Assessing Residency Programs

As soon as possible after the interview, record your impressions and update your checklist. When you get home, send a thank you note to recognize their hospitality and to reaffirm your interest in the program. In looking over your notes, you may discover several vital questions you did not ask during the interview. It is perfectly acceptable to call back for more information, particularly if one of your interviewers, frequently a resident, has invited you to contact him or her for more information.

Take plenty of time to rank the programs. You may want to put your notes aside for awhile to give yourself some time to air your thoughts. Talk through your reasoning with advisors, friends, and family but remember that the final decision is yours.

The following is a summary of some factors to consider in examining residency programs. This is by no means a comprehensive list nor is it in order of importance.

Department Chairperson. Important determinants of a training program are the philosophy and interests of the Chairperson of the Department. The Chairperson's ideas regarding education will permeate the entire staff. Find out how stable the Chairperson is in the position: an imminent departure could mean changes in the program during the transition. How much contact does the Chairperson have with house staff? How does the staff relate to him or her? Is the Chairperson willingly helpful in evolving your career plans after residency?

Program. Most good training programs have a well organized teaching approach. The rotations are varied with some experience in sub-specialties. The first year trainees in these programs assume a great deal of responsibility for the care of the patient. You should look at the diversity of problems encountered and the degree of responsibility accorded the house staff. How many procedures are residents performing in surgical specialties? Most programs make arrangements for their trainees to attend teaching conferences.

Fellow Residents. The quality of the resident staff and the variety of their backgrounds play an important part in your education. The commitment, esprit, and competence of the residents reflect the quality of the training program.

Residents and Fellows. What is the quality of the entire residency program? Do first year trainees stay on? Are clinical and research fellowships available and are they good? Talk to the residents! Call Vanderbilt graduates who are in programs for up to date impressions.

Students. Most good training programs include students on the ward team. How committed are the residents to teaching these students? What is the quality of the students?

Attending Clinical Staff. The quality of the attending staff and their interest, productivity and commitment to teaching is a good measure of the training program.

Graduates. The quality of a training program may be reflected in the success of its graduates. Looking at what the graduates of the past five or ten years are doing can determine potential career opportunities in teaching, research or clinical practice.

Research. What is the quantity and quality of research? Is research basic, clinical, or both? How much teaching is done by investigators? Are research opportunities available to clinical house staff?

Educational Environment. Review a weekly schedule of rounds, conferences and teaching sessions. Determine their variety and quality. What is the quality of the Departments of Radiology and Pathology and the clinical laboratories? What is the breadth and depth of specialty consultative services?

Hospital Administration. The hospital reflects the quality of its administration. Administrative concern for the needs of patients is expressed in the facilities available: clinics, emergency room, and waiting rooms. Progressive approaches to the care of drug addicts, alcoholics, and the mentally ill are other indicators of social involvement. The physical plant, food, quarters, salary, and other facilities are important but not necessarily of primary significance.

Nurses and Other Health Professionals. The quantity, quality, and morale of the nursing staff and other health professionals can determine to a large extent your ability to deliver good care to your patients.

The City. Obviously, the living conditions, expense, and availability of cultural and recreational facilities are factors in your decision. It has been said that this often underrated category is really the most important!

Personal. In approaching program selection, carefully consider what you want in your postgraduate training. For example, how important is it to you to have an academic setting, research oriented teaching, private practice oriented teaching, independent responsibility, a nice physical environment, a light workload. Hospitals will meet such criteria in varying degrees. Consider each hospital in terms of what it can do to meet your needs and, of course, what you can do to help meet its needs.

Remember: Whether you devise a point system or go by "gut feeling" to create your rank list, it should be based solely on the desirability of the program and not on your expectation that you will match at that hospital. There is no benefit in listing a program on any basis other than desirability!