As the 3rd year of your Caribbean medical school draws to a close, and residency application season is on the horizon, it is time for you to choose the right residency program, which will guide your career trajectory. Remember that residency programs come in different flavors. Every residency program is created differently, and each one of them will have unique strengths and weaknesses. So how do you choose a program that will nurture your skills and interests in medicine and pave way for a successful career in medicine? Since you will be spending the next 3-7 years of your life at this program, it is important that you make an informed choice. Let’s dig in.
Location
If you ask physicians and residents to reminisce what was their top deciding factor when it came to choosing between different residency programs, most would agree on the location of the program. Remember that your choice of location could potentially define your quality of life and quality of training down the lane. So, it is advisable to choose a location where you could be happy spending the next three to seven years of your life.
Your choice of location could be based on the kind of climate you enjoy, different training environments (city vs. urban area), cost of living considerations and choice of recreational activities. Not to mention, different patient populations and proximity to your support system. The last part is especially true for individuals who are married or in a committed relationship, have children, or have other familial obligations. What job opportunities are available to your spouse/significant other in your chosen location? If you add children to the equation, you should also be looking into child care and the quality of the public school system.
On the other hand, keep in mind that it is much harder to match into large university medical centers that have earned a name for their research and development. On the other hand, the probability of matching into medical residency positions in inner city, rural, or remote areas are typically higher. If you are looking to match into a program in a specialty/subspecialty that is in high demand, you might want to spread your wings and widen your choices beyond one location.
Program Characteristics
Look for residency programs that offer a well-rounded educational experience, plenty of research opportunities, a healthy work/life balance, and a supportive work environment. If you are looking into potential residency programs, a good place to start is to consider the strengths and weaknesses of the hospital as well as its educational and financial stability.
You also have to look at certain factors behind the program, such as the style of the program, the width and breadth of the program, how many residents are there in each class, is the program at a university hospital, city or country hospital, private hospital, or Veterans’ Affairs hospital? Do residents see a good variety of cases during their residency? How many procedures is each resident required to perform? Is the culture of the program a good fit for you?
Also look at the chair and the faculty. Find out where they trained, what fellowships they did, as well as their clinical and research skills and interests. What is the composition of the faculty (age, experience, training). If you see your future in research, you should explore the different research opportunities offered at each program and align yourself in a department with research expertise is valuable.
Track Record of the Program
Let’s take a moment to review your goals for the future here. Have you thought about pursuing a fellowship after residency? Do you wish to become an attending at a high prestige institute or do you want to practice privately? If you have narrowed down a few programs that interest you, find out how the graduates of those programs perform on the American Board of Surgery qualifying and certifying examinations, as well as the percentage of residents who passed the boards on their first attempt.
Ask what percentage of graduates enter fellowships and in what fields and how many go directly into private practice. If your ultimate goal is to pursue fellowship, and a particular program has a high match rate into the fellowships that you’re interested in, you can be certain of the ability of that program to help you realize your ambitions. While you will be exposed to myriad experiences over the course of your residency that may alter your career plans, you want to choose a program that helps you achieve your current goals.
Attitude of Current Residents
If possible, talk to the current residents of a program and find out what kind of people they are and if they seem content in their work. Find out their post residency plans, and what opportunities for clinical experiences, research time, and fellowships are available to them. Ask them how the workload is offset by the educational aspects of the program. Assess their attitude towards the faculty and the program itself. Is the faculty vested in their success and how supportive and readily accessible are they?
Does the program care about its residents? You can get a good idea about the level of support residents receive by looking into the quality of fellowships attained, turnover rate in the program, and number of residents that stay at the institution to complete fellowship. Also ask about the frequency and variety of cases residents in the program are exposed to during their training. How do they perceive the overall environment and work culture at their program? Is the program the right cultural fit for you?
Prestige of the Program
While the overall reputation of a program does hold merit, keep in mind that there are a lot of good programs that are not at Harvard. Not to mention reputation is pretty subjective; what is considered a top hospital for one specialty, may not fare equally well for another. Regardless, reputation is a good place to start if you are clueless as to the highly regarded programs in a field. While the ranking of programs varies depending on which source you are looking at, US News and World Report’s annual ranking offers a pretty good idea. Residency programs with stellar reputations and name power are synonymous with diverse patient populations, highly credentialed and research-oriented faculty, and top-tier research opportunities. Consider good reputation and prestige if your goal is to pursue competitive specialties and fellowships or establish a rigorous academic career.
Ready to Choose?
The Student Advisory and Support Program at WUSOM offers considerable resources to its students on preparing for and applying to residencies. Our knowledgeable staff, led by Dr. Pushparaj Shetty, helps students across every aspect of the match process from where and how to apply to maximize match percentage, to residency interview preparation and more. Talk to a trusted advisor today.
