Hello Everyone,
I have been a passive reader of the forums here for some time, and occasionally benefited from the discussion. (Although, there has been the occasional dumpster fire which was entertaining to watch) I am writing today to solicit some advice. I feel trapped in my current residency program, and I'm not happy with the overall trajectory. I soaped into a community internal medicine program, which trains almost exclusively hospitalists. I'm not sure whether this hospitalist training is intended, or perhaps because of the low match rate for fellowships. (10-15%, including residents rejected from "easy fellowships" like ID and nephro) My main concern is that I don't feel like this will not help me achieve my long term career goals. All of the attendings are private practice and have no long-term interest in teaching residents. Most rotations are primarily note-mills, as many of the attendings have fired their former NP/PA, and clamor to have residents on service to maximize their billing. There is no research infrastructure, and research funding is abysmally low. However since coronavirus, there is no ($0.00) research funding available for residents. Of the >50 residents in the training program, only 2 attended a research conference last year. I feel that a lot of my Co residents have given up, or don't appreciate the gravity of the situation. About half of the residents are FMG, who are just grateful to have matched and did not rotate at academic hospitals. When we do have frank conversations about the difficulties of fellowship match and the training at our program, the end result is usually “yeah, but what can we do about it?”
There is no specialty advising, and PD is of little help. I am not sure if the PD is oblivious, or pretends to be oblivious and actually doesn’t care. Last year, for example, we had a resident not match to fellowship despite having “11 first author publications.” I later looked into this and found this individual had published 11 case reports… I am not sure whether the resident thought this was a good idea, or if the individual was advised to do so by someone who believed case reports would count as research.
I would really like to transfer to an academic IM program, but those prospects seem far and few between. Alternatively, it may be an option to try for a nonaccredited fellowship after residency, and apply to accredited programs afterwards. I have been doing what I can, working on retrospective chart reviews to try to publish what is within my means, learning as much as I can, studying nightly.
TLDR: I am grateful to have matched, but I am 1 year in and have serious concerns. Community program with poor fellowship prospects, low board pass rates, >75% of residents soaped, no research, no name recognition.
I have been a passive reader of the forums here for some time, and occasionally benefited from the discussion. (Although, there has been the occasional dumpster fire which was entertaining to watch) I am writing today to solicit some advice. I feel trapped in my current residency program, and I'm not happy with the overall trajectory. I soaped into a community internal medicine program, which trains almost exclusively hospitalists. I'm not sure whether this hospitalist training is intended, or perhaps because of the low match rate for fellowships. (10-15%, including residents rejected from "easy fellowships" like ID and nephro) My main concern is that I don't feel like this will not help me achieve my long term career goals. All of the attendings are private practice and have no long-term interest in teaching residents. Most rotations are primarily note-mills, as many of the attendings have fired their former NP/PA, and clamor to have residents on service to maximize their billing. There is no research infrastructure, and research funding is abysmally low. However since coronavirus, there is no ($0.00) research funding available for residents. Of the >50 residents in the training program, only 2 attended a research conference last year. I feel that a lot of my Co residents have given up, or don't appreciate the gravity of the situation. About half of the residents are FMG, who are just grateful to have matched and did not rotate at academic hospitals. When we do have frank conversations about the difficulties of fellowship match and the training at our program, the end result is usually “yeah, but what can we do about it?”
There is no specialty advising, and PD is of little help. I am not sure if the PD is oblivious, or pretends to be oblivious and actually doesn’t care. Last year, for example, we had a resident not match to fellowship despite having “11 first author publications.” I later looked into this and found this individual had published 11 case reports… I am not sure whether the resident thought this was a good idea, or if the individual was advised to do so by someone who believed case reports would count as research.
I would really like to transfer to an academic IM program, but those prospects seem far and few between. Alternatively, it may be an option to try for a nonaccredited fellowship after residency, and apply to accredited programs afterwards. I have been doing what I can, working on retrospective chart reviews to try to publish what is within my means, learning as much as I can, studying nightly.
TLDR: I am grateful to have matched, but I am 1 year in and have serious concerns. Community program with poor fellowship prospects, low board pass rates, >75% of residents soaped, no research, no name recognition.
