How do Medical Students Evaluate Residency Programs?

[CyberMaxx]

Every so often, especially this time of year when pre-meds are starting to get multiple acceptances, a thread is created about how to evaluate match lists. Invariably current medical students explain why choosing programs based on match lists doesn't make any sense. One reason that is often given is that, as a pre-med, you do not know what residency programs are good within different specialties. Just because a residency program is based out of an academic institution which is considered a 'top' medical school doesn't necessarily mean that it is a 'top' residency program.

Statements like these have me wondering how do medical students, residents, etc. discover or determine what the 'top' residency programs in each specialty are? Is it through word of mouth or are there rankings of some sort? Are the best residency programs further categorized into academic versus community hospital based?

FYI: I am not asking so I can use match lists to help me choose between schools, I'm just generally curious. 😛

 

[BillrothI]

Word of mouth (from other students and preceptors) and audition rotations both play very important roles in choosing a residency program. Prospective residents can also learn a lot during residency interviews and pre-interview dinners.

-Bill

 

[Microglia]

Word of mouth (from other students and preceptors) and audition rotations both play very important roles in choosing a residency program. Prospective residents can also learn a lot during residency interviews and pre-interview dinners.

-Bill

From what I've heard from m4s, just about this. Word of mouth is huge, especially from the residency director of the program you want to go into at your university, as well as feelings you get from the interview, other students opinions, etc.

 

[amvet70]

I think it depends on how a med student defines a 'top' residency programs. Med students pick residencies for many reasons. Some do define a 'top' residency program because of reputation. Some med students already have extensive research backgrounds (e.g., PhDs, extensive publications, etc.). So they may define a ‘top’ residency as those where there are broad research opportunities. However many med school graduates will not be involved in research post med school. Some grew up in mid/small towns and just want to go back to where their or their spouse’s families are. Some have significant others who are still in school (a PhD program, a MS2 student, etc.) or are both MS4’s trying to couples match and so they select ‘top’ residencies in order to stay close. Furthermore, one MS4 may be at top of class where their significant other MS4 is at the bottom so that could determine how they define ‘top’ residencies. So, many med students define a ‘top’ residency by location or family related issues. The point is there is no way for you to learn the back stories of the matched students which could shed some light on their personal decision making processes. As a premed you may be 7-8 years or so away from looking at 'top' residency programs. What you now consider a 'top' residency program may have new meaning in the future say if you have a spouse and newborn. Focus your energy on getting into med school. You’ll have plenty of time to revisit this topic later.

 

[Catalystik]

how do medical students, residents, etc. discover or determine what the 'top' residency programs in each specialty are? Is it through word of mouth or are there rankings of some sort? Are the best residency programs further categorized into academic versus community hospital based?

Residencies are categorized as University vs Community-based, with the former generally carrying more cachet. Some med students decide relative merit by average Board pass rates (available on American Board of XXX websites), % of residents accepted into Fellowships-particularly those that are more competitive, rumors or truth about average Step I scores required, whether specialty-specific research is necessary for consideration, as well as program toxicity/reputation of the Program Director, whether the program has a pyramid system where residents are whittled away over time, and possibly by US News rankings of training-site hospitals. SDN "chancers" (current residents and fellows who have successfully navigated the interview process of a wide variety of institutions) in the Specialty-Specific Forums no doubt also have some impact on how various programs are viewed and are a terrific source of experiential information.

 

[Charles_Carmichael]

Every so often, especially this time of year when pre-meds are starting to get multiple acceptances, a thread is created about how to evaluate match lists. Invariably current medical students explain why choosing programs based on match lists doesn't make any sense. One reason that is often given is that, as a pre-med, you do not know what residency programs are good within different specialties. Just because a residency program is based out of an academic institution which is considered a 'top' medical school doesn't necessarily mean that it is a 'top' residency program.

That's not exactly the main reason, IMHO. It's pretty hard to judge a match list, even as a med student, because you don't know who matched at their top choice and who didn't. And, ultimately, matching at your top choice is what matters. So yea, maybe someone matched at IM at a "mid-tier" residency -- we don't know whether that was their top choice because of various reasons, whether it was one of their last choices, etc. Or maybe someone matched at the best residency on the planet, but they had actually ranked it 3rd or 4th because it meant moving away from their family, etc. That's the big reason, in my opinion, why it's hard to gain meaningful information from a match list.

Statements like these have me wondering how do medical students, residents, etc. discover or determine what the 'top' residency programs in each specialty are? Is it through word of mouth or are there rankings of some sort? Are the best residency programs further categorized into academic versus community hospital based?

FYI: I am not asking so I can use match lists to help me choose between schools, I'm just generally curious.

Word of mouth and talking with PDs at your home institution. It helps a bit looking at the specialty-specific forums on SDN too.

 

[Law2Doc]

Whether a program is a top one often turns on subtleties like who is the chairman and PD, what direction the program is going, what big named faculty are there, what new big names were brought in as compared to those that left in recent years etc. Generally things you won't know based on hospital/school name or the vibe you get on the interview day. So once you choose a specialty, you really need to get plugged in with a faculty mentor in the field who knows these things or can find out with a Phone call. Each specialty is a relatively small community -- they all go to the same meetings and generally know who are the big fish, the rising stars the falling stones. So yeah, I would say that match lists are dangerous weapons in the hands of people without enough information to use them. Put them aside, and actually talk to people in the field. You'll be shocked at how different your perspective will be.

 

[mvenus929]

There are a variety of reasons for choosing a residency. For me, I want a program with a lot of volume, that's mid-sized (for Peds, that means between 10 and 30-40 residents per year), and has fellowship opportunities within the institution. I'm less concerned with location, because I don't mind moving somewhere I've never lived before, but I did limit to more southern locales. Others look for programs that are 'resident-driven', meaning that the residents get first opportunity at procedures; locations near family; availability of research opportunities; academic vs. community; etc. When it comes time to rank them, gut feeling plays a huge role in where the program falls on the list.

Together with an adviser (or two or ten) in the specialty, you pick which programs (and how many) to apply to, and aim for a certain number of interviews based on your competitiveness. There is some self-selection involved--I didn't apply to CHOP or Boston Children's even though they are 'top' programs, because 1) I have no desire to live in those locations, and 2) I don't have the type of competitive application they seek in who they interview.