magnolia014 said:
How much does it matter for med-peds to go to a program that has a separate children's hospital? Also, is it generally better to interview later in January than, say, in November - does it really make much of a difference?
thanks! 🙂
At a Standalone Tertiary Children's Hospital:
-Increased breadth of experience--you will see all the "zebras" because they all come to you (and this may give you a skewed perception of what's common). Our pediatric rheumatology faculty claim this is a big asset of us training at the only children's hospital in the state; they are right to an extent.
-More exposure to subspecialty procedures, new technology, treatments etc (community programs will probably not be doing pediatric open heart, or stem cell transplants; community programs may not have an advanced PICU and NICU--unlikely opportunities for ECMO, HFOV, etc--this may be more relevant if you plan on subsequent subspecialty training especially if in critical care, cardiology, or hematology.)
-More potential for trauma exposure (Peds trauma centers are not usually at community hospitals)
-Higher volume, more opportunities for procedures, higher patient acuity (and I saw all of these as advantages for myself but other applicants may not)
-Do you get delivery experience? (You may have other opportunities within the system. Our system consists of 2 level 3 NICUs (one at our children's hospital) and 2 level 2 NICUs we get delivery experience in three of the four hospitals)
-For Med-Peds requires shuttling between at least two facilities (however this may or may not be difficult--at our institution the university medical center and our children's hospital are connected by both a tunnel and an above ground enclosed walkway)
I think ultimately there is no perfect program and the challenge is to figure out the program that is the best fit with your post residency goals. I chose to go to a University based program where we cover five hospitals. Although this may sound like a nightmare I've enjoyed the diversity. Our system consists of a standalone tertiary children's hospital (active stemcell and solid organs transplant program, large pediatric CV surgery program, regional perinatal center, the state pediatric burn unit, the pediatric critical care referal center for the state, one of two pediatric trauma centers in the state); a private tertiary care center (an adult level one trauma center and the other pediatric trauma center in the state; our system's adult CV surgery and cardiology center; an adult critical care referral center, they also have a level 3 NICU and do a lot of high risk OB (so you get a lot of delivery experience), their PICU, pediatrics floor, and pediatric rehab hospital sort of are a hospital within a hospital); a county hospital (level one adult trauma center, the main burn unit for the state, the county critical care referral center, and the hub of indigent care and public health in our county, there is a small pediatric floor and a level 2 NICU (another opportunity for delivery experience); a university medical center (the university hospital of our system, a major referral center for critical care, active stem cell and solid organs transplant program); and finally a tertiary VA medical center (solid ICU and cardiology opportunities, I'm sure the VA ward experience is similar to other VAs--although my medical school didn't have a VA affiliate so I was a bit surprised as an intern). For me this system provided a good balance between university and more community hospitals. Our PICUs and NICUs at both institutions are closed but our ICUs for the most part are open and I think I got more critical care experience as an intern than I might have gotten in some programs over the course of residency. For me this was a good thing but I plan on ultimately doing critical care and had I been geared more towards outpatient Med-Peds I might not have appreciated all of these opportunities.
As far as the interview time frame I don't think it really matters. Some of my class interviewed in November, some in January and we all matched here.
