Different schools for MD and residency, yes or no?

[Danbo1957]

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Me: MD 1985, Residency 1988. Back then there was pressure for many to attend a residency program at an institution other than where one received the MD. Feeling was that "they know you too well here"; the same MS3s and MS4s when you were MS1 are now residents; seven years at the same institution is too long; etc. Also, as is well known, choice of residency location determines where many will practice.

There was a feeling for some though, that if one stayed at the same institution for MD and residency, one might keep or earn favorite status with residents and attendings, gain a better chance at good rotation schedules, an advantage at getting Chief, etc.

And some newly MD'd (females especially) didn't want to move out of their homes, relocate, start over, etc...

What influenced you when you ranked your MD institution?

Thanks

 

[IndyXRT]

My medical school is the only one in the state and is quite large. Because many students want to stay in state to practice, a significant number of them stay for residency. This is actually encouraged, since one of the main purposes of the medical school (it is a state sponsored school, after all) is to provide physicians for our state. I think things might be significantly different had I gone to a place where multiple medical schools existed in the same state. Staying in one place has worked out pretty well for me, though. Since so many people do it here, nobody seems to think twice about it.

 

[Castro Viejo]

I went to school in the last un-gentrified part of New York City. "Ghetto" doesn't begin to describe it. "Baghdad" or "Kabul" are probably more descriptive. I had no desire to be in that kind of place anymore. I wanted to go to work without fear of being murdered on my way to yet another day of endless scut. So I had zero interest in staying with the Mothership.

 

[orientedtoself]

there are both positives and negatives for staying or leaving. i ended up leaving my md program for residency mostly because my husband couldn't find work in his field where we were.

+ for staying
you know the system
you know what you are getting into
support networks
not having to move

+ for leaving
learn a new way of doing things
explore a new place
step into a new role in a new place, nobody remembers you as a bumbling ms3

 

[DarthNeurology]

Me: MD 1985, Residency 1988. Back then there was pressure for many to attend a residency program at an institution other than where one received the MD. Feeling was that "they know you too well here"; the same MS3s and MS4s when you were MS1 are now residents; seven years at the same institution is too long; etc. Also, as is well known, choice of residency location determines where many will practice.

There was a feeling for some though, that if one stayed at the same institution for MD and residency, one might keep or earn favorite status with residents and attendings, gain a better chance at good rotation schedules, an advantage at getting Chief, etc.

And some newly MD'd (females especially) didn't want to move out of their homes, relocate, start over, etc...

What you influenced when you ranked your MD institution?

Thanks

I think that on a personal level in terms of becoming a better physician it is good to do residency somewhere else than medical school just because you learn how things are done a different way at a different place, . . . if all you know is one hospital system you are limited I think. However, if you go to the top 5-10 medical schools then obviously staying MGH for residency after medical school at Harvard is good. In terms of academics though, in PhD training you are expected to do your post-doc at a place different than PhD school, . . . i.e. there is really emphasis of training at multiple institutions to learn more. If you look at all of the big deans and department heads at a med school they have usually all rotated in from other places, i.e. to climb the academic ladder you have to move around to more quickly move up and show that you are good in several different places. If all you have on your c.v. is one place, med school at x, residency at x, faculty appointment at x, it looks like you are inbred and maybe just maintained your position by knowing everybody in that little pond and not based on merit. It looks more impressive when someone did residency at y, fellowship at z, department head at m, etc . . . it shows they were successful multiple places.

I know some medical students who would never want to train at their home institution for residency because they really didn't like the atmosphere or faculty at their medical school. A lot are indifferent, but inclined to go elsewhere. Some feel they can save time having to learn a new system but just staying put. Others lay down roots at their med school, but others want to leave to go back home. I would recommend doing an elective at an outside institution before settling on your home med school, one person I knew did this and was happy to find places a lot better than their home med school were available for residency.

 

[CorpusERdoc]

Me: MD 1985, Residency 1988. Back then there was pressure for many to attend a residency program at an institution other than where one received the MD. Feeling was that "they know you too well here"; the same MS3s and MS4s when you were MS1 are now residents; seven years at the same institution is too long; etc. Also, as is well known, choice of residency location determines where many will practice.

There was a feeling for some though, that if one stayed at the same institution for MD and residency, one might keep or earn favorite status with residents and attendings, gain a better chance at good rotation schedules, an advantage at getting Chief, etc.

And some newly MD'd (females especially) didn't want to move out of their homes, relocate, start over, etc...

What influenced you when you ranked your MD institution?

Thanks

Personally, I did not attend my first choice of medical school, and had no intention of remaining in that area. Residency is a "fresh start" to go where you want.

 

[QofQuimica]

I'd be interested in what those of you in the know think about this question for someone in my situation. I'm a PhD now in my third year of med school at a different institution than where I did my PhD. I will be doing a post doc at my med school before going through the match. Originally, I assumed like the OP suggested that I would definitely leave and go somewhere else for residency. Now I have mixed feelings. I have already lived in a dozen cities in five different states. You reach a point where you want to be settled with your life (even without having a family!). Would it be so awful for an academic career to stay put for residency? I am at an excellent research hospital. My dean is very enthusiastic about the idea of me staying and offered to help pull strings if I decided that I want to stay. I understand that if I do stay, it is with the expectation that I am going to be groomed to be faculty, and I will spend at least the early part of my career here. That wasn't my original plan when I first got here, but I am starting to think that I might be ok with it. Any thoughts pro or con would be appreciated. 🙂

 

[Blade28]

There's absolutely nothing wrong with staying at your home program for residency. You're comfortable there, know the system (hospitals, computer systems, nurses/ancillary staff, etc.), are familiar with the attendings and residents, etc. If it's a strong residency program, so much the better!

 

[yaah]

I think opinions on both side of this issue are fairly prevalent, so ultimately it depends on what your specific situation entails. Some say that if you do all of your training at one place and then get a job there, you have lost a lot of your leverage in acquiring a favorable contract or working situation. Others say the opposite - that because you have the experience there and know all of the people you can make it work more to your advantage. While there is something to be said for experiencing new ways of doing things and looking at things, there is also something to be said for consistency. Ultimately, once you are at an institution for more than a few months you become comfortable with it anyway, most likely. But having the full experience of training there at all levels gives you a familiarity with things that can't really be acquired any other way.

I would say though that if people are working hard to try to get you to stay that you have nothing to lose by staying. I think part of the difficulty would come if you stayed at one institution, despite opportunities to leave, and kept giving up a lot in order to stay there. You can always move at a later stage.

 

[NotAProgDirector]

Instead of doing a post-doc after medical school, consider a research pathway residency. It combines residency, a research postdoc, and a fellowship (if you want to specialize, can be done without). Assuming you were planning on a 3 year post doc, you'll save a year this way.

 

[QofQuimica]

Instead of doing a post-doc after medical school, consider a research pathway residency. It combines residency, a research postdoc, and a fellowship (if you want to specialize, can be done without). Assuming you were planning on a 3 year post doc, you'll save a year this way.

I would love to do one of these programs if I could. I know they are fairly common in path and IM, which are the most popular specialties for MD/PhDs. But I am thinking of going into anesthesiology, and unfortunately there don't seem to be very many combined track options. I only know of a few research anesthesia programs, some of which I won't realistically be able to apply for based on location. It's definitely worth exploring, though; thanks for making the suggestion.

 

[pillowhead]

In an ideal career world where everyone where no one had significant others' careers to think about, children with day care needs, aging parents or family members who needed support, or houses/condos that just aren't selling---moving around as much as possible is better. Of course going to Columbia for undergrad, UCSF for med school, Univ of Michigan for residency, and Emory for fellowship is going to look better and probably give you a wider breadth of experiences that staying at any one of those institutions for four years.

But in the real world, many people have one or more of the above compelling reasons to stay in one place. My husband's career compelled me to stay at the same place for residency that I went to med school...and that may very well lead me to stay here for fellowship. I'm not going to trade my marriage and living with my husband for same vague advantage of training in multiple institutions.

Most people won't fault you for that but if you are really looking to climb the academic ladder quickly, it is better to move around.