Dongyeon Joanna Kim, MD | Liana Tedesco, MD
November 2, 2022
Congratulations! For the past few months, you have gathered your letters of recommendation, edited your personal statement, crushed your sub-internship rotations, carefully selected programs to send your application to, and for some of you, navigated a whole new different hospital system. It is a whirlwind of a process, but you probably breathed a sigh of relief after you clicked on that “submit” button.
The daunting task now remains – how do you pick the right residency? No one can make this decision for you, and no one knows you better than you know yourself. As you look for a program that is your perfect fit, think about the kind of environment in which you thrive, the sort of peers who help you succeed, and the type of mentors from whom you want to learn and grow. As you begin your interview journey, below are some factors that may help you weed through all the information and find your best fit.
1Ultimate Goals and Priorities
Ask yourself where you see yourself in 20 years. Seems daunting but having this big picture goal can help guide your process. It might be in a big academic center, working with residents and medical students. You might want to be an educator, teaching students and leading curricular changes within the medical school. Maybe you see yourself as a future leader in national orthopedic societies. Your goal might include being prolific in research, and you are passionate about advancing the field of orthopedics with evidence-based medicine. Maybe you want to focus more on patient care and envision joining an outpatient practice in a community setting. Look for a program that would best align with your goals.
Once you have this vision, look at a program’s alumni. What types of fellowships do the residents achieve? What practice setting are they in? What geographic location? What committees do they sit on? The alumni network is a great way to see what kind of opportunities you may have in the future. The “right” residency program will not only help you reach these goals, but also help you best thrive and succeed.
Think about mentorship AND sponsorship. Will the faculty be invested in your success in the future beyond residency? Will they actively support your goals and objectives to get involved in local, regional, or national organizations? Sponsors help open doors for you and then you have to do the work from there.
Each program is structured differently, though the basics of most are similar. Most will have their rotation schedule from PGY1-5 listed on their website. This can provide a blueprint of which subspecialty rotations you will do when, how many times. Ask residents about the call schedule. Some will have a night float system and others will do 24 hours. These subtle differences should not make or break a program, but the more information you have, the better you can determine if it is a good fit for you! Understand if you rotate on all (or most) subspecialty services PRIOR to the PG-4 year so that you can work with subspecialty mentors who will support your fellowship pursuit.
Beyond the structure of the program itself, ask questions about how didactics are structured and how many self-learning opportunities are available (i.e. cadaver labs). If you want to be productive in research, ask how much support you will have in completing projects. Ask if there is dedicated research time built into the schedule. Some programs allow residents to take international electives. All of this ultimately culminates in the fellowship match – analyze the past and present residents and where they matched. Reach out and ask if residents feel supported and prepared for the fellowship match process. Don’t just look at the most recent graduate’s fellowship match – look at the prior years and especially look to see if top tier fellowships continue to take residents from that program – or is it a “one and done” situation.
Geographical location is often critical in making your final list. It is completely reasonable to prioritize where you want to be for the next five years. Maybe you want to be near your family or other support systems. Perhaps your significant other has a job offer that limits you to a certain geographical area or you want to explore a new part of the country. Is the city and/or the residency program family-friendly? Think also about the patient population you will be serving as a resident physician. Do you want to work in the VA? Do you want to work in a hospital with a high volume of trauma? Work with diverse immigrant or underserved populations? All of these contribute to the overall environment that you’ll be immersed in for the next five years.
4Culture and “Fit
This is the most nebulous and, arguably, most important factor! After your away rotations or interviews, ask yourself some key questions: Can I see myself working late nights and early mornings, the ups and the downs with this group of people? Can I lean on these people during hard days and difficult nights? Are these the people that I will develop life-long friendships with? Are the faculty people whom I will call on as mentors and evolve into colleagues and friends? These are the people that you will spend 80 hours a week with and finding your group of people that you can lean on is invaluable. It is especially difficult to analyze when more and more interactions are virtual – though nothing can replicate an in-person experience, reach out to as many residents as you can. Set up phone calls and facetimes. Ask about relationships amongst residents and between residents and attendings. See if there are any resident bonding events or traditions. Get a good feel of these intangibles – it makes a difference.
More important than anything, remember that residency programs want to match medical students who want to be there and who fit the mission of their program. Though it may feel one sided, you are interviewing programs as much as they are interviewing you. Before interviews begin, create a list of questions you would want to learn the answers to. Then, you can craft a more focused list of questions for each program. Create a living document where you can jot down notes during the interview and immediately after. What was your gut feeling after the interview? Are you excited? Do you think the program can provide the best educational and training experiences and that you can also be a valuable team member of the residency program? These notes might come useful when making your final rank list in March.
Be mindful that though interview day is intense and immersive, it is one day, one interaction, and one snapshot of the residency program. Don’t be afraid to reach out to residents, program directors, or faculty to get a better understanding of the program. Ask your faculty mentors and people you trust (even your loved ones not in medicine) for their thoughts.
We hope these tips will help you figure out how to find the best fit for you. Good luck with the process!
attitude. Be ready to work hard and learn. It is a tough and rewarding five years and you are just at the beginning.
DISCLOSURES: Dr. Kim This individual reported nothing to disclose. Dr. Tedesco This individual reported nothing to disclose.
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