- Joined
- Jul 11, 2003
- Messages
- 59
- Reaction score
- 0
Hi gang!!! can anyone tell me ,what are some of the disadvantages of being in a small program as compared to being in a moderate to large program? what about the no of calls?
program size
- Thread starter atropinedoc
- Start date
- Joined
- Jul 11, 2003
- Messages
- 59
- Reaction score
- 0
Hi there!!! where is everyone gone? will GP, BCMD or anyone else....... please answer my question? thanks.
- Joined
- Aug 15, 2003
- Messages
- 28,059
- Reaction score
- 438
I'm kind of wondering about this too. THis is currently part of my dilemma in figuring out how to rank programs. I currently have 3 that I really liked and was really impressed with, and am considering ranking #1 (although there are others that also impressed me a lot).
My thoughts: Big programs are somewhat more important if you are seriously contemplating an academic career, as you will make connections with people that are more well known nationally, and there will be more opportunities for research and further study. You also will see more difficult cases and consults, and be towards the forefront of trends in diagnostics, etc.
Smaller programs may generally have more of a collegial atmosphere, and more one-on-one attention. In fact, sometimes I think it might be easier to get involved in research projects at smaller places because there won't be as much competing for your attention (or the staff's attention). Small programs also tend to have to reputation of training generalists, (i.e. private practice) while larger programs can steer you more towards academics and specialty careers.
That being said, many people will end up doing a fellowship (or more) after residency, and even if you decide to go to a smaller program, if you are a smart and talented resident you can probably just go do a fellowship at Johns Hopkins, for example, and have many of the same opportunities, if not more, as someone who did their general residency there. Of course, many large prestigious programs do tend to favor people from their own training program for fellowships.
For someone like me who is interested in academics but has no specific career path beyond that in mind yet, a larger program may provide advantages, according to some pathologists I have talked to. But others have said that smaller programs may provide more of an opportunity to shine, and then be positioned for a top-notch fellowship. I have heard criticisms of some of the bigger programs in that the residents somewhat get "lost" in the shuffle and have to take more initiative on their own, and the volume is quite high so most of their day is spent doing work. Number of calls doesn't concern me that much so I haven't focused on it. As long as it isn't too malignant I will deal with it.
So, I don't know. I am still debating this with myself. I would say, however, that be careful what you mean by a "small" program. There is such a thing as too small. Pathology training does depend a lot on specimen and lab volume. A large referral-type hospital is more important.
My thoughts: Big programs are somewhat more important if you are seriously contemplating an academic career, as you will make connections with people that are more well known nationally, and there will be more opportunities for research and further study. You also will see more difficult cases and consults, and be towards the forefront of trends in diagnostics, etc.
Smaller programs may generally have more of a collegial atmosphere, and more one-on-one attention. In fact, sometimes I think it might be easier to get involved in research projects at smaller places because there won't be as much competing for your attention (or the staff's attention). Small programs also tend to have to reputation of training generalists, (i.e. private practice) while larger programs can steer you more towards academics and specialty careers.
That being said, many people will end up doing a fellowship (or more) after residency, and even if you decide to go to a smaller program, if you are a smart and talented resident you can probably just go do a fellowship at Johns Hopkins, for example, and have many of the same opportunities, if not more, as someone who did their general residency there. Of course, many large prestigious programs do tend to favor people from their own training program for fellowships.
For someone like me who is interested in academics but has no specific career path beyond that in mind yet, a larger program may provide advantages, according to some pathologists I have talked to. But others have said that smaller programs may provide more of an opportunity to shine, and then be positioned for a top-notch fellowship. I have heard criticisms of some of the bigger programs in that the residents somewhat get "lost" in the shuffle and have to take more initiative on their own, and the volume is quite high so most of their day is spent doing work. Number of calls doesn't concern me that much so I haven't focused on it. As long as it isn't too malignant I will deal with it.
So, I don't know. I am still debating this with myself. I would say, however, that be careful what you mean by a "small" program. There is such a thing as too small. Pathology training does depend a lot on specimen and lab volume. A large referral-type hospital is more important.
- Joined
- Jun 30, 2003
- Messages
- 429
- Reaction score
- 5
By size, I'm assuming you mean number of surgical specimens and/or number of residents. As far as surgical path specimen numbers go, you definately want to be at a university program that has good numbers (somewhere between 25K and 50K total is a good range) otherwise you won't get exposure to an adequate amount of cases. Of course, this also depends on the number of residents at the program; you want an adequate number of residents for the specimen load, otherwise you will get over or underworked. The best way to evaluate that is to ask the residents at that program if they feel overwhelmed with the workload or if the have to spend the day looking at study sets because there aren't enough cases to go around. Likewise, ask them if they feel they are getting enough exposure to different kinds of cases. Basically, provided the program gets enough total cases, if the caseload per resident is good, the actual size of the program is not as important (except maybe for call coverage; in that case, bigger is better!). For example, at IU we have 21 residents and our total specimen numbers, counting all five hospitals, is about 45,000/year; this works out to good exposure for all of us. Of course, I'm only talking about surgical path. You will have to look at other services as well and see how busy they are.
- Joined
- Jun 24, 2002
- Messages
- 267
- Reaction score
- 0
Hey, BCMD-
I've read about various numbers for surgical specimens felt to be ideal for a program, but, as you alluded to, doesn't a lot depend on #of specimens/resident, as opposed to total number which could either be diluted or concentrated depending on the number of residents? If that is the case, what would you consider to be a good number per resident? Thanks.
I've read about various numbers for surgical specimens felt to be ideal for a program, but, as you alluded to, doesn't a lot depend on #of specimens/resident, as opposed to total number which could either be diluted or concentrated depending on the number of residents? If that is the case, what would you consider to be a good number per resident? Thanks.
- Joined
- Jun 30, 2003
- Messages
- 429
- Reaction score
- 5
The number of specimens per resident is quite important. However, the total number of specimens an institution is very important as well. Generally, higher specimen numbers correlate with greater variety of specimens and that is the key point. You want to go to a program that sees enough of the weird and interesting specimens; every place will get plenty of routine stuff.
I'm not sure what a good number of specimens per resident is. Generally, if you are on a surg path month and are busy most of the day with signouts, grossing or whatever, you're seeing enough. If there is too much idle time, you may be getting inadequate exposure.
I'm not sure what a good number of specimens per resident is. Generally, if you are on a surg path month and are busy most of the day with signouts, grossing or whatever, you're seeing enough. If there is too much idle time, you may be getting inadequate exposure.
