Those in the medical world understand the difficulties and stress surrounding residency interviews. As the wife of an orthopedic resident, I am no stranger to the complications and logistical nightmares created by away rotations and interviews all around the country. I’ve gained wisdom from our personal journey and from listening to our medical colleagues.

Here are the top practical tips I’ve compiled for the Residency Interview Trail.

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Application Process

Create a preliminary list of your program rank

Create a list of the pros and cons of each program in a spreadsheet. Note things that will affect your day to day — how many residents do they accept per year? Do they do night call or night float? How many hospitals will you work in during your residency, and how far will you have to travel between each? Another really important question — does your specialty include the preliminary (intern) year, or do you have to apply separately for that?

If you can find a list of potential interview dates, go ahead and write that down as well. This list will help you establish your priorities in a program and allow you to map out your ideal interview schedule.

Have someone else check your email for interview invites

If you’re in the middle of rotating at a program, you’re not going to want to stop and check your smart phone every few minutes. Kiss that interview goodbye. So how do you handle the interview invites that are hopefully pouring into your inbox or through ERAS?

Find a person you trust with your life and your future career, and enlist them to help you. Share your login information for your email and to ERAS. Sit them down and show them how to respond appropriately to the invites, how to strategically pick the dates they offer you, and how to keep track of everything so you’re in the know. In our experience in the ortho world, interview invites went out to a certain number of applicants, and it was on a “first come, first serve” basis. This meant that if my husband did not accept the interview invite fast enough, he could lose out on an interview slot and be put on the wait list for an interview.

Research all program requirements on their official website before applying

There are hidden requirements for some programs that are not listed on ERAS. It is worth your time to go to each school individually and check their requirements. Many schools made my husband write a new personal statement, or add a second document explaining why he wanted to go to their program. The weirdest one was when a school required applicants to write a hand written letter explaining their interest in the program, and if you did not send that letter in, you would not get an invite. They want to make sure you’re paying attention.

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Money Matters

Consider a credit card with your airline of choice

If you’re near an airport that serves as a hub for a major airline, take a look at their credit cards so that you can gain points and earn free flights. We obtained a Southwest Visa Travel Card because we love Southwest. With Southwest (card or no card), you can change your flights without penalty, outright cancel a flight and not lose your money, and get two free bags under the plane. My husband estimates he got up to 4 free flights from using the Southwest card due to the surge of bonus points he was awarded.

Book Logistical Needs with a Flexible Company

Changing flights without a fee was an important feature for us when scheduling interviews, as the invites come in sporadically. Sometimes you have to try to change your interview dates around in order to make it to all of them. This same concept applies to car rentals and hotels — only book something if you are guaranteed the ability to change it or cancel it without losing money.

Take a loan out to cover interview trail expenses

If you’re going for a competitive speciality, anticipate having to spend money on all of your flights, hotels, car rentals, and food. If you’re applying for a less competitive specialty, you might get lucky and the program will fly you out and put you up at a hotel.

The bills rack up. Along with your expenses from 3rd year away rotations, the application fees for applying to 50+ programs, your current apartment rent — you might need that extra cushion money to pay for your interviews trail needs, particularly if you are having to do twice the number of interviews for a transition year program.

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Travel Tips

Get TSA pre-check

TSA pre-check cost us $85 each for 5 years, and it was the best money we’ve ever spent. With TSA pre-check, you can zip through the TSA security lines at the airport and get to your gate in a timely manner. The longest we have ever had to wait in line was 10 minutes. We were nervous because it wrapped around several times, but it went quickly because people did not have to take off shoes, jackets, or remove laptops out of their bags.

To get TSA pre-approved, we had to go to an office that took our fingerprints, photos, and required us to fill out some official paperwork. We set up a meeting ahead of time and in total it was less than 30 minutes. We received our approval and TSA numbers within a few weeks. Learn more here.

Always bring your important clothes as a carry-on

What happens if you run into a delayed flight due to weather and your checked bag doesn’t make it? What do you do if it’s a Sunday night, your only suit or dressy outfit is in another city’s airport, and your interview is at 7 am the next morning? This happened to a fellow interviewer we met on the trail. He had to spend several hundreds dollars to buy a suit for his next day interview at one of the only places left open on a Sunday night.

Take all your essentials on the plane with you: dress clothes, extra underwear, basic toiletries and make up, dress shoes, phone charger.

Bring a portable steamer to iron out wrinkles

Shine your shoes, comb your hair, and make sure those wrinkles are out of your dress clothes. Ironing might not be possible wherever you go, so we recommend a portable steamer. You fill it up with water, plug it in, and allow the device to heat up the water. This is the portable mini handheld steamer my husband consistently uses and recommends. You can also try the old trick of hanging your clothes in the bathroom (away from the shower), turning on the shower water to super hot for several minutes, closing the door, and allowing the shower’s natural steam to iron out your clothes for you.

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Interview Recommendations

Have a funny YouTube video or joke to tell at every interview

My husband says that in several interviews he was asked to share a funny joke or a funny YouTube video. Has something unique and quirky that makes you interesting so that you can entertain the residents who are interviewing you.

Brush up on your politics

Know your current politics, especially as it pertains to socio-economic status of your patients. Intimately know how the current political climate affects healthcare. Have an opinion on socialized vs privatized healthcare, the current model of Medicare and Medicaid, and health care access. Have ideas of what changes you would make to the healthcare system.

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Residency Programs

Don’t trust what they tell you

Programs will tell you what they want to get you to rank them high. I don’t care how much they try to woo you, how many presents they send, do not change your rank list on the empty promises of these programs. Do not cancel interviews because a program tells you that you are going to get a spot with them. Do not believe your friend if they tell you that you are definitely the program’s number one pick.

We have heard too many horror stories that have negatively affected medical students for the rest of their lives and careers. When it comes down to it, a program will pick the resident that looks best for their program and who gets along with their residents. Sometimes there are unseen politics at play here, no matter how impartial this process is meant to be.

Don’t assume you will end up at your residency of choice

This is worth repeating: don’t assume anything. Don’t buy a house before you know the city you will end up in; don’t make unchangeable plans until you know what state you will be living in next. It is best to live in this terrifying time of uncertainty without making any firm plans. It is very difficult and stressful to not know where you will spend the next several years of your life, particularly if you are married or have children, as your residency will directly affect your loved ones. Relieve this stress the best way you can and just know that there is a light at the end of the tunnel — Match Day!

Don’t apply to rotate at a school unless you really want to go there

This tip might be too little, too late for some of you. We’ve heard several times from program coordinators, residents, and directors that if you applied to rotate at a school during your 4th year and then turned down their invitation so you could rotate elsewhere, chances are you won’t get an interview invite. Think about it from the school’s perspective: if you didn’t want to rotate there, you didn’t really want to end up at their program. That might not be true from your perspective, but the school will likely get 500+ applications for residency and they have to turn some people down. They will turn down the people who have turned them down in the past; you’re basically adding yourself to their black list. It can hurt you to apply to too many schools for 4th year rotations, so choose wisely here and don’t burn bridges.

Create your Match List

Depending on your specialty of choice and the number of interviews you take, you might balk at the suggestion that I’ve heard from other seasoned residents and spouses: you do not have to rank a program just because you’ve interviewed there. Sometimes it’s better to leave a program off your list than to rank them and potentially risk matching there. Is it better to match into a program that you hate that’s a bad fit, or is it better to take the year off and try again? If you don’t match at all and you left a program or two off your rank list, will that haunt you? Only you can answer that.  Bear in mind that some of the more competitive specialties do not look kindly upon applicants who are re-applying after not matching the first time.

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Personal Recommendations

Don’t make big plans until you have all the facts

Pro tip: if you’re going to plan a fantastic post-graduation trip (which I highly recommend), wait until Match Day to book those flights. It will end up costing you money to change your departing flight to a new city.

On another note, programs officially begin July 1, but many require you to begin your Orientation in early or mid-June. Until you find out the exact date you need to start your residency, hold off on making impressive plans in June — otherwise you may miss out on fun or required events.

Consider how the residency program will affect your loved ones before you apply

On a personal level, seriously consider the work-life balance of the residency programs. Some programs have a reputation for overworking their residents or for creating a malignant environment. Is that something you want to deal with for the next couple of years? How does that compare to the prestige of the program and how will your relationships handle this kind of program?

Don’t ignore the city

If you are married, or if you have children, how will your potential move to a new state affect their lives? If your spouse works, do you have a backup plan if your spouse cannot take their job with them to a new city or state? Do you know the quality of the school districts in the areas you are considering for residency?

What does the city have to offer you and your family? Talk to the locals to get a sense of what they do for fun. If you can, take an extra day before or after your interview to get to know the city. Be aware of what things in a city you can’t live with and without. My husband could not stand the thought of living in a major metropolitan city due to the commute time; I could not stand the thought of living in a tiny city with no cultural events or activities. It is not unwise to leave programs off your list because you cannot imagine living in a particular city for multiple years.  The important thing is to compromise and find balance with your spouse.

In the end, Match Day is a roll of the dice. You likely will not end up in the city of your choice, but it is always better than ending up in a city or program you hate.

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Keep this in Mind

What’s your back up plan?

No one likes to think about not matching or having to scramble, but it would be unwise of you to assume that this won’t happen to you. What will you do if you don’t match? Will you scramble into a different residency? Will you take a research year and try the Interview Trail again next year? Does your specialty of choice look kindly on people who are applying for a second time if it’s very competitive? If you work as a preliminary student in a hospital, will you have the opportunity to match into that residency program?

Match Day

Match Day is an emotional day for everyone. Many people do not get their first or top choices, and some people have their immediate dreams crushed because they did not match or had to scramble. Be emotionally cognizant of your colleagues and their loved ones in your celebration. If you did end up matching in the specialty of your choice, consider yourself blessed. You will hopefully find that your new city, your new residency, and your new life are exactly what you wanted and needed.

Your future is bright, no matter what surprise Match Day holds for you.

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Good luck on your upcoming residency interviews. If you have another tip you’d like to add, please leave a comment or feel free to contact me.