Ridiculous Residency Vacancies

Every morning, I wake up, make coffee, and forage through the great thicket of the internet in search of residency vacancies. The internet or 'web,' as you know, expands continuously just as the universe, and with it arise visions of alternate realties somewhere pleasantly distant and unmoored in the daily rut of routine. Navigating it requires skill and experience and I admit to possessing neither. However, I've built a steady habit of scouring specific websites in my search for residencies. When I come upon a position I like, I deploy the residency application algorithm now updated into my brain's latest software - it's an app - and switch the 'application mode' tab to 'on.' Hereafter the process is automatic - CV, diploma, dean's letter, transcript, and USMLE files are sent, along with a specifically crafted statement of interest. An e-mail is fashioned for each program director or coordinator with the attachment of aforementioned files, and once it is sent 'application mode' turns back to 'off,' idling my reeling brain into the honey-sweet hibernation of accomplishment. Muscles un-tense, the coffee cup is put down, and I turn my dawdling attention to my cat, who starts purring as she glimpses my smile. And thus the application cycle goes on and around for each vacancy that I spot.

However, of late I've woken up, chugged my coffee, and have noticed a stream of ridiculous residency vacancy postings online. As a reminder, the sites I use include inforesidency, residentswap, program directors in surgery, and SDN, among others. Several ads offer UNPAID positions to CURRENT RESIDENTS. See below for examples.



The gall of this posting consists in the program's desire to "recruit an exceptional general surgery resident" (read: someone already in clinical residency receiving a salary) for a "minimum commitment of one year" of research work in a "non-paid, full-time volunteer position." I don't seek to single this posting out in particular, as I've run into multiple others like it, but the main, overarching issue with these kinds of job ads is they are recruiting slave labor. The underlying message implicit in these postings is "if you put in your indentured servitude, you MAY have a chance at a shot somewhere, maybe even with us."



This brings up another point: Who but the independently wealthy can afford such a digression in their surgical careers for the sake of bettering one's CV? Further, who but the independently wealthy can lead reasonably-accomodated lives while performing residencies or fellowships in cost-prohibitive areas like Manhattan, Los Angeles or the Bay Area? In such places, the system of resident selection authomatically benefits those with means and preferred insiders at the expense of a bona fide meritocracy. There have even been plenty of programs where Faculty persons have selected their own progeny as residents! Absurd examples aside, it is important to note that Medicine and its specialties has rigid borders to keep out the rabble from the hallowed inner circles of accumulated power and self-aggrandizement.

In short, if you lack the financial means, do not apply.

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