Making my rank list order has been one of the most tedious tasks of my life.  One second I feel like Program A is the best fit for me and before you know it Program B has made its case to be at the top.  A few minutes later I’m considering Program C and then the process repeats itself.
Is there any surefire way to pick the best program? I don’t know, only time will tell but there are a few questions that I’ve found to be important to me.  It’s definitely worth being confident in your top 3 choices…American graduates succeed in placing 90% of their students there while Caribbean schools place over half. So without further ado, here’s whats going through my mind.

Will I learn how to be a competent physician at this program?

This is, for me, the most important question. I’ve already dedicated 4 years of my life and countless hours to get this far. And more than that, I made a commitment to become the best physician I could possibly be. Succeeding in that endeavor means spending my time at a program that sees me as more than another cog in the wheel. It’s easy to tell which programs are resident-centric. They have more teaching time, the residents are enthusiastic about the voice they have in changing the direction of the program, there are poster boards from local and national competitions on the walls and the attendings are approachable.

What kind of opportunities will going here grant me?

Eventually residency finishes and you want to be ready to face the world as an independent practitioner. When I hand my resume to a prospective employer and they see the name of my program what will they think? Will they be impressed, neutral, or perhaps critical?

On the interview trail I’ve always asked what the graduating class was doing. Some talked about their offers, others were enthusiastically telling me about their hard-earned fellowship positions and others laughed and told me that when the time came I’d be more than OK. I’m going to be in their shoes sooner than I think and I want those shoes to be moving in a positive direction.

There are other opportunities that came up during the trail. These involved research (some programs emphasize it more than others), going to conventions, global expedition trips, and more! Having the resources to create these opportunities is impressive and makes me think twice about the program showing them off.

Are the people here like me? Will I fit in?

Every program I’ve visited had a unique culture in which it’s residents fit into. Some were made up of 20-something year old singles who were excited to get together for a night on the town on a day off. Others were more family oriented and the rest struck some chord in between. All I want is to be in a place where its OK to be myself.  More than that I want to be in a place where I feel welcomed. I’ll never forget the program I visited that dedicated a 2nd year resident as our host for the day. Many would find that a boring role but he was absolutely thrilled! He showed us pictures of the holiday parties (in which he was dressed up in a hilarious outfit) and he introduced us to the ancillary staff who were excited to meet potential new residents. You could tell that the environment was connected and that everyone looked out for one another. That’s the kind of place I want to spend the next couple years in.

What will it be like living here?

Residency is already long. All my friends currently in the trenches are encouraging me to enjoy my time while I have it [and not waste it writing]. I bet its even longer when there’s nothing to do when you’re off work and no one to spend time with! Cost of living is something that comes up in my mind too. If I’m living further than I’d like, will I be able to save money to visit my loved ones? Will I have the savings to have a gym membership? The occasional nice dinner? HBO? Okay fine, maybe not HBO but at least netflix…[right?]

Does it feel nice to work in the hospital?

This is important to me! I don’t want to work in a place that looks like its being held up with chewed Trident gum. Come on. I’ll be spending 90% of my time there! Sleeping in it, eating there, socializing there, probably crying there too. I want it to be somewhere I’m happy. Admittedly I am someone who’s keen on  his surroundings BUT I’ve heard many people agree with me so I’m putting it on here

Does it seem like people are nice to one another?

I don’t need to feel threatened when making a decision at 3AM when someone’s BP runs too high [call everyone]. I also don’t ever want to dread going into work because I don’t like the people there. Medicine is a lifestyle and I’ve grown so much as a person just getting through medical school and learning how to approach the world differently. I want to enjoy my time in the hospital [well as much as anyone could]. No one should get in the way of that.

Are people excited about what they’re doing here?

I’ll never forget the resident during my 3rd year IM rotation who stared at me as if the light behind his eyes hadn’t been turned on for days when I started talking about the patient down the hall with a rare disease [mesothelioma]. I honestly just felt dumb. Where was the enthusiasm! I know work is draining but it can be interesting too. 

So those are some of the questions running through my mind as that lock in day for rank lists draws nearer and nearer. I hope I make the right choice and also hope I end up somewhere I can grow and learn. Good luck to everyone! We’ve come so far!

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