What was your journey like for 4th year clerkships?
What do programs really look for in an applicant besides GPA/Rank/Research/boards 1st Pass?
How busy is 1st year of residency? What do you like? What do you dislike?
Are you married, and if so, do you plan to have children and when?
Do they pay you enough to eat?
So, for me, my 4th year clerkships were kind of different. I did 5 because I had to retake my part I boards in June. My grades weren't super great so when I was selecting programs I selected based on- no GPA requirements, and if they gave food/housing to students of some sort. I ended up starting my first in Philly, then to NJ then to FL, then to MI, then finishing my last one in Philly. It was kind of hard because it was expensive and I didn't know anybody where I was going but I got along ok. The big things are to make sure you show up on time, don't leave until you are told you can, and try not to get in the way too much. We residents don't like that. Even if you go to a place and it's total crap and you hate it; don't dick around, because people at that program could know people you like at another program and your reputation could be trash.
What programs look for depend on the program. There are programs that are super academic that are all about the grades portfolio. The program I am with, for example, don't care. If they like you and you seem competent you have a chance to get in. Me and my fellow residents literally sit down sometimes and discuss: do we like this one? do we not like this one? is (s)he annoying? without any worrying about their grades. I don't know how much research matters, though, for some programs because they are heavy in research like Temple's program and others are not. It won't hurt you but if you're depending on research to save you if your personality sucks and you're irresponsible and grades suck then you'll probably have a bad time.
How busy 1st year is depends on a lot. My program is less busy than many other places. I have classmates in the region pulling 90+ hrs per week with heavy on call and stuff. I do maybe 50-55 at the most, but when I'm working, I'M WORKING. We have busy clinics we cover, and a generally average surgery load. We aren't like these places that have 500 surgeries a day and everyone gets all their numbers by 1st year's ending but there are definitely places like that. Our call is fairly light because we don't have an ED attached to our hospital. And then also you have external rotations which when you do those, you work however long they tell you to. So you can be working 60 hrs a week at your base hospital then go off to ED and be working 100. I like the clinics and the wound care and getting my hands involved, even in a small amount, in cases. I don't like call, call sucks, but usually only 1st years take heavy call so I'll survive. and me and my co-1st years are fairly good about distributing call equally
Am I married. NO
Do I want to have kids. NO
When do I think is best to plan them? I mean residency generally might suck and the first few years out might probably suck so if you want to birth a kid then honestly probably just do it. It might suck regardless.
Do they pay you enough to eat? What do you want to eat? You want to go to prime rib steakhouse every day? probably not without ancillary income. You want to eat regular vegetables and stuff? sure? My program gives us free (albeit sometimes mediocre) food though. It saves a lot. There are only so many ways you can mess up bacon and eggs and potatoes. Also it depends on where you go. Making 50K in Alabama, or Texas (no income tax)for example, gets you farther than 50K in New York or California. I've read that there are loans out there for residents who need a little extra money to survive (which I think that being a thing is crap to begin with, but that's a whole other conversation).
One thing I would recommend though is pay attention to cost of living. I understand that people got family and other reasons for wanting to pick certain places, but residency is just 3-4 years. You won't learn everything about everything. You will graduate and maybe never have seen some things. Just because you will be an attending doesn't mean you can't ask for help or have known everything. But look at the cost of living in certain places, especially if you have a family, because is it really worth it to desperately try for Residency X in Manhattan when you can also try for Residency B in Cleveland or Residency F in Tennessee and generally get paid the same amount but be able to save a little money?
Another thing- without ancillary income, be frugal. You don't need to be buying a boat and a sports car and opera tickets on resident's salary
