Roadmap to Residency: - AAMC

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Roadmap to Residency: FromApplication to the Match and BeyondIII. Specialty ChoiceThe process of choosing one’s specialty ishighly personal and both a challengingand rewarding effort. To assist medicalstudents and their career advisors in thisprocess, the AAMC sponsors a structuredfour-phase career planningprogram, Careers in Medicine (CiM,www.aamc.org/careersinmedicine).Other resources regarding specialtyselection can be found in theBibliography (Appendix A).CiM Phase 1, Understanding Yourself,involves a self-assessment by the studentof his or her personal interests, skills,goals, and values. Phase 2, ExploringOptions, involves exploration of thevariety of specialties and medical careeroptions. Phase 3, Choosing a Speciality,involves a comparison of what waslearned during self-assessment with theinformation gathered about variousspecialties and medical career optionsunder consideration, leading to adecision about the specialty that will bepursued during residency training. Phase4, Getting into Residency, involves applicationto, and acceptance by, a residencytraining program.The CiM program provides extensiveinformation about specific specialty andresidency selection processes, including aproposed four-year timeline and voluminousdata about a broad range ofspecialties. The CiM Specialty Pages(www.aamc.org/careersinmedicine)contain general information about thenature of the work in each specialty,training requirements, the personalitycharacteristics of physicians practicing inthe specialty, current workforce andcompensation statistics, and links torelevant professional associations andinformation resources.Students enrolled at U.S. allopathic,selected osteopathic, and Canadianmedical schools also have access, througha password-protected CiM Web site, to avariety of assessment and decisionmakingtools to assist them in the careerplanning process, as well as to detailedinformation about all ACGME-accreditedspecialties. Students can receive an accesscode from their school’s CiM liaison, whois usually a staff person in the Office ofStudent Affairs or Academic Affairs.For each specialty, it is helpful todetermine the number of residencyprogram positions available in thedesired specialty and the number ofapplicants for that specialty in order toassess the competitiveness of the applicationprocess for that specialty. TheFREIDA Online® Web site, maintainedby the American Medical Association(www.ama-assn.org/go/freida), providesaggregate information on ACGMEprograms, including the total number ofresidents per specialty, average programsize, and average number of interviewsprovided per program, as well as informationon the number of graduates andtheir career choices.Applicants may also wish to review theAugust 2006 joint AAMC and NRMPreport entitled, “Charting Outcomes inthe Match.” This report provides informationfor each of 17 specialtiesregarding the following five characteristicsof matched and unmatched applicants:USMLE Step 1 score, number ofpublications, participation in researchprojects, length of rank order list, andmembership in Alpha Omega Alphamedical honor society. The report can beaccessed in PDF format on the AAMCand NRMP Web sites at:www.aamc.org/publications andwww.nrmp.org/matchoutcomes.pdf,respectively.5Association of American Medical Colleges, 2005
Roadmap to Residency: FromApplication to the Match and BeyondIV. Residency Program Selection CriteriaResidency applicants should be knowledgeableabout the path for training in achosen specialty, as well as about thepersonal criteria they will employ inselecting a residency program.A. Understanding the trainingpath for the chosen specialtyInformation about the training paths formany specialties and subspecialties isavailable on the Careers in Medicine Website (www.aamc.org/students/cim/specialties.htm). The Graduate MedicalEducation Directory (the “Green Book”)published annually by the AmericanMedical Association (www.amaassn.org/ama/pub/category/3991.html)also lists contact information for 8,250ACGME-accredited and combinedspecialty programs and 1,700 graduatemedical education teaching institutions,data for and descriptions of all specialtiesand subspecialties, and American Boardof Medical Specialties medical specialtyboard certification requirements. Anotherkey AMA resource is FREIDA Online®(Fellowship and Residency ElectronicInteractive Database Access, www.amaassn.org/go/freida),an online databasecontaining information on 8,200+graduate medical education programsaccredited by the ACGME, as well as on200+ combined specialty programs.FREIDA permits comparison of specialtieson such factors as length of training,program size, number of faculty, work andeducational environments, and compensation,as well as on the career plans ofgraduates from various specialties asreported by their program directors.B. Residency program selectioncriteriaResidency applicants should consider inadvance the criteria by which they willinitially assess programs to determinehow many and to which programs theywill make application, as well as todetermine, after visiting programs atwhich they have been invited tointerview, those programs that they willplace on their rank order list (ROL). Atleast three different types of criteria canbe employed in this process: those aboutthe nature and quality of the educationalprogram, those based on personal preferencesand needs, and those based onresidency agreement and stipend issues.• Program issues:a. Morale of current residents (lookfor satisfied residents)b. Current accreditation statusc. Program qualityd. Program sizee. Educational structure: requiredrotations, formal curriculum,informal learning opportunities,support systemsf. Clinical responsibilities: callschedule, supervisory structure,ancillary supportg. Opportunities for research andteachingh. Evaluation processes: timing andstructure of resident evaluationi. Program type: academic orcommunity; hospital-based orambulatoryj. Opportunities for interaction withresidents in other residency trainingprogramsk. Reputation of program directorand faculty membersl. Success of graduates in obtainingfellowships.• Personal issues:a. Locationb. Housingc. Cost of livingd. Proximity to family memberse. Spousal and family opportunities.• Residency agreement and stipendissues:a. Stipendb. Leave: vacation, sick, andprofessionalc. Benefits: health, liability, anddisability insurance (including datesof initial coverage for newresidents)d. Other prerequisites.6Association of American Medical Colleges, 2005
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