Few things to look for in programs

1.  Academic Affiliation – Are they university or university affiliated?

Academically affiliated programs let you work with medical students.  These programs are also viewed as more ‘scholarly’, and as a result, can help you get into a sub-specialty, research, or academic medicine (that is, become an Attending).  The negative is that the support (blood draws, IV sticks, patient transport), pay, and general treatment of residents are often worse than non-university programs.  The reverse is true for community (non-university) programs.

2. Presence of other residencies/fellowships – These strengthen a program educationally because there’s more of a willingness by the other departments and sub-specialties to actually teach.  Private doctors tend to be more interested in the bottom line ($$$) and less interested in helping you learn.

3. Board pass rate – This is for the qualifying exam that people in your specialty take after residency.  Ask the program director for your specialty—about where you can find this information.

4. Stability of the program – These questions include

--Do they have full accreditation, and for how long (this can be found on www.acgme.org under ‘listings of accredited programs’)?

--Are they about to be merged with another residency program, and if so, how will this affect your training?

--How long has the program director been there?  If he/she hasn’t been there too long, why did the old program director leave?

--Do the hospital(s) where the programs are located have enough patients (both number and variety) for your education, needs and interests.  It goes without saying that important issues to you such as lifestyle, academic reputation, and location should be explored as well.

--Are the residents reasonably happy and content or do they persistently ‘bad mouth’ the program?

Program information can be found on the web or by writing the respective programs.  Helpful web sites are AMA/Frieda and careerMD (www.careermd.com).  Be wary of program information on Frieda regarding work hours and call, as this information might not be updated regularly.

Doing externships in your first choice program can strengthen your chances of matching there.  If not at that program, then one that is in that area of the country leading to increased familiarity with the other residency programs in the general area.

The argument against doing an externship at your first choice is that you could screw up and give the powers that be a negative impression of you.  I believe it takes two people to make a negative impression.  If your first choice is a place where either you were not comfortable working or they didn’t extend themselves to help you work, then maybe it shouldn’t be your first choice after all.

One last word regarding externships.  Usually these are sub-internships on the general hospital wards.  Sometimes you can arrange externships in sub-specialty rotations such as cardiology or nephrology.  These can be a bit more laid back in terms of workload, but you are on the periphery of the residency program when you work in a sub-specialty.  If you choose this route then you need to be more aggressive in talking with attendings and going to conferences in order to learn more about the program and to make a good impression.

So after you know what to look for and have gathered the facts, it is time to put together a balanced application list for ERAS.  I divided mine into thirds; the “pie in the sky” dream programs, the solid good reputation programs, and the programs that were easier to get into.

After interviewing, write down your impression of the programs so you can remember them when you rank programs.  Make sure to send thank you notes to the interviewers and program directors as soon as possible after the interview.  If you are truly interested in a program after the interview (probably a top three choice), consider scheduling a second look tour by talking with the residency coordinator.  This is usually a day spent with an in-hospital team and/or in the out-patient clinics.  It allows you to get better acquainted with the program, and shows the program that you are very interested in it.