Residency Advisor
You are three weeks into peak interview season. It is a Wednesday night. Your email inbox has 14 “Thank you for interviewing with us” messages, 6 “We look forward to keeping in touch” replies, and 3 programs you have not heard from since the interview. Your calendar is packed with Zoom links, hotel confirmations, and flight credits.
And you have this constant low-level panic: Am I following up enough? Too much? With the right people? At the right time?
Here is the reality: during peak season (roughly mid-November through January), the students who stay systematically organized on a weekly basis end up less anxious and make cleaner rank lists. The ones who rely on “I’ll remember”…do not.
I am going to walk you week by week, then drill down into what you should do every single week, broken by day. This is the follow-up rhythm that keeps you visible, polite, and sane—without becoming “that applicant” who emails every 48 hours.
Before Peak Season: The 60–30 Day Setup (One-Time Prep)
If you are already in the middle of peak season, skim this and do the setup this weekend. It will save you.
4–8 Weeks Before Peak Season
At this point you should:
Use a spreadsheet or Notion/Airtable. Do not try to keep this in your head.
Minimum columns:
| Column | Purpose |
|---|---|
| Program Name | Quick ID |
| Specialty/Track | Categorical (e.g., Categorical IM, Prelim) |
| Interview Date | Core time anchor |
| Interviewers | Names / roles |
| Thank You Sent? | Y/N + date |
| Notes / Vibes | Immediate impressions |
| Follow-Up Due | Next action date |
| Priority Tier | A / B / C interest level |
Add whatever else you like, but these are non-negotiable.
- Decide your “program tiers”
You are going to follow up differently depending on how much you care.
- Tier A: Top 5–8 programs you would be thrilled to attend
- Tier B: Solid programs you would rank in the middle
- Tier C: Safety / back-up programs
You are not writing this for them; you are writing it for you. So be honest.
- Set your baseline communication rules
To avoid impulsive emailing when anxious, set rules before you are emotional.
For example (these are reasonable):
- Thank you emails: within 24–48 hours of each interview
- Extra follow-up for Tier A: 1 organized update mid-season, 1 clarification email if needed
- No “love letters” or “you’re my #1” before the official period where it is appropriate and allowed in your specialty
- No more than 1–2 emails per program after the initial thank you, unless they ask for something
Write your rules at the top of your spreadsheet. Refer to them when your brain wants to spiral.
Structure of Peak Season: Weekly Rhythm Overview
During peak interview season (roughly 6–10 weeks), every week should follow a pattern:
- Sunday – Reset, plan, and log
- Monday – Send bulk thank yous and first-wave follow-ups
- Tuesday – Reserved for program-specific tasks and forms
- Wednesday – Light touch: quick notes, clarifications
- Thursday – Second-wave thank yous, late-week interviews
- Friday – Archive, summarize, prep for weekend interviews
- Saturday – Minimal: interviews only, log impressions afterward
Think of this as your “follow-up autopilot.” You do not reinvent the wheel every week—you just run the same loop.
| Period | Event |
|---|---|
| Planning - Sunday | Review past week, update tracker, plan emails |
| Communication - Monday | Main thank you emails + initial follow-ups |
| Communication - Tuesday | Program forms, portals, special requests |
| Communication - Wednesday | Light clarifications + brief nudges |
| Communication - Thursday | Late-week interview thank yous |
| Wrap-up - Friday | Summarize impressions, file emails |
| Wrap-up - Saturday | Interview + immediate notes only |
Week 1 of Peak Season: Establish the System
At this point you should be getting your first cluster of interviews and thank-you emails.
Sunday: Set the Baseline
Fill your tracker with all interviews scheduled so far.
- Enter dates, program names, interview format (virtual vs in-person), and specialty/track.
- Add a rough tier (A/B/C) for each, even if it is a guess.
Block weekly follow-up time on your calendar.
- 30–45 minutes on Sunday evening
- 30 minutes on Monday
- 15–20 minutes each Wednesday and Friday
If it is not on your calendar, it will get swallowed by travel and fatigue.
- Create 2–3 thank-you templates.
You are not copy-pasting the same thing to everyone, but you should not be writing from scratch at 11:30 p.m. after a 6-interview day.
Have:
- A template for program leadership / PD
- A template for faculty interviewers
- A template for residents / chief residents
Leave obvious gaps to personalize: specific patients, cases discussed, career topics, research overlap.
Week-by-Week Plan During Peak Season
Let us assume an 8-week peak season. I will give you the structure you can adapt, but the core idea: Weeks 1–2 set habits, Weeks 3–6 run the machine, Weeks 7–8 pivot toward ranking decisions and closing loops.
Week 2–3: Dial in Your Weekly Follow-Up Rhythm
You now have multiple interviews behind you and more ahead. This is where people either get organized—or lose control.
Every Sunday (Weeks 2–3): Weekly Reset
At this point you should:
Review all interviews from the prior week.
For each program:- Confirm: “Thank you sent?” yes/no
- Write 2–3 bullet impressions in Notes/Vibes (culture, location, red flags, stand-out strengths). Do it now or you will forget.
Update your priority tiers.
- Some Tier B’s will quietly become Tier A’s after you meet the residents.
- Some programs will quietly drop to C after you realize the call schedule is brutal.
Plan the week’s follow-up tasks.
Make a mini-list:- Programs I still owe a thank you
- Programs I need to send a clarifying question or update to
- Any missing documents (USMLE transcript, SLOE uploads, etc.)
Write this list down. Physical notebook, planner, electronic—does not matter. But external, not in your head.
Monday (Weeks 2–3): Main Thank-You and Follow-Up Day
Your goal on Monday: clear the backlog and send all primary communication for interviews from Thu–Sat of the prior week.
Tasks:
- Send thank you emails for:
- Thursday interviews
- Friday interviews
- Saturday interviews (if any)
Reasonable timing rule: 24–48 hours is ideal, but Monday morning is fine for Friday/Saturday interviews. Better late and thoughtful than rushed and sloppy.
Example structure for a PD / leadership thank you (keep it specific, short, and sincere):
- 1 sentence: Thank you + mention date
- 1–2 sentences: Specifics you appreciated (resident camaraderie, curriculum, unique clinic, something they said)
- 1 sentence: Reiterate your interest and fit
- 1 sentence: Close with openness to further questions
You do not need to restate your CV. They have it.
Tuesday: Program-Specific Requests and Portals
At this point you should clear any administrative clutter so it does not bleed into the rest of your week.
Complete any:
- Post-interview surveys
- Preference forms
- Additional information requests
Log:
- “Program requested X” + date in your tracker
- “Form completed” date
This matters when you are three weeks out and cannot remember whether you actually uploaded that “photo for resident introduction slide.”
Wednesday: Light Midweek Touch
Wednesday is your “low-pressure” follow-up slot.
Use it for:
- Clarifying questions that came up after reflecting on interviews
- Quick, targeted follow-up to a resident or chief you clicked with:
- Example: “You mentioned the global health elective—could you share how residents typically schedule that around ICU months?”
Keep these to programs that are Tier A or B. Do not spam every place. It makes you look scattered.
Thursday: Late-Week Interview Thank You Prep
At this point you should pre-draft skeletons for any Friday/Saturday interviews for the coming week.
Why? Because you will be tired afterward.
Do this:
- Make a simple draft for each upcoming program with:
- PD’s name spelled correctly
- Program name, location, and track correct
- A blank sentence where you will insert one specific detail from your interview day
After each interview, you drop in one or two specific points and send within 24 hours.
Friday: Weekly Archive and Vibe Check
Friday is for building future-you’s sanity.
After your last interview of the week (or in the evening if you have Saturday interviews):
Update tracker for:
- Interviewer names (spellings matter)
- Quick pros/cons list for each program
- Any notable comments you heard like “Our program really values X” (these help when you write follow-ups or rank lists)
Color-code or mark:
- Programs that surprised you positively
- Programs that raised quiet red flags
Do not ignore the red flags. “We work hard here” said with a strained laugh is usually code for “you will live in the hospital.”
Weeks 4–6: Maintaining the Machine (And Avoiding Over-Follow-Up)
By now, you have 8–20+ interviews either completed or scheduled. You are tired. This is where people start sending desperate emails. Do not do that.
At this point you should tighten your follow-up, not crank it up.
Sunday: Triage and Prioritize
Your Sunday reset now includes triage.
Review all completed interviews.
- Label each program as:
- “Definitely rank”
- “Maybe rank”
- “Probably not rank”
- Label each program as:
For “Definitely rank” programs (especially Tier A):
- Ask: Do I need one more thoughtful follow-up?
- Example: You have a new publication, leadership role, or a significant update that actually matters to them.
- Or there was a specific question they asked that you can now answer better.
- Ask: Do I need one more thoughtful follow-up?
If yes, schedule 1 email for the coming week. One. Not three.
- For “Maybe” programs:
- Leave them alone unless you have a genuine question or update. Silence is not fatal.
Monday–Wednesday: Single Strategic Update Window
Choose one of these days per week to send any strategic updates to Tier A programs.
Content that is worth sending:
- New publication accepted
- Significant award, new leadership role, or visa status change
- Clarification related to your fit (e.g., “I realized I did not fully explain my interest in clinician-educator tracks…”)
Content that is not worth sending:
- “I am still very interested” with no substance
- You re-attaching your CV just because
- Long treatises on why they are your dream program before it is appropriate to state that
Keep these emails focused, 4–6 sentences. Log the date and content in your tracker.
| Category | Value |
|---|---|
| Thank You | 1 |
| Substantive Update | 1 |
| Clarification Email | 1 |
Three types of emails is plenty. More looks needy.
Thursday–Friday: Protect Your Energy, Keep the Basics
You are still doing:
- 24–48 hour thank yous
- Friday logging and pros/cons
- Mild midweek clarifications
But you are also:
- Saying no to the urge to “check in” with every PD
- Ignoring myths from classmates like “My cousin’s friend emailed every week and matched derm at MGH”
The programs are tracking your professionalism, not your email volume.
Weeks 7–8: Late-Season Follow-Up and Rank List Alignment
Now you are nearing the end. Interviews are slowing down. Rank list stress is ramping up.
At this point you should shift your weekly follow-up toward closing loops and aligning communication with your eventual ranking.
Sunday: Rank List Draft + Communication Plan
During weeks 7–8, your Sunday looks slightly different.
Sketch a provisional rank list.
Not final. But put programs in rough order.Identify:
- Potential #1 program
- Next 3–5 programs that you genuinely like and will rank highly
- Programs that you will probably drop from your list
Match follow-up to reality.
If you know you will rank a program very low or not at all, there is usually no reason for extra follow-up beyond what you have already done.
Monday–Wednesday: Final Thoughtful Touches (Only If Appropriate)
Many specialties have unwritten (or written) rules around post-interview communication and “love letters.” Know your specialty’s culture and any explicit instructions from programs. If they said “Please do not send us post-interview communication,” respect that. Period.
For programs where it is acceptable and you plan to rank them highly:
- Send one late-season email:
- Reaffirming your interest
- Briefly restating why you feel you fit there (match their values, training style, or tracks)
- Keeping it honest—never tell more than one program they are your clear #1 if you say it explicitly
This is not mandatory. I have seen applicants match very well with zero of these. But if you send them, make them:
- Short
- Specific
- Aligned with how you will actually rank them
Thursday–Friday: Final Clean-Up and Documentation
End of peak season, you want your documentation tight:
Confirm every interview is logged with:
- Date, names, thank you sent
- Pros / cons
- Any red/green flags
- Any post-interview communication dates
Make sure your email folders are clean:
- One folder for each program (or at least one big “Residency 202X” folder)
- Star or flag any important institutional messages (rank list deadlines, portals, etc.)
This organizational clean-up makes rank list week much faster and far less emotional. You are looking at data, not vibes alone.
A Quick Visual: Weekly Follow-Up Focus Across the Season
| Category | Value |
|---|---|
| Week 1-2 | 70 |
| Week 3-4 | 60 |
| Week 5-6 | 45 |
| Week 7-8 | 25 |
Interpretation:
- Higher values early = more routine thank you + basic follow-up
- Decreasing over time = fewer new interviews, more focus on rank list and selective communication
Common Follow-Up Mistakes I See (And When They Usually Happen)
You are busy and tired, so you will be tempted to cut corners. Here is when things usually go wrong, chronologically.
Early Season (Weeks 1–2)
Mistake: Sending no thank you emails “because some people say they don’t matter.”
- Reality: They will not get you the spot, but being the one person who sends nothing at all in a small specialty is a bad look.
Fix: 3–6 line thank yous. Minimal effort. High professionalism.
Mid-Season (Weeks 3–6)
Mistake: Over-following up with programs you are anxious about but not actually that interested in.
- Example: Sending 3 emails to a mid-tier program because you think you “performed poorly” there.
Fix: Follow your pre-set rules. One thank you. One meaningful update if you really have it. Stop.
Late Season (Weeks 7–8)
Mistake: Telling multiple programs they are your #1.
- PDs talk. Residents talk. Word gets around.
Fix: If you choose to send a “you’re my top choice” message, say it to exactly one program and mean it. For others, say “I will rank your program very highly” if that is true.
How to Use Residents Strategically (Without Annoying Them)
Residents are often your best reality check—but they are also exhausted.
At this point in the season (middle to late), your weekly plan should include very selective resident follow-up:
Email or message a resident when:
- You had a strong rapport
- You have a narrow, practical question that is hard to answer via the website
- You want a sense of culture that did not fully come across
Do not:
- Ask residents to advocate for you repeatedly
- Send long essays about your interest in the program
- Expect detailed career counseling by email
One clean, respectful email is fine. Two might be fine. Three is too many.
Putting It Together: A Sample Week During Peak Season
Let me show you how this actually looks when implemented.
You just finished:
- Mon: University IM virtual
- Wed: Community IM in-person
- Fri: Academic IM virtual
Sunday night:
Open tracker, log:
- Monday U-IM: pros (strong teaching, 3+1 schedule), cons (location)
- Wednesday Community: pros (supportive PD, diverse patients), cons (less research)
- Friday Academic: pros (ICU autonomy), cons (heavy call)
Check “Thank You Sent?”:
- Monday U-IM – yes
- Wednesday Community – yes
- Friday Academic – no (plan to send Monday)
Monday 9–9:30 a.m.:
- Send thank you to Friday Academic PD and interviewers
- Complete Academic IM post-interview survey
- Log “Thank you sent – 11/21” in tracker
Wednesday 7–7:15 p.m.:
- Email resident from University IM you clicked with:
- One specific question about research mentorship structure
- Log: “Resident follow-up sent – research mentorship Q”
Friday 5–5:20 p.m.:
- Update pros/cons after you have sat with it for a few days
- Realize University IM quietly moved into Tier A for you
- Add note: “Consider one update email later in season re: new QI project role”
This is what a calm, sustainable follow-up week looks like.
Your Next Step Today
Open a blank spreadsheet or your note-taking app right now. Create columns for:
- Program
- Interview Date
- Thank You Sent?
- Notes / Vibes
- Tier (A/B/C)
- Follow-Up Due
Then enter every interview you have completed so far and mark which programs still need a thank you or a brief follow-up this week. That is your to-do list for the next 3 days.
