Another Perspective On The Residency Matching Process

One of the most perplexing events on the road to becoming a podiatric physician is the infamous residency match.

Each year in March, right around the onset of spring, schools post placement results for future residents. The chances of podiatry students matching in the past have varied from feast to famine. In some years, there were more residency positions than there were residents to fill them. At other times, unfortunately, there were significantly more students than available residency positions. I applaud recent strides in ensuring that more students successfully match with a residency program.       

The yearlong-plus process leading up to the match is grueling to say the least. There are many variables that play a role in the outcome. The process begins during the third year of podiatry school when students must decide where to apply for externships. Teachers advise us to speak with upperclassmen who have visited various programs of interest, school residency/externship coordinators and even current residents at programs that we have targeted for possible externship opportunities.

In most circumstances, doing an externship or, at the very least, visiting residency programs is advantageous to all parties. It will give you a chance to see firsthand the hospital facilities, typical patient population and surgical caseload. Most importantly you get a chance to meet the residents and attendings. Some programs are better fits than others and being physically able to interact with people involved with those programs will help you better discern your desire to devote three to four years of your life there.  

Another factor to consider is the program’s geographic location as it may relate to competitiveness. Programs in close proximity to podiatry schools are usually popular and may have more visitors/externs because of the convenience. Additionally, residency programs close to podiatry schools may have affiliations with hospitals and be familiar with students from schools close in vicinity due to rotations or because the attendings serve as faculty. This may give students at the schools closest to the residency programs a slight advantage. However, it is not a bad idea, if circumstances allow, to diversify your externship program rotations geographically. Although there has been a recent push for the standardization of podiatric medical and surgical training, schools are still slightly different from one another and the educational experience for all is better if one can interact with students from a variety of schools.  

After a year or so of externships, students then undergo a daunting interview process. It is advisable to interview at more places than you may have visited or externed, especially since interviews happen in January, and there is still a bit of time to visit programs that either you impressed or that impressed you at the interview. It is important to prepare for interviews from both a social and academic standpoint. Pay close attention during externships to see what types of cases you discussed during academic sessions. Once interviews have concluded, students and residency program directors have the opportunity to rank order their preferences.    

Podiatry is not unique in that all of its students do not find matching programs. Allopathic and osteopathic medical students do not all match either. I am glad to see the podiatric medicine profession recognized how problematic it was for talented students, who devoted numerous hours to studying and insurmountable funds for tuition, not to have the opportunity to match because of residency program shortages. It is admirable to see a push for encouragement and support to create more residency programs, and to open more spots for future residents in programs that were greatly exceeding the minimum number of surgical cases required for certificate completion. It will bring back some integrity to our profession that we have lost over the past years due to the substantial shortage of available residency slots.   

Some may argue that oversaturating programs with residents will be detrimental to post-graduate training, which recently underwent some changes to make it more competitive with other specialty residency training. Last year, the American Podiatric Medical Association (APMA) invoked Vision 2015: The Path to Parity in order to accomplish this task. The greatest tangible success of this vision was the mandate that all podiatric medicine and surgical residencies be at least three years in length, comparable to the minimum length of some residencies for our allopathic and osteopathic counterparts. I would argue that the number of required cases and patient encounters has been standardized, but not lowered. In 2009, the Council on Podiatric Medical Education (CPME) Residency Review Committee began closely evaluating residency programs to ensure they could accommodate additional residents, resulting in the creation of many new residency programs, and the expansion of resident positions in preexisting programs. In 2015 alone, the committee added seven new residency positions in 10 programs.  

The match process allows for many different outcomes, many of which are based on pure chance. Indeed, there still remains work to do on the part of the podiatric medical profession in order to ensure enough commendable residency programs available for all of the well-qualified podiatric medical students to be able to match.

Dr. Ryans is a graduate of the SSM DePaul Residency Program in St. Louis and is now in practice.