Sole Purpose 43
Picking a Residency: Why the HECK a San Diego Sunshine Girl Moved to INDIANA

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Today, I’m tackling one of the questions I get asked the most: "What the heck am I doing living in Indiana???" Well, the short answer is, I moved here for three years of phenomenal training. But seriously, deciding on a residency program is no small feat—it’s an incredibly difficult and *super* stressful process. Honestly, residency interviews felt like a people-pleaser’s nightmare.

So today, I want to dive into how I went about choosing a residency program and, more importantly, why I ended up at Ascension St. Vincent in Indianapolis.

Interviews Themselves
Let's talk interviews! I’m a firm believer in casting a wide net instead of a small one. So, I applied to all 12 “free” interviews (no additional cost, woo!) and also applied to every program where I externed, since I genuinely enjoyed those experiences. I even visited several other programs to fill up the rest of my interviews.

Side Note: If a program doesn’t offer you an externship, it’s NOT the end of the world (even though it may feel like it—I definitely acted like it was the end and assumed the program must *hate* me). But they don’t hate you! It's competitive, and externship selection isn’t a perfect indicator of who will make a great resident.

If you’re interested in a program where you didn’t extern, don’t panic! Email them, visit, attend their academic days. Get to know the program as much as possible without having externed there. Just try not to be *too* overzealous or annoying to the staff and residents!

THE Excel
As you probably know, I’m a little detail-oriented (okay, maybe *slightly* neurotic... check out my kayaking and neuroticism article if you want proof of how I'm working on it!). So, before I even started my externships, I created a master Excel spreadsheet to track everything I’d want in a potential residency. Naturally, I made categories where I could fill in info as I externed.
 

The categories included:

This method gave me something to look back on, capturing my TRUE feelings at the time, free from the rose-colored glasses I tend to wear when reminiscing about the positives of a program.

I also created an Excel "algorithm" (yes, I’m *that* person) that assigned points to various aspects of the programs, and then tallied them. Since I made the spreadsheet, the point values and grading criteria were tailored to my interests. Categories had different weightings, with a score of 5 for things that were super important to me, and 0.5 for things of minor importance. I’ll admit, it was a bit over-the-top, but hey—it worked!

Location
Affordable housing
Safety around where I would live
Places to run
Proximity to loved ones (family, friends, my boyfriend)
Program driving amount.
Forever home ability (is this somewhere I could possibly live forever)
Weather survivability (let’s not forget I am from sunny San Diego, but I did go to Colorado for undergrad)
Run club presence (I am in fact a part of a run club and it seems silly but genuinely is a small thing that could make a location a bit of a better fit for me, this was a 0.5-point item).

Academics
Quality of academics
Research
Presence of cadaver lab
Conference money

Vibes
Overall resident vibes
Program director
Day to day attendings
Work life balance
Call schedule
Autonomy of residents

Program Itself
Do they get their numbers
Preform TARs
Preform Ex-Fixes
Have pediatrics
Have a balance of surgery and clinic (I believe I shouldn’t cut on a patient unless I can also work them up and work up their complications and post op care)

Future
Ability of residents to get jobs after
Networking ability
Opportunity to teach

Places to Lose Points – I would take away points for these categories
Yelling or abuse of attendings to residents in OR
Overly exhausted interns (yes, every intern is tired, but like EXCESSIVE work for no reason)
No fun things to do in the location
Overly particular/weird attendings
Bad upper residents
The general daily traffic amount

So, after all that time and effort creating my objective point system to find the *perfect* residency, guess what happened? I ended up with a three-way tie. Yep, after all the careful calculations, I was left with three top contenders. But honestly, I think this speaks to the quality of the programs I externed at—there are just so many amazing options out there. I’m absolutely thrilled to be at St. Vincent, but if I hadn’t gotten my top choice, I know I would’ve been just fine starting my career at another fantastic program.

Now, here's a piece of advice: be real with yourself. I knew I could survive three years away from my family and friends back home (thank goodness for airplanes), but I also knew I couldn’t survive somewhere where I couldn’t run outside safely—or worse, where I’d be stuck on a treadmill every day. I also know that while I could handle working in an OR with an attending who screams and throws things, I don't learn well in that environment. In fact, it would probably lead to more mistakes, not less.

Sometimes I wish I could be the kind of robot surgeon who just perfects the craft all day, every day, without ever trimming toenails in clinic. And yes, I LOVE being in the OR. But I also love that after a week of call, I get to see a simple nail patient, chat with them, and watch them walk out of the clinic happy. Balance and diversity of cases is important to me. I’m at an amazing program where, as a first-year resident, I got to be a part of a total ankle replacement in my FIRST month. But I also get to do DM foot checks and nail trims in between surgeries, or on clinic days. I do a lot of wound care and I like the variety, and I like doing it all—from the complex to the simple.

Stay tuned for next week when I dive into why I specifically chose Ascension St. Vincent Indianapolis!