Picking a Residency Program

13 May

How to pick through the hundreds of residency programs available:

  • There is a residency out there that is more geared toward you than others.  To find this program you must be willing to put in the time to find it and consider what you actually want in a program.  The more time you put in to this process that happier experience you will be in the next 3-5 years.
  • On Denver Health’s Emergency Medicine Residency page they provide a great list of suggested items about what to look for in a residency.  It’s obviously ER geared but the message is: ‘put thought into what you are looking for before submitting an application to 100 random programs’.  I think you will find that you will be able to be a lot more genuine during your residency interviews if you have put in the time to make sure it’s at least a good choice for you on paper.
  • I recommend making a spreadsheet of the different components you are looking for in a residency and then fill it in as you do your research, interviews and audition rotations.  You can make a column for questions you’d like answered. It’s difficult to remember all of the subtle differences in the programs so this is something I found to be really helpful both in deciding which programs to apply for, interview at and rank.  I had a specific color code that I used to help me also.


  • Check with your specialty colleges to see if they offer free student memberships, residency fairs or may have a student chapter to find advice on applying to your field of medicine. I found that a lot of the student chapters would host residency fairs at annual meetings for various specialty colleges. A list of the AOA specialty colleges is listed on the American Osteopathic Association (AOA) webpage and a list of the Allopathic specialty colleges is found on the Association of American Medical Colleges (AAMC) webpage.
  • Do not trust the information to be up to date on residency program websites or program search sites such as Osteopathic Opportunities, or FREIDA. These are great references for general information, but contact the programs coordinators (not the program directors) directly to clarify any questions about their program.  Remember to make the program coordinators your friend, speak professionally with them and respect their time because they too can have input on your application.
  • Learn about the Match. Depending if you are DO or MD, learn about both the AOA match, serviced by National Matching Services, Inc. and the ACGME match, serviced by the National Resident Matching Program and the match rules before interviewing.  There are interview rules listed for each match, what you can and can not say in interviews and in communication between the interview and the match.  Learning about the different match processes should also help you determine if you want to enter one or both of the matches, if applicable.  You are completely able to do both* if you are a DO student but think hard about the implications of entering each match, it’s a personal decision for everyone. *pending the merger.
  • If you are a DO student applying to MD residencies I would highly advise researching to make sure the residency is “DO friendly” if you plan to put a lot of energy toward getting into that residency.  Ways you can do this is to check if there are other DO residents currently in the program, DO faculty, DO program director, and if they accept COMLEX scores.  You never know how the program is changing so it’s not a bad idea to ask the coordinator or program director if they take DOs if it’s not obvious to you.
  • Now that I have started residency, I highly recommend if you are going into a specialty area of medicine to go to a program that requires off-service resident rotations in general fields of medicine such as Internal Medicine, ICU, ER, etc.  This has really been a highlight of my intern year so far and has taught me a lot more than I ever imagined about managing patients.  My experience has been that I have been able to learn a lot more actually managing patients than I did in medical school since I wasn’t really making the big decisions or responsible for the patient’s outcomes. Once you have that responsibility on your shoulders it forces you to learn the medicine much more thoroughly.  I am personally not a fan of medicine/ER, etc so I felt like this was really important for me to develop my skill-set rather than ignore it as some residencies do permit if they do not require many off-service rotations.
  • Finally, if you like a program and you are really interested in knowing if it’s the one for you, book an audition rotation or sub-internship there!

Questions to ask yourself when looking for the right residency for you:

  1. Does it matter to you how many residents the programs accept per year?
    • How many co-residents do you want?
  2. Does it matter to you where or what size city the program is in?
  3. Does it matter to you what the call schedule is like?
    • Example: Night float vs. Every 3 days a 24hr shift?
    • Example: How many weekends off a month?
    • Personally, I like routine so I wanted night float months
  4. Does it matter to you if there are fellowships at the program?
    • This can be beneficial as “a feeder program” because fellowship programs may favor a resident they already know and trust to join their program.
    • It can also be a negative as fellows often end up doing more of the surgeries, managing the patients, etc. If you’re at a program without fellowships, you’re the first assist/surgeon on those cases instead of a fellow.
  5. Does it matter to you if there are residents from other programs rotating in, or you rotating out (opposed vs. unopposed residency)?
    • Do you mind rotating out to a different program/hospital if that is part of the curriculum?
    • Do you mind if those rotations you’re going out to are not part of your day to day training and you may only be exposed to them for 1-2 months?
  6. Does it matter to you if the program is affiliated with certain religious or private groups?
    • For ob/gyn residents this could mean learning or not learning various contraceptive/abortion practices
  7. Does it matter to you if the program is non-profit?
    • Tuition payback anyone?
  8. Does it matter to you what the required procedure numbers are for each resident and how difficult it is to achieve these numbers?
    • Did past residents have trouble getting their numbers?
  9. Does it matter to you if previous residents passed their boards on first take?
  10. Does didactic style matter to you?
    • Some residencies rely on resident presentations/lectures, some have more attending lectures.
    • Perhaps you prefer more time to read on your own, is there time for this?
  11. Does it matter to you if the hospital is a receiving hospital, trauma center, or community based center?
    • For ob/gyn, the NICU level determines which gestational age neonate gets delivered there which can be important for achieving your goals.
    • Trauma/Receiving centers are going to give you more of your high acuity patients from outlying facilities.
  12. Does it matter to you how close the residents are able to live to the program?
    • I personally hate any commuting so having to run in and out of the hospital all of the time made me want to be able to live close in.
  13. Does it matter to you how safe the neighborhoods are, how much housing costs or perhaps even proximity of a good school district?
    • What is your pay and can you afford to live off of this amount in a reasonable neighborhood for your lifestyle?
  14. Does it matter to you if past residents have gone on to fellowships or not?
  15. Does it matter to you if the hospital is research heavy or not?
    • Is there staff to help you with research projects?
  16. Does it matter to you what population demographics you serve?
    • Underserved populations often have higher morbidity and interesting pathology which may interest you.


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