Choosing where to apply for medical residency is an important decision and should be handled with contemplation and reflection. While you are permitted to apply to as many programs as you would like with your single ERAS application, this can make submission unnecessarily expensive; furthermore, some committees may expect personal statements or secondary essays tailored to why you are applying to their programs. For this reason, it is better to be honest with yourself about where you would like to and realistically can train and tailor your list accordingly.
How to Decide Where to Apply to Residency:
As you evaluate your options for residency, we recommend considering these 3 important questions to make the decision easier:
1. What type of training you need for your professional aspirations?
Evaluating your professional aspirations is closely tied into selecting the list of programs to which you will apply, simply because you want to ensure that the training you receive will prepare you for later career success. For example, if you are interested in caring for underserved populations, it would make sense to identify and apply to residencies that will provide the privilege to care for these patients. Furthermore, if your plan is to apply into a competitive fellowship after you finish residency, some programs may more readily connect you with opportunities and allow you to network with leaders in your chosen field. For these reasons among many others, your career choices should feature prominently in your decision-making about where you will send your application.
Simultaneously, you also want to consider your fit with these programs. This is of course best evaluated during your interview day and interactions with faculty and residents, but it may be possible to learn quite a bit by reviewing the curriculum, resident opportunities, and fellowship match list on program websites.
2. In what region(s) will you be comfortable spending 3-7 years of your life?
Because you will be spending three to seven years of your life in the place where you complete your training, it is perfectly reasonable to consider where geographically you would like to pass this period of your life. If you are from, have family in, or connections to certain regions of the country, it may be worthwhile to explore residencies in these places. Furthermore, while many larger academic programs are centered around large metropolitan cities, others are located in more rural locations. Each of these environments offer different advantages and challenges; it is important to consider what your career aspirations are and identify how that can influence where you may have the best training.
Furthermore, some programs, and particularly those associated with more competitive specialties, will also consider your geographic ties in an attempt to ascertain whether your decision to apply to a program was motivated by genuine interest. For example, if you have lived on the west coast for the majority of your life and have never been to the northeast, it may be difficult to present a compelling case for why you would now decide to transplant to a new region. Data points that residency programs will use to this end include the hometown you list on your application, where you completed your medical education, and the location of your away rotations if you completed any. If you do intend to migrate to an area where you do not have connections, completing away rotations in and near the region can demonstrate that interest.
3. How competitive is your application?
Finally, it is important to be realistic about the competitiveness of your application, even if it is often difficult to accurately predict. The general rule of thumb is that you should apply to a spectrum of programs, some to which you could comfortably match and others which might represent more of a reach. If you create your list with too much of the former, you might have been able to match at a more competitive program where you would have been a better fit, while if your list is heavily weighted towards the latter, you risk not having as many interview invitations and going unmatched.
In evaluating your competitiveness, it is worthwhile to review your list with a trusted mentor who could provide candid advice. Likewise, you should do the same with your loved ones since moving for residency can represent a major life event.
Best of luck with your residency applications! Here are some additional resources to help you through the process: