Many residency programs look similar, because all are subject to the same regulations of the accrediting bodies, and many excellent medical educators are located throughout the United States. Aspects to consider are the diversity of patient-care experiences you will have, the degree of autonomy you will have in overseeing patient care as you grow in your competence, whether the residents are treated with respect and whether the program is responsive to residents’ needs and listens to their ideas for improvements. Programs with multiple, linked venues like VA hospitals, public hospitals and referral hospitals naturally provide such an experience. Some referral hospitals provide both the tertiary-care environment and care for the indigent, so it is important to learn exactly which patient populations are served. You should seek a training program that will challenge your knowledge and skills, thereby providing you the opportunity to optimize your residency years and grow into a well-prepared physician regardless of whether you plan to go directly into practice or seek subspecialty training.
If you’re wondering the difference between university-based versus community-based training programs (IU School of Medicine residencies are the former), consider whether there are opportunities to be involved in teaching of medical students. If you are interested in a fellowship, determine if there are fellows in the program to help you understand their role. It’s often helpful to contact IU School of Medicine students currently in community programs to understand their experiences thus far.
How well you prepare your application reflects your ability to manage tasks and articulate your goals. Poorly prepared, incomplete and late applications don’t send the best signals about your readiness for a program. Seek letters of recommendation from your faculty early in the process and ask them to submit a strong letter of recommendation by the due date.
Explain any gaps in your training in your personal statement to show transparency. Some students are inclined to avoid awkward issues such as not getting into medical school on their first attempt, but an honest story about adversity and persistence can be beneficial. Along those lines, a little humility can go a long way even though you are trying to market yourself to prospective programs. At this stage in your training, it’s perfectly okay to feel uncertain of your eventual career goals and, in fact, demonstrating an open mind to a variety of careers is often something program directors find appealing.
It’s difficult (and expensive) to interview at more than 10 places in a month. Attempt to narrow your choices before beginning interviews.
Ask a faculty member if they can write you a strong letter of recommendation. If the answer is no, then move on to another person. Clerkship rotations provide an optimal time to get letters of recommendation. When you finish working with a faculty, ask if he/she would be able to write you a strong letter of recommendation. Each year, faculty members expect requests for letters of recommendation; it’s part of the job as an academic clinician. Other sources for recommendation include faculty with whom you have completed a project or spent significant time, e.g., your ICM2 preceptor.
In general, there are three types of letters: general, Medical Student Performance Evaluation, and Chairman Letter.
General Letters of Reference: Most residency programs will ask for letters of references from faculty members with whom you have worked directly. Typically, you identify these faculty members and ask them if they can write you a strong letter of support. Most students waive the right to review these letters of reference, as available under the 1974 Family Educational Rights and Privacy Act, but that is entirely your choice. A letter of reference is often considered to carry much more weight if the subject of the reference does not know its contents. You will want to ask for these letters early in the process, ideally while the faculty member’s experience with you is fresh. The number of letters required from residency programs varies by institution. To find more information of the particular institutional visit the AMA Residency and Fellowship Database.
Medical Student Performance Evaluation (MSPE): These letters are also known as Dean’s Letters and are written by the lead advisor assigned to you by the school. The letters follow a template agreed upon by medical schools accredited by the Liaison Committee on Medical Education. You will have an opportunity to contribute to certain portions of this letter and view it prior to its entry into ERAS. The school will contact you and initiate the process with you and your lead advisor.
Chairman’s Letter: Some residency programs request a letter of reference from the department Chair. See above “How to get letters of recommendation?”
Schedule a lighter rotation or even a vacation during the interviews. IU School of Medicine generally interviews candidates from the beginning of November to the end of January, which is fairly standard across schools. Doing this will consolidate interviews and lower travel expenses.
In addition to using some vacation time for interviews, consider taking some time off before your residency begins. Residency is a fun and exciting time of your life, but it will also be a busy time.