Community program vs Community, university-affiliated

[fouracle]

Hello, curious if anyone has any insights. I am really curious about the different program models. Academic programs are obvious. I am more so curious about community programs vs university-affiliated community programs. How should I view the latter in terms of preparing for a career in academic radiology/landing top fellowships?

Examples that come to mind are Mt Sinai West (confusing because it is ranked so highly on Doximity) and Mount Auburn Hospital (Harvard affiliated?).

Should I view these programs as closer to academic programs or community? Should I rank these programs below other academic programs that are mid- to upper- tier? Or can I view them as equal and just rank based on soft factors like location?

Thanks so much!

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[SeisK]

I may be mistaken but for my program they’re buying up surrounding practices, including one housing a prior community rads residency, and then slapping the big institution name on them. Faculty are very sparingly shared. General resources are not. Research opportunities and faculty-name connections are not.

n=1, however. It may be that other academic institutions when they acquire a smaller community residency really open up and mix them into the program.

 

[guytakingboards]

I'd separate the two ideas. A career in academic radiology does not equal landing a top fellowship.

The overwhelming number of people in "top" fellowships still go into private practice.

If you truly want a career in academic radiology, go to an academic program where you can be mentored and supported appropriately. Even a university-affiliated community program will have less opportunities for research and other resume building activities.

If you just want to go to a top fellowship, that's not that hard in general unless you're talking IR. But the university affiliated community programs usually have an upper hand at sending graduates to the mothership programs. A quick glance at Mount Auburn's graduate placement shows they send 1-2 people to MGH or BWH every year.

 

[fouracle]

I'd separate the two ideas. A career in academic radiology does not equal landing a top fellowship.

The overwhelming number of people in "top" fellowships still go into private practice.

If you truly want a career in academic radiology, go to an academic program where you can be mentored and supported appropriately. Even a university-affiliated community program will have less opportunities for research and other resume building activities.

If you just want to go to a top fellowship, that's not that hard in general unless you're talking IR. But the university affiliated community programs usually have an upper hand at sending graduates to the mothership programs. A quick glance at Mount Auburn's graduate placement shows they send 1-2 people to MGH or BWH every year.

Thanks for the insight! Would going to a top fellowship like MGH not set you up well for an academic career? My original thinking was that landing a “top” fellowship could open any doors, whether academic or private practice.

 

[IRattending2021]

Thanks for the insight! Would going to a top fellowship like MGH not set you up well for an academic career? My original thinking was that landing a “top” fellowship could open any doors, whether academic or private practice.

It doesn’t. Mostly highly desirable jobs look at residency connections first because A. Fellowships are not competitive and B. Timing of job search which starts early in fellowship year so your name brand fellowship may matter less than your name brand residency.

 

[guytakingboards]

Thanks for the insight! Would going to a top fellowship like MGH not set you up well for an academic career? My original thinking was that landing a “top” fellowship could open any doors, whether academic or private practice.

IRattending2021 pretty much explained why a top fellowship doesn't just magically open doors.

If you *really* want to go into academics, the name brand of your training spots counts but really it'll come down to your scholastic productivity to get you that great first job and to later get promoted. Often times academic promotions are simply "you need [X] number of publications and [y] number of first author publications". That's why going to an academic residency is important. The research opportunites, support and mentorship for early CV building are just better.

Flipside, a lot of the top fellowship programs like MGH have significant non-clinical/research requirements and/or don't expect a lot of productivity from their fellows. All that time to do research is great if you're going into academics, but spending a lot of time not doing clinical work makes zero sense if you're going into private practice.

I, for lack of a better word, chose a working fellowship. I read a lot cases, saw a large spectrum of pathology, and came out very clinically sound. I did minimal research though.

You gotta make that decision on academics vs private way earlier than in fellowship year. That decision will shape how the latter part of your residency and fellowship go. Are you gonna be the person crushing the list or the person giving lectures and doing research projects?

 

[Taurus]

I echo what others have said about private practice. They love loaded CV’s with top pedigree training but they will throw you out like yesterday’s bath water if you can’t clear the list fast enough. It’s a double-edged sword.

 

[fouracle]

Thanks everyone for the useful info!

On the flip side, if I just wanted to do private practice, does it matter in the slightest which program model I choose?

 

[guytakingboards]

Thanks everyone for the useful info!

On the flip side, if I just wanted to do private practice, does it matter in the slightest which program model I choose?

It’s not an unimportant consideration.

Academic programs tend to have better teaching and a much wider spectrum of pathology. They also practice closer to the leading edge of the field, doing procedures and studies that might not be commonly seen in community practice.

There are definitely some drawbacks to some academic programs. You might be fighting with the fellows for higher level cases and procedures. They might have a lot higher requirements on scholarly production (if you’re not interested in it).

There’s no better way to learn radiology than to actually be doing it (reading cases and doing procedures). I chose a resident driven residency and fellow-driven fellowship and came out well-equipped for a private career.

 

[Tiger100]

10 years ago people from MGH and UCSF had to do two fellowships to get an OK job.

These days, you need to have a pulse and the ability to log in into a computer to get a good job.


My whole point is that don't think about it too much. First choose the location that you like more and then try go to a good program in that location. Do a good job during residency and I guarantee that most programs will prepare you for private practice.

Don't make too much fuss about differences between different programs. Most of them are good enough and the rest is on you.

Now if you really like to have a Harvard or Hopkins name on your certificate to hang it on the wall and show it to your grandchildren, that's a different story. It doesn't make a difference in your future career in private practice, but I don't blame people if they want to have it. After-all, we live in a society that people are willing to spend 100K on a watch to just show off. So you won't be any different by seeking a brand name on your certificate.

 

[Gadofosveset]

The watch analogy is a good one, except they’re all Timex watches, but some have Rolex stamped on them.

Or maybe a better analogy… programs are like entry level brand name minivans, X1, Q3, GLA… they’re all the same car, but you can be a proud Mercedes owner if you want to pay a little more. It’s only when you get to the upper levels do you get the benefits within each brand (but even then they tend to be more similar than different). Someone who knows nothing about cars may be impressed; those who do know that a GLA is not an AMG GT.

So is the X1, Q3, GLA that much better than a Highlander, Tiguan, or Tucson? Only marginally? They’ll all get you where you need to go. Maybe these have some practical benefits the brand names don’t have? But like Tiger says, no matter what the facts are, people will go for the brand name.

Just don’t end up with a Grand Caravan.

 

[qxrt]

Program connections are the most important consideration when choosing a training program, particularly if you are interested in a job in a specific geographic area. You can talk about "workhorse vs academic" residencies or fellowships or whatnot and claim you got better training than the ivory-tower trainee (or vice versa), but from a PP groups perspective, the most important characteristics are attitude, speed, and quality of work, and the name of the residency or fellowship you went to has no correlation with the first two, and variable correlation with the last. When a PP group has enough connections to hire a known strong candidate, they will prioritize that over name brand pretty much every time.

Highly desirable metros good jobs are still tough to find as an outsider without connections regardless of the market, and some good groups do their hiring through word of mouth while rarely posting ads. You may find a strange disconnect when having difficulty trying to break into a popular metro area as an outsider, while everyone around you is currently saying the job market is red hot.

Community programs with academic affiliation are closer to other community programs than academic. They may have some benefit in placing residents for fellowship at the local prestigious university center due to connections, but outside of that, the training is more characteristic of the hospital you train at, not the university program the hospital is affiliated with. And as others have said, radiology fellowships (outside of maybe IR) are easy for anyone to get, even the ones at brand-name places.