Preparing for Residency

When it comes to submitting residency applications, cast a wide net

Brendan Murphy , Senior News Writer

Making the Rounds

Meet Your Match | A realistic approach to applying with Deborah Spitz, MD

Jul 21, 2023

Physician residency applicants have options. Depending on the physician specialty being pursued there might be several hundred programs to which a future physician can submit an application. 

Narrowing those options takes time and research. Doing so effectively also takes an awareness of where you stand as an applicant and your own career goals. 

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Deborah Spitz, MD, directs residency training in the Department of Psychiatry and Behavioral Neuroscience at University of Chicago Medicine. During a recent episode of the “AMA Making the Rounds” podcast series called “Meet Your Match,” Dr. Spitz spoke to what a targeted, realistic approach in picking the programs one applies to looks like and how it can be done effectively.

Here are some of the key takeaways.

In recent years, several specialties—including psychiatry, Dr. Spitz pointed out—have moved toward a more holistic approach to evaluating residency candidates. That means less emphasis on board scores and the number of honors a candidate has earned and more focus on attributes such as leadership and service orientation.

The changes in how candidates are viewed, combined with the move away from numerical scoring to pass-fail grading on Step 1 of the United States Medical Licensing Examination, might make it hard for residency applicants to get an understanding of how their qualifications measure up. With there being no set equation, it helps to ask people in the know about the strength of your qualifications, particularly physicians in the specialty to which you plan to apply.

“It is important to find out from your mentors not only how competitive you are, but what are the highly competitive programs? What are the middle programs? And what are the … less competitive programs, so that you can apply across the range of programs,” Dr. Spitz said.

“Another good source of information is the students who graduated a year ago. So, in your medical school, is there somebody who went into the field that you want to go into? Talk to them, find out where they applied, find out what they thought about the programs, find out whether they liked them.”

As applicants embark on the residency-selection process, no online resource contains as much information as FREIDA™, the AMA Residency and Fellowship Database®, which includes more than 13,000 Accreditation Council for Graduate Medical Education-accredited residency programs, and offers a streamlined user experience.

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Even if you are considered a top-tier applicant, applying to programs across the spectrum of competitiveness is a prudent approach.

Dr. Spitz’s advice was to pick a number of programs—the recommended number will vary by specialty—you are going to apply to based on feedback from your mentors and advisers, then divide your applications.

“Apply to one-third of them that might be challenging for you to get in, apply to one-third that are quite realistic based on what you know, and apply to one-third that are easy. That gives you a cushion,” she said.

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Regardless of where you stand on the spectrum of competitiveness, the name brand isn’t always the right fit. Dr. Spitz recommended considering fit over other criteria when determining which programs one applies to.

“Some very highly prestigious, highly competitive programs are not very comfortable places to be,” Dr. Spitz said. “You're going to spend several years of your life in a program. So, when people interview, they really need to pay attention to the residents they speak with and what those residents say. Does it feel good to be in this program? Do they feel that they're getting the attention that they need? Do they feel that they're getting teaching? Do they feel that the teachers care about them? Those are all things that matter—whatever field you go into.”