Where to apply?

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Baby Einstein

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I have *no idea* how to narrow it down, besides geography. All program websites look similar. It's hard to get an idea of which programs could be a good fit. How did you/will you decide where to apply? Thanks for your suggestions.

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I have *no idea* how to narrow it down, besides geography. All program websites look similar. It's hard to get an idea of which programs could be a good fit. How did you/will you decide where to apply? Thanks for your suggestions.

I thought someone who had been through it recently might reply, but since no one has yet, I'll start by throwing out ideas.

First thing to do is to start talking to people who know programs. Talk to residents, faculty, folks on SDN, etc. Ask them about their program and what they know about other programs.

If you have a strong interest in a fellowship in any particular area, then focus on attendings in that field. A grain of salt can be applied to what they say, but you may get some insights.

Consider whether you want a large or small program and how much you are interested in community pediatrics.

Good luck!
 
When I was deciding where to apply, a few factors went into it. The biggest for me was geography. My wife and I wanted to be relatively close to our parents, which meant somwehere in the western US. Fortunately for me, that aren't that many programs in the west, especially outside of California. Other things I looked at:

* Program Reputation--I got a feel for this by talking to people at my home program and poking around websites--fairly or unfairly, a program that has few US medical school graduates probably doesn't have as much of a reputation as a program that's mostly US grads.

* Program Setting--at a free-standing children's hospital or not? Are there experiences outside the main program site? (I wanted a program based at a big children's hospital but with rotations at a more community-oriented hospital.)

* Size of Program--At a little program, you tend to know your peers (and faculty) better, but there's less flexibility is someone is ill or needs time off for other reasons while at a bigger program, there's definitely more flexibility for things that come up. There may also be more resources devoted to the program at a larger program (e.g., more full time staff or money), but that varies a lot.

* Program Culture/Personality--Admitedlly, this is hard to judge from afar, but you can sometimes get a feet from what is on websites or by talking to people who interviewed at the program the year before. The program I ended up definitely has an "outdoorsy" personality among the residents which fit me well, and you could see a little of that in the materials that the program sent out to applicants before they interviewed.

* Fellowship Opportunities - I wanted a program where I felt like I would feel comfortable staying in the same place for fellowship in three years so that I could keep that option open. My wife was frankly a little tired of picking up and moving every few years, so having the option will be a great thing. You'll hear all sorts of thoughts on whether havingn a lot of fellows is a good thing or a bad thing, but for me, I think that fellows tend to spend more time teaching and are able to teach at a resident level better than many attendings, so I like having them around.

In any event, there are a lot of good programs out there. I ended up interviewing at 12 programs, and felt that I would have been happy at 8 of them (which were the 8 that I ended up ranking). And despite my best efforts to figure out which programs I'd like in advance, there were a couple I expected to love that I hated and a couple I didn't really expect to like that ended up in my top 5, so you never know. Good luck as you apply this year!
 
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I think a lot of it will have to be word-of-mouth.

I'd also encourage applying to a larger # of programs so you can have interviews to choose from/group by geography, etc. You never know which "reach" school will want to interview you, and there may also be some that you expect to be offered a spot at that do not ever contact you.

I would agree that all websites look similar and everyone will discuss how their board pass rate is fantastic and their mix of clinical and research experiences is just perfect. But sometimes I could get a feel for some red flags--outdated website, lack of consistent leadership (i.e. chair and PD and assistant PD and faculty all have been there <2 years).

Also, call me crazy but I enjoyed looking at the pics of the current residents. Then I could ask myself--self, would you want to be locked up in the ER or NICU with these people for 24-30 hours x 3 years?
 
It always helps to look at yourself and find out what's important to you first. Are you thinking you want to do a fellowship? Or are you 3 years and out to be a generalist extraordinaire? Is research important to you? Are you the type who finds lectures to be really important for your learning, or do you regularly try to skip out of going to morning report/noon conference?

At least by getting a sense of what you want, you'll have a frame of reference to start judging whether a program fits your needs.

I would caution at least a little bit about relying solely on word of mouth. You never know why someone loves or hates a place. And you won't know until you've been if a place is right for you. I think everyone has places that surprise them (good or bad) when they go through the process. Lastly, word of mouth can often leave out whole regions of the country if no one knows anything about the place. I say that last part from experience as my current program is very well known regionally, and yet, no one knew anything about it at my medical school.
 
yeah, I guess I was kinda trying to go the same way but from a different POV.

I am also at a program that is large and great (IMHO), but because of geography I don't think the national reputation is quite as robust as it could be.

So I needed word of mouth to get people to tell me about different far-flung programs that they had come across that I would never find in US News or by reading author affiliations in NEJM or something.

I think there are tons of great lesser-known places out there, and you've really gotta hunt them down. So if you ask 10 people for their opinions and those 10 people moved from 10 different cities in the country, then you might get very useful word of mouth.
 
My biggest things were geography and program size, to start off with. I didn't apply anywhere outside New England and NY state (even then, nowhere far upstate). I went to med school further from home and had no interest in staying away, so my geography line was by Far my biggest thing.

Then I somewhat arbitrarily chose not to apply anywhere with an intern class of 21+. I personally do better in smaller groups, and I knew I would thrive better as a resident not having 40 co-interns to try to know.

After that it was word-of-mouth and eyeing the program stats a little. I was leaning more towards primary care, but I'm not 100% on that. Most programs will throw the 50-50 or 60-40 percent at you. That's not helpful. If I saw a program with a LOT more going into fellowship, it nudged them down my list of considerations, but I still applied to some that were more academic than community-based.

Word-of-mouth can be hard if you're say, in CA and want to go back to the Midwest or something. A lot of the residents at my home program had never done aways or interviewed at the programs I was thinking of (again, b/c of geography). Attendings were helpful though, and some residents had friends that knew of programs. It's kind of a crapshoot, in a way.

Some programs have much better websites than others. I tried to be conscious of this and not let it factor in too much, but it IS nice to have a lot of website info to work with. Like programs that plot out your curriculum all 3 years- nice. If a program mandated a lot of research or tons of ICU, I avoided those, because I knew those were things I didn't want to be forced to do. A lot of the curriculum is standardized of course, but if you can find where they adjust the parts they have control over, that can help you get an idea if it's a good fit for you. This is another thing that was helpful to me on interviews, when you Will get this information.
 
Over the years, most students come down to this decision above all others. They like some things about a program and other things about another program. In my experience, once you have applied and interviewed and found a certain number that you like then it comes down to location. For what its worth-the majority of programs will educate you well and prepare you for your career.
 
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