How to Choose a Residency Program

Blog Post Focus – Considerations for Choosing Residency Programs

This blog post is to share thoughts when it comes to choosing residency programs. Like all of medical education it is stressful. I want to share some of my thoughts so hopefully it is a bit less stressful than it was for me.

Big Message First – Take What You Can Get

Choosing a residency program is stressful, but is pretty simple how I look at it.  You should take what you can get, and should only withdraw applying to programs you know you would hate or that you cannot go to.  What do I mean?

Apply to Any Programs You can Tolerate & Ignore How Everyone Apparently Gets Their Top Choices

When applying for residency programs you select each program you want to consider.  Sure, you expect to match and want the BEST program for you.  However, life can be frustrating and the MATCH is a frustrating experience for many people. 

You may hear about everyone say “I matched to my first choice” and “I chose my program because…” but likely they are lying to you.  Most people match, but not everyone.  Even fewer people match to their top choice programs.  All the time people match to programs that were not their top choice and even to programs at which they didn’t want to match.

Rotations and A Direct Exposure to Programs

During rotations you get exposure first-hand at certain programs.  You can get a sense if it is a place you really want to be, could be, or could not stomach.  So long as you could be there and become the physician you want to be you should apply.  If you have serious doubts about that program or know you would suffer there then strike it off.  If you place it at the bottom of your rank list…you may still match their and be miserable.

Being Unmatched is Terrible

That being said going unmatched is terrible – less likely to match the following year into ANY specialty, and much less likely to match into your desired specialty—with all your debt and no certainty of becoming a resident-trained physician. Additionally, there may be a sense of catastrophic failure or of a sense you are no longer a good candidate if one is unmatched. Consider for yourself if you would rather go unmatched than end up at an institution that you know you would be miserable at.

More Residency Applicants than Residency Positions

More Residency Applicants than Residency Positions

The following link to NRMP data for the residency match for NRMP Match 2023 https://www.nrmp.org/match-data-analytics/residency-data-reports/ shows that there were 42,952 certified applicants and only 40,375 total positions. That means that there were 2577 more applicants than positions available.  That is a huge number of applicants who cannot match due to their being too many applicants and too few positions for residency.

Increase Your Chances

Consider applying to as many programs as you can to increase your chances of matching.  If you cannot apply to certain areas because of family or other obligation, don’t sweat—just apply to all programs that would be reasonable for you.  If you know you would be miserable at a program and that would be worse than going unmatched – don’t apply to that program.

One additional thought then, is if you would be okay applying to a less competitive specialty.  If you are set on Specialty X, but think you would be okay with Specialty Y…then prepare applications for those programs too.

Final Thoughts—Do What You Can To Match and Avoid Being Unmatched

Do what you can to match.  Avoid going unmatched as much as possible. There are more applicants for residency positions than available positions so people will go unmatched. Consider applying for any programs other than ones you know you would be worse off matching at than going unmatched.

Resources

Check out the following link to NRMP about making and certifying a rank order list for residency programs https://www.nrmp.org/residency-applicants/.

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