Physicians offer a road map for the geography of Match rankings

A career as a physician is a decades-long journey. In the context of that timeline, a three- or four-year residency may seem somewhat insignificant.

So, the location at which one spends their residency may simply be a stop-over for some. But, for others, the stop-over may become a permanent home. A group of young physicians offered their tips on how to factor geography in with Match rankings in advance of the Feb. 21 deadline for fourth-year medical students to submit their list.

By the time he was submitting his Match ranking list, Chirag Shah, MD, an anesthesiology and critical care resident at University of Chicago Medicine, had been away from his family in Chicago for more than 10 years. After college, he worked in New York and then attended medical school at Case Western Reserve University School of Medicine, in Cleveland.

“When I left home, my parents were 53, 54. Now they’re 64, 65,” Dr. Shah said. “They have medical issues. They have life issues. They’re getting older and they’re not as sturdy. I feel like it’s an important time to catch up with them.

“You need a good support structure, whether it’s friends, your family or even your fellow residents,” he explained. “You’re going to have some sort of a setback—everyone does. If you don’t have that support structure, you might struggle more than you need to.”

So when it came time to finalize his Match ranking list, he ordered programs geographically, beginning with those in Chicago.

“I only ranked programs in major cities, but I included each program in each of those cities,” he said. “I ranked Chicago programs first, then all the programs in Boston, then San Francisco. I thought, ‘Chicago is where I’m going to be happiest for the next four, five, six years. This is where I want to be.’”

Matthew Lecuyer, MD, a pediatric emergency medicine fellow at Brown University, grew up in New England and attended undergrad and medical school in the region. For his residency, he wanted a change. He found that his top three destination cities were Chicago, Philadelphia and Washington, and applied to multiple programs in each of those locations. He matched with Northwestern University’s Feinberg School of Medicine, allowing him to work at the Ann & Robert H. Lurie Children’s Hospital of Chicago.

“I was ecstatic to move to Chicago,” Dr. Lecuyer said. “I knew folks who were out there already. I knew I meshed well with the class [of incoming residents].

“Part of entering in the match is agreeing that you will go for at least a year to a program. My advice to applicants is do not rank anywhere you wouldn’t be happy moving to.”

Tyler Andre, MD, formerly chief resident of the emergency medicine program at Western Michigan University School of Medicine, echoes those sentiments. He relocated from Southern California to Western Michigan for his residency and found it be a good fit.  

“It’s not healthy for a resident to not like the place they’re in,” Dr. Andre said. “The thing I tell students often is, ‘A resident who is happy in residency is going to learn more, work harder and study smarter because they’re in a good place.’ You finish your shift, you go home, you might open a textbook, you might do some practice questions.

“The resident who doesn’t enjoy where they are or the people they’re with will hate going to work, and, after work, will go home and binge-watch Netflix or do something nonproductive in an effort to forget about having to go to work the next day.”

After completing her undergraduate medical education at Thomas Jefferson University in Philadelphia, Tina Shah, MD, MPH, opted to stay the course by doing her residency training at the same institution.

“Philadelphia was a place I had lived in for four years and really enjoyed,” Dr. Shah said. “It fit my criteria as being a big city with a lot to do and I had a support network. For me, I felt that residency may have been a time to take a leap. I did interview at places in California where I didn’t have family or a strong friends network because part of me … wanted to get exposed to more than one way of practicing medicine. At least once, you should go to a different place. 

For that reason, Dr. Shah opted to do her fellowship a pulmonary and critical care fellowship at University of Chicago Medicine following her residency.

“In fellowship, I took the leap and went to Chicago,” she said. “I realized then that there is something to be said about having a support network. I think because of that, I had a rockier first six months. Not that it should preclude people from reaching for the stars, but it’s good to strategize ahead of time on building that support network.”