Road to residency

For every medical or osteopathic student aspiring to be a clinician, a key stop along the way is residency.

In total, there are 23 major types of residency programs, and to ultimately find one that is a good fit you need to figure out what sort of training you’re looking for, complete the application process, and participate in the match.

We’ll go over the specifics of applying to a US residency program, but some aspects of the process are universal.

One way to think about any career is to think about the intersection of four goals—What can you be paid for? What does the world need? What do you love? and What are you good at?

Most would agree that becoming a physician offers a reasonable salary, but some professions pay much more than others especially when it’s broken down by an hourly rate.

The pay rate, as well as the number of hours and type of hours, meaning night shifts versus day shifts and taking call, are all important factors to consider.

The world also needs physicians, but some types of physicians are more important to certain communities.

For example, really great primary care physicians are in high demand especially in lower income communities.

That leaves what you love and what you’re good at.

Figuring that out is often the biggest challenge for medical students, but hopefully you’ve had a variety of clinical experiences to help you figure out whether you like to work with adults or children, in an operating room or in a clinic, in front of a microscope or a light box.

We can also flip this around and ask—what do residency program directors think is important in selecting an applicant?

Well the National Resident Matching Program conducts surveys where they ask that exact question, and out of 33 items, the top five across all specialties were 1. USMLE Step 1/ COMLEX 1 score, 2. Letters of recommendation in the specialty, 3. The Dean’s letter, 4. USMLE Step 2 (CK) score, and 5. Grades in clerkships.

At the very bottom of the list is the USMLE Step 3/COMLEX level 3 score.

So, knowing what you want and what residency program directors want is a good first step, but then comes the process of actually applying to a specific specialty within a hospital system, some of which even have subtracks within a program.

It’s important to get to know each program you’re interested in, because just like applicants, each one is different.

Start by reaching out and getting to know current residents and faculty, maybe even paying a visit or scheduling a rotation if you are able to fit it into your schedule.

This all takes time, but is worth the effort.

The key here is to start early, and to get to know the various programs as well as the communities that house them.

After you’ve decided on a list of residencies that you want to apply to, it’s time to put together your application.

First off, there’s your personal statement which is where you can tell your story and why you’re applying.

Remember that people relate to one another through stories, so this is your chance to tell an authentic story that allows the residency program admissions committee to get to know you.