ER Docs - how big a factor was the residency you attended when getting first job and next jobs?

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Enik

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I think a lot of med students (myself included) don't quite understand how important is place you trained at when getting your first job and thereafter. To make this post applicable to most, lets assume that most people want want to work in community in a moderately a competitive job market.

I feel like most post my peers (again myself included) continuously flip rank list #s based on fit and reputation and length without actually knowing how much any of that matters. Does going to Denver and working to death for four years really open that many doors for you as compared to any other mid tier program?


Being from Chicago, does going into a 4 year well known program like Cook or Northwestern yield you better job opportunities than going to UIC or Christ (both of which are solid and well known programs) since 90% of all of us will end up working at community shops anyways. Does a "prestigious" residency let you land a job inside the city and a mid-tier one a job that you have to drive 45 min to get to in the burbs? 10 years into practice, does anyone even care where you went to residency?

Again, before I get attacked I'm making this as general as possible. I do get that academic and 4 residencies will make it easier to break into academia (if that's your thing) or fellowships. I'm speaking based purely on getting a job after graduating as well as thereafter.
 
In the community it’s just regional first job after that it’s experience after 5 years no one cares where you went to school. Just like real life
 
I think a lot of med students (myself included) don't quite understand how important is place you trained at when getting your first job and thereafter. To make this post applicable to most, lets assume that most people want want to work in community in a moderately a competitive job market.

I feel like most post my peers (again myself included) continuously flip rank list #s based on fit and reputation and length without actually knowing how much any of that matters. Does going to Denver and working to death for four years really open that many doors for you as compared to any other mid tier program?


Being from Chicago, does going into a 4 year well known program like Cook or Northwestern yield you better job opportunities than going to UIC or Christ (both of which are solid and well known programs) since 90% of all of us will end up working at community shops anyways. Does a "prestigious" residency let you land a job inside the city and a mid-tier one a job that you have to drive 45 min to get to in the burbs? 10 years into practice, does anyone even care where you went to residency?

Again, before I get attacked I'm making this as general as possible. I do get that academic and 4 residencies will make it easier to break into academia (if that's your thing) or fellowships. I'm speaking based purely on getting a job after graduating as well as thereafter.

Networking is more important than anything. If you go to a "big name" place and sit back you'll end up with whatever you can get. If you're going for competitive SDG type jobs you'll be busting your ass at conferences making those connections, regardless if you're coming from a community shop or some pseudo-perceived highly ranked place.
 
I got a few interviews because my program had grads that could get my CV in front of the director. It seemed like prestige didnt matter as much as having an alumni network that could get a foot in the door for those places.

In the end none of that mattered and I signed at a place where we didn’t have any alumni. All I did was email the director listed on their website and we went from there.

If you’re bound for the community I would focus on where you think you want to practice after residency and favor programs that have alumni in that area.
 
Regional first. The primary deciding factor is if we can have faculty we know and trust vouch for a resident. That trumps almost anything. A lesser factor in that regard is that if we know they are from that region, there is a chance they will stick around. There is little worse than having a physician leave off-cycle. There is always a fear that the guy from southern California will decide to bolt that first winter.

Apart from that, outside of academics, program reputation makes little difference. This isn't like for a surgeon where the hospital can advertise a "Mayo trained neurosurgeon." Our basic hiring criteria are can someone see patients at a reasonable rate with minimal lawsuits or criminal prosecutions, and not cause dissent within our group or start a civil war with other physicians. We are looking for great physicians and great people, but we really don't care about publications or academic success that is normally associated with an "elite" residency program.
 
My guess is that going to a better known program could have opened more doors for me. Because I wasn’t at a big name residency, I also wasn’t exposed to as many doors in terms of most people were not thinking like that. Most residents in my program were aiming to go back to practice where they were from. Not alot of people were looking for academics. It just wasn't discussed as much. Now the people who were into EMS-program was all about EMS- got their fellowships but they all applied to regional fellowships.

It appears that the resident going to a big name residency would also be interested in a big name fellowship and then intested in a big name employer after that.

So you need to know what you’re aiming for from an early stage.
Just like with anything in life, it helps if someone knows you.
 
The primary deciding factor is if we can have faculty we know and trust vouch for a resident.
because some people come out of residency not ready or because you're trying to avoid douchebags or both
 
Doesn't matter. It might be easier to interview at regional places where you live, and I think someone said when I interviewed ("Oh, NewYork-Presbyterian, that's a good residency"), but I got my job, in part, due to networking and probably a bit of luck.
 
Who you know, or who your program director (or APD, or chair, or whoever) knows will help more than the general reputation of your program. But regionally, programs will have a reputation since a sizable number of graduates will stay local. However, it is possible for a place to have a bad reputation based on previous experience with a grad(s). I know of one academic place that will not routinely hire from a certain Ivy-league EM program. And I remember a senior faculty member at a NE program saying how graduates from county programs usually do not fare well at their shop (he named a specific place in the midwest that students constantly tout as "badass", etc).

But, truth be told, most people get jobs based on their interview, or having applied or interviewed at just the right time. Plenty of jobs, especially those with CMGs, will take just about anyone with a pulse.
 
Most of our new grads are local, most of people coming to work with us from another region have at least 3-5 years experience and good references.

If you're a new grad and trained at one of these new programs popping up with no reputation and no way for us to know if your training was good, we're very likely to hire someone else.
 
Most groups just want to make sure that you're a normal person, with sound personal skills and medical skills, who is interested in the area/hospital (for a variety of reasons) and that your significant other is interested as well. Training at Cook CO and going to rural Mississippi may not work out. It goes the other way as well. As someone who is in a more niche market, personality and ties to the community are as important as any other factor in selection, especially for partner track.
 
It didn't seem to matter at all. Maybe it's because I didn't go to a terrible residency. First job was with a large CMG. License + pulse + held up my end of a conversation for 10 minutes = job.
 
No offense to you personally, but CMGs will literally take anyone.
It didn't seem to matter at all. Maybe it's because I didn't go to a terrible residency. First job was with a large CMG. License + pulse + held up my end of a conversation for 10 minutes = job.

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Depends.

CMGs much more likely to take FM/IM people. Also more likely to sponsor BS things like "EM fellowship" for FM folks. I'm not saying FM/IM people are bad physicians, but they are not BCEM.

Literally all CMGs care about is having someone that can sign a chart and use them as a tool to extract money from a payor.
I agree. Can't say that the quality of the physicians between SDG and CMG has been that different though.

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Depends.

CMGs much more likely to take FM/IM people. Also more likely to sponsor BS things like "EM fellowship" for FM folks. I'm not saying FM/IM people are bad physicians, but they are not BCEM.

Literally all CMGs care about is having someone that can sign a chart and use them as a tool to extract money from a payor.

Sent from my Pixel 3 using SDN mobile

Agree. I was only thinking of my EM colleagues that I worked with. One or two jokers, the remainder were fine. Lots of terrible NPs/PAs, FM, and non-boarded docs. Since these folks were outside of their scope of training I wasn't counting them. Tons of fake residencies / fellowships. Corporate EM training for the FM! "Fellowship" for the midlevels, etc. Lots of places CMGs are the only game in town and there are lots of BCEM working at them. In some ways these docs were less isolated and incestuous in their practice of medicine than a middle of nowhere SDG.
 
Do you have a pulse and a medical license?
EDIT: Damn, someone already used this joke.
 
Who you know, or who your program director (or APD, or chair, or whoever) knows will help more than the general reputation of your program. But regionally, programs will have a reputation since a sizable number of graduates will stay local. However, it is possible for a place to have a bad reputation based on previous experience with a grad(s). I know of one academic place that will not routinely hire from a certain Ivy-league EM program. And I remember a senior faculty member at a NE program saying how graduates from county programs usually do not fare well at their shop (he named a specific place in the midwest that students constantly tout as "badass", etc).

But, truth be told, most people get jobs based on their interview, or having applied or interviewed at just the right time. Plenty of jobs, especially those with CMGs, will take just about anyone with a pulse.

Oooooohh. Spill the dirt. Name names.
 
I think a lot of med students (myself included) don't quite understand how important is place you trained at when getting your first job and thereafter. To make this post applicable to most, lets assume that most people want want to work in community in a moderately a competitive job market.

I feel like most post my peers (again myself included) continuously flip rank list #s based on fit and reputation and length without actually knowing how much any of that matters. Does going to Denver and working to death for four years really open that many doors for you as compared to any other mid tier program?


Being from Chicago, does going into a 4 year well known program like Cook or Northwestern yield you better job opportunities than going to UIC or Christ (both of which are solid and well known programs) since 90% of all of us will end up working at community shops anyways. Does a "prestigious" residency let you land a job inside the city and a mid-tier one a job that you have to drive 45 min to get to in the burbs? 10 years into practice, does anyone even care where you went to residency?

Again, before I get attacked I'm making this as general as possible. I do get that academic and 4 residencies will make it easier to break into academia (if that's your thing) or fellowships. I'm speaking based purely on getting a job after graduating as well as thereafter.
A lot of people have given good advice in this thread.

for my n=1, I know for a fact that my experience as chief resident at a academic “prestigious” 4 year program helped immensely in getting a job at a similar style program as faculty.

however, I have peers at my institution that went to less prestigious places, but brought different things to the table (research, etc). So you’re residency doesn’t not define where you can work but it definitely helps to open doors. folks at top academic places know everyone else at the top academic places, so it’s easier to gain a foothold.
 
What everyone else said above. That said, as someone who trained in Chicago for residency.. others may disagree but UIC/Christ residents are in my opinion the most solid and well trained residents in the area. If you want to go into academics, it helps to come from an academic program. County prepares well for .. well county obviously and the community (minus white affluent patient population hospitals). For the vast majority of the jobs, if you have faculty to vouch for you, a solid alumni network, and board certified/residency trained/active medical license, you should be fine
 
What everyone else said above. That said, as someone who trained in Chicago for residency.. others may disagree but UIC/Christ residents are in my opinion the most solid and well trained residents in the area. If you want to go into academics, it helps to come from an academic program. County prepares well for .. well county obviously and the community (minus white affluent patient population hospitals). For the vast majority of the jobs, if you have faculty to vouch for you, a solid alumni network, and board certified/residency trained/active medical license, you should be fine
Agree to disagree😉
 
The only places your residency matters are super academic shops where your pedigree still matters to department chairs.
 
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