New vs old residency for community job placement

[Forgotmypwtwice]

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So obviously with a older residency you have a larger alumni network, but if both of these places do not put any alumni in certain community area that I want to move to, does it matter on the residency? I really like the new program since it seems like it will be a solid EM residency in 5-10 years and where I'll be the happiest, but I'm worried about not getting community jobs after I am done with residency.

FWIW this is all southeast

 

[miacomet]

Do you want to work in a competitive area (Portland, Jackson Hole, Bozeman, Salt Lake City, Austin, Denver)? If not, it's probably not a big deal. If yes, it would be helpful to attend a residency with connections to those areas.

 

[Forgotmypwtwice]

Do you want to work in a competitive area (Portland, Jackson Hole, Bozeman, Salt Lake City, Austin, Denver)? If not, it's probably not a big deal. If yes, it would be helpful to attend a residency with connections to those areas.

Nope, small cities in the southeast that don't really have any EM residency near by (2hrs to 3hrs away). I'm just trying to make sure I'm not screwing my self with this new residency since it is unknown and most the of the grads stayed near the area.

 

[miacomet]

Nope, small cities in the southeast that don't really have any EM residency near by (2hrs to 3hrs away). I'm just trying to make sure I'm not screwing my self with this new residency since it is unknown and most the of the grads stayed near the area.

No offense to small cities in the southeast, but unless we are talking Raleigh-Durham or some other popular area, you will be FINE. A new residency might be awesome- they will be enthusiastic about their first few classes and you will get to help shape the residency.

 

[DeadCactus]

Alumni networks and strong program reputations can be helpful but it's only a smart part of the puzzle. Networking is still something you do more than something magically bestowed upon you by a program.

 

[gamerEMdoc]

Do you want to work in a competitive area (Portland, Jackson Hole, Bozeman, Salt Lake City, Austin, Denver)?

Honestly, even then its not impossible to get a decent job. One of our chiefs got a job in Austin, Tx this year. Not a CMG job either. She isn't from Texas and we've have only 1-2 past grads in the entire state (most of our grads are in the northeast, although we have a sizable chunk out west as well).

 

[miacomet]

Honestly, even then its not impossible to get a decent job. One of our chiefs got a job in Austin, Tx this year. Not a CMG job either. She isn't from Texas and we've have only 1-2 past grads in the entire state (most of our grads are in the northeast, although we have a sizable chunk out west as well).

Agreed. But it helps so have some kind of connection.

 

[gamerEMdoc]

True. That's basically the case with every occupation.

 

[Forgotmypwtwice]

True. That's basically the case with every occupation.

Another quick question, what is the viewpoint on the newer ER residencies? Is there any worry that recent grads may not be trained as well?

Thanks to all responses, my 1 and 2 are bugging me.

 

[miacomet]

Another quick question, what is the viewpoint on the newer ER residencies? Is there any worry that recent grads may not be trained as well?

Thanks to all responses, my 1 and 2 are bugging me.

If it's CMG, avoid. Otherwise, site-specific.

 

[EctopicFetus]

I think it depends on the faculty there and who they know. Thats more powerful than an alumni network. If the faculty at that site is all from one residency then it might be tough as in general they will all know the same people. I am faculty in a newish residency and our docs have incredible connections all across the US.

Last year we had people go to texas, ohio, SC, Maine, California, georgia etc. One of the docs got a job offer in Arizona but turned it down. The jobs were all connection based as our faculty has an incredibly wide reach due to involvement in EM.

 

[Groove]

So obviously with a older residency you have a larger alumni network, but if both of these places do not put any alumni in certain community area that I want to move to, does it matter on the residency? I really like the new program since it seems like it will be a solid EM residency in 5-10 years and where I'll be the happiest, but I'm worried about not getting community jobs after I am done with residency.

FWIW this is all southeast

Dude, I work in the SE. Nobody cares unless you're trying to break into a saturated market where one of your attendings might know someone. Rarely does this happen and not in the way you think. Most of the time it's saving you some legwork by handing you a contact to a group you wouldn't have known about otherwise unless you did some research in a particular area. If it's a coveted position, chances are it's gonna cost ya to become part of it. Sure, if you're trying to move to Asheville after residency then some contacts might help, but why would you move there right out of residency and work for half the pay? Find a decent CMG out of residency and work a few years to pay off your loans with no sweat equity and no anxiety. Those of us in admin hiring for a CMG don't care who you know. We care if you're ABEM BE/BC, and if you have a good attitude (translation....aren't going to generate complaints from admin, patients or nursing). Can you play nice with others. That's it. Notice I didn't say "well trained". Why? Because if you're graduating from an RRC approved residency program, I already know you're well trained. I don't care who you know, or who you rubbed elbows with in residency or who you did a research project with or any of that business. People like to think they have "connections" that make or break opportunities and it always makes me chuckle. You're talking about a specialty where we still can't generate enough docs to fill the need. Jobs are everywhere. You're going to have so many people begging you to come work for them after residency, throwing sign on bonuses and loan repayment money in your face. Don't fall for the group that tells you how lucky you are to have them consider you and that they might be willing to take you on as long as you're willing to sign on the sweat equity line and work all nights for the next couple of years.

Whatever you do, don't pick a residency program based on connections. That's ridiculous. Pick the one that speaks to you and that you feel will give you the best training and where you will enjoy living for the next 3-4 years. Everything else will be fine. I graduated from a Southern program and I traveled to ACEP my graduating year and walked down to the job fair floor. I had two offers from CO, two from NC (one from Asheville), one from MS, one from TN. Basically, I had an offer from everyone I talked to there at the event and anyone else I taked to when I got home. Some were CMG, others SDG. I had zero connections. Nobody cared. Nobody asked who I knew.

 

[r-e-l-a-x]

^ this makes me feel good

 

[TheComebacKid]

I don't know.

I've heard that certain markets i.e. Denver, Portland, Salt Lake City etc are VERY hard to break into coming from an outside place. Sure, you could be very accomplished, easy to work with and a good fit coming from some far off residency, or you could be very accomplished, easy to work and a good fit coming from Denver Health where one of the faculty members vouches for you. In a tight market, if you are an employer and have one job opening, who are you going to take? The Denver Health person, no?

 

[Groove]

I don't know.

I've heard that certain markets i.e. Denver, Portland, Salt Lake City etc are VERY hard to break into coming from an outside place. Sure, you could be very accomplished, easy to work with and a good fit coming from some far off residency, or you could be very accomplished, easy to work and a good fit coming from Denver Health where one of the faculty members vouches for you. In a tight market, if you are an employer and have one job opening, who are you going to take? The Denver Health person, no?

It's all relative. In my above example, both my CO offers were from Denver and I forgot about one in Pueblo. I wasn't interested in any of them in the end due to the level of sweat equity. (50% loss of income for 2-3 years, and I had huge loans at the time) Pueblo paid the best from what I remember but I didn't have any interest in living down there. All of them were SDG and have since sold out to a CMG.

I guess if you really want to break into a completely sh**ty market out of residency where people are clamoring for jobs that pay 50% of what most EPs make elsewhere, then sure... a connection or two might help. But why? If I was that hell bent on living near a ski town, I'd build my house right up against the slopes and do locums making real money. So many other aspects of a residency program take precedence over something as ephemeral and nebulous as "good connections". Go some place you'll be happy for 3-4 years. Everything will work out just fine. Especially here in the SE where jobs abound. I can't speak for NYC or some of these other places.

If we're speaking about Denver though...you don't need any connections if it's USACS. They freely admit that most of their new hires are all residents willing to work for pennies. They'll hire anybody in a heart beat for that $150/hr and the lucky doc can move into suburbia and start living their CO dream while paying off those loans on the 50 year plan.

 

[TheComebacKid]

It's all relative. In my above example, both my CO offers were from Denver and I forgot about one in Pueblo. I wasn't interested in any of them in the end due to the level of sweat equity. (50% loss of income for 2-3 years, and I had huge loans at the time) Pueblo paid the best from what I remember but I didn't have any interest in living down there. All of them were SDG and have since sold out to a CMG.

I guess if you really want to break into a completely sh**ty market out of residency where people are clamoring for jobs that pay 50% of what most EPs make elsewhere, then sure... a connection or two might help. But why? If I was that hell bent on living near a ski town, I'd build my house right up against the slopes and do locums making real money. So many other aspects of a residency program take precedence over something as ephemeral and nebulous as "good connections". Go some place you'll be happy for 3-4 years. Everything will work out just fine. Especially here in the SE where jobs abound. I can't speak for NYC or some of these other places.

If we're speaking about Denver though...you don't need any connections if it's USACS. They freely admit that most of their new hires are all residents willing to work for pennies. They'll hire anybody in a heart beat for that $150/hr and the lucky doc can move into suburbia and start living their CO dream while paying off those loans on the 50 year plan.

Interesting. I can say for sure that USACS is not at the top of my list as a potential employer, thank god.

Just out of curiosity (you may or may not have much experience when it comes to this) what about academics? Most of your comments seem very much directed to community EM. Lets say you are interested in academics AND want to live in Denver. Given how inbred these academic programs are, and how competitive academic jobs seem to be in desirable markets, it seems like you would have an edge if you trained at that program because you are a known entity, right?

Asking for a friend.

 

[Brigade4Radiant]

Of you can live wherever you want and fly out and do locums work less and make more money.

 

[miacomet]

It's all relative. In my above example, both my CO offers were from Denver and I forgot about one in Pueblo. I wasn't interested in any of them in the end due to the level of sweat equity. (50% loss of income for 2-3 years, and I had huge loans at the time) Pueblo paid the best from what I remember but I didn't have any interest in living down there. All of them were SDG and have since sold out to a CMG.

I guess if you really want to break into a completely sh**ty market out of residency where people are clamoring for jobs that pay 50% of what most EPs make elsewhere, then sure... a connection or two might help. But why? If I was that hell bent on living near a ski town, I'd build my house right up against the slopes and do locums making real money. So many other aspects of a residency program take precedence over something as ephemeral and nebulous as "good connections". Go some place you'll be happy for 3-4 years. Everything will work out just fine. Especially here in the SE where jobs abound. I can't speak for NYC or some of these other places.

If we're speaking about Denver though...you don't need any connections if it's USACS. They freely admit that most of their new hires are all residents willing to work for pennies. They'll hire anybody in a heart beat for that $150/hr and the lucky doc can move into suburbia and start living their CO dream while paying off those loans on the 50 year plan.

1. Denver is not a ski town
2. Denver is not a ski town
3. There are jobs (I won't say plenty) paying $200 an hour on up in ski areas in the West.
4. It would help if you had a connection for such jobs
5. Many of these jobs pay more than some locums gigs. Locums is not paying so well right now.
6. Being in academics in Denver (which is not a ski town) is going to make for a tough, poorly remunerated life. May or may not be worth it to you.
7. Do not live in Denver if skiing is your passion. It is not a ski town.
8. None of this is relevant for the OP who wants to live in the SE, which is neither competitive nor a ski area.

 

[Groove]

1. Denver is not a ski town
2. Denver is not a ski town
3. There are jobs (I won't say plenty) paying $200 an hour on up in ski areas in the West.
4. It would help if you had a connection for such jobs
5. Many of these jobs pay more than some locums gigs. Locums is not paying so well right now.
6. Being in academics in Denver (which is not a ski town) is going to make for a tough, poorly remunerated life. May or may not be worth it to you.
7. Do not live in Denver if skiing is your passion. It is not a ski town.
8. None of this is relevant for the OP who wants to live in the SE, which is neither competitive nor a ski area.

I know, I know... I was talking about Denver and then more or less got off on a tangent with what I would do if I wanted to work in a "difficult" CO market. In my case, it would be a ski town. I'd fly and do locums for a week, then fly into DEN and drive 1.5 hours to my house.