PERSPECTIVE The Internship and Residency Application Hassle

Two applicants describe their experiences in applying for training in internal medicine. Information sent to the applicants about training programs was frequently inadequate to make an informed decision. Often institutions did not make clear their policies on interviews, and frequently the interviews themselves were unsatisfactory in purpose and conduct. The opportunity for applicants to meet with house staff members to discuss the training program varied greatly. Recommendations are offered to improve the application procedure, for the benefit of both the applicant and the training institution. EACH YEAR more than ten thousand senior medical students face the problem of applying for postgraduate medical training, as do many interns and residents who choose to switch programs. In 1972 to 1973 approximately 11 000 interns and 45 000 residents were in training in the United States; almost 13 000 were in internal medicine (1). Recent reports document the increasing concern about organization and design of postgraduate training programs (2, 3). The National Intern and Resident Matching Pro-gram and universal acceptance dates for training positions are examples of the attempt to simplify application pro-cedures. Little consideration, however, has been given to how well the applicant is informed of an institution's program by the current procedures, and the applicant's reaction to the application and interview process has not been examined. Despite changes in the structure of post-graduate medical education, the application procedure is likely to retain much of the same format. We describe here our experiences, as two recent gradu-ates of medical schools in the United States, in applying to major university teaching hospitals for postgraduate internship and residency training in internal medicine. We faced many problems in attempting to select an internal medicine training program