Community vs. Academic Programs

[MS05']

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I'm a third (almost 4th year) set on going into EM and have been sifting through various EM residency programs online to figure out what I like/where I'll fit in. I guess my question is, what are the differences between community and academic programs? From what little I've heard, the attendings at a community program are a little less likely to teach and you need to more actively educate yourself (i.e. teach yourself.) Other than that I'm wondering what the differences are, for example, hire-ability after the residency and can a community program graduate take a faculty position after graduation (with the same ease of a university based program). Any additional info would be much appreciated!

 

[BassDominator]

I think it's hard to generalize about teaching. It depends on the institution as well as the residents/attendings you work with.

I'm sure you can get a good job coming out of community hospital residency. If you have your eyes on fellowship or an academic position, I think it would be really hard to do coming from a community hospital. You need research experience to launch these kind of careers.... which generally only occurs at university affiliated programs.

The bright side is there are a bunch of good pseudo-community hospitals.... essentially hospitals that look and feel like a community hospital but are university affiliated.

 

[Jeff698]

I'm in your same boat (rising fourth year and EM bound) but I'll share what I've heard from our last several years of matching students. The conventional wisdom is that community EM programs (really more like EM programs based at private rather than community hospitals) have less volume and typically make up for it with more lectures and other didactics. The other option is a county hospital where the volume is much higher and there is less time for didactic teaching...more of a learn by doing thing.

I have no way of knowing if any of that is true or not. I suspect most programs, regardless of setting, have some combination of the two.

Take care and good luck. Maybe I'll see you on the interview trail.

Jeff

 

[SewerRat]

When I was in your shoes 1 year ago, people always asked me whether I wanted to train at an community, academic or county setting. I really went into my sub-internships thinking that most programs were clearly defined as only one or the other.

This is true for classically hard-core county places, like USC, Cook County and Highland; and some community programs like Orlando; and some heavy academic sites like Stanford (although they do go to S.F.General).

However, there are programs out there that are a good combination of all. UC Davis combines a county and a university hospital in one site. Denver Health rotates at Denver General (the Original Knife and Gun Club county hospital), as well as the University of Colorado, a local community hospital and a children's hospital.

After seeing the variety of programs out there, I felt that you actually can have the best of both worlds and I ended up ranking my programs accordingly.

But I confess, if I had to pick only one type of training site, I would go with county for sure.

 

[Seaglass]

I have no way of knowing if any of that is true or not.

It's not. The patient census is extremely variable between hospitals and doesn't fall out into a comunity/academic divide very well. For example, the very old academic EM program I'm heading to has a considerably lower census than two community programs I interviewed at (York and Christiana).

C

 

[MS05']

"I'm sure you can get a good job coming out of community hospital residency. If you have your eyes on fellowship or an academic position, I think it would be really hard to do coming from a community hospital. You need research experience to launch these kind of careers"

Okay, so as mentioned above, let's take Orlando as an example. Say I wanted to match there and that they're a known community program and I have an interest in tox or EMS after residency. Would doing research on my own (out of curiosity I checked their website and they mentioned they have two full time research nurses and a PhD research coordinator) be equivical to doing a residency at a university/county program?

 

[Seaglass]

I'm sure you can get a good job coming out of community hospital residency.

The Community/Academic divide is not nearly as great in EM as it is in other fields. There are many community programs that have research programs that are as strong as any academic and stronger than some (Carolinas comes to mind). From what I've heard from attendings and residents it's not much harder to get into a good fellowship from a community program than from your average academic program. IMHO when chairs are looking to expand faculty they are looking much more at what you are bringing to the program in the way of research experience/clinical expertise than where you did your residency.

C