Things we wish we knew when applying for residency

Things we wish we knew when applying for residency

Once upon a time my Dr. H had no idea what specialty he wanted to pick, eventually chose one and began the application process. We had three kids by the end of medical school, so naturally we wanted to make sure we applied to programs with decent schools nearby, avoid inner cities, and be able to afford to live on a resident salary, as I stay home with our kids. 

This ruled out most big-name programs. We applied to solid programs without big names for the most part, even though we were coming from a big name medical school. 

The big name medical school has great success getting its students into other big name residencies (and an extremely low rate of scrambling), but we learned their advice is insufficient for other programs. 

He got plenty of interviews. We even started turning them down, since statistically we should have been guaranteed to match. He kept in touch with each program and asked further questions. However, he didn't go on any second looks, thinking he didn't need them. We revisited two or three of them together, but didn't notify the programs that we dropped by. Big mistake!

He didn't match. We scrambled into a different specialty. Stressful! Though it worked out.

What did we do wrong in the interview season? Lots of things, as it turned out.

Two years later, that different specialty wasn't going to work out for my Dr. H as a good career, so we started over. We applied in another specialty entirely, one that he had had limited exposure to in medical school but he now realized he quite liked. He now had a top name medical school and a solid name from his residency program to boot for his application. Because he had to keep working, we were limited by time and expense: all the programs we applied to were in driving distance except for three, of which we had little hope of landing interviews. 

He started getting tons of interviews - nearly every program we had applied to, yet he turned none down until he felt confident that this time around, programs were genuinely interested in him as a top contender for their spots. If a program so much as mentioned a return to visit again before the Match, he made a point of coming back. I even went along on those second visits, as a prop for him to say in effect, "Look! I'm so interested I brought my wife!" 

We matched into a top-tier program which fit within our financial and living criteria. 

What had we learned? He needed to sell himself better. He's a humble guy, and reserved. Yet he needed to convince every program that he wanted to be there, and there alone. The first time around, most programs seemed to think that since he was coming from a big name school, he probably wasn't very interested in their program other than as a backup, and he didn't signal sufficiently to them otherwise. Programs that aren't big names don't care if they have big name residents. The second time around he made sure he could answer that "why this program" question adequately to each and every program.

We learned that programs like to take students from the same med schools if they have good experiences with that school's students - which was a large part of how we landed our scrambled spot. 

We learned that real interest from a program is difficult to discern because of rules stating that programs can't officially invite applicants for a second look. Literally, they are forced to mention it as an aside, and wait to see which students care to return to indicate their interest. It's like an awkward new dating relationship! 

Lastly, we learned that some schools value a statistic of little value, measuring how many of their residents came from the program's top ranked choices. Some schools value this more than others, even though it doesn't matter a bit in real life. For instance, one program boasted that they always filled their four spots within their first five ranked students - which only means they were careful to rank students they knew were very serious about ranking their program #1. Which is funny - because you had better believe that if a program is telling you they're ranking you on top that they are telling everyone else the same thing!

We failed to do away-rotations in either case, which is another terrific way to convince a program that you are serious about them. In the first case, we were short sighted. Away-rotations are worth any inconvenience and expense. In the second case, it wasn't possible because he was still acting as a resident, finishing out the year.

So. Applying for residency is quite the ordeal, but I hope that some of this may prove helpful to this year's applicants! Try not to make our mistakes, if nothing else. Good luck!