The Residency Interview: Making the Most

of It
Phyllis Kopriva, Director, American Medical Association Women and Minority Services
Setting Up Your Interviews
Make arrangements for your interviews as early as possible without scheduling them so early as
to look pushy or over-anxious. Certain programs interview by invitation only. In those cases you
must send in your application and hope for the best. If you are extremely interested in a program,
consider doing a visiting elective there before your fourth year.
About the Match Process
As a rule of thumb, program directors would like to be finished with their interviews by January
so they can attend to the administrative details in order to meet the National Resident Matching
Program (NRMP) deadlines.
The NRMP is sponsored by five organizations, the American Board of Medical Specialties
(ABMS), the American Medical Association (AMA), the Association of American Medical
Colleges (AAMC), the American Hospital Association (AHA), and the Council of Medical
Specialty Societies (CMSS). Each year, the NRMP conducts a match that is designed to optimize
the rank ordered choices of students and program directors. Registration opens in August with a
final deadline of December 1. From mid January through February, candidates and programs
submit their preference lists. In the third week of March, the results of the Match are announced.
It is a good idea, however, to get a few interviews under your belt before you go to the ones that
you regard as the most important. And it is reasonable to expect that after a dozen interviews you
will be battle-weary. Therefore, scheduling your most prized interviews in the middle might
promote the best results.
Research the Program
Research the program as much as possible before you go so that you will be able to target your
questions for that program, rather than doing a generic interview. You might check to see if any
graduates of your medical school are there, and if so, consider getting in touch with them. Do
some research on the latest developments in the specialty that youre interested in, including
what types of people theyre looking for. Different specialty programs may have different
priorities - leadership, community involvement, research, or clinical abilities.
Review your application, personal statement and curriculum vitae and prepare yourself to discuss
anything that youve mentioned on them, including any research that youve done. Prepare a list
of questions that you want to have answered during your stay. And remember, you dont have to
memorize your questions; you can take your notes into the interview.
Plan Your Trip Well
Housing. Some students find it helpful to make prior arrangements for housing in residents

quarters. At the same time, check to see if you can schedule an interview on a day when you can
attend morning rounds or a teaching conference. If you have the time, stay an extra day to talk
with residents. Time and again, respondents reported the value of information gained from this
source.
(For help in finding local housing during your interviews, you can also call the American
Medical Association.The AMA Alliance, in partnership with the AMAResident and Fellow and
Medical Student Sections, runs the Community Welcoming Program -- which finds on-site hosts
for fourth-year medical students and their families as they interview for residency. This helps
medical students minimize travel costs while keeping them connected with organized medicine.
More information about the Community Welcoming Program, including how to request housing
and how to become a host, is available on the AMA Alliance website )
What to Pack: A residency interview is a job interview, and the propriety of your dress reflects a
sense of being in touch with the world. Your choice of a residency, and their choice of a
candidate to whom they can entrust patients, is serious business. For men and for women, suits
are serious clothes and are appropriate for interviews. Failure to wear professional-looking
clothes might not cost you a placement, but it can distract the interviewer. Sweaters and slacks
are okay when you're on call in certain programs, but your safest bet when you interview is to
dress for success. Business schools impart lots of information to their graduates about how to
dress for job interviews; medical schools do not. But don't be fooled. Although you may not be
going for job in banking, you are interviewing for a professional position.
In addition to carefully planning what clothes to bring, run through the other possibilities that
may arise while youre away. You may go for a meal with one of the residents. It could rain, so
take an umbrella. It is easy to spill something on a shirt, spot a tie, or rip a seam. Pack
accordingly.
The First Impression
Students often go into the interview room very nervous. Most adjust quickly, but wish they could
avoid the early jitters. If this applies to you, and it probably does, follow these helpful hints:

Be on time.
Get the names, including spellings, of the interviewers from the departmental secretary so
that you know who youre seeing.
Look your interviews in the eye, greet them by name and offer your hand for a firm
handshake.
Smile.
Let everyone else sit down first (old fashioned manners).
If youre offered coffee or tea, but youre pretty shaky, refuse it.
Take a deep breath and proceed.

During the Interview

Selecting your residency program is a major decision a decision that you will have to make after
very brief contact with people who may be your associates for a long time. Value the

impressions that you make of the program and the people, and keep track of those feelings about
the interview to assess how suitable the fit is between you and the program.
Direct each question to the appropriate interviewer (i.e. program funding to the director and call
schedules to the residents). Consider which questions are appropriate for the interview, and
which are for a less formal setting. For example:
Think about your real priorities and make sure you express them. And, ask your questions at the
appropriate times. The beginning of the interview is not the best moment to ask about salary,
benefits and call schedules. Although they are legitimate questions, bad timing or asking the
wrong people could make your interviewers uncomfortable about your values. In addition,
questions that challenge or confront interviewers can be alienating; nuances such as tone and
word choice are important. What is wrong with your program? is more difficult to answer than
What are some of the challenges that I might face here?
Investigate each year of residency; students often direct their focus only on the first year. And
dont try to buddy up with faculty by telling each of them that you want to go into their specialty
- they might compare notes later.
Beyond the Questions
In answering questions about what kind of person you are, why you went to medical school, and
what you want to accomplish, you will want to try and distinguish yourself from the other
interviewees. However, that is often difficult to do. Many have reported that the most common
questions were sometimes the hardest to answer, for example, Why to you want to be a doctor?
Most of us become physicians for the same reasons -- to save lives, improve health care in
America, help people, make a contribution to society, and so forth. That is not to say that
you should not say those things; by all means do so. After all, that probably is what you hope
that you will be contributing.
But in addition to your heartfelt answers to those questions, you can distinguish yourself by
showing that you have spent time in introspection and that you understand how your experiences
have shaped you and influenced your decisions about becoming a physician and choosing your
residency. One experienced interviewer told us, Everyone has a story, but many of the students
we see dont seem as if they know their own particular stories. Many have not really thought
through their lives and what they want. Spend some time with yourself before the interview; ask
yourself these questions:

What are your expectations of what your life will be like after residency? Whats your
visual image of your life as a doctor?
What have you done in your life that shows that you are a hard working and dedicated?
(Remember, it doesnt have to be restricted to medicine.)
What besides medicine do you have in your life that you feel passionate about?

What About Lifestyle

The medical profession continues to debate the advantages and disadvantages of the intensity of
the residency demands and schedules. Long resident work hours, sleep deprivation, high stress

levels, relationship interruptions -- these are somewhat par for the course in a typical residency
program, but of legitimate concern nonetheless -- particularly as you may think about your now
or future spouse or children.
Its appropriate to ask about call schedules such as How often will I be taking call or What
are the expectations for a new resident But too many questions about time off will make you
look like youre picking your residency on that basis, which does not speak well to the program.
Its a fine balance.
After the Interview
Go back to your housing and immediately write down your impressions of the interview. After a
few interviews, you will tend to start forgetting what happened where. Write a description or
make a list of what you liked and didnt like, and do it right after the interview because you
wont remember later.
Dont rank a program you will feel uncomfortable working for. If youre going to interview at
many programs, its a good idea to prepare a checklist in advance of the factors that are
particularly important to you that you can use for all your interviews. At the end of the process
you can then use a consistent rating system to help sort out your decision.
Follow up your interview with a note of thanks -- but not one that sounds like a form letter. Make
sure that you sound genuinely interested.
Commonly Asked Questions
Interviewers routinely ask certain questions of applicants, and for some of them you will have
ready answers. Interviewees report that they found some questions appropriate; others they felt to
be off-limits, though frequently asked. Ranked among the most difficult to answer were vague,
open-ended or very general questions. Interviewees reported anxiety about questions like, Tell
me about yourself, or What do you want to know about the program?, and yet those were the
kinds of questions they repeatedly faced.
Another common question was about personal weaknesses. As one respondent said: You should
pick something that doesnt expose some horrible shortcoming -- something that could actually
be seen as a strength. For example, you may feel that Im a perfectionist, I trust people too
much. Or Im too organized. You certainly cant respond, Im insensitive, cruel and lazy!
If you are prepared to answer the following list, you should be ready for many of the questions
you will face.

Why did you choose this specialty?

Why are you interested in this program?
What are your goals?
Tell me about yourself?
What did you do before medicine? (To an older student)
Why should we pick you?
What are your strengths?

What are your weaknesses?

Where else have you applied?
Are you interested in academic or in clinical medicine?
Do you want to do research?
Where will you rank us?
What was the most interesting case that you have been involved in?
Present a case that you handled during medical school.
Do you plan to do a fellowship?
What could you offer this program?
How do you rank in your class?
Do you see any problems managing a professional and a personal life?
Are you prepared for the rigors of residency?
Where do you see yourself in 5 years?
What questions do you have?

Uncommonly Asked Questions

Beyond the routine questions, there are others that are more difficult, unusual, or even strange
inquiries that may not seem to pertain to your future as a doctor. You cannot prepare for all the
questions you hear about through the grapevine. Nor can you prepare for all the remote
possibilities that you conjure up in your head.
Questions that are unexpected often fall under the general category of getting to know you. Its a
good idea to spend some time on personal reflection before you start the interviewing process;
give some thought to who you are in the world both as a doctor and as a person, what you like
and dislike, why youre in medicine and what you want out of your residency.
If you are asked something that seems pretty off-beat, it is probably best to assume that you are
being judged on your grace under pressure as much as on the substance of your answer. Some
program directors think that the way to test your smarts in the face of medical emergency is to
put you into a crisis in your interview.
Remember, not all interviewers are equally skilled. You can correct some of the problems you
encounter by keeping the interview focused. When questions are asked that dont seem germane
to the interview, you may tend to over-answer hoping to hit on something your interviewer
wants. But dont go on and on. If youre asked a question about whether there are any physicians
in your family, you neednt give a monosyllabic yes or no, but dont do your family tree, either.
Rambling in an interview robs you and the interviewer of the opportunity to exchange the
information you both need.
The following is a list of some uncommonly asked questions as reported by students:

Are you religious?

What is the one event you are proudest of in your life?
What do you plan to do after residency?
What are your hobbies?
What do you think about housestaff unionization?

How would you redesign the health care system?

Why did you get (a certain) low grade?

Of course, no one wants to force the issue, if possible. Instead be ready to use such opportunities
to gauge the real environment and philosophy of the institution. For example, you might respond,
Im glad that you asked that question. It gives me an opportunity to ask you the employee mix
and patient demographics hereand your philosophy on teaching cultural competency. Im very
interested in improving the health status of minority populations.
An approach like this can open a dialogue between you and the interviewer. It also gives you an
opportunity to find out how the attitudes of the program reflect (or dont reflect) your own. In a
wider context you question can elicit information about the working conditions of the program,
which affect all residents.
Questions to Ask During Interviews
Everyone who interviews for a residency has different priorities and ideas about what they want
in a placement. Therefore, there is no way that someone can send you into your interview with a
list and tell you that if you ask these questions you will cover everything that you need to know.
In addition, different specialties demand that different questions be asked. However, it is very
important for two reasons that you develop a set of questions. First, it is imperative that you
glean the information that you need to assess the program; as one respondent to the questionnaire
said, Youre interviewing them just as much as theyre interviewing you. Second, it is a handy
emergency procedure in the event that you run into an interviewer who wants you to direct the
interview. The following is a list of questions for which you may want answers, broken down
into categories which may also be useful as a guideline for developing your own questions. Be
careful not to ask a question that is already covered in the literature on that program.
Education/Philosophy:

What is the philosophy of the program?

Who are the faculty?
What kind of curriculum is offered?
How many hospitals participate in the program?
Is a thesis or publication required during training?
Is there time and funding for conferences and meetings?
To what extent do residents manage patients?
What is the patient mix and what are the community demographics?
Do residents perform surgery?
Is the program changing, and why?
What do residents here like most and least?
What are the research, clinical, teaching opportunities?
What is the scope of experience I can expect?
What is the program like (in the sub-specialty Im interested in)?
Where are the graduates of the program now?
How much elective time is there and how is it usually used?
Is the Chairperson staying?

What percentage of graduates enter fellowships?

How is the training divided?
What are the weaknesses of the program?
Do residents have time to read?
How available are the attendings (including nights and weekends)?
What were the results of the last accreditation visit?
Are there any joint residency activities?
What is the patient mix? Does it reflect the community demographics?
What kind of community outreach might we be involved in?

Competitiveness of the Program:

What do you look for in a candidate?

How many people do you rank?
How do your residents perform on boards?
What is this program most respected for?
What is the ownership of this institution?
How financially stable is the program?

Quality of Life:

What is the mix of married and unmarried residents?

What is the racial/ethnic/gender breakdown of residents?
Do the residents socialize as a group?
Are their support groups?
Is there an Office of Minority Affairs? What is its role?
How many residents are there?
What is call schedule like?
What happens if someone is sick?
Characterize faculty-resident relationships.
What is the relationship between this program and other specialties?
Have any housestaff left, and why?
What do you expect of your housestaff?
Is there a house staff grievance process?
How are complaints handled?
What is the parental leave policy?

Benefits:

Do you offer health, life, disability insurance?

What is the salary?
What is your meal plan?
What kind of vacation time do you offer?
Do you have sick days?
Do you have maternity/parental leave?
Does the curriculum include training in cultural competence?

Is training offered in medical Spanish or other languages?

Does the program seek and actively recruit minority residents?
How many attendings/faculty are minorities, and are efforts being made to actively
recruit them as well?
Does the medical school have an Office of Minority Affairs?
What is the make-up of the patient population?
Is the program or hospital involved in any projects to help the undeserved?

Other Things You Might Want to Know

There are other questions that you wont be asking in the interview but might want to investigate
on your own. For example:
Where is it?

Do you like the city?

Do you like the fact that its rural, or in a suburb?
What is the community seem like?
What is the climate like?
What kind of transportation is available?
What is the access to theater, movies, sporting facilities, the great outdoors?
What are the financial implications of living here?

The Hospital:

How are the individual call rooms?

What are the meals like?
What is the library like?
Can you easily photocopy articles you need?
Where are the lockers?
Do men and women have equal facilities?
Are there fitness facilities?

Not Matched? The Decision to Reapply

Written by Ugo A. Ezenkwele, MD, Resident, Department of Emergency Medicine,
Hospital of the University of Pennsylvania
Its two days before Match Day at exactly 12:00 pm and you receive the dreaded call from your
Dean. You did not match. Uh oh! What do you do now? Should you scramble for a spot in an
unmatched residency program, apply for a one year research grant giving yourself time to
reassess, or throw the towel in entirely and give up the hope of ever becoming a physician?
These are tough decisions to make and you have 48 hours to make them. What do you do?
Fortunately, you are not alone. In 2000, the National Residency Matching Program (NRMP)
offered 20,598 first-year positions among 3679 programs. 25,462 applicants participated and of

these, eighty-nine percent matched. Among those who did not match were graduates of US
accredited medical schools, former graduates of US medical schools, US osteopathic students,
Canadian students and graduates of foreign medical schools. Therefore, throughout the US and
the world, people like you are faced with the decision of what to do.
Lets look at some options: 1) The Scramble for an Unmatched Spot; 2) A Year Off; and 3) A
Life other than Medicine.
The Scramble for an Unmatched Spot
After you have received the call, your Dean will provide you with a list of programs with open
residency positions. Your task will be to call these programs, find the one most favorable and
submit your name. The key is to be prepared. Make sure you own a fax machine or have access
to one. Furthermore, have someone available (either a spouse, friend or colleague) who will help
you with the process of contacting residency programs. As soon as you know the unfilled
positions, download the contact information and start phoning. The key is to start with the
programs you already interviewed, then proceed to other programs in your specialty in a
favorable geographical location. If the program agrees you may use the ERAS application
service. If not, fax or email your applications immediately!
If you are fortunate you may end up in a program in which you interviewed or one within your
specialty. Advantages are you have a job, especially in the field you are interested in and at the
end of it all, you will be a medical doctor. The disadvantages are you may end up in a specialty
that is different from the one you are interested in and/or you may end up without a job. Some
people will opt to undertake a transitional or preliminary position in medicine or surgery for a
year that will allow them to re-enter the match the following year.
The key with the scramble is to be prepared. The possibility of not matching can happen to
anyone and not being prepared can result in others in a similar position making off with choice
residency positions.
A Year Off
For some people, a year off is an excellent opportunity. During that period most will spend time
bolstering their resumes either with research projects, volunteer exercises, and/or extra degrees
(e.g., a masters in business, public health, or the sciences). It is imperative that you spend this
time wisely. During the following Match period, most residency directors and/or or program
directors would like to know what you spent the extra time doing.
People do not match for various reasons. Whether you set your sights too high, or you ranked too
few places, or you were "deceived" into believing you had a spot, etc, the reality is a year off is
not the time to travel the world. It is the time to strengthen your application and make sure
history does not repeat itself.
Furthermore, being prepared is also important if you choose this option. Recognize that applying
for research positions or graduate programs require a lengthy application process with letters of
recommendation, personal statements, and/or project proposals. Fortunately, much of this you
have prepared already. However deadlines may have passed. Therefore, being prepared with

appropriate contact information, knowing whom to call for an immediate response and being
able to identify an appropriate research mentor would be helpful toward ensuring a successful
year off.
A Life Other Than Medicine
You have come this far and dedicated nearly a decade of your life toward medicine. I would
advise you to persist and continue toward a career path in medicine. Do not let the fact that you
did not match become a deterrent toward that goal. If you scramble and/or take a year off to try
again, chances are you will persevere. However, if you decide to discontinue for any number of
reasons there are multiple other fields related to medicine which look for students who have
graduated from medical school. These include: consulting, health care research firms, investment
banking companies, health maintenance organizations, and non-profit organizations. Your
options are open.

Making the Most of Your Residency

Part 1: Successful Life Balance in Residency
Written by Sheila Roundtree, MD, Internal Medicine, Columbia, South Carolina, AMA-MAS
Governing Council Member-at-Large
Physicians in training can extract an invaluable lesson from the wild. The female lion is
responsible for securing prey for her family to consume for sustenance. Typically, the lioness
partakes first, then shares the remainder of the kill with her cubs and mate. You can learn from
this scenario. Make certain that your needs are met and you will be well positioned to provide
the best of care to patients and the most of yourself to your friends and family. Although the
residency years are almost uniformly mentally and physically taxing, one can emerge healthy
and successful.
Network Effectively
Interns and residents often relocate to a new city to pursue post-graduate training. Networking
prior to the move may provide a unique opportunity to establish new relationships and gain
insight into the community. For example, I contacted several physicians who worked in the
Southern town where I trained (weeks before I moved). My new acquaintances provided me
invaluable information concerning housing, travel routes and employment possibilities for my
husband. Additionally, I developed a support system with people who enthusiastically invite me
to social functions and are always available to offer professional advice.
Most communities have at least one established minority sponsored organization for health
professionals. Those who join such groups benefit from ample opportunities to make new
friends and, possibly, build a referral base for the future. Entities such as the National Medical
Association, National Hispanic Medical Association, and the Association of American Indian
Physicians offer excellent educational venues and impact the healthcare system via political
vehicles. Also, join the AMA Resident and Fellow Section, and get in touch with your local
county and state medical associations, most of which also support, resident and young physicians
sections. Involvement in professional organizations also often provides a vehicle for your spouse

or significant other to develop new relationships as well. Moreover, consider allying with
members of your Greek letter organization, religious affiliates, and other groups of interest in
your new town.
Maintaining Healthy Relationships in Residency
Most people find that the happier their loved ones, the greater their potential for personal
happiness. Be sure to keep the lines of communication open between you and those closest to
you . This is a critical time in which you are launching a career; solidifying your personal
identity and establishing committed relationships. Keep in mind, however, that those who
comprise your support system need you as well. Remain in tune with their goals, struggles, and
triumphs.
Stay connected with life events. Try to tailor your schedule so that you may attend weddings,
baptisms, graduation exercises and the like. Although you may not be able to attend all such
functions, your effort and interest will be appreciated and you will be able to find support when
you need it as well.
Try to have at least one meal a day with your family or significant other when you are not on
call. On call days, perhaps they can join you at the hospital for a brief visit, should your
workload permit. If visits are not feasible, however, communicate via email or phone. Fiercely
protect your leave allotment, and plan time away from work strategically. I find that taking a
vacation in the midst of a demanding stretch of call months is particularly helpful. Seize every
opportunity to rejuvenate your spirit, mind, and body.
Getting the Work Done. Early in your intern year, obtain practical information regarding your
residency program and the functional aspects of your institution from upper level members of the
housestaff. Quickly identify at least one senior resident who is especially knowledgeable and
willing to help a newcomer. Keep a good pocket guide specific to your specialty accessible at all
times.
Work efficiently, and lay out clearly defined goals in your mind and/or on paper. Lurie et al.
discovered that during a typical twenty-four hour call, most housestaff spend a mere eightyseven to one hundred and seventy-five minutes on true patient-related activities. Surprisingly,
most of their time was spent starting intravenous lines, drawing blood, transporting patients and
similar activities. Delegate these types of tasks where appropriate. Take advantage of the
specialty expertise available in your place of practice e.g. radiology, pathology, . . . In the long
run, these consultations may save time and facilitate better patient care.
Ascertain that each member of your team, including medical students, has clearly delineated
responsibilities. Foster a sense of team spirit. Remember that cohesive teams are much more
likely to operate efficiently. You may find it worthwhile to convene with your team doing the
course of the call day in order to assess everyone's progress and identify those who need
assistance. Prioritize tasks, realizing that priorities may change pending patients' status.
Healthy Habits for Life
Exercise. I strongly recommend engaging in aerobic exercise balanced with low to moderate

level weight training several times per week. Initially, such frequent exercise may seem
unrealistic for the house officer committed to frequent call and long in-house hours. Take
advantage of your days off as well as the days you are able to leave work early. Those who
exercise regularly are less likely to miss time from work due to illness, and physical activity is
one of the best diffusers of stress.
Furthermore, exercise is proven to enhance ones sense of personal well being, facilitate weight
control and decrease the incidence of vascular diseases. (Does this sound familiar?) I often
power walk in the morning when I am due to work later in the day. Interestingly, a post-call
workout may set the backdrop for more restful sleep.
Diet. Unfortunately, many house officers gain a significant amount of weight during residency,
and the number of overweight residents seems to be on the rise. Plan to eat at regular intervals,
and resist the temptation to consume snacks high in fat and concentrated sugar content. Opt,
instead, for fruit and lower calorie snacks. Substitute spring water or flavored water in lieu of
soft drinks. Limit total fat consumption to 35% or less of your total caloric intake. And, when
ordering take-out meals, select a lighter fare entree on (at least) some occasions. We must
display the level of discipline that we expect from our patients.
Sleep. Obviously, ensuring that one receives adequate rest is of paramount importance for the
house officer. Although most trainees fall asleep readily once relieved from their duties, a
surprising number complain of sleep pattern disturbances. Most authorities recommend going to
bed and awakening approximately the same time daily in order to establish a stable biological
clock.
The average adult requires seven to nine hours of sleep nightly in order to feel well and rested.
Keep in mind, however, that there are physiologically short sleepers who need only three to five
hours of sleep per night. Conversely, the physiologically long sleepers require more.
Remain cognizant and respectful of your personal sleep requirements. Avoid working in the
bedroom; preserve this sanctuary for relaxation and sleep. While some folk sleep well after
exercise, others may notice that they experience difficulty resting after a vigorous workout.
Furthermore, heavy caffeine intake should be avoided in those who are vulnerable. Although a
regular sleep schedule is advisable, by all means, take naps whenever you can when you are on
call!
Go Forth Boldly. You are destined to complete residency successfully. Never doubt yourself or
your abilities. Admittedly, the learning curve is quite steep during these formative years.
Nevertheless, you are well equipped to effectively negotiate any challenges that lay ahead. After
all, you graduated from medical school, remember?
Part 2: Life in Residency and Beyond
Written by Erica Phillips, MD, Resident, Department of Medicine, Hospital of the University of
Pennsylvania

The philosophy of most training programs is twofold: 1) to provide a core curriculum designed
to promote the acquisition of basic clinical competencies in a particular field and 2) to tailor the
educational experience to meet the career objectives of its trainees. This latter principle is
challenging given the uncertainty that many trainees have about their career goals. In addition,
during graduate medical education there is the likelihood that a trainee will change their career
goals several times. One of the most difficult tasks during graduate medical education is to look
forward to the future when the present day is wearing you down.
The first year, post-medical school completion, is spent predominantly developing survival
skills. These skills will develop in areas such as time management, and team development. At the
same time there is the adjustment for friends and loved ones to a new environment, and your
busy schedule. The truth is you will often find yourself pondering over the same two questions
When will I sleep and When will I eat. In between these thoughts, it is advisable to try and
think about the following;
Feedback from fellow interns, residents, and faculty is key. If it is not readily offered then
initiate the discussion at least midway during each rotation.
Talk to your program director early on, especially if you are having difficulty
adjustingbecause, whether you realize it or not, they already know. Dont wait to be called into
the office.
Seek out a mentor(s) early in your training.
If you have done research or have a research idea that you would like to develop talk about it,
talk about it, talk about it. someone will be listening and opportunities will open up.
Based on the specialty of the program, after the first graduate medical education year the trainee
will gain a higher level of responsibility in the form of supervising medical students, interns,
coordinating patient care, and performing procedures to touch on a few. The active pursuit of
fellowships, and employment will vary based on the length of each individual training program
but the general principles remain the same.
If your institution is lacking individuals with similar career objectives or mentors who can advise
you on achieving your objectives, contact your local/national medical associations and
neighboring institutions.
Join and attend a national meeting in your specialty. Many programs provide funding for trainees
to attend national meetings. Remember to take your business cards because networking is key.
If you do not have a curriculum vitae, start writing one. Ask your program director to review it
on completion. Update your CV on a continual basis. Document all curricular activities
(conference presentations, submission of an abstract to a journal, an award, etc.) as they occur.
When presenting or teaching, consider having the attendees complete an evaluation. Compiling
this feedback will allow you to carve out a clinical expertise, which is especially important
when pursuing a career in academia.

Choose wisely when requesting recommendations from faculty members. The status of the
faculty member (i.e.; chairman, well known researcher) is less important than how well they
know you as a house officer and person.
If applying for fellowships, speak to as many faculty members in your respective department.
They will be able to offer advice on the reputations of other programs, as well as provide
referrals. Remember the application and interview process for fellowships is far different than
residency. Overall it is a less competitive environment, whereby honesty is your best policy.
Dont tell a program you are truly interested in them and make a verbal commitment if you are
not. The word gets around.
Be prepared to apply broadly for competitive fellowships (i.e. cardiology, thoracic surgery) and
keep your options open when looking for employment in popular cities like New York, or San
Francisco.
When searching for employment, talk with those who have recently completed the process to
gain a sense of the market for your specialty and skills. Throughout training you will be
approached by at least one if not several head hunter groups. Ask around about the individuals
groups before providing personal information. Overall they are a useful source. Faculty
members, program chairs and directors are excellent sources for employment referrals. Be open
with them about asking around on your behalf. Journals are another excellent source for
identifying openings in various market places. However, remember there are hundreds of other
physicians reading the same ad, so do not expect a quick response.
Have a lawyer that specializes in medical contractile agreement review your contract before
signing. Dont hesitate to ask for special amenities like coverage of moving expenses and
licensing fees. The worst that can happen is they say no.
These are just a few key points that may seem obvious, but often take the back seat in the hectic
schedule of a house officer. The most important thing to remember is that its never to late.

Residency Programs: An Inside Look

This online resource guide is a work in process and, as such, our Minority Affairs Section (MAS)
colleagues continue to provide materials and add their particular insight. Following below is a
look inside some the the residency programs that you might be considering. Obviously, this is
not an inclusive list, however, we will continue to add information on other specialties as our
colleagues volunteer it. We welcome your contributions. If you would like to contribute to this
piece, send us an e-mail and we will review your topic for possible inclusion.
Anesthesiology

Written by William A. McDade, MD, PhD, Department of Anethesiology and Critical Care, The
University of Chicago, Associate Dean of Multicultural Affairs, The Pritzker School of Medicine

Qualities of Anesthesiologists
Candidates who tend to do best in anesthesiology are those who have an affinity for more
technical and manually oriented activities. Those who particularly enjoyed anatomy,
pharmacology, physiology, biochemistry, biomedical engineering, biostatistics and basic science
research are going to find anesthesiology particularly fascinating. While there is a great deal of
cognition required of an anesthesiologist, the true passion of the clinician is the ability to perform
special skills to a high level. Anesthesiologists are expert in the management of airway and
circulatory problems in critically ill patients. They are adept in pharmacology, drug delivery
systems, use of blood products, and techniques of regional and central neuraxial blockade.
Because decision-making is of the utmost importance, anesthesiologists must be astute clinicians
and logical scientists. Anesthesiology is a hypothesis driven field where there is a blend of
application of specific knowledge, exercise of clinical judgment and performance of a myriad of
technical skills. Further, because time is frequently of the essence in the operating room setting,
these decisions are often make quickly, wherein each intervention serves as the instrument to test
the next hypothesis.
Frequently, and incorrectly, anesthesiologists are thought of as having only to use
pharmacotherapy to allay a patients anxiety. However, few anesthesiologists rely on drugs to
achieve this end; rather, the competent anesthesiologist is able to use excellent interpersonal
skills to inform the patient and ease anxiety. The anesthesiologist typically does not have patients
who are soley in their care. Rather, anesthesiology is a consultation practice exercised in the
association with a surgeon and/or an internist. Therefore, as a consultant, the anesthesiologist has
to be able to communicate with a variety of colleagues as well. Those who seek variety are
definitely fulfilled with a career in anesthesiology for it is truly at the intersection of all medical
disciplines. Because any patient can have a surgical problem, clinical anesthesiology may
involve neonatology, pediatrics, adult medicine, obstetrics, radiology and, of course, surgery.
Knowledge in all these areas, as they relate to anesthesiology, is required by the consultant
anesthesiologist.
For the individual who wants more of the traditional patient-doctor setting, there is the
possibility of a career spawned from anesthesiology in intensive care medicine or pain
management. These certified fellowship programs follow initial training in anesthesiology and
offer the ability to have a career in which patients look to you as their doctor. Still, you are not
the primary care physician for the patient and therefore act in a consultation capacity. However,
you have a longer interaction with a given patient and you form a more lasting bond between the
patient and their familes. In critical care, continuous relationships with patients throughout a
finite critical illness are formed. There are still many procedures to perform and rapid
assessment, diagnosis and therapy implementation are vital. In pain management, there are
likewise many technical procedures to perform, but the assessment can be less acute and the
relationship between the patient and you can be quite long-lasting throughout the duration of a
patients painful condition.
Medical School Exposure to Anesthesiology
It is uncommon for medical school students to interact with anesthesiologists during the
preclinical years. If you identify one early in the medical school curriculum it is most likely in
the context of pharmacology, physiology or in research. In addition, many medical schools do

not have a required third year rotation in anesthesiology, so as a student, you may not get the
opportunity to learn about what anesthesiologists do during your third year unless you venture to
the head of the OR table during your surgery rotation and ask questions. Not every medical
school even offers academic electives in anesthesiology in the third or fourth years; whereas, a
select few mandate an anesthesiology rotation as a clinical requirement. This variability exists
because of the way in which anesthesiology has developed as a field.
There was surgery long before there was anesthesiology. When it was invented late in the
nineteenth century, surgery without pain was seen as the single greatest contribution to humanity
of all time. However, because the emphasis was on the drugs used to cause analgesia, amnesia,
autonomic control and surgical immobility and the use of these drugs seemingly could be
provided to patients without a great deal of apparent effort, less skilled individuals were enlisted
to hold the ether mask. It soon became clear that some skill was necessary, but anesthesia could
be delivered by individuals who were less significant in the role of patient care than the
surgeons. This impression, fueled by ignorance of the science underlying anesthesiology, led to
the slow development of the field and its relative subjugation by surgical departments. The path
to forging anesthesiology as a rigorous academic discipline with equality to peer departments
within the hospital and medical school has been hard fought. However, due to the nature of this
less highly regarded position in medical society, anesthesiology became a land of opportunity for
the disenfranchised in medicine.
Surgery is still a mostly white, male dominated field of practice within medicine. The common
perception of a surgeon is a strong, demigod, who works inhuman hours and who stands ready
with intelligence, skill, and scalpel, ready to tackle the next big case. Women were not easily
accepted into their ranks, nor were minorities or the less highly regarded. These individuals
could not be the operating room principal in twentieth century America. However, they could
work for the surgeon, and administer the gases used to cause anesthesia. That was seen as a
minor role, subordinate to the surgery itself, and American society accepted these individuals
into the operating rooms so long as the captain was the white, male surgeon. The legacy of this
discrimination is a persistent relative overpopulation of women and minorities in anesthesiology.
This is a credit to anesthesiology as it is now populated by a great diversity of individuals and it
typically one of the most diverse staffs within most medical schools and hospitals. This may
provide for a more comfortable environment for the minority candidate and represents a
continuing opportunity for fellowship and collegiality.
The Road to Anesthesiology Residency
If you are thinking about anesthesiology residency, then it is good to do a rotation in it. Look for
opportunities to take an elective rotation in it during your surgery rotation in third year. You will
appreciate the integration of basic and clinical sciences, the hours spent in patient care, the
excitement of learning invasive techniques, and the sense of problem solving pace and technique.
If you like this, schedule an early fourth year month-long elective in anesthesiology. In the fourth
year, you will have the ability to see the various subspecialty areas within anesthesiology and
you will then develop an idea of the breadth of the field. You will also have the opportunity to
have worked with a number of anesthesiologists as mentors, role models and advisors. Certainly
ask them questions but allow them to get to know you too. Choose one as your principal advisor
and then a few more of whom you will use as additional supporters. Make sure you have worked

with these people and that they know you to be a hard-working, intelligent and motivated
candidate fro residency.
Think about the type of practice in which you would feel most comfortable when you finish
training. Is it academic or private, high volume bread & butter cases or low volume challenging
cases with critically ill patients?This will help you to decide the level of rigor of the department
to which you will want to apply. Some programs are high volume, others are slower. There is
good and bad in each. High volume programs give you great exposure to clinical examples, but
the high volume makes reading harder to squeeze in and the days longer. Low volume is also
good because it allows more time to read and to be taught by the excellent staff in the department
you choose. Some departments place heavy emphasis on didactic opportunities and have
multiple learning conferences during the week. Others have only one conference per week and
an approach to patient care that encourages less supervised and more clinical independence. You
have to determine your learning style and which program will be best suited for you.
Anesthesiology has undergone a large swing in desirability among residency candidates in recent
years. There was a move favoring it in the late 1980s fueled by high income associated with the
reimbursement rates paid to physicians who billed based on the number of procedures they
performed. Anesthesiologists were near the very top of all physician earners at that time. In the
early 1990s there was the institution of the Resource Based Relative Value Scale that was
designed to financially reward cognitive activities of physicians to increase fairness in
compensation and to reduce health costs at the expense of more procedurally oriented physician
reimbursement. Anesthesiologists, being in this latter group saw their real income reduced by
Medicare, Medicaid and insurers by a nearly one third decrement. This caused some dynamic
changes within the residency training community. Because practicing anesthesiologists were not
retiring as rapidly due to the decreased compensation, newly trained anesthesiologists were not
being hired when they completed residency. If they were, the track to partnership within a group
was greatly prolonged and there were reports of extreme predatory practices. Once again, the less
highly regarded and foreign medical school residency applicant looked to anesthesiology for an
opportunity, as other areas of medical study remained closed to them. The number of American
medical school graduates choosing anesthesiology reached it nadir in 1995, but has been steadily
increasing ever since then. In 2002, anesthesiology residency competition is a keen as it has ever
been for American graduates and so new elements in selection are being tested each year.
Only a few years ago, residency selection committees did not consider board scores in
determining whether to interview an anesthesiology American graduate. Now, a board score
above 200 is necessary to be interviewed at select programs. Candidates who have not yet passed
the USMLE Step 1 are not even considered by many programs. A few years ago, residency
programs paid for the travel expenses and hotel accommodation of interviewing candidates who
were American medical school graduates. Today, some programs debate whether to pay for
parking. So, times are changing in anesthesiology selectivity and successful candidates will have
to adjust accordingly.
Once you choose an advisor, then you must determine where you want to train. This may be
based on the institutional/departmental reputation or mission; the population served by the
institution; the opportunity to do challenging cases of a certain type at the institution; the

character of the department chairman; the teaching interest and ability of the faculty; the ability
to place its graduates in excellent fellowship programs; geographical and familial considerations;
the volume and variety of cases; the nature and amount of didactic programming; and,
collegiality among the residents and the espirit de corps.
You should go online to obtain information about any program you are considering and consider
applying widely. Because anesthesiology is a Post Graduate Year-2 specialty field, a separate
internship (Preliminary Year) must be obtained. This can be done in conjunction with the
residency in anesthesiology or apart from it. Typically, an anesthesiology program has a
relationship with the internal medicine department in the hospital that grants them a limited
number of PGY-1 positions for their trainees who need just one year prior to their first year of
anesthesiology (Clinical Anesthesia Year-1, or CA-1). So, a given anesthesiology training
program might have three year and four year positions. The 3-yr positions are for those
candidates who obtain their own internship independently of the anesthesiology program. The 4yr (Categorical) positions are for those candidates who allow the anesthesiology program to
schedule them for the internship at the same institution. In general, because it is less of a hassle
to move and to worry about applying to multiple programs in different disciplines and obtaining
letters for each, most people would opt for the categorical 4-yr program. Therefore they are more
competitive, and are often offered to lure the top candidates to a particular institution.
When you have gone to the online listing of programs and seen the selections of departments and
availability of 3- and 4-yr programs, meet with your advisors to discuss your choices. Include in
your selection of programs only those that you would really want to attend if matched there.
Because of the way the match works, you may not get your first choice and you are still
obligated to go to where ever you match; so, do not rank a program unless you really want to go
there. Put an assortment of programs in you mix including the very best, a few strong programs
and then a couple of safety schools. Safety schools are programs in your home state, or of lesser
reputation that will ensure that you will have a job on match day. Ask your advisors whether they
are able to write strongly supportive letters of recommendations for you. If they hesitate, do not
consider them further for a letter and withdraw your offer. You want anesthesiologists who are
well-known in the field to recommend you. However, if you do not have that option, then select
individuals who know you well and think highly of you. By having an academic anesthesiologist
as your advisor, they are typically linked into the community of university anesthesiologists or
the national societies of anesthesiology and are known to the community of scholars in the field.
This carries weight in program selection committees. However, surgeons and internists who
know you well and are supportive to you are also potential letter-writers.
Once your list of advisor-endorsed programs is complete, get your application completed. ERAS
has made the application process much easier. Some residency programs may also have an
additional supplemental application. You should check with each program administrator to
determine this. You should have your personal statement complete by the end of August. It
should be read by at least one of your advisors and discussed with you prior to your sending it
out. Your ERAS application should contain all of your community service work and the fact that
you are a member of the Student National Medical Association or other ethnic medical
association. On ERAS, there is no field to indicate your race and so some programs use the
excuse that the data are colorblind to limit the offers of interviews to non-minority students.

Your indication of participation in well-established minority organizations clarifies this for many
program directors and allows them to identify a candidate who could potentially improve their
diversity. There should be no attempt to mask your race or ethnicity because it is rarely used
against you in selection. Your letter writers should be confirmed by September. It may be
necessary to check with busy faculty to ensure they have completed your letters. Minority faculty
are especially busy and generally younger with multiple responsibilities, so be kind yet persistent
in your reminders to complete your letters in a timely fashion. From October through December
national meetings of the major medical organizations are held and faculty use these opportunities
to visit with old colleagues and talk about their residency programs. This is how your advisors
often learn about what is going on in programs around the country. You are often mentioned in
these conversations, one program director to another, or an advisor to residency review
committee member, or faculty to faculty in conversation. Information is shared and impressions
are shorn up following your visit. Therefore, try to arrange an early interview so that you can be
meaningfully discussed. The same conversations by telephone take place among program
directors, but the face to face chat is really powerful in helping you make it to the best programs.
If you have done research in medical school, you might also seek to participate in one of these
national meetings and then you personally get the opportunity to meet the individuals with whom
you will soon be interviewing. It makes an enormous difference in your favor if the first time you
meet someone from the program you desire to attend, it is at a national meeting and you are
presenting your data. When you appear for the interview, it will be as if you are speaking to a
friend.
Most anesthesiology residencies will invite you to interview on a certain day of the week. If you
plan to interview at multiple anesthesiology residencies in the same city or on the same coast,
they have often cooperated to hold interviews on days convenient to the candidate to allow one
pass per city. For instance, one may interview only on Mondays, another only on Tuesdays and
another only on Wednesdays to allow the candidate to fly there just once and cover all the
programs on one trip to reduce travel expenses. Take advantage of this and hold off scheduling
an interview with one program until you hear from other programs in the same region. While on
the interview trail, ask as many questions as you may have and always have a few prepared
questions based on your online investigations and conversations with your advisors. Keep a
record of the information you obtain at your visit so that you can refer to it later when match lists
are being prepared. Most interviews in anesthesiology are low-pressure affairs. Make sure that
you get e-mail addresses for key people you meet during the interview day. You may have
further questions later or you may want something clarified once you leave. Getting someones
number from the program also suggests that you are interested in that program, and the
programs belief that you are interested in them helps you tremendously. If you have the chance
to speak candidly to residents only, ask them the questions that you really want to know. How is
the learning environment?Do you see enough cases of this or that?How do the residents do on
the In-Service (Pre-board) Examination and the American Board of Anesthesiologists
Certification Exam?Do you feel the chairman really cares about you as the resident?Is there
mentorship and support for your ideas?Could I stay on there as faculty?Do the residents really
get along this well all the time?The questions about call schedule, vacation time, financial
compensation and fairness can be asked, but try not to get caught up in these details. Frankly,
one does not choose a program based on any of these factors that are all about the same from
program to program anyway. By dwelling on these items in particular, it suggests that you may

be far more interested in the lifestyle of the field than in learning as much as you can and being
member of the departmental team. This is an immediate turn off for most programs.
On the day of your interview, be there on time, no excuses. Your attire for your interview should
be business professional. You are applying for a job in which you are a consultant
anesthesiologist. Therefore, you must look the part. Even if you chose anesthesiology because
its the only job you can go to every day as a professional and never have to own a tie, borrow
one for your interview day. Be cordial to everyone, including secretaries and janitorial staff.
Everyone has input. Make friends among your colleagues there are the interview. You may want
to keep in contact with some of them as well. As a minority candidate, you may not see many
other minorities in a given program; and so, by teaming up with another minority student who is
interviewing in places similar to you, and therefore has as good a chance of matching there as
you do, you increase your chances of not being the only minority resident in your class. If you
have the opportunity to meet with minority residents already in the program on your interview
day, ask them some of the more difficult questions about race or ethnicity and the community,
patient population and program. Do minority residents graduate at the same rate of other
residents?What is the demographics of the patient population with respect to minority patients?Is
the community in which I plan to live hostile to minority individuals?How many minority faculty
and residents are represented in the program?You still need to use caution in being real with
minority residents and faculty. They typically still give a report on your interaction with them
and you want to be perceived and being excellent, so use discretion; but get your questions
answered.
Faculty, chairmen or program directors may say many things to you during the interview
process. Remember the goals of the program:They want a full residency class to come to work
July 1st; they want candidates who help them fulfill their service requirements, academic mission
and legacy; they want to be seen as being desirable and selective; they want to be viewed as
being honest and inviting; and, they want their residents to graduate without incident. In your
interview, do not give the selection committee cause to believe that any of these goals will not be
met after having interviewed you. The program, in turn, will sometimes suggest to you that you
are a highly desirable candidate in hopes of getting you to commit to them. Because the basis of
the National Residency Matching Programs software strategy is such that everyone gets their
highest, first available choice, a lot of baiting between candidates and programs is really
unnecessary; yet it persists. Simply put, do not believe it when a person at an institution tells you
that you are at the very top of the programs list, even if you are a superior student. It is illegal,
by NRMP rules, for them to tell you or to make an offer, and they are doing it in the hopes that
you will rank them more highly because of their expressed interest in you. In turn, another ploy
is for them to call you subsequent to your visit and to ask you where you ranked them. Your
response should always be cordial and above reproach and should be that you respectfully
decline to give exact details because it against the NRMP guidelines, however, you really
enjoyed the program and would find it hard to believe that anyone could not see how wonderful
it was.
After your interview, always send a thank you note by either snail mail or e-mail to thank your
interviewers, program director and chairman. If the chief resident or other residents were
especially helpful to you, thank them too. Do not be obsequious, but if you enjoyed yourself and

see a place for your career development there, let them know it and why you would be a good fit
for them. On ranklist submission meeting day, all your comments have been kept and are
brought out for discussion for final rankings in that department. Having shown continued interest
is as good as great USMLE scores.
Match Day and Beyond
Interviewing for residency often is useful when you apply for fellowships later, because people
know you and they remember. So, if you can afford it, go on all your interviews and meet the
program directors. If you had to decline an interview, do so graciously and cordially. Well, thats
it. On Match Day, enjoy yourself because you are about to embark on a wonderful adventure in
residency: The last step in a long journey.
The Dermatology Residency

Written by David Nieves, MD, Resident, Department of Dermatology, University of Rochester

School of Medicine and Dentistry
Dermatology is among the most difficult specialties in which to match. Dermatologists practice
medicine and surgery on patients of all ages. In many cases, dermatologists need only to look at
a lesion to arrive at a diagnosis. Dermatologists can immediately assess a skin lesions response
to therapy and modify a treatment regimen accordingly. Primarily an outpatient specialty,
dermatology enables its practitioners to enjoy a less demanding workload than physicians in
many other fields.
Academics
Interest in a career in dermatology is strong, yet the number of training positions is limited to
approximately 270 positions nationwide. Although it is difficult to know precisely how many
applicants fail to match in dermatology, it is estimated that as many as 33% or more may be
unsuccessful. Because competition is keen, successful applicants must prepare for their desired
career well in advance.
When considering a career in dermatology, applicants must realistically assess whether their
academic credentials to date would place them at a disadvantage. At many programs, the
majority of persons selected to be interviewed are AOA and have USMLE Step I scores of 230
or higher. While there are no absolute cutoffs and there will always be special cases, applicants
who are not in the top half of their class or who have USMLE Step I scores that are below the
national average are at very high risk of not matching.
The Dermatology clerkship
Although the third year is generally reserved for core clerkships, it is highly recommended that
potential applicants confirm their interest in the field early by doing the dermatology elective
during the third year. This can often be done by scheduling a clerkship such as psychiatry for the
fourth year. Try to do the dermatology rotation in the late winter or spring -- if it is done too
early, lack of clinical experience may cause a negative impression to be made on residents and
faculty (remember that most students take dermatology as a fourth-year elective).

At the end of the rotation, approach a faculty member with whom you had the best rapport and
ask to meet to discuss your interest in dermatology as a career. You should be prepared to
explain the reason for your interest in the field just as when applying to medical school you had
to explain your interest in a career as a physician. In the meeting, ask the faculty member for
his/her advice on the application process.
Research
During your meeting with your faculty advisor, ask about research opportunities in the
department not just laboratory research but also clinical projects as well. Doing research
enables you to demonstrate the ability to contribute to the advancement of the field. It also
enables you to build a close relationship with a faculty member who will then likely go to bat for
you with a strong letter of recommendation. When selecting a research project, factors to
consider include:
Do you have time to do a reasonable job on the project?
If its a lab project, do you have sufficient background in laboratory techniques to be efficient? If
not, are there technicians or grad students in the lab who can help you along?
Does the project make a meaningful contribution to the understanding and treatment of skin
disease?
Will you enjoy what youre working on?
Will you enjoy working with the person directing your work?
Is the faculty member directing your work well respected in the field, so that a letter from this
person catches the attention of an application review committee?
If the project is based in a laboratory, plan to set aside the summer months between third and
fourth year to work on the project full-time. If its a clinical one such as writing a case report or
review article it may be possible to work on it during other clerkships. Regardless of what you
do, it is recommended that you have some result in place by the time you send out your
application.
Recommendations
Aside from academic excellence, strong letters of recommendation are essential. Academic
dermatology is a very small field, and an applicant who is recommended by a senior faculty
member who is well-liked by members of an application committee will stand out of the crowd
more so than one who is recommended by an unknown junior faculty member. Of course, a letter
from a junior faculty member who likes you and knows you well is much more desirable than
one from a giant in the field who writes a few terse sentences that just rehashes your CV.
It would also be a good idea to do a sub-internship in medicine before applying, and to include a
strong letter of recommendation from the attending you worked with. In many cases, a subinternship is the only rotation in which the student is an essential part of a team with real

responsibility. A letter stating that your were prepared, responsible, and dependable when it
really counted says a lot about your potential to be a good resident.
Grand Rounds
Start going to Grand Rounds whenever possible. This demonstrates your solid commitment to
the field to the faculty in your schools own department.
Internship
In the past, dermatology was a late match in which the application season took place during the
summer/fall of internship. Dermatology program directors judged applicants not only on the
caliber of their performance in medical school, but also on the prestige of the internship that they
secured.
Today, dermatology is part of the standard match, and so no one knows where you will wind up
for internship. Nevertheless, program directors will often ask you where you have been
interviewed, and will be favorably impressed to hear that well-regarded academic programs are
considering you, generally in internal medicine. Most program directors encourage the internship
to be in internal medicine, though in the end if you match into a transitional program there is
little they can do to prevent it.
Incidentally, applicants interested in a career in pediatric dermatology should consider doing an
internship in pediatrics. While there are few if any one-year-only positions offered in pediatrics,
this can often be possible by special arrangements, such as working out an arrangement at your
medical school or by applying to pediatric categorical programs but explicitly stating in the
personal statement that you only want a one-year position. In the very near future, a special track
5-year will be available leading to board certification in pediatric dermatology (JAMA, April 25,
2001, p. 2065).
Applications
There are roughly 100 residency programs in the United States, most of which receive over 250
applications for only 1-3 spots. As a general rule of thumb, the total number of interviews
granted by a program tends to be 15 per opening (i.e., a program with 2 spots might interview 30
people). You should apply to a large number of programs, and set a goal of securing 10
interviews.
Interviewing
Dermatology operates on a slightly later schedule than other fields, and invitations to be
interviewed are not sent until mid-December. Before interviewing at a program, make sure to
thoroughly read the application brochure and check to see if a web site exists. Dress
conservatively. Also, if you have any personal cosmetic problems acne, significant unwanted
facial hair, etc consider getting this corrected well in advance of interviewing season.
Dermatology is a field that is focused on appearance, and it is important to look good for
interviews.
The questions asked most commonly are:
Why do you want to be a dermatologist?

What makes you interested in this program specifically?

Tell me about your research?
Do you have any questions about our program?
How do you like working with so-and-so (a well-known professor at your school)
In addition, many programs sponsor informal activities with residents to provide an inside
guide into what its really like to be at a program. Its a good idea to attend these events to learn
the things that the faculty wont tell you things that may ultimately influence your rank list.
Also, after the interview date, sometimes faculty may informally ask residents about their
impressions of the applicants.
The rank list
Follow your heart!
Have a backup plan in case you dont match in dermatology. If you interviewed for high-quality
preliminary programs in medicine, you can rank them at the end of your primary list after derm
programs. Medicine programs are flexible enough that at many places, someone can match as a
prelim and be allowed to stay on as a categorical resident (assuming, of course, that they perform
well during internship). However, the downside to this is that if you in fact match into a prelim
program, then this is still considered a match and you will NOT be eligible to participate in the
Scramble (or even know of your eligibility for it). Of course, there rarely are Scramble positions
available in dermatology anyway, so youre probably not missing out on much.
If you dont match
There are essentially three options at this point:
1. Do an internship. Re-apply either during internship or while doing research the following year.
2. Do a year of research and reapply during that year.
3. Give up on dermatology and select a different career.
Choosing between 1 and 2 is tricky. On the one hand, doing a year of research gives you
additional opportunities to enhance your CV, whereas reapplying during internship doesnt give
you much of a chance to improve your application. On the other hand, occasionally derm spots
open up with short notice, and can only be filled by someone who has already done an
internship. Getting that out of the way puts you in the running for these positions, because you
would be able to start working at a moments notice. Of course, finding out about these openings
can often be tricky they may be publicized by word of mouth, a mass mailing to department
chairmen, or an announcement at a national meeting. Its important to have a strong advocate in
dermatology circles who will keep an eye out for these for you.

Universities that offer formal research fellowships in dermatology include UCSF, Harvard, UT
Galveston, and Mount Sinai School of Medicine.
Emergency Medicine

Written by Jocelyn Freeman Garrick, MD, Assistant Professor, Department of Emergency

Medicine Kings County Medical Center
Emergency Medicine is a relatively new field. The American Board of Emergency Medicine was
first recognized as a specialty board just 22 years ago. Despite its novelty, Emergency Medicine
(EM) has become popular as a specialty and thus competitive. Emergency Medicine allows one
to be a jack of all trades while giving the freedom of a flexible schedule and healthy lifestyle.
As with most specialties, being prepared and having a mentor in your field is key to a successful
match.
A few items should be highlighted prior to creating a timetable for successful matching:
Three (3) year versus Four (4) year residencies. As you begin to make your list of residencies in
which you may be interested, you will notice that some are three-year programs and some are
four-year. Are there advantages and/or disadvantages to each? Most people who want a career in
academic EM will choose to do a four-year program. This does not mean that you will be
isolated from a career in academics if you attend a three-year program. The elective time in fouryear programs tend to be more spread out and gives one more opportunity to work on interests
and research. Three-year programs are packed with a lot of ER time and less electives. However,
residency is completed sooner. Approximately 2/3 of the nations EM residencies are three-year
and the remaining 1/3 are four-year.
Academic versus Community Emergency Medicine. Prior to applying to an EM program, one
should have an idea of what type of setting in which to practice. Academics requires one to work
in the Emergency Department, perform research and administrative duties, lecture and
supervising residents and medical students. Most academic positions are at large teaching
hospitals with EM residencies. Community positions offer clinical responsibility and a more
flexible schedule. Administrative tasks are usually present. Community EM also offers
opportunities to travel via locum tenens. Teaching opportunities may still be present.
Choosing a Residency Program. There are over one hundred emergency medicine programs
recognized nationally by the Residency Review Committee. If you plan well and are realistic in
your goals, you should be happy with your program selection. Selecting a program should not be
limited to the reputation of the program and quality of training. The dynamics of the city where
the hospital is located, cost of living, patient population, and quality of life outside the hospital
should be considered.
Research. Many students ask whether they should do research and if it is required to match in a
competitive program. It is not required but it can only help. Most EM departments have ongoing
research projects and love to have eager medical students help with data collection, chart review
and study design. While conducting research with an emergency physician, you will have the

opportunity to work with an attending one-on-one and form a relationship. In a few months you
may be able to ask that attending for a letter of recommendation.
Memberships. Join the Medical Student section of the Emergency Medicine Residents
Association. This should be done early in the third year. Besides getting a handbook, which is
useful for the application process, the monthly literature you receive will keep you abreast of
issues in the specialty. There is also a national conference where most residency programs will
be recruiting.
Timetable
1st and 2nd year.
Study hard! Make good grades and pass the boards. Participate in research and extra-curricular
activities.
May-July of Third/Fourth Year.
Obtain an advisor in the Emergency Department (ED). If your medical school does not have an
Emergency Medicine Department or Residency then seek one at a neighboring school or
hospital. This is not the time to be shy. Go to a neighboring hospital and find out where their ER
physicians trained. Ask one of them if they would be willing to mentor you during this process or
if they can recommend someone. If you have a neighboring medical school with an ED, arrange
to visit for a day. Speak to the Chairman of the department, the Director and the Residency
Director. Explain that your school doesnt have a department and you need an advisor. ER
physicians tend to be team oriented and willing to lend an extra hand.
Create your list of residencies for which to apply. The list should be based on the type of
environment in which you want to be (urban, community or rural), the career you have set forth
(academic or community), your personality, and your family structure. What if you like a
program but its location will limit opportunities for your spouse or significant other? In addition,
you should consider the diversity of the program, patient population and city. For example, if
youre considering a program thats in New York City but you hate the snow, the program
shouldnt be on your list.
When your list is complete, contact the programs to obtain an application (most now are
electronic) and program material. Narrow your list and work on the materials needed for your
application- the Curriculum Vitae, personal statement, transcripts, Deans Letter, letters of
recommendation and photos. The personal statement and CV should be reviewed by at least four
(4) people including your advisor.
Consider Doing an Outside Elective You may be at a medical school that requires ER as an
elective or at a school with a strong EM residency and choose to do an elective at your teaching
institution. However, some students may not have this opportunity and/or may want to
experience how another institution operates. Doing an outside elective may be beneficial. It
allows you to meet and work with ER-trained physicians, to meet other students going through
the process and hopefully you can form good relationships with the attendings during your
elective and obtain letters of recommendation. Before the elective, become familiar with the

administrative heads (Chair, Director, Residency Director). Network during the elective and
arrange your schedule so you may work with key individuals within the Department. Come
early, stay late, be a willing worker, participate in and attend lectures. This is your time to shine
and make an outstanding impression.
August-September of Fourth Year
Final revisions of your CV and personal statement should be completed and your letters of
recommendation should be obtained. At least two letters should be from well known or highly
regarded Emergency physicians.
Apply early -- I cannot stress this statement enough or in any other way. Apply early!
Early applications get first choice for interview dates. Some competitive programs fill all their
interview dates and applications received later in the process may not receive interviews (even if
the application is strong).
October- December of Fourth Year
Arrange Interviews. Most programs begin interviewing in late October and proceed through
early February. Some people have a strategy to interviewing and believe you shouldnt interview
very early or very late. I will suggest that you NOT interview on the last interview day. The
Directors are burned out and tired and may not even recognize your star quality. November
through January are safe months. Try to arrange electives during this time. For interview day, I
have two points to make, which may seem obvious to most but are missed by many:
1) Remain warm and friendly during the day. Act interested and ask questions. Interview days
can be long and exhausting especially if you traveled a distance the night before. Plan ahead, get
adequate rest so you can arrive early and be prepared. I cant say that enough.
2) Stay the entire day. If the program offers you a tour and you dont want to go, you dont want
to go to the program. Participate willingly in all activities.
Take notes. Youre not only being interviewed, you should be interviewing the program as well.
(It is important to take notes because after six or seven interviews, you can mix up the
programs). If youre not comfortable writing things down during the day, sit down as soon as
you leave the program and write everything you remember. Ask questions. Create a list of
standard questions to ask the residents and a separate list of questions for the attendings. Create a
rank list with pertinent questions for each program. (See Exhibit III. )
Spending Time in the ER Consider spending a few hours after your interview in the evening or
the night before in the ER. It gives you the opportunity to interact with the staff, to see how
responsibilities are divided and get to know some potential interviewers. Most tours are held at
10 or 11 AM when the ER is clean and relatively under control. It can be the complete opposite a
few hours later. Always send thank you letters and get the correct spelling of your interviewers
name. Remember, express real interest in the program of your choice with frequent notes,
telephone calls, visits and e-mail.

February of Fourth Year

Youve successfully matched in Emergency Medicine. Congratulations!
Obstetrics and Gynecology

Written by Joanne Quinones, MD, Resident, Department of Obstetrics and Gynecology, Hosptial
of the University of Pennsylvania
Why Obstetrics & Gynecology?
If you are interested in an exciting, fast-paced field, caring for patients at the office and the OR,
Ob Gyn is the field for you. The one thing that I think all medical students should realize is that
most of your residency you will be operating. Sure, primary care is emphasized in our training
but you still need to like the OR and should not mind the hours too much. You should enjoy both
surgery and office level care. After residency training, you can choose to subspecialize in
Maternal Fetal Medicine, Reproductive Endocrinology and Infertility, Gynecologic Oncology or
Pelvic Reconstruction/Urogynecology.
Where to apply?
Ob Gyn programs are available in both academic centers and community hospitals. Academic
programs are affiliated with major hospitals and offer the opportunity to work closely with
individuals renowned in the field. These programs tend to be competitive and sought after by
students interested in a future career in academics. From a community program you can also
pursue a career in academics, but it might take some extra work to get acquainted with mentors
who are academically active in the field. When applying to programs, get a feel for what the
general atmosphere is, and ask the residents about their career goals and the research.
What should I know

Remember that Obstetrics and Gynecology is a competitive match. Programs take into
consideration not only the grades from the clinical years but also your Step I score, your
involvement in research, and any memberships to societies such as Phi Beta Kappa and Alpha
Omega Alpha (AOA). During medical school you should aim for honors in medicine, surgery and
Ob Gyn rotations. You should demonstrate not only a strong knowledge base but also an
interest in performing procedures. Be pro-active during your rotations, helping the residents
during call and during office hours.

Find an advisor within the department. This individual could be the chairman of the department
but it could also be someone you worked very close with during your core clerkship. It should be
someone you feel comfortable with. He or she should guide you in what you need to do in order
to achieve matching at your place of interest. Finding an advisor early in the process is
important in order to ensure taking action in anything that you need to work on (grades, CV,
essay, interview skills, etc).

Apply to subspecialty electives within Ob Gyn (Maternal Fetal Medicine, Reproductive

Endocrinology and Infertility or Gynecologic Oncology). It is extremely helpful to participate in
these advanced electives (one or two at most). Your participation demonstrates commitment
and enthusiasm to the Ob Gyn faculty at your school. The electives can also help you figure out

if the field is really for you. I recommend applying for an elective at the hospital in which you
wish to match. Some people consider this to be a double edge sword since people can really
get to see if you are a good match for them (potentially affecting your chances if you happen to
not perform as well). But I feel that this offers an opportunity to figure out what life outside of
your medical school is like. I ended up doing that and it was an outstanding experience.

Dont forget that you will be working pretty hard for the next four years. With this in mind, keep
an open mind when interviewing. Talk to the residents about their experiences and get a sense
of whether they like the program. Sure, they will be at times tired and overworked, but overall,
you should be able to get an idea of whether the individuals enjoy their work. Enthusiasm is
hard to fake, so make sure you talk to different residents about their time at that particular
hospital.

When do I apply?
Spring:
Find an advisor and work on your fourth year schedule. Your goal should be to participate in one
or two electives within the field. These experiences will not only give you the opportunity to
shine but also should help you figure out whether the field is right for you.
Summer:
-Meet with your advisor to review your potential list of programs. Many times advisors know
individuals in the other programs and may even know the inside scoop giving you yet another
perspective on a potential program.
-Decide which faculty members will write your letters of recommendation (both within ObGyn
and within other departments). Let faculty members know ahead of time since many of them are
extremely busy with other responsibilities
-Start working on a personal statement your advisor should review and comment on your
essay. Work on the essay until you are completely satisfied.
-Start working on your Curriculum Vitae again have your advisor review it.
-Request applications from programs (you need to do this in order to receive each programs
packet).
Have your personal statement and CV ready by the end of the summer.
Early Fall:
-Complete and submit application through ERAS.
-Await emails and/or phone call from programs inviting you for interviews
Winter:
-Schedule interviews. This process may take up to two months. I strongly encourage to interview
at the sites were you are really interested in matching. The process is expensive (travel by car,

plane or train; hotel; meals; car rental; suit; shoes; bag) so make smart financial decisions
when deciding where to apply and thus interview.
-Prepare preliminary rank list and discuss with your advisor if you so desire.
February:
Submit match list to NRMP.
March:
Match Day!
In conclusion, keep an open mind during your application and interview process. Ask many
questions during the process and ask for advice from attendings and residents. Theres a lot to
learn from people who have been through the process once already.
1 Duff P. Development of a guidebook for senior students applying for residency training in
Obstetrics and Gynecology. Obstetrics & Gynecology 1995; 86: 140-143.
Pediatrics

Written by Malaka Jackson, MD, Resident, Department of Pediatrics, Children's Hospital of

Philadelphia
Considering Pediatrics?
Pediatrics is not just medicine for kids, rather it is a broad field in medicine that encompasses
the complete care of individuals from the pre-verbal, neonatal period through growth and
development into late adolescence. As a future pediatrician, you will have the opportunity to care
for and manage many aspects of health care for well, ill and medically complex children. You
will also be charged with promoting healthy and safe development of your patients through
preventative care and anticipatory guidance. You will have the opportunity to be an advocate in
the local community in which you practice and/or in the policy-making areas of local, state and
federal government promoting health care laws that directly affect the pediatric population.
Finally, by deciding to be a pediatrician, you have selected a career in which you can choose to
be a primary care physician, a subspecialist, a hospitalist, a principle research investigator or a
full-time pediatric advocate.
Applying in Pediatrics
Following the timeline as outlined in the Medicine section by Jeff Gonzalez, MD (above) is
also appropriate when applying to any of the 200+ pediatric residency programs in the country.
Early application is most advantageous when applying to top programs or if you are restricted
geographically, but applying early is recommended for all applicants. When reviewing program
information prior to and during your interviews, you may want to consider the following:
1)What proportion of time is spent in both general pediatric and subspecialty training?

2)Does the program have separate primary care and general application pools (This can become
important in two scenarios. First, if you know that you want to be a primary care pediatrician,
then you can forward your application to the program designed to offer more training hours in
general pediatrics. Second, this separation can be beneficial if you are really interested in a
particular program that offers both tracks because many programs will permit you to apply for
a position in each, thus increasing your chances of acceptance into the program. )?
3)How much time is designated for primary care/continuity clinic (Many programs schedule one
half day/week, but this can vary)?
4)Is there an opportunity to participate in off-site and abroad rotations?
5)Is research available and/or encouraged during residency training?
6)How much elective time is there throughout the residency training and when can it be
scheduled(i.e., as a PGY-1 vs. PGY-2, etc. )?
7)Does the residency program offer any formal teaching/exposure to healthcare policy and
management systems?
8)What role does advocacy play in resident education/training experience?
9)What teaching techniques are in place to enhance resident education hands-on training,
lectures, journal clubs?
10)Are residents directly involved in medical student education?
Want more information?
Further detailed information regarding Pediatrics can be found on The American Academy of
Pediatrics (AAP) Web site.
In addition, the AMAs FREIDA Web site lists pediatric programs which you can use to guide
your search in residency selection.
Psychiatry

Written by Mariana Mendez-Tadel, MD, Resident, Department of Psychiatry, Hospital of the

University of Pennsylvania
Psychiatry is a field of medicine that combines the practice of psychodynamic therapy with a
medical and psychopharmacological approach to behavioral health. Psychiatrists can enjoy a
career that includes long term patient care, many practice and subspecialty options, a good
lifestyle and reasonable work hours. Even though there have been concerns over the limitations
put on treatment coverage by many insurance plans, recent public awareness about the need for
better mental health treatment in this country is likely to positively influence the practice of
psychiatry.

Recent changes:
Though psychiatry was not a very competitive residency in the 90's, recent changes show an
increased interest in this field by medical students. For instance, the 2001 match saw the highest
fill rate in 5 years, and it is likely that the trend will continue. Not only does there seem to be
more interest for a career in psychiatry, but with the adoption of the ERAS application system by
most residency programs, the number of applicants per program has significantly increased.
However, it is still very unlikely that a good candidate would not be able to match in psychiatry.
Core clerkship and electives:
If you are interested in the field, early on, try to obtain as broad an exposure as possible during
your core clerkship, by choosing your rotation site carefully. Work hard, do well on the written
examinations and get a feel for the specialty. Also, because such a large part of Psychiatry is
outpatient work, it is a good idea to at least try to arrange for some exposure if it is not part of
your core rotation (for example by spending a few afternoons in the resident's outpatient clinic).
For electives, try to choose at least one where you will get to have significant participation and
responsibility over your patients, so you can show you are a good doctor and diagnostician.
Naturally, if you are interested in a particular subspecialty, try to do an elective in that area. A
good performance in a medical, pediatric, neurological or other non-psychiatry sub-internship
will be expected in any good residency program.
Advice and Advisors:
As with any other area of interest, it is essential to develop a good relationship with a resident or
an attending who can help you define your career goals. Their advise will be invaluable in
choosing residency programs, recommending electives and giving you a feel for what you should
look at when the time comes to rank programs. It is also important to get to know your local
psychiatry department. Whether you want to remain at the same institution for residency or you
want to go elsewhere, the head of the department, the program director or a well regarded
attending can be a great ally.
Letters of recommendation:
In general it is a good idea to achieve some balance in terms of who writes your letters. It is often
said that a letter by a well-known professor who does not know you well is not helpful. This is
partially true, but relationships and peer recognition are major forces in academia. It is probably
best to do a rotation with the well-known professor and ask for a letter, but also get one or two
from junior attendings who know you and can give detailed opinions about your
work. Balance is also most important in that you should not get letters only from your psychiatry
attendings, but also those from medicine, neurology, or pediatrics, particularly if you are
considering fellowships in areas that are related (such as child psychiatry, consult and liaison
etc). In fact, many programs will require one non-psychiatry letter.
Choosing a program:
Most residencies nowadays are four years in length. Internship is now integrated into the
categorical psychiatry program and includes a minimum of 4 months of medicine or emergency
medicine, 2 months of neurology and various other combinations of rotations. The majority
include at least a few months of inpatient psychiatry. However most programs will still allow

candidates who have already done an internship in another specialty or a transitional or

preliminary year to join the residency program as second years. Second year is usually entirely
devoted to inpatient rotations. The third and fourth years are mostly spent in the outpatient
setting. Some programs will allow residents to graduate in the third year as long as they continue
a fellowship immediately afterwards. Also there are a few combined programs in Psychiatry and
Medicine, Pediatrics, Neurology or Family Medicine- (not many, but can find them listed in
FRIEDA).
A few things to keep in mind when choosing where to apply are: career plans, intended subspecialty, location and naturally, any family or personal obligations. When it comes to career
plans, consider whether you want an academic career. If this is the case, you should definitely
apply to major academic centers where the research opportunities will be plentiful. Some
programs have dedicated research track spots or residency-into-fellowship research
opportunities. Naturally, this must be taken into consideration if you already know you are
interested in a sub-specialty.
Location and personal interests should concern you also-fortunately, because you will have a
reasonable amount of time to enjoy them, particularly after 2nd year. One last bit of practical
advise about this matter: find out what the opportunities are for moonlighting and when can you
start taking advantage of them. This can make an enormous difference in pay (and again
remember that most psychiatry residents are likely to have enough free time to afford a few
nights a month of paid call).
Interviewing for psychiatry residency should be an enjoyable process because (for reasons
mentioned earlier) even the most prestigious programs want to make a good impression and
secure the best candidates, and they will go to great lengths to make the experience a nice one for
them. Most psychiatrists are nice, and agreeable people- big bells should ring if you
find that the residents seem unhappy, or the attendings are distant or disagreeable.
A final note on training as a minority psychiatrist:
As a minority physician you can bring a different perspective into the practice of a specialty of
medicine which is, more than any other, dependent on an understanding of the patient as an
individual with social and cultural as well as physical heredity and circumstances. When
choosing where you will be spending the next four years, do not undervalue the importance of
diversity in your education as a resident.
Surgery

Written by Patricia Turner, MD, Resident, Department of Surgery, Howard University Hospital
and Vikisha Fripp, MD, Resident, Department of Surgery, Howard University Hospital
Once you decide on making Surgery your way of life, the process of obtaining a residency
position assumes highest importance. The preparatory phase can be very involved and intense;
however, keep in mind that every surgeon has successfully maneuvered through it before you.
The timeline for gathering letters of recommendation, finalizing your CV, and putting ERAS
together is the same for most specialties. . . the early bird catches the worm.

End of 3rd Year and 4th Year

Spring/Summer
Senior surgery elective in the area of surgery you want to specialize in (i.e., Plastics, Vascular,
ENT),
Choose an advisor. Someone who is honest, available, supportive and most importantly
knowledgeable in the area of your specialty.
Consider a SICU elective to familiarize yourself with surgical management of burns, trauma and
critically ill patients.
Like every specialty letters of recommendation are important. Be selective about who writes
your letter, keeping in mind the person who knows you best will write the best letter. A letter
from your chairman is a MUST. Make an appointment to meet with your chairman have your
CV and personal statement with you.
Early Fall (August, September)
Obtain information from FREIDA (i.e., addresses, contact names and phone numbers) regarding
programs.
Make a list of what you are looking for in a program. Match these criteria with what each
program is offering and get a defined list.
Finalize CV and personal statement for completion of ERAS.
Check your ERAS information to make sure that all materials are present and factual.
Remember Dean's Letters don't go out until November 1st.
Send off ERAS to the list of schools you have gathered from FREIDA. ERAS costs, so send to
schools you truly have an interest in interviewing with. There is no specific number; however,
most agree that at least 10-15 are a safe number.
As mentioned before, send Thank You letters to all persons who wrote you letters of
recommendation. . . whether you used them or not.
Late Fall (October, November
Interviewing (late November through early February)
The interview process is by far the most stressful portion of this process. The major areas of
focus are WHEN to interview, HOW MANY programs to interview with, WHAT TO WEAR to
the interview, and WHAT QUESTIONS to expect. All these questions have different answers
depending on whom you talk with. Therefore, I strongly recommend that you speak with your
advisor, talk with those who have interviewed before you at the institution and review frequently
asked question in the First Aid for the Match and all other published materials.

The interview months are designated late November through early February. Most people
reserve December or January off from clerkship to interview. December interview season is
truncated because of the holidays, so January may be the best month. Also, keep weather in mind
when in interviewing in the northern states; you may want to interview early in these states.
There is no perfect number. I suggest interviewing with at least 5-10 schools. Toward the 10th or
so interview fatigue becomes a factor, therefore, I recommend interviewing at your top schools
somewhere in the middle of the list. This allows you to become familiar with the process before
you have to put your best foot forward.
What to wear?
The conservative black or dark blue suit is ideal. Females can wear pant suits; however, the
conservative two-piece skirt/jacket combination is favored. Males should not wear distracting
ties; this is not the forum to exhibit your personality.
What questions to expect?
Every program asks their own special questions and has at least one hard-nosed interviewer. Stay
calm, focused and remember they asked you to interview with them. Be ready to ask questions
about the program. Look over the brochure provided to get information about the program; this
prevents asking questions that have already clearly been answered.
Deciding
Many factors go into choosing the best residency position for you. As mentioned before location,
length of program, family, institutional climate, placement, research and other requirements of
the program are very important and each has to be weighed. I recommend establishing a scoring
system for each and using this calculation to rank your residency programs.
If geographically restricted then it is imperative that you apply to as many programs in the area
as possible. Secondly, it becomes important that you inform each program of your interest to stay
in that area only. Have a PLAN B AREA that is close to your selected city.
Most surgery programs are 5-years, many are not; however, many factors can lengthen the total
time. Make sure there are no hidden pathways or obligatory research paths. Also ask about each
programs commitment to finishing the same number of interns they accept as chief/5th year
residents (Pyramidal program).
Family
Those students with families have more aspects to consider. Area schools and communities have
to investigated and visited before any final decision is made.
Institutional Climate
This topic may be one of the most important areas to consider. Speak with the residents at every
level and ascertain how they honestly feel about their fellow residents, the program, the
Chairman and the Program Director. Is the program stable? Are they expecting a change in the
Chairman, Vice-Chairman or Program Director position?

What is the program known for?

Have they matched any residents in the area you want to specialize in?
Research and Other Requirements
Research can be a very sensitive topic. Again, I suggest that you speak to multiple people before
making any decisions. Research is important if you are pursuing the tougher fellowships (i.e.,
Oncology, Transplant, Vascular, Cardiothoracic) and academic surgery. However, research may
not be as important for fellowships such as Plastics, and Critical Care. I can not overestimate the
importance of doing well on the ABSITE, mastering your surgical skill and being well thought of
by both your peers and your professors. Though research lengthens the total time in residency, it
allows for a break from the grind of residency. The research lifestyle is not as stressful and most
residents moonlight at area hospitals. Research areas have recently been expanded to include
pursuits of MBA, MSPH and Ph.D. degrees.

General Residency Questions

Written by Sydney Butts, MD
Question 1 Do you see any problems managing a professional and personal life?
For many of you, this is an issue with which you have grappled for many years, since youve
most likely been a high achiever in high school, college and medical school. But youve also
most likely been involved in some significant extra-curricular activities during many of these
years. I would talk about how youve done this in the past.
Now, direct questions about your plans to get married if you are single, or to have children are
personal ones. This question doesnt ask about family directly and you shouldnt feel compelled
to volunteer any information here if you dont want to. You could address this question by
saying that while the timing of when and how your family takes shape is very personal, having a
supportive family/support system is can be essential in attaining ones professional goals. You
could then go on to recount how a family member helped with a challenging academic problem
youve faced in the past. Or, you could give an example of how values you learned at home or in
a personal situation were translated into an experience at school or a job. (For example, how
your Moms organization of the household helped you to become an organized student). You
might also state how a parents professional accomplishments were inspirational to you (even if
they are not in medicine). For example, my fathers integrity in medicine made it an attractive
career choice for me. As a child, I derived immense pride from the fact that my parents had jobs
that they took pride in.
I would conclude by saying something like I see it more as a challenge because to do it
successfully while having a career youre proud of, takes ingenuity. You must utilize many
resources but ultimately a balanced life (family, a hobby youre passionate about, travel, friends)
makes you a more well-rounded doctor.

Question 2 Are you prepared for the rigors of residency?

I think this question is really asking: Do you know what the rigors of residency are? I would start
by saying (and if you havent done this already, you should) "I've talked to residents during
medical school about this issue" ( by saying this to start, you show the questioner that youve
thought about and have taken the initiative to find out about resident life). I think you want to
address the physical rigors and the emotional/ethical ones. I would stress that you see it as a
challenge more than a burden. In terms of physical rigors, I would respond by saying something
like I see that residency will force me to push myself in ways I never have before and thats
exciting. However it will be up to you as a resident to appreciate when things are becoming
overwhelming and seek out help during these times i.e. from colleagues, superiors, nursing staff,
etc. By doing this you are acknowledging that residency training is hard and that you cant do it
all alone. So one way to deal with the rigors of residency is to get help from others.
It is important to have professional mentors and emotional support throughout residency. You
will interact with people and form incredible relationships with your patients. Sometimes you
will need to vent. Sometimes you will need guidance about how to deal with a difficult patient or
their difficult family. So another way to deal with the emotional rigors of residency are to
identify people early on at work and at home that you talk to about some of these issues.
Question 3 Where do you see yourself in 5 years?
Have you thought about what interests you within the specialty to which you are applying? (for
example, if you are applying in internal medicine do you think you like cardiology?)
The question is asking whether you have thought about whether you will practice in an academic
or private practice setting. Of course, particularly these days, there are many options open to a
person with an MD degree. Many physicians go into hospital administration, industry (i.e.,
pharmaceutical research and development) medical policy, healthcare consulting, or journalism.
Within academic medicine, you may do mainly clinical work although many in academics
combine clinical work and research. Some physicians in academics focus primarily on clinical or
basic science research. You can focus on these areas during your answer also.
Keep in mind, many residencies have a stake in training people that they think will ultimately go
into academics because of their potential to pursue research and publish, develop new medical
technology, etc. People in academics also like to teach/train residents and medical students.
These are features of academics that appeal to many and you might want to highlight some of
these in your answer. The appeals of private practice often center around the degree of autonomy
and the ability to concentrate specifically on clinical work without having to split ones interests
between research and a clinical practice.
You may also want to describe the type of setting in which you see yourself practicing. You may
have an interest in serving a rural community or working in an urban setting.
Question 4 What questions do you have?
This is not a time to ask about vacation time or the quality of the on-call room. Any of these
issues can be asked of residents. Please be aware that questions you ask of the residents do not

fall on deaf ears. These are not your buddies and you should maintain a level of formality with
them also. If you say something inappropriate, the interview committee will hear about it.
Consider these questions:
1. How are residents evaluated by the program on a regular basis?
2. How do residents voice their opinions about aspects of the residency (i.e., do residents
evaluate their rotations and does this translate into changes)?
3. In which area do you think the residency is strongest/weakest?
4. If you are going into a specialty where you frequently work with other
specialties/ancillary services you might want to ask what type of relationship exists
among these groups. For example, people in ENT often work with plastic surgeons,
neurosurgeons, oral surgeons/dentists, even doing many operative cases jointly. If these
specialties don't work well together, it can have a significant impact on your training.