Most people who apply to a position want to be the ideal candidate. Employers want the ideal candidate, so they get a quality employee who will stay for the long term and not cause waves. Applicants want the ideal position, to progress their career and to maximize happiness. Sadly, there is no such thing as the ideal candidate or the ideal position. There’s only a good fit.
This became evident to me with one of my first residents. Our training program was designed to provide a high degree of autonomy to the residents. They chose how to spend their off-clinic time, what rotations to take, what research to pursue, how to study, etc. This worked great when I came through the program- I did external rotations at UCD in Ireland and at Royal Perth Hospital in Australia, I got five papers submitted for publication, and I passed the written section of boards the first time. This also worked great for the resident who came after me. But the next resident did not have a high degree of internal motivation. He needed a more structured program.
He had difficulty with deciding how to spend his time, did not seek out advice, and generally did not efficiently use his time. Ultimately he ended up not completing the program. I don’t see that as a failing of his or a failing of the program. It was a bad fit. Our program worked well with highly internally motivated residents and he needed a program which would tell him what to do and when. Subsequent residents were highly successful once we identified that we needed to tell residents about this feature of our program. We would tell applicants what our program was like during the interview, and if they needed more structure, there were great programs that could provide that out there. But ours was not one of them.
There are good programs. There are good candidates. But there is no perfect program or perfect candidate.
You have to be extremely honest with yourself:
What can you tolerate?
What kind of person are you?
How do you like to work?
Do you want to be the top in your field and climb over the bodies of your fallen enemies or are you happy just doddering along doing your thing and being happy?
How many hours and how hard do you ACTUALLY want to work?
Do you need the social status attendant with being in a top program?
Do you want high income, or more free time, lots of students/interns/residents to train, lots of time for research, more contact with students, or more time in the classroom?
Spend time dwelling on what you actually genuinely want.
This is less critical for internships- they are only a year, and you can tolerate almost anything for that span of time. When evaluating residencies and faculty positions, though, ask a lot of questions to make sure you would actually be happy where you are applying. Don’t just accept anything- your life is too short to waste it being miserable. Do you have a tale of a good position not being a good fit or visa versa?