I am in an Unopposed program that is university affiliated. Our main clinical site is at a 450 bed community hospital. However, because we are affiliated with the medical school next door from us, we are REQUIRED to do some of our rotations at the medical school's University Hospital.
When doing rotations at our main clinical site (the community hospital), I feel like I do and learn more. The FP residents are the ONLY residents in the entire hospital. In OB, I am the OB resident (not FM resident). In medicine, I am the medicine resident. In surgery, I am the surgical resident....and so on. We get involved in every aspect of the service we are in. When in OB, the OB/GYN attendings will raise hell if we are not present in the delivery room/CS. Same with surgery, medicine, and peds. Basicly we run the service we are rotating in. We are held accountable, and given lots of responsibilites. No competition with Internal Medicine over complicated cases and the ICU. We do it all. It can be VERY rough at times.
When doing rotations at the University Hospital, I feel like a medical student again. I had limited responsibilities, and we have to call the attending or senior resident for everything. When I am on call, I cannot do anything unless I notify the attending (even for something stupid like giving tylanol for pain). Also, admissions are done by the original residents, we only watch them, again like medical students. If there are procedures, the original residents get notified first, and they get to do the procedure, while I sit down and watch.
I do not know, but things could be different at opposed programs.
Just to contrast this with an opposed program here is how we operate.
We are located at a 700+ bed community hospital that is affiliated with the medical school. We have several other residency programs in our hospital IM, Peds, Surgery, Rads, Ortho, and OB.
We have our own Medicine and OB services. On Medicine we run it on our own. We take admissions for a good chunk of the community physicians and when an unassigned patient comes in they are alternated between IM and FM services. We have open SICU, ICU, CCU, PICUs that we admit and manage our patients in. For OB we share the floor with OB residents but have our own board that we manage indepently. They can't come in and steal our cases or poach a procedure as we are completely independt of them. We our also the only residents the community physicians use in the seperate birthing center. We have two months of ICU work and we are the only residents on the service. We have weekly scope clinic where the surgery attendings do scopes on our clinic patients exclusively so we our the only residents in the procedure room.
We do peds floor on the peds servce as interns and because the peds program is relatively small we basically function as peds interns for them when we are on. The floor would have hard time being run if they couldn't use our residents every month.
We never have to go to a University Hospital. And are never regulated to the role of a medical student (unless we are on rads where I've heard many a resident has rekindled the greatness of 4th year by leaving at noon
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To the OP:
I chose my program because it fit with what I wanted to do as an attending and the one I felt most comfortable in.
In particular I thought the following things shined
1) Strong clinic training: I want to do mostly clinic when I am an attending so this made sense.
2) Flexibility: Good number of elective months and I could decide if I wanted to do OB past the required 2 months in intern year. Where as some programs made the residents do 2 months every year.
3) Procedures: We do a good number of procedures due to our good relationship with surgery attendings and the hospitalist service that is staffed with a good number of our graduates. At the same time however you don't have to do the procedures. Going to work in Urgent care? Well then no one is going to force you to do that central line at 4 AM.
4) Atmosphere: I think as a whole we are a pretty laid back residency. And this is more of a personal preference but I've always viewed medicine as a job. At a lot of unopposed programs they see medicine as a higher calling and treat it as such. And thats fine to but you don't want to be the resident who just views it as a job at a residency full of people who think it's a higher calling and vice versa.
