Which residency programs should I apply to (and how many)?

The summer is an exciting time for fourth-year medical students. By this point in the year, many fourth-years have decided on a specialty to pursue, are traveling to new institutions for away rotations, and starting to work on their residency application via the Electronic Residency Application Service (ERAS). Since I was part of the inaugural class of a brand-new medical school, there weren’t recent graduates available to help guide my residency application process; thus, I turned to the internet to find answers to my questions.

What matters to me?

The first step in the application process is determining what is most important to you. For most medical students, what matters is geography and reputation of the program. When I was starting to look at residencies, I browsed AMA’s FREIDA Online — a comprehensive list of all residency programs and specific information like the program director, number of slots and USMLE Step scores, then created a spreadsheet of programs and their characteristics. Like any other database, the information provided is voluntarily supplied by programs and may not be up-to-date or available.

After coming up with a broad list of programs, I began to consider what mattered to me. Ultimately, I wanted to train in a program that would prepare me for anything once I graduated, so reputation mattered to me. While the SDN Forums can provide some information on this, it’s often outdated or from a questionable source. At the time of my application, the Doximity Residency Navigator had just released its first set of residency program rankings, so I checked it out. What I liked about the tool was the ability to sort by “reputation” and a clear methodology for how the rankings were established. It was also helpful to see the resident reviews of their own program, especially comments from alumni that have left an institution and can speak to how the training was either helpful or lacking in their practice. Sometimes alumni will also comment on subspecialties of a program were strongest or areas that need improvement. Since the navigator is based on alumni reviews, some smaller or newer programs may not have a lot of respondents, however, there is still helpful information available such as the program director or the number of filled spots. Once I reviewed some of the programs that interested me, I started populating a list of which ones I planned to apply to.

How many programs should I apply to?

Deciding how many programs to apply to is highly dependent on your application and how competitive of a specialty you’re applying to. As many applicants know, type of medical school (e.g., MD versus DO, U.S. versus foreign) and Step 1 score are very important components of an applicant’s success. Additionally, applicants to competitive specialties — like dermatology, ophthalmology, orthopedic surgery, urology, ENT — will generally apply to many more programs than an applicant to primary care specialties such as internal medicine, family medicine or pediatrics. One helpful resource to help guide the number of programs you apply to based on data can be found on the AAMC website. This resource provides specialty-specific data on what number of programs leads to “diminishing returns.”

I applied to 27 anesthesia, 11 transitional year and three preliminary medicine programs. Since I was at a new medical school, I was advised to apply to many more programs than I needed to. I received interview invitations to almost all of the programs I applied to, and, thus, had to turn out or cancel a significant number of them. Luckily, in the state of Michigan, there are a lot of options for transitional year programs, so I had a lot of options for internship.

Each medical student’s residency application experience is unique and the decision on which programs — as well as how many — to apply to are personal choices. By using recent alumni and internet resources, the goal is to optimize the likelihood of finding a good fit for your values.

Let me know in the comments how you decided to approach the residency application process.

Amanda Xi is an anesthesiology resident who blogs at her self-titled site, Amanda Xiand can be reached on Twitter @amandasxi.

Image credit: Shutterstock.com

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