MedEdits | Medical School Admissions Consulting

Sunday, December 14, 2008

Residency Admissions Hierarchy: Why Is It Important To Understand?

I realize that many applicants don't understand the hierarchy of residency admissions committees. Why is this important? It helps to understand what goes on behind the scenes of a residency program and who makes decisions. While the leadership of very small programs may only consist of a program director, larger programs may have up to two people at each level. The residency leadership hierarchy is as follows:

1) The Program Director (PD): The PD is the head honcho. Depending on the size of the program and the PD's style of leadership, the PD may have little to do with the nitty gritty of the residency admissions process. While the PD has ultimate veto power, he or she may also delegate most tasks to the Associate Program Director. A good program director attend every interview day to meet and interview applicants and may present an overview of the program. They have the final say when it comes to rank order lists. They also spend alot of time in meetings with medical school and hospital leadership which is why they are so dependent on their junior leadership.

2) The Associate Program Director (Associate PD): The Associate PD is often the backbone of the residency program. Typically Associate PDs review the bulk of the applications and participate in all interview days. They also intervene when a resident "crisis" comes up and serve as the "go to" person for the residents. The Associate PD and the PD work closely together. Associate PDs often serve as the PDs right hand wo/man. The Associate PD is often as influential in the residency admissions process as the PD. If a program is especially small, there may not be an Associate PD.

3) The Assistant Program Director (Assistant PD): The Assistant PD role is considered the "entry level" position in the residency leadership. Typically, the Assistant PD is the least influential in the hierarchy. Because of their lack of experience, Assistant PDs often don't review applications but do conduct a limited number of interviews. Usually their responsibilities and tasks are dictated by the Associate PD and PD and they are often assigned alot of "scut work." Some Assistant PDs say they feel like glorified chief residents. This is usually a stepping stone position to Associate PD. An especially small program may not have an Assistant PD.

Understanding what a title means may provide insight regarding a faculty member's role, experience and influence within a program.