Program size

[indieboy]

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what are the advantages and disadvantages of a large /medium /small sized program?

 

[Retinamark]

more camraderie in a big program
less on call in a big program (but when you are on call it's usually busier)

 

[Fermi]

This is a pretty broad question, and much of it has to do with your personal preferences regarding work environment. A large program means a large institution, which means you may not get to interact with and know many of your colleagues, chief residents, program directors and attendings. Large programs sometimes also means several clinical sites, which further exacerbates this problem and adds in the problem of learning multiple hospital layouts, nursing staff, computer systems, protocols, etc. I am struggling with the big program vs. small program because I'd like to really get to know all my colleagues and feel like I "belong" on staff at one or two hospitals. However, I really need a major academic program to meet my goals, and those are usually larger in size.

 

[trouta]

Less call. Thats the single biggest advantage.

Not to mention more people to interact with.

 

[lowbudget]

Big: Less call. Cross-coverage of other services varies depending on program and your responsibility. More buffer if one resident goes out (quits, gets pregnant, repeats rotation), more flexibility with switching call. More people to teach and bounce ideas. Admin may take too long to make decisions that impact a bigger number of residents. May have to share more procedures.

 

[Mike59]

Large programs tend to provide stability and certainty...At least in my field (Family Practice)

I get weary when I hear of programs that take very few residents per year and when some go unmatched, that's shaky...I wouldn't want to be at a program that has very few residents, when stuff goes wrong with administration you'll get hit hard and things can get quite unstable, there have been some horror stories out there.

 

[docB]

Big: Less call. Cross-coverage of other services varies depending on program and your responsibility. More buffer if one resident goes out (quits, gets pregnant, repeats rotation), more flexibility with switching call. More people to teach and bounce ideas. Admin may take too long to make decisions that impact a bigger number of residents. May have to share more procedures.

It is nice if there are more people to take up the slack on the pregnancy thing. It gets discouraging when you're on the hook with no one else to help and all the females can't work for a few months.