Sole Purpose 65
Picking Your Externships

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Today’s article is all about how I picked my externships. Whether you call them externships, sub-internships (Sub-Is), or clerkships, these are the 4–5-week rotations that fourth-year podiatric medical students complete at various residency programs. They’re a crucial part of the process—offering a chance to experience different programs, meet future colleagues, and gain more hands-on training in podiatric medicine and surgery.

The number of externships varies by school. I attended Western University of Health Sciences in Pomona, California, where we were allotted six externships. Below, I’ll share my monthly schedule along with a general idea of which regions of the country I was in.

I genuinely loved so many of the programs I rotated at—actually loved a lot of them. Honestly, I could have seen myself thriving at the majority of them. So let me be very clear: just because I didn’t rank a particular program #1 doesn’t mean it wasn’t excellent. Far from it. I would have been so thrilled to get any of my top 6 ranked programs.

Podiatry has some truly phenomenal training programs, and I was lucky to experience quite a few of them firsthand. Out of respect for the incredible residents, attendings, and staff I worked with, I won’t be listing exactly where I rotated or getting into the nitty-gritty of why I ranked certain programs the way I did.

My schedule was as follows:

April: Externship I – California
May: Externship II – East Coast June: Externship III – Indianapolis (YAY Ascension St Vincent Indy!)
July: CORE in LA –Visited programs in California
August: Externship III – Texas
September: Externship IV – West Coast
October: Externship V – Midwest
November: Externship VI – West Coast
December: Study for APMLE Part II and Interviews
January: Interviews and CORE
Rest of January – May: CORE Rotations

Choosing My Externship Programs

Back when I was a second-year student, I made it my mission to attend every residency lecture, preview day, or info session I could find—if the word “residency” was in the title, you could bet I was there, probably over-caffeinated and armed with an unreasonable number of highlighters. I wanted to soak up every detail to help guide my future decisions.

The first step in choosing externships is identifying your non-negotiables. For me, that meant having some honest, thoughtful conversations with my loved ones. In the end, I decided I was open to going anywhere in the U.S. if it meant finding a program where I truly fit and could grow both personally and professionally. I fully recognize that being able to cast such a wide net is a privilege—I don’t have children, my family is in good health, and my boyfriend travels frequently for work. He was fully on board with me prioritizing the best program for my training, reassuring me that weekend visits and strategic PTO would help us stay connected.

So, my advice is, be honest with yourself. If you need to stay close to home, that’s okay—own it and plan accordingly. Personally, I didn’t have family in Indianapolis when I matched here, but I’ve since built a community and truly feel happy (even if I do miss the ocean and good Mexican food).

When it came time to select externships, I started by meeting with my faculty mentor. I asked if there were any programs she thought would match well with my personality and learning style. It’s easy to focus on case numbers and prestige—and yes, those things matter—but so does fit. Residency is a long and challenging journey, and if you’re in an environment where you don’t feel supported or inspired to learn, even the “best” program can start to feel like the worst.

She gave me a thoughtful list of programs she believed would be a good match for me. I also reached out to other trusted faculty members to hear about their own training experiences and gather more recommendations. It’s all about combining objective info with some real talk from people who know you and want to see you succeed.

How I Researched and Chose My Externships

I think I genuinely went through the entire CASPR handbook—every single page. Twice. I started with the programs that were recommended to me by faculty or that I already knew about and quickly found myself with a list of 30-something options. The great thing about podiatry is that there’s no shortage of excellent residency programs that will more than prepare you both surgically and academically. The challenge is narrowing it down.

So, naturally, I made an Excel spreadsheet. (Because if you’re not using spreadsheets in med school, are you even a med student?)

I listed each program along with:

I also marked off whether or not I had attended a residency preview lecture from that program. If I hadn’t, I’d email the program coordinator and ask if I could sit in on their academics virtually or speak with a resident. Looking back, this was definitely overachiever behavior—but it worked. By the time I showed up for an externship, I’d usually already spoken to someone from the program, which made me feel a little more comfortable walking in on day one.

Joining a program’s academic sessions was incredibly helpful—it gave me a glimpse into the teaching style, the dynamic between residents and attendings, and a chance to brush up on things like X-ray readings. That said, this came with a small risk: you might get called on. So yes, join academics...but maybe brush up on your post-op protocols beforehand. You never know when your name’s going to pop up in the Zoom call of doom.

When it came to actually choosing my externship schedule, I tried to be strategic and vaguely geographical. My goal was to start in California, move through the East Coast, and then circle back to the West Coast. Reality check: that plan did not work out.

The Actual Externship Selection

Here’s how it actually works: You pick 3–4 externship options for each available month (for me, that was May, June, August, September, October, and November) and rank them 1–4. Pro tip: Do not put two of your top programs in the same month. If you get offers from both, you’ll have to pick one, and the other may not have availability in later months. Then in interviews you will have to answer why you didn’t select to extern there and it’s awkward.

I tried to schedule my “top choices” for later in the year (September, October, November) so I’d be more experienced by then. Ironically, I ended up rotating in Indianapolis in June—and that was the program I ultimately ranked #1. So really, you never know which program will feel like home until you’re there, seeing how they operate and imagining yourself as part of the team.

Externship selection goes through up to three rounds. Some people get all their months selected in the first round, some take all 3, but it varies. Be flexible, be strategic, and know that even if your original plan goes off the rails, you can still end up exactly where you’re meant to be.

On GPA, Class Rank, and Perspective

In the spirit of transparency: I didn’t have a “bad” GPA. I was comfortably above a 3.0, but I also wasn’t at the very top of my class. I’ve written before about how I failed an exam during my first semester, something that really impacted my class rank and, for a while, was a sore spot for me during the externship process. I ended up in the top half of my class and hovered near the top quarter, but on paper, I was a pretty average applicant, grade-wise.

That said, being an “average” student on paper doesn’t mean I was an average student overall—and it certainly doesn’t mean I’m a bad resident now. GPA and class rank are just one small piece of a much bigger picture.

Externship applications can feel frustratingly one-dimensional. You’re asked to present yourself with very limited information, and most of what programs see are academic. There’s no personal statement or essay. There’s no space to talk about your leadership roles, research, or extracurriculars. So even if you were heavily involved in your school community or had stellar interpersonal skills, there’s not really a spot for that to shine through. It’s like trying to capture your personality in a pie chart.

I remember one program where I really felt like I belonged. I loved everything about it. Everyone told me it was a perfect fit for me. I regularly joined their academic sessions, asked thoughtful questions, and genuinely imagined myself being a resident there. And then... they didn’t accept me for an externship. I was crushed. Absolutely devastated. I convinced myself that it reflected who I was as a person, that my career was over (I really can be so dramatic).

But here’s the kicker: I kept showing up. I visited the program, kept attending their academics when I could, and later interviewed with them. And during the interview... they didn’t even remember I hadn’t externed there. Seriously. All those tears and worries are for nothing because it didn’t matter. I highly ranked their program, and the interview went well, and they told me they felt like they had gotten to know me based on how involved I had still been despite no externship.

Final Thoughts

At the end of the day, planning your externships is a mix of strategy, self-reflection, and a little bit of chaos. No matter how many spreadsheets you make (and trust me, I made a lot), things won’t always go as planned. But that’s kind of the beauty of it. Every step—even the curveballs—teaches you something about yourself and what you need in a training environment.

Externship rejections? They sting. Trust me, I’ve been there, melodramatically spiraling over a single “no” like it was the end of the world. But spoiler alert: it wasn’t. And it never is. Programs are busy, extern slots are limited, and their decisions don’t define your worth or your future. Sometimes, all it takes is showing up—consistently, genuinely, and with a willingness to learn—to make a lasting impression.

And once you do land those externships, that’s just the beginning. Getting the rotation is not the prize—what you do with it is. Every single day on an externship is a chance to show who you are, how you think, how you treat others, and how much you want this. Whether you’re in your dream program or one you barely knew existed until the month before, show up with intention. Be the kind of team member you’d want to work with. Be teachable, be prepared, and be kind. Podiatry has SO MANY excellent training programs, and I truly believe you don’t have to be a perfect applicant to land in a great one. The path to residency isn’t always linear, but more often than not, it’ll lead you right where you’re meant to be.