Residency Match – In Hindsight

Image Credit: Pexels
Author: Jake Toy, DO
Modern Resident Blog Editor-in-Chief 
Publications & Social Media Committee Chair

The February 2019 rank residency list deadline is fast approaching. For some, the process of ranking their chosen emergency medicine programs in order of preference was straightforward. For others, including myself, the process of picking a program that balanced superb training and happiness was stress inducing and anxiety provoking to say the least.

As I ranked my programs, I reached out for advice from faculty advisors, peers, and family, only to discover an endless sea of competing thoughts and ideas. Upon searching in the depths of internet blogs, this only further cast a large shadow of doubt and bias on my own rank list. With each person I spoke with and article I read, I found myself left with more questions than answers. At one point, a TV commercial advertising a hospital I was considering as a “World-Class Research Institution & Top Ranked Hospital” threatened to disrupt an initial draft of my program rank list altogether. 

Amidst the mayhem, I came across a simple decision tool that was helpful toward finalizing my rank list. The beauty of this tool is that it is individualized. It enabled me to organize and prioritize what I was looking for in a residency without outside bias and appropriately evaluate the weight of each factor. For those fourth year students who are searching for a tangible resource to alleviate a few sleepless nights before the upcoming February submission date, this tool may provide new insight into your residency program rank list. 
To start, list the programs you are considering across the top row. In the left vertical column, list the 10 most important factors to you in an emergency medicine residency. I realized this is easier said than done… Ideally, it should be the first ten factors that pop into your mind. And most importantly, only the applicant should determine these 10 factors in order to reduce outside bias. Finally, rate the importance of each factor to you with regard to each program on a scale from 1 to 10. Total values should be calculated in the bottom row. Ideally, this will amount to a numerical score and clear rank order. 
Figure 1: A simple decision tool for ranking residency programs
Final Thoughts
I was chatting with a buddy from medical school recently and reflecting on our first months of intern year. In short, intern year is hard. Our initial ability to survive these first months, and hopefully till the end of residency, has been because of the locations we chose (including proximity to significant others, family, & friends) and our co-residents. Meeting your co-interns on the beach for volleyball, climbing with them after work, coming home to a place you share with your significant other, or visiting family on the weekends; I believe these aspects have been crucial to our success and happiness in residency thus far. 
As an interviewing medical student submerged within a hunger-games-like struggle for an emergency medicine residency position, it was easy to loose sight of these simple keys to residency happiness. On the interview trail, my friend and I were both infatuated by reputation and prestige, research and fellowship opportunities, and the prospect of exploring a new city or state. All of these were very important aspects that I considered and there were times during the interview season when they were my top priorities. Yet once all the interviews were over, and I laid out my thoughts in this decision tool, it fostered equal evaluation of all elements. For me, I refocused on program location and resident community. I am grateful that I continued to prioritize these factors as I find them central to my current happiness as an intern. 
For those entering the match in 2019, I hope you will be left with more answers than questions after reading this article. Good luck!