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What to Consider When Ranking Family Medicine Residency Programs

By now, you’ve probably stumbled upon countless blogs and videos with generic advice on how to create your residency rank list. In fact, here’s a post I wrote about choosing a residency program!

In my “catch-all” post, you’ll find tips for assessing a residency program based on a broad array of factors, such as its location, reputation, program size, etc. It’s good information to have, regardless of which specialty you’re thinking of going into, so be sure to take a look at it.

“Yes, that’s all well and good,” you may be saying to yourself, “but what about the specialty I’m going into? Where can I find information on how to select a program in my field?” And those are good questions! In fact, over my past few years as an advisor, I‘ve received more and more requests from students about specific recommendations for particular specialties.

So by popular demand, we’re going to start a series that details specific things to keep in mind when selecting residencies in different branches of medicine. We’ll do a post for each specialty (or most of them), but let’s start off by discussing what to consider when you’re selecting a family medicine residency program.

How to Choose a Family Medicine Residency Program

Family medicine residency programs provide the training and experience necessary to become a skilled and compassionate family physician, in addition to helping applicants become board certified licensed FM physicians in the US. Needless to say, you want to choose the right program, because it will have a huge impact on your career.

As a general piece of advice, after you complete a family medicine residency interview, it’s a good idea to jot down any likes and dislikes you had for that particular program. As you approach the rank list deadline, comb through your notes for each program and use them to help create your rank list.

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What to Look for in a Family Medicine Residency Program

When selecting a family medicine residency program, consider the following (they’re listed in no particular order, so focus on the criteria that align most with your career goals):

1. Program Accreditation

Ensure the program is accredited by the Accreditation Council for Graduate Medical Education (ACGME). Accredited programs meet specific standards for education and training and also have protections for residents such as vacation time, duty-hour restrictions, and call/night shift limitations.

2. Quality of Training and Board Pass Rates

As an attending, you’ll need to pass your boards to become board certified. FM is a bit different from other specialties because FM residents take their board certification exam in April, prior to graduating from residency (most other specialty boards occur after residency graduation and the graduates are “board eligible” until they pass).

The residents’ board scores are an indicator of how well the program trains them for their future jobs as evidence-based medical practitioners, so be sure to have a look at their pass rates.

3. Resident Satisfaction

Satisfaction at your job can help prevent burnout. Look for a residency program that can not only train you, but one the current residents seem to like. You’ll develop the skills needed to diagnose, treat, and manage patients during residency, but you also need to learn about self-care and work-life balance.

4. Curriculum

Review the curriculum and rotation schedule, along with elective options. Ensure the program provides a well-rounded experience in various areas of family medicine, such as obstetrics, pediatrics, a mix of inpatient and outpatient, etc. A well-structured curriculum should offer various elective options that allow residents to hone their skills and develop interest in fellowships such as sports medicine or geriatrics.

Furthermore, the program should have faculty in such fields, teaching and leading the electives in their particular specialty to ensure the program’s residents receive stellar training. An evolving curriculum is a good sign the program faculty review it and accept feedback to make improvements and properly prepare their residents.

Lastly, pay attention to how much inpatient vs clinic rotations you’ll have. For instance, if you want to practice as a FM hospitalist, you’ll want to have more inpatient training hours during residency.

5. The “Day-to-Day”

Ask about what this residency program is like on a day-to-day basis. This is a good question for current residents, as they’re literally in the trenches, going through it right now. Ask how many patients they typically see in a day, how they take calls after hours ( including how often), how many calls they receive, is it home call or in house, how many night calls are there, what about OB calls, etc.

6. Didactics

This refers to your designated learning time. Programs will usually have a half day of lectures/didactics or a lunch hour each day. Either option yields roughly 4-5 hours of didactics per week.

Questions you should ask include:

  1. Are lectures in person or virtual?
  2. Who are the primary lecturers, are they faculty, residents or other staff?
  3. Are there visiting professors?
  4. Is the content focused on medicine, or are there lessons on how to interview for a fellowship/job?
  5. How dedicated are the faculty to teaching (vs. research and other professional obligations)?

The point is, you want faculty who are committed to your training and success. Getting answers to these questions will give you a sense on whether your learning is a priority for them.

7. Program Setting 

You likely have already considered a program’s general location, now think about its specific setting. Training in an urban, suburban or rural setting can significantly impact your overall quality of life and the patient population you’ll be serving. Urban areas tend to have more diversity in terms of patient population, while suburban and rural areas allow FM providers and residents to train in a full-scope family practice.

There are other things, such as affiliation with medical schools as well as fellowship options and research offers after residency to consider as well. Urban areas may provide trainees more opportunities to work alongside renowned specialists and researchers who deliver relevant, high-quality seminars and lectures. 

8. Number of Clinical Sites 

Training at a residency program with a number of hospital and clinical facilities exposes you to various patient populations all with differing insurances, health literacy, and disease processes, thus allowing you to develop flexible strategies and adapt to a variety of practice settings.

However, also consider the fact you may have to rotate and drive to all of the various sites (trust me, driving 45 minutes from the hospital to your clinic really cuts down on your lunch break).

9. Opportunities Beyond FM

If you’re interested in research, look for programs that offer research opportunities and support for scholarly activities.

For fellowships, if you have a specific interest within family medicine (e.g., sports medicine, geriatrics, palliative care), check if the program offers fellowship opportunities in your area of interest. It’s important to have mentors who are core faculty members in the residency program that’ll support your interests.

10. Reputation and Alumni

Research the reputation of the program and its alumni. Networking and mentorship opportunities can be an extra boost for your career.

Consider where previous and current residents went for fellowships, and research what job offers they received. What previous residents have to say about a program can be instructive, but take their reviews with a grain of salt as some may be outdated.

11. Alignment with Your Career Goals

 Whether you want to practice full-scope FM in a rural setting or practice sports medicine while traveling with a professional sports team, ensure your residency program aligns with your career goals.

A common residency interview question is “where do you see yourself in x years?” Thinking critically about your answer ahead of time not only prepares you for the interview, it allows you to gauge each program’s curriculum strengths and how they’ll ultimately impact your training and future career. Many programs have options and electives for clinical research, fellowship, global health, and other various tracts. Look into all the offerings and see how they can tailor the program to meet your needs.

Naturally, different program structures yield different training experiences. How much you value those differences is subjective and depends on how you hope to practice. After all, you wouldn’t attend a program that offers little to no POCUS training if you want to apply for an ultrasound fellowship!

Further Reading

Family medicine differs a bit from other specialties, so naturally there are some considerations that are essential to thoroughly research and assess as you apply and rank your programs. Every applicant comes from a unique background and has different reasons for going into medicine, as well as different expectations for what they will get out of residency. Determine which aspects are most important to you and set your rank list accordingly.

Be sure to seek advice from mentors, and consider your personal and career goals in order to make a wise and informed choice. The right program can set you on a path to become a competent, compassionate, and successful family physician!

If you’re looking for more (free!) content to help you through Match season, check out these other posts from Blueprint tutors on the Med School blog:

About the Author

Mike is a driven tutor and supportive advisor. He received his MD from Baylor College of Medicine and then stayed for residency. He has recently taken a faculty position at Baylor because of his love for teaching. Mike’s philosophy is to elevate his students to their full potential with excellent exam scores, and successful interviews at top-tier programs. He holds the belief that you learn best from those close to you in training. Dr. Ren is passionate about his role as a mentor and has taught for much of his life – as an SAT tutor in high school, then as an MCAT instructor for the Princeton Review. At Baylor, he has held review courses for the FM shelf and board exams as Chief Resident.   For years, Dr. Ren has worked closely with the office of student affairs and has experience as an admissions advisor. He has mentored numerous students entering medical and residency and keeps in touch with many of them today as they embark on their road to aspiring physicians. His supportiveness and approachability put his students at ease and provide a safe learning environment where questions and conversation flow. For exam prep, Mike will help you develop critical reasoning skills and as an advisor he will hone your interview skills with insider knowledge to commonly asked admissions questions.