Incredibly superficial question about residencies

[Lacheln]

---

Members don't see this ad.

After 17 years in the northeast, I have decided I can't take ONE MORE WINTER HERE. I am only a first year, so, sadly at least 3 are in my future. However, having reached my limit, I am lustfully eyeing fourth year elective and residency locations already. Of course programs for residency are difficult to find information on at this stage of the game, so can anyone tell me anything about what fields dovetail nicely with places like Miami Miller, San Diego Scripps, or places that aren't on the coast or warm, but are sunny. For example, I'm very interested in EM in Colorado because I was born there and dig the outdoorsy schtuff. In terms of competitiveness, I expect to be an above average, but not super star, applicant. I am interested in both academic and community programs, but probably more those with some research component.

So, yeah, totally superficial question. No, I am not planning to define my career by which warm, sunny location I like best. No, I don't need lectures on how I can move after residency, or that location won't matter because I won't have a life anyway. Girls need to dream, so if you know of great programs in locations with ocean access and/or great skiing, lots of sun, and active, happy people, please throw me a bone so that I can have something to plan for and/or lust after. I'm particularly thinking about things like EM, Peds (inc subs), Neuro or critical care, but if the location/lifestyle sounds right, throw it out there. My major recreational activities are diving, skiing, sailing and hiking/camping.

 

[ShyRem]

EM in Colorado for residency has only one program - incredibly competitive.

 

[Lacheln]

EM in Colorado for residency has only one program - incredibly competitive.

Yeah, I know about that one. Sigh.

On another note, I meant to post this in allopathic, but can't delete it. Help?

 

[tremulousNeedle]

I am an EM resident, so I may be able to help you. Exactly what is your question? I read your OP and didn't see a '?' anywhere.

 

[Lacheln]

Sorry, yes, rambling.

My ?? is where are some notable programs in yummy locations, particularly those that overlap with things like EM, Peds (inc subs), Neuro or critical care. I guess by notable I mean anything from well regarded to filled with cool perks (like the red sox duties people get here in Boston in some programs). I'm not deluding myself into thinking that I deserve anything like that at this point, just want something to lust after.

 

[Superfrost]

northern california has a a nice mixture of mountains and oceans providing for decent skiing, sailing, hiking camping, and a little diving, and theres always university of hawaii, no skiing there though.

 

[phospho]

OP, I am TOTALLY with you. On another similar note, how hard is it to switch states when you go from medical school to residency? Is it like applying to a state med school as an out of state applicant? or is it easier?

thank you!!

 

[Random Anesthesiologist]

Sorry, yes, rambling.

My ?? is where are some notable programs in yummy locations, particularly those that overlap with things like EM, Peds (inc subs), Neuro or critical care. I guess by notable I mean anything from well regarded to filled with cool perks (like the red sox duties people get here in Boston in some programs). I'm not deluding myself into thinking that I deserve anything like that at this point, just want something to lust after.

FREIDA

 

[Lacheln]

OP, I am TOTALLY with you. On another similar note, how hard is it to switch states when you go from medical school to residency? Is it like applying to a state med school as an out of state applicant? or is it easier?

thank you!!

Join me in the sun. 😛

From what I've heard some of the intangibles that affect residency apps are regional preferences, familiarity with your school, audition rotations and/or knowing someone at the program. Just like your undergrad can help you if there is a strong relationship between your undergrad and a particular med school, or if your undergrad is exceptional. But I don't know in practice how hard that actually makes it.

FREIDA

Well, yes, I'm familiar with Freida. But that's not a great way to get a feel for a program...data yes, personal touch, no. Kind of sterile.

Anyway, looks like residency info is really hard to come by. Oh well.

 

[Random Anesthesiologist]

Well, yes, I'm familiar with Freida. But that's not a great way to get a feel for a program...data yes, personal touch, no. Kind of sterile.

Anyway, looks like residency info is really hard to come by. Oh well.

Your posts sound like you're interested in connecting desired geography and choice of residency specialty. FREIDA is a good place to start with that.

You may have heard of FREIDA, but others reading this thread may have not.

 

[da8s0859q]

After 17 years in the northeast, I have decided I can't take ONE MORE WINTER HERE. I am only a first year, so, sadly at least 3 are in my future. However, having reached my limit, I am lustfully eyeing fourth year elective and residency locations already. ... Miami Miller, San Diego Scripps, or places that aren't on the coast or warm, but are sunny. ... My major recreational activities are diving, skiing, sailing and hiking/camping.

I dunno, I don't think that's superficial at all. I'm also in a pretty hot climate, and I'll definitely be looking for colder ones come residency application time. No point in subjecting yourself to that sort of thing if it can be helped.

 

[tremulousNeedle]

Keep in mind that my comments come from my experiences inter viewing for EM. Also, these may seem non-specific simply because I don’t remember the details. I do not suppose there is a database with the information that you’re are looking for.

Given that EM is a relatively new specialty (though nearing 40 years) the locations of its prime programs usually aren’t in the same locations as traditionally well-known residencies in other specialties (if they are, it is usually a coincidence). There really isn’t a “top 10 best EM programs” list. Basically, for EM you can find good programs all across the nation in different cultural arenas and different climate zone.

For EM, next to “the feel of the program”, geography was cited as the next most important factor in rank list ordering (sorry, I don’t have a source; this info was given during a presentation). Geography encompasses people who want to return home after being away for med school, to people who want to be closer to relatives, to people who want to train in the sun. Perks like working as medical staff for a professional or college sports team is highly variable and can change within a program from year to year, but many programs have something like this.

Here are some minimal specifics:
Denver – very competitive programs, though many current residents, graduated residents, and interviewees got the impression that it is or was a malignant program, but that is a topic for a different thread.

OHSU – Is possibly the hardest EM residency to get into for the general applicant. First, I hear it is a great program. Second, it is the only civilian EM residency program that services those 5 large states in the northwest corner of the country (anyone from those states who wants to train near home will be vying for those positions).

New Mexico – Usually warm 11 months out of the year, winter is short and usually consists of frost and some wind, not really any know. It is surrounded by mountains that residents love to climb. Skiing is within a couple hours drive. A lot of extra areas to focus on like, wilderness medicine, tactical medicine, EMS, etc (see their website). The downside is that Albuquerque has not major professional sports teams and once you leave the metropolitan area there is not much in any direction for several hours.

Vanderbilt – Again, the weather is usually warm. Winters are short with minimal snow. You get to experience the atmosphere of Nashville city life. There is some rugged terrain nearby. There is great teaching here and excellent experience with EMS.

Others: I’ve heard good things about AZ and FL (except jacksonville) as well as the established CA programs.

http://www.saem.org/saemdnn/Home/Communities/MedicalStudents/ResidencyCatalog/tabid/680/Default.aspx

 

[illegallysmooth]

You sound like me every January. I've spent my entire 23 years in Buffalo, NY and Rochester, NY. I cannot take it anymore.

It's not a superficial question! Your happiness is the least superficial thing in the world.

 

[smq123]

Moving to allopathic.

 

[Lacheln]

Your posts sound like you're interested in connecting desired geography and choice of residency specialty. FREIDA is a good place to start with that.

You may have heard of FREIDA, but others reading this thread may have not.

Didnt mean to sound dismissive. But, I was under the impression that for most fields, excepting those that are very small and/or very competitive, there are programs pretty much everywhere. For example - there are peds programs in every major city I've looked at. Hence the desire to narrow things down. I used the Denver EM program as an example because it has a cool overlap between strong program and an area that is very enticing for outdoor activities. But I don't know where all the strong programs are outside of ne, and Frieda doesn't have info on competitiveness or anything like the background blurbs about an area that you'd find in school guides.

 

[Lacheln]

I dunno, I don't think that's superficial at all. I'm also in a pretty hot climate, and I'll definitely be looking for colder ones come residency application time. No point in subjecting yourself to that sort of thing if it can be helped.

We should trade. 🙂 Although, honestly it's not the cold, it's the GREY. Like school doesn't get tiresome enough on it's own, the world has to be depressed too? 😛

 

[Lacheln]

northern california has a a nice mixture of mountains and oceans providing for decent skiing, sailing, hiking camping, and a little diving, and theres always university of hawaii, no skiing there though.

Nor Cal is definitely high on my list. San Fran is awesome. Big Sur and Napa alone are motivation enough. 😀 I have no idea if I'll be competitive enough for something like UCSF, but it's something to work towards maybe.

 

[Lacheln]

Keep in mind that my comments come from my experiences inter viewing for EM. Also, these may seem non-specific simply because I don’t remember the details...

No, thank you! This was fantastic info. It's good to have the heads up about Denver, malignant is the absolutely last thing I want, life is too short. I hadn't thought about OHSU - I graduated from high school in Sunriver (central OR). I've thought about Vandy, especially since the med students seem so happy. Albuquerque is beautiful. Anyway, thanks so much for that extremely helpful post, and I will check out that site.

 

[Lacheln]

I think you still need to at least finish your 3rd year to get an idea of what specialty you'd like to do, but thinking about which geographic region you'd like to do your residency in early probably isn't a bad idea.

Don't give yourself oh so much credit. I think when you work with residents in your 3rd and 4th years you will see how overworked and mistreated residents are. Nobody is going to be giving you a candy cane on a bad day. Be glad they are even paying you a salary to begin with.

Not following you here. I didn't say anything about $$. Salaries are pretty standardized in residency anyway. And candy?? Um.

Speaking of the cash, money will be a HUGE factor to take into consideration. Can you afford to live in an expensive city in the warmer climates? You probably haven't factored this yet because you haven't accrued too much of a debt, but it will mean a lot to you once you're living on your own trying to save money.

I'm a nontrad and live in one of the most expensive cities here, so I have considered those issues. In fact $$ was one of my top considerations for med school because I didn't want debt to force me into a field I didn't love or an area I didn't like. It's definitely something to think about though. For example San Fran is one of my faves but it is also one of the few places more expensive than Boston.

It sounds like you've got some good options though, and are making sensible choices. 🙂

 

[45408]

Don't give yourself oh so much credit. I think when you work with residents in your 3rd and 4th years you will see how overworked and mistreated residents are. Nobody is going to be giving you a candy cane on a bad day. Be glad they are even paying you a salary to begin with.

They aren't. The federal government is. The hospital is getting a sweet deal.

 

[tremulousNeedle]

They aren't. The federal government is. The hospital is getting a sweet deal.

True; the residency programs get about $100K US for each resident (from the fed gov’t), but only pay them about 50K US. Granted they also pay for your malpractice insurance, your benefits, your program coordinator's salary, part of the program directors salary, etc. In the end the hospitals still keep a little for themselves.

 

[PathMD2010]

How bout Arkansas? Like Little Rock? From what I hear, it has a great Peds program. Dunno about the EM.

But you get nice sunny weather, the possibility of (some approx q2-3years) snow, and lots of outdoorsy stuff with great hiking, lakes, ect.

Louisiana/ TX are also nice warm spots but they get REALLY hot in the summer and are best for hunters rather than hiking/ sailing though it is possible in some spots. Austin for example.

UAB also has a great reputation and multiple good programs.

 

[phospho]

True; the residency programs get about $100K US for each resident (from the fed gov’t), but only pay them about 50K US. Granted they also pay for your malpractice insurance, your benefits, your program coordinator's salary, part of the program directors salary, etc. In the end the hospitals still keep a little for themselves.

wow, had no idea...

 

[45408]

True; the residency programs get about $100K US for each resident (from the fed gov’t), but only pay them about 50K US. Granted they also pay for your malpractice insurance, your benefits, your program coordinator's salary, part of the program directors salary, etc. In the end the hospitals still keep a little for themselves.

Plus, they get all your free labor. An intern might not provide much, but a PGY-6 sure does.

 

[sunset823]

OP, I feel your pain, but in the exact opposite sense - as a lifelong upper midwesterner interning in the (mid) south, I just had to skip out of my clinical day due to heat exhaustion. Killing me softly with this 98+ heat...So I've drawn an artificial line at 35' latitude (and that's only for slightly cooler coastal cities) below which it is out of the question for me to apply, no matter how good the programs are. Fortunately, I'm going against the grain of most people, so I don't think I'll have a hard time finding spots in my beloved snowy north 🙂
Edit: the one and only exception: San Diego. It's 68 degrees there right now, for a high :-O - what I would give to be on Coronado beach right now...

 

[virusgirl]

Lacheln! I miss you. I also really miss Massachusetts, even (especially) the winters. How about this, we will switch med school seats!!! New Orleans is plenty warm -- projected to reach 95 today (with thunderstorms! oh how I love these southern monsoons!)

 

[Random Anesthesiologist]

Didnt mean to sound dismissive. But, I was under the impression that for most fields, excepting those that are very small and/or very competitive, there are programs pretty much everywhere. For example - there are peds programs in every major city I've looked at. Hence the desire to narrow things down. I used the Denver EM program as an example because it has a cool overlap between strong program and an area that is very enticing for outdoor activities. But I don't know where all the strong programs are outside of ne, and Frieda doesn't have info on competitiveness or anything like the background blurbs about an area that you'd find in school guides.

That's ok, no sweat.

One thing I did like when I was perusing the site is, after putting in residency preference and location, there were links to the programs, so I could take a look at what they offered, mostly out of curiosity at this point.

All that aside, I don't think it's superficial either to want to find a program in a desired area. Many residents tend to end up practicing where they train, so might as well make the most of it.

 

[ButImLETired]

Oh! Oh! Come to Vandy! Yay! I can't tolerate the heat, but I'll show you around when you come visit!

 

[Lacheln]

True; the residency programs get about $100K US for each resident (from the fed gov’t), but only pay them about 50K US. Granted they also pay for your malpractice insurance, your benefits, your program coordinator's salary, part of the program directors salary, etc. In the end the hospitals still keep a little for themselves.

I didn't know this...I am preemptively pissed. Grr.

How bout Arkansas? Like Little Rock? From what I hear, it has a great Peds program. Dunno about the EM.

But you get nice sunny weather, the possibility of (some approx q2-3years) snow, and lots of outdoorsy stuff with great hiking, lakes, ect.

Louisiana/ TX are also nice warm spots but they get REALLY hot in the summer and are best for hunters rather than hiking/ sailing though it is possible in some spots. Austin for example.

UAB also has a great reputation and multiple good programs.

That is interesting. To be honest I guess I haven't really considered much of the middle of the country aside from the rockies. I lived in Omaha and IL for a while, but other than that not much experience. Food for thought, I will check out Arkansas. BTW, I grew up in Canadia, and until I was 12 and moved back here I thought Arkansas was a different state than Arkansaw. Oops.

OP, I feel your pain, but in the exact opposite sense - as a lifelong upper midwesterner interning in the (mid) south, I just had to skip out of my clinical day due to heat exhaustion. Killing me softly with this 98+ heat....

Humid heat is intolerable, you have my sympathies.

VG and Let, I miss you girls too so much! But I do think a tour of the south is in order for Lacheln.

Lacheln! I miss you. I also really miss Massachusetts, even (especially) the winters. How about this, we will switch med school seats!!! New Orleans is plenty warm -- projected to reach 95 today (with thunderstorms! oh how I love these southern monsoons!)

I checked my exam schedule for next year and it does not conflict with Jazz Fest. And anyway Miss Virus, you have a cute new boy and look like you are partying it up...NO agrees with you. 🙂

Oh! Oh! Come to Vandy! Yay! I can't tolerate the heat, but I'll show you around when you come visit!

Can you take me to a proper southern ball? So I can fart and rip my dress? I am SO there!!

 

[sunset823]

Humid heat is intolerable, you have my sympathies.

VG and Let, I miss you girls too so much! But I do think a tour of the south is in order for Lacheln.



I checked my exam schedule for next year and it does not conflict with Jazz Fest. And anyway Miss Virus, you have a cute new boy and look like you are partying it up...NO agrees with you. 🙂



Can you take me to a proper southern ball? So I can fart and rip my dress? I am SO there!!

wow, 3 best gal pals on SDN - that's kinda freaky haha - and as fyi, the intolerable place in the mid south I'm referring to is Vandy, as LET graciously corroborated 🙂 Nashville and Tennessee in general are beautiful places though...if you can get past the temperature and culture shock 😛

 

[smq123]

I'm particularly thinking about things like EM, Peds (inc subs), Neuro or critical care, but if the location/lifestyle sounds right, throw it out there. My major recreational activities are diving, skiing, sailing and hiking/camping.

Critical care is a subspecialty after anesthesia, IM, surgery, peds, or EM. So those are more specialties for you to consider. 🙂

But I don't know where all the strong programs are outside of ne, and Frieda doesn't have info on competitiveness or anything like the background blurbs about an area that you'd find in school guides.

Program "strength" and competitiveness do not always stay the same from year to year. Faculty come, faculty go, hospitals lose money, hospitals make money, etc.

 

[MossPoh]

Grass is always greener. I hate everything about the cold when I'm forced to walk in during the winter when I was up North. I hate the heat with its filthy hot stickiness when I have to walk in it during the summer while I'm in the South.

I've found out one thing though; As I progress through school I find myself spending less time outside because of life in general, so I bitch less about it.

 

[Hurricane95]

You're certainly not in error in starting to think about where you will want to do residency - it's very important!

I have no official references to give, but I've heard you have somewhere between a 60-70% chance of staying to practice in the same location where you did residency, so it's a big deal.

Come here - we have lots of people in miami fleeing the frigid north!
We have no EM program, but we do have great anesthesia, critical care and neurology programs, highly ranked.

 

[Lacheln]

Come here - we have lots of people in miami fleeing the frigid north!
We have no EM program, but we do have great anesthesia, critical care and neurology programs, highly ranked.

Haha, I was totally thinking about doing an away in Miami...like during Jan. All three of those sound intriguing actually. Question re: Miami - how much of a handicap is it if you don't speak spanish?

 

[Lacheln]

Critical care is a subspecialty after anesthesia, IM, surgery, peds, or EM. So those are more specialties for you to consider. 🙂

I didn't realize you can go critical care from surgery. I'm surprised surgeons want to learn all that medicine. 😉 KIDDING.

I've found out one thing though; As I progress through school I find myself spending less time outside because of life in general, so I bitch less about it.

Sad panda. 🙁

 

[pianola]

Haha, I was totally thinking about doing an away in Miami...like during Jan. All three of those sound intriguing actually. Question re: Miami - how much of a handicap is it if you don't speak spanish?

I have my own opinions about how much of a liability it is to not-speak Spanish here in Miami, but I'm not a 3rd year so I have no specific experience with rotations. My ex-roommate (just graduated into residency) seemed to think that she would have had a much easier time if she spoke Spanish...

Miami's official position is that "Spanish is helpful but not necessary."

On another topic, I <3 Miami "winter" weather, though. It's awesome. I was in shorts and a t-shirt up until December 18th this year.

 

[Lacheln]

I have my own opinions about how much of a liability it is to not-speak Spanish here in Miami, but I'm not a 3rd year so I have no specific experience with rotations. My ex-roommate (just graduated into residency) seemed to think that she would have had a much easier time if she spoke Spanish...

Miami's official position is that "Spanish is helpful but not necessary."

I guess that's sort of what I was expecting. I speak french, and although the party line is that speaking one latin language makes the others easier, I have found the opposite to be true, so I don't see myself getting proficient.

On another topic, I <3 Miami "winter" weather, though. It's awesome. I was in shorts and a t-shirt up until December 18th this year.

Jealous. So jealous. My birthday is Dec 1st - we lived in Fl when I was 5 and the highlight of that year was having an outdoor birthday party. It felt like the weather was a present just for me. 😛

 

[da8s0859q]

I have my own opinions about how much of a liability it is to not-speak Spanish here in Miami, but I'm not a 3rd year so I have no specific experience with rotations. My ex-roommate (just graduated into residency) seemed to think that she would have had a much easier time if she spoke Spanish...

Miami's official position is that "Spanish is helpful but not necessary."

On another topic, I <3 Miami "winter" weather, though. It's awesome. I was in shorts and a t-shirt up until December 18th this year.

Two things.

1. That actually sounds terrible, shorts in December. Then again, I like cold weather, soooo... I guess I'm not moving to Miami.

2. You're alive!

 

[pianola]

I guess that's sort of what I was expecting. I speak french, and although the party line is that speaking one latin language makes the others easier, I have found the opposite to be true, so I don't see myself getting proficient.

Yeah, I mean, personally, not-speaking Spanish has been a pretty big drawback for me in terms of speaking with the average person on the street where I live (no, I don't live in the posh parts of Miami, LOL). In terms of classes, obviously they are taught in English, but you're probably not interested in sitting in on 1st and 2nd year classes. 😉

My new roommate is going to be a 1st year at the medical school, but she's leaving a career as an RN at Jackson (the hospital at Miami). Seriously, one of the first questions she asked me when we met was "How do students do clinical rotations without speaking Spanish?"

...

I've been studying medical Spanish since first year, so it's helped a little bit with conversational Spanish. Better than nothing.

 

[pianola]

Two things.

1. That actually sounds terrible, shorts in December. Then again, I like cold weather, soooo... I guess I'm not moving to Miami.

2. You're alive!

EXI!!!! I missed you 🙂

 

[Lacheln]

Yeah, I mean, personally, not-speaking Spanish has been a pretty big drawback for me in terms of speaking with the average person on the street...

Yeah, I would think it'd be a cultural/social hinderance as much as anything. In terms of patient pop it is probably helpful everywhere. Maybe I'll torture myself with Rosetta stone some more.

It's a c/o 2013 reunion up in this joint. 😀

 

[rachmoninov3]

To the OP:

You certainly have nothing to be ashamed of in wanting to leave New England. I'm born and raised rocky mountains, and will die happy if that's all I see for the rest of my life.

However, a few things struck me about your post and the responses that I think are worth noting:

1. You have 4 more years at your institution...baring of course, away rotations. So you have 3 more winters to endure. It sounds like you might have a bit of the old SAD come winter (I don't blame you, I'd be depressed too). This might need be addressed as it will help you out greatly through medical school. It's a long haul. Med school is sucky. The winters are sucky. Don't make things suckier.

2. So everyone likes EM. The excitement. The diversity. The shift work. However, as you go about your medical education you have a high probability of changing you mind. I like all those things about EM too, but I need continuity. I need to know what happened to me patients. So much like EM, FM has everything but the shift work. You might also look into FM because of the greater amount of residencies in "yummy" locations.

 

[Lacheln]

To the OP:

You certainly have nothing to be ashamed of in wanting to leave New England. I'm born and raised rocky mountains, and will die happy if that's all I see for the rest of my life.

Yes, me too, and they are the bomb. NE has its charms for sure, but none of them are worth Dec-April here.

1. You have 4 more years at your institution...baring of course, away rotations. So you have 3 more winters to endure. It sounds like you might have a bit of the old SAD come winter (I don't blame you, I'd be depressed too). This might need be addressed as it will help you out greatly through medical school. It's a long haul. Med school is sucky. The winters are sucky. Don't make things suckier.

Yes, there is an SAD component. I have used prozac in the past, but I won't be taking any psych meds in med school b/c I've heard horror stories about how it can come back to bite you in the butt. I'm going the light therapy and exercise route for now.

2. So everyone likes EM. The excitement. The diversity. The shift work. However, as you go about your medical education you have a high probability of changing you mind. I like all those things about EM too, but I need continuity. I need to know what happened to me patients. So much like EM, FM has everything but the shift work. You might also look into FM because of the greater amount of residencies in "yummy" locations.

Interesting thought. I do realize most people change their minds, and am keeping an open mind. I actively don't want continuity actually...I prefer short/intense interactions with patients. In my limited experience I haven't seen much "excitement" in FM (although I think that depends a lot on where you practice - are you near to specialists? If no, you're going to do a lot more), and I think it's a field that sort of has to be your calling in order to deal with the long hours and ever-mounting bureaucracy. The primary care aspect of EM is the least appealing part, and the shift work is actually one the top attractants for me. You are right about the awesome locations available for FM though, and there are some decent $$ incentives for those too. My school is very pro primary care so I'm excited to see what it offers when it comes to that point. Thanks for the input!