February means celebrating Valentine’s Day, President’s Day, and…submitting your residency rank list! According to the NRMP website, this year’s rank list is due February 22 at 9 PM ET. (Side note: typing out the letters NRMP gave me slight PTSD because of my overly dramatic match week experience with them). For all the fourth year medical students out there, congratulations! Hitting “Submit” means you’re one step closer to
finding true love matching into the residency program of your dreams. Sorry, I’ve been watching too much The Bachelor lately.
Hopefully you have had a chance to check out my #PathtoMD posts that cover topics from how to pick your interview outfit to a day in the life of a dermatology resident. But right now, the biggest thing on your mind is probably how the heck do I make this rank list?! Here’s some of the factors I strongly considered when deciding where to spend the next 4 years of my life:
I put this in all caps because it is just like real estate. To be COMPLETELY honest, I think location is one of the top influencing factors. Many of the top notch programs offer equally good training (with few obvious differences, see below), so think about whether or not you want to spend a good chunk of your late twenties and early thirties in that city. If you’re married, does your spouse have good job prospects there? If you have kids, is this city a family-friendly place? If you’re single you probably have more freedom Some people want to be closer to their friends, some want to be closer to their family.
2. ACADEMIC POTENTIAL
If you’re interested in a career in academia, chances are you want to go to a program with strong research. This means there are many mentors who run labs or are willing to work with residents on projects. But aside from just mentors, you also need to know, is there funding available for residents to do research? Are there people available to help you do your IRB and statistics? Also, some programs especially in dermatology offer a combined clinical + research track. For example at my program we have a research fellowship in which a resident can do the initial 2 years of clinical training and then spend the last year mostly in a research lab. That’s a huge advantage for physician scientists who want to get a jumpstart on their academic career. These may not seem important to you right now but trust me, if you want to make a career out of doing research, it is important for you to go to a program that has a strong research community to set you up for success.
3. THE RESIDENTS
When I was interviewing I felt like I had a good sense of which residents were miserable, which genuinely loved their programs, and everything in between. If the residents you meet at the interview dinner or during the interview day seem genuinely happy, then that’s a really good sign. There’s no reason for residents to “fake it;” it doesn’t make a difference to us if you come here or not if we don’t like the place. But I’ve noticed that residents who really love their programs will go out of their way to speak with applicants, answer questions, and tell you why they love it there.
I’ve written about the importance of mentorship before in this post about how to match into dermatology (or other competitive specialties), but I want to repeat myself: mentorship is SO SO important. I view mentors as people whose lives I want to emulate, who want to help me in my career. I remember seeking out Dr. Kwong and Dr. Maurer at Stanford and UCSF respectively because one was such an expert at medical dermatology and the other was THE global health dermatology guru. I spent time working with both of them on research projects and shadowing them in clinic, and a mentorship blossomed out of that. Similarly, if you look at the list of faculty at a certain program, do you find someone whose career or research interests match yours? When you met them at the interview, did they seem like people who would be good mentors to you? The further we go along, the more important personal connections and relationships become, so you want to take this into consideration when deciding where to go for residency.
5. LOOKING AHEAD – FELLOWSHIPS
You’ve finally made it to 4th year of med school and now I’m telling you to imagine yourself at the end of residency?! Yes. Because you always have to stay one step ahead! If you’re interested in fellowship training AFTER residency, it sure helps to do residency at a place with a strong fellowship in whatever subspecialty you want to pursue. When you’re a resident you can work with and get to know people in your subspecialty, do research with them, and eventually get a letter of recommendation from them if all goes well. That will help a lot with your fellowship application. Subspecialty fields are small, so knowing doctors in the field is helpful. Similarly, you want to see if the program has done well with sending other residents in the past to certain subspecialties. Got your heart set on cardiology? See if there is good mentorship and research for that at different programs, and see if people have matched successfully into cardiology from these programs in the past.
This is where you put all the extra stuff you care about: work-life balance, elective time, networking opportunities, proximity to start ups (hey I come from Silicon Valley so I live for that stuff!), global health opportunities, salaries (differs by city; NYC residents make more than say Sacramento residents), culture and fit of the program, etc. You will also have personal preferences that you can throw into the mix.
So there’s my list of factors to consider when making your rank list! One last note: I remember when I applied in dermatology it was really hard to figure out which programs were the best. Sometimes schools you don’t hear about for one field are really really stellar in another field. For example, the “best” ophtho programs are considered to be University of Miami, Wills Eye Hospital (affiliated with Thomas Jefferson), Johns Hopkins, and University of Iowa. Unless you know many ophthalmologists who have been in the field for a while, you may not have guessed that those are the top programs. So when I was starting out in dermatology I used the Doximity’s residency navigator to get a sense of what top 20 programs were considered the most reputable or had the most research output. At the end of the day, these rankings are SUBJECTIVE, so use them as just one more piece of information when you’re making your overall decisions.
Good luck everyone!