Road to Residency

Each autumn, fourth-year medical students at the Vagelos College of Physicians and Surgeons (VP&S) embark on a ritual that is equal parts life-changing and career-defining—the residency interview process.

To secure a residency after medical school, students must be interviewed in person by representatives of the residency they wish to attend. Residencies send invitations in the fall, and students start interviews in October or November. Some complete as many as 20 or more by January, and many criss-cross the United States, covering thousands of miles of terrain. At the end, students and residencies submit their top choices to the National Residency Matching Program, which makes the final decision that is revealed on Match Day in March. This residency is their first job out of medical school. 

Etoro Ekpe, a Columbia medical student in the MD-MPH program, traveled to 21 interviews between October 2018 and January 2019. Ekpe wants to specialize in obstetrics & gynecology, a field she immersed herself in during two month-long electives in her fourth year of medical school.

The two electives solidified her decision to become an obstetrician/gynecologist. “During my electives, I was able to get to know patients better by following them through pregnancy, delivery, and postpartum,” she says.

Establishing close patient relationships is a common goal among aspiring ob/gyns, so knowing how to tell your unique story is a crucial piece of excelling on the residency trail. 

Ekpe used a moment from her preceptorship that had rooted in her memory. While on a 24-hour call, Ekpe was called to the side of a young pregnant woman who was admitted to the hospital with dangerously high blood pressure. The patient had been unaware of her condition because she had missed the majority of her prenatal visits. 

“I thought it was important to both treat the high blood pressure and understand the barriers that prevented her from attending prenatal visits,” says Ekpe. “I learned she needed to go to work and to school and she didn’t realize the importance of the visits. I told this story to my interviewers because addressing social determinants of health is an important part of caring for patients.”

Successful interviewing also hinges on preparing well in advance and staying organized through the whirlwind of interviews. 

Most students arrive at their destination the day before the interview, especially if they are going out of town, and dine with current residents that evening. Interview day features one to two or more interviews, presentations about the institution, and social events—activities meant to give students the fullest picture of each program.  

Daniel N. Arteaga, an MD-MBA student aiming for a residency in internal medicine, used the process to find a program with the right fit.

“In addition to exceptional training, I’m looking for opportunities in quality improvement, urban health, and leadership training,” says Arteaga. “I think these are things that will make me happier in the long run and contribute to my professional development.”

Arteaga’s outlook was shaped by his volunteer work at Columbia’s student-run primary care clinic, Columbia Student Medical Outreach. One patient of his needed a screening procedure after a physical exam and history indicated a possible cancer. Because she was uninsured, booking the procedure took nearly 10 months. 

“This patient’s situation gave me an appreciation for how we need better health care systems in general and made me see this is something I want to do,” says Arteaga. “I want to address the tough problems that affect people in real ways.”

Knowing what you want from your career as a doctor takes a lot of soul-searching for one person. What if you have to know for two people? 

Christopher Grubb and Neda Bionghi were engaged in Barcelona in spring 2018 and are participating in the match as a couple. They want to do their residencies at the same hospital, both in internal medicine. 

They have done many interviews across the country. They travel together to their destinations and interview separately. 

“It’s important to unstick from your couple and meet other people at these different places,” says Bionghi. “Chris and I gathered our own impressions and shared our thoughts later at home, instead of trying to discuss them during the interview days.” 

Though the interview process can be stressful, Grubb and Bionghi made the most of their time. “On some of the trips, we have been able to schedule multiple interviews in the same region and were able to explore on the way,” says Grubb. “Enjoy the cities where you’re interviewing.” 

Residency Interview Tips for Medical Students 

The VP&S Office of Medical Education provides extensive career planning resources. Every student interviewed for this story mentioned Lisa Mellman, MD, senior associate dean for student affairs, as an invaluable resource. Additional tips include: 

Scheduling Interviews: “It seems silly when they say watch your email at all times, but you should definitely watch your email closely, especially if you’re couples matching and you want to schedule the same dates,” says Grubb. “We found 20 minutes can make a difference. We scheduled all but one of our interviews within five minutes of receiving the emails and were able to schedule them for the same day.”

Preparing for Residency Interviews: “Have informal mock interviews to hear what you’re saying out loud,” says Ekpe. “I used the sheet of questions provided by VP&S and I wrote down my answers. It’s always great to prepare stories. They are the best way to stick in the interviewer’s head and create a picture of who you are.”

Interview Day: “Go to the dinners and happy hours and meet the people,” says Arteaga. “At a happy hour at the end of one interview day, I got to chat with a Nobel Laureate. It helped me get to know the culture of the residency.”

Accommodations: The VP&S Host Program helps fourth-year students interviewing for residency around the country defray some travel costs by staying with alumni hosts. “The residency interview process is costly,” says Laura Tewksbury Gilbert, student/alumni program coordinator at VP&S. “We have a strong network of alumni who generously provide housing to a student the night before an interview. This is an especially wonderful opportunity for young alumni to stay connected to the medical school without a monetary commitment. Many times, they are still in residency themselves and provide valuable information to students applying to that institution.”