New poster here. Just looking into peds programs for the upcoming year and wanted to get an opinion.
Do you think that residencies based in children's hospitals are better? I don't even know how to elaborate on "better." More opportunities? Better continuity of care? Just overall different vibe?
I realize that programs that are not based in a children's hospital still have all the requisite components. Or things like NICU months at a nearby women's hospital. But somehow with my limited knowledge it seems that a residency based in a children's hospital would be more beneficial because, well, it's a whole hospital devoted to the munchkins.
Thanks!
Good Question! I'm a resident at a general hospital (not a Children's hospital) and we also work a decent amount at the local Children's Hospital and spend one month at another (slightly more distant) Children's Hospital.
I think there are definite Pros/Cons:
Cons:
-You're hospital isn't built for kids. This can make things like getting an MRI, interpreting lab values, working with other departments, more challenging
-Your patients will be drawn to the title "Children's Hospital". While you and your peers can provide tremendous care, you won't have that label.
-You might be limited by your exposure. Children's hospitals have volume - that's why I still had to rotate through them. Also, a smaller hospital is more likely to be absent this subspecialty or that subspecialty
-Depending on the hospital, research opportunities are often more readily available at big children's hospitals.
-Same applies to fellowship programs. You'll likely work with fellowship directors face to face at some point in time during your residency.
Pros:
-Small programs generally mean you get more teaching and attention. At my hospital after the cardiologist does an echo s/he comes to give me a verbal report: "some TR, but not what's causing the problem" at other places I've literally seen it take days to get any news on an echo
-You'll likely get more chance to think and act independently. At large Children's Hospitals, admissions go through an ER staff doc, then a hospitalist attending carrying a page, and then finally to a resident. At my place (just an example) the ER consults peds and we go down, make an assessment, talk to our attendings via phone if we have questions and make the call. You get to be the one laying eyes on the kid and making a plan. At bigger places you are more of a plug-n-play system
-You're less likely to have fellows at a General Hospital - this means more chance to learn procedures and manage patients on your own.
-There's no room to hide in a small program. At a huge program, people can more easily squeeze through the cracks and still suck. We've all seen that resident, that sucks. In a small place they don't get that herd protection and need to rise up to meet those expectations.
These are a few of my random thoughts. I'm happy with program I'm at and I've seen both really good and TERRIBLE peds residency programs at dedicated Children's Hospitals.
