Residency Selections

[PlexusNexus19]

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Hey guys, asked this question in a thread in pre-allo but didn't get any responses 🙁


Can anyone comment on the key differences/prospects between a competitive program for a competitive specialty and a relatively less competitive program in the same specialty? I know Instatewaiter mentioned the increased autonomy present at competitive programs. Is there anything else?


Wondering if you could help me out, thanks!

 

[duckie99]

1. I'm not sure I totally understand your question. There are many reasons why a program may be more competitive than another including reputation, research potential, etc.

2. If you're pre-med this isn't something you need to worry about now.

3. If you're pre-med with the hope of going into a competitive field such as a surgical subspecialty then I highly recommend going to the highest pedigree med school you can. Name makes a big difference when applying to residency.

 

[mimelim]

I likewise do not really understand the question.

But, people drastically overestimate the importance of pedigree for residency. Maybe at the tip tip top it matters, but for 99% of applicants it doesn't make a difference at all.

 

[PlexusNexus19]

Thanks for both of your responses. So, I guess what I'm trying to ask is what specific benefits a traditionally competitive (primarily based on pedigree) program confers to a resident compared to a program that's less competitive (again based on pedigree) in that field. I'm not really looking to go into academic medicine, so research potential isn't that big of a factor personally.

e.g. for ophthalmology: bascom palmer (FL) vs. scott and white (TX)

@duckie99, I'm definitely not worrying about it haha. But I don't see the harm in being a little knowledgeable about the not too far-off future.

 

[DrSnips]

Thanks for both of your responses. So, I guess what I'm trying to ask is what specific benefits a traditionally competitive (primarily based on pedigree) program confers to a resident compared to a program that's less competitive (again based on pedigree) in that field. I'm not really looking to go into academic medicine, so research potential isn't that big of a factor personally.

e.g. for ophthalmology: bascom palmer (FL) vs. scott and white (TX)

@duckie99, I'm definitely not worrying about it haha. But I don't see the harm in being a little knowledgeable about the not too far-off future.

1. Research funding is a big one, the better programs tend to have more NIH dollars = more projects for residents to get involved in.
2. Fellowship matches are easier coming out of a better residency program (better match rates as well as matching at better places)
3. Better programs attract better faculty and better applicants, meaning your fellow residents and the people you work under are top notch.

 

[bjb305]

these are the things i've noticed...
vacation flexibility
book funding (up to $1500 per year difference between programs)
paid conferences
resident work hours
call schedules
other resources paid for studying
fellowships the residents get sent to
moonlighting capabilities
volume of cases
pathology seen
etc

 

[VenusinFurs]

these are the things i've noticed...
vacation flexibility
book funding (up to $1500 per year difference between programs)
paid conferences
resident work hours
call schedules
other resources paid for studying
fellowships the residents get sent to
moonlighting capabilities
volume of cases
pathology seen
etc

Maybe for some specialties.

 

[cowme]

First of all, competitiveness and prestigious are not synonymous. Even the tiny "big city" hospitals can be more competitive than some outstanding rural academic centers (Iowa, Mayo, for instance)

With regards to training, there are three tiers in general:

1) Big academic tertiary referral center -- from MGH down to Indiana University, all big referral centers are more or less identical in what kind of training they'll provide. They all have tons of research opportunities, tons of pathology and excellent teaching. You really aren't going to get any significantly different training at one place or another in this category.

2) Mid-smaller size academic centers, large community programs (say your medical college of wisconsin or Beaumont hospitals). These places may be lacking a bit in the grand scale research, but will probably see almost all the same pathology, and have excellent faculty. These hospitals are usually profit-based (rather than being funded by research grants), so they like to pump out volume and value patient turnover. People say these programs prepare you better for private practice as a result.

3) small community programs -- some risk here to be limited by bad teaching, lack of adequate volume/pathology. At the end of the day, still probably won't make any real difference on what kind of job you get.

 

[Cookie Queen]

A couple of things I've noticed on the interview trail that can make a program more "competitive"

1. Desirable location to live (things to do, young crowd, jobs for significant others)
2. Getting residents into top fellowships
3. Nicer facilities (brand new hospitals certainly are appealing....)
4. Variety of pathologies & subspecialists
5. High level of acuity (they are the referral center rather than referring out)
6. Really down-to-earth faculty, esp program directors (a charismatic PD who spends a lot of time with applicants on interview day and really seems to care about residents is a big draw if you ask me)
7. A mix of seasoned, established faculty & young, enthusiastic faculty

 

[Law2Doc]

A couple of things I've noticed on the interview trail that can make a program more "competitive"

1. Desirable location to live (things to do, young crowd, jobs for significant others)
2. Getting residents into top fellowships
3. Nicer facilities (brand new hospitals certainly are appealing....)
4. Variety of pathologies & subspecialists
5. High level of acuity (they are the referral center rather than referring out)
6. Really down-to-earth faculty, esp program directors (a charismatic PD who spends a lot of time with applicants on interview day and really seems to care about residents is a big draw if you ask me)
7. A mix of seasoned, established faculty & young, enthusiastic faculty

I'd say that #6 is actually more frequently seen at the not so competitive places. The big name attendings tend to go to the big name places based on their accomplishments, not their touchy feely skills. At a competitive place you are more likely to work with the guy who is a nasty SOB but has his name on your textbook and "invented" the sub specialty/procedure/technique than the guy who is down to earth or charismatic. Top places recruit attendings because they are top guys in the field, not because they really seem to care about residents. Sometimes you get lucky and they have both skill sets, but fewer guys get away with being SOBs the further down the competitiveness tier you go, so you'll come across guys who are less abrasive but less well known at lesser places. For training purposes you'd still want to apprentice with the top guys even if they are abrasive, though.