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is there any advantage or disadvantage in getting jobs or trying to move up the academic ladder by staying at 1 place for college+medschool+residency+fellowship vs moving around for each 1?
staying inhouse vs moving around
- Thread starter chef
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Continuity DOES have a value to program directors... and it's especially important if you're trying to land a job as an academic.
Of all the transitions you listed, the weakest connection is college to med school. The selection process beyond med school becomes more subjective and personalized by an order of magnitude.
At "top" schools, residency programs like to recruit students they've gotten to know who are interested in that field. It is usually preferable to retain a valuable student who they know than take a chance on someone who looks good on paper. That's why it's usually a "sure thing" for a few students applying in every field to match at their alma mater, regardless of the formalities of the NRMP. Ditto for fellowships, and for staying on faculty. At my institution, lots and lots (>50%) of medical school alumni get sucked into the Hopkins vortex and stay on for residency, fellowships, and many become faculty members.
For good or for ill, academics are an inbred bunch. If you're looking for a job in the real world, just go to the best programs you can. The job market is bright for most physicians in most parts of the country, and continuity of your training won't be as important as the strength of your training.
Cheers,
doepug
Of all the transitions you listed, the weakest connection is college to med school. The selection process beyond med school becomes more subjective and personalized by an order of magnitude.
At "top" schools, residency programs like to recruit students they've gotten to know who are interested in that field. It is usually preferable to retain a valuable student who they know than take a chance on someone who looks good on paper. That's why it's usually a "sure thing" for a few students applying in every field to match at their alma mater, regardless of the formalities of the NRMP. Ditto for fellowships, and for staying on faculty. At my institution, lots and lots (>50%) of medical school alumni get sucked into the Hopkins vortex and stay on for residency, fellowships, and many become faculty members.
For good or for ill, academics are an inbred bunch. If you're looking for a job in the real world, just go to the best programs you can. The job market is bright for most physicians in most parts of the country, and continuity of your training won't be as important as the strength of your training.
Cheers,
doepug
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doepug -
your post makes sense, but do you not think that some people become suspicious when you do all of your training at one institution, especially if that institution is not a total national powerhouse? Would you not be concerned that people think that you stay at one university because of non-academic reasons, which shows that your top priority is not the quality of your training but rather your attachment to a geographic area? During the admissions game I heard somebody important throw out this possibility.
There's alway the "grass is always greener on the other side" arguement. If you did part of your training at some other institution, you must have had a good reason, right? Therefore doing something away makes you more attractive, or so the arguement goes. Not sure if it holds water in the world of academic medicine
Furthermore, different institutions do things differently, right? Therefore it might make sense to at least spend some time away from your "home" institution to see how other people do things. This is something that an attending once mentioned that I should keep in mind as I approach the clinical years.
However, I personally see many very compelling reasons to stay at one institution.
- If you're at an extremely prestigious place
-Where you're at has a very strong program/emphasis in what you want to do, and simply has opportunities that don't exist elsewhere
-you have research connections where you currently are (similar to above)
Adcadet
your post makes sense, but do you not think that some people become suspicious when you do all of your training at one institution, especially if that institution is not a total national powerhouse? Would you not be concerned that people think that you stay at one university because of non-academic reasons, which shows that your top priority is not the quality of your training but rather your attachment to a geographic area? During the admissions game I heard somebody important throw out this possibility.
There's alway the "grass is always greener on the other side" arguement. If you did part of your training at some other institution, you must have had a good reason, right? Therefore doing something away makes you more attractive, or so the arguement goes. Not sure if it holds water in the world of academic medicine
Furthermore, different institutions do things differently, right? Therefore it might make sense to at least spend some time away from your "home" institution to see how other people do things. This is something that an attending once mentioned that I should keep in mind as I approach the clinical years.
However, I personally see many very compelling reasons to stay at one institution.
- If you're at an extremely prestigious place
-Where you're at has a very strong program/emphasis in what you want to do, and simply has opportunities that don't exist elsewhere
-you have research connections where you currently are (similar to above)
Adcadet
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I vaguely recall either reading in Iserson's or hearing some senior physician say that in-breeding is frowned upon by some academic institutions and might hurt when it comes time to apply for some fellowships too. However, I was told by my IM chairperson and residency director that going to same place for residency as medical school will not hurt your chances for IM fellowships. We have a good number of attendings here at U Maryland who were in-bred from med school through fellowship as well. A lot of times, professors brag about how they were in-bred, implying that they know the med school really well. I know that there is a preference for fellowship programs to pick residents from their home program, but at the same time, every residency and fellowship program also likes to have a decent percentage of "fresh blood", so there is also always some consideration for keeping the gene pool at least somewhat diverse. Based on that, I don't think that being in-bred is a strong plus or minus in terms of academics and fellowships. The one exception that I've heard that when it comes to picking chairpeople for major departments, they often do national searches because I don't think that they like people who were in-bred at their medical school or even who have even been on staff for a long time. So if it's your ultimate goal to become a chairperson for your med school, then it might help to go away for a while.
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Good points adcadet and ckent...
I certainly agree that physicians become better rounded when they train at a variety of institutions and are exposed to a variety of philosophies of medicine. Unless someone is upwardly mobile, however, this does not really happen in the world of academia.
Food for thought - until recently, the chairs of medicine and surgery at Hopkins were Hopkins grads and Hopkins trained. The chairs of several other departments are similarly inbred. Although national searches are conducted for department chairs, there's usually a battle between the "internal candidate" and the "external candidate." At Hopkins, it seems like the internal candidate usually wins unless the external candidate is truly exceptional or the selection committee wants to shake things up.
--doepug
I certainly agree that physicians become better rounded when they train at a variety of institutions and are exposed to a variety of philosophies of medicine. Unless someone is upwardly mobile, however, this does not really happen in the world of academia.
Food for thought - until recently, the chairs of medicine and surgery at Hopkins were Hopkins grads and Hopkins trained. The chairs of several other departments are similarly inbred. Although national searches are conducted for department chairs, there's usually a battle between the "internal candidate" and the "external candidate." At Hopkins, it seems like the internal candidate usually wins unless the external candidate is truly exceptional or the selection committee wants to shake things up.
--doepug
