Need Some Residency Advice

[PsychApplicant90]

Hi,

I am a longtime member but am posting this anonymously. I'm applying psych this season and am looking for some advice. Here's my situation. I am a non-traditional student (w/partner and children) originally from the East Coast but have been living in the MIdwest for ~10 years. I have gotten to know the program director at my home institution very well (in both a professional and personal context) over the past 2-3 years and he has told me in no uncertain terms on several occasions that if I want to stay here, I can. I applied to my home program and ~15 others which has yielded me 10 interviews; all programs I am actually interested in.

I think if I were single I probably would stay because I know the program well and find it to be generally pretty great, BUT....there are several factors which are drawing me back east. 1) Our parents are aging and we would like to be nearer to them (for us and our childrens' sake), 2) the educational opportunities for our children are objectively better on the east coast, 3) We miss the ocean, 4) We miss the culture of intellectualism in which we grew up.

I have options to rank Dartmouth, Brown, UVM, Maine Medical Center, Beth Israel, B&W, U Mass, University of Rochester, and BU. I have a few more interviews, but from what I have seen so far, I really like the program in Maine the best for several reasons. It just "feels right" and has pretty much everything I am looking for in a training program (I probably will not be doing a fellowship (maybe child, which Maine has) and am not interested in being a research/academic big shot). Maine Med is big enough and isolated enough from other healthcare systems that I think I would be getting great exposure to all kinds of pathology. I got such a great impression about the place during my interview: the residents, attendings, Portland, everything. Pretty much the only downside I can see is that Portland is not very racially diverse. The fact that it's a smaller program (5) is fine with me as none of the rotations are resident dependent (was told on interview day that last year 2 residents were both out on maternity leave at the same time and the other residents did not experience a significant increase in their schedules).

My home PD is pushing so hard for me to stay, and while I know he will be supportive of whatever decision I make, his response to Maine was "meh." That said, I feel like people at big academic programs are probably biased toward big academic programs.

My question is: would I be making a bad decision to choose a community program like Maine (it's actually kind of a hybrid with Tufts) over some more prestigious academic programs?

Thanks!

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[wolfvgang22]

No, you wouldn't necessarily be making a bad decision. This is a very personal decision and what you want isnt necessarily what others might desire, including your program director. I don't know what your career aspirations are in the long term, and you have to weigh the opportunities against each other and against your personal life. That said, psychiatry is probably one of the most flexible specialties in that location won't necessarily bar you from whatever career you desire if you are willing to move later.

 

[OldPsychDoc]

Go with your gut.

 

[dassie]

Hi,

I am a longtime member but am posting this anonymously. I'm applying psych this season and am looking for some advice. Here's my situation. I am a non-traditional student (w/partner and children) originally from the East Coast but have been living in the Mountain West for ~10 years. I have gotten to know the program director at my home institution very well (in both a professional and personal context) over the past 2-3 years and he has told me in no uncertain terms on several occasions that if I want to stay here, I can. I applied to my home program and ~15 others which has yielded me 10 interviews; all programs I am actually interested in.

I think if I were single I probably would stay because I know the program well and find it to be generally pretty great, BUT....there are several factors which are drawing me back east. 1) Our parents are aging and we would like to be nearer to them (for us and our childrens' sake), 2) the educational opportunities for our children are objectively better on the east coast, 3) We miss the ocean, 4) We miss the culture of intellectualism in which we grew up.

I have options to rank Dartmouth, Brown, UVM, Maine Medical Center, Beth Israel, B&W, U Mass, University of Rochester, and BU. I have a few more interviews, but from what I have seen so far, I really like the program in Maine the best for several reasons. It just "feels right" and has pretty much everything I am looking for in a training program (I probably will not be doing a fellowship (maybe child, which Maine has) and am not interested in being a research/academic big shot). Maine Med is big enough and isolated enough from other healthcare systems that I think I would be getting great exposure to all kinds of pathology. I got such a great impression about the place during my interview: the residents, attendings, Portland, everything. Pretty much the only downside I can see is that Portland is not very racially diverse. The fact that it's a smaller program (5) is fine with me as none of the rotations are resident dependent (was told on interview day that last year 2 residents were both out on maternity leave at the same time and the other residents did not experience a significant increase in their schedules).

My home PD is pushing so hard for me to stay, and while I know he will be supportive of whatever decision I make, his response to Maine was "meh." That said, I feel like people at big academic programs are probably biased toward big academic programs.

My question is: would I be making a bad decision to choose a community program like Maine (it's actually kind of a hybrid with Tufts) over some more prestigious academic programs?

Thanks!

1) the sense I’ve gotten from my attendings is that unless you want to be an Academic Physician - as in, a big name researcher or a tenure track professor, not just an attending at an academic institution - or want to market yourself for fancy cash only practice to millionaires, the name brand doesn’t matter a whole lot.

2) MMC does have a tufts affiliation. You get the .edu email address, med students, etc.

3) Portland is definitely not the most racially diverse, but does have a sizable Somali community. Plus, tons of people come from rural Maine, off the coast, on tiny islands etc. it also seems super LGBT friendly at least in the city. lots of ways to think about diversity aside from the lens of race. since you do have the tufts affiliation, it may be possible to do an away rotation in Boston, if you really want that as a part of your training.

4) your home PD ultimately wouldn’t want an unhappy resident (neither would your coresidents for that matter). Your family wouldn’t want an unhappy resident. Go with what you think will be the best for you.

If you want to know more about the city dm me! (Didn’t train there but have family there & visit a lot)

 

[PsychApplicant90]

Thanks for all the input so far. And just to clarify, I don’t want to give the impression that I would be unhappy at my home program, I’m just getting the feeling that the Maine program might be a little better fit, and feels like a good spot for my family.

 

[Crayola227]

I'm not in psych, but go with your gut. I didn't, and I was so, so wrong.

 

[PsychApplicant90]

I'm not in psych, but go with your gut. I didn't, and I was so, so wrong.

I'm sorry to hear that things are/were not what you expected/wanted, but I appreciate your advice and perspective. Part of me feels that it is pretty hard to accurately predict what a residency will actually be/feel

 

[Sushirolls]

Make your rank list in order of your preference. This old recommendation still applies. Put them in order how you want and let the chips lie where they may. The entire residency match process is filled with political good intentions. Some people do have true connections that can pay off to an expected match, but at the end of the day every PD is going to do their best to get some one who will work hard, not rock the boat, be teachable, dependable, and give them good PRITE scores so they can gloat to their other PD peers.

When the match results come out, and if you match at a different program, simply follow up with an abbreviated version and say, "hey, I just had to be closer to family. The family factor was stronger than my personal career aspirations to be here. Sorry PD." Any PD worth their salt won't be disappointed and will chalk it up to just another Match cycle.

Conversely, your home PD will just as easily offer a sure thing ranking to another candidate they believe are better than you regardless of personal connections. They wouldn't be doing their job if they didn't facilitate the broadest, deepest recruitment efforts for their program.

Let the Match do what its designed to.