Residency Prestige vs Quality of life

[DrJD]

Hypothetical question:

In general, when considering job prospects after residency, would the prestige of a program like Harvard be worth sacrificing the quality of life of a lower ranked program in a small to normal city?

While I know ranking residency programs is fruitless, there are general accepted tiers correct? So said a different way, would living in a small quasi-crappy apartment in a big city like Boston, LA or NYC in order to attend a top tier residency improve job prospects greatly? There are a ton of smaller programs in livable cities where one could own a house, have no traffic, etc. etc. that seem to give just as good an education.

Thoughts?

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[2012mdc]

Hypothetical question:

In general, when considering job prospects after residency, would the prestige of a program like Harvard be worth sacrificing the quality of life of a lower ranked program in a small to normal city?

While I know ranking residency programs is fruitless, there are general accepted tiers correct? So said a different way, would living in a small quasi-crappy apartment in a big city like Boston, LA or NYC in order to attend a top tier residency improve job prospects greatly? There are a ton of smaller programs in livable cities where one could own a house, have no traffic, etc. etc. that seem to give just as good an education.

Thoughts?

To piggyback on this post - How much does residency "name" matter if you do a big name fellowship afterward?

 

[myhandsarecold]

To piggyback on this post - How much does residency "name" matter if you do a big name fellowship afterward?

the name of the person calling the fellowship PD on your behalf matters a lot. several of our staff went to Harvard-affiliated fellowships, one after the other. BTW, our residency program is not the well-known, it's who has the bigger clout 🙄

 

[Zetterberg07]

Hypothetical question:

In general, when considering job prospects after residency, would the prestige of a program like Harvard be worth sacrificing the quality of life of a lower ranked program in a small to normal city?

While I know ranking residency programs is fruitless, there are general accepted tiers correct? So said a different way, would living in a small quasi-crappy apartment in a big city like Boston, LA or NYC in order to attend a top tier residency improve job prospects greatly? There are a ton of smaller programs in livable cities where one could own a house, have no traffic, etc. etc. that seem to give just as good an education.

Thoughts?

If you want an academic career, the clout of Harvard is beneficial. If you are sure you want to do private practice your future employers probably wont care much where you went and if anything training in the same area you want to practice would probably benefit you slightly (thanks to connections/networking).
However, IMHO the benefits of a good residency program go beyond strict employment prospects. The very strong rads programs (and there are quite a few of these, probably at least 35-40) will have a huge faculty, with most everyone practicing in their specific subspecialty. Think about it- someone who is fellowship trained in neuroradiology and only does neuroradiology is going to be able to teach it to you better than a general radiology attending at a small community program who might practice 3 or more specialties. It makes sense to learn neuro from the dedicated neuro guy even if your ultimate goal is to be the general radiologist in community practice. That being said, I would never go to a program located in a place I knew would make me unhappy, lifes to short to miserable for 5 years.

 

[MrBurns10]

If you want an academic career, the clout of Harvard is beneficial. If you are sure you want to do private practice your future employers probably wont care much where you went and if anything training in the same area you want to practice would probably benefit you slightly (thanks to connections/networking).
However, IMHO the benefits of a good residency program go beyond strict employment prospects. The very strong rads programs (and there are quite a few of these, probably at least 35-40) will have a huge faculty, with most everyone practicing in their specific subspecialty. Think about it- someone who is fellowship trained in neuroradiology and only does neuroradiology is going to be able to teach it to you better than a general radiology attending at a small community program who might practice 3 or more specialties. It makes sense to learn neuro from the dedicated neuro guy even if your ultimate goal is to be the general radiologist in community practice. That being said, I would never go to a program located in a place I knew would make me unhappy, lifes to short to miserable for 5 years.

I would agree that private practices oftentimes take local products, probably because they are most familiar with graduates of the local program and you may have a chance to moonlight there and build connections. I would disagree that where you train has no impact on PP, as the more well-recognized academic programs have great national recognition that can sometimes give you a boost no matter to where you're trying to relocate.

Anyway, while I do think where you can train can help you to a degree, I don't find it to be a "top 10 or bust" kind of thing. Personally, I ranked several programs over top 10 ones last year. Your happiness is undoubtedly the most important thing to consider.

 

[Zetterberg07]

I would agree that private practices oftentimes take local products, probably because they are most familiar with graduates of the local program and you may have a chance to moonlight there and build connections. I would disagree that where you train has no impact on PP, as the more well-recognized academic programs have great national recognition that can sometimes give you a boost no matter to where you're trying to relocate.

Anyway, while I do think where you can train can help you to a degree, I don't find it to be a "top 10 or bust" kind of thing. Personally, I ranked several programs over top 10 ones last year. Your happiness is undoubtedly the most important thing to consider.

Fair enough. Although I would bet that most of the pp groups that would lean more toward caring a lot about your pedigree would tend to be located in the high cost of living places the OP wants to avoid in the first place (northeast, cali, hawaii, etc.) But admittedly as an MS4 I'm not even close to having explored the job market yet so I'm just passing along what I've heard.

 

[MrBurns10]

Fair enough. Although I would bet that most of the pp groups that would lean more toward caring a lot about your pedigree would tend to be located in the high cost of living places the OP wants to avoid in the first place (northeast, cali, hawaii, etc.) But admittedly as an MS4 I'm not even close to having explored the job market yet so I'm just passing along what I've heard.

Well, I'm only an intern so my comments were also just based on things I've heard. 🙂

I think the consensus is that you can get a great education from almost any program and that happiness should never be sacrificed for prestige. But I personally would make it a continuum...if you know you'll be miserable at MGH, rank it last. If you think you'll be happy at MGH vs really happy at Community Program X, then I would argue that being happy at MGH would be worth it in the long run.

 

[colbgw02]

Pedigree counts, but it's pretty far down the list. Private practice groups want people who are hard-working, efficient, and easy to get along with. If you're slow, lazy, socially awkward, or an *****hole, then you're going to lose out even if you're brilliant or your CV is impressive. As someone else mentioned, prestigious training tends to help in private practice most with regards to networking and not because people are dying to work with someone whose IQ is 200.

 

[RisingSun]

For anyone curious about where the residents go from small/community programs, often digging around on the program's website will produce a list of where past grads trained for fellowship etc. You will see that even the smallest community program (Sacred Heart in Spokane) has people going into great fellowships at prestigious places. Don't let the name of a program deter you from training somewhere. There are plenty of other factors that you should be using to compare programs. I think that you will also find that residents at programs that take very good care of them, which most community programs do, are extremely happy and could not imagine training elsewhere.

 

[LuckyST]

I agree 100% with everything RisingSun wrote. It is so important to find the program that is the right fit for you, and name is only a very small part of that.

However... if you are considering a career in academics, name does seem to have an impact. In my (very limited) experience, the quality of research training between programs seems to vary much more than the quality of clinical training, and there are really only a dozen or so programs that have a strong history of producing successful academic radiologists with research careers. So if you are dead set on academics, and especially the research side of academics, this is something you may want to consider.

 

[MrBurns10]

For anyone curious about where the residents go from small/community programs, often digging around on the program's website will produce a list of where past grads trained for fellowship etc. You will see that even the smallest community program (Sacred Heart in Spokane) has people going into great fellowships at prestigious places. Don't let the name of a program deter you from training somewhere. There are plenty of other factors that you should be using to compare programs. I think that you will also find that residents at programs that take very good care of them, which most community programs do, are extremely happy and could not imagine training elsewhere.

The only thing I'll add is that, with the new boards structure, I foresee fellowship becoming almost mandatory (just my opinion). Right now most radiology fellowships aren't very competitive, but if that does happen, who knows how competitive they'll become? And if they do become competitive, will program name matter more? These are questions I don't think anyone knows the answer to but are worth mentioning in any discussion on this topic.

Anyway, I'm not at all saying prestige should be the biggest factor in determining your rank list. Quite the opposite! Location was the biggest determinant in my ROL. But I also don't think pedigree means absolutely nothing...how much it means to you is very personal.