Selecting The Top Candidates For Residency Slots

After completing the interview and ranking process, these residency directors discuss how they narrow down their choices for joining the residency program while keeping the relevant rules in mind.

Q:

Now that you have completed your interviews with potential residents and submitted your rankings, have you reviewed how many applicants you are considering were externs versus those who visited your program? How many candidates did you rank? How do you approach this process?

A:

Craig Clifford, DPM, MHA, FACFAS, FACFAOM, says his residency program typically interviews externs. His program has two or three externs per month from May to December, adding up to about 18 to 20 interviewees per year. He will occasionally interview a student who did not do an externship but did do a day visit.

Strictly from a numbers perspective, Keith Cook, DPM, FACFAS, usually has more externs than visitors to his program. Although his program gives more consideration to those applicants that have externed with or visited the program as they show a serious interest in the program, he does not exclude quality applicants who did not extern or visit. Generally, Dr. Cook says 75 to 80 percent of interviewees have externed or visited the program.

William Urbas, DPM, notes his program has a policy of inviting those who have externed at his hospital system for an interview. The remaining students his program invites for interviews are usually students who have visited the program during the week. The program also offers interviews to those who have attended the hospital’s lectures, given on three Saturdays, on how to prepare for interviews. Dr. Urbas says the Saturday programs, usually well attended by students from several podiatry schools, are also a chance to meet the program’s residents and attending physicians.

H. John Visser, DPM, FACFAS, says 10 of the 18 candidates he ranked did complete an externship with his program. Carmina Quiroga, DPM, notes the program ranked all 18. Drs. Visser and Quiroga offer their first interviews to all candidates who complete externships with the program. They then provide remaining interview slots to candidates based on their applications.

Of the 20 or so students that Dr. Clifford interviews, he will usually rank about half but notes that he ranked 13 students in 2019. He and his colleagues approach ranking based on callback interviews. Dr. Clifford says the initial interview is purely academic and after interviewing all candidates, he looks at the scores and will usually grant callback interviews to the top half. He ranks all students who got a call back.

Ranking is always a difficult process, according to Dr. Urbas, who notes that his program considers a number of factors. These factors include grades, whether the student passed the boards on the first try and how students performed during the externship or visits. Following the interview process, Dr. Urbas and colleagues rank the students on how they did during interviews and then using the aforementioned criteria, they rank students overall. He usually ranks approximately 15 to 20 students.

Dr. Cook does not have a minimum or maximum number that his program ranks. He will rank all candidates whom he thinks will be a good fit for the program.

Q:

Do you call your top applicants and discuss their interview and possibly joining your program without violating the rules of the Central Application Service for Podiatric Residencies/Council of Teaching Hospitals (CASPR/COTH)? How much influence do you receive from your current residents before making your final selections?

A:

After completing interviews, Drs. Visser and Quiroga like to contact the top potential candidates to further discuss their interest in the program. They say this assists them in finalizing the ranking. Dr. Clifford does not call applicants to discuss the interview or the rank, preferring to let the system work the way it was intended. At interviews, he tells callback candidates they will be ranked but the program can't tell them their current ranking. Dr. Cook also does not call the top applicants. Following the interviews, he invites all of the candidates intended for ranking to a social event and informs them all they are going to be ranked. Dr. Cook also instructs the applicants to rank the programs in their order of preference.

Dr. Urbas does not call any applicants but cites “a pretty intricate subculture surrounding this whole interview process.” His program’s residents talk to residents from other programs who may have been friends or classmates and he says they will naturally begin to talk about which students they are interested in having join their program. Dr. Urbas says some students will reach out to his program’s residents to see how they have done in the interview process.

Dr. Cook says current residents play a big role in his program’s rankings.

“We want to be as certain as possible the residents will be able to work well together and often the residents will be able to determine a candidate’s true work ethic and personality,” points out Dr. Cook.

Drs. Visser and Quiroga ask their current residents to rank the externs who have accepted interviews to assist in the decision of the program’s Centralized Residency Interview Process (CRIP) panel.

“While the final ranking is decided solely by our CRIP panel, we think it is important to have our current residents’ feedback when making our final decision,” note Drs. Visser and Quiroga. “Our current residents do have a significant say in our program because they know what is involved in being a resident in our program and the type of student that would fit well and perform well at our program,” says Dr. Urbas.

Dr. Clifford says current residents have minimal influence on his program’s final selections.

Q:

When a top resident candidate drops out, how do you handle that? Have you had a situation when a top candidate dropped out due to being guaranteed a spot with another residency program? Do you contact your COTH representative in these situations?

A:

Dr. Urbas says if one of the top candidates informs his program they are choosing another program, he and his colleagues “are always happy in the sense that residents need to feel comfortable where they will be spending the next three or four years.” He adds that he does not want a candidate who has no interest in his program.

In Dr. Cook’s program, the ranking does not change if a candidate drops out, saying candidates are still ranked in the order in which the program wants them.

Dr. Cook’s residency program has had good candidates drop out because they were guaranteed a position in another program.

“Unfortunately, there are some unscrupulous program directors who place pressure on the candidates to commit to their programs, and some that are not truthful to candidates when they guarantee a spot,” says Dr. Cook.

In those situations, Dr. Cook has contacted his COTH representative but notes the situation is difficult to police. He hopes students “understand the process and rank all of the programs they desire in the order of their choice.”

Some candidates have said they are not ranking Dr. Urbas’ program because they have been guaranteed a spot at another residency program and Dr. Urbas says this situation is “not too unusual.” He does not contact his COTH representatives in these situations, calling it “the nature of the residency interview process.” Drs. Visser and Quiroga have had top candidates notify them that they have accepted a position with another program prior to rankings, and also have not contacted their COTH rep.  

Since his program does not call candidates to discuss rankings, Dr. Clifford is unaware if the program has had anyone drop out.

In addition, Dr. Urbas calls for CASPR/COTH to enforce that all residency programs participate in the central interview process held in Frisco, Texas.

“Until then, we will have programs skirting the rules,” maintains Dr. Urbas. “The central application process was formed and meant to reduce the anxiety and cost of the process to the student but unfortunately, this has fallen short.”

Dr. Urbas cites situations when students would fly to Texas for one or two interviews, and then have to return home for multiple interviews for programs that do not participate in the central interview process. He calls for CASPR/COTH to address this problem.  

Dr. Cook is the Director of Podiatric Medical Education at University Hospital in Newark, N.J. He is a Fellow of the American College of Foot and Ankle Surgeons

Dr. Quiroga is the Assistant Director of the DePaul Health Center in Bridgeton, MO. She is a Fellow of the American College of Foot and Ankle Surgeons, and is in private practice at multiple locations in Missouri.

Dr. Urbas is the Director of the Foot and Ankle Surgical Residency Program at the Crozer-Keystone System in Pennsylvania. He is the Chief of Foot and Ankle Surgery at Mercy Catholic Medical Center in Darby, Pa. Dr. Urbas is a Fellow of the American College of Foot and Ankle Surgeons, and a Diplomate of the American Board of Foot and Ankle Surgery.

Dr. Visser is the Director of the SSM Depaul Hospital Foot and Ankle Surgery Residency. He is a Fellow of the American College of Foot and Ankle Surgeons.

Dr. Bernstein is the Director of the Podiatric Residency Program at Bryn Mawr Hospital in Wayne, Pa. He is a Fellow of the American College of Foot and Ankle Surgeons.