Medical

Residency: The Interview and Selection Process

Residency applications! The light at the end of the tunnel, and the process that will chart the course for the next 3+ years of your life and your spouse’s medical career. No big deal, or anything! It is an incredibly exciting time, while also being quite unsettling. Here’s what to expect and how to make it as joyful of a process as possible.
Going into MS4
Prior to the beginning of MS4, your spouse will likely have decided on what specialty they want to pursue, or is considering dual-applying for residency. It’s important that you come together to discuss your spouse’s career goals and how it will shape your family’s future. Are they choosing a specialty with notoriously long hours and time away from family? Will they need to be at a medical center in a large city? Do they want to practice internationally or in a rural setting?
Your spouse may not know the answers to these questions yet, but it is still important to begin the conversation. It will give you both an opportunity to discover and express your preferences and desires in order to start forming an idea of what to expect going forward. How will these career decisions affect you individually, as well as your relationship?
Let the process begin! Applying to programs
The beginning of the residency application process entails researching programs and selecting which ones, and how many, to apply to. The recommendations will vary depending on the specialty, so your spouse may be applying to fewer than ten or more than thirty programs. How will you determine which programs might be a good fit?
Unfortunately, it’s similar to applying for medical school programs: you won’t know too much about the inner-workings of the program unless you have contacts there who can give you an inside look. With little information to go off of, many people choose to apply to programs based on the following criteria:
1. Name or Prestige
2. Location
3. Number of residents in the program
4. Focus of the program (does the program excel at or offer more training in a sub-specialty or particular part of practice?)
5. Benefits (salary, insurance, time off, meal plans, etc)
As you look through the sea of program names and information, you will encounter your first, “What if we don’t choose the right program?” moment. Truth is, there often is no single “right program.” It’s impossible to know how your spouse will like a program before they are going through it. Your best bet is to choose programs based on whatever information you have at the time, what place will be workable for both you and your partner, and your instincts.
In addition to researching programs, your spouse will need to ask for letters of recommendation, and submit the letters along with their Step 1 scores (and possibly Step 2 scores, if they’ve taken it in time) into their application. Your spouse will spend hours perfecting their application and writing essays. This will be reminiscent of all those hours of studying, nose pressed to the computer screen, but it’s definitely not as intense time-wise and there will be an element of fun involved in the process. You’re planning your future!
Once everything is prepared to submit, step back for a day and then have your spouse go back in to double-check that absolutely everything is submitted the way they want. The computer program that is used for the application process is clunky and not very intuitive, and stupid mistakes happen every year that range from something as simple as a student forgetting to assign a document to the programs they are applying to, to an entire residency program failing to submit their rank list in time and not being able to participate in The Match (yes, this really happened!!). The point is, get everything ready early and give yourself time to figure out the process and to double check the work.
Waiting for interviews
The second step is waiting for interview invitations to arrive. Everyone is nervous about hearing back from programs, especially if they have their heart set on a certain one. Try not to freak out about how quickly your spouse’s classmates are getting invitations. Some programs start sending out individual invitations the same day that applications come in, while others may sit on them for weeks.
Some programs send an “e-mail blast” to more applicants than they can interview, and simply fill their slots with the first people to respond to their invitation. The “e-mail blast” is probably the most anxiety-inducing method, as some people have been known to set up special alert sounds on their phones to let them know when a new email has come in, and then drop whatever they are doing to check their email every time a new email arrives. This is not a common way to send out interview invitations, but it has been known to happen.
As you start to receive interview invitations, you will naturally be overjoyed and will want to shout it from the rooftops! Each program comes with the possibility of a new adventure, and you will be excited to talk about everything with your fellow med spouses. However, I caution you to take a moment to assess your med friends’ situations before you start listing off program invitations.
Ask if they’ve heard back from any programs yet and if so, rejoice together, and if not, wait until they ask you and then reply with something to the effect of, “The interviews are trickling in.” Some specialties may wait for a while before notifying applicants, and will hold interviews later than other specialties. Be supportive of your friends that are still waiting to hear, and if you are one that is waiting, fear not! You will get interviews!
Once the invitations come in, your spouse will select dates to interview. Interview season lasts for several months starting in October and going through January. If you have the opportunity to go with your spouse to some interviews, take advantage of it! You may end up staying in the hotel room or wandering the city by yourself while they interview, BUT it will give you a chance to get a feel for the place and most importantly, get a feel for how your spouse enjoyed the program.
Alternatively, if your spouse wants to go alone so they can focus, try your best to be understanding and supportive of this. This may be the first time they’ve really interviewed for a professional job, or it has been a long time since they have. The goal is for them to feel confident and supported!
In order to help yourself later when you create your program rank list, you will want a way to distinguish between the programs. A really cool idea we received was to have your spouse record themselves talking about the program right after the interview, before they forget what they liked and didn’t like about it. The reality is that on paper most of the programs will end up looking the same. The best way to capture how your spouse “felt” about the program is to hear them talk about it. Did they sound excited? Was it just ok?
Making your rank list
Pour yourself a glass of something and get ready for the ultimate game of uncertainty and program shuffle! Unless you know exactly where you’re hoping to go, you and your spouse will hash out the pros and cons of each program and location, make some lists, and look up information about all the program cities. What do these various cities offer? How close would you be to friends and family? Are there possible support groups either through the program or in the community (such as a church, mom’s groups, exercise club, etc)?
After you make your first rank list, you will probably revisit it and rearrange it numerous times before finally closing your eyes, saying a prayer, and hitting the submit button. Deadlines for rank list submissions is usually mid-February. For a list of important residency application dates, head to the National Residency Match Program website.
Waiting for The Match
Of all the waiting to be done before and during medical school, waiting for The Match takes the cake! To read all about Match Day and how to survive this roller-coaster ride, head on over to: The Match: A Guide for the Big Day.
Conclusion
Applying for residency is a complicated process filled with a mix of thrills and chills. Your number one goal during this time is to communicate with your spouse and come together as a team. Talk about your dreams, desires, goals, and anticipated needs going forward. This is your time to name some necessities and expectations! You will want to enter into this matching game feeling heard, understood, and on the same page with your spouse. No matter what the results are in the end, you’ll be together and will find a way to make it work!

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Amy Rakowczyk is a medical spouse, mother, writer, singer, and former voice instructor. She currently resides in Galveston, TX with her husband and two young daughters. She enjoys helping other spouses navigate the world of medicine and actively participates in support groups and activities. Her hus... Amy Rakowczyk is a medical spouse, mother, writer, singer, and former voice instructor. She currently resides in Galveston, TX with her husband and tw...