I just finished residency and had an amazing time. Looking back to when I was applying to programs (which truly doesn’t seem that long ago), here is the specific advice that I think would have been useful:
Do some navel gazing and create your own calculus
Reading threads like this can be helpful for getting the ideas of others, but don’t try to incorporate what others look for in a program. Sit down and do some self-analysis, figure out what’s important to you and only you (and SO, if applicable). And don’t feel bad if your criteria is unlike others. It should be, dammit. You’re different as well.
Strike this from your lips: “I want to go to a top program…” No. Think harder. What are you really saying? Do you want to go to a research powerhouse? Why? If it’s not to do research, think again. Is it that you really want to have the ego stroke of saying a name people are impressed with? If that’s your cup of tea, that’s fine. Put Harvard Southshore waaaaay above a program like University of Washington. Heck, University of Notre Dame will really impress people, and they don’t even have a residency. Do you want to get great training? You don't need a top program for this. Be specific.
“Top program” is like saying “most beautiful person.” It’s really in the eyes of the beholder and is really a matter of taste. Decide the things you want and then prioritize the things you want. After that, recognize that some of the things you want will come at the expense of other things you want.
Personal example, here’s what I wanted in a program:
- Top notch county experience working with the underserved.
- Good exposure to veteran’s mental health. Not just a VA experience (which vary wildly), but a VA experience that is evidence-based, education-focused, and providing top care to the vets (this is a very personal thing for me)
- Academic program that a big enough name that I’d see lots of zebras and not just horses and potentially carve out a niche for myself
- Lots of fellowships so I could develop specialized skillets in some, maybe even go into fellowship
- Good location with lots to do in my off time
- Near a big body of water. Not important to everyone, but I get itchy if I'm away from that.
- Easy enough schedule that I’d have lots of time to pursue hobbies
I applied to programs that would scratch as many of those itches as possible. I actually found one that satisfied most of them. In fact it satisfied all of them, except for the last bullet point. Because it had all these things, it required a lot of hard work to take advantage of them. So I worked long and hard (much self-imposed, like doing the Chief thing). But I had the option of choosing a program with less work at the expense of missing out the VA experience I wanted and less of the county thing. I chose to sacrifice the easy schedule instead.
Had I gone with someone else's calculus of what to look for in a program I undoubtedly would have been less happy. I might have ended up in a more prestigious program, but really, it doesn't matter. Mine was a lot of hard work, I learned a ton, made some amazing connections, and am pretty well set up for the career I wanted. It's prestige matters only in its strengths that gave it the prestige that overlap with my interests. But I'm only as happy as I am because I went with my yardstick instead of someone else's. I encourage you all to do the same.
I don't post on SDN as much as I used to for a variety of reasons. I'm happy to help applicants when they are looking for programs to apply for however I can, but I can't really say what they should look for. It's so personalized. Plenty of folks will have advice like looking for research, funding, easy call, county experience, lots of therapy, etc. But it's really like asking whether you should prefer blonds or brunettes. Or whatever the female equivalent would be. Ripped vs. Dadbods? Is that still a thing? With my diet I hope so...
