Does residency location matter?

[DPTinthemaking15]

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I will be entering medical school this Fall, and I have a question regarding residency. I see post from time to time on SDN that talk about competitive residency locations. What is the point of matching in a location like this?

Here is the reason I ask: The wife and I moved to a “larger” city and it sucks. We come from a small, one red light town, and I intend on moving back after residency. Are there any benefits matching at Hopkins (just an example), over a community hospital?

Edit: I know residency is a long time away. I’m just curious if matching at a competitive program is worth it for a small town person like myself lol.

 

[Rekt]

Depends on what you're going into and your career goals. The short answer is yes and no.

 

[deleted610572]

Depends what you are interested in. The more specialized, the bigger the population you need to get a solid education. If you want primary care then you can pretty much go to with any population size to get a solid education. Bigger, popular programs bring more prestige that can help match into fellowships as well.

 

[Stagg737]

Here is the reason I ask: The wife and I moved to a “larger” city and it sucks. We come from a small, one red light town, and I intend on moving back after residency. Are there any benefits matching at Hopkins (just an example), over a community hospital?

Based on that, for you the answer is no. As long as the program you go to gives you a strong clinical education it wouldn't make a difference.

Depends what you are interested in. The more specialized, the bigger the population you need to get a solid education. If you want primary care then you can pretty much go to with any population size to get a solid education. Bigger, popular programs bring more prestige that can help match into fellowships as well.

I disagree. I think for generalists having a broader population is more important. Generalists are going to see a wider variety of cases walk through their door than the specialist, so the FM/IM/peds docs need a bigger population with greater variety. The more sub-specialized you are the less variety you'll need but you'll need to work with as many people in that narrower scope as possible to really master that technique/area.

 

[Black Coffee 24/7]

I will be entering medical school this Fall, and I have a question regarding residency. I see post from time to time on SDN that talk about competitive residency locations. What is the point of matching in a location like this?

Here is the reason I ask: The wife and I moved to a “larger” city and it sucks. We come from a small, one red light town, and I intend on moving back after residency. Are there any benefits matching at Hopkins (just an example), over a community hospital?

Edit: I know residency is a long time away. I’m just curious if matching at a competitive program is worth it for a small town person like myself lol.

If you are set on FM, I would stay away from FM residencies in big cities where FM docs act like referring bellboys for all sub-specialist daddies.

 

[DPTinthemaking15]

Based on that, for you the answer is no. As long as the program you go to gives you a strong clinical education it wouldn't make a difference.



I disagree. I think for generalists having a broader population is more important. Generalists are going to see a wider variety of cases walk through their door than the specialist, so the FM/IM/peds docs need a bigger population with greater variety. The more sub-specialized you are the less variety you'll need but you'll need to work with as many people in that narrower scope as possible to really master that technique/area.

Thank you for the information. If I were to apply for fellowships, would I need to look for academic programs? I can see myself enjoying just about anything (with the exception of derm haha), but I want to keep my options open.

 

[DPTinthemaking15]

If you are set on FM, I would stay away from FM residencies in big cities where FM docs act like referring bellboys for all sub-specialist daddies.

I WANT to like FM, because there are a few scholarship opportunities out there, but I will definitely stay away from larger areas. Thank you for the advice.

 

[deleted950463]

If you grew up in a small town and want to go back to a small town, location of residency does not matter.

If you grew up in San Francisco and realize all SF rad onc docs graduated from UCSF, it may be necessary to do rad onc at UCSF for a chance to work in SF, so in that case locatiln matters.

 

[Black Coffee 24/7]

If you grew up in a small town and want to go back to a small town, location of residency does not matter.

If you grew up in San Francisco and realize all SF rad onc docs graduated from UCSF, it may be necessary to do rad onc at UCSF for a chance to work in SF, so in that case locatiln matters.

I don't understand the infatuation with SF. SF is where an attending physician can make 300-400K and still live with a roommate with a total commute time of 2-3 hrs.

Thank God for all the suckers wanting to live in SF and LA.

 

[Mass Effect]

You can find plenty of academic programs that aren't in big cities and some community programs in big cities, so it's not about that. I would go where you'll get the best training, even if your desire is to move back to your small town afterwards.

 

[DPTinthemaking15]

If you grew up in a small town and want to go back to a small town, location of residency does not matter.

If you grew up in San Francisco and realize all SF rad onc docs graduated from UCSF, it may be necessary to do rad onc at UCSF for a chance to work in SF, so in that case locatiln matters.

This is what I was hoping. Thank you.

I don't understand the infatuation with SF. SF is where an attending physician can make 300-400K and still live with a roommate with a total commute time of 2-3 hrs.

Thank God for all the suckers wanting to live in SF and LA.

LAWDDD... The wife and I have friends that would LOVE to live in CA and NY. We couldn’t imagine living there. I know it sounds like we are sticks in the mud (we love traveling the world lol), but the price of living is outrageous.

Some people hate city life and others hate country life. Meanwhile, I’ll gladly drive 20 minutes to town and live on a farm lol.

 

[group_theory]

According to the AAMC 2017 State Physician Workforce data 1 (Figure 4.3) on how many physicians stay in the same state that they did their residency - the median is 44.9% (the highest is California at over 70%, the lowest is New Hampshire at below 30%)

Can where you do your residency have an impact on your job search and location? Maybe. It's easier to look for jobs locally while you are a resident since you are in the area. There are word of mouth from other physicians (previous residents, attendings, etc) that can vouch for you, or know an opening that isn't advertised or given to a recruiter yet, etc. Plus it is easier to interview for jobs locally while a resident given the time constraints. Plus you will be familiar with the locality and whether you want to stay or not, plus knowing whether the practice/hospital/group is a reputable group, a sweat shop, pill mill, etc.

If your interest is academic medicine, then attending a university program (residency/fellowship) is important since research opportunities (along with publications/presentations) will go a long way to pad your CV. Brand name is more important in academia than private practice

In private practice, brand name doesn't have the catch that you see in academia. They want someone who is a good fit (can work well with others, have the skill sets and knowledge, and can generate revenue).

If you want practice in a remote environment, I agree that getting as broad a training as possible is important because you won't have the specialty backup that you might have at a larger medical center or city. While training at a large academic medical center may mean more complex pathologies and exposures to more difficult patients - make sure your training also gives you enough bread-and-butter cases so that you can be confident as a solo practitioner without backup.2




1. https://members.aamc.org/eweb/upload/2017 State Physician Workforce Data Report.pdf

2. yes, this is a lie - you are never confident when you are a brand new attending. Sheer terror (and impostor syndrome) is more likely

 

[IntheClouds4ever]

If your town has a hospital, go talk to them and find out what niche they need. If you are thinking private practice you’ll really need a lot more clinic. Find a residency that is unopposed and has the resources and patient numbers to diverse your education/experience to fit your goals. Example; I want nothing to do with OB, but want to do FM with hospitalist and ER options in rural America. My top choice has supplied residents to my local hospital for the last few years to fill clinic, hospitalist, and ER roles. Just figure out what your end game is and find a residency that can help you do it. Location means nothing in your case.

 

[DPTinthemaking15]

According to the AAMC 2017 State Physician Workforce data 1 (Figure 4.3) on how many physicians stay in the same state that they did their residency - the median is 44.9% (the highest is California at over 70%, the lowest is New Hampshire at below 30%)

Can where you do your residency have an impact on your job search and location? Maybe. It's easier to look for jobs locally while you are a resident since you are in the area. There are word of mouth from other physicians (previous residents, attendings, etc) that can vouch for you, or know an opening that isn't advertised or given to a recruiter yet, etc. Plus it is easier to interview for jobs locally while a resident given the time constraints. Plus you will be familiar with the locality and whether you want to stay or not, plus knowing whether the practice/hospital/group is a reputable group, a sweat shop, pill mill, etc.

If your interest is academic medicine, then attending a university program (residency/fellowship) is important since research opportunities (along with publications/presentations) will go a long way to pad your CV. Brand name is more important in academia than private practice

In private practice, brand name doesn't have the catch that you see in academia. They want someone who is a good fit (can work well with others, have the skill sets and knowledge, and can generate revenue).

If you want practice in a remote environment, I agree that getting as broad a training as possible is important because you won't have the specialty backup that you might have at a larger medical center or city. While training at a large academic medical center may mean more complex pathologies and exposures to more difficult patients - make sure your training also gives you enough bread-and-butter cases so that you can be confident as a solo practitioner without backup.2.




1. https://members.aamc.org/eweb/upload/2017 State Physician Workforce Data Report.pdf

2. yes, this is a lie - you are never confident when you are a brand new attending. Sheer terror (and impostor syndrome) is more likely

I will definitely get a broad training (hopefully). The population size of my hometown is below 1,800 people Yeah, in our hometown all people know is “Oh, so-and-so is a Doctor.” And if you have a decent personality, they believe you are the greatest thing since sliced bread.

If your town has a hospital, go talk to them and find out what niche they need. If you are thinking private practice you’ll really need a lot more clinic. Find a residency that is unopposed and has the resources and patient numbers to diverse your education/experience to fit your goals. Example; I want nothing to do with OB, but want to do FM with hospitalist and ER options in rural America. My top choice has supplied residents to my local hospital for the last few years to fill clinic, hospitalist, and ER roles. Just figure out what your end game is and find a residency that can help you do it. Location means nothing in your case.

Thank you for this! This helped push a certain residency location up on my list. I will definitely ask my local hospital what their thoughts are.

Edit: Sorry for the crazy font. My phone is doing whatever it wants.

 

[jslo85]

What everyone else said above basically. I think it is important to be some place that you and your family will be happy for residency, three years may seem like a short time and it is in the big picture but this is really important. The other like someone said above is if you're planning to go back to a rural setting to practice post residency that is as small as I am imagining, you want to train in an unopposed residency. I currently train in a big city and most FM residents that I come across have some type of percentage split between inpatient and clinic depending on which program they're from but all of them practice a similar consultant heavy medicine that is not what you will be doing in a rural setting. You will need to be proficient in deliveries, gyn procedures, simple derm procedures, scopes, minor surgical procedures, and well you get the picture, procedures in general. No academic and likely no large city program will train their residents to be heavily procedural so if what you wish to become a rural physician, keep this in mind .