Need some input/advice patient load

[WhatUpDoc!]

---

Members do not see this ad.

So I'll be finishing up the interview season next week (whew, so glad my ears can take a rest from the barrage of altitude changes, but will miss soft hotel beds 🙁 ) and now I'm having second thoughts on an issue that I didn't think would be a problem for me. Before I started this whole ordeal, I was fairly sold on the idea of attending a program where residents felt that the caseload was appropriate and still believed they had the opportunity to read about their patients. This was the atmosphere that I grew accustomed to during my clinical years and I guess I'm more comfortable with the familiar. BUT now, I've interviewed at a few programs where the residents blatantly said that they have no time to read (and are not expected to) and carry a ridiculous number of patients. Only problem is, everybody at aforementioned programs seemed perfectly happy and even had convincing arguments that high volume training is the only way to go. So now I'm torn between whether I should stray away from my comfort zone or stick with what I know (smaller, community-based programs).

A few advantages I see (with disadvantages obviously being the opposite of each category):

High volume program - More pathology, more learning experiences, greater breadth of knowledge when practicing in real world
Lower (not low) volume program - Less stressful, more time to read, more time for teaching and other didactic activities

So can anyone offer some words of wisdom in regards to using patient volume as a criteria for residency selection? I'm knocking out my ROL before New Year's (on paper anyways)!

 

[BigNavyPedsGuy]

So, my home program typically has a more manageable case load with time to read, but during our internship we spend two months at a hospital that is almost overwhelmed with patients and you barely have enough time to get work done, let alone learn.

There are pros and cons to both. Unfortunately, all I can say is go where you think you'd be happy, whether it be swamped or not. I personally didn't like the kid factory jsut because it's the only time in any level of my training that I really felt like patients=work and not people. I would've burned out there, but that was as much the culture of the program as anything.

Go where you see yourself fitting in.

 

[CrazyPeds527]

There are definitely larger, academic-based programs where the volume is well balanced with time to read and learn, although maybe less than some community based programs.

I agree with BigNavy; in addition to happiness, this all comes down to style - think back over the last 4 years (and before) and think about how you have learned best. Each program will try to sell you on their style (our recruitment is no different), but in the end, it's all about how you feel you learn best. If you feel most comfortable training in a place where you can read a fair amount, go for it. If you are more of a kinesthetic learner and learn by doing/seeing, maybe a higher volume place is for you.

Also dont be afraid to change your first rank order list; I did and it worked out well for me (don't do it 3 minutes before deadline though - recipe for second guessing disaster!)

 

[generic]

I'd say there should be enough programs out there that are either in the middle of the road with respect to this, or that offer training at 2 or more hospitals that can give you both kinds of flavors (like mine).

The other, far more important, bit of advice I have for you is to buy a new mattress. I definitely would not miss hotel beds after a long month on the road interviewing...haha

 

[.edu-MD]

Only problem is, everybody at aforementioned programs seemed perfectly happy and even had convincing arguments that high volume training is the only way to go.

I think people tend to get used to their situation and grow to accept it. Once you're immersed in the culture of the residency it's probably difficult to compare to other places, especially since any previous experience would have been fairly minimal (during med school). They also may not know there are alternatives if they stayed at the same place and only interviewed at similar types of programs.

 

[WhatUpDoc!]

Thanks for the responses guys. Glad I have a few months to sort this issue out, but it appears that getting a new mattress will be the more pressing task at hand