regional bias post-residency?

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polylux

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Assuming I want to end up in a certain area eventually, is moving to another area and getting a job after residency difficult? It seems like there is an obvious bias for say, Western U/COMP students in CA residencies, or a bias for OUH-COM students in Ohio, but does that bias translate into the field post-residency as well?

In other words, if I want to end up on the west coast eventually, but not necessarily for residency, would it still matter if I went to somewhere like UNECOM/PCOM/CUSOM or another school that isn't in the region? Does it effect my chances of becoming an attending in CA if I do my residency in MA or vice versa?

If there is a bias, does it change depending on specialty? Is it easier for IM to move around than EM? Or Gen Surg vs Urology?

Apologies if this has been asked before; I couldn't find a thread that wasn't residency specific.

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Only reason it vaguely might seem to matter is because many alumni live in that area and it is easier to network to get your job, but no, once you have an attending status, it's all good. Some groups may like you even more because you bring east coast culture and it's good to have variety in medicine and have connections nationally.
 
Yea, pretty much as said above: Getting a job post residency is usually based on your qualifications. In residency, lots of abstract things (like where you grew up, where you went to school, where your parents live) have relevance. But it appears that *most* places in *most* fields are recruiting from across the country to fill their needs. Of course there is a certain value to having connections. Connections get you places, but at the attending level the connections "get" you places, but not having connections doesnt appear to "lose" you places.
 
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Geting a job out of residency is EASY. You just need to have finished your training and are board certified. The rest really doesn't matter. The only problem I have seen is trying to get a job where there is a saturated market but that is true for any career/field.

I am from Alaska, med school in Penn, Residency in Texas. Had my first job in Montana, the next in Colorado, the next in Oregon, the next in Nevada. No one ever said to me "we are not going to hire you because you aren't from here or didn't do residency here, etc".
 
Thank you guys for your responses!

I assume it's common for big metropolitan areas like Boston or NYC or SF or LA to be saturated? Is it typically pretty saturated in the suburbs around those areas too? Do you really have to be like rural for the market to be not saturated?
 
Thank you guys for your responses!

I assume it's common for big metropolitan areas like Boston or NYC or SF or LA to be saturated? Is it typically pretty saturated in the suburbs around those areas too? Do you really have to be like rural for the market to be not saturated?
Depends on what your career choice is. Primary care is never saturated.
 
What about Hospitalist? EM? Heme/Onc?

I guess a better question would be where to find this kind of information? I've obviously very far off this search, so I know things will change by the time I get there. I'm just interested in how the market works.
 
It's hard to answer your question because you're asking us to predict the future. What field will be saturated, what field will be in demand?

Right now, pathology and radiology are saturated fields .... a few years ago they were not (and were in demand). Heme/Onc is starting to become saturated (according to my heme/onc friends). Nephrology is a tough market. There is a shortage of pulmonologist/intensivist nationwide.

Once you pick your field and complete your training .... the market may be completely different. There may not be any openings, or there may be tons. It's hard to know. What is true now may not be true tomorrow.

Medicine doesn't really follow simple macroeconomic principles (such as supply/demand) so it's hard to predict the future due to too many outside influences affecting the market.

By the time you complete residency, your priorities may change. You may have wanted academic medicine, but decided you hate academic culture or you want more money. Or you may have been fallen in love with academic medicine, teaching and doing research. You may want to move to cross country to your ideal location, or you may already have family and your spouse does not want to move due to variety of factors (jobs, family, schools, moving the kids, house payments, etc). Or you may have no choice to move because the market is saturated.

A lot of people stay within the same geographic region as their residency/fellowship because they are familiar with the area, know the practices (and the reputation), know the resources of the area (not just health/medical resources, but other stuff like things to do on weekends, good schools/bad schools, etc). They may have picked that residency/fellowship because of family (or desire to be in the area) and have no desire to leave. It's also easier to establish network and connections to area docs while in residency (and can establish a good referral base once you leave training). Then there's inertia - some people don't want to move again. Then there are people who can't stay still. The area docs (and practices) also know the type of training that you received. It's a bigger variable if you look outside the region unless you come from a big-name place (ie Mayo, MGH, Hopkins, UCSF, etc) - but then the fear from private practice groups is that you're not ready for the demands of private practice (PP and academia are different beast)


However, the one constant when looking for a job - No one cares what your USMLE or COMLEX scores are. No one cares if you are ranked in the top quartile or bottom quartile. No one cares if you are a DO or MD. What they do look for are: Are you board certified? Do you bring the skills/expertise that the business needs currently (either to fill a gap or to expand)? Are you a crazy loon that can't work with any office staff, or patients? Are you a danger to patients? Are you responsible?

Long winded answer, that doesn't really answer your question, but I hope it gives you some insight/perspective.


*an open secret that a lot of premed don't know - if you work in academic medicine (Mass Gen, Duke, Hopkins, etc) - your pay will be significantly lower than your private practice counterpart. A 2008 MGMA survey showed that academic primary care compensation was $158,218 compare to $186,044 for private practice primary care. For specialties, academia pays $238,587 compare to $339,738 for private practice.
 
Thanks a ton for your response! Honestly my main concern was just that if I go to med school then residency in one place, I would end up getting kind of pidgeon-holed into staying in that area and wouldn't be able to leave easily. Eventually, I'd like to end up near family, but my family is scattered in MA and CA... which are definitely physician saturated. I'm just trying to do research in various fields and such to I have something to talk to my family about.
 
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