Matching Matters: Prestige vs Location

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Choosing a residency program is one of the most important decisions for a medical student to make. There are many factors that should be taken into consideration while deciding where to apply, one of which is prestige vs. comfort. Should you stick with a hospital with a good name and a good history? Or should you settle down in a hospital where you can build a future and continue to serve that community?

As with any important life decision, the weight that students give to certain factors should reflect the values and priorities of that individual. Miriam Nojan, a resident at UCI’s internal medicine program recalls her decision-making process when choosing a residency program: “In choosing a medical school, I was willing to be further from home and had a rich experience at Wash U in Saint Louis learning from wonderful clinicians. When it was time to apply for residency, I had more factors to consider; I had just gotten married and wanted to be close to my family, and because of this, I primarily applied to academic programs in Southern California where I could have a balance of both.”

Some students have chosen to give a high quality of life a greater weight than the prestige of a program. A redditor identified as “Welldoc” listed several benefits of choosing a program in a place where you can comfortably settle down, such as building a family, buying a house, and settling into adulthood. Life outside the hospital is just as important as the hospital itself.

However, others have different motives. If you are single, and have more flexibility over where you live, you might tend to rank prestige of a program over comfort of location. One medical student student commenting on realized that she’s only doing residency once, therefore she’d rather do it at a top rated program. Her rationale was that when you’re done, you’re done; you can move on with your life after that if you so choose.

Nojan recognizes the challenges of making such an important decision. When asked about the important factors to consider in a program, she said that “Residents can sometimes be surprised by elements of their program they might not have considered beforehand. I think having a good system in place for comparing programs is important, as well as making sure to have all your questions answered about metrics that are important to you during the interview process. That helps to ensure matching with a program that’s a good fit without compromises in areas of true value.”

Some claim that prestige is more important if you’re concerned with building a high-level academic career. Go with the program you believe you will want to stick with and choose a specialty that you are most passionate about.

However, program location is still an important factor to consider as well as prestige. Many medical students choose a residency program that is in a location where they would like to get a job afterwards. Students who are  struggling to find a job in one state could end up choosing a residency in a state that is less saturated and has more open positions.

At the end of the day, you have to go with your gut. You have dedicated your life to a career of healing people, so take some time to think about which patients you most enjoy working with and which area of medicine you continue to find fascinating. After all, life is too short to be consumed with what could happen, what might happen, or will I be happy with my choice?

Justin Kravcik
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