does residency quality improve future job prospects?

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*brobro*

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Curious MS3 here...

1) Does the quality or perceived quality (i.e. brand name places like Mayo) of an FM residency strongly influence what kind of job one can get? For instance, let's say I'm looking for that sweet suburb spot with very few medicaid patients...I imagine this is a hard market to break into because there are established practices with people who like their jobs (perhaps I'm being naive and feel free to correct me)? Is it easier to get access to these job markets if you are coming out of a more competitive residency?

2) How does one "rate" the residencies in FM? Are your typical Mayo, Stanford, etc. competitive for quality or brand name? Are some community program actually perceived as much better in the world of FM because of training quality?

I appreciate any insight, thanks so much!

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1. In a way yes. There are some very strong FM residencies that employers like to get their physicians from.
2. You rate the residencies by the quality of their graduates. Objectively you can look at their past board pass rates or look at where they end up after residency. Now this is a huge overgeneralization, as there are good FM programs out there, but usually the top medical schools tend to have a weak FM program (specialty driven schools). I don't even think Stanford has a family medicine residency (there is an unopposed/community FM residency in San Jose that's affiliated with Stanford). If you want good training you either go community based or go to a primary care heavy medical school that trains FM docs in heavy inpatient, OB, ER, contains fellowships, etc.
 
1. In a way yes. There are some very strong FM residencies that employers like to get their physicians from.
2. You rate the residencies by the quality of their graduates. Objectively you can look at their past board pass rates or look at where they end up after residency. Now this is a huge overgeneralization, as there are good FM programs out there, but usually the top medical schools tend to have a weak FM program (specialty driven schools). I don't even think Stanford has a family medicine residency (there is an unopposed/community FM residency in San Jose that's affiliated with Stanford). If you want good training you either go community based or go to a primary care heavy medical school that trains FM docs in heavy inpatient, OB, ER, contains fellowships, etc.

Speaking from experience, your comments on top medical schools having weak FM programs -- spot on.... and being an FM resident in a specialty heavy university system -- you're the last in line for everything -- At a certain large center in the Southwest (cough), as an FM resident I was:

1) Told I was too stupid to read the English language by a renal specialist
2) slapped in the head by an attending during an OB rotation
3) told that I would not get trained in colposcopies during my OB rotation as they had to train their own residents -- when I offered to take an elective to get the training I was told,"No -- you are not getting trained in colposcopies at this institution because you're FM"
4) made to wait in line for deliveries behind NP students, EMT students, medical students
5) Sent to fetch lunch -- I had asked everyone that was in the specialty clinic if they wanted something when I booked to the cafeteria -- this intern wasn't there and couldn't be found, so I went, grabbed what people wanted and my lunch -- as I sat down to eat my soup, with an MS3 sitting beside me doing practice questions, the intern of the specialty turns to me, admires my "yummy" soup and promptly orders me down to the cafeteria to get them some and leaves the mS3 sitting there -- since I was the off service intern and they had input into my review, I went and came back to cold soup.
6) Told by ophthalmology that they were doing mainly DM/HTN stuff and had nothing to teach me so go home and read
7) Got in trouble for calling the attending at night when I had a patient that was going into septic shock and I was considering doing an ICU transfer -- was scolded that I didn't know how to manage a fever
8) Got to sit and watch pre-op exams in ortho with no allowed hands on patient contact --

So, needless to say, it was an unpleasant experience -- I would not recommend an FM residency attached to a medical school -- either go community based or out in the boonies -- around North Texas that translates into JPS or UT Tyler (great program but not real well known -- they were very high on my list -- didn't list them #1 for family reasons).
 
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Speaking from experience, your comments on top medical schools having weak FM programs -- spot on.... and being an FM resident in a specialty heavy university system -- you're the last in line for everything -- At a certain large center in the Southwest (cough), as an FM resident I was:

1) Told I was too stupid to read the English language by a renal specialist
2) slapped in the head by an attending during an OB rotation
3) told that I would not get trained in colposcopies during my OB rotation as they had to train their own residents -- when I offered to take an elective to get the training I was told,"No -- you are not getting trained in colposcopies at this institution because you're FM"

So, needless to say, it was an unpleasant experience -- I would not recommend an FM residency attached to a medical school -- either go community based or out in the boonies -- around North Texas that translates into JPS or UT Tyler (great program but not real well known -- they were very high on my list -- didn't list them #1 for family reasons).

This is really messed up. Not only did this program short change its trainees, but probably discouraged the med students from pursuing the field. And yet, many of the executives who work for the hospital system affiliated with the medical school probably parrot "the need for primary care" in all interactions with the community, business leaders.

Makes me want to holler, and throw up both my hands.
 
This is really messed up. Not only did this program short change its trainees, but probably discouraged the med students from pursuing the field. And yet, many of the executives who work for the hospital system affiliated with the medical school probably parrot "the need for primary care" in all interactions with the community, business leaders.

Makes me want to holler, and throw up both my hands.

This place was absolutely giddy when they managed to get one MS from the local medical school to match into the program -- but they never filled on first match anyway -- most of the med students who wanted to pursue FM (a VERY small amount) went to other programs in the local area --- and these people would say with a straight face that the reason why is that they wanted a different experience than the MS environment they were in -- never thought that the quality of the program sucked....
 
Speaking from experience, your comments on top medical schools having weak FM programs -- spot on.... and being an FM resident in a specialty heavy university system -- you're the last in line for everything -- At a certain large center in the Southwest (cough), as an FM resident I was:

1) Told I was too stupid to read the English language by a renal specialist
2) slapped in the head by an attending during an OB rotation
3) told that I would not get trained in colposcopies during my OB rotation as they had to train their own residents -- when I offered to take an elective to get the training I was told,"No -- you are not getting trained in colposcopies at this institution because you're FM"
4) made to wait in line for deliveries behind NP students, EMT students, medical students
5) Sent to fetch lunch -- I had asked everyone that was in the specialty clinic if they wanted something when I booked to the cafeteria -- this intern wasn't there and couldn't be found, so I went, grabbed what people wanted and my lunch -- as I sat down to eat my soup, with an MS3 sitting beside me doing practice questions, the intern of the specialty turns to me, admires my "yummy" soup and promptly orders me down to the cafeteria to get them some and leaves the mS3 sitting there -- since I was the off service intern and they had input into my review, I went and came back to cold soup.
6) Told by ophthalmology that they were doing mainly DM/HTN stuff and had nothing to teach me so go home and read
7) Got in trouble for calling the attending at night when I had a patient that was going into septic shock and I was considering doing an ICU transfer -- was scolded that I didn't know how to manage a fever
8) Got to sit and watch pre-op exams in ortho with no allowed hands on patient contact --

So, needless to say, it was an unpleasant experience -- I would not recommend an FM residency attached to a medical school -- either go community based or out in the boonies -- around North Texas that translates into JPS or UT Tyler (great program but not real well known -- they were very high on my list -- didn't list them #1 for family reasons).

Yikes.
 
1. In a way yes. There are some very strong FM residencies that employers like to get their physicians from.
2. You rate the residencies by the quality of their graduates. Objectively you can look at their past board pass rates or look at where they end up after residency. Now this is a huge overgeneralization, as there are good FM programs out there, but usually the top medical schools tend to have a weak FM program (specialty driven schools). I don't even think Stanford has a family medicine residency (there is an unopposed/community FM residency in San Jose that's affiliated with Stanford). If you want good training you either go community based or go to a primary care heavy medical school that trains FM docs in heavy inpatient, OB, ER, contains fellowships, etc.

While this is all true, I don't know of many places that have so many applicants they can afford to be choosey.

I mean sure, we'd all like to have all our doctors from places with very rigorous training (Ventura being the stereotypical example), but that obviously isn't possible. Plus, the vast majority of positions don't care how well you can intubate or whether you can do a solo c-section. They want you to be competent at outpatient stuff and not be a jerk. Practices don't want to get sued and they don't want patients to leave because they don't like the new guy.
 
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While I may not be able to do a c-section solo (nor care to), I certainly can intubate, that's for sure.

It really is about the outpatient management, how well you related to office staff/docs and your patients. I'm glad my 3rd year has us in the clinic a good 50% of our year, if not more. Being efficient is a good thing, too.
 
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