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How to Choose a Residency - Points to Consider

Introduction

What you are seeking in family practice programs can be a highly individual matter and will relate to your own personal goals and desired areas of study. There is a wide range of programs and you may not want the same things other applicants want.

On interview day, you will have questions. Put them down ahead of time in their order of importance to you. Some questions will be better answered by the program director, by the other faculty or by residents. You will want information about the hospital, the FP clinic, educational program and other matters. The section below will suggest pertinent questions.

Where to Interview

Some areas of the country emphasize different aspects of family medicine than others. Ask what the main emphasis is in the area of the country where you are interviewing. Is it behavioral medicine, OB, geriatrics, general surgery, etc? Rural programs will be different in their emphasis than inner city programs due to the nature of their populations.

If your interest is in academia, a university program will allow you to learn appropriate skills and to meet appropriate role models. University programs usually have a larger FP faculty, residents in other specialties, medical students and a wide choice of clinical electives. Community programs usually have less competition with other residencies, rely on private attendings for much of the educational program and are good learning sites for practice in communities. In any program, ask how long it has been in existence and how much support the community and affiliated hospital gives to the program.

Interview Day

On this day, you gather as much information as you can about a program and let their people have a look at you. Most programs have you interview with the program director or chairman of the department, one or two faculty members, and usually the FP residents. You should have answers to questions such as these: how did you hear about our program; how did you get interested in FP; what could you bring to our program; what do you do to relax; what are your future goals in FP? You will be given a lot of written material. Save it for later.

It is a good idea to quickly find out a little about those with whom you will be interviewing to see if you have any common interests or backgrounds. This information is often available on the program website. Preparation of a case showing your interest in a certain area may be a good idea as you may be asked about this.

In interviewing, nonverbal clues are very important, so look for them when asking questions. Watch for eye contact.

Makes notes. Rely on your impressions. Do you like the atmosphere in the clinic and the hospital? Are the people genuine, friendly, and intelligent? Is this an environment in which you will learn well? When you get home, look at your notes.

If you were well treated and are still interested in the program, you might want to write a thank-you note to the director. It is also a good idea to write notes to the person who put you up for the night.

If you are invited back for a second look and you are interested in the program, go again and collect more information.

The Residency Director

  • What is the direction of program?
  • What changes in the curriculum?
  • FP's political power in the community?
  • Stability of the program and hospital, FP faculty, new faculty?
  • Funding from where? Is it stable?
  • His/Her philosophy of FP?
  • What graduates of the program do now? What % pass their boards? What kind of practice: solo vs. group, OB, urban vs. suburban vs. rural, academic FP, third world?
  • Where do graduates go?
  • Problems with graduates obtaining priviledges? How is documentation achieved in the program?
  • How are residents evaluated?
  • Computer use? Practice management?
Be careful when asking about the weaknesses of the program. Your questions should be more specific.

Other Faculty

  • Ask questions pertaining to their area of interest or research: OB, behavioral science, etc.
  • What background? Private practice?
  • Why they came here?
  • Private attending physician's commitment to teaching?
  • Do FP faculty do OB? (Important if they attend when you see OB patients in the clinic)
Try to see faculty in action on the floor or in the clinic.

Residents

  • Why they chose this program?
  • Is it living up to their expectations?
  • Strengths of the program? What could be improved?
  • Quality of fellow residents?
  • Do they interact socially?
  • Where do FP residents stand in the hospital: respected by residents in other specialties?
  • Quality of interaction with clinic FP attendings? Ward attendings? Private attendings?
  • Living in the community? Community involvement?
Try to see residents in action, especially in clinic. Observe attitudes.

The FP Clinic

  • Number of centers? Near hospital? Rural clinics?
  • Availability of attendings teaching on site? Help with procedures?
  • What is clinic population? Age, range, racial mix, OB, Peds?
  • What patient education programs are available?
  • Are behavioral science faculty helpful with cases? Are programs interactive to teach counseling and management of social prgorams?
  • How are the charts set up? Is there an EMR?

The Hospital

  • Number of beds? Diversity of patients?
  • Call schedule: number of admissions per night? Med students?
  • Enough call rooms available?
  • Ancillary services: phlebotomy, IV teams, nursing, clinical labs? Does the hospital work well?
  • IM? Follow patients into unit, unit experience, responsibility, supervision?
  • OB volume? Who teaches?
  • Are there Peds residents? Adequate volume? Good outpatient? NICU?
  • What is ER experience?
  • Is surgery first assist? Outpatient?
  • Is psych inpatient relevant?

Educational Programs

  • What library facilities available? Good hours? Close to wards? Good family practice/primary care collection?
  • What research opportunities?
  • What is FP conference schedule? How is it organized?
  • Is there overlay of behavioral medicine teaching? Geriatrics?
  • What is procedure experience for LP's, unit procedures, colposcopy, sigmoidoscopy,. casting, suturing, intubation?
  • Programs in neonatal resuscitation? ALSO? ACLS?ATLS?
  • Community experiences - home visit, nursing home, sports medicine?

Miscellaneous

  • What are benefits? Salary? Insurance? Money for conferences/books? Relocation reimbursement, loan repayment, moonlighting permitted/with or without malpractice insurance coverage?
  • What provisions for meals, lab coats, parking, vacation, xeroxing privileges? Child care or sick child care?
  • How helpful and friendly are clinic staff? Department secretary?
  • What type of environment in the city where residency is located? Cultural amenities? Cost of living? Recreational activities? Schools? Club for spouses? Employment or education for spouse?
Dr. Michael Mazzone, Director
Waukesha Family Medicine
Residency Program

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