Residency

What factors do applicants weigh most when picking residency programs?

Medicine is a calling, many people feel. You don’t choose it. It chooses you. As far as which programs physicians train in, there’s a bit more choice.

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What factors do medical students consider most—and least—when choosing residency programs? Recent data released by the National Resident Matching Program (NRMP) shed some light on that question.

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Every other year, the NRMP conducts a survey that aims to weigh the factors to which applicants give strongest consideration when applying to and ranking programs. Of those applicants who completed rank-order list, more than 40 percent responded to the 2019 version of the survey.

Survey respondents were asked to list the factors that influenced both application and ranking choices and the relative importance of each of those factors on a scale of 1-5.

Most important factors

The top five factors applicants who were active U.S. allopathic senior medical students considered when applying to programs were as follows:

  • Desired geographic location—cited by 88 percent of applicants across all specialties (mean importance rating of 4.5).

  • Perceived goodness of fit—cited by 84 percent (mean importance rating of 4.7).

  • Reputation of program—cited by 83 percent (mean importance rating of 4.2).

  • Academic medical center program—cited by 68 percent (mean importance rating of 4.4).

  • Quality of residents in program—cited by 67 percent (mean importance rating of 4.5).

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The top five factors listed by applicants who were active U.S. allopathic senior medical students ranking programs were as follows:

  • Overall goodness of fit—cited by 89 percent of applicants across all specialties (mean importance rating of 4.8).

  • Interview day experience—cited by 82 percent (mean importance rating of 4.6).

  • Desired geographic location—cited by 77 percent (mean importance rating of 4.6).

  • Quality of residents in program—cited by 75 percent (mean importance rating of 4.6).

  • Reputation of program—cited by 71 percent (mean importance rating of 4.3).

Least important factors for applying and ranking

The list of factors survey respondents considered was composed of 40 options. Of those options, these were the five least cited factors among active U.S. allopathic senior medical students applying to a program:

  • Opportunity for training in systems-based practice—cited by 13 percent of applicants across all specialties (mean importance rating of 3.7).

  • Alternative duty hours—cited by 8 percent (mean importance rating of 3.5).

  • Schools for my children in the area—cited by 6 percent (mean importance rating of 3.8).

  • Other benefits—cited by 5 percent (mean importance rating of 3.8).

  • Presence of a previous match violation—cited by 4 percent (mean importance rating of 4.1).

The list of least important factors for ranking a program had the same five factors in the same order.

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Ranking strategy and application statistics

A few other interesting nuggets came out of the applicant survey, among them:

  • U.S. seniors most commonly ranked the programs in order of their preference, with 88 percent citing that as a strategy for ranking programs. Seventy-four percent ranked all the programs they were willing to attend and and 68 percent ranked all programs with which they interviewed, regardless of preference.

  • The median number of applications submitted by U.S. seniors who matched was 39. The median number of interviews offered to matched U.S. seniors was 17, with those applicants attending an average of 13 interviews. Matched U.S. seniors ranked an average of 13 programs.

  • The median number of applications submitted by U.S. seniors who did not match was 59. The median number of interviews offered to applicants who did not match was seven with those applicants attending an average of seven interviews and ranking an average of seven programs.