It may be beneficial to start creating a preliminary rank list based on information that is available to you for each program. As you complete your interviews you can move programs up or down until you’ve created your final rank list. While these are not in any particular order, they are all things to consider while putting your rank list together.
Many students have already considered geographical location when applying to residency programs, but as EM has become more competitive students are applying more broadly. When making your Match list it is still important to consider where you will be living for the next three to four years. Consider the climate, living expenses, things to do in the area, and how far away you are willing to be from family and friends. If you have a significant other, but are not going through the Couples Match, ranking in the same geographical location is something that may be more important to you than other candidates.
A major consideration when creating your rank list is whether you feel a three or four year program is right for you. Both have benefits as well as downsides. Three year programs offer a faster route to begin your own practice or fellowship. Whereas four year programs offer an additional year of mentored training that some feel make you more appealing to prospective employers. Three year programs also offer a financial advantage over a four year program, as you make an attending’s salary one year earlier. However, hospitals with a four year residency program may not hire a new graduate from three year program without an additional year of experience. Also, three year programs may be more congested with less elective time compared to a four year program. Some would suggest that the added time in a four year program allows you to explore possible niches within EM. Opinions on the ideal training length will continue to vary, but ultimately both models offer excellent training for EM physicians. What matters is that you find the right training model to fit you.
Both community and university programs offer great training experiences. While both will prepare you for a successful career, each have unique differences. Community hospitals tend to have smaller residency programs with less total residents. Often there are plenty of procedures and hands on time with limited competition from residents in other specialties. Community programs also mirror the practice setting that a majority of graduates will go into after residency. On the other hand, university hospitals generally have a greater focus on research and academics. Often they have more resources at their disposal which allows them to practice medicine that is cutting edge. University hospitals also tend to be tertiary care centers where you can see a diverse patient population with complex pathology leading to unique experiences in off-service as well as ED rotations.
It is important to keep in mind that many programs blur the line between these two types of institutions. University programs have community ED rotations, and some community programs are affiliated with university centers. It ultimately comes down to researching the specific program to see what experiences they offer to their residents, and deciding what setting will be best for you.
Faculty may be an important consideration when making your rank list. This is especially true if you have a specific niche or research focus in mind. If there are active research projects in areas that interest you, you may want to rank that program higher on your list. Faculty with specific interests such as EMS or critical care can also be beneficial if you have a particular interest in that area. They can provide mentorship, additional experiences, and act as a networking source for future endeavors in that sub-specialty.
Looking at the fellowships offered at a program can be important especially if you intend to pursue a fellowship after residency. While things can change during your residency, being at a program with the fellowship you intend to pursue can be a huge bonus. You will be able to establish a relationship with the fellowship director as well as have easier access to projects and research. Even if you intend to go directly into practice, having fellowship programs can put expertise in different niches of emergency medicine at your disposal.
Away rotations are the best way to see if you fit in and like a program. Unfortunately it’s impossible to do away rotations with every program where you are interviewing. Therefore, much of your impression is based off of interview day. It is a chance to tour the facility, ask questions, as well as meet the faculty and residents. The residency website will give you important information, and many students also use word of mouth to get an overall impression of a program. Use all the resources at your disposal to learn about a residency. You’ll be there for the next three to four years so it’s important that you feel you will fit in with the program.
This is by no means an all-encompassing list. There are many other attributes of programs that should be considered when making your rank list. Make sure to research the program and ask any questions you feel are important during your interview.
Best of luck during interview season and in your future residencies!
Author: Matthew Camara, MSIV - Ross University, International Rep, AAEM/RSA Medical Student Council
Source: Zigrossi D. 2014. Ranking Programs: Medical Student Stretegies. In: Kazzi A, Rosen B, Shanahan R, editors. Rules of the Road For Medical Students the Guide for a Career in Emergency Medicine. 2nd ed. Milwaukee, WI: AAEM/RSA. p. 65-70.