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The Greatest

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Leading up to and all throughout interview season, I often get questions asking:

How do I figure out what the “best” residency program is? Is there a ranking or a website or some other reference?

These questions are natural. Throughout all of your prior education, there have been lists upon lists and rankings upon rankings. What are the top college? Is my high school an 4 star school? What the best preschools? As high achievers, we seem to have an obsession with finding and acquiring the best opportunity. However, residency is different than any other learning experience you have had so far.

In my opinion, there is no such thing absolute “the best residency program”. In part this is because most programs are functionally the same at baseline. The ACGME requires this. In addition, in residency, you mainly get out of it what you put into it.

More importantly, while all along the line of education, you get out of it what you put into it, more so than any other time in your training, residency is mostly about the effort you can put into it. If you go to a “great” residency but put in no effort, you will be a crummy doctor and people will quickly figure that out. If you go to an “average” residency but put a lot of work in and dedicate yourself, you will still be great.

The differences between residency programs come in the extras. Are the people there people you get along with? And not just the residents, but the faculty and the nurses and the office staff? Do you feel comfortable there? Some people thrive in an environment that is competitive and aggressive. Others thrive in a more collaborative situation. Does a program have access to research you are interested in? Do they have the global health or advocacy or specialty you want?

And while I would not recommend deciding on a residency program primarily based on these things, there are certainly outside of the hospital considerations: Is the city fun? Does it have the sports that you like to play or watch? Is the cultural scene what you are interested in in terms of symphony or dance or opera? Does you family live close enough for you? Far enough away for you? Back in the day when I made my rank list, I knew what my top 2 choices were and what my bottom choice was. I had no idea how to separate the middle group. Everything else was essentially the same. I ended up deciding based on which ones offered free parking and which ones did not. It wasn’t the most important deciding factor, but if everything else was equal, paying for parking was a big deal for me.

free-parking

These things only you know. And if you pay attention to and tend to the things that are important to you, you will be happier in the long run and perform better in residency and beyond. Besides there is no real strategy to making a rank list. You put your favorite program at the top, your least favorite at the bottom. All the others in between. If a place is so terrible, you would rather be unmatched than go there, don’t rank it.

If you are having trouble deciding what program to rank where, you should ask people you trust to help out. You certainly don’t have to have a faculty member or a mentor look over your list, but certainly if you are truly struggling with your decision or are unsure talking with someone is a good idea. Make sure it is someone who knows you well, and is someone you feel confident will help you work through what you value and why and how that affects their rank list. If you think that person is one of your mentors, then you should do that. It is reasonable to be cautious about sharing your rank list with faculty members that are also decision-makers within the residency program. Invariably these are all reasonable and fair-minded people who want to make sure that you are happy wherever you go fro residency. It shouldn’t affect your place on the rank list here, but a little bit of prudence never hurts. In the end, there is only one person looking out for you in this entire process and that is you.

No matter what, when you talk your list over with someone, I would advise you to have specific questions in mind and/or specific objectives to achieve out of the conversation. Otherwise you may lose sight of what is important to you and what residency programs are truly a good fit for you.

Given the title of this post, I would be remiss if I did not make a few gratuitous references to being “The Greatest”. If you like sports and over the top celebrities, I suggest going here. And if you like catchy songs that may or may not have played during the glorious run of the Chicago Cubs to the 2016 World Series, click here.

Remember, rank lists are due by 9pm EST on February 22nd, 2017! The end is in sight!

The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.
Author

Michael McKenna

Dr. McKenna is a graduate of IU School of Medicine, where he also completed a pediatric residency. He served as chief resident and was an Assistant Professor in the Department of Pediatrics and the Associate Program Director for the pediatric residency p...