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How to Choose a Medical Residency Program That’s Just Right

You — who has put so much time and sweat, so many tears, and maybe even some blood into your tenure as a medical student — deserve to match into a residency program that will not only teach you the ins-and-outs of your specialty, but also foster a positive learning environment. But how does one pick the best program for oneself?

In my NRMP ranking experience I thought about things not only scientifically but emotionally as well.

After the long and arduous interview season, it was difficult for me to tell one program from another. In radiology, interview days between programs are very similar and, by the end of several months of interviewing, I found myself mixing together some of the finer details of the programs I’d visited. Naturally, I began to experience some anxiety about of this; so I set up an objective scoring system to negotiate this in my mind.

For me, it was important to meet six major parameters in a medical residency program:

    1. Major U.S. City: This is what determined imaging volume
    2. Level 1 Trauma Center: This is what determines acuity for radiologists/surgeons
    3. Programs with more than 8 residents per class: Because I very much enjoy people
    4. Medical Schools actively intertwined in the healthcare system: Because I very much enjoy teaching people
    5. A university program that encourages resident research: Because learning is awesome!
    6. Opportunities for fellowship within the institution: Because this indicates that the case volume is sufficient for fellowship training as well

Now, by no means should anyone read this and think that these six criteria of mine are the ONLY ones that matter when deciding upon a rank list. These were merely the factors that were most important to me. What’s important is that you spend time thinking about what you need from a residency program to feel that both your education and your happiness are being equally fulfilled. Happy residents are productive residents who learn well. You could be at the best program ever (on paper) but if you are miserable, you won’t be learning much. Thus, if you find your happiness is tied to a certain region, a type of climate, proximity to family members, etc., then you should absolutely make those criteria a priority.

I began assigning up to six points per residency program (based on the above criteria) and subjectively broke score ties as I encountered them.

For example: if two programs scored a six, but one program was in “Unfun City, USA” and the other was in “Totally Awesomeville, USA,” the latter took the cake. At the time, I decided that the quality of education I was receiving from a program was more important to me than the location; but by no means did I ever feel like I was compromising my own happiness.

When it comes to other subjective details, it’s important to keep things in perspective when selecting a residency program.

Some of the residency perks are nice, but these shouldn’t be a major motivating factor in your decision making process. Book funds, moonlighting, and free tablets are all great, but these are relatively small advantages that hardly compare to a top-notch education or the exciting opportunities found within a new location and career. Instead, criteria such as the friendliness of residents and faculty, resources for help, and an environment that promotes your education as well as patient care are factors you’ll want to evaluate during your interview experiences. Examine how these environments make you feel: they’ll play a big role in your subjective rankings later.

All that said, the funniest part of the process for me was at the very end. Upon comparing my list compiled from a purely subjective point of view with my list derived from instinct and objectivity, I found that my lists were completely identical.

Thus, my advice to applicants is: don’t put too much stress into ranking your residency programs. You have known throughout the interview season which places felt excellent and which ones did not. You are also already very aware of the quality of education you can expect, as well as the collegiality of each program. Stay away from rumors, rank based on your instinct (with a little bit of objectivity if you feel it necessary) and trust that however you rank, your list will be the perfect list for you.


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