In this article, Miko Rose, DO, shares a journaling exercise that can help students determine their No. 1 priority for residency.
Follow your heart

To get into the residency program of your dreams, know what your No. 1 priority is

Here’s a list of some of the common top priorities and steps to take to find the best residency program for each.

Editor’s note: This story is the second in a series on landing your dream residency. Here’s part one. This is an opinion piece; the views expressed are the author’s own and do not necessarily represent the views of The DO or the AOA.

As an assistant professor who works closely with residents and has reviewed hundreds of applications for our psychiatry residency slots over the past eight years, I’ve learned a thing or two about how the most successful candidates land their dream residencies.

One of my biggest takeaways is that it’s critical to gain clarity on what you truly want—and understand that what you want will be different than what your classmates want. Everyone’s career and life goals are unique.

Below are some common top priorities and steps to take to find the best residency program for each.

The specialty

Many of you will fall in love with a specialty. If a specific specialty is your No. 1 priority, then find a program that will provide the best possible training for excellence within your field. Go anywhere in the country, move family with you if needed—and focus on programs with the highest rankings within that specialty.

Location, location, location

Perhaps, however, your No. 1 priority is not a specific specialty. Maybe your dream for years has been to live in a geographic region you adore, a region that will facilitate the lifestyle you want. If, for example, your greatest dream is to live in Hawaii and you truly love any specialty within primary care, you might want to consider applying to a few different specialties throughout the state.

Family

For many candidates, family will be a top priority, whether that means living near extended family or finding a program in a location that works for your spouse and/or children.

These candidates can consider places they could easily move with their family as well as potential locations’ job opportunities for their partner and schools for their children. If you’re trying to stay in a specific location, start making connections with programs and colleagues there as early as you can to lay the groundwork for getting into a residency there.

A supportive program

Other candidates will place the most importance on finding a program that offers a sense of belonging, support and community. The kind of program where the residents and attendings come to see one another as family. When you visit the program, you may see that the program directors and residents all interact socially.

Current residents might say things like, “Residency is hard, and I could not have made it through with any other group of people.” If this sounds like you, when you rotate and interview, pay very close attention to how the residents and attendings interact and the personal chemistry you feel with everyone you encounter. 


Research

If your joie de vivre is reading about and working on research projects, do not let that go. Narrow your search to programs that have a research focus. In these programs, the majority of residents will spend a significant amount of their time on research projects.

Exploring your priorities: A journaling exercise

If you need assistance determining your top priority, start by finding a quiet place when you’re pretty relaxed. Set a timer for five minutes. Write down the five activities you enjoy the most along with the core experiences you enjoy about each.

Let’s say you wrote skydiving—the core experiences may be adventure and adrenaline. Or painting—the core experiences might be expression of creativity, attention to detail and using your hands. Or having dinner with close friends—the core experiences could be conversation, connectedness and community.

Don’t worry about what you’re writing, just let the words flow. After the timer dings, go back and review what you wrote. Highlight the common experiences that emerge. If you’re not sure, keep doing this for a few nights.

My journey

When I was applying to residency, I was the single mother of a 15-month-old little girl. I realized the most important dream in my life at that time was to be the best mother possible while also being a primary care physician. This would require finding a program that offered somewhat flexible scheduling and would allow me to take time off to care for my daughter when needed.

Although I was seeking a family medicine position, a chance encounter with an internal medicine program director led me to consider a program in this specialty. Because this was a brand-new residency program, there would be no overnight call, and the program director assured me I could take time off when I needed to be with my daughter.

I jumped at the chance to join what I knew would be an incredibly supportive program because I realized that flexibility of schedule and community were more important to me than medical specialty.

A few months into my training, I learned that I had an affinity for listening to people’s problems and intuitively understanding the nuances of organic versus psychological challenges. I was unexpectedly drawn to psychiatry. I ultimately transferred to a psychiatry program; during my search, I again focused on schedule flexibility and community.

Go with your gut

Ever hear people talk about a “gut feeling” that just didn’t make sense, but they acted on it anyway? Like stopping at an intersection with a green light, seeing all lanes wide open and clear, but you had the instinct to stop just as a car came speeding through a red light?

That feeling of unease is your body’s telltale indicator that something is not right. Let’s say you’ve finally been accepted to do a sub-internship rotation in a competitive surgery program. You start the rotation, and soon after arriving, you start to feel a sense of nausea and unease.

On paper, this program looks like your dream, but something just feels “off.” You apply anyway, but do not get accepted to the program. Years later, you hear about multiple residents from that program being fired and attempting suicide around the time you were rotating there. Your body had been giving you the “check engine” light.

We have all also experienced the opposite. Where everything is aligned and it feels like time stands still. This phenomenon is called “peak flow.” During a rotation that’s truly a good fit, you may look up to realize several hours have passed and you did not even notice the time. You made decisions and came up with creative solutions. Looking back, you have no idea how you made these things happen so quickly and effortlessly.

For more info

For more tips on landing the residency program of your dreams, you can watch a webinar I recently hosted on the topic through the College of Osteopathic Student Government Presidents and the Student Osteopathic Medical Association here.

Related reading:

To get into the residency program of your dreams, know your brand

Matching into residency: A breakdown of 10 specialties

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