Questions to consider for residency

[DrIng]

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As a result of dissatisfation about aspects of my current job I was thinking of questions you should ask before starting work somewhere and thought these might also make worthwhile thigns to consider when contemplating a residency position. So here's my list of things to consider:
* Is there someone who screens patients when you're on call (i.e. crisis team/mental health nurse/ER doctor) or do you see everyone who presents "acting funny" or saying they're suicidal?
* What is the culture of the place? Can patients be kept in emergency overnight or do they have to be seen and admitted within a couple of hours (regardless of the time)?
* What happens when you need to admit someone but all the beds are full? (i.e. do you have to go and discharge someone from the ward in the middle of the night or do they remain in emergency/medical bed etc?
* everywhere says thaty have protected time for teaching but how protected is protected- and do nursing staff buy into the culture of teaching as sacred time or do they think you can be interupted if they need you?

Anyway, just some thoughts others feel free to put there in as well.

 

[Anasazi23]

* How much support do you have on call? Is there a senior resident for backup should you need it? Are attendings available? Or are you thrown to the wolves and expected to get things right?

* How much social work do they expect you to do? Believe it or not, some places expect residents to do managed care clinical reviews, verify insurance, and come up with discharge plans and housing for patients. You should not have to do any of this as a resident. If you are doing it, they're using you as cheap labor to save on hiring more social workers.

* How much paperwork are you required to do? Is the order/note system computerized? Do you have a 17 page psychiatric assessment form that must be obsessively filled out on admission?

* Moonlighting. Is it allowed? Will you be sitting around in your fourth year playing x-box all night while studying for the boards (not necessarily a bad thing)? Or can you work 20 hrs/week and make a few extra thousand a month for that house down payment and new car?

* Vacation time. Are you assigned vacation? Can you split up the weeks? Will they force you to take your month's vacation in July so that you have nothing left for the rest of the entire year? (this happens)

 

[atsai3]

How much social work do they expect you to do? Believe it or not, some places expect residents to do managed care clinical reviews, verify insurance, and come up with discharge plans and housing for patients. You should not have to do any of this as a resident. If you are doing it, they're using you as cheap labor to save on hiring more social workers.

Just curious-- which hospitals / residency programs are the worst offenders as regards to this specifically? I had been told by one of my friends who did a month rotation at Stanford that their residents basically have no social work support at all and spend all of their time in the ED trying to take care of dispo.

-AT.

 

[alina_s]

* Figure out what the program means by "protected time" for lectures, clinic, etc. Attendings have highly variable attitudes about covering for residents when they have other obligations and continuity clinic won't sound so good if "protected time" means that you just aren't physically on the ward but your pager is going off and the work is piling up.

 

[raspberry swirl]

ooo i like this thread. if we can get some more posts, this would be a great thing for people who will be interviewing this fall (like me) to print out and take with us, so we can remember some things to ask the residents. if there is anything you wish you knew before you ranked your programs, im sure all of us 4th year students would find it helpful to hear it.

 

[whopper]

Word of warning.

I had a lot of "great" questions when I interviewed. In short, I didn't really trust any answer I got above the table. E.g questions to the Chief Resident, or to the Program director.

I was able to get some questions by residents under the table. E.g. These people were friends of mine before they entered the program. I had one person tell me they wouldn't have gone to the program they were in had they known what they knew at the time.

So my suggestion is, in addition to good questions, you need to get a good source.

 

[DrIng]

Consider family firendly-ness as well. (this is an under the table question) Find out what the programs view is likely to be if your wife/husband/kids/mum are sick. Do they take a what-the hell-are-you-doing-here? approach and tell you to go home and look after your family or do they take the approach of medicine-is-a-vocation-and-all-else-is-secondary. And it's important to find out not only the programs view but the predominant opinion among attendings...

 

[DrIng]

Another important consideration, how much 'help' is there, working with a desperate shortage of good nursing/allied staff support is not much fun- do you want to be finding accomodation for your patients?