Section A
Introduction
Decision Algorithm
Studies have shown that choosing a residency program is the most stressful aspect of medical training. The algorithm below may provide some structure to making the decision. Additionally, this algorithm highlights the importance of gathering information so that you can make an educated decision rather than on impulse or word of mouth.
Furthermore, through usage of this algorithm, you may realize truths about career decision making. For instances you may see that there is a crossover of responsibilities in a set of specialties (e.g.. Emergency Medicine, Family Medicine plus Emergency and a internist who consults to the Emergency Room), each specialty has diversity in responsibilities, and there is variability in many career options; variability in day to day duties need not depend on your field of choice.
You must be completely honest with yourself about your potential abilities, strengths, weaknesses, goals, and what you want and need in life. Also remember the variables mentioned in the Introduction section for determining what factors are most important to you.
By identifying your strengths and weaknesses you will be able to make some tentative specialty choices.
Read about these specialties, including the information included in the Program Profiles and Career Profiles. Talk to specialists. By matching your strengths, weaknesses, and interests, you will likely find that you can eliminate some specialties easily and put a few on the top of your list for further consideration. Begin by shadowing or observing physicians in fields that you think you may be interested. This will allow you gain a realistic appreciation of what the specialty offers. Many medical students find that their perception of a field actually differs from the real duties and routine of physician in that field. It is important to fully understand the fields you may be interested in.
Now that you have tentatively narrowed down your search, you must get further information on the programs.
Talk to residents, clerks, friends, mentors. Attend career nights. Do mini-electives/observerships in these areas. Get a feel for all aspects of the life this specialty has to offer. At this point you are not trying to secure a position, but simply trying to make up your mind.
Gather as much information and experience as possible.
The following questions to ask your preceptor may serve as leading points of discussion to further your understanding of the specialty:
1. Why did you choose your specialty?
2. What are the top 3 things about your job?
3. What are 3 things you dislike about your job?
4. What else where you considering and why did you choose your specialty?
5. Do you have any regrets? What would you choose now?
6. How does your job affect your lifestyle?
7. Can you tell me about the job market?
8. How is the residency?
Now that you have decided on your top specialty(ies), it is your job to do what is necessary to secure your desired position.
Find out what these programs require. Build yourself and your resume so that you are competitive. You might need to do research, take on a sport, do extracurricular activities, become more social, or work on your clinical and/or research skills.
Consider doing electives in the specialty, particularly in the location you want to match to. Also, if you have an idea of which program and/or school you would like to attend for residency, try to “fit” your electives and extracurriculars to your choices. You want your activities to demonstrate your interest in that city and the specialty. Also consider the relative importance of the factors listed in Section A, Introduction in regards to which school and city are your best “fit”. For example, if someone was interested in community-based practice they may want to consider a less research focused school.
By now you have made a quality decision, have chosen a specialty and one or more backups that suit you, and have begun to act in a way to secure it. You have chosen these specialties because they match most closely to what will make you (not your parents, friends, etc.) most happy.
Keep up the hard work. Stay the course.
The time comes to submit your application.
You have made a big decision and it is understandable at this stage to feel stress and anxiety due to the uncertainty of your future.
Try to stay confident knowing that you have done your best. At the end of the day, it’s likely that you will get one of your top three choices.
(Refer to The Application Process for a more detailed explanation of this step of the process.)