Small vs Large Programs

[Dr.Curly]

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What are the pros and cons of a small surgical residency with say <4 categoricals versus >4 categoricals +/- fellows?

 

[Dr.Curly]

Anyone?

 

[ACSurgeon]

Anyone?

Small programs: possible pros: more cases to go around, better interpersonal relationships amongst residents and with staff. Possible cons: more call. Higher likelihood of not finding enough like-minded people (less diversity).

Large programs: pros: more people to share call, different personalities. Cons: interference by other learners

This does not include the obvious: research funding, academic caliber and overall volume. While these might be more prevelant in larger programs, I'd examine those separately.

 

[ACSurgeon]

I don't even know that it is always fair to call these differences pros and cons. The structure and feel of a small vs large program is just very different; not necessarily superior or inferior but different. Some will find aspects of a smaller program appealing while others prefer a larger one.


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That's why I said "possible." I essentially list some of the pros for one type of program as cons for the other type of program. It depends on what one is looking for. Even then, I'm sure there are many exceptions.

 

[thedrjojo]

larger programs tend to more likely to have more than 1 affiliated hospital, which can be a pro or a con depending on if you want that variety and different exposure vs the fragmentation.

 

[stealth vector01]

Small programs: possible pros: more cases to go around, better interpersonal relationships amongst residents and with staff. Possible cons: more call. Higher likelihood of not finding enough like-minded people (less diversity).

Large programs: pros: more people to share call, different personalities. Cons: interference by other learners

This does not include the obvious: research funding, academic caliber and overall volume. While these might be more prevelant in larger programs, I'd examine those separately.

Good points:

If the small program is really good, and has great leadership and attendings I think it may be something to look at. However, with smaller programs there are a few things to keep in mind: If you loose a redisdent, call schedule can be more painful. It it looses an attending or two, your surgical education/ medical education may take a big hit. If there is a bad personality, there are fewer people to dilute it. Overall less diversity. Sort of like families...

 

[funshi baba]

i'm in a small program (3/ year).My biggest concern going to a surgical residency was early operative experience. I wanted to operate from day 1 and Small programs gives you that. Although it means you will have to do floor work while also juggling OR coverage. you also take more call. Up till recently, I took up 7-8 in house calls/month but the truth is you get use to it. Downside for me is the connection and networking, especially now that im applying for a fellowship. Small programs dont have that clout and you have to put it some work on your own to get what you want. If the program does not have a record of placing residents into fellowship, then you might be the first. I have several chieves that went into Acute care surgery. SO if you want plastic, CRS, vascular etc, you might be the first one and have to navigate that route.