Deciding between Academic vs Community programs

[MisterMukwa]

Hi all

4th year here on the interview trail for DR. Have been fortunate to have a number of interviews for a wide variety of programs, ranging from small community to T20 academic.

I’m really struggling with making sense of a rank list. At this moment, I’m thinking I will probably do PP. I don’t really have much interest in research, although I would be interested in some teaching involvement. Im also not really interested in hyper competitive locations (NYC, LA, Boston, etc).

That said, how much of a difference does academic vs community make for training PP radiologists? It seems like fellowship can basically be obtained from anywhere. I’ve interviewed at a couple of community residencies through health systems that have transplant, Onc, level 1 trauma, peds, etc so it doesn’t seem like acuity/study complexity is a major concern. I know the general mantra is to attend a large academic center for residency if possible, but I’m unsure how much of a difference it really makes.

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[bobjonesbob]

If you list specific programs people can give you more informed recommendations but places that have level 1 trauma, transplants, and childrens hospitals aren't really considered community programs.

Without knowing any specifics here are a few general thoughts:
-In general academic programs will provide better training. There's a difference having your cases readout by a subspecialist in each section including the stuff you read on call.
-Programs that are more resident run offer better training. Some places have no attendings or fellows working 5p-8a. Some places have subspecialty fellow/attending coverage in the evening and ED attendings 24/7. Having that independence early is beneficial.
-Formal readouts should be nonnegotiable for the first couple years and ideally still regularly taking place as a senior resident on day time rotations. I know some community programs that basically don't do any readouts. You don't want to be at a place like that.
-All that being said, most things will even out in the end especially if you end up practicing predominantly in one subspecialty that you do a fellowship in.

 

[MisterMukwa]

A couple of the community programs I felt good about were Aurora St Luke’s (Milwaukee) and Corewell Grand Rapids (formerly Spectrum). Aurora didn’t have Level 1 adult trauma and Corewell didn’t have much kidney/liver transplant, but seemed well rounded otherwise with great acuity. Both are also associated with big subspecialist PP rads groups. Baptist Memorial in Memphis also seemed fairly strong, although definitely less high end cases. All had primarily in person readouts, some independent call, and subspecialty readouts.

Academic programs I interviewed at include Minnesota, Indiana, Ohio St, Wake Forest, UAB, and Mayo Jacksonville. I felt like didactics/teaching might be a bit stronger overall, but it didn’t seem like a major difference to me.

 

[guytakingboards]

My opinion would be academic/university program nearly every time.

Whatever your fellowship is, you'll get good sub-spec training in that field. The bigger question is will you get sub-spec level training in your resident rotations in the "general radiology" fields

I don't love chest radiology but I got almost 3/4's of a year of chest rotations during residency at a lung transplant center and saw damn near every pulmonary (and most cardiac) pathology in the review books. Similar with body: my residency had liver/kidney transplants, brisk oncology services and I saw high level everything. If you're at a good academic program, they will teach you to break down a case and provide a sub-spec level report.... even if you're not ultimately going into that field. I was never as strong at chest or body as I was at the end of R4.

Granted, not every university/academic program is good at teaching but at minimum they'll have the diversity of pathology to teach you. Community programs won't be able to teach you in that way. I used to work in a hybrid academic program and in no way was the overall teaching or spectrum of pathology anywhere near as good as the lower tier academic program that I trained at.

Among the programs that you listed, UAB will by a large margin blow away any of the community programs you listed. It's the referral center for the entire state of Alabama. I would expect some of the other University programs to be similar. (**EDIT, Minnesota will lose cases to Mayo. Ohio State will lose cases to CCF. At least within state lines, UAB is losing cases to no one).

To put it another way, community hospital systems big enough to have a residency program are still only referral centers for other smaller hospitals within the same system. University hospitals are referral centers for the stuff that the Aurora St. Luke's, Corewell Grand Rapids and other community systems can't figure out.

**Second shoutout to UAB. I didn't train there but I interviewed there and ultimately trained elsewhere in the South. I'd put the pathology on par with Vandy/Emory and above Duke and UTSW. IMO it's the biggest sleeper program in the south.

 

[bobjonesbob]

Would definitely recommend Minnesota, Indiana, Ohio St, Wake Forest, and UAB be at the top of your list.

 

[colbgw02]

A couple of the community programs I felt good about were Aurora St Luke’s (Milwaukee) and Corewell Grand Rapids (formerly Spectrum). Aurora didn’t have Level 1 adult trauma and Corewell didn’t have much kidney/liver transplant, but seemed well rounded otherwise with great acuity. Both are also associated with big subspecialist PP rads groups. Baptist Memorial in Memphis also seemed fairly strong, although definitely less high end cases. All had primarily in person readouts, some independent call, and subspecialty readouts.

Academic programs I interviewed at include Minnesota, Indiana, Ohio St, Wake Forest, UAB, and Mayo Jacksonville. I felt like didactics/teaching might be a bit stronger overall, but it didn’t seem like a major difference to me.

I have virtually nothing to offer about the other programs you listed, but if you'd like more information about UAB, please feel free to DM me.

 

[MisterMukwa]

I appreciate all of the replies! That really clears things up.