Ranking the rest of our life (or the next 5 or 6 years anyway)

I've been getting a lot of questions lately about what we're doing/where we're going after I graduate from medical school in a few months. It's a complicated answer, that starts with, "I don't know."

First of all, I'm going to be a radiologist. I realize that many people are not sure what a radiologist is/does, and that the first question that comes to mind is probably "taking x-rays?" No, not taking x-rays, that's a radiographer. A diagnostic radiologist is an MD who is trained to know what imaging studies are required and to interpret medical images such as MRIs, CT scans, and ultrasounds, in order to diagnose disease. There is not a ton of patient interaction, but there is a lot of doctor interaction, as a radiologist is in general a consultant to other doctors. So why would anyone want to do that? There are lots of reasons, which I won't get into now, other than to say radiology is awesome.

Training:
The way it works with radiology is that you must be a licensed physician before beginning a radiology residency--which means I have to do a one-year intern year in order to get licensed. So, starting in June, I will be a medical intern somewhere, doing mostly internal medicine (like what J.D. and Elliot did on Scrubs).



In June 2012, I will start a 4-5 year radiology residency somewhere else.

Somewhere:
Between October 28 and January 21, I interviewed for positions at hospitals.  I went to 27 different programs in 8 states, 15 for radiology, and 12 for my intern year. I know, that's a lot. Excessive? Actually, not really--I assure you that for radiology, it's pretty average, as it is a very competitive specialty. If I were to display my travels like a rock-and-roll tour on the back of a t-shirt, it would look like this:

Oct 28, 2010 - Albuquerque, NM
Nov 4, 2010 - Colton, CA
Nov 12, 2010 - Seattle, WA
Nov 16, 2010 - Oakland, CA
Nov 17, 2010 - Santa Clara, CA
Nov 18, 2010 - Santa Clara, CA
Nov 19, 2010 - San Diego, CA
Nov 20, 2010 - Torrance, CA
Dec 3, 2010 - Denver, CO
Dec 8, 2010 -  Los Angeles, CA
Dec 9, 2010 - Los Angeles, CA
Dec 13, 2010 - St. Louis, MO
Dec 14, 2010 - Irvine, CA
Dec 16, 2010 - Portland, OR
Dec 17, 2010 - San Diego, CA
Dec 21, 2010 - Santa Barbara, CA
Dec 28, 2010 - Oakland, CA
Jan 3, 2011 - Philadelphia, PA
Jan 4, 2011 - Boston, MA
Jan 7, 2011 - San Francisco, CA
Jan 10, 2011 - Sacramento, CA
Jan 11, 2011 - Palo Alto, CA
Jan 12, 2011 - Los Angeles, CA
Jan 13, 2011 - San Francisco, CA
Jan 18, 2011 - San Diego, CA
Jan 20, 2011 - Boston, MA
Jan 21, 2011 - Boston, MA

In all, there were 103 individual interviews at 27 programs in 8 states, 10 round trip flights, 16 nights in hotels, 6 rental cars, about 2,500 miles driven, and about $6000 in the red. It was exhausting and it was great when it was over.



The Match:
Many people hear about all the interviews I went on and say "well, it sounds like you will have lots of options!" Well, not really how it works. Have you heard of The Match? In a nutshell, you apply for residency programs. You are either invited to interview, or not. You interview at programs.  You rank the programs from most preferred to least preferred.  The programs rank the interviewees from most preferred to least preferred. A computer algorithm then pairs applicants to programs based on these preferences, and voila, you are matched. So you really only have one option once the rank list is made--the one you are matched to. Match day is March 17.  So I will know then where we are going, both for internship and for residency.

Ranking:
The difficulty is choosing how to rank the programs. There are lots of factors you have to consider, including but not limited to: location (i.e. cool city, proximity to family, proximity to friends, weather, adventure factor), quality of program (quality of the faculty, facilities, teaching, prestige, future job/fellowship prospects), and gut feeling (how did the place feel, would I fit in, etc).




It makes it really hard. I think I would be thrilled to match at any of my top 10 radiology programs, which include these cities (in alphabetical order): 

Boston, MA
Los Angeles, CA
Palo Alto, CA
Philadelphia, PA
San Diego, CA
San Francisco, CA
Seattle, WA
St. Louis, MO

So, our rank list is due on Wednesday, Feb 23rd. After then, there are no more choices, just waiting for Match day.

How would you rank these places? How should we do it!!!????