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Selecting a Residency Program

There are two phases to the process of selecting a residency program. The first involves selecting an initial group of programs. It may be helpful to visit local, regional or national residency fairs. This can enable you to obtain preliminary information about several residency programs from across the nation in a short period of time. An example of a national residency fair is the AAFP's annual National Conference of Family Medicine Residents and Medical Students, held each summer in Kansas City, Missouri. Each year, family medicine residency programs from across the country exhibit at this meeting.

After you complete the initial information gathering, the second phase occurs. This phase includes interviewing at a select group of programs and confronting the task of preparing your rank order list. At this point, you should have a considerable amount of information about each of the programs in which you are interested. Then, the decision-making process is a matter of remembering the goals you set for yourself at the beginning of this journey and establishing your priorities among the various attractions you found in each program.

This section will deal with the first, and possibly, more difficult phase of residency selection-which is deciding where you are going to apply. A more detailed look at the purpose of interviews is covered in the next section.

General Information

At some point, you will have established enough of an interest in a specialty that you are willing to confine your investigation to programs in this specialty.

For most specialties, the first step is to consult the Graduate Medical Education Directory, which lists all residency programs accredited by the ACGME. Again, this directory should be available in your medical school library but is also available from the AMA (see References and Resources section). The directory will tell you the name of the program director, the hospital, the numbers of hospital admissions and outpatient visits and the number of residency positions available in each program in which you are interested. Usually, based on geographic considerations or information you may have heard about certain programs in your chosen specialty, you will be able to come up with a list of programs from which you wish to request information and application materials. There is certainly no limit to the number of programs you can write for information. It's better to be liberal early in the process and narrow the field later.

Some general points about choosing programs:

• Don't eliminate a program because you think or assume that you are not a strong enough candidate. You really don't know that until you've gotten through the first stages of the applications process, so don't let anyone discourage you.
• Keep an open mind about the quality of each program. Even though you may have never heard of St. Someone's Hospital, it might have an excellent program. There are too many residency programs in each specialty for anyone to keep a running tab on which is the best program. Furthermore, the goals of each residency program within a specialty are varied enough that different programs excel for different reasons.
• Financial considerations can be a factor. While there are ways to limit costs, the amount of travel required to interview at a large number of programs can be very expensive. Some airlines offer continuous fare tickets, which are a significant advantage over purchasing individual fares. However, this does mean having to do most of your interviewing in one long trip.

Once you have settled on an initial pool of programs and have received written information about each one, you must now decide where you will apply. To help you decide, consider looking for other sources of information to balance the information provided by the programs.

A few specialty societies (American Academy of Family Physicians and American Psychiatry Association for example) have developed their own residency directories, which frequently are accessible on the Web. These directories include information on frequency of call, number of graduates from the program, number of residents in each training year, number of faculty, salary and benefits, etc. If you are interested in these specialties, look for these directories in your medical library or contact the respective specialty societies (see list of National Medical Specialty Societies beginning on page 22).

Your medical library or the department chair in your medical school may keep files on residency program information. The chair and other faculty members in the department may have first-hand information about some programs and can give you guidance as to the amount of variance among different programs in their specialty. You may want to ask them which programs they consider to be the "best" and why. Ask them why they chose their own training programs.

Lastly, many medical schools are willing to provide students with the names and residency locations of previous graduates. Consider contacting those physicians who are doing their residencies in your chosen field to ask them why they chose their programs and what other programs they considered.

If you are satisfied with the amount of information you have at hand, you are now ready to return to a period of self-analysis to determine which programs are most likely to meet your needs, and are therefore worth applying to. Again, there is no penalty for making an initial application to as many programs as you want, but consider whether it is worth the cost for both you and the programs if you already know you're not interested.

Based on what you know about yourself, your career goals, and about each program, what factors are important or even crucial to your choice of a residency program? Could you definitely include or exclude a program on the basis of a single criteria? What is the relative importance of the following factors?:

• Geographic location
• Type of institution ­ university hospital-based? community hospital-based?
• Age and stability of program
• Academic reputation
• Frequency of call
• Faculty to resident ratio
• Number and type of conferences
• Structure and flexibility of curriculum
• Provisions for maternity/paternity leave
• Availability of shared or part-time residency positions
• Physical characteristics of the hospital ­ age, atmosphere, etc.
• Presence of other training programs in hospital
• Patient population-racial, gender-based and socioeconomic mix
• Community ­ housing, employment opportunities for spouse/significant other, recreational activities, etc.
• Opportunities for further postgraduate training in same hospital.

There may be other important factors for you that are not included on this list. Whatever your criteria, let your rational assessment of your needs determine which options to pursue. After you have sent in your application and initiated the process of having deans' letters, transcripts and reference letters sent, you must now wait to see if you are invited to interview. Assuming you are invited to interview at all or plan to visit most of the programs on your list, you should once again review your list to determine if there are programs you can eliminate based either upon new information or careful reconsideration.

You may have as few as three or as many as two dozen or more programs at which you plan to interview. You may have doubts about your list and at the last minute add back a few programs. In any case, accept the margin of doubt and have confidence in your ability to think rationally ­ after all, you've pared down an endless variety of options into a manageable group of choices.

ERAS

MyERAS provides a list of all programs eligible to participate in ERAS 2006 along with basic contact information. Programs not participating in ERAS 2006 are included for informational purposes, but cannot be selected. Applicants should contact these programs for their application materials. Some programs may have more than one program track to which applicants may apply. Exercise caution when selecting programs; ERAS fees are based on the number of programs selected. Be sure to contact programs for their requirements, deadlines, and other information BEFORE you select them using MyERAS. A selection based upon the information in MyERAS is not sufficient for your career decisions.