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probably a silly question, but i'm still a little new to all this and would very much appreciate an explanation.
Difference among county vs. academic vs. community programs?
- Thread starter wanderlustin
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The terminology is murky any not completely clear-cut, but here's my take on it. Others are welcome to agree/disagree/modify as desired. I hesitate to give examples of programs in each type so as not to step on any toes.
Academic: Generally programs centered at university hospitals with high research output. These programs may (but not always) suffer from issues such as lower patient volumes or over-reaching specialty services that may reduce the number of procedures in the ED. The hope is that these traits allow for more teaching on shifts.
County: May be characterized by large patient volumes, more underserved populations, and (hopefully) greater resident autonomy. The places I consider "county" are typically more chaotic but allow for more procedures and greater resident responsibility, perhaps due to less attending oversight.
Community: This designation is the most difficult to label because some community programs are fiercely academic, others are as wild as the "county" programs but simply have a better patient mix. I would instead label such hospitals/programs as "Balanced". These are programs that have a very broad patient mix (if one hospital) or feature several hospitals that allow for a diverse residency experience. There is ideally balance between didactics and hands-on learning.
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The key is to identify the learning & training style that fits you and hopefully such a program will help you become a good doc.
Academic: Generally programs centered at university hospitals with high research output. These programs may (but not always) suffer from issues such as lower patient volumes or over-reaching specialty services that may reduce the number of procedures in the ED. The hope is that these traits allow for more teaching on shifts.
County: May be characterized by large patient volumes, more underserved populations, and (hopefully) greater resident autonomy. The places I consider "county" are typically more chaotic but allow for more procedures and greater resident responsibility, perhaps due to less attending oversight.
Community: This designation is the most difficult to label because some community programs are fiercely academic, others are as wild as the "county" programs but simply have a better patient mix. I would instead label such hospitals/programs as "Balanced". These are programs that have a very broad patient mix (if one hospital) or feature several hospitals that allow for a diverse residency experience. There is ideally balance between didactics and hands-on learning.
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The key is to identify the learning & training style that fits you and hopefully such a program will help you become a good doc.
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that is extremely helpful. thanks!
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Oftentimes programs have several different hospitals that you train at with an idea to 'diversify' your experience, i suppose. As I still have 5 weeks of med school left 🙁, I don't know how well that actually works, but it sounds like a good idea....
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Props to you for calling out those who scream "DO A SEARCH LOLZ !!111!!!"
The answer CHANGES, frequently.
I'm going to defer to those who are "in" academic programs at present... BUT....
in my *recent* experience...
"Academia" = lots of acuity, lots of teaching, but every other service is in your mouth.
"Community" = less acuity, decent teaching... get used to the real world.
"County" = Dear god, man.
I can be wrong. I can be disagreed with. I am only n = 1.
... but I'm going to throw in my two cents.
The answer CHANGES, frequently.
I'm going to defer to those who are "in" academic programs at present... BUT....
in my *recent* experience...
"Academia" = lots of acuity, lots of teaching, but every other service is in your mouth.
"Community" = less acuity, decent teaching... get used to the real world.
"County" = Dear god, man.
I can be wrong. I can be disagreed with. I am only n = 1.
... but I'm going to throw in my two cents.
academia = tertiary care hospital with multiple residency programs and most departments that you can think of.
community = none to a couple of residency programs, lacking multiple specialty and subspecialty departments
community = none to a couple of residency programs, lacking multiple specialty and subspecialty departments
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Where I trained, I split my time evenly at an academic and county setting. We had the same specialties available to us at both places with a few exceptions.
We also did other rotations in a busy suburban 'community' hospital and one month in a 5 bed 'rural' ED. Made for well-rounded training and a taste of the different types of ED settings.
I felt there was more autonomy at the county shop. It was also the trauma center, so the patient mix differed.
We also did other rotations in a busy suburban 'community' hospital and one month in a 5 bed 'rural' ED. Made for well-rounded training and a taste of the different types of ED settings.
I felt there was more autonomy at the county shop. It was also the trauma center, so the patient mix differed.
