Location vs Quality

[Herpeto]

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Is it better to select a residency based on location versus quality. I have read wthat many people believe Utah is one of the best programs and it happens to be one of the locations on my list. However, I have also considered Boston, Oregon, Washington, Utah, and Colorado. There are two programs in Colorado, one in Denver and one in Colorado Springs, has anyone been to the Colorado Springs location? Does anyone have any input as to quality of programs at the other locations?

To me the benefit of training at a University and research based clinic is that the technology and methodologies are generally far more advanced than most community practices. On the other hand, I don't know enough about Path to say that technology really has a huge role since we need to look at slides anyway.

H

 

[Pingu]

If you have family issues or other things going on in which you need to stay in a particular state, then you should choose by location. Otherwise, check out the town when you interview because it could be the greatest program in the world, but you might hate the town and the people who live there. But choosing a program because the town has a statue of the world's largest jackrabbit or because you like to luge and they have the best facilities for that is probably a bad idea.

Plus you have to move there which is expensive and pain in the butt.

 

[Herpeto]

Will I even have time in residency to care what the town is like, or will I be at the hospital the entire time? I have no family obligation to consider so I would move where I thought I may settle down for a few years after residency. Although that probably won't be the case either because I'll just have to move again when I do a Fellowship. Is it possible to sleep and shower in the hospital thereby forgoing the move for a fellowship and just living in the hospital or a car?

H

 

[deschutes]

Ha I like the way you think!

Sidestepping the whole community vs. university/tertiary care issue since there's another current thread, I think location and quality aren't necessarily mutually exclusive.

Also, depending on what program and what track you choose, yes you will have varying amounts of time away from the hospital. But it still doesn't involve a call room in the hospital. The others can correct me if I'm mistaken, but I don't think many places actually have call rooms for pathology...

Presumably if you go somewhere without winter it might be possible to survive in a car 🙂 But keep in mind you're going to be making money during residency and fellowship - if you're single you'll be so spoilt during residency with having money at last that you'll probably want to rent a decent place during fellowship.

 

[Weil-Felix]

Is it better to select a residency based on location versus quality. I have read wthat many people believe Utah is one of the best programs and it happens to be one of the locations on my list. However, I have also considered Boston, Oregon, Washington, Utah, and Colorado. There are two programs in Colorado, one in Denver and one in Colorado Springs, has anyone been to the Colorado Springs location? Does anyone have any input as to quality of programs at the other locations?

To me the benefit of training at a University and research based clinic is that the technology and methodologies are generally far more advanced than most community practices. On the other hand, I don't know enough about Path to say that technology really has a huge role since we need to look at slides anyway.

H

Yes, I know tons about the Colorado Springs progam. There was a very recent thread which you should read called Community based pathology programs. It was started a couple of days ago, so it should still be easy to find. As far as technology, our program a lot of diagnostic modalities available at our fingertips including flow, cytogentics, FISH. That's fairly unusual for a community hospital to have all those things.


I assume you're joking about the whole living in your car idea! By the way, you will have plenty of free time during residency. Location will probably matter at least a little to you unless you are a couch potato that just sits and watches TV all evening. But obviously, it's not the only consideration for most people.

 

[Herpeto]

I'll check out the thread on Community hospitals to get a better idea of Colorado Springs, thanks. As far as doing a fellowship in a different location than where I did my residency it presents a conundrum. If I like the place where I did my residency and my wife and I would like to stay there then I would rather leave for a year while my wife stays there so we don't have to move twice. And even though I will be making money while in residency and my wife makes great money, I would rather spend the money on paying off my student loan and home if I have one before having to rent an additonal place where I am doing a fellowship. Do employers offer to pay off student loans or a portion of them to hire you or is the field not that competitive? If I have some free time during residency then I definitely want to be somewhere that I can hike, mountain bike, etc..

What do you guys think about the programs in Massachusetts compared to Utah or Oregon? Is Mass General the best one in Massachusetts?

 

[deschutes]

I hear you about moving for fellowship.

If you have a vague idea of what you want to do eventually, then you might want to apply to those places that have fellowships in that area if you haven't already.

I honestly can't say about employers offering help with student loans! When I moved for residency I got an Employee Relocation Assistance Packet. It talked about reimbursement of relocation costs for faculty/staff, but somehow I don't think residents or fellows are eligible for this.

As for the eternal question of "which program is the best"...

I won't answer your question directly - we all have our loyalties so it is difficult for various reasons to publicly criticize any institution on an Internet forum 🙂

Obviously there is going to be some competition to this claim. "Best" really is how you define it. Certainly the big name programs will give you incredible exposure and anyone would be over the moon to receive an interview invitation from them! But that does not necessarily mean that you won't find a program you really like somewhere else.

 

[b&ierstiefel]

What do you guys think about the programs in Massachusetts compared to Utah or Oregon? Is Mass General the best one in Massachusetts?

Although I am biased towards my own program, I give the edge to MGH as to the best program in Massachusetts.

MGH and BWH are continuing to change and remain strong. At both programs the specimen load has been steadily increasing. At both programs, the complexity of the cases have also been increasing. Both programs have remarkable faculty in various areas. Diagnostically, though, I still give the edge to MGH.

I've heard that Colvin is stepping down at MGH (is this really true?) and that Louis might be taking over. He has already started to increase the focus on basic science research emphasis and this will only get better if he takes over.

Some people here have told me that the personalities of the two programs may differ. Personally, I loved MGH and BWH when I interviewed at both programs. MGH is a fabulous program.

 

[yaah]

It's best to select a residency program based on the best fit for you. If that's location, so be it. If you are a good resident you will succeed almost anywhere. Do not pick a program just because of reputation if you didn't like it or get a good feeling on your interview day.

 

[Pingu]

Do not pick a program just because of reputation if you didn't like it or get a good feeling on your interview day

The converse to this is true also: if you have a bad feeling, you should probably pay attention to it, unless you are someone who sees doom around every corner or you have just eaten bad sushi, in which case it is just you. But you should be in tune with yourself while interviewing, if something feels awkward or weird, there may be something the program isn't sharing

 

[Herpeto]

How is a private practice set up? Is the practice open seven days a week? Do you sign a multi-year contract or is the first year just to see if you fit into the practice? Is pay negotiated every year?

Also, how prepared did you feel when you were starting residency? Did you know many of the stains and procedures? How about identification of diseases?

 

[b&ierstiefel]

Also, how prepared did you feel when you were starting residency? Did you know many of the stains and procedures? How about identification of diseases?

I knew little to nothing. I didn't even prepare during the few months before residency started...I was doing a postdoc during the 4th year of med school.

The learning curve is steep when residency starts. You can't help but learn things.

 

[cytoborg]

Is it better to select a residency based on location versus quality. I have read wthat many people believe Utah is one of the best programs and it happens to be one of the locations on my list. However, I have also considered Boston, Oregon, Washington, Utah, and Colorado. There are two programs in Colorado, one in Denver and one in Colorado Springs, has anyone been to the Colorado Springs location? Does anyone have any input as to quality of programs at the other locations?

To me the benefit of training at a University and research based clinic is that the technology and methodologies are generally far more advanced than most community practices. On the other hand, I don't know enough about Path to say that technology really has a huge role since we need to look at slides anyway.

H

Hopefully "quality" and location aren't mutually exclusive attributes in a program! There are some fantastic programs out there in fabulous locations (of course those tend to be the most competetive programs obviously). You will have to balance a number of factors when looking for the best overall package that suits you. Location was important to me as I've learned it makes a big difference in my quality of life and overall happiness. It also can help to do residency in the geographic location you hope to practice in, since you make regional connections. But I certainly wouldn't want to be at a weak program just for the sake of being in a particular geographic area. You will have to find the balance that works for you.

I can't speak for the "quality" of most programs you mentioned. I did interview at OHSU and was quite impressed with their program. They seem to offer excellent preparation for a career in private practice pathology. Portland is also a beautiful, affordable city.

 

[cytoborg]

Also, how prepared did you feel when you were starting residency? Did you know many of the stains and procedures? How about identification of diseases?

Most people know next to nothing when starting. It's tough, but it's expected.