Book Review: Medical School and the Residency Match

There’s a new residency guidebook on the scene, Medical School and the Residency Match, and the reviews on Amazon are great. So I’m reviewing it.

This time, instead of being written by a residency consultant (like this or this), the book is written by a group of post-match medical students. As such, it’s a refreshingly honest take and not full of the usual spiels. On one hand, books written by program directors (this is probably the best) may be more authoritative, but they are sometimes over the top and not relatable or easily actionable. For one, what people say they want and what they actually want aren’t necessarily the same thing. Secondly, there isn’t a single path to success. Sometimes it’s nice to be reminded that people like you have been doing just fine, thank you.

MSatRM is written by 13 post-match MS4s, who have provided their thoughts and experiences with the match process from matriculation to Match Day. Chapters include topics such as “The Classroom Years” as well “The Outside World” and the “The Interview Trail,” and each contributor weighs in. It’s got a little something for all medical students, with the bulk of the book dedicated to fourth year and The Match. So with that background, here are my thoughts:

Represented specialties include 1 dermatology, 2 general surgery, 2 internal medicine, 1 family medicine, 2 emergency medicine, 1 PM&R, 1 urology, and 2 anesthesia. While most of the residency process is broadly applicable, only a fraction of possibilities are presented here, which does somewhat limit the applicability of the student experiences. For example, Burt Johnson, the urology applicant/resident, does a nice job of discussing some of the unique aspects of his field but doesn’t really touch on others (like the early AUA [non-NRMP] match). Many of the most competitive fields are not included,1There’s no radiology, neurosurgery, ophthalmology, ENT, etc. and most of the advanced specialties aren’t either, so topics like prelim and TY years are not meaningfully expounded on. Ultimately, this creates a book of experiences, only some of which may be relatable and relevant to you. Hometowns are sometimes mentioned but medical school names are not, nor are the “top” residencies to which people matched, which while not surprising, adds further to the vagueness.2Whether it’s true or not, I think the inclusion of “top” in the subtitle just plays into the appeal to authority fallacy anyway

It’s also written by US allopathic students applying to US allopathic residencies. While some aspects will apply to DOs and IMGs, those groups have unique issues that are of course not covered in this limited scope.3Which I think is a good thing, you can’t be everything to everyone.

There are also some scattered grammatical errors and typos, probably an average number for a self-published / CreateSpace title but more than you’d see from a conventional publisher. None are substantive, but they of course do detract. This is a book written in the largely unedited words of its contributors.

Overall, the format is refreshing and conversational. It’s a nice tour, but you’ll still have a lot of specifics to get elsewhere (your specialty advisors, recent graduates or post-match MS4s from your school). This isn’t a substitute for doing your own homework but a tour down the process for you to start formulating your own thoughts. The failures and successes of your peers are actually more important, because some aspects of medical education and residency planning are institution-related if not institution-specific. At the same time, I do think it’s helpful to get perspectives from outside the bubble of your own school and its biases. There can be a debilitating echo chamber effect from drawing knowledge from too small and too local a source. The contributors’ views sometimes differ but are more measured and reasonable than you’re likely to get trying to distill sensible advice from SDN etc.

There are some duds.4Just because you succeed doesn’t mean you’re doing it right or that you know why you succeeded in the first place An example: One student tells how he saved up money every month from his student loans starting his MS1 year so that he would have money to interview and not need to take out any new loans. Of course, the counterargument is missing: that’s actually not really that great of an idea. That extra money is accruing interest from the day you receive it. Financially, you’d actually be better off taking out that new loan your MS4 year than hoarding loan money at a high interest rate for a few years when you don’t need it.5Not including the 1% origination fee, an extra $1000 your MS1 year for interviews is already almost $1200 by the time your MS4 year starts, will capitalize upon graduation, and then will continue to grow at a larger principal amount until repayment. Not a massive difference in the grand scheme of things but certainly not the best solution for everyone.

Without a cohesive narrative to run throughout, there is no single viewpoint or take home message (the closest thing would be Johnson’s entries, which are generally a bit longer). Ultimately this is a design choice, and a significant portion of the book consists of the contributors telling you it’s going to be okay and that you should largely relax and do what feels right. And that’s probably the best advice.