How to Choose the Best Residency and Postdoctoral Fellowship Programs

How to Choose the Best Residency and Postdoctoral Fellowship Programs

Christine Vinci, PhD

Moffitt Cancer Center

Choosing the best residency and postdoctoral positions can be very challenging and exciting at the same time. There are not only multiple program-specific factors to consider, but also personal factors (e.g., significant others, family) that might be relevant. For many people, these decisions come with moving out of state (and sometimes across the country) for unknown periods of time.

Despite all of these challenges, residency and postdoc can be pretty awesome experiences too. First, you are continuing to advance in your training (the light at the end of the tunnel is near!). Second, you get to really specify what is most important to you (e.g., a specific research area; working with a unique clinical population; area of the country to live in). This begins with where you decide to apply, all the way through accepting a position. Third, you will meet and interact with all kinds of people. I can honestly say that one of the main reasons I enjoyed my residency and postdoc experiences so much is because of my fellow trainees and the faculty. 

To give a bit of background about myself – I completed my PhD in Clinical Psychology at Louisiana State University in Baton Rouge, LA. I applied to several residency programs across the entire country and had 9 interviews. I was matched at the University of Mississippi Medical Center/G.V. Sonny Montgomery Veterans Affairs Medical Center. I then moved to Houston, TX for my postdoctoral fellowship, which I completed at MD Anderson and Rice University over 2.5 years. I am currently in my third year as a faculty member at Moffitt Cancer Center in Tampa, FL. As you can see, I moved around a lot, and each decision I made came with new considerations.  

Below I outline some key factors to consider when exploring residency and postdoctoral options. It might be helpful to create a spreadsheet to keep track of this information after interviewing at each site, as sites can blend together really quickly! This can be especially helpful for residency interviews, as they often occur back-to-back over a short period of time. Tracking can help for a few reasons: 1) it gets you thinking about what is most important to you in advance, 2) it allows you to keep track of what various sites can offer you, and 3) you can ultimately rank-order your sites by preference.

Fit. I would argue that fit is one of the most important indicators of whether a program is right for you. Here, I’m mainly talking about whether this program fits your specific training and career goals. For residency, I wanted to have protected research time, the ability to extend my research skills in specific ways (e.g., grant writing; number of publications), and to get clinical experience on both substance use and PTSD rotations. For postdoc, I wanted a research-focused position where I could apply for grants and get more in-depth experience with my research area of interest; I also wanted to get licensed as a clinical psychologist.

Some questions to ask yourself in relation to fit: Does the program offer rotations and/or research experiences that match my long-term goals? Will this program advance my training? Does the research program complement my current research interests, while also providing me with new and interesting opportunities? For residency – are the rotations what I want; is there much variety between rotations (does this matter to me in the first place?); am I guaranteed certain rotations? Most people a take postdoctoral fellowship to extend their training in specific ways. Some questions to consider – can I get the specific training I need with this particular lab or faculty member; what is the mentoring style of the PI; what types of projects will I be a part of and what are my expected roles on these projects; what types of clinical experiences/rotations will I get?

Feedback From Those Already In The Program. Information collected from those currently in the program (or alumni) can be invaluable. The data you are collecting here may be verbal or nonverbal – so keep your eyes open! No position is perfect, so hopefully you learn about both the positives and negatives of a given position.

Does it look like people enjoy being there? Do they speak with general enthusiasm for the position? I have been on interviews where it “sounded like” everything was great, but my observations told me otherwise (e.g., very little exchange [much less positive] was made when handed off from interview to interview; in larger gatherings, no one speaking to one another). If you are meeting with multiple people, ask the same questions over and over again to gauge whether you are getting consistent answers.

Significant Other. You might have to strongly consider whether your significant other and/or family can move to certain locations. This may be less of a concern for residency, as it is only 1 year (and many, many people do live apart for that year). Postdoc positions can be longer and may lead into faculty positions. Thus, more consideration may be made in these cases. Every situation is different, and moving from city to city is likely an inevitable part of this career trajectory for most people. For example, my now husband and I lived apart in separate cities for residency, as that made the most sense for us.

Location. Where you are located for residency or postdoc may be more or less important, depending on your personal circumstances. That said, the less geographically restrictive you are, the better your chances of being accepted into a program that really fits your needs. I applied all over the country for my residency, and I ranked Jackson, MS as my first preference, whereas a placement in California was second (two very different locations!). For my postdoc, I limited myself a bit more geographically, as that made the most sense for my personal circumstances.

Other factors that may be important to consider for some locations are cost, commute time, and desirability/likeability of the area. Nonetheless, just because you think a given location is not “desirable” to live in, that is not necessarily a good reason to not apply – you might be surprised! In the end, residency is only one year, and postdocs are time-limited, so you can typically move elsewhere if needed.

General Work Environment/Culture. Understanding what your day-to-day environment will look like can be very important. Are people generally in the office every day? What does your work space look like? Do people collaborate with one another (is that the norm)? Do people seem generally happy or pretty stressed out? Does it seem that the residents or postdocs are well-respected? What is the culture of the city/town you will be living in?

In sum, there are many different factors to consider when choosing the best residency or postdoctoral fellowship program. I highly recommend reaching out to faculty and former graduate students in your program for advice as well. There is no “right way” to do this, and you have to make the best decision for you at that point in time. I wish you the best of luck on your journey!