Ya. I agree that they are not created equal but I hear that the 3rd and 4th years are to get hands on experience to figure out what you want to do vs. others say pick a place with multiple residencies so you are auditioning at that base hospital pretty much for 2 years.
Yeah, which is one reason why this is the one thing I always hate about asking the question because everyone gives the same canned, generic BS answer about doing more (always in reference to being first assist in surgery) verses going to a place with programs (always in reference to the illustrious "face time" that magically gets people into any residency).
I think a lot of generalities get thrown around about what a stereotypical academic site is like vs. a place without residency programs. I think the oft-cited examble of being able to do more may or may not be true and can certainly be highly site or preceptor dependent. I can see how doing surgery without any residents around would give someone an opportunity to do more, but I question how applicable this is across the different specialties. For example, if a preceptor has his own practice with his own patients that he has a relationship with and that know him, I think it'd be less likely that patients, or even the physician, would be as willing to have you do things first-hand to have you learn. I've heard numerous stories where people
have been given a lot of first-hand experience in those circumstances, but I question if that's the exception rather than the rule.
As far as how beneficial it is to have residency programs at a rotation site, I also question that. I'm only assuming that by the timing of this and by the nature of what you've said that you're at KCOM, but I think this value getting played up seems to be a Kirksville phenomenon. By that I mean that they take people into their residency who did their rotations there and that being a KCOM graduate is almost a prerequisite to a residency at Northeast Regional. To me it seems like this thinking carries over into the impression that other places feel the same way about taking their own students. An important thing that I had to consider was that the average person often ranks more than 10 programs and what they're looking for in a residency will likely change over the course of rotations. I think a lot of people feel like if they don't get a certain rotation spot that they won't get that particular residency. Who knows. I haven't scrutinized the matchlists, but I'd be interested in seeing how many actually matched to core sites (meaning its likely they changed their mind or other options were available).
But again, I'm not going for orthopedic surgery and I'm not trying to land a radiology spot, so my thinking may be a bit skewed toward my own priorities. A lot of the "hospital-based" places also seem to put you with preceptors for rotations. One thing I do worry about with doing a preceptorship is that you may not get a well-rounded exposure to a particular field because it's more than likely that each preceptor will have his/her own little niche that they stick with. One site that I really thought gave pretty good all-around exposure was Genesys.
Anyhow, that's my thinking.
