Clinical training at hospitals without certain residencies

[MadRadLad]

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.

---

Members don't see this ad.

 

[gyngyn]

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.

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.

 

[MadRadLad]

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.

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?

 

[WillburCobb]

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.

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.

 

[gyngyn]

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?

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).

 

[gyngyn]

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. None the less, if you're on top of things and proactive, setting them up shouldn't be an issue.

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.

 

[MadRadLad]

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).

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.

 

[WillburCobb]

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.

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.

 

[faw20]

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).

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.

 

[DrBowtie]

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.

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

 

[gyngyn]

Lack of letter in your chosen specialty is considered a significant problem... even in family medicine.

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.

 

[faw20]

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.

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).

 

[gyngyn]

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 men to be a family doctor, and questions the motive of the application (ie the applicant may be applying for internal medicine, on, radiology, etc and using family medicine as a back-up).

That seems reasonable, even likely to be true!

 

[Caesar]

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.

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.

 

[WillburCobb]

Some value the rotating in a program with residents (it's required for EM)

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.

 

[Caesar]

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 program.

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.

 

[WillburCobb]

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.

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.

 

[Caesar]

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.

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.