Advice for 4th Years: Creating Your Best Residency Application

The residency application process is winding down for the current cycle. As this is my second season reviewing applications to my residency program as a resident, I’ve across some insight that I wished I had as a fourth year medical student applying to residency. Being on the other side of the fence, I gained a deeper appreciation for the process and the care my program invested in selecting this year’s applicants. I will share some insight along with examples from current residents at various programs in the country. Here are five tips for 2017-2018 cycle applicants and beyond.
1. Absolutely write a unique personal statement to your top programs
Ideally, you should write one for each program to which you apply. However, since many students apply to anywhere from 30 to 150 programs, writing one for each program obviously isn’t feasible. My advice is to pick your top 5 or 10 programs, places for which you’ve done extensive research and have a very good idea of where you will fit in with the team. Write unique personal statements for these programs, integrating the program’s mission statement and unique strengths into your statement. Really dig into how what you’re already doing will fit in with the program’s goals and culture. Elaborate how you’ll add value to the program and embody the values for which the programs stands. One application that I’ve read gave one or two very brief examples illustrating how the applicant has already adopted the principles our program tries to cultivate in its residents. Such examples can really lend support to why you’d be a good candidate for the program; after all, the process is called the “match” for a reason.
After reviewing applications and speaking with candidates, I realized that this is one of the more under-utilized approaches to communicating your value to residency programs. Yet the personal statement is practically the only method you have to communicate that value to the interviewing and selections committee outside of an interview or outside of completing a rotation with the program in question (more tips regarding that below). My assumption is that ERAS (the application service you’ll be using) recognizes this and was programmed to allow an infinite number of personal statements for this purpose. Despite this, my personal experience has shown that perhaps less than 10% of students write a unique personal statement to even one single program. I admit that as a student I didn’t write unique personal statements to the programs to which I applied. Perhaps I would have had more interviews or been offered interviews earlier in the cycle and not persistently bite my nails until December or early January.
A current resident at a nearby Internal Medicine program did write unique personal statements when he was applying. His advice is to start in March and complete one every 2-3 weeks. This way, you’ll give yourself ample to conduct research on the program and reach out to people at your school or the program for more information. Write several drafts and have people give you feedback on your drafts. By the time the application service opens, you will been done with unique personal statements for at least your top 5 programs and can submit a general personal statement to the rest of the programs on your list.
2. Rotate at your desired residency site
Okay, this one is a little bit of a no brainer. Even so, I’ve supervised students who rotate with our program only to forget why they’re here to begin with. Since this article is written with current and future third year medical students in mind, it’s important to consider your performance on fourth year rotations as part of your application. Functionally, they are an extended interview with programs that may consider you. Most interviews are so short that they’re no better than speed dating (in terms of getting to know someone). Rotating with the program is the best way to get to know everyone with whom you may be working in the not-so-distant future.
Here are some of the worst things I’ve seen prospective candidates do while rotating with our program.
1.  Complaining about the work load, most often out loud for some reason. It’s easy to be caught in this since medicine is not an easy job or field to study, and you’re just blowing off steam. We get it, but it can cast you in a bad light. After all, if you’re complaining about the workload for one or two months, how can you do the job for 3-7 years? Try to put a smile on for the month and find the balance you’ll need during residency now while on rotations. You’re going to be ahead of the pack.
2. Complaining about the people, often within earshot of others working in the same program and hospital. Be careful about this one. If you match into the program, you’ll be working with those about whom you complained. This doesn’t work in your favor. As an intern, you’ll need help from almost everyone: nurses, techs, CNAs, and even janitors.
3. Not being humble. As medical students, you may have a fresher memory of details about processes that we’ve all forgotten once we left medical school. In which case, know the best time to bring out that knowledge to make yourself stand out. Never lecture the attendings or your seniors. What’s worse, I’ve seen students question their attendings in front of patients and their families while on rounds. If you see the opportunity to correct someone, do it respectfully. Most residency programs are looking for people they can teach and want to be taught, not people who know everything or act like they do.
3. Reach out to your top programs if you can’t set up a rotation
Sometimes, you won’t be able to rotate with your top programs. Whether the rotation is too competitive or the medical center can’t accommodate visiting students, you should still find ways to reach out to your desired programs. You could email each program and ask if there are other ways to gain experience with them. Molly, a current first year Emergency Medicine resident spent her weekends as a fourth year student volunteering at the hospital where her top program is located after she couldn’t get a rotation. “I asked to volunteer in the ER and since I told them I was a fourth year student, they were happy to take me. They knew that I could help with a lot since I was a senior in medical school. I met all the current residents and the attendings as well. When I was offered the interview, they already knew how dedicated I was to the program.”
Similar advice was given to me by Edward, a second year PM&R resident. He contacted multiple program attendings in his area and asked if he could shadow them in their clinics during his free time. Quite a few were happy to have him since he wasn’t asking for a longer term commitment. “Just shadowing a day or two here or there in the month made such an impact. I was interviewed at all the programs whose attendings I shadowed and got my top pick in the match.”
Programs are very usually impressed when you are proactive and try to create opportunities for yourself. Even if a rotation or shadowing isn’t already set up through your school, you can be the first to set one up.
4. Be honest with yourself
Almost all rotating students that I have supervised are wonderful and ambitious people. As such, you’ll often find yourself compromising your own preferences and standards for a program just so you’re more likely to match. My advice is to not do this. After interviewing several students this year, I began to pick up on certain vibes rather quickly. Although a student may know our mission statement by heart, we do pick up on vibes that he/she may not entirely identify with our program. It doesn’t necessarily count against you, but it’s much worse for you if you end up at a program you don’t like or does not have the necessary resources to aid in your development. This career will be something that you’ll do for the next 30+ years and it’s important to be with a program that’ll develop you into the physician you want to be.
5. Enjoy your fourth year
This is the advice you’ll like. Despite all the hustle and bustle that the first half of fourth year can bring, you do have more opportunities to enjoy medical school in your fourth year than any other time. Definitely do all you can the first half of your senior year, from excelling during critical rotations to reaching out to your dream programs. However sometime after late January, give yourself some “me” time. I remember asking the interns and residents as an interviewing student what I should study and read to prepare for residency. Like many students, I felt nervous about my newly earned responsibility to patients and therefore wanted to make sure I could put my best foot forward. Their advice to me is the same advice I will offer to you: relax, reconnect with family and travel to places that makes you happy or have not explored. You will have plenty of support during your intern year to learn all you need to learn. Take up your old hobbies and see if you can find something you’d like to continue doing during your time off from residency responsibilities. You do want some disconnect from the medical environment before you become entrenched in it for 3-7 years, or even more if you’re one of the brave souls going into surgical fellowships.
I hope the above advice has been useful for you. If you know these pieces of advice and are already planning to implement them, then you’re way ahead of the pack. I wish the current applicants good fortune on their match and hope the same for future matches.

AJ Brown is a third-year Internal Medicine resident physician. Once she completes her Internal Medicine residency, she will continue on to her gastroe...