3 Key Features to Look for When Ranking a Residency/Fellowship Program: A Program Director's Advice

This Article is Part of The Road to Residency Series.

One question I get asked every year from my mentees, trainees and medical students especially during the residency and fellowship season has been: “How do I rank programs?” Or “I am confused between these 2-3 programs; can you help me with the rank order list?”.

Today, I’ll cover a step-by-step approach, including some secrets in order to make this process effortless for you.

A little bit about myself. I just completed my gig as a fellowship program director and as a resident selection committee member. Approximately 10 years ago, I was a residency applicant doing the same thing as you are doing today. Five years ago, I was going through the same routine for fellowship with the same questions, that you are contemplating on. Now, being on the other side of the table and interacting with other PDs, faculty and GME leaders, this has helped me identify and isolate many secrets, that I’ll be sharing with you in the coming weeks and months. This is the one of the many in the Road to Residency series.

Obviously, you will have some personal preferences such as the hospital’s proximity to family or home, is it in a large city or not, is there a decent night life, or whatever it may be. The following 3 factors can be utilized as an adjunct to your personal preference to ensure you rank your programs based on their true worth!

Here are the secrets.

1) Look for Mentors in the Prospective Residency Program?

People (with mentoring mindset) at the training program and not JUST its name or location matters in the long run. This is more critical for residency program selection than for fellowship. If you really look around, folks who have been successful will always mention that they had great mentors.

When you interview, even if it is tele-interviewing, try to analyze the people there. You should specifically look for these two things:

a) Are the residents or fellows, including chiefs, personable along with being exceptional professionals? Do they talk about you or just themselves during the interview? Are they volunteering information that will impact your personal and family life when you move there?

b) And second, do the faculty, especially in the area you are interested in, provide mentorship. Don’t hesitate to ask about their previous mentees. For example, I would ask, “Can you share a name or characteristics of one of your trainees who you mentored that you remember and are really proud of?, Or something along these lines: “I’d love to know what faculty like to see in their successful graduates?”. You should be able to google the chair, PD and other folks in leadership roles to see if they have a record of ‘developing’ successful mentees. The last point will connect with this one. So, stay with me here.

2) Figure Out if There are Faculty-Led Clinical Teaching Sessions:

The second one is tricky. Does the program provide content to its trainees? Meaning does the program focus on “what to do?” and do they have a method in place? Meaning “how to do it?”. The way to approach this is, during your interview, ask questions regarding how a typical day for residents goes by. In most programs, didactic will be mentioned. So, you should go deeper and ask deeper questions on didactic and about grand rounds. You ask, how does a typical didactic look like. Now, you will hear about power point talks, journal clubs and what not. However, you are looking to hear about faculty sponsored clinical sessions that happen routinely. Even if its quarterly if not monthly or weekly, you will take it.

Only a few programs have an inbuilt didactic where they either bring a patient to the teaching session and/or the attending faculty is doing a clinical case to share their insights and perspectives. Or there are live surgical procedures being shared while the faculty is doing a commentary for trainees’ learning. Faculty involvement with simultaneous patient inclusion is key. Programs with this type of content are GOLD. It shows that their leadership is not only fulfilling ACGME regulations, but they sincerely think about their trainees. Clinical hands on LEARNING sessions with faculty is what you are seeking. If you find it, give bonus points to this program and consider it highly. Why? Because, this is the most relevant content with academic intentions a program can create for their trainees. I can attest that this is the most challenging to do. I can organize a journal club, a power-talk, some lectures, some M&Ms, but for me to create, develop and persist with a exclusive clinical vignette or exam focused or procedural session on a routine basis…..it requires motivation and vision from the program leadership. Now, you may say that as I become a senior where your fellowship is a highly sophisticated procedural training, like in my case, should I expect spoon-feeding? My answer is, Yes. Your program could sponsor a week for you to be at a fellow’s conference where you will be doing surgical procedures and learning new skills as part of your training. This needs to be embedded in your fellowship program. So, what I am trying to say, ensure there is content and there is an inbuilt structure in place with a road-map to provide academic training to trainees.

3) Know Where the Programs’ Alumni Are:

You ought to see, and if not available, figure out where the trainees have gone in the last 5-10 years. I like my mentees to google PDs, division chiefs of the regional programs and see if the program trainees have been able to hold some of those positions. This not only tells you whether your potential program trains competitive people who may become future leaders, but another important aspect is, does the program hold regional, if not, national influence. You may be surprised, but the first year in practice, you will realize that there is so much more to real life than just training. The program needs to have some reputation built in. If not, it just tells you about the current leadership or lack of. Remember, this program and its reputation will be with you forever, so you need to know where it stands before you commit to it.

Now, this is certainly not a comprehensive list, it surely is a tried and tested recipe for your successful training. Add your personal preferences, such as close to family, be in a large city or not, have a nice night life, etc. The above 3 factors, I have applied and so have my hundreds of mentees. It always works.

For questions and comments, email me at atif@doctorsmovement.com.

Doctorsmovement.com takes no responsibility of the content and its implications.

Atif Zafar, MD is a physician, entrepreneur, and the author of the book "Why Doctors Need To Be Leaders". He can be reached at atif@doctorsmovement.com.

The physician-leadership book is available on Amazon: www.atifzafar.com/book.