Residency Prestige (Academics) for Surgical Fields

[workaholic007]

For the best surgical education is it better to go to a big name academic hospital or community hospital for residency? i have been hearing varying opinions such as academic programs have less access to cases but easier to specialize. Can anyone provide insight?

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[PrideOrPanthers]

For the best surgical education is it better to go to a big name academic hospital or community hospital for residency? i have been hearing varying opinions such as academic programs have less access to cases but easier to specialize. Can anyone provide insight?

Depends on what your goals are IMO. If you are looking to go into academic medicine, it would benefit you to go to an academic program where prestige and access to research opportunities help with that career path. If your looking to go into private practice, many “mid tier” and community programs can give you more reps in the OR with less research opportunities and prestige factors. You’ll still match into a fellowship program although it may not at Harvard, Yale, etc. overall I think it depends on your career goals are

 

[WinslowPringle]

Depends on what you want, how you learn, and the individual programs. Community residencies can absolutely offer outstanding surgical education with much less hierarchy and more autonomy than university associated programs but again it depends on the individual program. You can specialize (ie, do fellowship) from pretty much any residency in any field with the exception of peds surg and maybe surg onc. I would absolutely recommend looking at community programs though if you are interested in operating early and often. I’m biased though - did med school at a Big Name academic place, doing fellowship at a Name Brand academic place, did away rotations in med school and residency in university and community programs and did residency at a community place - the overall amount of operating was more and higher quality at the community places than the university ones. I would hate to be a GS resident at any of the academic places I’ve been.

 

[AnatomyGrey12]

I'll echo both of the above. It completely depends on what your career goals are.

 

[Lem0nz]

Residency sucks way less at a community program unless you want to be a surgeon scientist, and VERY few of us want to be that. For all the reasons above, but you can really boil it down to two sentences. That's the first, the second is that academic programs with big names make you significantly more competitive for sought after fellowships that also have big names.

You know, in general. Of course there's the one offs.

 

[aldol16]

It really depends on what you want and your ambition. If you're the kind of person who wants to have a name that's well known on your resume just for the sake of having the name, then you have your answer. If not, then it'll depend on whether you want to go into academic medicine or private practice. If you want to go into academic practice, then obviously you need to go to an academic place. These places tend to like research productivity and prestige of residency program (along with the connections) makes a difference. This is why one of the things that people ask during residency apps is whether residents tend to get the fellowships they want. Fellowships are pretty much standard if you want to go into academic medicine, btw. But since the academic places have a lot of people training there including fellows, your operative experience as a resident can vary. At some programs, you get a lot less operative experience with the understanding that you catch up during fellowship.

If you want to go into private practice, it won't really matter where you go. You probably want to go to a place that gets you tons of reps - there's a negative correlation between this and the higher up the academic ladder you go. Doesn't universally apply as there are exceptions but it's something you can expect.

 

[GadRads]

From talking to several people, it seems mid-tier academic and community programs provide better hands on training than the very top places. I honestly don't think it matters all that much where you train in most cases.

 

[Banco]

As many have said, it just depends. If you want to generalize, you could say that if you want an academic career or a competitive fellowship, you should aim for an academic program. If you're certain that you want to go into private practice, then it doesn't matter too much - many community/hybrid programs give excellent training and enough research opportunities. That isn't to say though that at academic centers you'll get bad training - they can all be very different.

 

[Redpancreas]

Depends on what you want, how you learn, and the individual programs. Community residencies can absolutely offer outstanding surgical education with much less hierarchy and more autonomy than university associated programs but again it depends on the individual program. You can specialize (ie, do fellowship) from pretty much any residency in any field with the exception of peds surg and maybe surg onc. I would absolutely recommend looking at community programs though if you are interested in operating early and often. I’m biased though - did med school at a Big Name academic place, doing fellowship at a Name Brand academic place, did away rotations in med school and residency in university and community programs and did residency at a community place - the overall amount of operating was more and higher quality at the community places than the university ones. I would hate to be a GS resident at any of the academic places I’ve been.

This seems to be the ideal training path but the issue (at least in the IM world) is how to break back into the academic world for fellowship (or even obtain a competitive fellowship) if you've dipped into the community world for residency.

 

[Lawpy]

Serious question: is it an SDN meme to view top tier surgery programs as malignant torture places where residents fight with fellows for procedures and residents have little to no autonomy? Or does this actually happen across any top tier surgery program?

 

[workaholic007]

Serious question: is it an SDN meme to view top tier surgery programs as malignant torture places where residents fight with fellows for procedures and residents have little to no autonomy? Or does this actually happen across any top tier surgery program?

this highlights one of my aims of this question

 

[Lem0nz]

Serious question: is it an SDN meme to view top tier surgery programs as malignant torture places where residents fight with fellows for procedures and residents have little to no autonomy? Or does this actually happen across any top tier surgery program?

Not necessarily malignant torture places, but the fighting fellows is real, significantly less autonomy is real. Having gotten to know a fair few of our surgeons who are recent grads I think a fair few came from community esque places so it *is* harder for us to comment on the frank malignancy. But, for example, my medical school was at a university and I observed a lot of malignant behavior that did not occur in my residency. The trope was real. I also know from experience that matched PGY level for PGY level from my community program to the top tier academic program in my city of training my operative skills were quite literally years beyond the top tier university residents skills and the attendings told us so when rotating at places like trauma and childrens, and transplant. So that is definitely real as well.

Us community folk usually extrapolate this because around the end of my residency I was confident but still a little hesitant about operating by myself - I certainly could do it, no problem, but I would be VERY slow and careful on a big/complicated case and be ready to ask for help.

I cannot even IMAGINE what the university kids are feeling when they graduate if that's how I feel when I'm deemed extremely more competent then they are for the level of training I'm at.

 

[Lem0nz]

Tldr~ almost certainly real and not a meme but there are always exceptions.