Evaluating residencies

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fldoctorgirl

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Hi! I'm a baby MS2 who doesn't know much about how to evaluate residency quality. I've been looking into IM residency programs in Florida and have noticed something interesting when looking at the resident rosters: a lot of the programs in South Florida are filled with mostly IMGs. Does this mean the programs aren't that good? I'm talking like maybe 2-3 US MDs, a few DOs, and like 15 IMGs.

Any tips for evaluating residency programs in general?
 
Hi! I'm a baby MS2 who doesn't know much about how to evaluate residency quality. I've been looking into IM residency programs in Florida and have noticed something interesting when looking at the resident rosters: a lot of the programs in South Florida are filled with mostly IMGs. Does this mean the programs aren't that good? I'm talking like maybe 2-3 US MDs, a few DOs, and like 15 IMGs.

Any tips for evaluating residency programs in general?
There are not a lot of established academic programs in fla...UF in Gainesville , UM ...many are brand new or community programs...so ...UF mostly AMGs... UM has a program that allows Spanish speaking FMGs have exposure to the US healthcare system and take many of them into residency.
 
I'm interested in doing IM residency in FL as well. A particular program with lots of fellowship programs I was looking at that accepts about half DOs is the UF in Jacksonville, but the other half of their residents are also IMGs. I'm still keeping an eye on it for a possible audition, but I was wondering why so many IMGs on their roster.
 
I'm interested in doing IM residency in FL as well. A particular program with lots of fellowship programs I was looking at that accepts about half DOs is the UF in Jacksonville, but the other half of their residents are also IMGs. I'm still keeping an eye on it for a possible audition, but I was wondering why so many IMGs on their roster.
Because that program has been historically FMG friendly...there is a DO school in Fla so is also why DO friendly

Many of the FMGs there are from AIIMS... it’s arguably the best medical school in India.

And while it’s UF... it’s not Gainesville ... kinda like ccf in fla is not ccf in cleveland
 
There are not a lot of established academic programs in fla...UF in Gainesville , UM ...many are brand new or community programs...so ...UF mostly AMGs... UM has a program that allows Spanish speaking FMGs have exposure to the US healthcare system and take many of them into residency.
Does it matter, though, if one isn't interested in pursuing fellowship? My main goal is to match near home, which is South Florida, and as of right now I'm pretty sure I don't want to pursue a fellowship-- so I've been looking at the community programs near my home anyways. Should I be concerned when looking at residency rosters and seeing so many IMGs, or does it not matter?
 
Does it matter, though, if one isn't interested in pursuing fellowship? My main goal is to match near home, which is South Florida, and as of right now I'm pretty sure I don't want to pursue a fellowship-- so I've been looking at the community programs near my home anyways. Should I be concerned when looking at residency rosters and seeing so many IMGs, or does it not matter?
So you have noted quite a few times your opinion of IMGs and full disclosure (since you apparently have not looked at my history ) , I am an IMG...not only that, I’m a Caribbean grad as well...I matched at a university IM program and then matched at a university endocrine fellow ship...all on the first try, at my top choices.

Realize first that many of those residents are FMGs...from domiciled medical schools in their home countries and each and every one of them have significantly high step scores to even get a chance to be a resident at these programs.
Realize that those IMGs too had to work hard in their respective off shore schools to get the chance to be residents in the US
Realize that south fla is not really a place where US grads want to be ...maybe Miami, but after being down there, many do not want to stay...so programs down there have to look to other applicants to fill their needs.

Any ACGME accredited IM program will have the tools to make you a competent physician...some places it can be more of a struggle than at others.
 
So you have noted quite a few times your opinion of IMGs and full disclosure (since you apparently have not looked at my history ) , I am an IMG...not only that, I’m a Caribbean grad as well...I matched at a university IM program and then matched at a university endocrine fellow ship...all on the first try, at my top choices.

Realize first that many of those residents are FMGs...from domiciled medical schools in their home countries and each and every one of them have significantly high step scores to even get a chance to be a resident at these programs.
Realize that those IMGs too had to work hard in their respective off shore schools to get the chance to be residents in the US
Realize that south fla is not really a place where US grads want to be ...maybe Miami, but after being down there, many do not want to stay...so programs down there have to look to other applicants to fill their needs.

Any ACGME accredited IM program will have the tools to make you a competent physician...some places it can be more of a struggle than at others.

I'm saying this not because I have a problem with IMGs, In fact I have mad respect for someone that went to the Caribbean, come out and succeed, but the main thing I have heard about programs that accept a lot of IMGs is that these programs know how desperate these applicants are to match anywhere they can in the US, and therefore they are often malignant programs looking for people to overwork with PDs oftern treating residents poorly/unfairly. I don't know to which extent I can believe in these stereotypical statements, but this is why sometimes US grads are skeptical of IMG friendly programs.
 
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So you have noted quite a few times your opinion of IMGs and full disclosure (since you apparently have not looked at my history ) , I am an IMG...not only that, I’m a Caribbean grad as well...I matched at a university IM program and then matched at a university endocrine fellow ship...all on the first try, at my top choices.

Realize first that many of those residents are FMGs...from domiciled medical schools in their home countries and each and every one of them have significantly high step scores to even get a chance to be a resident at these programs.
Realize that those IMGs too had to work hard in their respective off shore schools to get the chance to be residents in the US
Realize that south fla is not really a place where US grads want to be ...maybe Miami, but after being down there, many do not want to stay...so programs down there have to look to other applicants to fill their needs.

Any ACGME accredited IM program will have the tools to make you a competent physician...some places it can be more of a struggle than at others.
Oh no, I hope I didn't come off the wrong way! My thoughts are more along the line of what @DrStephenStrange just said-- I have always heard it perpetuated on here that we should avoid programs with a high amount of IMGs because they are likely poor quality, malignant programs. I posted this thread in the hopes of figuring out whether that was true, because I want to go to a program that will make me a competent physician, like you say in the last sentence of your post. I just wanted to be sure there wasn't some reason to avoid these programs when my time comes. Again, I hope I didn't offend you.
 
I'm saying this not because I have a problem with IMGs, In fact I have mad respect for someone that went to the Caribbean, come out and succeed, but the main thing I have heard about programs that accepts a lot of IMGs is that these programs know how desperate these applicants are to match anywhere they can in the US, and therefore they are often malignant programs looking for people to overwork with PDs oftern treating residents poorly/unfairly. I don't know to which extent I can believe in these stereotypical statements, but this is why sometimes US grads are skeptical of IMG friendly programs.
And that is a valid point, though most of the more malignant programs are where you generally have FMGs that were attendings in their home countries as residents...those programs are generally looking for people to do the work and not so much interested in teaching...F/IMG friendly programs or DO friendly programs that have fresh out of med school tend to be in places that don’t attract USMD grads...middle of nowhere, not major cities, few young single people, etc...

Look to see what the schedules are like for the intern and residents...is there elective and research time allotted and where do the residents go for fellowship and in what specialties... that can give you some idea of the type of program.
 
I think one of the hardest things to do is really figure out what a program is really like. Like are residents a-holes and do the attendings eat interns for breakfast. I think you can always ask the residents who work there. I feel like this is 50/50 though. A good amount will likely not tell you the truth. Med students are also a great resource. They rotate with the program so can tell you if people really hate their lives. The doximity reviews aren't totally worthless. But also the new website, ratearesidency.com, has a bunch of reviews for Florida IM programs.
 
Evaluate a residency program by their past fellowship matches, in house fellowships, and lifestyle of the residents. A lot of Florida programs, especially the FMG heavy ones are malignant and others are just flat out new and are still working out the basics of how to train residents and or have no academic opportunities.

But aside from that for a lot of people the weather, the location, and lifestyle aren't for them. I lived around Miami for a while and while I did believe that the area was nice to vacation and enjoy I didn't necessarily find myself loving it.
 
Also, see what their med student said about the residency.
big-name programs that cannot keep their own med student usually a huge red flags.
 
USF seems to be a very strong program, especially in the realm of ID. I personally know the IBD director there as she's a DO who ended up doing her advanced fellowship with MGH/Harvard Medical School.
 
USF seems to be a very strong program, especially in the realm of ID. I personally know the IBD director there as she's a DO who ended up doing her advanced fellowship with MGH/Harvard Medical School.
My issue is I'd rather be closer to home, which is basically Miami/Ft. Lauderdale area. Outside of Jackson/UM, most of the programs seem to be more community (you have FAU but I don't know if that really counts as academic since it's not their own hospital or anything like that). When I looked at rosters for a big chunk of the programs, they had barely any US MDs, while some had almost no US grads in general. I'm pretty sure I don't want to do a fellowship, so I'm just not sure whether this should matter at all or to what extent.
 
In your position, probably my first step is to decide what is more important to me (you). Are you thinking about going into a highly research-heavy, academic career? into a fellowship? if so is it a competitive fellowship or less so? 90% of the time this is going to dictate where you end up. If any of those things are important to you, then not only you don't have a lot to choose from, but also you should consider expanding your options to nearby states so you have backup options. That is not to say that you won't learn a lot from a community hospital-based residency or that your chances for the fellowship are not good. I did my residency in a community hospital and the 3 classes in front of me and my own class all matched into their fellowship of choice including some prestigious institutions and competitive fellowships such as GI, Cards and Critical care.
I think once you have that figured out, the choices become more clear. If you are planning on stopping after your residency and being an internist, there is certainly plenty of value from getting your education from a more respected university hospital, but at the end of the day, if you are going to end up practicing 40 years in a community hospital, the value of 3 year residency in a university program gets diluted in my opinion and some other aspects of the residency program might make an otherwise "inferior" (in terms of reputation/academic pedigree that's it) more desirable.

As for the FMG/IMG part... Florida, in particular, the areas near the big cities, are very diverse with a lot of Hispanic population and immigrants. This also means it attracts residents that already live in the area (which are more likely to be immigrants themselves) and leadership (such as program directors and coordinators) which in turn are also immigrants themselves. During my interview days, I noticed that many, if not most of the hospitals near large metropolitan areas had more IMG/FMGs. Also noticed that when the PD was Indian, more Indians residents were selected, when the PD was Cuban, more Hispanics and when the PD was middle eastern more middle eastern were selected. Many things might be playing into this. Some residents that graduated in the US and only speak English might rank a program in Miami where 40% speak pure Spanish lower simply because they don't want to deal with it and program directors might rank slightly higher those residents that are more culturally similar to him/her or even the patient's population (this is likely mostly subconscious, don't go screaming FRAUD! just yet).
 
In your position, probably my first step is to decide what is more important to me (you). Are you thinking about going into a highly research-heavy, academic career? into a fellowship? if so is it a competitive fellowship or less so? 90% of the time this is going to dictate where you end up. If any of those things are important to you, then not only you don't have a lot to choose from, but also you should consider expanding your options to nearby states so you have backup options. That is not to say that you won't learn a lot from a community hospital-based residency or that your chances for the fellowship are not good. I did my residency in a community hospital and the 3 classes in front of me and my own class all matched into their fellowship of choice including some prestigious institutions and competitive fellowships such as GI, Cards and Critical care.
I think once you have that figured out, the choices become more clear. If you are planning on stopping after your residency and being an internist, there is certainly plenty of value from getting your education from a more respected university hospital, but at the end of the day, if you are going to end up practicing 40 years in a community hospital, the value of 3 year residency in a university program gets diluted in my opinion and some other aspects of the residency program might make an otherwise "inferior" (in terms of reputation/academic pedigree that's it) more desirable.

As for the FMG/IMG part... Florida, in particular, the areas near the big cities, are very diverse with a lot of Hispanic population and immigrants. This also means it attracts residents that already live in the area (which are more likely to be immigrants themselves) and leadership (such as program directors and coordinators) which in turn are also immigrants themselves. During my interview days, I noticed that many, if not most of the hospitals near large metropolitan areas had more IMG/FMGs. Also noticed that when the PD was Indian, more Indians residents were selected, when the PD was Cuban, more Hispanics and when the PD was middle eastern more middle eastern were selected. Many things might be playing into this. Some residents that graduated in the US and only speak English might rank a program in Miami where 40% speak pure Spanish lower simply because they don't want to deal with it and program directors might rank slightly higher those residents that are more culturally similar to him/her or even the patient's population (this is likely mostly subconscious, don't go screaming FRAUD! just yet).
Thank you! This response is really well written and I appreciate it as it helps a lot!
 
My issue is I'd rather be closer to home, which is basically Miami/Ft. Lauderdale area. Outside of Jackson/UM, most of the programs seem to be more community (you have FAU but I don't know if that really counts as academic since it's not their own hospital or anything like that). When I looked at rosters for a big chunk of the programs, they had barely any US MDs, while some had almost no US grads in general. I'm pretty sure I don't want to do a fellowship, so I'm just not sure whether this should matter at all or to what extent.

As an MS2, I don't believe you'll really know what you want to do (fellowship vs hospitalist vs specialty) until you take your boards and start rotations. Then plans become more clear and much more realistic when you get those scores back and actually get thrown into rotations to learn what an intern does in each of those specialties.

You want to go to the best program possible if you are considering fellowship. Beyond being at a university system, you can also pursue a community program that has in-house fellowships. It makes life harder if you don't have those.

I'm going to be honest: you're going to have to expect possibility of not going home if your academic career is priority. If going home is absolutely, positively a must, then you need to shift views and accept the possibility that you will not go to a program that is best for your career. If you can come to terms with that, it will make the whole process easier for you down the road. Not saying its impossible to have both, but it may not happen and I've seen too many people become disenchanted with residency when they were surprised about this in their 4th year.

FAU is still academic, they have three main teaching hospitals all of which with a ton of residencies and fellowships. It doesn't need to be a university named hospital to be a teaching hospital.....for example, Harvard medical school doesn't have a Harvard Hospital. They have three very big flagship teaching affiliates (MGH, BWH, BIDMC). UMKC has a county hospital and a private hospital with UMKC not in the name, again still the definition of academic teaching hospitals.
 
As an MS2, I don't believe you'll really know what you want to do (fellowship vs hospitalist vs specialty) until you take your boards and start rotations. Then plans become more clear and much more realistic when you get those scores back and actually get thrown into rotations to learn what an intern does in each of those specialties.

You want to go to the best program possible if you are considering fellowship. Beyond being at a university system, you can also pursue a community program that has in-house fellowships. It makes life harder if you don't have those.

I'm going to be honest: you're going to have to expect possibility of not going home if your academic career is priority. If going home is absolutely, positively a must, then you need to shift views and accept the possibility that you will not go to a program that is best for your career. If you can come to terms with that, it will make the whole process easier for you down the road. Not saying its impossible to have both, but it may not happen and I've seen too many people become disenchanted with residency when they were surprised about this in their 4th year.

FAU is still academic, they have three main teaching hospitals all of which with a ton of residencies and fellowships. It doesn't need to be a university named hospital to be a teaching hospital.....for example, Harvard medical school doesn't have a Harvard Hospital. They have three very big flagship teaching affiliates (MGH, BWH, BIDMC). UMKC has a county hospital and a private hospital with UMKC not in the name, again still the definition of academic teaching hospitals.
I agree about not being 100% sure about what I'd like to do, my question is more investigational on whether or not the roster of residents or perceived prestige of a program matters if one isn't interested in academics or specializing. I know that if you want to pursue fellowship, you should go to a university program or a program with fellowships. I say that I am pretty sure I don't want to specialize more from a lifestyle perspective....unless I find that I would absolutely hate being a PCP (I'm leaning more towards IM at the moment, but FM is on the table as well), I can't see myself pursuing fellowship or any other specialty. The same thing kind of goes for going home-- of course it's not absolutely a must, but it's something I would prefer if the outcomes would be the same (end up a PCP whether I go to UF or Broward Health, for example). I don't want to sacrifice my entire life for medicine, I love medicine but I personally think I would be happier not letting it take over my life. My question is more just to find out, if I do decide that I want to be either a PCP or a hospitalist, does it matter whether I go to UF or USF or UM, or whether I go to Broward Health or Memorial or Cleveland Clinic, you know? Although I admit it may be too early to be asking this question, it's really just something I'm more curious about. There may not be a right answer, either.
 
if I do decide that I want to be either a PCP or a hospitalist, does it matter whether I go to UF or USF or UM, or whether I go to Broward Health or Memorial or Cleveland Clinic, you know? Although I admit it may be too early to be asking this question, it's really just something I'm more curious about. There may not be a right answer, either.

No it wouldn't matter in the face of getting ur training and becoming a hospitalist. The quality of the training and the resources each place will have will vary but in the long run the training is similar, it allows you to take your board certification in internal medicine, which when passed gives you pretty much access to be a hospitalist at most places.

If you want to be an academic hospitalist where you can teach and potential do some research, try and stick with a more academic program that will have resources for that. If you really don't care for that aspect, go wherever you feel you will get the best training which I honestly don't think you'll know until you start interviewing for places (which is where I am at right now).
 
No it wouldn't matter in the face of getting ur training and becoming a hospitalist. The quality of the training and the resources each place will have will vary but in the long run the training is similar, it allows you to take your board certification in internal medicine, which when passed gives you pretty much access to be a hospitalist at most places.

If you want to be an academic hospitalist where you can teach and potential do some research, try and stick with a more academic program that will have resources for that. If you really don't care for that aspect, go wherever you feel you will get the best training which I honestly don't think you'll know until you start interviewing for places (which is where I am at right now).
Good luck with your interviews!
 
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