pros/cons of small vs big residency programs

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artificialtears

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What's people's take on smaller (2-3 spots) vs bigger (4-8 spots) programs?

For smaller programs--does that usually mean the services aren't that busy and that's why they don't need that many residents? Or that it may be busy, but they just work the residents harder and residents need to take more calls than other larger programs?

Also, if a co-resident for some reason takes time off during residency (ie for maternity leave or for some reason quits the program), does that mean the residents in the smaller sized programs tend to get screwed over more because there's less number of residents to cover for the missing person?

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What's people's take on smaller (2-3 spots) vs bigger (4-8 spots) programs?

For smaller programs--does that usually mean the services aren't that busy and that's why they don't need that many residents? Or that it may be busy, but they just work the residents harder and residents need to take more calls than other larger programs?

Also, if a co-resident for some reason takes time off during residency (ie for maternity leave or for some reason quits the program), does that mean the residents in the smaller sized programs tend to get screwed over more because there's less number of residents to cover for the missing person?

i think some of it is a personal preference. i know i did not want to be at any program with only 2 residents, but was happier in the 3-5 range. usually, the number of resident spots reflects the number of residents needed for how busy the place is. i think it varies, some places with 2 residents are very slow and some places with 2 are very busy and likely will do fine with 3. either way, if there are 2 residents, you will definitely take more call.

yes, if someone takes time off or leaves a program, everyone else has to pick up the slack which is usually noticed more in smaller programs.
 
Bigger programs typically have larger faculty.

More faculty -> more exposure/experience to the different sub-specialties.

More exposure -> better residency experience.

Of course, there are aberrations to this general tread... eg. I remember when Utah only had 2 residents... I'm sure each of their residents were doing at least 250-300 cataracts by the time they were done.

And of course, much less call with more residents!

-J
 
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In smaller programs, you're also under the gun or under observation that much more from faculty. can be both good and bad - meaning they know who's good, but they also know who struggling or not.

Large - IMHO - am sure others may have other opinions - residents are happier as more support, and faculty are less stuck up on individual applicants. More room for error so to speak....and of course the lesser call helps like others have said!
 
I think larger residencies offer you more broad experience as you will likely be working with more faculty in more settings. Probably more things in place to help you get research, surgical and clinical experience as well. You can choose to "fly underneath the radar" if you want. Call is spread out amongst more residents. Perhaps more difficult to stand out from the crowd if that's your thing or if you're thinking about a competitive fellowship or job and need great letters of recommendation.

Only advantage I can see to a small residency is possibly more surgical experience, although if it's 2 residents, there may not be enough volume as it is. Other advantage is maybe a more "personal" intimate relationship between you, your peers and your faculty. The increased call would stink though.
 
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