Choosing externships may seem overwhelming at times, but there are a couple things you can keep in mind to help guide your selection. Often the first step is to decide what type of program(s) you may be interested in and whether you are bound to a certain location. Other things to consider are individual program requirements, expenses, and how many places you should be going.
Type of Program:
Try to establish what type of program you think you prefer, but keep an open mind. A lot of the information you get about different programs comes from the experiences of your colleagues and upper classmen, so it may be somewhat biased and unreliable. It’s important to remember that residency programs are constantly changing in terms of residents, attendings, and even directors, so one student’s experience at a program may be completely different than another’s depending on when they go. Additionally, you may be getting your information from people who prefer a completely different type of program than you. When talking to your colleagues, try not to get caught up in how much they loved or hated a program. Instead, try to ask about specifics: what a typical day is like for a student or a resident, surgical load and distribution, frequency and types of didactics, number of residents and attendings, etc.
If you think you have a good idea of what type of residency you are interested in, then it is reasonable to spend most or all of your externship months at programs that offer that type of experience. However, you may want to use at least one month to try something a little different or find time to visit a couple different types of programs just to make sure you are selecting the best fit. It was not uncommon for people to think they wanted a certain type of residency, only to find out halfway through externships that they would actually prefer something different.
If you aren’t certain what type of residency you are looking for, try to choose a good variety for externships. Based on what you enjoy most, find other similar types of programs to visit during the year.
If you’re bound to or prefer a certain location, you should obviously focus on going to externships and visiting programs in that area. However, be prepared to be flexible with the type of residency you are looking for if location is your main criteria.
It’s also important to pay attention to the program’s requirements and to be realistic. While there is often some degree of leniency and flexibility, make sure your GPA is at least close to the minimum required for the majority of externships you choose. Unfortunately, a program accepting you as an extern does not always indicate they’ll consider you as candidate for their residency if your application is well below their bottom-line requirements, even if you have an amazing month.
If you are interested in a program that states they only select from people who extern, then you need to make sure you spend one of your months there or contact the program to see if visiting for a certain number of days will fulfill the requirement. There are also some residencies that do not have externships, but may still expect you to find time to visit. If you are not a US citizen, make sure the programs you are interested in can sponsor your visa.
Externships can be very expensive, especially if you have to fly to the location, rent a car and housing for the month, and pay for your own meals. If you feel strongly about a specific program or location, then unfortunately the cost may just be part of the deal and you need to budget accordingly. However, if you are casually applying to various externships and just choose one because you think it would be fun to spend a month in a specific place, you may want to consider the associated expenses.
Number of Programs:
Although there is no magic number, I would recommend spending time at 5-10 programs prior to January interviews. Sometimes visiting a program is just as helpful as externing at one, so don’t be discouraged if your externship schedule doesn’t work out the way you hoped or if you feel it would be too expensive to spend an entire month at a program. If possible, it is probably better to spend more than one day visiting a program to get a better sense of what the program is like and to meet more residents and attendings. However, even a single day will at least let a program know you are interested.
Jacquie Morrison PGY-1,
IPED member Mercy Health Regional Medical Center, Lorain OH
KSUCPM Valedictorian Class of 2015