Deciding Which Residency Programs to Apply To

In this post, I share the resources I used to help me decide which programs to apply to and tips for creating your program list! Keep in mind that this is written in perspective of someone applying to Internal Medicine/Primary Care, though I think you can refashion some of these for your specialty 🙂 Scroll all the way down for those of you interested in IM/PC. I also have a tidbit for those of you applying to competitive specialties!

Resources

• FREIDA
  • Find programs by geographic region, program type, special tracks, ability to take notes on each program
• AAMC Residency Explorer
  • More statistical data like applicant statistics, resident demographics, etc.
  • Explore how you compare to matched applicants of different programs
  • Compare residency programs
• Doximity Residency Navigator
  • See reviews of programs, feeder schools
  • Filter programs by research output, reputation
• Texas Star (accessed through my medical school, see if yours participates)
  • More stats like average Step 1 or 2 scores
  • Can see where you stand compared to other applicants
• National Residency Match Program (NRMP) Reports
  • Charting Outcomes: average Step scores, research experiences, volunteering, etc. for applicants in each specialty
  • Program Director Survey: what program directors in each specialty weigh when interviewing and ranking applicants

Factors to Consider

Location

• Would you like to be near family? East Coast? West Coast?
• Do you want to be near family? Do you want to go somewhere where your partner will have positive job prospects?
• Use FREIDA

Career Goals

• Do you want to pursue primary care or do a fellowship?
• Do you want to apply to programs that offer a Primary Care track?
• What programs have high match rates into the fellowships that you’re interested in?
• Use FREIDA for details about the program and Doximity for specialization/fellowship information

University/Academic or Community

• Do you want to stay in academics where you will have more exposure to subspecialties?
• Do you want to work in a community hospital where you will have more exposure to general medicine and primary care?
• Use FREIDA

Reputation/Prestige

• Important if you want to pursue competitive specialties and fellowships or establish a rigorous academic career.
• Use Doximity

Research Output

• Important if you want to pursue competitive fellowship that needs tons of research experience
• Use Doximity

Info about the Primary Care Track for Internal Medicine Applicants

If you’re like me and know you want to go into primary care and have zero interest in sub-specializing in non-primary care fields (cardiology, endocrinology), I highly recommend applying to primary care tracks that many Internal Medicine residencies offer. Your schedule and curriculum is different, as well as your access to mentors. The primary care sub-specialties include geriatrics, obesity medicine, and addiction medicine, to name the most common ones. Primary Care residents have more access to electives in these fields.

What sets the Primary Care track from the typical categorical track is the ratio of inpatient and outpatient time. Most Internal Medicine residencies by nature are predominantly inpatient, though ACGME requires residents to spend 1/3 of their training in inpatient and 1/3 outpatient. The remaining 1/3 is going to vary. If you’re in the primary care track, that 1/3 is likely going to be ambulatory. If you’re in a traditional categorical track, that 1/3 is mostly inpatient.

Not all primary care tracks are created equal. Some are just mere pathways, new, and less established, while other programs have strong primary care tracks with up to 12-15 spots. With that said, it’s essential to do your research!

Personally, primary care tracks made up the bulk of the programs I applied. I love both inpatient and outpatient medicine and I simply could not choose yet which I want to focus on in the future. Internists nowadays no longer practice the traditional model of rounding in the hospital in the morning and going to clinic in the afternoon. There’s more flexibility to practice both at an academic center, however most internists still end up practicing more of one than the other.

Making Your List

1. Go on FREIDA to make your list based on geographic preferences, tracks, urban/rural setting.
2. Narrow down your list based on Step scores, statistics, and profile.
3. Narrow down your list more based on career goals (primary care or fellowship), university vs. community, reputation/prestige, research output.
4. Narrow down your list further by visiting each program’s website and getting a sense of their mission or fit. If you’re unsure, leave it on the list. If/when you receive an interview, you will likely receive more information about the program and get a better feel of it.

Of course, this process is going to be different for anyone. You probably have a good idea of what kind of program you’re looking for. For example, I knew that I wanted to go to a program that offers strong primary care training, a positive culture towards geriatrics, and a program located on the West Coast. It’s helpful to have something like this going into this. For others who want to specialize, they may want to go to a prestigious program with high research output with no geographical preference. Don’t worry about the details of the program like the curriculum, personality fit, etc., as all of this information will be given to you when you interview.

How Many Programs Should I Apply To?

Unfortunately in the area of COVID and the shift to virtual interviews, there are so many unknowns. The virtual format led to a skyrocketing of applications in all specialties. This means that less competitive applicants will receive less interviews while the most competitive applicants will receive the most.

First let me share some data with you for Internal Medicine.

• Average Number of Applications
  • USG: 37.1 (2020), 38.8 (2021)
  • IMG: 89.9 (2020), 98.9 (2021)
  • US MD Public: 32.7 (2020), 33.7 (2021)
  • US MD Private: 31.2 (2020), 32.5 (2021)
  • DO: 49.8 (2020), 52.8 (2021)

As you can see, the average number of applications for US MD applicants hasn’t increased as significantly as it has for our DO and IMG counterparts. I can’t remember where I read this, but there’s been talk that for USMD applicants, it’s not necessary to apply to more than 40 programs if you are moderately competitive. But if you are paranoid like me you may apply to in the upper range of normal, which is what I did. I applied to 39 programs. In hindsight, I think this was overdoing it because I ended up declining many interviews because of interview burnout. Those interviews would be better going to our IMG and US DO friends.

For My Friends Applying to Competitive or Surgical Specialties

I’m going to share some pointers based on the experiences of my close friends who applied to very competitive or surgical specialties.

• Apply broadly
• High Step scores are not sufficient anymore (research, letters are also important)
• Use your personal statement to your advantage to help you stand out
• Find out how important research is, as this can make you less competitive if you do not have any

Hope this helps!

Kelly

Internal medicine resident physician at UCLA, primary care track. VCU School of Medicine c/o 2022. SoCal born and raised.

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