I want to offer my perspective. The people who have written above have all clearly worked hard and are to be congratulated for their efforts, but I have some different/alternate views on answers to these questions. I'm sure we'll disagree on things, but different programs expect different things from students, and so what's right one place will be wrong elsewhere.
What allowed you to cinch your residency? Tips for success? Stats going in?
Generally agree with what was written above with respect to working hard. I was in the top half of my class, which is another way of saying I was in the middle of the pack in terms of grades. Personally I think there was a huge element of luck in my story, which I have written about in detail elsewhere. During my reapplication year, I matched at a program where applications are so competitive I don't understand how I got interviewed. I did well enough in my interview to get ranked, and ranked highly enough to match. But it's like climbing a mountain, a tiny ledge can be a foothold that gets you closer to the top.
Some other advice:
1) The simple act of putting your face out there can count for a lot. Sometimes, it will make enough of an impact that the program director spends an extra 10 seconds looking over your CV and puts you in the "yes" column when it comes down to who to rank and how high. Other times you'll make a visit and no one will care, maybe they give you the finger, and that sucks because you probably racked up a lot of travel expenses. Don't like it? Hate the game, not the players.
2) Make a list of your best attributes and accomplishments. Now cross off anything related to school, research, podiatry, medicine, surgery, academics in general. Anything that's left are the things that make you interesting. Those are the selling points that get you ranked a little higher.
3) First year students should seek out mentors among the upperclassmen. If I could have done only one thing differently it would have been that. I've always been a lone wolf, but life could have been easier in school if I had a bit of advice every now and then.
Are the hours/workload worse compared to podiatry school or is it a different kind of hard?
I think "different kind of hard" is an apt way of putting it. As a student your motivation is to impress the residents in hopes that they'll say kind things about you to the director. As a resident, your motivation is to do what's right for your patients, which for me anyway is more of a reason to get out of bed every day. I have a lot more autonomy now, so I don't necessarily care what anyone thinks about me, my work speaks for itself. In terms of hours, I worked like a maniac as an intern, but I'm in a position where I can delegate tasks now.
From a training perspective, you shouldn't be placed in a position where you're outside of your depth without having a senior resident or attending to call on for advice. (Adequate supervision is a residency accreditation requirement.) The only real life and death scenario a PGY-1 is ever faced with is "does this patient need emergency surgery?" and even then it's an attending call. Your first nec fash case will have your heart pounding, but even that you have a few hours to get your ducks in a row. Anything else can be discussed over teaching rounds.
Did you have to fight any turf wars with ortho or was everything pretty established?
We don't fight ortho over the trauma because we rotate with ortho and do trauma with them.
What kind of research interested you? Any ongoing projects?
Case reports are relatively easy to bang out, every PGY-1 should look out for something to write up. Anything else is harder and probably requires a coordinated effort. The hardest part is making sure you have the case volume to do anything meaningful and hopefully see the project completed before you graduate. If you can form a good team of like-minded residents and attendings, you'll be solid. Do a pubmed search for Adam Smasher and you can see what I've been up to.
What was the fellowship process like? How competitive/rare are they? Reason you decided to pursue one?
I made an attempt at applying to fellowships, but I resolved not to do a fellowship just so I could say I did one, so I was selective in my applications. What I found was that some fellowships you almost have to know the right people to be considered. The other problem is that while many fellowships offer an incredible experience, there are fellowships that are a waste of time. To be accredited by ACFAS, a fellowship director only needs to prove that there are 300 cases available for the training year. Fixing a pinky toe hammertoe counts towards that total.
In terms of salaries, most fellowships pay $50-60k, whereas a modest net income for a first year associate might be $100-110k. I'm not 100% convinced a graduating fellow can get much of a salary bump over what he could have gotten fresh out of residency. So that's $50k opportunity cost. What else could you do with $50k over the course of a year?
Still, it would have been nice to get involved in a fellowship where they have the case volume to base some nice papers and use that as a springboard to a more academic practice, though the money is a rather nice consolation prize.
What are your plans after residency?
I'll be joining a group practice that's continuing to expand locations. The starting salary is good, but nothing to boast over, but all the partners are approaching retirement age, and I could be heir to an empire before I'm 40. Yes, private practice is not what it used to be, but I think a group practice is still a viable model and I'll have plenty of autonomy. The business side of podiatry is rather interesting if you take the time to think about it.
Did you do all of this while raising a family? If so, what were some challenges?
Yes. It's hard. PM me.
How much swing do the residents have in ranking 4th years/prospective residents? I understand this varies program to program but, perhaps you can comment on your program specifically and maybe what your general gauge of this practice is? As I understand it- having alumni of your school as residents usually helps and rarely hurts.
Personally I don't get involved much with students. Don't get me wrong, I enjoy teaching, but I work more efficiently without students and I'm not going to make life hell for students like some residents made life hell for me. In my opinion, many residents enjoy a little too much being in a position of judgement over potential applicants. Really, a resident should be focused on their patients' needs and their own academic development. And if you're at a good program, you're going to match good applicants no matter where the chips may fall, so why obsess?
Also, I would caution against programs where the residents have too much pull, the interview process can deteriorate into a popularity contest.
