I am interested in a residency that is new, only 2 years old, no graduated class yet. I want to double check that it is going through the appropriate motions to be accredited and wont close in the middle of my training. ACGME website says it has initial accreditation. what does that mean? Are there any other things that I should take into account with a new residency?
new residency
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You would think the ACGME would make this easy to understand. They don't.
First, the chance of the program closing in the middle of your residency is slim. Programs have to be really bad, for years on end, with multiple attempts to improve, before they get closed. Or, their funding completely collapses. Both of these are unlikely.
All new programs are on "Initial Accreditation" for 2 years. They have a full site visit before they are allowed to open at all, and then after 2 years have another full site visit. The ACGME wants to make sure that they are doing what they said they would do. If there are areas of deficiency, the ACGME will let them fix them. They will change to "Full Accreditation" or "Probation" depending on their site visit, with the former much more likely -- before being put on probation, they would be given several rounds of warnings (unless they were doing something completely horrible).
"Full Accreditation" is an old term, and is being phased out.
So, for a new program, from my vantage:
Pluses:
1. The institution recently had no residents. Hence, they are used to doing everything themselves. Therefore, you're unlikely to be dumped on.
2. The faculty chosen to run the program are probably really invested.
3. Because they didn't have a program prior, they can build anything they want. They are not stuck with "this is the way it's always been done".
Minuses:
1. They are building as they go. What will your PGY-3 be like? No one knows, because no one has done it yet.
2. Will their grads pass the boards? Unknown.
3. Could the whole thing implode? Honestly, it's unlikely. The biggest worry would be the institution pulling the financial plug, not the ACGME.
4. Jobs, fellowships ... all an unknown. But probably will be fine.
First, the chance of the program closing in the middle of your residency is slim. Programs have to be really bad, for years on end, with multiple attempts to improve, before they get closed. Or, their funding completely collapses. Both of these are unlikely.
All new programs are on "Initial Accreditation" for 2 years. They have a full site visit before they are allowed to open at all, and then after 2 years have another full site visit. The ACGME wants to make sure that they are doing what they said they would do. If there are areas of deficiency, the ACGME will let them fix them. They will change to "Full Accreditation" or "Probation" depending on their site visit, with the former much more likely -- before being put on probation, they would be given several rounds of warnings (unless they were doing something completely horrible).
"Full Accreditation" is an old term, and is being phased out.
So, for a new program, from my vantage:
Pluses:
1. The institution recently had no residents. Hence, they are used to doing everything themselves. Therefore, you're unlikely to be dumped on.
2. The faculty chosen to run the program are probably really invested.
3. Because they didn't have a program prior, they can build anything they want. They are not stuck with "this is the way it's always been done".
Minuses:
1. They are building as they go. What will your PGY-3 be like? No one knows, because no one has done it yet.
2. Will their grads pass the boards? Unknown.
3. Could the whole thing implode? Honestly, it's unlikely. The biggest worry would be the institution pulling the financial plug, not the ACGME.
4. Jobs, fellowships ... all an unknown. But probably will be fine.
Thank you for the insight @aProgDirector
I had a similar question. I've interviewed at a location where I would be the first incoming class in there residency. Brand new program. It's a community hospital with excellent faculty from great institutions. I loved the experience and discussions with the PD and aPD during my visit. I know many variables go in to making a comparison between different programs but wanted your opinion.
Comparing the above type of program with another community hospital that has been well established in a major city like LA or NY for a 15+ that has average board pass rates, less then average fellowship matches in the past few years (2 or 3 out of 20), lots of workload and immense pathology but residents dont get treated that well and are "dumped" on. Faculty isn't that great and residents are not too cheery. And the new community hospital program is in a much smaller city, the size of the hospital is smaller but extremely enthusiastic faculty with excellent backgrounds ready to teach and great personalities.
I'm having a difficult time to choose when it comes to ranking. I've had many interviews in larger city community hospitals and I think I would learn a lot more due to the sheer volume and pathology but I got a really good feeling from the new program and really loved there academic background and enthusiasm.
I want to be a great internist and I do want to pursue a fellowship post-residency. Which do you think would afford me the best opportunities?
I had a similar question. I've interviewed at a location where I would be the first incoming class in there residency. Brand new program. It's a community hospital with excellent faculty from great institutions. I loved the experience and discussions with the PD and aPD during my visit. I know many variables go in to making a comparison between different programs but wanted your opinion.
Comparing the above type of program with another community hospital that has been well established in a major city like LA or NY for a 15+ that has average board pass rates, less then average fellowship matches in the past few years (2 or 3 out of 20), lots of workload and immense pathology but residents dont get treated that well and are "dumped" on. Faculty isn't that great and residents are not too cheery. And the new community hospital program is in a much smaller city, the size of the hospital is smaller but extremely enthusiastic faculty with excellent backgrounds ready to teach and great personalities.
I'm having a difficult time to choose when it comes to ranking. I've had many interviews in larger city community hospitals and I think I would learn a lot more due to the sheer volume and pathology but I got a really good feeling from the new program and really loved there academic background and enthusiasm.
I want to be a great internist and I do want to pursue a fellowship post-residency. Which do you think would afford me the best opportunities?
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I think it depends on what kind of fellowship you are looking for. Nephrology and ID are easy to get. GI and Cardiology are much more difficult. The others are in the middle. Getting a fellowship from a new program that is community based without their own in house fellowships will be a challenge.
That said, the most important thing is that you thrive. If you're miserable in your residency program, your chances of getting a fellowship aren't great.
That said, the most important thing is that you thrive. If you're miserable in your residency program, your chances of getting a fellowship aren't great.
