Choosing the right program...

[DireWolf]

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for you.

In talking with countless residents in different specialties at different hospitals, it seems that people's motivations for choosing particular programs can be divided into 3 general categories.

1. Location. These people didn't care what program they got into, just as long as it was in a particular city, state, or region.

2. Reputation. These people didn't care about anything but how prestigious their program seemed.

3. Little bit of everything. These people looked at the entire picture - location, reputation, caseload, pathology, facilities, etc. This is how you would expect most people to make their decisions. However, I was surprised to see a relatively equal split among the three categories.

The reason I bring this up is because now that I am starting to research different programs, I see my philosophy changing. I used to be in category 3, tending to look at all the in-and-outs of a program. But lately, I've shifted more towards category 1, where location outweighs everything else. This philosophy is based on the premise that all the programs have to pass a certification process, so the minimum training requirements will be attained at any program. In addition, matching into the specialty of your choice is the ultimate goal, and everything after that is a bonus.

So where do you fit in?

And if you fall into category 1, what were your primary motivations for making location the most important determinant? Examples include: family and friends in the area, weather, always wanted to live in a particular city, significant other, etc.

 

[yaah]

My most important factor was how I felt on the interview day - was the program dedicated to teaching, what were the other residents like, how did the faculty treat teaching responsibilities and balance teaching and service work, etc. Location was also somewhat important to me in that I wasn't too enthused about a big city, because I didn't want to live in a studio apartment and pay hundreds a month for parking.

Reputation was very peripheral, although when you consider the above factors I did, that sort of comes into play, because quite often (although far from universal!) the programs with the best reputation are that way for a reason.

 

[edmadison]

Location is important, especially if you have significant other issues, but ponder this:

There are 168 hours in every week. You will be working 80 of them. That leaves 88 for everything else: communting, studying, sleeping, playing. Do your self a favor. Pick a program with a good fit for your personality. If you don't click with your program you'll be miserable, even if you live in Disney World.

Ed

 

[PassinGas]

I agree with Yaah...when looking at several programs that I thought were good, the final judgment for me came down to my gut feeling on interview day.

That being said, how I felt on interview day in large part was influenced by (in no particular order) what the environment at the hospital was like, how I interacted with the residents, how the residents interacted with each other/faculty, how eager the faculty were about teaching, what was the progress/reputation of the program, what were the didactics/board prep like, was there a balanced lifestyle, and what the city was like. Usually if all the above were good/great, then the program had a good/great reputation.

The city was definitely very important to me. I interviewed all over, but I knew the particular area of the country I would prefer, and that definitely helped sort out my top 3 choices.

If you are like me, you will just know where you want to rank #1...or at least which programs are in your top 2. Your gut will tell you. Then you will also know which programs you want to rank towards the end of your list. The hard part is placing those middle programs...you will have to figure out what is important to you.

To be honest, though, like you said, to match into your specialty of choice is the goal, and if you keep that in mind, you will most likely be happy no matter where you match.

 

[yaah]

Definitely - a prestigious program won't mean squat for your career if you don't fit in well there, are unhappy living there, or don't mesh with the style of the program. Better to be happy and productive than stressed out and unhappy.

 

[GenSurg]

Most of my choice came down to location. This may or may not have been the best way to go. How you fit in with the current residents can be very important. I used my second and third choices based on the pre-interview dinner and how I interacted with the residents. You are going to be spending a lot of time with the other residents, and this can be quite painful if you are working with people you don't care for. Also, if the hospital is a dump, it can be painful to spend so much time there. I've known several cases of how scabies runs rampant among residents because the call room sheets didn't get changed.

http://www.freeiPods.com/?r=20049323

 

[fantasty]

Not there yet, but I've been thinking about this a lot. And I'm thinking location will be a major factor.

I do think the characteristics of the city will have a big impact on those hours away from the hospital. First, my sig other is older than I am and wants to settle down. We've decided that we can only handle about one more move. So, it's either move for residency, or move when looking for the first "real" position. Plus, as I become easily miserable based on my surroundings, I do have both weather and sociopolitical factors limiting big chunks of the country for me

From a career standpoint, I'm planning on internal med. Honestly, there are good quality programs *everywhere*. Furthermore, if I specialize, it'll probably be in a less competitative field anyhow. So, I'm pretty sure most of the cities I really would like to go to will have decent opportunities. But, the major career factor for me is the likelihood of getting an academic position. Luckily, there are some short-tracking and clinical scientist options that increase the chances of making a home at the place where you train, which is very appealing to me.