I was thinking today during an interview that at a place I did not have a great gut feeling about that perhaps following that feeling was somehow limiting. I think that our gut feeling can simply reflect a comfort level with an institution, but I think that perhaps to really achieve our best we need to be pushed outside our comfort level and be at a place that will challenge us in new ways. I think that if our gut feeling is simply a reflection of a recognition of something as foreign vs. familiar then perhaps it is not very usefull. Anyone else experience this?

I agree that moving to a new environment, where perhaps medicine is practiced differently than what is familiar, will likely work to improve your level of training. As for personal experience, I have learned that my gut feeling can be dead wrong. I had the worse interview day at the medical school I am now graduating from and was sure that I killed my chances of geting in. I remember talking about how I would never be something like a radiologist who has minimal contact with patients and that such a career would be meaningless only to find out my interviewer was a radiologist. The second interview that day was even worse. Anyway, I digress.

I was thinking today during an interview that at a place I did not have a great gut feeling about that perhaps following that feeling was somehow limiting. I think that our gut feeling can simply reflect a comfort level with an institution, but I think that perhaps to really achieve our best we need to be pushed outside our comfort level and be at a place that will challenge us in new ways. I think that if our gut feeling is simply a reflection of a recognition of something as foreign vs. familiar then perhaps it is not very usefull. Anyone else experience this?
I experience deja vu everytime I walk into a VA (my medical school is affiliated with a VA); the smell of the government cleansers combined with the government mystery meat is consistent at all the VA hospitals that I have been to. In a way I feel at home at the VA, I have an idea of what the patient population is like and the level of ancillary services (or lack of). I feel my first impression can tell me whether or not I will fit into the program even though I don't know the staff, the other residents or even where the bathrooms are. I have the feeling that I will be pushed well outside of my comfort level as an intern, but in a way that fear keeps me from getting complacent and careless.

I disagree. You know what you like and what you don't like, why pick something that doesn't jive with you? Gut feeling is not a level of comfort, it's the atmosphere and the spirit of the program, the oppressive effect hospital architecture has on your psyche, the adrenaline of walking around a crappy neighborhood around the hospital, etc.

You've got to rely on your gut feeling to a certain extent, most of the programs are going to tell you the same thing and the match creates a monopoly where it is virtually impossible to negotiate for salary and benefits as in the real world free market economy.

I think there are many factors that go into the "gut feeling", including interactions with residents, location, and facilities. After some interviews, I think to myself, "These are my people" while at others, I can't wait to get out. And it's hard to describe why some people are my people and others aren't. I didn't expect "gut feeling" to be a big part of my decision-making, but I think it will be.

agree with the OP to an extent. I started realizing about 1/2 way through interview trail that some of my best "gut feeling" interview places would be places where I'd "be a good fit", but then realized that, for several places, this just meant that the residents were very much alike and generally from the same region of the country...... something I have come to realize that I do not like in a program..... because even though I may "fit in", I might possibly not grow personally or be stretched or challenged.

I was most impressed with a program director who said that her program is not a cookie-cutter program and seeks individuals from different but interesting backgrounds from varying regions of the country.

I would say, though, that one should connect on some level with the leadership of the program in order to have something to hang your hat on , at least philosophically. Otherwise, your choice would be based on wishful or hopeful thinking...... not a steady foundation when the hard times in residency come, as they will in all residencies.

carpe

I've felt that when it comes to "gut feelings" I always question the positive impressions but trust the negative impressions (as long as the neg. impression isn't something like "the cab I took to the place ripped me off" or 'the food was horrible"). If something really rubs me raw enough to distract me away from the 'we're the best program in the universe' vibe that the program leadership is telling you, its going to be worse when I'm on hour 87 out of 80 during the week on my 4th ward month as an intern and I should probably go with it.

On the other hand, some of the good vibes I can't always put my finger on, esp. the highly - touted interviews. Am I just so psyched that I got an interview at the place and overlooking anything else? Esp. after I did a second look at one of the "top 5 programs" and found it to be entirely different from my original glowing 1st impression... I guess its the gut feeling that remains after all the number crunching, and immediate impression that really counts, eh?

After 15(!) programs, I still have yet to find the perfect mix of program strength, reputation, location, and mix of residents...