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Clinical training at hospitals without certain residencies

Discussion in 'Pre-Medical Allopathic [ MD ]' started by TheThirdLevel, 05.18.14.

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  1. TheThirdLevel

    TheThirdLevel 5+ Year Member

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    So this is a little bit of an odd question. If you're getting your clinical training at a school whose hospital doesn't have a specific residency, will that affect your ability to land a good residency in that specialty?

    For example, let's say that you're attending a school that has links to 1-2 teaching hospitals. Neither of those hospitals have residency programs in, say, neurology. I assume you'll do your neurology clerkships with some neurologists at that hospital, but it's not a specific program there.

    Does that hold you back at all from some of the top residencies in the field, simply by virtue of that hospital not offering further training in that field? I assume this can be assuaged by doing an away rotation elsewhere, but I was just curious.

    I just used neurology as an example, but I mean it for any specialty really.
     
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  3. gyngyn

    gyngyn Professor Gold Donor 5+ Year Member

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    It is often helpful to have a letter from a well-known member of a particular specialty, but you can always do an elective for this.
     
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  4. TheThirdLevel

    TheThirdLevel 5+ Year Member

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    Is it fairly common to be able to get an elective away rotation in most fields?
    Also, would a lack of such a letter preclude you from more competitive programs? Or lead to an uphill battle?
     
  5. WillburCobb

    WillburCobb I am the pull out king Banned Account on Hold 5+ Year Member

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    As Gyngyn stated attending a school with associated residency programs may help but attending one without won't really hurt. My school only has psych, IM, FM, and general surgery, yet each year the match list is fairly representative of all specialties. Also, the value of away rotations is debatable. For every resident and attending who says they're necessary you'll find one who says otherwise (in the DO world they may be of more value). None the less, if you're on top of things and proactive, setting them up shouldn't be an issue.
     
  6. gyngyn

    gyngyn Professor Gold Donor 5+ Year Member

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    It's very common to do electives for a letter or an audition.
    Lack of a letter in your chosen specialty would be a significant problem in any specialty, not just "competitive" ones (except maybe in Family Medicine).
     
  7. gyngyn

    gyngyn Professor Gold Donor 5+ Year Member

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    Multiple away electives are becoming a real problem with little evidence that they do much good.
    A single elective in one's specialty of choice is not so problematic. It gives the student a chance to confirm their decision after experience in a different institution. Some students become convinced that they want to specialize in a particular field just because their school has a particularly accessible department or student experience. They do not come to realize that the good experience was idiosyncratic to the school until they venture out.
     
  8. TheThirdLevel

    TheThirdLevel 5+ Year Member

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    I'm not saying lack of a letter specifically (i.e. you get get one from a neurologist at your home institution despite them not having a neurology residency), just one from a clinical rotation at a hospital that has a residency program in that specialty.

    Thanks for the responses both of you.
     
  9. WillburCobb

    WillburCobb I am the pull out king Banned Account on Hold 5+ Year Member

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    In your opinion how valuable/necessary do you feel away rotations are? I've talked with several 4th years, grads, residents, and deans at my school, and have been perusing the resident/attending forums on this topic and have gotten very mixed responses.
     
  10. faw20

    faw20 2+ Year Member

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    Lack of letter in your chosen specialty is considered a significant problem... even in family medicine. As a medical student, you should do a rotation somewhere in your chosen specialty. How else will you know if you like that specialty?

    I wouldn't be as concerned about getting that experience as a premed. Depending on your location, you might be lucky to get any clinical experience.
     
  11. DrBowtie

    DrBowtie Final Countdown Moderator Emeritus 10+ Year Member

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    It's pretty field dependent as well as dependent on the applicant (stats and personality).
     
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  12. gyngyn

    gyngyn Professor Gold Donor 5+ Year Member

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    Maybe it's just where I work, but even the better FM programs have taken my students with letters from IM, peds and just about anything else! Even without a FM letter.
     
    Last edited: 05.18.14
  13. faw20

    faw20 2+ Year Member

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    Obviously YMMV. My program considers it a red flag if the applicant has NO letter from a family physician. Most of the time there is one letter from a family physician and the other letters are from other specialties. Lack of letter from a family physician signifies the applicant may not understand what it mean to be a family doctor, and questions the motive of the application (ie the applicant may be applying for internal medicine, ob, radiology, etc and using family medicine as a back-up).
     
    Last edited: 05.18.14
  14. gyngyn

    gyngyn Professor Gold Donor 5+ Year Member

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    That seems reasonable, even likely to be true!
     
  15. Caesar

    Caesar In Memory of Riley Jane SDN Administrator 7+ Year Member

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    It's going to depend on the residency. Some value the rotating in a program with residents (it's required for EM), some couldn't care less if you have or not (many FM programs). Most the time if you don't have the field at your institutions you won't be the first person to want to do the field and folks there will know what to do to help you get a spot.
     
  16. WillburCobb

    WillburCobb I am the pull out king Banned Account on Hold 5+ Year Member

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    I realize I'm only an incoming MS1 and don't mean to be "that guy" but I can name at least 8 current residents off the top of my head (probably more if I did some digging) who matched EM in the past several years without doing away rotations, and doing EM electives where there is no EM residency program.
     
    Last edited: 05.19.14
  17. Caesar

    Caesar In Memory of Riley Jane SDN Administrator 7+ Year Member

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    SLOE is required by >95% of programs. It's usually not a formal written requirement they just throw the app in the don't interview pile unless you have a compelling reason not to. Spend time on the EM forum and you'll hear from some faculty about them and the uselessness of not having any.
     
    Last edited: 05.19.14
  18. WillburCobb

    WillburCobb I am the pull out king Banned Account on Hold 5+ Year Member

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    Does the SLOE have to come from faculty that are part of an EM residency program though? I can't find anything that says that's necessary in a quick Google search. Also, I edited my previous post from "EM programs" to "EM residency programs" if that changes or clarifies anything.
     
  19. Caesar

    Caesar In Memory of Riley Jane SDN Administrator 7+ Year Member

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    http://www.cordem.org/i4a/pages/index.cfm?pageid=3743
    must be EM Faculty to complete the SLOE. You can Google "SLOE EM" and get info about it.
     

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