I am wondering if certain residencies won’t take older students. I will be 44 when I graduate from med school and I have heard that certain sub-specialties won’t consider me. Is that true? Are there residencies that are highly recommended for older students? I know my career will consist of paying back my student loans at this late phase, the law of diminishing returns, I suppose, but I am hoping to get into a competitive residency. Any suggestions are much appreciated.
I have “heard” about this issue, and some PD’s may have concerns but in general it will boil down to your performance in medical school and the steps. I guess something like neurosurgery may be more difficult for an applicant in the mid-40’s due to the length? but I have no hard facts regarding this. You will have to pursue that which you enjoy and see what happens.
Obviously the residencies that come to mind to be more “age” accomodating would be the shorter ones like FM/IM/Peds/Psych/Path/etc .
Good luck
Thanks for the response. My main interest has always been emergency medicine, and it is also what I hope to pursue as a career, but I am also aware that other doors may open when I get exposed to the different specialties. It is good to hear that if I do well in school, rotations, and on the step exams that I could get a good residency, regardless of my age. I know that neurosurgery and the likes are probably out because of the length of time to complete everything.
Thanks for the information!
EM is a great specialty and age will not be an issue. I was general surgery bound for sure but after much thought and soul searching, I am IM bound. Keep us posted and good luck in third year!
Thanks! Is third year really that bad? I am hoping that my many years of clinical experience will pay off then. But we will see.
Third year is where the fun begins! You are out of the classroom; seeing patients; learning from residents and attendings; learning through experience; polishing your basic skills for history and physical, diagnosis and management; and just learning which areas you like the best.
Completing your core rotations will leave you with the best idea of what you want to do. Did you really love family med? Or surgery? Or Ob/Gyn? Or pediatrics? EM? Or, in my case, internal med?
Once you have done these, you will be ready to start scheduling your fourth year rotations in different hospitals you might want to consider for residency. It is a lot of hard work. . . and a lot of fun!! 
Third year is a lot of work and a lot of hours. At my school, it’s not uncommon to expect to be at the hospital from 4:30 am to 6 or 7 at night while on your surgery rotation (which is usually the worst hour-wise). I think what probably makes third year worse more than the hours is that you’re really not in control of your own time anymore. To a certain extent, while in med 1 and 2, you have a fair amount of control over your time, by deciding how much to study and when. In third year, that’s not the case.
Once you have a good idea of what specialty you will be pursuing a match in, you can enhance your chances of getting the residency you want by doing an “audition rotation” with that residency program. While third year of med school is highly structured with few if any options in your schedule, fourth year med school is extremely flexible and you’ll have multiple elective rotations where you can go do a rotation as an Acting Intern with your top residency choice as a way of getting to know you.
I think this is an especially good tactic if you are: A) trying to get into a competitive program, and B) concerned that “on paper,” you don’t look like the best candidate to invite for a residency interview.
OTOH it can blow up in your face if you go to an audition rotation and aren’t a rock star. As a resident, I was amazed at the fourth year students who came in for audition rotations and then dipped out early, avoided work, complained when asked to do extra stuff if the team was shorthanded, or otherwise demonstrated a poor work ethic. Not to be ageist or overgeneralize, but these tended to be, um, folks who were life-experience-impaired. 
But the bottom line is that you should go into what appeals to you. Any specialty is going to require a lot of hard work so you have to love it. Don’t think about age and definitely don’t put together a list in your head of “age-friendly” specialties prior to experiencing it. You may surprise yourself.
Mary
Thanks for that information. Valuable advice that I haven’t heard before about 3rd and 4th year rotations and auditions, etc. And I will now erase my “ageist” perspective and just see what I really enjoy in 3rd and 4th year. That feels like a long way off still!!
To be perfectly frank after 5 progressively more intensive years of training, I cannot ‘imagine’ any residency being easy/easier for older folks. I feel 80-something right now. But, I know that I will quickly recover once ‘real life’ resumes.
Enter your chosen specialty because it is your passion & all of the hard work will be for good, for the most part. There is a profound difference in “good tired” & “unhappy tired” - referring back to our keynote speaker waaaaaay back in 2003. If you are doing what you love, then that fatigue will be accompanied by contentment.
interviews and rotations when you are 40 with late twenty to early 30 year olds with no life experience has been strange for me. I feel like they are in a different stage of life and hard to relate to them.
- efex101 Said:
I have "heard" about this issue, and some PD's may have concerns but in general it will boil down to your performance in medical school and the steps.
I heard some years back about a 50 something year medical student not matching into surgery (this person scrambled into a spot from what I understand) who had outstanding STEP scores and grades from medical school. In my mind the ONLY reason this person had to scramble was due to ageism.
- pathdr2b Said:
- efex101 Said:
I have "heard" about this issue, and some PD's may have concerns but in general it will boil down to your performance in medical school and the steps.
I heard some years back about a 50 something year medical student not matching into surgery (this person scrambled into a spot from what I understand) who had outstanding STEP scores and grades from medical school. In my mind the ONLY reason this person had to scramble was due to ageism.
Or, maybe they interviewed poorly, had weak letters of rec, screwed up their USMLE/COMLEX, sub-par clinical grades or any of an infinite collection of reasons outside of ageism. I would hesitate to make assumptions or accusations on heresay...
Sometimes people make late decisions regarding a specialty and end up scrambling because they’ve changed their minds, don’t want to match into the specialty that they’d been considering or go to any of the programs where they’ve interviewed. So this is another reason other than age-related.
Matching is SUCH a subjective process that I, too, would hesitate to label a person’s difficulty matching as due to any one particular thing. I can certainly imagine age being a concern if there are other concerns, however.
Mary
2 points
#1 We had a neurosurgery (NSG) resident that was in his late 40’s…he was from India and already was an attending NSG there…he came to the US and was not accepted into NSG initially because of his training, so he went through anesthesia residency and was an attending anesthesiologist for 5 years before he was accepted into the NSG residency. It was interesting to watch the new NSG attendings go to the “1st year” NSG resident to ask his opinion on what to do
#2 Re: your audition…As a resident we were asked to go through each of the residency candidates…it was hard to pick through ones that had not done a rotation there (and we did pick a few that did not rotate with us) and easier to talk about and give our thoughts on people that we worked with…And don’t forget that on outside rotations you are also being watched, maybe by someone that is a 4th year, who will be an intern when you are applying or by other residents. Also the nurses/unit secretaries/techs evaluated each of the students that came through as well, so be nice to them too.
Good luck
Rachel
Also the nurses/unit secretaries/techs evaluated each of the students that came through as well, so be nice to them too.
My dad told me when I entered the business world to treat the receptionist, janitors, food workers, bus drivers, internal mail delivery personnel, etc exactly as I would the CEO.
At 22, I did not really understand my "old" , 54 year old dad at the time (he was an executive with Fortune 50 at the time)... but he was right. I treat everyone equally - no matter race, religion, education, job description, etc - and it has been amazing for me to hear later how doors that might have otherwise been closed were at least moved slightly ajar for me...