Competitive Market - Denver CO or Souther California - Advice

[clibby]

I get that you're joking and I understand that a lot of three year grads are probably upset to hear this but my program places grads at plenty of competitive areas. I saw 3.5 pph during my 3rd year and I’m sure most community shops wouldn’t pass up those types of RVU’s

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[Torsion]

As a long time medical director in an extremely competitive city, I can say that I don’t care where you did your residency. Four year vs three? Who cares! What’s important is how well we get along when we meet, how you do on your interview dinner with your potential future colleagues, and sometimes references.

How well someone interviews for a job is a make or break moment for pretty much every field. Now as a resident on the other side of the residency interview process it is clear to me just how much of a popularity contest the hiring process can be. Someone from "best medical school" with a 270 Step 1 who is awkward or arrogant is not getting the job, while someone from a lesser known program who is fun and a hard worker will be ranked higher.

That said, I would have to say that whether we are talking about a democratic group hiring a residency grad or the residency match process, familiarity has to count for something. We aren't flipping coins to decide where to rank someone and I'm sure private groups aren't either. If a 4th year student has a great Sub I with us and has good scores they will likely be shoe-in to rank to match because we are familiar with them. In the same way SDGs - while often hiring from a wide variety of programs - disproportionately hire from local residency programs that they are either affiliated with or familiar with. This is certainly true for the 3 groups I am most familiar with. There is no substitute for a 3 year job interview.

 

[southerndoc]

Clearly this is a hostile place to ask real questions. I just wanted to know some job options for those areas, yeah this is a hard year, hence the questions. Any other year I'd call up on 3-5 alumni contacts and be hired by now, but the 2021 hiring season is crazy. I didn't mean to come off as arrogant, I'm just very proud of my success at my program, and really want to live someplace a little more consistent with my current lifestyle.

Don't take it personally. If the powerhouse that you are graduating from is one that is known to produce good EM physicians then it will give you a leg up despite what others say. I doubt you would mention the word powerhouse in your interview. Big names do draw some attention and you may have an advantage to securing an interview.

Despite what some people say, if all things are equal between two applicants, I will hire one trained at a 4-year program or a 3-year + fellowship over a standard 3-year graduate. As what @Mr Bitterness said, your interview and your pre/post-interview dinner with the other docs will make or break you. Nobody wants someone who won't fit in even if you went to a big program, scored perfectly on your MCAT/USMLE/ABEM, etc. If you can't stand the 3 am test or what I call the "stuck in the elevator" test, then you're toast. I frequently ask myself could I tolerate being stuck in a broken elevator for an hour with someone.

To those replying to the OP, please try to keep it civil and directly answer the question. We all make mistakes. I doubt the OP would ever post "powerhouse" again and probably didn't intend for it to come across like it did (there have been numerous people complaining about all the residencies popping up left and right, so it does offer an advantage for someone graduating from a well-established residency program).

 

[Rekt]

I get that you're joking and I understand that a lot of three year grads are probably upset to hear this but my program places grads at plenty of competitive areas. I saw 3.5 pph during my 3rd year and I’m sure most community shops wouldn’t pass up those types of RVU’s

No you didn't.

Even if that was true, then all you're seeing are urgent care cases at your four year powerhouse residency.

 

[Dr Mantis Toboggan]

I get that you're joking and I understand that a lot of three year grads are probably upset to hear this but my program places grads at plenty of competitive areas. I saw 3.5 pph during my 3rd year and I’m sure most community shops wouldn’t pass up those types of RVU’s

loving the troll account, keep it up.

 

[Fox800]

This is grade A+ trolling.

3.5 PPH as a PGY-3...loooool

 

[NITRAS]

This is grade A+ trolling.

3.5 PPH as a PGY-3...loooool

I was guilty of thinking I was the shizz as a PGY3 getting ready to graduate. Most people don't' realize how different it is to be the attending, and how much harder it is. They will learn.

 

[CliveStaples]

I get that you're joking and I understand that a lot of three year grads are probably upset to hear this but my program places grads at plenty of competitive areas. I saw 3.5 pph during my 3rd year and I’m sure most community shops wouldn’t pass up those types of RVU’s

Ugh, he took me for a ride. I thought there was a 50/50 shot he was trolling up until this post but this seals it. Now my serious response looks dumb.

 

[EM Junkie]

The sad part is, most of us who have ever interviewed docs for jobs have interviewed a guy/girl just like the OP. To all the other residents reading this, FYI this guy/gal never gets the job.

 

[Dr Mantis Toboggan]

This is grade A+ trolling.

3.5 PPH as a PGY-3...loooool

30+ on a nine hour shift? We all did that on the reg back in the day.

 

[helodoc]

I mean 3.5 pph is not trolling, overnights we see 35+ pts, a bunch of sick resus patients that get everything then straight to ICU (I've done more subclavian cordises than mosf of the new trauma surgery fellows), then flip the not sick patients a couple times.

I don't get what is eye roll worthy about that number. I'm just saying that we learn how to move much better than a lot of other places - all I meant.

Anyway, sorry for sidetracking the conversation, just trying to illustrate how typically of an easy time we have getting jobs, but this year is different and was just seeking advice.

 

[RustedFox]

I mean 3.5 pph is not trolling, overnights we see 35+ pts, a bunch of sick resus patients that get everything then straight to ICU (I've done more subclavian cordises than mosf of the new trauma surgery fellows), then flip the not sick patients a couple times.

I don't get what is eye roll worthy about that number. I'm just saying that we learn how to move much better than a lot of other places - all I meant.

Anyway, sorry for sidetracking the conversation, just trying to illustrate how typically of an easy time we have getting jobs, but this year is different and was just seeking advice.

I get you, homey.
The lessons here are multiple.

1.) You need thick skin in this business. We're going to give you the once-over hard, and then we're going to do it again. Expect nothing less from attendinghood.
2.) Expect your PPH to drop precipitously once you're an attending, and you finally need to take care of the unseen responsibilities and tasks.
3.) A dozen+ ER attendings with what is probably hundreds of years of collective experience under their collective belts aren't all wrong.
4.) Picking "one place to live for the rest of your life" is more than a touch short-sighted. As the prophet John Lennon wrote: "Life is what happens while you were busy making other plans." I had zero idea that I would be in Florida at all, let alone almost eight years now. I thought I "would be here for life". I want the hell out. Yesterday.
5.) Truly; nobody cares where you did residency.

Good luck, amigo. Those are all very, very, important lessons.

 

[Dr Mantis Toboggan]

I mean 3.5 pph is not trolling, overnights we see 35+ pts, a bunch of sick resus patients that get everything then straight to ICU (I've done more subclavian cordises than mosf of the new trauma surgery fellows), then flip the not sick patients a couple times.

I don't get what is eye roll worthy about that number. I'm just saying that we learn how to move much better than a lot of other places - all I meant.

Anyway, sorry for sidetracking the conversation, just trying to illustrate how typically of an easy time we have getting jobs, but this year is different and was just seeking advice.

so, not trying to dox you (because ultimately I DGAF but this is amusing).

midwestern 4 year programs which could be considered “powerhouse” (generous stretch with this list):

Cook
The ‘Nati
Michigan
Northwestern
Wash U

I’m old by the standards of this boards so long out of the game but I would wager at none of those is the 3rd year seeing 35 a night while dropping subclavian cordi (is that word? don’t care I like it) on the reg.

but play on playa

 

[bearstanley]

dude, as one of your peers who is also graduating this year from a 'competitive' four year program and going into the community-- please stop, you're making us look bad.

 

[Fox800]

30+ on a nine hour shift? We all did that on the reg back in the day.

Sure, and I saw 50+ patients a shift as a PGY-3 when my juniors were doing all of the charting, lac repairs, etc and I was supervising. See what I did there?

 

[southerndoc]

Closing the thread... it's run it's course.