Interested in academia, but county residency?

[Alejandro]

Just wanted an opinion on this-I know that EM as a specialty is pretty unique in that the "big names" aren't the same ones you typically see on some sort of UNWR like in IM or surgery, but I was curious about the value in choosing an academic program versus a county program for residency, if I'm ultimately interested in academia?

I feel a county residency would prepare me to be a bad@ss in the ED, which I would suppose give me some benefit in applying for jobs out of residency, but I figured those in academic circles would prefer those from such circles?

Currently, I do a fair bit of premed advising and I have always enjoyed teaching so I don't know, maybe I want to go down the route of being a student advisor, or a adcom dean or something down the future. I figure if I enjoy doing these activities for fun in my spare time, then i guess it shouldn't hurt to try to make this a part of my career in the future, if at all possible (course, these jobs don't just fall in your lap either, i'm sure).

Just to give an example, I was considering doing an away at highland, but I know they're not a "university-associated" shop, however i think it's fair to say it's one of the powerhouses on the west coast and I'm sure respected nationally too. I would imagine coming out of highland would be a strength for finding jobs post residency (probably both academic and community). But then you look at a place like UCIrvine or Stanford, which probably aren't the first few names you'd think of for a west coast giant, but it's obviously affiliated to the university, which I guess if I stayed along post residency, it could be easier to find a job that sorta fits what I mentioned above? Or an academic position elsewhere?

Just trying to figure out which 1-2 programs I really want to slot in for my away rotations-there are just too many awesome programs! Aaaarrrrrg.

Anyway, just was curious what everyone's thoughts on this might be. Cheers.

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[TooMuchResearch]

Academic does not equal university. Some of the big names in EM research work at academic county hospitals.

 

[Arcan57]

RRC rules restrict "core" faculty to a maximum number of shifts or hours per month. While theoretically the core faculty could all be doing admin or education, in practice many of them are going to be supplementing the department coffers with research money. Grady in Atlanta is as county as anything but Emory is also a huge name in research.

 

[DrDrummer]

Hennepin County. Emory. LA. Etc.

 

[EM4Reals]

I think you're confusing "academic" with university affiliated. Most big name county programs are usually very "academic" and crank out a lot of research. Sometimes the county programs do not have unlimited money/resources like a lot of those "ivory tower" hospitals (i.e. UCSF, stanford, HAEMR, Hopkins, etc). If you want to do a bunch of research, sometimes those university affinity hospitals can provide you with more support than the poorer county institutions but this is not universal. I think what is more important is the type of environment you want to train in. Do you want to train at a purely university hopsital based academic program, one that has 1/2 county 1/2 university, or pure county. They all have their different pros and cons which can be discussed at lengths.

I think you'll have a better chance getting an academic job going to a well known and respected county program than some smaller less known community or university based hospital. Also, getting a job in academics is a lot with how you set yourself up. For example, are you interested in education...so were you a chief resident? Are you interested in research...so did you get involved in research at your program? Some of the county programs are also affiliated with medical schools, so you can also be a mentor or be part of the medical school facutly as well. (examples: LAC+USC, UCLA-Harbor, Cook County w/ Rush)

 

[namethatsmell]

Go where you think you will become the best EP you can be. Period. Consider the strengths of a program's clinical training and how happy you'd envision yourself being a resident there. After that everything else is small potatoes.

I also agree with the above poster--rather than focus on how "academic" a program is, consider what kind of environment(s) you want to learn in. My program is split between county, ivory tower, and community shops and I'm extremely thankful for this. On the other hand, I can see the appeal of training at a single site and only having to learn how one hospital works.

You never know how your interests will change, but if you focus on becoming an excellent clinician first there will always be opportunities to get involved with academics later...ie you can pursue research and education fellowships offered at many of the more brand name/ivory tower shops (when you will actually have time to devote yourself to significant projects and research).

 

[dotcb]

It doesn't matter. Go where you feel you'll get the best training and is a good fit for you and your life.

 

[Alejandro]

Thanks everyone for the input!

I understand what you guys are saying, probably best for me to focus on being a clinician first-the rest will fall into place on its own. And if I really want to do academia, it'll most likely find its way into my life on its own anyway.