Does it make a difference in the quality of training that the residents get? It sounds like a resident-run service has more autonomy and thus would give more practical training.
Different types of programs:
1- Academic centers: A lot of fellows and are usually fellow run.
2- Small community programs: Don't have fellows. Are usually resident run.
3- Large community programs or small academic centers: Something in between.
There are a lot of caveats here. For example, most places that have high volume and diverse pathology, have fellows. There are always exceptions. But giving low cost of a fellow compared to a junior faculty, a lot of places with enough volume have fellows.
This may cause a lot of arguments, but in general places without fellows, do not have the diversity of pathology and subspecialty training.
Resident run program may seem great a first, but believe me, after your second year, you will enter a state of plateau where you do not see the required diversity of pathology. Also you will not have the opportunity of interact with subspecialty attending who are the top of their field. Usually the training is better in your first 1.5 years of residency in resident run programs, but after that you need something beyond the bread and butter radiology.
Most big academic centers have found ways to make sure their residents have enough exposure to high end radiology by having dedicated rotations in MR or for example having smaller hospitals run by residents. For example in most places smaller satellite hospitals or VA system is run by residents, so it will compensate for less autonomy and less experience in high end cases at the main teaching hospital.
Again, it may insult some, but I have found a lot of justifications from the people who could not match into the big names. For example making stories that how people from smaller programs are better prepared for pp and ....
Anyway, I will go to the program that best fits my personality, and also location wise is in the place that I may stay in the future. A lot of big places, give you enough autonomy to be able to handle pp volume right after residency, yet you will see great diverse pathology and also will have the opportunity to make connections with some of the biggest people in the field. This is an opportunity that is very difficult to come by if you do not go to certain programs. Don't take it for granted.
Many groups can handle most of radiology these days. They are looking for someone who can bring something new to the table.
Good Luck.
