how to pick a fm residency?

[Dr McSteamy]

besides location location location, and un/opposed

is there anything else i should look out for?


or should i put on a blindfold and start clicking?

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[Toohotinvegas33]

I would go

1.location I want to live
2. Reputation
3. # of days off
4. pay
5. insurance coverage for me and family
6. CME money

 

[MeowMix]

The biggest differences I found included peds exposure. Many programs do not have their own peds inpt service, and you will have to rotate somewhere else to see inpt peds, let alone PICU. You will have a required peds urgent care rotation everywhere, but often not in your own hospital. So you should think about how much you want to do peds.

Another big diff is how much OB you do. Some of the most OB-intensive programs will tell you flat out, do not come here unless you really want to do OB. This does not mean that you will get to be primary on C-sections (a rarity). Instead, it means that you will do a lot of deliveries and prenatal care.

The other thing I would really look at is hours and use of your time. Our program does not pre-round or do group rounds, which means we can get to work at 7:30, and instead of spending hours following a crowd of white coats around the floor, we just go and see our patients and get the work done. Usually everything is done by noon and one person stays through the day until night float comes on. I liked this idea; I love it in practice. I hated rounding for hours and never learned much. Only you can know if that is right for you.

 

[Dr McSteamy]

do most programs give you time to do electives e.g derm clinic, etc? besides the usual peds/obgyn depts.

 

[Shinken]

do most programs give you time to do electives e.g derm clinic, etc?

Yes.

Also, if you have a family make sure you understand the program's call schedule very well.

 

[BSEMD]

I would go

1.location I want to live
2. Reputation
3. # of days off
4. pay
5. insurance coverage for me and family
6. CME money

Great - now tell me please how to find a reliable source of "Reputation," as #1 is up to each individual, and # 3-6 is invariably available on the program's website.

Serious question here

 

[EdibleEgg]

Pay is similar enough among different residency programs that it should really be a non issue. Sure it's a factor, as is CME money, book funds, etc. But an extra two thousand bucks won't change your lifestyle much. Call schedule is also not as big of an issue as some make it out to be. Sure it matters, but the eighty hour work week applies regardless of where you are. Also, if you opt for a really cush call schedule, you MAY miss out on important parts of your training. Reputation is tremendously tough to evaluate.

If you know somethings about your future desired practice, it will help tremendously. Location is tremendously important. A very high number of residents stay in the area of residency training. Networking makes it much easier to find a job/practice opportunity. Several residencies recieve funding based on how many residents stay in the state/area and you may be lead in that direction (my residency would only post jobs within the state). Do you plan on seeing lots of kids? Do you want practice in the hospital? Do you want to do scopes of other procedures? If so call and ask very specific questions. Do not ask, "can I get scopes at your program?" Ask, "How many of the residents who graduated in the last few years are performing endoscopy?" If you want to deliver, find out how many FM attendings are actively practicing obstetrics.

 

[iatrosB]

my approach:

darts + Missouri map

 

[Toohotinvegas33]

Great - now tell me please how to find a reliable source of "Reputation," as #1 is up to each individual, and # 3-6 is invariably available on the program's website.

Serious question here

You rotate at programs X and Y, and while you are there you ask about program Z, if its a great program somebody is going to know about it (the opposite should also be true for crapping programs). Also 3-6 is usually somewhere, here is an example from a program in my hometown

http://www.lvfamilymedicine.com/benefits.htm

that freida site may also have some info. (for DO programs our opportunities site list pay, days off, etc)

 

[sophiejane]

I would go

1.location I want to live
2. Reputation
3. # of days off
4. pay
5. insurance coverage for me and family
6. CME money

Wow, I have to seriously disagree with all but No. 1. I think one of the reasons people end up being unhappy at their residency is because they don't think about what really matters, which is the training. Location is important, but beyond that, unless you really are just looking to get by and don't care what you are and are not prepared to do when you graduate, you should really give some more thought to the kind of practice you want and which programs are going to train you best to have that practice.

Reputation is a nebulous thing. You should visit and make up your own mind, and while you are there, be relentless with your questions and learn as much as you possibly can about the program, how it is run, and how it trains its residents.

 

[secretwave101]

Happy residents are important. Get emails, talk to them outside the the interview day. Pissed residents won't hold back for long. You'll get the skinny with a little nudging. Oh, but make sure you hit the ones on their way out...not the ones with vested interest in getting you to the program so they can work you like Moses in Egypt.

Reputation is total crap, I think. There's no such reality, especially in family medicine. Training emphasis is much more important. For example, if you don't like OB - perfectly reasonable - you'd HATE my program. It's very OB-heavy. Other programs are very outpatient-focused.

I'd put some emphasis on night-float systems over traditional call. Most (not everybody) people swear by the float. I wouldn't spend too much time figuring out detailed call schedules (I rarely understand mine after 2 full years), but float vs. no-float is a good thing to work out in your mind. I'm a pro-floater, BTW.

 

[Peeshee]

Just by going on interviews, you will never get a good feel of the program. You have to spend some significant time there to see what is REALLY going on behind the scenes.
Reputation does not mean much since a place can have the BEST reputation but you still may not be happy there.
If you are really into lots of procedures (colonoscopy, C-sctns, etc.) then go to an unopposed program. If you are unsure, I would suggest spending time in an unopposed program and also an opposed program to get a better feel for how each are. OB may be a significant part of one residency's curriculum and may be overwhelming to you if you are not that interested in it, so I would highly suggest you spend some time there or at least ask a lot of residents about this.
Truly, you will never be able to completely know about a program unless you are actually a resident there. That's why lots of people try to switch after their first year. But knowing this, and by obtaining as much info. as you can in addition to observation, you can make the best informed decision.

 

[MeowMix]

If you can't rotate at a program as an MS4, at least go back before/after the interview and spend a morning or night on service. Ideally, in January when everyone is most tired and demoralized and will give you the straight-up (maybe overly cynical) truth. I did this most places I interviewed and it was hugely valuable.

Be aware that if you do this, you can easily end up getting (gently) pimped, so be prepared.

 

[Toohotinvegas33]

Reputation is a nebulous thing. .

There has to be a reason why a certain program has a reputation, as in they have good teaching or happy residents and just not a "name" .

 

[tcpro]

i agree, happy residents is the #1 Key to your happiness.

pay close attention to the current interns, and you should do a 2nd look if you're seriously interested and follow them on the wards or in clinic. Remember those interns will be your seniors and potentially any of them can be the one you take call with.

there is something to be said with reputation. not among med students but in the community and neighboring clinics. if you want to find your job in the same area, coming for a program that consitently produces strong docs is really beneficial to you.

this helped me ALOT during my job interviews. if you could find an ex-grad in the clinic or clinic network that is strong, they seem to trust you will be strong as well. (esp if you know that person directly and he/she can vouch for you).