Difficult decision about programs

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carddr

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The deadline for the Rank Order List is coming up Feb.21st. Can anyone give me some advice on Community-Based program versus University-Based? I am really torn as to which one holds the best cards for me right now. The programs I have interviewed have mostly been University Based and emphasize more lectures and research (in fact in one program 1 year has to be research) and the Community Based seems to offer much more hands on experience according to the residents in the program that I talked to. Is University Based more prestigious and therefor I can get better job or better Fellowship if I choose that route?? Thanks for input.

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Depends a little on the specialty you're doing I believe.

I'm kind of in the same boat you are. I'm leaning toward the community type program for hands-on experience. This may mean giving up a little of a competitive edge when/if fellowship time comes around. I actually like the "university affiliated/community based" programs the best. Nice combination of university name and ability to do research with the bonus of a more private type setting.

Who knows.
 
This depends on your specialty and your career goals. In some specialties some of the most prestigious residencies are indeed community based. (I'm told OB/GYN is like this, although not being one, I can't confirm) Likewise the more competitive the specialty, the more likely having an academic affiliation will help you, with a few exceptions, some sub-specialties seem to have a community based program tilt (for example Colon and Rectal Surgery).

That being said...my advice is going to sound incredibly unhelpful but I'm going to say it anyway, Go with your heart. Being miserable at the #1 program (if there ever was such a thing) in your field will almost certainly mean that you will not thrive as a person and thus not excel as a resident, which will ruin your chances far quicker than going to any community program (almost). Imagine having the most respected guy in the subspecialty you want to enter think you are a dolt! That can't be good. On the other hand, if you go to a quality community based program that is smart enough to get you the exposure that you need to the people you need to meet (I can think of many community based programs that have allowed their residents to either rotate away, or go away for research to gain exposure) and you are "the best resident they ever had" because you _love_ it there, you will have a fighting chance. Will you be fighting an uphill battle by not going to a Big-Name program? Yes. The way I see it though, if you love what you do and the people you do it with, then you can't go wrong.

As far as job after residency: I would say that if you want an university based academic job, then it is hands down much easier to score one from a University based program. Assuming that you (like the majority of people) want to enter private practice, I would say that the job market is more limited geographically in community programs (their alumni based isn't usually nationwide) but otherwise they generally find excellent practice opportunities.

Hope this helps you.
 
Very sound advice, thanks. I am shooting for surgery, Ortho to be exact, so which variable I choose is going to matter a great deal. I would love the hands-on stuff, but need all the credentials I can get. I have interviewed at a couple of the combined University/Community programs so will look at that with a more informed eye.
 
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