It’s August and that means a) the summer is passing by way too quickly and b) it’s getting to that time of residency program applications again! For my friends out there who are in medicine, I know what you’re going through, and I’ve put together a bunch of #PathtoMD posts to help you out along the way, from how to pick your interview outfit to rocking your residency interviews. But before you get too deep in the interview process, first things first: you have to choose which residency programs you want to apply to. It can be hard to figure out which programs to apply to, which is why I wanted to write a post about some of the factors that came into play when I was deciding between programs to apply to and to rank.

Location, Location, Location

When I talk to my colleagues about their experiences choosing between residency programs, many expressed that location of the program was one of their top deciding factors. This was particularly true for my colleagues who are married, have children, or have other familial obligations or ties to a certain area. Let’s be completely frank here, when you’re looking at residency programs in a similar tier, the training you will get at each one is more or less equally strong. The little differences between each residency program, as mentioned in the rest of this post, can sway you one way or another, but if the training is equivalent, location can make a big difference and sometimes be the ultimate deciding factor.

Mentorship

I think the further I got in my career, the more I grew to fully appreciated the importance of a good mentor, someone who will take you under his or her wing and be your role model in your professional life. I touched on this topic before in my post about how to match into dermatology (or other competitive specialties), but I can’t stress this enough. A mentor can inspire you to go into a certain specialty, explore a certain area of research, decide to subspecialize, set up your practice a certain way, and more. If you have a certain faculty members that you really admire at a certain program, whether it is their research area or their career path, consider exploring those relationships further in residency.

Research

Some individuals know that they want to devote their lives to academic medicine and scientific or clinical research. Others want to be able to do research to explore and/or get into a competitive subspecialty. Whatever your reason, if a certain medical center is particularly strong in your research interest, that is a good reason to take a closer look at that residency program. The Doximity residency navigator compiled top ten programs in each field filtered by research output, so if that is something that interests you, take a look here (scroll to the bottom for ranking by research output). To find a research advisor in your particular field, pay attention to the authors and the institutions putting out major landmark trials and publications in your area of interest. This will also be something you can talk about at interviews.

Track Record

Medicine as a whole is becoming more and more subspecialized, so the track record of alumni from different programs after graduating is another thing to consider. For example, if you are applying in dermatology and know that you want to be a Mohs surgeon right off the bat, you want to try to train at a program with a strong Mohs department, a Mohs surgeon who can mentor you, and with a good history of sending past trainees onto Mohs fellowships. If no one from that program has ever gone into the subspecialty you are considering, your path may be a bit harder (though definitely not impossible).

Subspecialties

This goes along with the track record point above. If you know you want to end up in cardiology, it would help to go to an internal medicine program with a strong cardiology department. During residency you can get to know the cardiologists, do research with them, and improve your chances of staying on for further training. Even if you don’t want to stay at that institution for fellowship, working with respected physicians in their subspecialties can only help you when it comes to applications, because they can help you write letters of recommendation, vouch for you, etc.

Extras

I used this as a catch all for the miscellaneous factors left. There are a lot of things that go into this category, such as work-life balance, happiness of the residents you meet, elective time and opportunities, global health opportunities, salaries (because that changes depending on what region of the US your program is in!), culture and fit of the program, etc. There’s also a lot of personal preferences, which only you will know.

Reputation

I put this one last because I think reputation is very subjective. I included reputation as one of the fields because if someone has no idea which are the highly regarded programs in a field, this is one place to start looking. I remember when I switched into applying for dermatology (you can read the brutally honest saga here), I didn’t really know much about which programs were considered to deliver the best training. I remember googling “top derm programs” and coming across Dr. Wu’s article from Cutis published in 2014. Reading through the top NIH funded programs and the top regarded dermatology programs gave me some inkling as to which programs seemed to be research powerhouses and which had a reputation of excellent resident training. Now, just as a demonstration of how subjective rankings are, NYU Dermatology ranked 17th in Dr. Wu’s methodology, whereas it has ranked either 1st or 3rd for the last two years according to Doximity’s residency navigator. Where does NYU Derm actually fall? It doesn’t matter because at the end of the day, I know that NYU delivers excellent clinical training in the field of dermatology and no ranking will change that. So what I’m saying is that the reputation of a residency program according to the Doximity navigator is just one piece of a much larger picture to consider when evaluating different programs.

What factors played into your decision about medical residency programs? Would love to hear!