Pros and Cons of smaller programs...

[McP]

Any thoughts on the pros and cons of smaller programs? I am interviewing at a range of different programs. So far I've heard that at a smaller program, everyone knows you really well but I was wondering if there might be any other aspects to take into consideration. Thanks!

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[kgal1]

CON:

less flexibility in scheduling
ie. vacation time, rotation changes, etc.

 

[pediatron]

Okay, these are broad generalizations, but they do come from some experience with both....

PROS
-typically fewer admits on call night because smaller programs are typically at smaller medical centers
-fewer a holes/ egos than large academic centers which often have researchers who are "stuck" having to teach annoying residents and med students when the could be in the lab or writing papers
-good bread and butter peds/ general peds
-your attendings may be more invested in your future which may pay off for letters and jobs
-more support

CONS
-typically lower volume for learning
-zebras will be sent to other institutions of there are no sub-speciaists capable of handling them
-Only 5 interns total? crappy schedule intern year and beyond
-no big name

 

[bks524]

I went to a medium size program 36 residents. Here are my thoughts

Pros:
1. more intimate/more facetime with attendings
2. Usually very flexible because they generally don't rely on residents as much as bigger programs. I disagree with the other posters on this point. I have friends that went to programs with <5 residents per year and they had very favorable schedules.
3. More perks ie moving expenses, paid CME, big book allowances
4. More time to read about patients

Cons:
1. Small volume
2. Often lack diversity of subspecialists (but not always)
3. Many programs are plagued with "private" patients which are followed by their primary doc. This is good, because you meet the people in the community, but it is bad if they don't want to educate or meet you.
4. Many times you do have to send away your most interesting patients.

+/- Usually more prepared for primary care than subspecialty care

My thoughts

 

[McP]

Thanks for the input!

McP