Thursday, November 29, 2012

How to Get to Residency - a *hopefully* simplified explaination from a medical student's wife

I have been asked many times how the process of how getting a residency position works. If you know someone who has been through it you may have some idea but if you haven't I am going to try to give a simplified version of the process from the outsider's perspective of a medical student's wife.

FYI - Residency is a 3+ year paid training under attending physicians at hospitals and clinics that all doctors who desire to be board certified must complete.

1. Go to college, complete pre-med requirements, get into and attend medical school and pass all your exams.
 You need to go to and pass medical school and pass the national board exams, Step 1 and Step 2, in order to qualify for residency. Medical school is 4 years. At most schools the first 2 years are mostly classes (I've heard them compared to trying to drink from a fire hydrant) and the last 2 years are mostly clinical rotations.

2. Choose what specialty you want to pursue.
During your clinical rotations you get a taste of just about every kind of specialty to help you, hopefully, narrow this down.

3. Decide what type of resident training you want and what is most important to you in a residency program then research programs that offer the training you want in the specialty you want to pursue.
 It's important to consider the scope of training that you want, location, what benefits are important, etc.

I am not sure if every specialty offers a conference but going to the AAFP National Conference of Family Medicine Residents and Medical Students was helpful for us to give us a chance to talk one on one with many different residents and attendings from various programs across the country all in one place. It is an overwhelming conference though so go in knowing that. We were able to cross a few programs off of our list and pick up a few programs as well at the conference.

We used the AAFP website to help us narrow down our options. AMA's FREIDA website is also helpful to get a look at programs in all specialties.

4. Apply to residency programs through ERAS
The number of programs you apply to largely depends on how difficult to get into the specialty you are pursuing is and how good of a candidate you are. Your medical school adviser will help you make that decision.

The application involves various parts including: transcripts, personal statement, CV, letters of recommendation, programs you are applying to, and a photo. You can start putting information into your application on 7/1 (I think) but applications can not be submitted until 9/1.

On 10/1 every applicants' Dean's Letter is sent out to the programs that the applicant applied to.

5. Schedule residency program interviews
Once your application is complete it is uploaded by residency programs and they start looking over applications and deciding who to invite for interviews. Every programs has a different method for doing this. Some look at applications every day, some only look at them once a week. Some contact applicants by email, some by phone and some by snail mail.

6. Interview at programs that invited you to interview
In our experience, at most programs,  the interview involves a dinner with residents the night before the formal interview day. The formal interview starts as early as 7am and goes until as late as 4:30pm. The interview day usually involves about 4 interviews with residents, faculty, and the program director, a tour of the facilities, lunch, and sometimes a driving tour of the area.

Interview season runs from October through January.

7. Rank for the Match
After all interviews are over applicants submit a "rank order list" to the NRMP. In this list you place the program that you want to be at most in the first position and on down to the program that you want to be in least. This year you can submit your rank order list starting on 1/15 and it is required to be in by 2/20 at 9pm EST at the very latest.

There are various ways that I have heard that applicants have come up with their rank order list. One couple we met re-ranked their program list after each interview deciding where the most recent program fit in so by the time they got home from all of their interviews their rank order list was done. One couple was thinking that they would each make their own rank order list and have a friend pretend to be a computer to compare their lists to see where each program would fall. For us it has been a constant conversation about things that we like best and things that we aren't so sure on. There is no perfect program. There are definite good things and not as good things about each program. We are still praying and researching to try to figure out how we are going to rank our list. I have heard it recommended that students not rank any program that they are not willing to be at, that it is better to scramble than match at a program that you don't want to be at.

At the same time the residency programs also submit a rank order list of applicants. Each program has a different way of coming up with their list of preferred candidates.

Ranking is a double blind process where neither the applicants nor the programs can see where they rank on each others' lists. Both of these lists are submitted into a computer and put through an algorithm that compiles all the lists and determines the best fits for residents and programs based on the lists that were submitted.

8. Wait for Match Day
Match Day is the 3rd Friday in March. On the Monday before Match Day all applicants find out if they matched and all programs find out if they filled. If you don't match there is a new program called Supplemental Offer & Acceptance Program which I don't understand fully because I haven't really looked at it. Lord willing we will match and won't have to worry about it but just open up our envelop on Friday, March 15 and find out where we are going!

When students register for ERAS it is a binding agreement and they are agreeing to work for whatever program they match at. At the same time programs are agreeing to hire everyone who matches at their program.

That about sums it up as far as I understand it. Hopefully I got it right and you are not more confused after reading this!

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