What to Look For in a Residency Program

This blog was originally published in July, 2020, and updated in August 2024 by Marisa Ulrich and Dr. Olivia Negris.

Selecting the Right Residency Program

As the 3rd year of medical school begins wrapping up and residency application season is on the horizon, it’s time to not only officially decide what type of doctor to become, but also what kind of residency program you hope to train in. It’s easy to get lost in interview preparation, but care should be taken to ensure that you are going to be happy with where you ultimately match. When compiling a list of these programs, there are several key factors to keep in mind.

You’ll spend 3-7 years of your life in this program, and it’s about more than just the work. It’s important to think about whether you will be a good fit for this program and if the program will be a good fit for you. Below are some considerations that our own tutors emphasized when compiling their rank list. Priorities are different depending on the person, but reflecting on your preferences will guide you towards your best fit. 

Geographic Location

For many of my colleagues, location was a top distinguishing factor when choosing between different residency programs. Different locations come with different climates, training environments (urban vs. urban vs. rural area), weekend activities (city vs. mountains vs. ocean vs. farmland), patient populations, and lastly, variable proximity to your family and loved ones (discussed next). Another important consideration is where you would like to end up at the end of residency. Many people stay in the same general region as their residency program, so looking beyond residency into attending-hood is never a bad exercise. 

Proximity to Support System

Residency can be grueling. It often comes with unexpected challenges–both physically and emotionally. While you will undoubtedly have the support of your coresidents, your historical support system has stood the test of time. It’s important to be close to a support system, whether this is your family or friends.

Some residents prioritize training in an environment that supports their family life, whether that’s being close to their own family, parents, siblings, or a close-knit group of friends. Whatever your situation, it’s essential to find a program that fits your personal needs outside of the hospital. With limited time off during residency, being close to loved ones can make a big difference. You’ll appreciate being able to see them frequently, especially during holidays and other special occasions.

Couples matching can be a high-stress experience, but there’s good news: it’s often successful. In 2024, about 90% of couples who applied (1,097 out of 1,218) both matched, according to according to NRMP match data. Focusing on regions with a high density of hospital systems can improve your chances of a successful couples match (whether that be at the same hospital, or different hospitals in the same city).

Research Opportunities

Depending on how you envision your future career, research may or may not be important to you. If you see your future as a physician scientist, have an interest in mentoring students and trainees, or simply want the option to pursue scholarly activity during residency, it’s important to explore the different research opportunities offered at each program. Certain residency programs have research requirements–this can be quite involved (ex: 1 publication/year). Different programs also receive different NIH funding, have varying access to statisticians, and have vastly different research infrastructure. Oftentimes, current residents have the best insight as to each institution’s research details. Resident socials and Q&A sessions are a great opportunity to get more information.

Regardless of what you practice in the future, many residencies are often considered academic or non-academic. This will certainly influence the type of opportunities available to you, and how your mentors and colleagues view research throughout your residency. Similar views regarding research will set you up for success, regardless of what your specific goals are. 

Track Record

Thinking again to your future – where do you envision yourself?  Do you already know that you wish to pursue a fellowship after residency? Is becoming an attending in a highly competitive academic program a goal of yours? Do you want to move into private practice? It’s important to take the time to look at recent graduates from your residency program of interest and see what they did and where they went after graduating. Often, programs will post lists of their alumni so you can explore this information if you take the time to do so.

Additionally, it is important to ask this question of “Where do your residents go next after graduating?” when you are attending residency program open houses, pre- or post-interview social hours, or during your actual interview. If past residents were successfully able to match into a certain fellowship, and that is also your goal, that speaks highly of the program’s ability to help you achieve that goal.

Assessing where past residents end up geographically, can also be helpful if you have family or a partner that leads you to have a strong preference for your postgraduate location of practice. Keep in mind, that your interests and preferences may change during your training so it is OK if you do not know some of these future plans for certain. However it is best to set yourself up for success based on the available information and discussions prior to making a residency program rank list. 

Mentorship 

Mentorship is a valuable aspect of a residency program, providing guidance, support, and insight from experienced professionals to less experienced residents. Consider what you hope to gain from a mentorship experience. Do you want a mentor to guide you in pursuing research, finding professional development opportunities, or advancing your clinical skills? Alternatively, do you hope to mentor medical students during your residency, helping to nurture their growth in medicine?

To find a program that aligns with your mentorship goals, look at the faculty you’ll be working with regularly. Is there a core faculty group primarily involved in resident training, or are there volunteer faculty who rotate through clinics? Is the program tied to a medical school with rotating students on your team?

Some programs offer formal mentoring through resident-faculty or student-resident pairings, while others have advising “houses” or “families.” If you want this extra level of involvement, research these opportunities on program websites or ask about them when interacting with current residents and faculty. Mentorship can help residents navigate their training, boosting confidence and competence, and opening doors to networking opportunities and collaborations that contribute to long-term career success and satisfaction.

Work-Life Balance

Regardless of your medical specialty, residency is demanding, with long hours and intense workloads. But prioritizing work-life balance helps prevent burnout and promotes mental health. When choosing a program, consider the work-life balance it offers. It is a key indicator of resident well-being and professional success.

So ask yourself, what does the culture of the program seem to be? Do they value time outside of the hospital and resident wellness? Have there been any work hour violations reported? What is the schedule like? How frequently are the residents on call?  The best way to get this information is directly from the residents themselves (current, and possibly past), as it likely will not be available on the program’s website. This is the time to use your connections and ask around to get information about the program. Programs that support balance through flexible scheduling, wellness resources, and a positive culture help residents manage stress and develop sustainable habits, ultimately leading to a more fulfilling and successful career in medicine.

Reputation

We’re addressing reputation last because it can be highly subjective. Rankings can vary depending on the resource, and what’s considered top-tier for one specialty may not be for another.

Despite this, many medical students find reputation to be an important guiding factor, especially if other factors aren’t as important. Historically, reputation has been based on factors like faculty credentials, successful fellowship matches, research access, and clinical experience diversity.

However, reputations can change with new program leadership, resident classes, and chief residents. So, take online reviews with a grain of salt and consider your own experiences and impressions of a program. For example, a program once known for being “toxic” might have a new director who prioritizes wellness, leading to a significant culture shift that contradicts its previous reputation.

Conclusion

Regardless of what you prioritize, reflecting on these aspects of residency are essential to ensure you are feeling and functioning your best throughout residency. Interviews are certainly a time for programs to evaluate you, but you are also evaluating them! Take this opportunity to ask questions and think critically about what you want out of your training. These programs are accredited to train you in your respective specialty – you will be a board eligible physician no matter where you complete training. However, each residency experience is unique and has its own blend of offerings. You deserve a program where you will thrive both personally and professionally.

Now that you’ve considered the key factors in selecting the right residency program, it’s time to take the next step. At Elite Medical Prep, our expert advisors can help you navigate the complex process of researching and ranking programs. We’ll ensure you find the perfect fit for your personal and professional goals. Schedule a consultation with us today to learn more about our comprehensive residency advising services. Take the first step towards a successful and fulfilling career in medicine.