How to Choose a
Family Medicine Residency

Points to Consider

Introduction

What you are seeking in family medicine programs can be a highly individual matter and will relate to your own personal goals and desired areas of study. There is a wide range of programs and you may not want the same things other applicants want.

On interview day, you will have questions. Write them down ahead of time in their order of importance to you. Some questions will be better answered by the program director, by the other faculty or by residents. You will want information about the hospital, the FM clinic, educational program and other matters. The section below suggests some pertinent questions.

Where to Interview

Some areas of the country emphasize different aspects of family medicine than others. Ask what the main emphasis is in the area of the country where you are interviewing. Is it behavioral medicine, OB, geriatrics, general surgery, etc? Rural programs will be different in their emphasis than inner city programs due to the nature of their populations.

If your interest is in academia, a university program will allow you to learn appropriate skills and to meet appropriate role models. University programs usually have a larger FM faculty, residents in other specialties, medical students and a wide choice of clinical electives. Community programs usually have less competition with other residencies, rely on private attendings for much of the educational program and are good learning sites for practice in communities. In any program, ask how long it has been in existence and how much support the community and affiliated hospital gives to the program.

Interview Day

On this day, you gather as much information as you can about a program and let their people have a look at you. Most programs have you interview with the program director or chairperson of the department, one or two faculty members, and usually the FM residents. You should have answers to questions such as these: how did you hear about our program; how did you get interested in FM; what could you bring to our program; what do you do to relax; what are your future goals in FM? You will be given a lot of written material. Save it for later.


It is a good idea to quickly find out a little about those with whom you will be interviewing to see if you have any common interests or backgrounds. This information is often available on the program website. Preparation of a case showing your interest in a certain area may be a good idea as you may be asked about this.

In interviewing, nonverbal clues are very important, so look for them when asking questions. Watch for eye contact.

Makes notes. Rely on your impressions. Do you like the atmosphere in the clinic and the hospital? Are the people genuine, friendly, and intelligent? Is this an environment in which you will learn well? When you get home, look at your notes.

If you are invited back for a second look and you are interested in the program, consider going again and collecting more information, although this is not usually required.

The Residency Director

  • What is the direction of the program?

  • What changes have there been, or are planned in the curriculum?

  • What is FM's political power in the community?

  • What is the stability of the program and hospital, FM faculty, are there new faculty?

  • The program gets funding from where? Is it stable?

  • What is his / her philosophy of FM?

  • What do graduates of the program do now? What % pass their boards? What kind of practice: solo vs. group, OB, urban vs. suburban vs. rural, academic FM, developing world?

  • Where do graduates go?

  • Have there been problems with graduates obtaining privileges? How is documentation achieved in the program?

  • How are residents evaluated?

  • What training is there in practice management?

Be careful when asking about the weaknesses of the program. Your questions should be more specific.

Other Faculty

  • Ask questions pertaining to their area of interest or research: OB, behavioral science, etc.

  • What is their background? Private practice?

  • Why did they come here?

  • If there are private attendings physicians, what is their commitment to teaching?

  • Do FM faculty do OB? (it is important if they attend when you see OB patients in the clinic)

Try to see faculty in action on the floor or in the clinic.

Residents

  • Why did they chose this program?

  • Is it living up to their expectations?

  • Strengths of the program? What could be improved?

  • Quality of fellow residents?

  • Do they interact socially?

  • Where do FM residents stand in the hospital: respected by residents in other specialties?

  • Quality of interaction with clinic FM attendings? Ward attendings? Private attendings?

  • Are they living in the community? Do they have community involvement?

Try to see residents in action, especially in clinic. Observe attitudes.

The FM Clinic

  • Number of centers? Near hospital? Rural clinics?

  • What is the availability of attendings teaching on site? What is the help with procedures?

  • What is the clinic population? Age range, racial mix, OB, peds?

  • What patient education programs are available?

  • Are behavioral science faculty helpful with cases? Are programs interactive to teach counseling and management of social programs?

  • How is the EMR set up? Does the EMR integrate with the hospital inpatient EMR?

The Hospital

  • Number of beds? Diversity of patients?

  • Call schedule: number of admissions per night? Med students?

  • Are there enough call rooms available?

  • Ancillary services: phlebotomy, IV teams, nursing, clinical labs? Does the hospital work well?

  • IM? Does FM follow patients into unit, unit experience, responsibility, supervision?

  • OB volume? Who teaches?

  • Are there Peds residents? Is there adequate volume? Good outpatient? NICU?

  • What is the ER experience?

  • Is surgery first assist? Outpatient?

  • Is psych inpatient relevant?

Educational Programs

  • What library resources are available? Is there easy access? Is there a good family practice/primary care collection?

  • What are the research opportunities?

  • What is the FM conference schedule? How is it organized?

  • Is there overlay of behavioral medicine teaching? Geriatrics?

  • What is procedure experience for LP's, unit procedures, colposcopy, sigmoidoscopy,. casting, suturing, intubation?

  • Are there programs in neonatal resuscitation? ALSO? ACLS? ATLS?

  • Community experiences - home visit, nursing home, sports medicine?

Miscellaneous

  • What are benefits? Salary? Insurance? Money for conferences/electronic resources? Relocation reimbursement, loan repayment, moonlighting permitted/with or without malpractice insurance coverage?

  • What are the provisions for meals, lab coats, parking, vacation? Child care or sick child care?

  • How helpful and friendly are clinic staff? Department admin?

  • What type of environment is the city where residency is located? Cultural amenities? Cost of living? Recreational activities? Schools? Clubs for spouses? Employment or education for spouse?

After Interview Season

When you are done with all your interviews, review your notes and the written material you got from all the programs you interviewed at. Which programs emerged as leaders? Which fell to the bottom of your list? This article may help you decide which factors are more important than others when considering a program. After you have made your rank list, press submit, sit back, and wait for the big day. We hope to see you soon.