What to Look For in a Residency Program

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 for students to not only officially decide what type of doctor they’d like to become, but also what kind of residency program they hope to train in. Before getting too deep into the interview process, students first need to choose which residency programs they want to apply to and ultimately interview at. When compiling a list of these programs, there are several key factors that ought to be kept in mind. You will be spending the next 3-7 years of your life at this program; 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. The factors listed below may be prioritized differently for each individual–you need to think about what is important to you!

Geographic Location

For many of my colleagues, location was frequently the top distinguishing factor when choosing between different residency programs. Different locations come along with different climates, different training environments (city vs. urban area), different weekend activities (city vs. mountains vs. ocean vs. farmland), different patient populations, and lastly, different proximity to your family and loved ones (discussed next).

Proximity to Support System

Residency can be grueling and hard; it comes along with unexpected challenges–both physically and emotionally. It’s important to be close to a support system, whether this is your family or friends. Certain residents already have a family of their own–spouse and/or children–and for them it is a top priority to train in an environment that would help support their family life. Other residents find it a priority to be close to their parents and siblings. Others have a close group of friends from college or childhood, all living in the same area, and hope to return there to train. Whatever the case may be, it’s important you find the type of environment that will allow you to feel supported outside of the hospital. You don’t have a lot of time off during residency to travel for holidays, etc, so being close to loved ones and being able to see them more frequently can make a huge difference.

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 as a research mentor, 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) and others are more laid back with no requirements at all. Different programs also receive different NIH funding, have varying access to statisticians, and may or may not have mentors willing to help guide resident’s work. 

Track Record

Thinking again to your future – do you want to pursue a fellowship after residency? Do you want to become an attending in a highly competitive academic program? Do you want to do private practice? It’s important to look at and ask where prior graduating residents went upon finishing each residency program. 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.

Mentorship 

This could be one of two things. Do you hope to have a mentor who will guide you during your training, such as helping you pursue research on the side or advocating for you? As another option, do you hope to serve as a mentor to medical students during your training and help nurture their growth in medicine? If the answer is yes to either of those questions, it will be important to look at the faculty you will regularly be working with–is there a core faculty group primarily involved in resident training, or is there a lot of volunteer faculty that rotate through clinics? Is the residency program tied to a medical school so you will have rotating students?

Work-Life Balance

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? What is the schedule like? How frequently are the residents on call?  The best way to get this information is 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.

Reputation

I’m placing this last because reputation can be very subjective. The program rankings can vary depending on what resource you are looking at. In addition, what’s considered a “top” hospital for one specialty, may be a “low-tier” place to pursue another specialty. However, that being said, many med students find this factor an important guiding tool, especially if the factors above may not be as important.