Why is It so Important to Do Residency at a "Good" Place?

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I think it also depends on what you are looking for. Put yourself in these two scenarios:

(1) You're working in a smaller community hospital. The neighborhood is not great, but not bad. Everyone knows each other. People don't look at your ID badge and then say hi to you... they look at your face. Security doesn't treat you like vermin. You start rounds on patients with DM, asthma, obesity, hbp, .... bread and butter stuff you might see in your real practice. You get really good at treating this. The nurses aren't terribly territorial and you perfect your blood draws, your iv lines. You look forward going to work. You round and your attendings teach you. On the weekends, your co-residents grab a burger together.


(2) You are at a large institution's tertiary care center. You see the zebras that require fundamental knowledge of physiology. You see the cases few get to see in their life times. From cardiac myxomas to alien hand syndrome, your intellect is tinkled. You see cutting edge treatments ranging from whipple's to gamma knife therapy. Modern treatment at its best. Your attendings are worried about paying the bills though, and teaching is... not a priority. The iv nurse works on her schedule. The nurses are a cliquey entity to be dealt with. every year it seems, a resident is pushed out under specious circumstances. the fellows cherry pick the awesome cases. It's not uncommon for a senior resident to barge in the room and takeover the patient. You get yelled at, and you're just not sure why.


If you've a the skin of a dinosaur and the brain of an owl, maybe #2 is looking delicious. If you're more down to earth, maybe #1.

Originally Posted by Walker2011

(1) You're working in a smaller community hospital. The neighborhood is not great, but not bad. Everyone knows each other. People don't look at your ID badge and then say hi to you... they look at your face. Security doesn't treat you like vermin...You round and your attendings teach you. On the weekends, your co-residents grab a burger together.

(2) You are at a large institution's tertiary care center...It's not uncommon for a senior resident to barge in the room and takeover the patient. You get yelled at, and you're just not sure why.

If you've a the skin of a dinosaur and the brain of an owl, maybe #2 is looking delicious. If you're more down to earth, maybe #1.

But the two situations are not mutually exclusive. We rotate at a private hospital here in addition to our university teaching hospital (and county hospital, and VA, and children's hospital). I can tell you I've had some lousy didactic conferences at the university hospital, and some outstanding ones at the community hospital. I can also tell you that I've developed some great relationships with hospital staff and attendings at the university hospital, while there have been some malignant personalities at the community hospital.

Both are good for their own reasons. Tough to generalize and say one is ALWAYS this, or one is ALWAYS that. I picked a residency that would give me broad exposure to many types of hospitals (see above).