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I had spent roughly three and a half years looking forward to opening that letter on match day. Going through interviews during the fall and winter of my fourth year, I constantly found myself thinking, “Is this the place where I will end up?” Matching in to a residency is one of the biggest events of your life – not only are you making a choice that will significantly impact your career, you are also making a decision that will impact the next 3-7 years of your personal life. No pressure, right?

When I opened my letter, my first thought was, “…sh*t.” I had just matched at my second choice and one of the best programs for obstetrics and gynecology, yet I couldn’t have been more dissatisfied with my match. It was at that moment that I realized that I had made my rank list for all of the wrong reasons.

Fortunately, there is a happy ending to my story. A year later, after having went back in to the match for internal medicine, I was opening a new letter—one that I was much happier to see. So what did I learn in the twelve months leading up to my second match? How can I help you avoid a similar situation? 

1. Pick a place—not a name.

What do I mean by this? When going through interviews and creating your rank list, it is easy to get caught up in the names of the programs. Places like Johns Hopkins, Brigham & Women’s, and the Mayo Clinic seem very appealing and are great places to do your training, but they aren’t right for everyone. So while the name might seem great on paper, ask yourself if the culture of the program is a good fit for you. I certainly did not do this during my first time in the match. Selecting my top 5 programs was an exercise in “what looks better on paper.” Not once did I stop to think about how my laid back and humorous personality would fit in a rigid and controlling environment like where I ultimately ended up.

2. People matter.

As you make your rank list, ask yourself things like:

  • What were the residents like?
  • Did I have fun interacting with these people?
  • Can I see myself working with these people for the next few years?
Residency is tough, and with an 80-hour work week (or more), you will likely be spending more time around these people than anyone else. So how you fit in matters. The easier it was to make conversation with the residents at the pre-interview dinner or while on a tour of the hospital, the higher the likelihood of it being a good fit.

3. Location, location, location.

For many people, where you live is a very important part of life. When making a decision on your rank list, you should really consider if you can actually see yourself living in a certain location. If you find yourself saying something like, “I’d rather not match than have to live in ______”, then you probably shouldn’t be ranking that program.

Ask yourself if you are comfortable moving to a new city where you don’t know anyone else. And a question that's easy to overlook: How important is being close to your family?

Also, try to consider things like cost of living and the quality of life associated with each city. While some people are okay with living on a resident’s salary in New York City, others might prefer living in a more cost-efficient city where their $45,000—$52,000 yearly salary goes a longer way.

4. Think about your future goals.

At the end of your residency, you will have the opportunity to become a board certified physician in that specialty regardless of what program you were assigned through the match. However, many people desire to go beyond this and hope to pursue fellowship training. If this is your goal, make your rank list with this as part of your consideration. For instance, it is well known that applicants for Gyn Oncology who completed residency at a program with a Gyn Oncology fellowship tend to match at a higher percentage than applicants coming from a residency without an affiliated fellowship. Make sure the program you're choosing will be able to help you achieve your future career goals.

5. Curriculum matters.

Again, make sure that the structure of the program matches your goals for training, research and the quality of life you desire. This is your training; make sure you are going to be happy with the quality of it.

6. If applicable, ask your significant other.

Try to remember that you are not the only person who this decision impacts. Make sure your significant other is happy with your decision and is on board with your choices. At the end of the day, your ultimate match will have a very significant impact on their personal and professional life. As I’ve learned during my year and a half of marriage—happy wife, happy life!

So there you have it. Try to keep these things in mind as you make your rank list in the coming months and make sure that you end up at a program that is a great fit for you. March 18th is right around the corner!

Residency Advisement with MST
Dr. Christopher Carrubba

Dr. Christopher Carrubba

USMLE Tutor & Senior Contributing Editor
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