How much does the prestige/location of residency matter?

[rdanny]

Hi everyone,

I've been reading some old threads and I have been talking to some IMG's who have completed residency. Many of them state that the residencies which they were offered were often times the ones the US grads did not want at all (they were hardly ranked or ranked very low). This was either due to location or the program being considered bad.

However, they were unable to give me valid concrete reasons as to what makes a particular program bad or good and what implications it would have on a future career.

Does this have to do with the training one receives during residency? Research opportunities? Pathology or friendliness of the staff?

I was under the assumption that all residency programs (regardless of location) had to offer some basal level of training that was necessary for someone to eventually practice.

Please forgive me if this question seems poorly worded or trivial. I tried doing some background search on this topic and I haven't been able to clearly formulate a straight answer. I have an interest in Anesthesiology and I would be happy to match into some low-ranking community hospital as long as it won't hinder me in my ability to get a job later on (I don't really care about the location). However, I also don't want to receive inadequate training that would make me more susceptible to making an error when treating a patient.

Any insight or advice on this matter would be greatly appreciated!

Thanks!

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[cowme]

A graduate of any program should be able to get a job unless they are in very poor standing. Coming from an unknown program, you may not have your pick of location, but you will get a job for sure.

 

[Law2Doc]

Undesirable residencies can be so for a variety of reasons. First they can be outright malignant, where the residents are treated poorly, overworked to the extent of the allowed duty hours (and sometimes beyond), not taught, scutted out badly, berated, given all the onerous tasks and bad shifts in the hospital, no electives, etc. There's a range of treatments residents can get at a residency and a marked difference when attendings regard you as a future colleage vs a whipping boy. Second a residency can be poorly geared toward getting folks into fellowships. If a program hasnt had success at this in the past, doesn't give good letters, doesn't let it's residents have time to interview, and doesn't have attendings willing to make phone calls, this puts a program behind those that do all this. Third, teaching is important. There are places where the attendings keep their knowledge tucked away and don't really spend dedicated time teaching. There are places where all the didactic lectures are resident run, which sometimes is the blind leading the blind. Fourth, undesirable locations, and fifth, less desirable specialties.

In terms of job prospects, fellowship opportunities would be most significantly impacted, but certainly specialty choice is going to impact your career choices as well.

 

[dragonfly99]

Undesirable residencies can be so for a variety of reasons. First they can be outright malignant, where the residents are treated poorly, overworked to the extent of the allowed duty hours (and sometimes beyond), not taught, scutted out badly, berated, given all the onerous tasks and bad shifts in the hospital, no electives, etc. There's a range of treatments residents can get at a residency and a marked difference when attendings regard you as a future colleage vs a whipping boy. Second a residency can be poorly geared toward getting folks into fellowships. If a program hasnt had success at this in the past, doesn't give good letters, doesn't let it's residents have time to interview, and doesn't have attendings willing to make phone calls, this puts a program behind those that do all this. Third, teaching is important. There are places where the attendings keep their knowledge tucked away and don't really spend dedicated time teaching. There are places where all the didactic lectures are resident run, which sometimes is the blind leading the blind. Fourth, undesirable locations, and fifth, less desirable specialties.

In terms of job prospects, fellowship opportunities would be most significantly impacted, but certainly specialty choice is going to impact your career choices as well.

I agree with this. Also, not all residencies are going to prepare you equally, in terms of the clinical experience you will get. Some residencies have no research opportunities at all, essentially. Also, some residencies offer little ICU/critical care experience. Some places just do not have a very big ICU and/or transfer most of their sicker patients on to a bigger, better, more advanced hospital. In order to remain accredited, residencies are required to meet some minimum standards and they are inspected by the ACGME. However, I wouldn't say they are all the same. Not all colleges/universities are the same, either. Not all corporations are the same (etc. etc). People's perception of your medical school (or just lack of knowledge of it, perhaps, if you go to a foreign school) as well as your board scores and med school evaluations are going to affect where you are able to get a residency.