You are a fourth year medical student. You’ve worked hard for three years, passed the USMLE with flying colors, conducted some spectacular extracurricular work. And you’ve decided to pursue diagnostic radiology.
Many factors determine whether you will end up at a choice residency program. USMLE scores, clinical grades, application, personal statement, the interview, and – of course – the ranked list.
The evaluation goes both ways. It is not at all unusual for some applicants to create tabulated spreadsheets detailing their evaluation of individual programs based on their own criteria, Moneyball style.
All of these factors determine how a program sees you, but this post is about how you see yourself fitting in a residency program.
The single most important factor that will determine how you spend the four years of your diagnostic radiology residency life is your co-residents. They will be your colleagues, friends, and some of these relationships will become lifelong.
Meet The Residents
An elective rotation at a residency program of interest is the best source of information. Short of that, most residency programs on interview day will provide time to interact with the current residents. (If not, it is worth at least thinking about “why not?”)
A few things to keep in mind when interacting with residents either in the reading room or at an interview meal.
- Is the working environment casual or formal?
- Do residents take routine lunch breaks or eat at their own workstations?
- Do residents feel overwhelmed by the daily work?
- Do residents spend time with each other outside of work?
That factors affect these points. These are functions of the residents as well as the residency, attending, and even daily work load.
Paradox of Complaints
Do ask residents what they dislike about the program. You are not interested in the specific problems individually. Instead, pay attention to how openly these residents voice their concerns, and whether the program leadership do anything about them.
Based on my experience applying to residency (admittedly 4 years ago now), the discussion usually fall into one of three categories:
- The program is great but there are a few issues. Here are examples and what we’re doing to fix them.
- Funny you should ask. Let me detail how miserable I am here.
- The program is great. Here are things I like about it.
Radiology residents are human beings, and humans have the remarkable ability of always finding fault with something, even if they love it. In the same way that you might reevaluate a person who claims “the world needs no improvement,” a training program whose residents lack constructive feedback in their training warrants a double take.
That’s You In 2 Years
Each radiology residency has a personality, and that personality comes from its residents. Dan Gilbert’s book Stumbling on Happiness closes with a comment about seeking happiness. Although everyone is unique, we are not too different. Thus, the best predictor for happiness comes from observation of those who are further along the path we will ourselves take. Short of peering into a crystal ball, talking to the residents will be the closest thing you can do peering into the future.
Don’t Forget Your Co-Applicants
I have learned that every residency class has a different dynamic. At my program, some classes are cohesive and social, spending a lot of time together. Other classes maintain a more professional and less personal relationship. And on occasion, some residents will not get along.
It is incredibly difficult to predict how a class culture will evolve. However, you can sometimes get a sense by interacting with your co-applicants. Get to know them.
Simple math suggests that on average one or two of those who interview with you will end up in your residency class.
Suppose a residency program has room for 5 and is interviewing 40 applicants in groups of 10. This means that if you match to this program, the balance of probability favors that 1 of your classmate will have interviewed in your group. And that’s excluding anyone you will have met at another interview!
Conclusion
At the end of your medical school education you will have been in a meritocratic environment for over twenty years.
It can be very difficult to think of selecting a residency program as a fit rather than a rank, particularly when the application process literally asks for a ranked list.
While the number of Teslas that power a hospital’s MRI magnet, the availability of advanced imaging techniques, or the number of high impact publications its faculty members generate all contribute to your radiology training experience, the core group worth most of your attention remains a program’s residents.
And in many ways, this is the one area where gut feeling still counts.
