How to Get The Residency You Want

Updated September 9, 2021. The article was updated to correct minor grammatical errors and to update technical details.

Getting matched to a residency program is nearly a year-long process, but where do you even begin? Here is a general timeline of what your Residency Match journey may look like from start to finish:

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Did you know that when it comes to landing the residency you want, your interpersonal and communication skills matter just as much as your academic acumen? All you have to do is look at the 2016 residency match data to see how critical it is that you effectively interact with others.

The National Resident Matching Program fills positions for 23 specialties. In each of them, three of the top five factors used by program directors to rank potential residents included interpersonal skills. That means that even though test scores may be used to select applicants for interviews, once you get in the door, you better be able to relate to and converse with the program director, faculty, and staff if you want to land the residency of choice.

Top 5 Factors to Getting Selected

Let’s look at the overview first. In all specialties, the top five factors used to select applicants for residency interviews were:

1. USMLE Step 1/COMLEX Level 1 score
2. Letter of Recommendation (LoR) in the specialty
3. Medical Student Performance Evaluation (MSPE/Dean’s Letter)
4. USMLE Step 2 CK/COMLEX Level 2 CE score
5. Grades in required clerkships

However, once you are clinically and academically vetted, your ability to communicate takes center stage in the decision-making process. For all specialties, 95% cited interpersonal skills as a top factor in ranking applicants for residency selection.

Top 5 Factors To Rank Applicants

1. Interactions with faculty during interview and visit
2. Interpersonal skills
3. Interactions with house staff during interview and visit
4. Feedback from current residents
5. USMLE Step 1/COMLEX Level 1 score

When you dive deeper and look at the individual factors used to rank each applicant, those that relate to personal qualities rank higher than USMLE test scores. On a scale of 1 – 5, 5 being “very important,” programs cited the importance of tests vs. personal skills as follows:

● USMLE Step 1/COMLEX Level 1: 4.1
● USMLE Step 2 CK/COMLEX level 2 CE Score: 4.1
● Evidence of professionalism and ethics: 4.6
● Perceived commitment to specialty: 4.4
● Perceived interest in the program and leadership qualities: 4.2

But I don’t want to talk to patients, I want to operate on them

If you think that communication skills are considered important only in specialties where the physician has a lot of patient-facing time, consider this:

● Anesthesiology programs ranked interpersonal skills as 4.9 (the same as Family Medicine ).
● Surgery ranked interpersonal skills as 4.8 (the same as Internal Medicine).

When it comes to emergency medicine, 100% of program directors said interpersonal skills were important. For Pediatrics, 100% said that “interactions with faculty during interview and visit” were of top importance.

So alongside science, research, and evidence-based medicine, communication skills have to be finely honed. This is good news. Did you or your family members ever receive care from a physician with a poor bedside manner? Which did you remember: the rude manner or the care you received? (We’re betting on a rude manner.) If a physician is cold or perceived to be devoid of empathy, the physician-patient bond doesn’t form, and that is a problem because that bond lies at the heart of great care.

Today, communication is a metric

Communication has always been part of successful physician-patient relationships. From home visits of old to hospice care today, human beings relating to humans is the bedrock of medical practice. Now, it’s a metric. Healthcare measures many things in the delivery of care and climbing to the top of the ladder is patient-physician communication.

For the hospital’s bottom line: Patients are rating their doctors’ communication skills on the Center for Medicare & Medicaid Services’ HCAHPS Survey, and the performance is linked to reimbursement.

For diagnostic accuracy: The ability to accurately diagnose a patient depends upon listening and communication skills. Most diagnostic decisions come from the history-taking component of the interview, yet studies of clinician-patient visits show that physicians interrupt patients after only 17 seconds.

For inpatient satisfaction: Lack of communication about delays in the emergency department, overly brief interactions with the covering hospitalist, or jousting between consulting and attending physicians in front of the patient can be alarming. However, patient satisfaction increased when providers took the patient’s problem seriously, explained information clearly, and provided viable options.

For patient outcomes: Studies validate that good, effective communication has a therapeutic effect for patients. Patients who understand their doctors are more likely to acknowledge health problems, understand treatment options, modify their behaviors and comply with medication schedules.

Say what you mean

The American Psychological Association underscores the importance of improving physician-patient education saying, “Sharing information is a critical piece of health care. In so much of medicine, we often don’t pay attention to that human interaction — and that’s when you get problems.”

Of course, communication is part of a larger wheel that includes the patient, colleagues, administrators and support staff. However, it all begins with the physician, and that’s you. If you want to be a physician you have to open the residency door, and that means communicating effectively with residency program directors and staff.

Sydney J. Harris was a journalist with Chicago’s leading newspapers for more than 50 years and he nailed it when he said; “The two words ‘information’ and ‘communication’ are often used interchangeably, but they signify quite different things. Information is giving out; communication is getting through.”

Doctors, start your dialogue engines. Your future is about to be discussed.

This is a guest post from BoardVitals and is an excerpt from their free ebook A Complete Guide to Medical Residency. Enjoy! Preparing for your Residency is a lot of work, but getting matched is well worth the effort.