How to get into the best residency program

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

residentphysici

Member
7+ Year Member
15+ Year Member
20+ Year Member
Joined
Jun 8, 2003
Messages
26
Reaction score
2
The most important reason for choosing a residency program is to get your dream job afterwards. Whatever tolerable prestigious program it takes for you to get your dream job should be the one that you choose.

1. Before jumping into the programs, you must first start with your ideal job (location, cases, hours, salary, type, etc.) You should have a very good idea of the job you want. During my 4th year of medical school, I did not have enough insite as to what a real life anesthesiologist did. So, I contacted a local group, convinved my school to give me credit, and I did a month long rotation with that private group. I worked with as many attendings as possible and asked a ton of questions. I also contacted about 10 physician recruiters and asked about the type of anesthesiologist they were recruiting for. Then, I followed those subspecialists at the group and learned more about them too. At the end of the month, I had a very good idea what an private anesthesiologist did. Yes, as a medical student I was cold-calling doctors I never met and asking for info.

2. Since most residents will practice within 150 miles of their residency program, locations is very important. If you know what city/state you want to practice in, contact those groups and ask which program in the area do they recommend. I did not have a location in mind, so I asked anesthesiologists (about 10) from several groups around the country where I should go. They said, Johns Hopkins, Harvard programs, Duke, UCSF, Virginia Mason, etc. From that list, my wife could only tolerate living in Baltimore. Now some anesthesiologists said it didn't matter where I went, but they themselves told me they would look highly on a job applicant from the big names. I also called my recruiter contacts and asked them where would give me the advantage when I graduated. And each agreed with the big names.

3. Once you narrowed your search down, now go out there and interview and inspect them like a medical examiner at a crime scene. Programs will twist the truth and hide things from you. Some will offer you sweet income deals to make up for some deficiencies. Always get several phone numbers from the residents at your interviews and talk to the medical students. I had great interviews and when I spoke to the residents over the hone, I was shocked to find all of the information that was hidden from me. At Johns Hopkins, Jeff Kirsch gave me his presentation and what to expect. All of the other residents concured. When I called them on the phone, they told me the SAME thing. I didn't want to work that hard or that late, but they were honest, and the alumni network was vast and nationwide.

Pick a residency program with high expectations of you because this is what will happen when you are a new grad. At JHH, they through me right into cases with extremely sick patients during my first month alone. Pick one that will allow outside rotations so you can get used to different charts, patients, monitors, and protocols. Pick one with a high board passing rate. Pick one with an alumni network within the dream practices that you want or the location you want to be. And lastly, pick a program with superb residents. My colleagues were so smart that it motivated me to study hard and improve my clinical skills.

4. Add up the numbers. Can you afford to live there? Will your spouse, children, and or social life suffer? Can you deal with the workload or the expectations? As the check marks pile up, your best program becomes clear.

5. Name means every thing in medicine. The assumption is that if a big name place chose you, then you must be an excellent physician. The truth may be completely different, but that is not what gets you the interview or even the job. If you narrow it down to several programs that meets your criteria, go with the big name!

With all of the information I gathered during my residency search, I developed my web site. Hope that it helps you too. Despite many late nights of regret during residency, I was soooooooooo glad that I did it this way when I started looking for a job.
 
Thank you for the information. I think you're right about much of it as I experienced the same phenomena in the earlier phases of education, namely undergraduate and medical school. True, there are plenty of boneheads, even at the Ivies, but the name sure does open doors. When I was applying to gas programs last fall outside of the match, I was offered interviews based solely on an interest email that mentioned my undergrad and med school names. That's it, no boards, no GPAs, nothing. Sometimes I think it's a shame that things work that way, but I figure there must be a reason we shell out as much $$ as we do to get that little piece of paper with the "right" university stamp on it.

That being said, what were your impressions of other programs as you went through Hopkins? I ask this more for others as my destiny is already set and I'm headed to Mayo for gas this coming June. I heard many of the same things regarding the "big" programs while on the interview circuit. I had always questioned which programs were the "big" ones and, for the most part, was always told JH, MGH, B&W, UCSF, Mayo, U. Mich, and Wash U. I also heard fairly good things about many other programs, including U. of Washington, Baylor, Penn, Yale, Vandy, UTSW, and Duke. I suppose there are many good programs out there. Who do you and members of your group (or like groups) consider to be the "big" programs when screening CVs of potential colleagues?

Anyhow, I will not proceed to further beat a dead horse, but I am very interested in learning what someone who has graduated from a top-five program thinks in regard to other programs. I also appreciated your entry regarding the first several months of practice as a new private practitioner. Please keep us updated with other such insight.


Cheers,
PM
 
My impression of other programs, since I had many friends at other programs, is that there are many great programs other than the big names. Unfortunately, you can't express these things on a CV.

I'll mention another program that I actually had as my top choice at the time. It was MCV/VCU in Richmond. The hours were great, they paid $50 per hour after 4 or 5 PM, there were minimal weekends and no 24 hour calls. It was a great lifestyle program at the time. But here were the problems back in 1998:

1. Large IMG class. Why could they not attract more US grads?
2. Many of their residents had switched out of other residencies
3. I only met with 2 residents during my visit vs 30+ at Hopkins.
4. I had to go through the residency director to get a resident contact. At Hopkins, every single resident's phone number was given to me to call at will.
5. The 150 mile radius would have limited effective job search while Hopkins had former residents at 46 states.

Because we get several applicants from big programs (Hopkins, Yale, Duke, Virginia Mason, Harvard affiliates, UCSF, Wash U, Penn) we only look at the other programs that our partners attended. Plus, if Jeff Kirsch (the former Hopkins residency director and current Chairperson at Oregon) calls and says hire someone, I drop every other CV and hire that person. But once that hurdle is crossed, then it becomes a "will this person fit in" issue. I routinely call the PACU where the applicant works and talk to the nurses about them.
 
The nice thing about coming out of a JHU, Mass General, U. Penn, or UCSF is that you can essentially find a job anywhere. All four have strong alumni groups and the nationwide prestige of their programs carry a lot of weight in the private sector, wherever you plan on going.

Most places have clout only in the 150 or so mile radius surrounding the program (some a little more regional, like Duke's influence on southern practices) usually because most of the guys who practice in that area most likely came out of that program or they're very aware of what sort of people come out of those places based on their experiences with their partners, associates, etc.

Anesthesiologists (much like many of the other subspecialists) are a suspicious bunch -- they like known quantities and often rely on the recommendations of others they trust (e.g. fellow partners/former program directors/chairmen) when it comes to hiring.

So, if you want to practice in Chicago, it might help to come out of a strong top five program or one of the stronger Chicago area programs. It won't help to come out of, say, Oregon, unless you either have skills or training that few people in that Chicagoland group have (but want/need) or you have really strong backers with some sort of "in" at that hospital/group.

Conversely, if you wanted to practice in Portland, the board eligible Rush trained physician is probably at some disadvantage in comparison to the OHSU grad, but the Mass General grad still has some clout.
 
Top