Written by Patricia Turner, MD, Resident, Department of Surgery, Howard University Hospital and Vikisha Fripp, MD, Resident, Department of Surgery, Howard University Hospital

Source: AMA

Once you decide on making Surgery your way of life, the process of obtaining a residency position assumes highest importance. The preparatory phase can be very involved and intense; however, keep in mind that every surgeon has successfully maneuvered through it before you. The timeline for gathering letters of recommendation, finalizing your CV, and putting ERAS together is the same for most specialties. . . the early bird catches the worm.

End of 3rd Year and 4th Year

Spring/Summer Senior surgery elective in the area of surgery you want to specialize in (i.e. Plastics, Vascular, ENT), Choose an advisor. Someone who is honest, available, supportive and most importantly knowledgeable in the area of your specialty. Consider a SICU elective to familiarize yourself with surgical management of burns, trauma and critically ill patients.

Like every specialty letters of recommendation are important.  Be selective about who writes your letter, keeping in mind the person who knows you best will write the best letter.  A letter from your chairman is a MUST.  Make an appointment to meet with your chairman… have your CV and personal statement with you. 

Early Fall (August, September) Obtain information from FREIDA (i.e. addresses, contact names and phone numbers) regarding programs.

Make a list of what you are looking for in a program. Match these criteria with what each program is offering and get a defined list.

Finalize CV and personal statement for completion of ERAS. 

Check your ERAS information to make sure that all materials are present and factual.  Remember Dean's Letters don't go out until November 1st.

Send off ERAS to the list of schools you have gathered from FREIDA. ERAS costs, so send to schools you truly have an interest in interviewing with. There is no specific number; however, most agree that at least 10-15 are a safe number.

As mentioned before, send Thank You letters to all persons who wrote you letters of recommendation. . . whether you used them or not.

Late Fall (October, November)

Interviewing (late November through early February)

The interview process is by far the most stressful portion of this process.  The major areas of focus are WHEN to interview, HOW MANY programs to interview with, WHAT TO WEAR to the interview, and WHAT QUESTIONS to expect.  All these questions have different answers depending on whom you talk with.  Therefore, I strongly recommend that you speak with your advisor, talk with those who have interviewed before you at the institution and review frequently asked question in the ‘First Aid for the Match’ and all other published materials.

The interview months are designated late November through early February. Most people reserve December or January off from clerkship to interview.December interview season is truncated because of the holidays, so January may be the best month. Also, keep weather in mind when in interviewing in the northern states; you may want to interview early in these states.

There is no perfect number. I suggest interviewing with at least 5-10 schools. Toward the 10th or so interview fatigue becomes a factor, therefore, I recommend interviewing at your top schools somewhere in the middle of the list. This allows you to become familiar with the process before you have to put your best foot forward.

What to wear?

The conservative black or dark blue suit is ideal. Females can wear pant suits; however, the conservative two-piece skirt/jacket combination is favored. Males should not wear distracting ties; this is not the forum to exhibit your personality.

What questions to expect?

Every program asks their own special questions and has at least one hard-nosed interviewer. Stay calm, focused and remember they asked you to interview with them. Be ready to ask questions about the program. Look over the brochure provided to get information about the program; this prevents asking questions that have already clearly been answered.

Deciding

Many factors go into choosing the best residency position for you. As mentioned before location, length of program, family, institutional climate, placement, research and other requirements of the program are very important and each has to be weighed. I recommend establishing a scoring system for each and using this calculation to rank your residency programs.

If geographically restricted then it is imperative that you apply to as many programs in the area as possible. Secondly, it becomes important that you inform each program of your interest to stay in that area only. Have a PLAN B AREA that is close to your selected city.

Most surgery programs are 5-years, many are not; however, many factors can lengthen the total time.Make sure there are no hidden pathways or obligatory research paths. Also ask about each program’s commitment to finishing the same number of interns they accept as chief/5th year residents (Pyramidal program).

Family

Those students with families have more aspects to consider. Area schools and communities have to investigated and visited before any final decision is made.

Institutional Climate

This topic may be one of the most important areas to consider. Speak with the residents at every level and ascertain how they honestly feel about their fellow residents, the program, the Chairman and the Program Director. Is the program stable? Are they expecting a change in the Chairman, Vice-Chairman or Program Director position?

What is the program known for? Have they matched any residents in the area you want to specialize in?

Research and Other Requirements

Research can be a very sensitive topic. Again, I suggest that you speak to multiple people before making any decisions. Research is important if you are pursuing the tougher fellowships (i.e. Oncology, Transplant, Vascular, Cardiothoracic) and academic surgery. However, research may not be as important for fellowships such as Plastics, and Critical Care. I can not overestimate the importance of doing well on the ABSITE, mastering your surgical skill and being well thought of by both your peers and your professors.Though research lengthens the total time in residency, it allows for a break from the grind of residency. The research lifestyle is not as stressful and most residents moonlight at area hospitals. Research areas have recently been expanded to include pursuits of MBA, MSPH and Ph.D. degrees.