Part 3: Do Your Homework
Just because you completed your CV in ERAS don’t think that your work is done. Thought you could tune out for a while? Wrong. Remember all those goals you worked on defining? You need to have a very clear understanding of which programs are best suited to help you accomplish your goals. Picking the wrong programs to look at may mean a very different course in life. Now that you know what you want, find out where to get it.
Too many applicants are using a “shot gun” approach to choosing programs: Apply to as many programs as you can and see what happens. Well this is a rather insecure and immature approach to something you have been working on your whole life. Not many other professionals apply to 60 jobs and hope for the best. This approach is also very expensive and timely. What do you do if they all invite you? How do you know which ones to accept and which to cancel? What if two programs you really like offer you interviews on the same day? What about the clerkships you are on?
You need to step back and really think about your priorities in training. Which programs meet your wish list?
- Field
- Location
- Mentors
- Research Opportunities
- Size of Residency
- Leaders and Mentors
- Hospital Type – University, Hybrid, Community
- Income and Benefits
Perhaps one of the most important things to look at is what you are “buying” at the end of residency. When you are thinking about buying something that takes time to make or requires special order, you look at the companies prior projects. Other homes they have built or prior customer experience, for example. You can’t see what you will look like after residency yet, but you can look at the graduates of the program:
- Where did they come from? Is it like where I came from? Am I competitive?
- Where do they go?
- What jobs do they take?
- Do they go into practice or fellowship?
- If they get into fellowships, are they competitive?
- Are they capable of going straight into practice if they choose or are they forced to go for more training?
- Did they get board certified? (Board pass rates are very important)
You should investigate every program you intend to apply to. Be sure you are competitive also. If they meet your priorities, then apply. If not, don’t waste their time or yours. Not all programs are the same and there are going to be a handful of programs that best fit your goals. Focus on those. Treating the applications like a buffet will only leave you with that same level of regret afterwards.
Hopefully you have a list of 20 to 30 programs at the most. Anything more than this is unrealistic. You won’t have time to interview at more than about 20. Twelve to 15 programs is a good goal for most applicants with reasonable scores . Many fields have studied this and the number needed to match is often 15 or less. So don’t kill yourself trying to do more, especially if your Step 1 score is near or above the national mean for those applying in your field (mathematically the majority of applicants are near or above the mean, think about it).
Now that you have your 15 programs, take the time to dive into each one BEFORE the interview trail and BEFORE the invitations start coming in. If you have the programs well studied early, then it will be easy to quickly navigate conflicts in your schedule. You will be able to prioritize which programs are a better fit for you. Don’t worry about what your friends are doing. Don’t let your ambitious and competitive nature get in the way of accomplishing YOUR goals.
Pretty much all programs offer a wealth of information on their website. In fact, if you can’t find much online, it could be a red flag about how much pride they take in their program (not always). Start by looking at the graduates, as discussed above. Look into the mission statement if they have one. Then look into key faculty. There are certain people you are highly likely to meet on the day of your interview and who will play a large role in your development:
- Chair of the Department
- Program Director (PD)
- Associate Program Director
- Assistant Program Director
- Program Coordinator/Administrator
These are often the people making the selection of who to invite for interviews and how to rank them. Keep in mind also that the Program Director is the one ultimately responsible for certifying the rank list. This person is usually the most important person in the interview process. In some programs, the Chair will trump the Program Director in the decision process, but most Chairs will likely defer to the PD.
You can then do your research about these people. If you have notes on each of these people going into the interview, you will be better prepared to have meaningful conversation with them when they are deciding your fate. Things to look into:
- Where did they do residency? You may have faculty at your medical school that trained with them. These connections can be more valuable than anything else. If you have a mentor in medical school that trained with a doc at your ideal program, ask them to write a letter of recommendation for you, even if it’s the only place you use that letter for.
- What are their clinical interests? You may have similar interests. You may not. Remember that doctors have big egos. We like being flattered, but in subtle ways. If you are able to guide a conversation and questions toward their field of interest, they are more likely to remember you in a positive light. You don’t have to and should not be fake though. You can ask relevant questions about things like how they approach patient care based on their practice. It’s more clever to ask a cardiologist about the volume of interventional procedures they do and their thoughts on drug eluding stents if you know in advanced they are an interventional cardiologist and not an electrophysiologist. These types of subtle measures will reflect your interest in the program and your maturity.
- What research have they work on/published? This is similar to above. In addition, it allows you to ask them about opportunities for you during residency. “So Dr. Young, I see you published your work on stroke prevention in the elderly population. Is this an ongoing project because I would be interested in opportunities to expand on this work?” These are the type of questions that spark conversation. You’re more likely to be attractive to the program. You will impress them without looking too arrogant. It also shows them that you envision yourself fitting it and contributing to their program.
- What are their personal interests? There is a fine line that you need to be careful of here. You don’t want to cross over into stalking. If there is easily accessible information then use it to your advantage. If a doctor has made it clear they like NFL football or cooking, then you can throw that into the conversation. They may have things in their office that play as cues. They may have a bio on the program website. If it pops up only on their social media, then perhaps leave it alone (they may also be checking your social media before the interview, so clean up your posts).
- What courses do they teach? This is the same as above. Remember that academic life is about more than just research. Education is another big part of it. This also lets you see how committed the faculty are to education.
- What organizations do they belong to? Another clue into interests. It also offers a glimpse into how evidence based medicine plays a role in their practice. We’ve all seen doctors who practice in silos, and it’s not pretty. Participating in regional and national organizations offers doctors a dialogue with best practices. You want to learn those best practices, so your future mentors better understand them.
- What leadership positions do they hold? Another chance for flattery. This also clues you into the caliber of doctors that will be training you. If they are well respected by colleagues then you are also likely to respect them.
As you can see, there is quite a bit you can do to take away the anxiety of encountering the unknown on interview day. If you do your homework, you can almost script out exactly what the conversation will sound like.
Another important thing to remember: NEVER be rude to the Program Coordinator. This is the right hand to the PD often. The Coordinator will make sure it’s known if you are disrespectful. Always be courteous. For example, if you have not heard from the program yet about an interview, try, “Dear . . . ., I have a particular interest in your program given its track record in training highly competent physicians. I was wondering if there is any information regarding the status of my application?” This will go over better than, “I haven’t not yet received an invitation for interview. I would like you to get back to me as soon as possible.” Rude applicants don’t get interviews.
The programs don’t owe you anything. There are many applicants. Don’t make any moves that will burn bridges. Respond promptly when they reach out to you. 2-5 days is ideal. Don’t ghost a program because you are waiting to hear back from other programs first. If you don’t know immediately what your response to a program will be if you are offered an interview, then it means you didn’t do your homework well.
If you need to reschedule or cancel, be forward and respectful. Programs anticipate this and understand. “Dear Coordinator, a conflict has come up in my interview schedule. Is there an opportunity to interview on a different day, as I am still very interested in your program?” If the answer is no, then you just need to be straight with them. They will get over it. “Thank you, but unfortunately I must cancel. I very much appreciate your consideration of my application and I apologize for any inconvenience this has caused.”
Another rule of thumb. If it’s less than a week to the interview, cancelling is a real jerk move. Programs may not be able to fill that spot, so you harmed both the program and other potential candidates. More than 2 weeks is ideal. If you have to cancel, do it as soon as possible.
With this homework complete, you are on the home stretch. Now all you have to do is nail the interview and your residency spot is in hand.