By Dr. James M. Dahle, WCI Founder
Interviewing for residency can be really expensive. Expenses include:
This could easily add up to thousands and thousands of dollars at a time in your life when your income, net worth, and credit are all at their lowest. The costs (and the risk of not matching) are even higher for International Medical Graduates (IMGs), Foreign Medical Graduates (FMGs), DOs, couples, and anyone applying in super-competitive specialties. A recent study calculated it out and found that most MS4s spend between $1,000-$13,225 with a median of $4,000 for residency interview costs (when I originally published this story in 2017, it was between $1,000-$5,000 for an average of 12 interviews). If you spread that median of $4,000 over the same average of 12 interviews, that's $333 or so per interview. That's pretty amazing actually, but forgive me for my incredulity. More likely, students never added up all the damage.
Either way, let's talk about it.
How to Reduce Cost of Interview Expenses
#1 Figure Out What You Want in Advance
Part of the interview process is figuring out what you want in your residency program. The more of that you can do in advance, the better off you're going to be in the end. Not sure whether you want to live on the West Coast, East Coast, or Midwest? The interview process is an expensive way to figure that out. Want a residency with more critical care time? Then don't apply to programs that have minimal time in the ICU. Still haven't decided between your two favorite specialties? That's going to cost you.
#2 Know Yourself
You need to get a sense for how you stack up with your peers. Are you a particularly strong applicant, middle of the road, or weak? The weaker your application relative to the competitiveness of your specialty, the more programs you need to apply to and the more interviews you need to go on. Are you Alpha Omega Alpha (AOA) at a US MD school with 270 board scores applying in family practice and most interested in programs in your state? This is going to be a very inexpensive process for you. Are you an IMG with average board scores applying in orthopedics? This is going to cost you some money.
I totally blew this when I applied. I applied to 30 programs and got invited to interview at 28. I interviewed at 21. What I should have done was applied to 12 and interviewed at eight. Relative to my competitors, I was a strong applicant in only a moderately competitive field. If you're not sure where you stack up and your faculty advisors aren't helpful, then sure, apply to a few more programs. Applications are cheap compared to airfare (and especially compared to a year of lost attending-level earnings). But if you're getting invited to interview everywhere you apply, you don't need to go on all of those interviews.
#3 Stay with the Residents
Many programs offer you the opportunity to stay with a resident. Take advantage. Not only is this a chance to show one of the residents how cool you are, but you also get the inside scoop on the program and the interview process. Oh, and you don't have to pay for a hotel room, WiFi, parking, and maybe even some food. While you're at it, try to arrange to go to the free dinners the night before for the same reasons—save some money and meet more residents. It is entirely possible to eat dinner the night before, breakfast and lunch at the interview, dinner the next night at the next residency program, and NEVER pay for food while interviewing if you can line up your interviews just right. Just remember that those dinners and the time you spend at the resident's house are all part of your interview, so be on your best behavior.
As a general rule, MS4s have more time than money and should live their life accordingly. Unless you're going a long way to interview, you're probably going to be better off buying a couple of tanks of gas for your beater than an airplane ticket, airport parking, and car rental fees. So drive when you can. I was a little handicapped by this when I was applying. When I applied, the closest EM residency program to my medical school was 12 hours away. I had to buy a few tickets, but it was a lot fewer than you might imagine with 21 interviews. I knocked out 10 of those interviews with a single round-trip flight. I flew into Michigan and then drove to Maine, interviewing in Michigan, Indiana, Pennsylvania, New York, and Maine along the way.
#5 Leave Your Partner Home
Of those 21 interviews, guess how many my partner went on with me? Two. She didn't need to go places she had been before, and she didn't need to go to all my “safety school” interviews. Leaving your partner home as much as possible saves on airfare and makes it more likely to stay on a resident's couch when it's just you.
#6 Be Smart About Geography
This varies a lot by specialty, but the more you can limit your geography, the better. If you are in school on the East Coast and want to stay there and you are not in a hyper-competitive specialty, you can probably find plenty of driveable interviews to attend. But even if you want to go somewhere across the country, try to only apply in one area. The worst thing you can do is schedule one interview in Georgia, one in Maine, one in Texas, one in Michigan, one in San Diego, and one in Seattle. Six separate trips. Not cheap. Now if you have to do that because those are your only interviews, then do it. But being smart about geography when applying can eliminate expenses for most people.
Line up your interviews one day after another. You drive all afternoon, make it to the resident dinner, sleep at the resident's house, wake up and eat at the interview, and then drive to the next resident dinner. Five days away from home, five interviews knocked out. Sure, it probably won't work out quite that well, but if you can knock out 3-4 interviews in the same week and make it home for the weekend, you're doing it right.
I applied to two programs in North Carolina, and I was invited to interview at only one of them. I didn't go. It wasn't worth a trip across the country for only one interview when I had plenty of others and it wasn't a program I was dying to see anyway.
#7 Pack Food
I confess I didn't do this one (remember I wasn't very smart about money prior to about PGY3). But if you really want to save some money on the interview trail, you can bring food with you for the occasional meal you'll have to pay for yourself. Or swing by a grocery store. Restaurants aren't for food, they're for carefully planned experiences with people you care about.
#8 No One Cares How Much Your Suit Cost
You should wear a suit or its female equivalent to interview. It does not have to be expensive or fancy, just professional and conservative. If you watched what you ate as an MS3, you might even be able to use the same one you wore for your medical school interviews. Nobody cares. These people all wear pajamas to work. Your goal when dressing for an interview is to not stand out because of what you are wearing. Stand out for other reasons like your awesome personality. Conservative and conformity are the names of the game here. You don't want them to remember what you wore.
And guess what? At every interview you go to, you interview with different people. They don't know what you wore the day before at the interview across town. So even if you wear the same suit five days in a row, nobody who matters will know. And those who do know (co-interviewees), are doing the same thing. You don't need five outfits. Those threads are expensive. Here's another news flash: you don't have to wash suits every time you wear them. Wait until you spill something on them.
#9 Minimize Fees and Interest
Most interviewees aren't paying cash for their interview costs like I did. They're spending borrowed money. It might have been just regular student loan money they budgeted for these costs, it might be a special interview/relocation loan, or it could just be a good old-fashioned credit card. Try to minimize the cost of doing this. Remember that every dollar you spend will be three by the time you pay it back. If you're going to use a credit card, get one with a 0% deal for the first year and pay it off in your first couple of months of residency. If it is a special loan, don't take out more than you need, and shop around for the best possible terms. You can start with whatever your financial aid office is recommending, but recognize that might not be the best choice. At least you can usually defer them for the first three years of your residency.
#10 Meet People
Going on the interview trail is a lot of fun. You meet a lot of people just like you with all the same worries and issues. You'll make some friends and lots of acquaintances. Occasionally, you might even be able to pool expenses like sharing a ride between interviews or a hotel room.
One other thing to think about that wasn't around when this article was first published. Since the pandemic, so many of these interviews have been conducted on Zoom. I'm not sure if that option will continue to be offered in the future, but if an online interview is offered, it could be worth taking advantage of that opportunity to save money from traveling across the country. If you have a list of top-3 residencies, though, it's still probably worth traveling to those.
What do you think? What did you do to reduce your interviewing expenses? What do you wish you had done? Comment below!
[This updated post was originally published in 2017.]