Location vs program

[poiuytre]

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I am almost done interviewing and I have a dilemma that I would like some help with.
(These are both programs traditionally regarded as "top") There is a program on the west coast that is located in a beautiful area, sort of affordable, has good clinical training just not good mentoring. It seems like you are on your own at this program (in terms of doing anything outside what is expected, for example if I wanted to do some clinical research, there would probably be no time and no one would advocate/support that). I love the location and the idea of living in such a beautiful area. But I have interviewed at other programs in not great locations that have more structure/support for residents to do clinical research and to have mentoring.
So the question I have is, how different are graduates of top programs at the end of residency? Does it really make a difference in terms of career trajectory whether you did research as a resident or not? For example if I wanted to do academics, would it hurt to not have research or strong mentoring throughout residency?

Thanks for any thoughts and happy thanksgiving!

 

[TexasPhysician]

It would probably hurt if you want to do academics at a top program, but otherwise, I would choose the program where you would be happiest.

 

[poiuytre]

Thank you @TexasPhysician

 

[notdeadyet]

If both are top programs, the difference would be minimal.

The program with more structured mentoring might kick open that first job more easily and help you start your career, but after the first job, you're pretty much as good as your last one.

The research opportunities are critical if you are going into research in academics. If you are going into a career of clinical care and teaching, you don't need tons. And if you're looking at top programs, you'll have plenty of opportunity to get involved in the lighter stuff.

 

[downwithDTB]

There is a ton of time before match lists are due. A few things to consider: most of your happiness quotient will be based on your day to day activities... How much will missing out on flexibility affect your daily happiness vs. the location? Then there is to consider that you're setting yourself up for your day to day for the rest of your life.

Next, perhaps spend a little time refining what you mean by academics. Are you interested in self funding your own research program, running clinical trials, becoming a PD or chair, or being a floor attending? Do you have a strong desire to work at a powerhouse program like MGH or UCLA or would a lower tier more clinically focused academic program be just fine? The answer for different permutations here will probably be wildy different.

Once you've gotten an idea of what you want, start asking programs: how many of their grads are doing this? Find people who recently got those jobs and look at their credentials. Compare them to recent grads of these programs and if you need to, ask some extra questions of your contacts at programs of interest as to how you might attain those credentials.

Also, for future interviews, try laying a career goal out (leave out the program teirs part) and ask how the program will get you there... For example: right now I think I'd like to be a floor attending on an academic inpatient unit? How many of your recent grads have done this and how will you prepare me for the academic aspect?

Finally, I'm curious why you don't think this program has good mentoring... Hardly something they'd shout, no?

 

[Psychotic]

If both programs are considered "top" I don't really see the dilemma.

Personally I ranked place over program. Go with your gut, because no one can tell you how to do it.

Separate mentoring prospects from academics rep - there are worthy mentors in programs of all stripes and focus.

 

[Bartelby]

I agree with notdeadyet that what you want out of a career matters a lot especially with regard to research. If you want research to be a major part of your career then you should go where the good mentors are. Working with someone well established in the field and willing to help can make all the difference in your success in research.

That said, if you want more of a teaching or administrative role (and research is more of an 'add-on' than central focus for you) I think location might win out in this scenario. Especially if you plan to stay local after training and seek out a job where you trained.

 

[poiuytre]

Thank you everyone for your comments and questions to think about.
I am not a research type (no MD/PhD, just a couple of publications about clinical research that included focus groups) but would like to keep that door open in case I want to go into academics. I think I'd end up involved in teaching more than anything. Thanks @notdeadyet for noting the distinction between research and clinical care/teaching.
@downwithDTB - actually the residents and leadership were clear that this is a place where you have to make things happen for yourself. A resident said he had only seen the PD once in the last year. Other said that they have mentors but it sounded more like people you can ask questions after you have rotated with them. I think I could find a mentor or two but it will just be more work and I'd be on my own.
Thanks all!

 

[Dharma]

#gowiththegut

 

[notdeadyet]

- actually the residents and leadership were clear that this is a place where you have to make things happen for yourself. A resident said he had only seen the PD once in the last year. Other said that they have mentors but it sounded more like people you can ask questions after you have rotated with them. I think I could find a mentor or two but it will just be more work and I'd be on my own.

Yeah, that would be a real negative in my book. I was pretty self sufficient as a resident and went to a program that was big and academic and known for requiring folks to do things for themselves, but we had a very active PD and close mentoring.

You don't need it so much when things are going well, but you certainly do when they are not. Also, when you get to the point that you want to tailor the program to sit your professional goals, that can be challenging to do without good mentoring and a hands on PD.

If the program in question is a really good one, I wonder how much the issue is a lack of mentoring vs a lack of an organized mentoring program, as these an be two different things. By any chance are you interviewing on the west coast after medical school elsewhere?

 

[FlowRate]

I'm in a similar spot. I have so many great connections at my home program and they're trying really hard to recruit me -- helps that I really like the program, but I don't like the location. Interviewed at another place in a really great location, but wondering if I'd really be happy starting over from scratch w/r/t connections and research opportunities. I also think the training is better at my home program, although my home program also probably works harder. And it would be even further away from my family than I am already.

Honestly, I'm just working on figuring out what I really want from residency given my current options and, more important and in line with other folks ITT, what I want from my career. I think the choice becomes more clear with an end goal in mind.

 

[Shikima]

Familiarity isn't necessary a bad place to start off with. Will you be there 'forever'? Not likely. But it will allow you to grow and help you develop the confidence you'll need.

 

[Igor4sugry]

I am almost done interviewing and I have a dilemma that I would like some help with.
(These are both programs traditionally regarded as "top") There is a program on the west coast that is located in a beautiful area, sort of affordable, has good clinical training just not good mentoring. It seems like you are on your own at this program (in terms of doing anything outside what is expected, for example if I wanted to do some clinical research, there would probably be no time and no one would advocate/support that). I love the location and the idea of living in such a beautiful area. But I have interviewed at other programs in not great locations that have more structure/support for residents to do clinical research and to have mentoring.
So the question I have is, how different are graduates of top programs at the end of residency? Does it really make a difference in terms of career trajectory whether you did research as a resident or not? For example if I wanted to do academics, would it hurt to not have research or strong mentoring throughout residency?

Thanks for any thoughts and happy thanksgiving!

I suggest to attend a top program close to home. So that you have support of family, which cannot be understated. Particularly if you plan to have children (as psych residency lends itself well for this). Step away from considering narrow criteria (academics, mentorship, possibility of future academic job). Look at things outside of all this. Residency is 4 years of your life. Also keep in mind that your single day interview visit can only rule out places you absolutely did not like. Its quite difficult to get a good understanding or feel for the program from interview day alone.

 

[splik]

It doesn't really help to be so vague. But there are no top programs on the west coast that don't provide adequate support for residents to clinical research and the like. By definition you have to provide that to your residents in order to be a "top program". So either this is not a program that would be regarded as such or you have not got a sense of theopportunitiee a available. There is a difference between having to carve out your own path (essential for success anywhere) and not being supported in your goals if you invest the time and effort to make it happen.

 

[poiuytre]

It is probably more likely that I don't have a sense of the opportunities available as @splik mentions. I am sorry I am being too vague with the program specifics, I guess I can only get vague responses! I am appreciating the comments though and all the factors to think about when choosing a place.