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The Residency Search


Ok, where to begin. The search for a residency is very stressful and confusing so I've decided to make this little guide to help my little medlets in their future endeavors. I can't help you with choosing what residency you want to do but here is some info I wish I had a little earlier in my career. Here are some good sources to start off with.

1) The Match - Nice ppt on residencies and internships given to us by our own Dr. DeGeatano. A great place to start.

2) CiM - This is the Careers in Medicine website. 80% of it is useless since its not written for DO's but there are a few useful pieces on info there. Peruse the site and glean what you can. Don't bother with the stupid personality tests. If you need a survey to tell you what to dedicate the rest of your life to you're in trouble. Get the info, and make the best choice you can. I don't think you can ever be 100% but you can at least be informed. Now don't email me and say something like "I knew 100% since I was 12 years old that I wanted to be a (insert specialty here)" At 12 years old you didn't know a damn thing about medicine, and if you did and still wanted to be a doctor you should be committed.

3) You want residencies? Here they are... all of them!
AOA - Osteopathic Residencies
AMA - Allopathic Residencies

Those are the 2 searchable databases for all the allopathic and osteopathic residencies that exist in the country. All the info you need is there. Contact info, spots, salaries, benefits... its all on those 2 sites organized into a neat little package. Now keep in mind that my personal experience is going to be from a civilian Internal Medicine standpoint so if you are military or going for Neurology, there is other crap you have to worry about that I really don't have much information on. So you'll have to do your homework. All I can tell you is that Military has their own match something or other and that if you want Neuro you need to participate in the San Fransisco match.

ALLOPATHIC VS OSTEOPATHIC
Here is some info you should now about the AOA and AMA match processes. The AOA match comes first in February, and then the AMA match is in March. If you match into a DO slot you are automatically withdrawn from the AMA match. So, this means that if you really want an AMA residency you have to essentially forgo the AOA match and take your chances. This takes some balls and might not be a prudent move. The only other way to get an AMA spot is to sign as an independent applicant. We can only do this with AMA spots since we are not considered independent applicants with the AOA. Signing as an independent applicant is just that, the hospital either liked you that much when you did your elective there or you have some connection in the administration that they offered you a contract to sign before the match. While this is not the most frequent of occurrences it does happen, but don't bet the farm on it. Now I don't want to discourage you too much. There are DO's at Jackson, there are DO's at Cleveland Clinic, AMA spots are attainable.

Now, if you plan on practicing in Florida, Pennsylvania, Michigan, Oklahoma, or West Virgina you need to do a traditional rotating internship year. This is built into most DO residencies but not MD residencies. If you get an AMA spot you'll need to deal with this through some maze of hoops called resolution 42. It's doable but a royal pain in the ass I'm sure and something that you need to be aware of. That being said, when searching for programs, whether or not they are AOA or AMA really doesn't matter, you need to judge each one individually. AMA programs are not inherently better than AOA programs. It should be noted though that DO spots are for DO's only. Allopathic spots have MD, DO, and FMG applicants. There are alot more applicants than spots increasing the competition. Now, I'm not saying that DO spots are not competitive but just by number crunching you usually have better chances of landing one due to the smaller applicant base.

The Process: Starting in your third year you get a feel about what you want to do and where you want to do it. Unfortunately, you need to have a good idea about what you want to do so early in the game that it completely negates the purpose of rotating through different specialties... but I guess that's life. Anyway, take your best guess at what you want to do and where and rotate through those hospitals during your prime "audition" months which would be September through December of fourth year. January can be a very good month since you will be at the hospital and fresh in their minds when they are making their final rankings, but its late in the game if they've already made up their minds, so take it for what its worth. Different residencies accept applications at different times so check with each one and apply early. I believe most of them start in July. Also try and remember that you really need to rotate through the hospitals you want to apply to. Programs tend to not take applicants sight unseen (again, it does happen sometimes but don't bank on it) so you really need to go not only to make yourself known but to see the place you'll be working for the next 3 years if not more! Remember this is a job search. You better like where you work or else the hell that is residency is going to really be a nightmare.

The basic process is that you apply to a bunch of programs starting in July, you interview with some of these over the next few months, then you rank the ones you interviewed at and submit it to the match. You will be using ERAS for all of your application but I won't go into it here, there is plenty of info on it elsewhere. All the hospitals also submit a ranking list of students to the match. A team of monkeys work round the clock on it and BAM, they send out the results. When you get your match, if you match, you're locked in. If you don't like it you're screwed... so DON'T RANK A PLACE YOU DON'T WANT TO GO. It's a contract and you'll have legal ramifications if you break it... and you know how much we hate legal ramifications.

It's worth mentioning that sometime after your interviews and before the match you will be contacted by some of the programs you have applied to. Whether blunt or veiled, they will be giving you info about how they will rank you Many of them will also be looking for you to tell them how you will rank them. Now, all of this is probably against the "rules" of the match, but it happens at almost every program so be prepared. That's all I need to say for the moment. I'll go into it a bit more in my tips for residency section.
If you match, its all over, you can relax on your final rotations (don't kill anybody) and pack for your new home for the next few years. If not the you have the pleasure of being part of the cluster f.... I mean scramble. On that magic day in February when you get your match, ironically usually around Valentines day, if you are not matched a list of programs with open spots is sent to you. You now frantically call them and beg for acceptance. Now, just because these are unmatched spots doesn't mean they are bad spots or bad programs. On the contrary, every now and then a fairly competitive spot remains open so don't think you are doomed to family medicine in Casper, Wyoming if you don't match (on a side note to the good people of Casper, Wyoming, I'm sure the have a great program and they pay really well. I'm just picking on them because they are in the middle of nowhere). The MD match is basically the same process only it happens in March, after all of this nonsense.

I hope this sheds some light on the mystery that is the match. The resources above are very good so please use them. If you have any questions or comments feel free to drop me a line. Good luck with the rest of school.



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