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By Shari Buck, VP Product at Doximity

Choosing a medical residency program is one of the biggest decisions of a physician’s career. With hundreds of programs to choose from and a paucity of historical comparative data available, the process can be overwhelming. It’s also expensive: A 2012 survey of graduating medical students at the University of Missouri found the interview trail cost students $6,600 on average, and expenses can be significantly higher for competitive specialties such as ophthalmology.

As medical students face increasing competition for a limited number of residency positions, discovering and investing time into programs that may be a tailored fit becomes increasingly important. Yet “fit” is not one size fits all. While nothing trumps an applicant’s perception of a program’s “gestalt” after spending a few days on campus, few resources exist to help students discover and compare options throughout the application process.

An unprecedented look into resident satisfaction

With that in mind, we’re excited to introduce the 2015-2016 Residency Navigator. Over the summer, Doximity members have contributed over 94,000 anonymized ratings and hand-written reviews on important aspects of their residency experience, such as career guidance, schedule flexibility for pregnancy and other life events, program culture and clinical diversity.
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Where are residents happiest?

While there’s no way to know for sure today if geography, climate, extracurricular activities or have an effect on clinical training satisfaction, it’s interesting to note that satisfaction data from current residents and recent alumni have varied by state.

Oregon residents, for example, were the most satisfied by their training. Who knows — maybe it’s because of Portland’s high density of micro-breweries. Residents in Nevada, on the other hand, perhaps have too much student debt to enjoy the casinos.

Happiest residents:

  1. Oregon - 100%
  2. Vermont - 97.5%
  3. Utah - 97%
  4. Minnesota - 96.5%
  5. North Carolina - 96%

Unhappiest residents:

  1. Oklahoma - 81.5%
  2. South Dakota - 80%
  3. Mississippi - 79%
  4. Arkansas - 78%
  5. Nevada - 75%

Male vs female residents: Who’s happier?

Residency can be extremely stressful, but that doesn’t mean life as a resident is miserable. However, female residents in general appear to be less satisfied. Only 91% of women rated their programs at least 4 out of 5 stars in “Overall rating: willingness to recommend this program to others” compared to 94% of men.

As U.S. News reports: “The gender gap was wider in certain historically male-dominated specialties, including orthopedic surgery (83.7 percent for women vs. 95.9 percent for men; p<.05), general surgery (84.9 percent vs. 92.4 percent; p<.05) and anesthesiology (88.6 percent vs. 92.9 percent; p<.05).

Thankfully, the world is changing, and right before our eyes. Efforts such as the #ILookLikeASurgeon movement help ensure that today’s surgical specialties will not discourage prospective female applicants.
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Work/life balance, in the eye of the beholder?

Duty hour standards, such as the capped 80 hour work week, are designed to protect newly-minted physicians (and their patients, although the jury’s still out on whether it helps) from sleep deprivation and decreased performance. However, as some residents have noted, reality differs from what is documented. In this year’s Residency Navigator, physicians rated their residency programs on “Work hours: tolerability of shift and call schedules” and “Schedule flexibility: accommodation for weddings, pregnancy, deaths, etc”, providing a glimpse into which programs and specialties have the best work/life balance.

Specialties with highest average of Work Hours & Schedule Flexibility ratings:

  1. Physical Medicine & Rehabilitation
  2. Dermatology
  3. Radiation Oncology
  4. Orthopedic Surgery
  5. Emergency Medicine

Lowest:

  1. Anesthesiology
  2. Neurology
  3. OB/GYN

Perhaps not surprisingly, physical medicine & rehabilitation, dermatology, and radiation oncology were amongst the top 3 in the list. What may be surprising is that the rest of the list did not necessarily sort just by “easy” or “tough” stereotypical schedules. For example, radiology (generally thought to have more flexibility) and neurological surgery (generally thought to have less flexibility) both ranked near the middle of the pack. To understand this, we should keep in mind that survey respondents rated their own residency program, thus creating a measure of expected flexibility vs actual flexibility. Both dermatology and radiology are perceived to offer better hours than neurosurgery, but that is expected. The difference may be that dermatology programs meet or exceed expectations at a higher rate than radiology and neurosurgery programs. We’ll return to this analysis in greater detail as more physicians contribute feedback on their residency experience.

Physicians empowering physicians

There are thousands of incredible clinical residency programs — all of which should be applauded for their efforts training young doctors. However, not all programs are created equal, and choosing a program is a highly personal process. Residency Navigator helps students begin that journey. We’d like to thank our Doximity members for sharing their training experiences, it’s an inspirational example of what the world’s largest body of physicians can achieve together, and we hope it will prove valuable to the next generation of physicians.

Visit Residency Navigator: https://residency.doximity.com/

Shari Buck is Vice President of Product Management at Doximity