Quantcast

crazy vs. cushy EM residency program

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

photodr2

New Member
7+ Year Member
Joined
Feb 12, 2010
Messages
7
Reaction score
0
With one last month to go before submitting my rank list I thought I'd get this forum's opinion on the pros and cons of two types of residency programs I am considering for my #1 spot.

Type 1: county hospital, big established program, tons of procedures, lots of autonomy, but a traditional curriculum that takes you out of the ED for much of your intern year. No pushing patients down the hallway, but definitely a work-and-learn program.

Type 2: big academic tertiary referral center with relatively new EM program, more attending supervision/teaching, less autonomy, more time in the ED, especially as an intern, relatively easy schedule with off-service rotations being tailored to EM needs. Fewer procedures. More time at home with family.

Which type of program do you think produces a stronger, more competent/confident resident? Graduates of which type of program holds a stronger hand when the time comes to find a job in the community/academics? If you had to do it all over again, which would you choose?
 

Rendar5

Full Member
15+ Year Member
Joined
Nov 12, 2003
Messages
7,045
Reaction score
749
It's whichever environment you thrive on. You don't need that many procedures to get good at them, but don need too few either. You don't need tons of floor months, but you need sufficient ICU months to get proficient at taking care of teh critical patient when you can't get them to the ICU in a timely manner. You will have plenty of autonomy when you graduate, no matter what, but if you learn best by just doing and making some mistakes or getting constant supervision, you want the practice style that suits you.
 

dotcb

---------
10+ Year Member
15+ Year Member
Joined
Oct 16, 2001
Messages
731
Reaction score
125
Easy - #1. You learn the most when you're in the driver's seat. You want a long enough leash for flexibility, plus good teaching and enough supervision to be safe.
 

QuackaDO

Full Member
7+ Year Member
Joined
Jul 1, 2009
Messages
484
Reaction score
38
What does your gut tell you? Then that's your answer cuz any answer you get from anyone to this post will be THEIR gut feeling since nobody has actually done both styles, even if they have experienced both (one as a resident, one as attending for example). Everyone will tell you what they think is best but what IS the best is what's the best for you, not for them. Kinda like the whole match thing, lol!
 

NERDY

Member
15+ Year Member
Joined
Oct 22, 2004
Messages
376
Reaction score
21
Don't forget you need time to study/read/etc. Would program #1 give you time to study the material that you don't see everyday in the ED?
 

DeadCactus

Full Member
Lifetime Donor
15+ Year Member
Joined
Oct 28, 2006
Messages
2,873
Reaction score
1,390
No right answer. Books can't replace patient contact, patients can't replace books, and both are useless if you're too burnt out to remain engaged in learning. Everyone has a different optimum between the three factors, you have to decide on your own.
 
D

da8s0859q

No right answer. Books can't replace patient contact, patients can't replace books, and both are useless if you're too burnt out to remain engaged in learning. Everyone has a different optimum between the three factors, you have to decide on your own.

This for sure. I am a lowly PGY ~1.5 but would argue that you will get more or less out of residency compared to others depending on how much you put into it, and residency is hard as a rule, so there is nothing inherently wrong with #2. Do what suits you best.
 

photodr2

New Member
7+ Year Member
Joined
Feb 12, 2010
Messages
7
Reaction score
0
Thanks for all the thoughts on this. My gut tells me that the county program is best for me, but I was also curious if there is a difference in perception between the different types of programs from an employment perspective.
 

EvoDevo

Forging a Different Path
Moderator Emeritus
15+ Year Member
Joined
Jun 5, 2003
Messages
20,373
Reaction score
28
Go with program number 1.

As an attending about 1.5 yrs out of residency and working in a community hospital, I have been amazed at how relevant all of those other "useless" off service months turned out to be. In my practice today, I have used it all, including the PICU, trauma surgery, trauma and surgical ICU, MICU, medicine floor months, pediatrics, etc. I mean, just about every bit of it. In fact, I even wish that some of them had been even harder/less "tailored to EM" because you know what? Sometimes you don't know what you don't know until it's too late.

TL;DR: go for the harder, less tailored program (at least in intern year). Your older self will thank you in 4-5 years.
 
Top