First, is it prudent or realistic to select FM residencies based on the ones that offer the greatest percentage of hours in outpatient / community / ambulatory care settings? Do FM residencies even vary that much on this criterion?
Yes it is possible. You look at the curriculum and count up how many rotations you have inpatient vs outpatient and look into how many days/half days you are in clinic. Yes, there are residencies that are very outpatient focused and very inpatient focused.
My advise is, no, it is not prudent to pick residencies based on number of hours spent in the hospital vs not, UNLESS you are willing to make a bet on your future (i.e. you have a clear vision/path to what kind of a job you will go for). My advise while you are in training is to train broadly and intensely, but that's me and my philosophy. The reason why is because the business of health care is not driven by pure economic principles. Health care carries a lot of political risk. Any change in health care policy changes the game that we all play to make money. Right now, the game being played is outpatient medicine, but who knows how long that will last.
If you choose a BALANCED residency program, you will be versatile enough to adapt to abrupt changes in health care policy.
If you want to limit your job opportunities open to you when you get out, then fine, pick a outpatient-oriented or inpatient-oriented residency. For example, if you look at the want-ads, being able to do OB (low risk or with c-section) opens up a lot of doors and you get paid more. But most FM residents balk at the idea of doing OB, and thus those doors are closed to them from the start. Who knows what will happen to primary care obstetrics in 5 years by the time you get out (and who knows where your life will take you in 5 years where those skills may be needed). If you go somewhere where you don't learn those skills, it's going to be really hard to pick them up when you get out on your own. Hope that makes sense... Unless, of course, you already know how your life will proceed. Some people take over their parents' practice and so for the near term, their vision of what their practice will look like is very tangible. For some of us who don't have that predetermined path, we're subjected to "what's out there" and so if you train broadly, you will position yourself to take advantage of opportunities for your dream job.
Secondly, how similar is the inpatiant / hospital-based component of the FM residency to an IM residency? Would I be attending morning report, rounds, academic lectures, and ER call alongside my IM colleagues, assuming my site offers an IM residency?
Every program is different, so you need to ask and assess for yourself. Generally speaking, an unopposed program will have an adult FM service very similar to an IM residency. But, some unopposed programs will have an arrangement with the hospital's IM staff (i.e. private practicing attendings), so you need to ask what is the role of the FM service in the hospital regardless of if you're at an opposed or unopposed program. Some places alternate call nights, for example, while other programs will triage certain cases to certain services. Once you start interviewing and seeing how different programs work, you'll be able to compare and contrast.
Most places if there's an IM residency and if you rotate with the IM residents, you will be expected to do whatever they do as an "off-service" resident.
Thirdly, I've been looking at FM residencies, and have seen that some match extremely few residents -- 0~3 in any given year. Is this a good sign or not?
The match list is only a proxy for what's going on but it doesn't tell the whole story. For example, you make your rank list, right? The more programs you list, the better chance you will match in a program. If you ranked only 1 program, there's a higher risk that you may go unmatched, right? Well... that's the same thing that goes on on the residency side. Some programs will fill because they interview a whole lot of people and rank a whole lot of people so that they don't go unfilled; while other programs who rank less will risk going unfilled and need to tap the scramble pool.
That being said, it may be possible that certain programs aren't that desirable and have a problem recruiting, so they end up going unfilled while others that are popular and competitive will tend to fill.
My point is that while the match list is informative, it's doesn't tell the whole story because your match rates can vary based on multiple factors.
What would be the pluses and minuses to doing a residency where I was one of very few FM residents, or even the only one, as opposed to doing a big academic program that offers and fills 12~15 seats every year?
Programs need to have enough work to sustain and support the residents they are recruiting. So you can assume that there's a lot going on with big programs. Small programs may have a lot of work too, but maybe not to the extent as the big program. Who really cares, to be honest? What matters is how much work/exposure is happening on a per-resident basis.
The RRC requires a particular ratio of faculty to residents. So at big programs, you must have more faculty and at small programs you will have less faculty.
The bigger the program, the more complex the system, the more bureaucratic it becomes. Smaller programs are more personal and intimate. Smaller program have less complexities.
The smaller the program, the less flexible the schedule is. So if you go to a small program, and someone gets sick, pregnant, needs to take extended time off, or gets held behind or fired or quits, each individual needs to step up, whereas in big programs, the work can easily be absorbed.
Big programs have bigger clout. So when you graduate from the program, and you're looking for a job, there's already a lot of former residents out there who know you who can help you get a job.
The smaller the program, the easier it is to design a curriculum targeted at those residents. The bigger the program, the more diversity and more opinions you have, which means it's harder to design something that pleases everyone.
