Rank list help

[rads_2016]

I am originally from an area with a competitive job market. I am trying to make my rank list and trying to decide which programs are better for my long term career and ability to live near my family after residency (getting a job anywhere on the West Coast could work for me).

I can choose to rank some excellent programs with good connections in the areas that I want to eventually live in, or I can rank other "top" programs that I interviewed at (think some subset of MSK, MDA, HROP, Penn) which have a better "name brand," might provide better training, and seem like really great places to spend 4 years.

I know the conventional wisdom is to do residency in an area that you want to live in, but is that true even given the potential opportunity to train at top places (and potentially even one of the big 3)? In the job market 5 years from now, will the name brand of top programs outweigh the connections and networking ability of already being in the desired area?

I realize this issue is complex and nuanced, but any advice about this, especially with regard to the job market will really help me make my ROL. Thanks in advance.

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[Gfunk6]

In my experience in recruiting RO candidates to a large private practice in the SF Bay Area I can offer the following observation: we need to find people who are committed to stay in the area. The best surrogate of this is first degree relatives who live here or a spouse who needs to be employed here. A second best surrogate is if someone has no ties here but graduated from UCSF/Stanford and wants to stay.

If people from top tier programs apply without ties, I tend to pass.

A lot of candidates have both relatives here AND graduated from UCSF/Stanford. They are almost always at top of initial screens.

 

[mpdoc2]

In my experience in recruiting RO candidates to a large private practice in the SF Bay Area I can offer the following observation: we need to find people who are committed to stay in the area. The best surrogate of this is first degree relatives who live here or a spouse who needs to be employed here. A second best surrogate is if someone has no ties here but graduated from UCSF/Stanford and wants to stay.

If people from top tier programs apply without ties, I tend to pass.

A lot of candidates have both relatives here AND graduated from UCSF/Stanford. They are almost always at top of initial screens.

Out of curiosity why is there so much emphasis on ties to the area? I could understand if you were in the middle of no-where, and worried about the candidate leaving after they get some experience. But a place like SF I'd imagine people will tend to want to stay unless they're given a very bad contract.

 

[medgator]

Out of curiosity why is there so much emphasis on ties to the area? I could understand if you were in the middle of no-where, and worried about the candidate leaving after they get some experience. But a place like SF I'd imagine people will tend to want to stay unless they're given a very bad contract.

The ties are even stronger when there is blood involved imo. As someone who returned back close to "home", I get exactly where gfunk is coming from.

Cali is a competitive area to practice and reimbursement can be a tougher issue than elsewhere. SF is a great city but every place has its caveats. Someone with ties may just get it better. At the of day, excessive turnover is bad for an established practice.

 

[Gfunk6]

I want people who will stay and not leave after a year or two. Family is key to stability. It takes years to build relationships with referring MDs, so having a revolving door of ROs is not optimal.

 

[mpdoc2]

I want people who will stay and not leave after a year or two. Family is key to stability. It takes years to build relationships with referring MDs, so having a revolving door of ROs is not optimal.

Interesting, thanks for the input.

 

[mpdoc2]

The ties are even stronger when there is blood involved imo. As someone who returned back close to "home", I get exactly where gfunk is coming from.

Cali is a competitive area to practice and reimbursement can be a tougher issue than elsewhere. SF is a great city but every place has its caveats. Someone with ties may just get it better. At the of day, excessive turnover is bad for an established practice.

This made me kind of LOL. Blood must be involved! Kind of vampirish.

 

[BobbyHeenan]

Agree with other posters above.

If geographic region is extremely important to you, then I would try to train (or rank the highest) the best (or perceived best) program in that region. In addition to to what has been posted, being in that region for training lends itself to more opportunities to interact with those that will be hiring when you graduate (via moonlighting or calling to discuss a referral, committees, meetings, etc).

There is also a way at interviews once out of training to tactfully explain (without sounding like an entitled or stuck up d-bag) how you had opportunities to interview at (insert MDA, MSKC, Harvard, etc), but you felt *at home* at (insert west coast program) and were thoroughly pleased with both your training and locale. This will be another way you can convince those hiring of your commitment to the region.

 

[evilbooyaa]

Agree with other posters above.

If geographic region is extremely important to you, then I would try to train (or rank the highest) the best (or perceived best) program in that region. In addition to to what has been posted, being in that region for training lends itself to more opportunities to interact with those that will be hiring when you graduate (via moonlighting or calling to discuss a referral, committees, meetings, etc).

There is also a way at interviews once out of training to tactfully explain (without sounding like an entitled or stuck up d-bag) how you had opportunities to interview at (insert MDA, MSKC, Harvard, etc), but you felt *at home* at (insert west coast program) and were thoroughly pleased with both your training and locale. This will be another way you can convince those hiring of your commitment to the region.

But what if you ranked MDA/MSKCC/HROP top 3 and only ranked at your number 4, which was the west coast program? Employers would have no way of validating that.

 

[BobbyHeenan]

But what if you ranked MDA/MSKCC/HROP top 3 and only ranked at your number 4, which was the west coast program? Employers would have no way of validating that.

Of course not. You're overthinking it. No employer is going to try to verify your rank list.

It's just conversation fodder for an interview and may very well be the truth in the original posters case. I wouldn't tell them a lie about your rank list, but if you genuinely chose to rank west coast programs higher than the perceived top program in the land, I think it's fine to mention this to an employer. Others may disagree, and of course they can't verify that...but there's lots of things you will talk about when you interview or negotiate a contract that aren't verifiable. Just tell the truth.