DO CONTACTS MATTER FOR A RESIDENCY ?

"Shhhhhhhhhhh !! ...don't talk aloud about that... ", Melissa told John as John asked her if it was true that Maria got in because she had 'friends' in the program ?

Connections, Nepotism, Cronysim , Bias, Partiality , favouritism ....all leaves of the same tree, eh ? :-) Contacts and connections have always mattered to various degrees - do matter - and will matter in all walks of life - not just a residency. It's undispensable and as much we hate to admit it, every now and then we hear rumors about someone who got in because of connections.

Connections work like powerful recommendation letters. As a program director, would YOU too not be inclined to interview a person who is personally recommended by someone within your program or someone close ? The question we all have is : How much do they really matter ?

It's well known now that knowing residents in a program seems to help getting interview spots - especially the ones that have been your medical school seniors or batchmates. In most cases, this helps ONLY upto the stage of getting an interview call. After that, the person must impress the selectors based on his OWN credentials, personality and strengths. As example, let me cite a story I heard from a old pal the last year: A candidate got called in for a interview at an excellent IM program after a 3rd year resident suggested him to the director. However, during the interview, the candidate could not justify his very low scores on the Step 2 , could not carry himself well through the interview questions and was NOT ranked.

Program Directors carry a responsibility of a good resident team and are answerable not only to board of directors of the program but also to the American Medical Association. So, while its true that contacts give an edge, eventually choices are made based on merit and impressions of the faculty and residents during the interview.

As my observership-sponsoring physician joked, "Sometimes, it's not HOW MUCH you know , it is WHO you know " ;-)

Having said that, let's go over some scenarios where contacts have proved helpful for interviews and, if candidate was good, a residency spot :

1. Knowing a current resident of good standing / Chief Resident - So if you are still in medical school while you read this, it's time to do your seniors favours more often ..you never know whose help you will need ;-)

2. Your spouse or spouse-to-be is a current resident : Some say that works better than going for a couple match ;-) i.e. one person gets in first and 'pulls in' the second the next year!

3. Your Observership / Externship / Clinical Research physician personally calls / writes to the Program director - especially if in the same institution

4. Relatives in high positions......(hmmm, need I say more) ?

5. Plus getting those vital US Clinical Experiences themselves often needs contacts. Like this 2006 paper [PDF] that discusses IMG resident issues found:

"Of the 33 IMG residents interviewed, 18 expressed frustration with the difficulty getting clinical externships in the US. Ten of the 33 IMGs had a friend or family member that was able to provide or arrange an externship in the US."


All this discussion carries a long-term lesson though - when you all have your residencies and get working, it's important to be known as a reliable, high-quality, hard-working and pleasant personality. Work on your contacts as friends and treasure them always - NOT as something you need to use, but because you are good, warm human being. Your professional impression at work goes a subtle but long way in opening new doors in the future career paths :-) Recommendations are of great importance in the US and in the medical field, the importance of recommendations goes back to history ! Yeah, long long time ago where there no AAMC, physicians had to rely only on the word of fellow physicians for the quality of new recruits...



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