Dual applied but would be happy in either specialty

[Erasticat2025]

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So currently I have been blessed to have 7+ interviews in one specialty and 1 interview in a competitive specialty.

The predicament I am in is the competitive specialty I got an interview at is at a decently established program and I think I would like it but it is over 8 hours away from my family. On the other hand the other specialty that I got invites to are like 45 minutes around where my family is and they have in house fellowships that I want to pursue BUT they are HCA programs.

Any thoughts on this? Are the HCA IM programs bad enough to rank the program that is 8+ hours away higher than the ones closer to my family even if I would be happy in either specialty? For reference I have a husband and children as well who would be moving with me and the family we would be moving away from would be the support system we have.

Help. Me. lol

 

[Rapsidy]

This is coming from someone where family is very important so take it with that perspective. Yes, the HCA probably sucks, but it’s only a temporary time in your life. How old are your children? That might be a factor too if they are at a point where changing schools and making a whole new friend list would be hard for them.

If you truly would be happy in either, then I personally wouldn’t want to leave my support systems, and make my entire family move for me if I had other options. That being said, if you’ll truly regret missing out on the competitive specialty, that needs to be weighed as well.

 

[NotAProgDirector]

I think it also depends on what you mean by "family support system". There's a big difference between "it would be nice to be close to family" and "we can't function without family support for child care"

 

[Erasticat2025]

This is coming from someone where family is very important so take it with that perspective. Yes, the HCA probably sucks, but it’s only a temporary time in your life. How old are your children? That might be a factor too if they are at a point where changing schools and making a whole new friend list would be hard for them.

If you truly would be happy in either, then I personally wouldn’t want to leave my support systems, and make my entire family move for me if I had other options. That being said, if you’ll truly regret missing out on the competitive specialty, that needs to be weighed as well.

So I am okay with being overworked thats not my issue with HCA at all. I want to make sure I can match into a fellowship. I am worried that going to an HCA may hinder this.

I think I would honestly be happy in either specialty. The competitive specialty is something I have wanted my whole life but now that I have kids I fear the lifestyle and residency may be to hard on my children.

 

[Erasticat2025]

I think it also depends on what you mean by "family support system". There's a big difference between "it would be nice to be close to family" and "we can't function without family support for child care"

I mean family support system as in we have been away from family for all of medical school and we now have a new born and my husband is in school as well so having family near to help with the kids would be a huge relief. I just dont know if giving up this competitive specialty is something I should do for a residency at an HCA.

 

[DOVinciRobot]

I cannot recommend HCA programs in any specialty. Their training is viewed as sub par. Their graduates are also viewed as second tier for fellowships and jobs, and they will heavily shunt you to working in the HCA system. That is why their programs exist.

I also have a family and kids but cannot recommend choosing an HCA program for family reasons. Residency ends and is a temporary period in your life, don't handcuff yourself

 

[voxveritatisetlucis]

Depends which fellowships you’re interested in. GI, cards, hemeonc, pccm all extremely difficult and probably off the table from an HCA.

 

[JBM16BYU]

My recommendation would be to go to the best quality program where you can get the best quality education to set you up for the best future. Previous comments are right, residency is a short time in your life, but that goes both ways. Not knowing the specifics for any of the programs, I will say this: it can be a short time in your life in a program that may be better for lifestyle (ex. close to family) but may lack in education components and make matching into a desired fellowship (or obtaining the desired job) more difficult, or, a short time in your life that may be better in education but may be harder in lifestyle (ex. farther away from family). If it were me, I would rank the programs in order of best quality education I can get to set me up for the best future in medicine.

 

[Erasticat2025]

Depends which fellowships you’re interested in. GI, cards, hemeonc, pccm all extremely difficult and probably off the table from an HCA.

Interesting. I am interested in Cards and potentially interventional after that as well as PCCM or H/O. Would you say this goes for those programs that have built in fellowships at their HCA? For instance somewhere that I interviewed at so far says that they shuttle their residents who are interested in cards to their in house cardio program. Do you think they are lying or?

 

[Erasticat2025]

My recommendation would be to go to the best quality program where you can get the best quality education to set you up for the best future. Previous comments are right, residency is a short time in your life, but that goes both ways. Not knowing the specifics for any of the programs, I will say this: it can be a short time in your life in a program that may be better for lifestyle (ex. close to family) but may lack in education components and make matching into a desired fellowship (or obtaining the desired job) more difficult, or, a short time in your life that may be better in education but may be harder in lifestyle (ex. farther away from family). If it were me, I would rank the programs in order of best quality education I can get to set me up for the best future in medicine.

Thank you for this comment. I will say that the specialties I have invites at include surgery and Internal med. The surgery programs I have invites to are further away and the IM so far are closer. The surgery programs are also community programs (nonHCA) that I am unsure if they are better or worse than the IM programs that I have invites at.

 

[Erasticat2025]

Also the HCA program I am most interested in is associated with a university and their published fellowship match is pretty impressive but IDK.

 

[voxveritatisetlucis]

Interesting. I am interested in Cards and potentially interventional after that as well as PCCM or H/O. Would you say this goes for those programs that have built in fellowships at their HCA? For instance somewhere that I interviewed at so far says that they shuttle their residents who are interested in cards to their in house cardio program. Do you think they are lying or?

They may not be lying and it’s probably easy to check based on their current fellows but you may run into an issue if 5 co-residents all want cards and there is only 1 spot because it would likely be difficult to get a non in house spot from HCA

 

[voxveritatisetlucis]

Thank you for this comment. I will say that the specialties I have invites at include surgery and Internal med. The surgery programs I have invites to are further away and the IM so far are closer. The surgery programs are also community programs (nonHCA) that I am unsure if they are better or worse than the IM programs that I have invites at.

I think it comes down to whether you want to be a surgeon. From a community surgery program, you’re guaranteed to be a surgeon whereas from a community IM program you may have to be a hospitalist or PCP (or less competitive fellowship like endo or ID). Sure, you might not be able to match peds surgery or surg onc from a community program, but you can still be a general, trauma surgeon etc.


Also don’t surgery programs usually do batch releases of interviews in late October? You may get more surgery interviews

 

[Erasticat2025]

I think it comes down to whether you want to be a surgeon. From a community surgery program, you’re guaranteed to be a surgeon whereas from a community IM program you may have to be a hospitalist or PCP (or less competitive fellowship like endo or ID). Sure, you might not be able to match peds surgery or surg onc from a community program, but you can still be a general, trauma surgeon etc.


Also don’t surgery programs usually do batch releases of interviews in late October? You may get more surgery interviews

This is an outlook I had not yet thought of. Honestly, I just want to be a good parent. I love surgery but feel selfish to take my husband and kids from where our families are at when I have the opportunity to stay within a 25 minute drive to our home town.

 

[Erasticat2025]

They may not be lying and it’s probably easy to check based on their current fellows but you may run into an issue if 5 co-residents all want cards and there is only 1 spot because it would likely be difficult to get a non in house spot from HCA

The certain program that I am interested in thats close to home has matched cardio and GI at hopkins and duke. They seem to match 2-3 cardio as well as other fellowships every year. Not sure if mayne this certain program being affiliated with a university plays a role.

 

[Nontrad_FL_LGBT]

This is an outlook I had not yet thought of. Honestly, I just want to be a good parent. I love surgery but feel selfish to take my husband and kids from where our families are at when I have the opportunity to stay within a 25 minute drive to our home town.

Consider if your family would feel potential resentment from you not chasing you dreams in a few years, especially if you can't match a fellowship you want. My dad had to stay at home and not have a career and it really darkened my childhood because he was clearly unhappy. 5 years of hard training for a lifetime of doing what you love would be worth it to me, but it might not be to you.

 

[TwoDogMed]

If it is the HCA program I am thinking of down south, they have quite a few IMG and DO. These programs, espcially HCA, tend to be malignant. However, this particular program is associated with an MD school so it may be different. I would talk to their residents first.