Judging if a residency program is the right fit

[smmypnts]

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I was wondering if anyone had feedback on how to determine if a residency is the right fit based on your interview days.

I recently interviewed at what is considered a top program located in a big city (I won't name the program since I don't want to bias anyone). The impression that I got from the residents is that they are generally happy at the program but they seemed slightly more overworked and stressed out than at other programs that I have visited. One of my faculty interviews was with an attending on a busy inpatient service who emphasized that one of the things he looks for in a resident is someone who can work quickly and independently. He also said that during my first year I won't have very much time to read as the service is busy and residents works involves long hours. It seemed to me like the program may prioritize resident productivity over learning.

At the end of the day I wanted to like the program because it is considered strong yet I was left with the impression that it wasn't the best fit for me.

Do all the top programs have this feel... Are all the good programs very busy and intense because they are considered good programs and therefore care for a larger and sicker patient load? Another thought I had is that while his description might sound intimidating to a medical student, I will be starting Neuro after doing a prelim med year and I might be more prepared for this kind of working environment after doing a busy prelim. My concerns about the program now might seem less valid when I start the program as a PGY2.

Does anyone have any thoughts on what makes a program a good or poor fit? And how valid are these impressions after seeing a program once on interview day?

 

[Plecopotamus]

As a current applicant, I can't really answer your question(s) other than to say everybody tells me that you get a gut feeling about the places when you visit.

On that note, I have been asking other applicants how they felt about the interviews they've had at their home programs -- I have heard either "pretty accurate" or "made themselves sound way better than they are." Nobody has told me that they felt on the whole the residency where they did their rotations undersold itself. So if the impression they leave is less than appealing to you, I suspect it's unlikely that the reality is better than what you're perceiving. I'm sure there are exceptions, but I don't know if I'd want to count on being one of them.

 

[typhoonegator]

No one can tell you what makes a program feel good or bad to anyone. As stated, it is often a gut feeling. I think a lot of people overthink it.

Most of the top programs are in big cities, and many care for large indigent populations with staffing that leaves something to be desired. There is often a large focus on inpatient neurology in these places, particularly in the PGY2 year. While I certainly agree that it isn't for everyone, there is much to be said for the learning-through-experience methods at these places. It's pretty tough to forget the NIF and VC cutoffs in GBS once you've been the only person standing between your patient and a certain death. And why read about NMDA-R encephalitis when you can take care of someone with it? As I said, not for everyone, but I loved it.

Then again, I'm a neurointensivist, so I might be in the minority in a lot of discussions of neurology education.