Where do you get started when thinking about Post-Graduate Training (aka residency)?

What Field?

      First, decide what you want to do!  Of course, this is easier said than done.  It's important to have residency in mind during the didactic years, but you won't be coming to any concrete decisions.  These years are a good time to research what things may be interesting to you.  You can start by reading books like "Iserson's Guide to Getting a Residency", or other similar books.  It's worth it to buy the most recent addition, as statistics change annually.  Use these years to ask any doctors you may know what they like or dislike about their fields.  Most importantly think about what is important to you?  Cardiologists and surgeons may have call and unpredictable schedules, while emergency medicine and hospitalist (internal) medicine will have a much more planned out schedule.  It's okay to think about lifestyle considerations at this point, it is your life! 

     Third year is the time to put the rubber to the road.  You may love surgery so much, grueling call and residency won't matter anymore, or the "monotonomy" of shift work will seem so convinient to plan around.  This is the year to put life-syle considerations to the side, and try to find what you love!  No amount of research can give more insight that a four week rotation can.  So, be patient with yourself, this is the time to learn what you like.

Training Options

     After you decide what you want to do, you must consider how you plan to accomplish this goal. Pathways include traditional rotating osteopathic internship preceding residency, combined internship/residency program, allopathic residency training, or military training. Choices are difficult to make but you must take into account your goal, prior commitments, desired location of program and specialty. Here is some more details on your options:

• Internship-only programs: Also called "Traditional Year".  These programs involve a one-year commitment between the applicant and the institution for an OGME-1 internship position only. These are not linked to residency positions, you must apply separately to a formal residency.  These are falling out of favor, and most programs integrate an "internship" (specialized to the field) into their residency program. 
• Combined internship/residency programs: These programs combine both an OGME-1 internship position commencing followed by an OGME-2,3(4) residency position in a particular specialty. Any type of internship program (traditional rotating, special emphasis, specialty track) may be linked with a residency program to form a combined internship/residency program.  Most programs are becoming this way.  This distinction is clearly made on the AOA Opportunities site, under "Other Program Information".
• Allopathic internship/residency programs: The MD match is a completely separate process.  It requires separate registration, separate intervies and clerkships and occurs on a different date.  The MD match is after the DO match.  If you match DO, you will automatically be removed from the MD matching process.  The exception to the rule is the San Francisco match.  It encompasses Neurotology, ophthalmology and plastic surgery.  (It has nothing to do with San Francisco, CA).  http://www.sfmatch.org/index.htm

   Most specialties participate in the ERAS application.  This is a centralized system, similar to the one we all used applying to medical school.  You will use this to upload LORs, CVs, and applications to programs.

What to do Now

•  Make a list of personal musts: family, spousal career commitments, hometown proximity... This can all play a role in narrowing the broad world of Osteopathic Medicine 
• Pool your resources: ask mentors, friends, what their experience has been with certain fields
• Use the AOA's Clearinghouse to research specialties:  http://www.osteopathic.org/inside-aoa/Education/students/student-specialty-clearinghouse/Pages/default.aspx
• Visit http://www.opportunities.osteopathic.org/search/search.cfm and research various programs/speciaties
• STAY ORGANIZED

Additional Links

Committee of Interns and Residents:  www.cirseiu.org/medschool/Default.aspx

If you are thinking about practicing in a state which requires a traditional rotating osteopathic internship, (Florida, Michigan, Pennsylvania, Oklahoma) you must begin your search on the opportunities link on the AOA website: http://opportunities.aoa-net.org/index.htm

ERAS Application

Make sure to start working on your applications early. Registration for internship and residency is now done electronically on ERAS at http://www.aamc.org/students/eras/start.htm.

As you are working on applications, here are some tips:
 

• Get started early! Make sure to work on personal statements and obtain letters of recommendation well in advance! It may even be helpful to begin requesting letters from your preceptors in your third year so that you will have plenty of opportunity to get a few really strong ones.
• When trying to add a little spice to your application, consider adding details that an interviewer may find interesting. Despite what you may read in some places, you can put hobbies on your application, but don't put boring adjectives such as "reading" instead put "reading English literature" or instead of "exercising" put "cross-country skiing." Specific interests may give you an edge and a connection to an interviewer!
• Practice questions before your interviews and go to each website before the interview to learn more about the program. The most common question you will be asked is what questions do you have for me? Sound easy? Think again - especially on interview number gazillion!
• Think about questions to ask your interviewers about topics such as mentoring, didactics, changes in the program, elective time, research opportunities, etc. Stay away from benefits, resident free-time, work hours, and anything about the word "malignant."
• Let program directors know if you are couples matching, you can get each other interviews!!!
• Consider sending written Thank You notes to all program directors and/or interviewers after all interviews. There is no hard and fast rule, but all correspondence with programs goes into your file that is reviewed when their rank committee meets. It can't hurt to look like you're very interested in their program.

The Process

Interviews are conducted according to schedules announced by individual training institutions. Students are responsible for contacting individual institutions and for arranging their own interviews. It is advisable to interview with several programs in order to make an informed decision regarding the best program for your individual needs.


Students and institutions may express their interest in each other and may discuss their expected rankings of each other. Institutions may inform their most preferred applicants that they are in a favored position, and students may similarly inform their most preferred programs. However, institutions and students must not make statements implying or requesting a commitment, and must not pressure each other to reveal their ranking intentions. Although institutions or students may volunteer how they plan to rank each other, they must not request such information. Volunteered information must be limited to "very likely", "likely", or "unlikely" to rank in a top position.

Students and institutions must not make any verbal or written commitments or contracts for appointment prior to the release of the Match results. Any such verbal or written commitments are non-binding and have no effect on the Match. Institutions shall not impose or enforce local requirements in an attempt to subvert the fair application of these rules. Institutions violating Match rules by requesting ranking information from students, or by requiring students to make verbal or written commitments or contracts before the release of the Match results, may be sanctioned by the AOA and prohibited from recruiting in the subsequent Match.

The Rank Order Lists submitted by students and programs for the Match will be the sole determinant of their respective preferences for the Match. Only the official Match results constitute binding obligations between students and institutions.

The Match is administered on behalf of the AOA by National Matching Services Inc. (NMS). Each student must register directly with NMS in order to be eligible for participation in the Match.

Already finished looking at internships, or finished with your internship all together? Then it is time to start researching residency opportunities on:
http://opportunities.osteopathic.org/.