Location, location, location

[Freak]

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Is it wiser to train (residency) at a better place further away from your final location, or to train closer to your final destination at the expense of your program.

Also, how many different "jobs" do people start before they settle down in their career. In research academics, it seems that many people have 2-3 different University affiliations (no regional localization) before settling down. I was wondering if this was a skewed perspective and how the market is in private practice.

My SO has a job offer in the DC metro-area, but for the first few years, they would probably be willing to accommodate telecommuting. In the end, it would probably be best to end up settling down there.

 

[pathstudent]

Is it wiser to train (residency) at a better place further away from your final location, or to train closer to your final destination at the expense of your program.

Also, how many different "jobs" do people start before they settle down in their career. In research academics, it seems that many people have 2-3 different University affiliations (no regional localization) before settling down. I was wondering if this was a skewed perspective and how the market is in private practice.

My SO has a job offer in the DC metro-area, but for the first few years, they would probably be willing to accommodate telecommuting. In the end, it would probably be best to end up settling down there.

Dude you got Hopkins near D.C. What program were you hoping to match at, Olympus Medical Center?

 

[KCShaw]

Depends on what you personally hold most important. If you come out of any program competent and confident, there will be a job out there *somewhere* for you. Programs with a better reputation give you a slightly bigger toe when you're trying to get your foot in the door for a job, especially if you're trying to limit yourself to a single city or small region -- the last place you train will be the place that follows you most "loudly" through the rest of your career. People always seem to want to know where you finished your training (this includes fellowship if you do one, so AP/CP residency isn't -always- the most loudly recognized component).

Personally, if I really had a choice, I'd pick the program that feels the most right from a training perspective -- usually one with a stronger reputation than the others, but sometimes the people you meet while interviewing make a difference. But, obviously, that depends on how it affects your personal life, which is a personal decision.

Settling into a job I think is also a personal issue. Sometimes a given job just isn't what you thought it was when you accepted it. Sometimes people just don't feel settled in their jobs until they're settled in their personal lives. Sometimes people think they want to go private because of the money, then realize they don't like the pace; some think they want to go academic, then realize the money, teaching, and pressure to publish isn't worth the numerical caseload difference. So, sometimes people move around until they find peace. I don't think it's specific to pathology itself?

 

[2121115]

Is it wiser to train (residency) at a better place further away from your final location, or to train closer to your final destination at the expense of your program.

Also, how many different "jobs" do people start before they settle down in their career. In research academics, it seems that many people have 2-3 different University affiliations (no regional localization) before settling down. I was wondering if this was a skewed perspective and how the market is in private practice.

My SO has a job offer in the DC metro-area, but for the first few years, they would probably be willing to accommodate telecommuting. In the end, it would probably be best to end up settling down there.

Always go for the better program. You can always go back to wherever you were from and get your foot in the door with a big name on your CV. Where you train matters... A LOT.

 

[BU Pathology]

According to the workforce survey from the AAMC, about 45% of pathologist practice in the same state where they did their training, see attached page from the survey results. Of course that means that 55% trained in a state different from where they practice.

In Jim Collins book "Good to Great" one of the defining characteristics of successful companies was their policy of promoting from within rather than constantly looking to the outside for talent. Since the 2001 publication of that book more academic institutions are considering internal candidates as the best option, rather than someone who would not even be considered.

Obtaining the best possible training is certainly sound advice. Where this training takes place is probalby less important for your eventual practice location.

 

[Freak]

Dude you got Hopkins near D.C. What program were you hoping to match at, Olympus Medical Center?

So is the correct protocol to write my residency contract before I interview, or should I hand it to them in person at my interview?


KCShaw, I totally agree about the personal mix with the people (as we will likely spend a fair bit of time together). Having been in school for many years now, that is definitely a lesson well learned 🙂

I was planning on going for the best that I could hit, but I was not sure if Path was one of those careers where "who you know" is more important than "what you know". I have seen this happen before and I just wanted to get some feedback from people further down the line.

 

[Euchromatin]

Also, how many different "jobs" do people start before they settle down in their career. In research academics, it seems that many people have 2-3 different University affiliations (no regional localization) before settling down. I was wondering if this was a skewed perspective and how the market is in private practice.

Several of my attendings have told me that pathologists, on average, have 2.5 different jobs during their career, which would correlate nicely with the 2-3 University affiliations you seem to see. I'm not sure if they got the number from a study, survey, or just anecdotal experiences, but they seem to be referring to both private practice and academic pathologists when this statistic is thrown around.

I can't really comment on the ultimate benefit of prestige vs. location of residency in securing a job yet, as I'm only PGY-1. I'm hoping that my choice of a program located where I would like to practice (and where I felt most comfortable) over bigger name programs elsewhere will work out for me.

 

[pathstudent]

So is the correct protocol to write my residency contract before I interview, or should I hand it to them in person at my interview?
.

You are asking if you should sell yourself short with the caliber of training so you can be close d.c. I dare say if you have little to no chance of getting into JHU, then you have little chance to get into any top program.

But I believe that most competitive AMGs can get into the program that is their first choice. And given your PhD. you should be able to match into most top programs without trouble.

Apply to JHU, if you get an interview, rank them #1, and you will likely go there and be near your sweetie pie.

 

[deleted314957]

Pathstudent, you really seem to be hung-up/pre-occupied about being in, amongst or associated with these "top programs". You don't name names but we all are aware of several of them. You sound sharp and I could probably use you as a consultant.

For the most part they are populated by a fantastic group of docs and support personel that offer the best care in the world and wonderful consultation resources.

Are there embaressments and flaws in those places?--Sure---they are all over. But you seem to forget that many of us have been in one of those places, had our umbilical cord severed and are now so goddamned busy with being the lab medical director of a ~180 bed community hospital with a full surg/cyto sign out schedule and all the admin crap that we could not write a paper if we had to. And many of us kind of prefer that. But never forget that some of us grunts who decided not to stay lived in your ivory tower as youths and had looked down on the masses and now have decades of experience in the mean streets.

 

[pathstudent]

No that freak was asking if he should sacrifice going to a great program in order to live in dc. My point is that there are already great programs in dc. So if he thinks he is too good for zone programs but not good enough for others than just what he is talking about. Evidently he freak thinks jhu is a long shot for him. So what programs does he think he is too good for

Pathstudent, you really seem to be hung-up/pre-occupied about being in, amongst or associated with these "top programs". You don't name names but we all are aware of several of them. You sound sharp and I could probably use you as a consultant.

For the most part they are populated by a fantastic group of docs and support personel that offer the best care in the world and wonderful consultation resources.

Are there embaressments and flaws in those places?--Sure---they are all over. But you seem to forget that many of us have been in one of those places, had our umbilical cord severed and are now so goddamned busy with being the lab medical director of a ~180 bed community hospital with a full surg/cyto sign out schedule and all the admin crap that we could not write a paper if we had to. And many of us kind of prefer that. But never forget that some of us grunts who decided not to stay lived in your ivory tower as youths and had looked down on the masses and now have decades of experience in the mean streets.

 

[Freak]

I am at a "top institution" for med school. You are quite correct that I feel I should be competitive for top programs, however, given the recent years matches that I have seen, the PhD is much less valued than what it once was. We have people every year who do not match because they simply rank one program (or very few); this seems unwise to make such a gamble.

Also, as I have never been to JHU path, I would not really want to spend 4 years there if it turns out I hate the program. I remember back in the day when I was interviewing for med school, and my interviews actually changed my decision on where to go (from what I had initially envisioned certain programs to be like).

 

[pathstudent]

I am at a "top institution" for med school. You are quite correct that I feel I should be competitive for top programs, however, given the recent years matches that I have seen, the PhD is much less valued than what it once was. We have people every year who do not match because they simply rank one program (or very few); this seems unwise to make such a gamble.

Also, as I have never been to JHU path, I would not really want to spend 4 years there if it turns out I hate the program. I remember back in the day when I was interviewing for med school, and my interviews actually changed my decision on where to go (from what I had initially envisioned certain programs to be like).

Trust me. Everyone thinks their program is sliced bread. If you go to JHU, you will have great training, be forever connected and be close to your sweetie-pie, so stop making things difficult and do what you need to do to go there. You are one of those self-sabotagers.