This is an important question, especially now that applicants can signal to programs their preferred area when applying for residency in the U.S. through the Match. If you dream of doing residency in the U.S. and going through the USMLE process, this answer can help you.

Choosing where to do your residency is a big decision, since it involves a major life change.

Think carefully about these three questions:

1. What is your priority?

Program/institution reputation vs. location.

Thinking about these pillars doesn’t mean you won’t look for programs that offer both, but it’s important to know which one matters more and weighs more heavily for you.

2. Is your priority aligned with your career goal?

Here are two examples:

Career goal: becoming an academic professor at an Ivy League/top-10 institution, or working 80% as a researcher and 20% seeing patients.

For this profile, location shouldn’t be the priority. It wouldn’t make sense, because limiting yourself geographically makes it harder to match into top academic programs, which are already extremely competitive. In this case, the fewer limitations, the better.

Career goal: finishing residency and living peacefully, working in an outpatient clinic or a community hospital.

For this profile, reputation shouldn’t be the priority, because matching into extremely high-reputation programs will be a big challenge, and likely won’t make a meaningful difference in your career. In the U.S., medical training standards are high, and most residency programs are excellent.

Now stop and think for a minute about your goals and your priority. Align both before moving forward.

3. How and where would you like to live?

The United States is huge, and there are major differences between states: socioeconomic, cultural, climatic, and environmental.

For example, if you’re someone who dislikes cold weather, you need to know that some places in the U.S. get very cold, with low temperatures for much of the year. Take that into consideration and don’t underestimate climate and sociocultural differences, because they can directly impact your experience and daily life.

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