talk on the phone. This is an extra step.

Onsites generally happen either the week before Christmas (for some MCPHS programs) or the weeks following the holiday. Mine were from January 3rd through the end of the following week, with one “onsite” over the phone with the managing partners of one company. I had no issues with travel, lodging, or any other arrangements, but the HR representatives were all very responsive when I had questions (mostly about the rental vehicles!).

The Onsites

With preparation the onsite interviews were actually one of the easier parts of the process. Each company was a little different but all of them followed the itinerary to a tee and were largely focused on getting to know you as a person, what your goals are, and assessing your fit based on what the program has to offer. As one of my interviewers put it while I was there

“The fact that you are here at all indicates that you can absolutely excel at this job. Everyone we have invited here today will no problems. This is a matter of learning about who you are, what you want, and how well it aligns with our goals and what we have to offer you.”

As part of the process in each case I was meeting senior leadership (VP, Director level), the team I would be working with, current and past fellows, and sometimes just other interested parties. Since I knew a little about each of them going in it was much easier to get started on a strong foot. Time absolutely flies by–all 4-8 hours of interviews (lunch was provided when needed!).

With the exception of one interview at one onsite I felt like the team was genuinely interested in getting to know me and I actually had quite a bit of fun.

Remember, if you have made it to this stage: they want to hire you. Be yourself, have fun, and ask questions. This is about you finding a program that is right for you, not just a program! At this stage it is appropriate to ask more questions about living arrangements, the city, what they do for fun, logistic things like the commute and public transportation, etc. Compensation is still of the table.

The Presentation

An object of dread by many fellowship and residency applicants, the presentation was unquestionably the most stressful part of each interview day. Each of my programs provided specific details about what they were looking for and they were conveniently very similar: ~15 minute presentation on an industry relevant topic. This will vary from company to company, so keep a close eye on exactly what you are being asked to do; don’t hesitate to ask follow-up questions. Generally, a PowerPoint was suggested and I was usually asked to send it to a coordinator ahead of time.

I developed a presentation specifically for this purpose, but many people have successfully used presentations that they have given before. I used a topic that was more relevant for companies in the oncology space, but still applicable elsewhere. Where possible, an ideal presentation does more than show off your speaking skills:

  • Allows you to showcase your knowledge, interests, or projects that fall outside the scope of your CV or what might come up in an interview
  • Allows you to highlight your hook, tell your story, and importantly, tie these in directly with the business and patient-care interests of the company
  • Is a topic you know well and are comfortable discussing outside the scope of my presentation and answering questions about, and lets you be the expert in the room
  • Lets you show people what you’re made of!

Speaking of the audience, in each case it was between 10 and 20 people, usually all of my interviewers plus a handful of other individuals. They were always a good audience, attentive, and asked thoughtful (but not overly difficult) questions afterwards. After about 5-10 minutes of answering questions I was shuttled to my next interview. In one case I was provided a rubric, stating that I would be graded on the quality and organization on content, speaking style and delivery, as well as ability to answer questions. Many programs do this similarly.

Waiting

Following each onsite interview I either sent thank you emails to each of my interviewers or mailed them a personalized thank you card based on the decision timeline. Sooner: email; later: letter.

This waiting period is the absolute worst part. After you’ve completed onsites (though you may have some stragglers) and your hand is down it is only a matter of keeping your phone on you at all times and waiting. I made a point of asking when I could expect to hear back at each onsite.

I will not lie: there was some intense self-reflection and considerable stress during this time. I was waiting on bated breath with every phone call carrying with it the potential to be a great or terrible moment. This is normal. It is not fun. But you will get through it!

Each program called me with either a “no” (which I appreciated just the same) or a “yes”, which is obviously the preferred option!

Handling Offers

If you are lucky and receive an offer, congrats! I was lucky in that the timelines for my interviews and offers worked out very well: I heard within a week about all of the programs I applied to.

It doesn’t always go this smoothly: generally, you will have 3-5 business days to accept or decline the offer. One of the most common questions I receive is related to the anxiety about receiving an offer from a second or lower choice program well before having the chance to interview or receive an offer with a first choice program. My response to this is always bird in the hand. For those unfamiliar with this ancient idiom:

…having something, even if it is a lesser quantity, is better than taking the chance of losing it in order to attain something else that seems more desirable.

My recommendation here is built on the premises established throughout this article, that you did your research and only applied and agreed to interview with solid programs that would benefit you personally and professionally. Done correctly, even your last choice at this point should still be a good option. Once again, please refer back to What are the odds here, really? There is a non-trivial chance that your interview with your first choice program goes great and you are still not offered the role. Now you have ended in a situation where you have nothing.

That doesn’t mean there aren’t mitigation strategies. Depending on the relative timing you can request an extension on the offer expiration date that allows you some more time to decide and potentially interview with your first choice program. The company you are asking may say yes, but don’t be offended if they tell you that the date is the date, either. Remember that they are also competing for exceptional applicants and cannot afford to waste time if you are not interested. If you manage to interview with your first choice, be sure to let them know that you have other offers on the table and if they are interested in you they will need to move quickly. Be transparent about this to avoid wasting anyone’s time.

If your first choice interview is further out, you might also consider contacting your first choice program and ask candidly–“I have other offers but I am still very excited about your program. What do you think is realistic to expect from interviewing with you?” Emphasize that you received an offer but still think of their company as a better fit and importantly, articulate why you believe that this is the case. Ask them if it is possible to provide a decision on your candidacy more quickly. If they agree and they can accelerate their timeline that says a lot about them. Worst case, you will get some additional information that could help you make this difficult decision.

No matter what happens, do not accept an offer and withdraw it later. Not only is this very rude, but depending on the timing you may have left that program without any options, leaving their program potentially unfilled. This is bad for everyone pursuing a fellowship.

Small aside: negotiating fellowship offers

Generally, there is absolutely no room to negotiate fellowship offers; most offers are "take it or leave it". If you did open a negotiation, consider that you generally have zero leverage with no relevant experience and the sponsor likely has numerous qualified candidates in the wings if you turn them down. The reward tends to be low given typical fellow salaries and generous benefits. On top of this, many of these programs have no flexibility like they would be a 'normal' hire, especially for programs with multiple positions.

Ultimately, the risk is high (see What are my odds here, really?) and the upside is relatively low. Unless you have multiple offers and you are a very strong candidate you are unlikely to make much headway in a negotiation.

Accepting Offers

Thankfully, my first choice offered me a position and I could not be happier! I accepted on the phone and received the offer materials later that same day. Once you accept an offer, be sure to notify any programs that you have upcoming interviews with that you are withdrawing your application and allows them to invite someone else and avoids wasting their time. Now you can celebrate! Congrats!


Wrap Up

Phew, that is a lot. Hopefully my journey helps you navigate your own! If you know yourself, have engaged in your work in pharmacy school, and can get excited about the work you will be doing in a non-traditional role, I have every confidence that you will get through these stressful few months a better, gainfully employed pharmacist! Have additional questions? Consider contacting me.

Other things to consider: all the programs I applied for did not require becoming licensed, only that you hold a PharmD. It is never a bad idea to get and maintain your license (it will only get harder to pass the exams the longer that you wait). Be sure to ask your program what their requirements are if you are considering not becoming licensed.

Be sure to thank your friends in the Advancement Office and Career Connections for all of their help over the years!

For additional information I recommend this book: Pursue the Fellowship, (link to sample) that covers just about everything you could ever want to know. The author, Kimberly Gittings, was a fellow Xcenda who I had the chance to meet and interview with! She knows her stuff. Additional information can be found on program specific pages and many, many other sources. For those you who attend the University of Michigan, please consider Dr. Kraft’s class P3 year is invaluable, as are most tips about interviews relevant to residency applications.

More on ONCOgen: What Is Context-Free Grammar?

This post contains more details about the inner workings of ONCOgen, a software program that can generate New England Journal of Medicine-formatted clinical trials. You can read more on the ONCOgen page or at the first post in this series.

When you pick up a scientific paper the expectation is that a certain, specific set of information is included in the manuscript that allows the reader to understand why the experiment was performed, what experiment was performed, what the results of the experiment were, and how they were analyzed. While we expect the authors to provide their interpretation of the results and their significance, we as the readers rightfully expect to have enough information to judge the results for ourselves.

In broad strokes, the information in every clinical trial comes through in four major sections:

  • Background & Introduction
  • Methods
  • Results
  • Discussion

Each of these can be subdivided further. For example, a Methods section may include any or all of the items below:

  • Patient Population
  • Study Design
  • End points
  • Assessments
  • Statistical Analysis
  • Study Oversight

While each section might be worded a little differently or subsections might be more or less inclusive,  everything should be there. You can keep breaking this down further: a sentence or two about inclusion criteria; a sentence about the a priori significance level; and a few sentences describing the target disease with lab values or specific biomarker requirements.

For the purposes of writing a fake paper, the high-level structure of a paper seems like an easy target; even the paragraph level seems pretty straight-forward. But there are practically a million ways to say, well, stuff. How do you make semi-convincing fake verbiage?

Well, we have to zoom in a little more for that.

Continue reading More on ONCOgen: What Is Context-Free Grammar?

ONCOgen: the Clinical Trial Generator

Atezolizumab is an inverse JAK2 enhancer that has been shown to increase PD-1 capilloactivity in cytocytes and adipocytes. There has been collaborative research in the classification of transdisciplinary dactylical cardiolyses which gives reason to believe that geriatric biophysics could have applications in newly diagnosed, platinum-resistant, CD93-positive myeloproliferative disorders. In our research we validated the menigotolerability of entero-BCR-ABL enhancers on keratoparesis risk in volunteers with renal cell tumors.

Update: a more detailed look at the inner-workings of ONCOgen are detailed here.

ONCOgen is a software program that uses context-free grammar with an extensive library of medical terms and phrases derived from over a thousand clinical trials, drug information resources, and personal experience to “randomly” generate a clinical trial manuscript. Context-free grammar is, at its core level, a set of rules for computer generated mad-libs.

Not just a fun play on words, ONCOgen is designed to be the spiritual successor to other applications of context-free grammar such as SCIgen—which generates computer science papers—and Mathgen—that generates high-level math papers. SCIgen became notorious after having one of it’s papers accepted to a high-profile conference and later, the announcement that over 100 SCIgen-generated papers and abstracts were being retracted from prominent subscription publishing houses. Another major story surrounded the submission of a faked paper to 304 open-access journals. In the end, 157 (52%) of journals accepted the hopelessly flawed experiment.

Consider arXive vs snarXive (archive versus snark-ive), a game where the user is asked to guess which of two high-energy physics paper titles are real—one pulled from a database of such papers and the other computer generated. The overall correct guess rate sits around 59%. I went 1 for 6 on my first attempt. Why is this so hard? Jargon, abbreviation, and good-old-fashioned benefit-of-the-doubt.

Just like the jargon in high-energy physics or doctorate-level mathematics, medicine has its own set of buzzwords and thankfully, an enormous set of prefixes, suffixes, Latin and Greek root words, and arcane sounding but systematic naming conventions. Add to this the standardized journal-ready formats for clinical trial manuscripts whose structure makes these documents amenable to this kind of reductionist approach.

Unfortunately, in order to generate properly formatted papers ONCOgen needs LaTeX and a few additional things on the backend that my current website hosting provider is unable to accommodate. Until then, I have provided a number of pre-generated abstracts here that you can “generate” on the ONCOgen page.

Take me to the papers! or, a more detailed look at the inner-workings of the program.

The Financial Formulary: 7 Lessons Prescription Drugs Can Teach Us About Money

Note: inspired by much of the discussion at my College of Pharmacy regarding financial planning, this was written in the same vein as the content from the good folk over at the White Coat Investor, a personal finance blog aimed at high income professionals. I have personally learned a great deal from his writing although much of it does not apply to me at the moment (i.e. real estate). In the spirit of paying it forward I re-imagined many of the good financial principles as a cure to the ails that many soon-to-be-recent-graduates like myself must contend with.

Many recent graduates suffer from a condition known as mountains of debt. Symptoms of this often debilitating disorder can include insomnia, GI upset, fatigue, and feelings of dread and/or helplessness. Mountains of debt has been identified as a risk factor in divorce, crushed dreams, and ramen noodles.

Luckily, there is a cure.

The tools contained within the Financial Formulary that follows offers a few of the proverbial prescriptions for success that can be easily adapted to prevent and treat even the most serious cases of this pervasive condition.

1) Primary Prevention
If heart disease and compound interest teach us anything, it’s that a few little changes early on can make big differences down the road. Just as the cardiovascular risk reduction seen with atorvastatin and aspirin compound to help protect you from a heart attack, making a few modest lifestyle changes now as a student to minimize your loan burden and invest in your future could mean hundreds of thousands of dollars more when you reach retirement. A little bit of fiduciary diet and exercise can go a long way in minimizing the number of years it will take to reach a secure, heart healthy retirement—not to mention shave a few inches off your waistline.

2) Personalized Pharmacotherapy
While best practices exist for the treatment of most any disease, the knowledge and clinical judgment of the provider accounts for the final successful application of these guidelines to each individual patient. Developing this same personalized approach is necessary to establish any savvy financial plan. Define your goals and priorities—ask yourself where you want to be in five, ten, or thirty years—then adapt your income to those priorities in a way that will let you hit that target. There is no one always-works cookie-cutter approach in either pharmacy or finance. Optimal pharmacotherapy always depends on more than just patient age or comorbidities. Likewise, work to find the balance between your desired quality of life, achieving your goals, and building the financial security that will carry you through your golden years.

3) Rescue Medications
No matter how well your patients might be managing their asthma, angina, or diabetes, you’ve prepared them to be ready for the unexpected. It’s not a matter of if, but a matter of when the asthmatic will need their albuterol or the coronary artery disease patient will need to reach for their nitroglycerin. The same can be said for financial surprises, be it a car repair, medical bill, or broken appliance. As a student, resident, or recent graduate, keeping a few thousand dollars in the bank for unwanted excitement will help keep otherwise small emergencies from snowballing and potentially derailing your carefully laid plans. Speaking of emergencies, don’t forget to have insurance for those catastrophic moments—like lawsuits and surgeries—that could otherwise ruin you.

4) Evidence-Based Medicine
It seems like every five minutes someone—whether it be your financial advisor, your college roommate’s half-brother, or that one guy on television—has the next surefire thing to beat the market. Just like that expensive new brand name medication might not stand the test of time, chances are your in-law’s hot investment won’t live up to the hype. Trends like gold, tech-stocks, or green coffee bean extract prove that trying to time the market is a losing proposition. Remember, the only thing that is going to appreciate when investing along with those talking heads is your blood pressure. Be sure to carefully evaluate any prospective investment strategy just like you would any new clinical trial. If you do your due diligence, by retirement age you’ll be enjoying the warm tropical sun rather than banking on the next sure-fire investment secrets to pay the bills.

5) Medication Adherence
For the same reason you shouldn’t stop taking your antibiotic as soon as you feel better, be on guard for lifestyle inflation. It is much easier to complete the course by keeping expenses low to wipe out your debt quickly after graduation. The alternative—waiting until later when the debt has re-multiplied and resistance has developed to reigning in your expenses—could mean tens of thousands of dollars in unnecessary interest payments and years of avoidable stress and complications. Sit down and develop a debt management plan early on. Evaluate the patient, identify the bug, and then target that 22% APR MRSA with some financial vancomycin and repeat with your next debt. Don’t be afraid to enjoy a bit of your new salary, but remember that the principles of compound interest work just as well for the bank as they do for you.

6) Therapeutic Drug Monitoring
Chances are, your blood pressure and hemoglobin A1c aren’t going to stay the same forever. Don’t even get me started on INR for you warfarin users out there. There is a reason you should go in for—at the very least—an annual checkup. No hospital is going to dose gentamicin and forget about it, and no dentist is going to tell you that your recent root canal is the last word in your oral health. The plans and priorities you have today will change, your financial situation will change, and life always finds a way to surprise you. Getting married? Buying a house? Diagnosed with cancer? A periodic reassessment of your priorities, assets, and strategies will let you catch problems early, make adjustments as necessary, and ensure that your treatment of choice remains appropriate.

7) Continuing Education
So you’ve graduated, opened all of your retirement accounts, and started paying down your debt. Did you think you were finally done? Just as your newfound profession requires you to stay on top of a constantly evolving set of medications and standards-of-care, the world of finance doesn’t allow you to set-and-forget. Much like any hospital formulary, the rules governing taxes and investment vehicles are constantly in flux, and ignorance of changes can lead to costly mistakes. The most effective and efficient treatment is provided by those working at top of their game, and it follows that those who stay abreast of new developments in the world of finance will reap the greatest rewards.

Summary
While mountains of debt is often unavoidable for most new graduates, with good adherence to the prescriptions for success outlined in the Financial Formulary, it is a condition that is easily managed and—given enough time, discipline, and planning—even cured.

Principles of Password Design

Try to guess the most secure password:

  1. [email protected]!14z21Hb&[email protected]
  2. LazyBumblebeesEvenOrange

Passwords are the face of computer security. Just about everything you use online or off—more often than not—requires an account and an associated password. Ultimately, the goal of that requirement is to simply provide a form of identity verification, asking: “is the person sitting behind the keyboard right now the same person that should have access to this resource?”

Unfortunately, passwords are one of the weakest forms of identity verification, especially as used by the vast majority of the computer-using population. To combat this, websites—particularly those where money is involved—began using password requirements to enforce security when creating a login. While this used to be entirely the purview of banking sites, the proliferation of largely arbitrary, complex, and nonstandard password rules often DECREASE the relative security of the password that the user invents. On top of this, the sites implementing these complex rules often undermine their entire schema by incorrectly managing their database or enforcing additional arbitrary requirements.

For some context here, check out some of the most common passwords:

I hope to illustrate some of the weaknesses of passwords by walking through some of the basic password attack vectors and the elements of cryptography employed in their creation. Hopefully, you can use this information to create more easily remembered, secure passwords.

Password Search Space/Depth

Have you ever considered why websites ask you to include UPPERCASE, lowercase, a number, and a symbol in your most secure passwords?

This is the first principle of password design: the number of permutations, or the “search space” required to brute force your chosen password. You might remember from highschool the principles of combination versus permutation. As you can use the same letter, number, or symbol multiple times and the order of the characters matter, passwords use permutation, not combination. So how can we apply this?

Take your typical four digit PIN: 1111. Let’s list our assumptions:

  • Each character is a number from 0-9.
  • There are four characters.
  • Numbers can be used more than once and can be in any order.

Based on what we know, we can conclude that there are 10^4 (10,000) permutations, where 10 is the number of possible characters (0,1,2,3,4,5,6,7,8,9) and the exponent is the length of the password. Starting at 0000, then 1000, then 2000 all the way to 9999 we can simply generate each permutation of digits, try the PIN, and if it fails, try the next one. This is the essence of brute force password cracking—there is no information to guide the search—we just try each and every permutation until one of them works.

So what happens to our search space when we change the rules? Let’s look again at our four character PIN if our user can also use lowercase letters. There are 26 lowercase letters: with our 10 digits + 26 lowercase letters the number of possible characters is now 36. Our password is still four characters long, so our exponent is still 4, giving us 36^4 or possible permutations. Adding UPPERCASE (another 26 characters), and symbols (another 33 characters) additionally increase our search space.

  • Numbers: 10^4, 10,000
  • Numbers+lower: 36^4, 1,679,616, 167 fold increase over numbers
  • Numbers+UPPER+lower: 62^4, 14,776,336, 8 fold increase over numbers+lowers
  • Everything: 95^4, 81,450,625, 5 fold increase over numbers+UPPER+lowers

If I were to brute force—generating each possible combination at a conservative 1,000 guesses per second (a speed easily achievable by many graphing calculators) it would take just 10 seconds to crack our numbers-only password, about 30 minutes for our numbers+lowercase, all the way up to about 22 hours for our full keyboard.

It becomes evident why websites like to require increased complexity, forcing you to use UPPER and lowercase, symbols, and numbers when creating your password. Unfortunately, this has the side-effect of forcing the creation of passwords like @Aj8, V&t1Kv4s, or Ba#$J5—passwords that are not only difficult to remember but are missing another crucial piece of the password puzzle.

Knowing what you know now, which of the following passwords will take the longest to guess?

  1. 3ED45
  2. 3eD45
  3. 3ed4%
  4. 33445

Given that all of these passwords are five characters long, C has numbers, symbols, and lowercase letters, the largest search space.

KEY: A: 17 hours, B: 1.5 weeks, C: 2.6 weeks, D: 2 minutes

Password Length

For the first element, we focused on the base number of the permutation calculation, starting with 10 and ending on 95. As you might imagine changing the exponent you can change the number of permutations by orders of magnitude. In the previous example, our password was four characters long, what happens to our permutations if we add just one character?

Numbers only: 10^5, 100,000, 10 fold increase over 4 characters

Numbers+lower: 36^5, 60,466,176, 36 fold increase over 4 characters

Numbers+lower+UPPER: 62^5, 916,132,832, 62 fold increase over 4 characters

Everything: 95^5, 7,737,809,375, 95 fold increase over 4 characters

Notice a difference? Unlike the diminishing returns we observe when incrementally increasing the search space at a given length, we see literal exponential increases in the search space by simply adding one or two characters.

Revisiting our graphing calculator brute force attempt (1,000 guesses per second), cracking our everything-password goes from 22 hours with four characters to nearly six months with five, an enormous difference.

We aren’t finished yet: we’ll now look at the final and most important component.

Using similar passwords from the previous section, which of the following passwords will take the longest to guess?

  1. 3ED4517
  2. 3eD45
  3. 3eD4%
  4. 3344526

Despite C encompassing the largest search space (an everything password), both A and D are two digits longer. However, despite what you might hear on TV, length is not everything. D (appropriately) only contains numbers—a very small search space—which despite the increase in length leads to a relatively small number of permutations and by far the shortest brute force time. Choice A with a mix of length and search space leads to the longest brute force time of these options by a considerable margin.

KEY: A: 2.5 years, B: 1.5 weeks, C: 3 months, D: 3 hours

Password Entropy

This one is a little more complicated than the previous two. Just like we learned in thermodynamics, entropy is randomness. Therefore, a strong password will have a high degree of randomness that makes it difficult to guess. Essentially, password entropy is a mathematical measure of a passwords “guessability” by a brute force attack. Recall the brute force method: generate each password permutation in order, aaaa > baaa > caaa etc. Assuming that we, as the attackers, know the password generation rules, we can determine the size of the search space and the probability of guessing any password at random. It stands to reason then that a randomly generated password with n characters will sometimes be generated very early in the total search space (if the password was aaaa, for instance) and sometimes be generated very late (in the case of zzzz). On average, a brute force attack will find the password half-way through a given search space. Mathematically, we can represent the number of “bits” of entropy via the base-2 logarithm of the total number of permutations.

To illustrate this, let’s return to our first four digit PIN: 1111. Our total search space was 10^4, or 10,000 permutations. By taking the base-2 logarithm we can determine the number of bits of entropy. 10,000 = 2^n, or 13.288 bits of entropy.

Now what would a password look like with just one additional bit of entropy?

2^14.288 = x, giving us a total number of permutations of 20,000. As you might expect given a base-2 logarithm, one additional bit of entropy doubles the number of guesses required for an attacker to find the correct password.

In a way, entropy is an extension of our first and second principles. Both length and search space factor into the entropy of a password. If entropy is entirely based on the number of permutations and that is based entirely on our first and second principles, why exactly are we talking about this?

The reason is randomness. Humans are ludicrously bad at coming up with random passwords and computers are only slightly better. Unlike the prior two principles, entropy is important due to the social engineering component of brute force attacks, something I will cover further in the future as it is beyond the scope of this discussion.

For now, we’ll focus on what “randomness” actually means in this context. Surely, the password GmKa$5VM is random but in what way? Each character was chosen as randomly as possible from a character space of 95 possible choices, giving about 6.5 bits of entropy per character (see here for how per character entropy is calculated). The idea here is that we can randomly generate passwords with a high degree of entropy; however, these passwords are a nightmare from a usability perspective. Most people have trouble remembering more than a small handful of password, let alone ones that are literally designed to be pattern-free.

But what if we come at this from another direction? Take Diceware for instance, a wordlist that contains 7776 short, English words. If we were to randomly select a word from this list, the possibility of correctly guessing any random word is 1/7776 or nearly 13 bits of entropy per element. Compare this to the probability of guessing any random character: 1/95. As bit strength entropy is additive, we get an entropy of a randomly selected password “aaaa” (6+6+6+6) of 24 bits. Selecting four random words from the Diceware list: “climbharrowjumpalong” gives us a total entropy of (13+13+13+13) 46 bits of entropy entirely independent of length.

Ultimately, entropy is about creating passwords that are unique and difficult to guess.

The Takeaway

We’ve covered three principles of creating a strong password:

  • Search space: the number of possible things that each character in a password is drawn from,
  • Length: how many characters you need to guess correctly and in the proper order
  • Entropy: how unique and difficult to guess your password is, as a measure of the other principles

It is important to remember that none of these principles alone can create a strong password. The word “password” is eight characters long (not a minimal acceptable length, in my opinion) but is also one of the most commonly used passwords on the planet. The [email protected] covers the search space requirement but is only four characters long. However, the password that combines both of the first two elements, “[email protected]%p” is virtually impossible to remember! As Randal Munroe of XKCD points out, we have been training users for decades to create passwords that are both difficult for humans to remember and easy for computers to guess. My online banking site, for instance, requires numbers, letters (both upper and lower case) and symbols, but caps passwords at EIGHT CHARACTERS, almost entirely defeating the purpose of the increased search space.

So how can we create passwords that are both usable and secure?

Passphrases: picking several words at random from a dictionary or creating a unique sentence. Bonus points for incorporating punctuation and numbers for search space considerations.

Site-handing/padding: adding between 5-10 memorable characters to the beginning or end of your password. Ideally, these characters can be generated from some aspect of the site you can easily remember.

The world of IT security is enormous and these techniques only scratch the surface of things that you should be considering when keeping yourself safe online. I hope to cover more of the social engineering aspects in a future DYK, but for now, think about your passwords? How long would this take to crack on my graphing calculator, let alone my GPU used for video gaming, or the supercomputer used by a motivated nation-state? You can put it to the test and find out.

For some further reading, check out this paper from Microsoft about common user password creation habits. You’ll probably be surprised (or not) to find out how users create passwords.

Now, after all of that, which of the passwords above is the most secure? At this point, you’re probably unsurprised to learn that password 2—LazyBumblebeesEvenOrange—is orders of magnitude more secure than password 1. Just don’t go using it anywhere!

Happy security!

All About Speedrunning

Remember all of those games you played as a kid? Games like Mario 64, Ocarina of Time, Banjo Kazooie, and the like? Well you might be surprised to learn that there exists an entire subculture of people who try to complete these games as quickly as possible. From what I understand speedrunners live for the sake of the puzzle; figuring out all the programming quirks, tricks, and unexpected oddities that make each game unique. In programming, this is known as an “optimization problem,” or the process of finding the ideal solution to a set of parameters.

To give you some perspective, the world record speedrun for Zelda: Ocarina of Time is just a few seconds over 18 minutes. I know what you are probably thinking right now. Allow me to explain how something like this is possible.

In competitive speedrunning (and yes, there are competitions) there are a number of types:

No-glitch, where players go through the game as any normal player would, finding the optimal path through movement and mechanics, completing the game as the developers intended.

Glitch, where players take advantage of (usually fascinating) programming errors or memory mis-allocation to do something they could otherwise not do, such as clip through a wall to get to a new area or get an item they otherwise would not get for some time. They do not play the game as the developers intended, but work entirely within the game itself.

Tool-assisted: the optimization problem in the literal sense, writing a computer program to aid the player in completing the game in the most optimal way (down to the frame) or write to the game’s memory to allow certain behaviors. These players use external tools to allow them to complete the game more quickly.

Beyond this, there are several other sub-classifications that I won’t go into now that deal with %completion and other game specific objectives. There is a lot of granularity.

That Ocarina of Time speedrun is the world record glitch playthrough, working entirely within the game but clipping through walls, using movement and damage bugs, and moving through and around areas in ways the developers did not intend. Executing many of these glitches requires an enormous amount of skill and timing that I personally do not possess.

Remember those competitions I mentioned? Beyond just informal ones, there was an enormous annual fundraiser that had many of the worlds best speedrunners stream live for a week straight (24hr/day) that raised $1.5 million for charity. Yes I watched it. Yes it was pretty cool. Not to mention that people will actually compete to see who can complete the game the fastest, all starting at the same time (a race).

If you are interested in watching an 18min Ocarina of Time speedrun, the previous world record holder (3s slower than current, that is how quickly that this world moves) did a commentary about how some of these glitches were discovered, what he does to execute them, and that also serves as a good background to the community in general and the history of the game itself.

When things get crazy is when you enter the world of tool assisted speedruns (TAS), allowing you to do absurd things (such as writing a game within a Pokemon Red cartridge by changing the number of Potions or Pokeballs that you have, altering the memory value at those locations, then running it as a program) or program the entirety of Super Mario Brothers within Mario 64 by taking advantage of a buffer overflow. Stuff like this seriously blows my mind. Check out this article on ArsTechnica that explains a lot of what they did.

So there you go, a little bit about speedrunning. Chances are, if you played it, people speedrun it, Take a peek at how quickly they’ve beaten your favorite game. Note that all of these are “any%” meaning that they get through to the end titles as quickly as possible, skipping anything that is unnecessary (as opposed to 100% runs).

The Physics of the Impossible Drive

Around this time last year a series of small experiments run at Eagleworks—a NASA research and development lab—became big news. The subject of these experiments—the EmDrive and the Cannae Drive—are two independently invented “reactionless” propulsion systems.

Why are these experiments so exciting? The way that these drives may be working turns our understanding of physics on its head. As you might be familiar ,all chemical rockets (think the Apollo or fireworks) work on more-or-less the same principle: direct the rapidly expanding gasses from the combustion of fuel and an oxidizer through a nozzle. The focused hypersonic movement of the gas pushes the rocket in the opposite direction through the conservation of momentum (Newton’s Third Law). Other types of rockets, such as ion rockets (https://en.wikipedia.org/wiki/Ion_thruster), utilize the same principle by accelerating gasses to high speed using an electromagnetic field. Rockets that work in this manner are collectively known as reaction rockets.

Reaction rockets all share one critical drawback: they all must carry their own fuel. Fuel is heavy, I’ll let Randal Munroe of XKCD explain why this is a problem:

“If we want to launch a 65-kilogram spaceship, we need to burn around 90 kilograms of fuel. We load that fuel on board—and now our spaceship weighs 155 kilograms. A 155-kilogram spaceship requires 215 kilograms of fuel, so we load another 125 kilograms on board…

…fortunately, we’re saved from an infinite loop—where we add 1.3 kilograms for every 1 kilogram we add—by the fact that we don’t have to carry that fuel all the way up. We burn it as we go, so we get lighter and lighter, which means we need less and less fuel. But we do have to lift the fuel partway.”

For decades, long-term space exploration has been limited by the fuel problem and continues to represent a significant practical barrier. Overcoming the fuel problem would be a breakthrough of untold magnitude.

After all of that, what exactly is this reactionless drive? Chances are if you have read/watched/played any science fiction, a staple of faster-than-light space travel was a reactionless drive of some sort—an engine able to generate thrust without focusing the exhaust from the combustion of a propellant. Unfortunately, basic tenets of physics are not on our side. Remember Newton’s Third Law and the conservation of momentum? The same reason that a figure skater spins faster when they tuck in their legs is the same reason that rockets work at all. Removing the high-speed exhaust (and its mass) from the equation there is suddenly no force to move your rocket. Based on our current understanding of physics such an engine would indeed be an “impossible drive.”

With that, let’s look at the technologies causing the stir and what exactly they seem to be capable of. Before we begin I would like to remind you that we have very little certainty on any of the following; scientists are attempting to document and explain this unusual phenomenon.

Both the EmDrive and the Cannae Drive likely function on similar principles. You might have seen toys like this one that work on the principle that while photons have no relativistic mass, they do still possess momentum (start here for a discussion of this, or for a more formal treatment here). When the photons hit the wheel they transfer a small amount of energy, and with enough of them they overcome friction forces and turn the wheel. This action is known as radiation pressure, a principle loosely analogous to the water pressure that moves a turbine in a hydroelectric dam. The running hypothesis is that rapidly creating photons at specific frequencies in a specially designed chamber allows the particles to be focused out in one direction. Other hypotheses involve phrases like “quantum foam” and “space bubbles” that have not yet been entirely worked out into something cohesive. The inventor of the Cannae Drive claims that the particular shape of the internal cavity is critical to the design, although this has yet to be validated.

Both drive designs were independently tested by Eagleworks at the Johnson Space Center.

EmDrive test summary:

  1. A test at 2500W of power during which a thrust of 750 millinewtons was measured by a Chinese team at the Chinese Northwestern Polytechnical University
  2. A test at 50W of power during which a thrust of 50 micronewtons was measured by Eagleworks at the Johnson Space Center at ~760 Torr of pressure. (Summer 2014)
  3. A test at 50 W of power during which a thrust of 50 micronewtons was measured by Eagleworks at the Johnson Space Center at ~5.0×10−6torr or pressure. (Early 2015)

Now the Cannae test summary. They did three trials with different experimental setups:

  1. The device as the inventor designed it
  2. The device as the inventor designed it without the slotting that the inventor claimed was critical
  3. A control test that used the same energy, but without the cavity present in the design

Results summary:

  1. Approximately 25 micronewtons of thrust at 50W
  2. The same results as test #1, showing that at the very least, the slotting provided no benefit or detriment to the effect happening
  3. No measurable thrust

Tests were conducted on an apparatus that could measure down to 10 micronewtons and in multiple directions. It is important to note that these tests were not conducted in a vacuum like the EmDrive tests.

As you can see, incredibly tiny amounts of thrust are being generated at these low power levels. A force of 50 micronewtons is approximately the amount of force required to launch a few ants into space. Tiny, but significant.

Normally, technology this early in its development cycle—especially one that is throwing a wrench into several well established principles of Newtonian physics—would be greeted by an enormous amount of skepticism. Thankfully this holds true: I have rarely seen more critical discussion about an emerging technology than I have about these reactionless drives. What is certain is that there is something going on here. Whether or not it does turn out to be a reactionless drive remains to be seen. Larger scale tests at a higher power will be completed this year and should provide more insight. A fourth experiment with the EmDrive (not listed above) was conducted with a device called a Michelson interferometer inside the chamber—a device that is capable of measuring changes in spacetime (a gross oversimplification). The device noted changes in the compression of spacetime within the chamber while the EmDrive was activated. If your reaction to that last sentence was anything like mine, this discussion might be interesting.

Should this technology pan out, the implications are enormous. Virtually every form of transportation (including cars, bikes, and planes) in addition to rocketry and space exploration can benefit greatly from the development of a power efficient reactionless drive. I have been following these experiments closely for the last year, and given that they have been turned over for dozens of reviews and still hold any amount of water a year later is exciting.

With developments like these we are one step closer to the world I dreamed of as a child. Outer space gets closer every day.

Further reading:

  1. Papers from the experiments, including a set done by a Chinese laboratory (disclosure: sponsored by the inventor): One Two Three
  2. More detailed write-ups on the EmDrive
  3. Lengthy forum discussion on the experiments
  4. Historical “attempts” at the development of a reactionless drive; which (unsurprisingly) all sounds very similar to the history of perpetual motion machines.
  5. Discussion of the Michelson interferometer experiment
  6. Eagleworks data

The Falcon 9 Lander by SpaceX

SpaceX, a rocket propulsion company founded by Elon Musk (Tesla Motors, Paypal), has been developing a reusable launch vehicle for the delivery of materials to orbit efficiently and for low cost. Currently, the cost of putting one pound of stuff in orbit is about $15,000, largely as the rockets used to deliver these payloads (the Delta and Atlas series rockets) are not reusable and are destroyed completely after launch.

What SpaceX has been working on is a launch vehicle that gets the stuff up there then lands itself automatically on a barge out in the middle of the ocean. Imagine balancing a broom handle on your palm. Now imagine that traveling at thousands of miles an hour. Now imagine your other hand is moving up and down on 30 foot waves and how you have to toss the supersonic broom handle–which weighs over 100,000lbs and is over 150 feet tall–to your other hand and catch it straight up and ever so gently.

You can imagine that this is not an easy task. Here is a Vine of the first landing attempt.

No cigar indeed. Post-mortem: ran out of fuel and hydraulic fluid for manipulating the grid fins that stabilize the rocket. So they tried again today. This was the result.

Much better. Unfortunately it had slightly too much horizontal velocity and tipped over. Still an enormous improvement, and this rocket delivered supplies to the ISS as a bonus.

Already the Falcon 9 has decreased per pound low Earth orbit launch costs by a factor of 3 without the landing capability. I cannot wait until economical launch vehicles finally put the serious development of space within reach.

So excited.

More on the Falcon 9
More on the first test of the lander (includes a post-mortem)