Stupid Q: What are the benefits of getting into prestigious residency programs?

[willclock]

Hi,
This is probably a very stupid question but I'm a clueless pre-med so please enlighten me
What are the benefits of getting into prestigious residency programs? This is similar to "Does it matter where I go to med school?" type of question, but I don't know what the answer is. I'm not asking if a certain specialty is "better" than others, but how for a given residency, where you train (say MGH vs much lesser known place) makes a difference.
And in general, what happens after residency? Where do you get the actual job and what/who decides your salary as a post-resident doctor?

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[Tigger14]

1. Prestigious residency programs have importance relative to your goals. If you plan an academic career, or a fellowship in a highly competitive specialty, the program, and more importantly, the people who trained you, can make a tremendous difference in what doors open for you. For example, in surgery, one typically chooses either a community program (broad generalization: more operating, less research, plan to go into private practice, not attached to a super-competitive area like surgical oncology or pediatric surgery) or an academic program (opposite of above generalizations). For community programs, name is less important in general. For academic programs, the name helps, but it is really the names of your attendings that make the difference. They have the connections to help you get interviews in other academic areas. Having said this, every rule was made to be broken... I am graduating from a community program and going to fellowship at an elite academic program. (Insert smiley still undergoing CPR after Match Day )
2. After residency, two primary choices can be made: continue in fellowship training, or get a job. That depends on what your ultimate career goal is.
3. After residency or fellowship, your job hunt is like a normal person's... either placement agencies contact you, or you contact groups in which you are interested. Just like any other job, where you go depends on your geographic preference, who you feel comfortable working with, and what benefits are offered. Salary and related compensation issues are complex, and usually open to some negotiation. On other threads, people have posted websites that list average pay for various specialties, but I can't remember where they are right now.

Hope this helps.

 

[willclock]

Thanks!!
I was surprised to see so many hits for this thread and yet only one reply

I have some follow-up questions:
Do the employers offer you a higher salary if you're from a more prestigious med school or residency programs? I guess these are two separate questions...

What is the point of doing a fellowship after residency training is done?

 

[deleted109597]

Prestige is what you make of it.

No, you won't get a higher salary if you go into the community.

Doing a fellowship? Well, you would get to do the things that fellowship allows, and there are plenty of fellowships out there. Try looking them up some time.

 

[flipflopsnsnow]

i am at the point where i cant decide where to put my top 2 choices for residencies on my rank list (which one to put #1 vs #2)
one is a community program that is medium-small sized and not very well known nationally (and i read on some thread here that they didnt fill one year not too long ago, and i am not sure how to use that information)
another is a community program that is a lot more academic and has ties with 2 other big name hospitals down the road--- but i know it would potentially get me a foot in the door to those bigger name places in the future.

so, big name versus small name???

i felt better at the smaller named place so i worry about making connections or fellowships or things in the future.... how much does all of that matter????

 

[Winged Scapula]

I have some follow-up questions:
Do the employers offer you a higher salary if you're from a more prestigious med school or residency programs?

That is not generally a factor. However, someone with an impressive CV may be considered for more prestigious positions (ie, Department Chair, Dean of Medical School, Medical Director, etc.) which can rake in more $$. In most cases, the salary negotiation does not involve, "pay me more, I'm a grad of BMS", etc.

What is the point of doing a fellowship after residency training is done?

1) to specialize further
2) to focus your clinical and research goals and interests
3) to avoid getting a real job
4) to compete in a market where the generalists have it covered
5) to make more money (although not always a given)
6) because your field of choice requires it

 

[stiffany]

How competitive is general surgery residency in general? I noticed a poster above mentioning that pediatric surgery is really competitive. Is this because it's a subspecialized program with a small number of spots post-fellowship or is surgery more of a ROAD type specialty in terms of competition?

In terms of "needing" a competitive residency (and thus doing well and going to a competitive med school), the take home message then based on the info above is that this only matters if one decides to subspecialize and/or go into a more research based career?

Thanks in advance for entertaining the questions of a relative noobie.

 

[Winged Scapula]

How competitive is general surgery residency in general?

Much more so than it used to be. In the NRMP last year, there was 1 open spot after the match and many who went unmatched.

I noticed a poster above mentioning that pediatric surgery is really competitive.

That it is - long considered the MOST competitive of the surgical fellowships, but it has been surpassed by Plastics. There are 33 active programs and 34 positions last year. Only 52% of applicants matched. http://www.nrmp.org/fellow/match_name/ped_surgery/stats.html

Is this because it's a subspecialized program with a small number of spots post-fellowship or is surgery more of a ROAD type specialty in terms of competition?

Not sure what a ROAD specialty is. Please enlighten. At any rate, Peds is competitive because there are only a small number of spots.

In terms of "needing" a competitive residency (and thus doing well and going to a competitive med school), the take home message then based on the info above is that this only matters if one decides to subspecialize and/or go into a more research based career?

I suppose, in a general sense, that would be true. For example, if you want to be a community surgeon doing bread and butter cases, it might be a mistake to do your residency at someplace like Cleveland Clinic or Mass Gen which can be really geared toward fellowship and academic careers. OTOH, there is nothing wrong with getting a good education, so one should no assume that a competitive program doesn't fit your needs - they may be fantastic in your field...

IMHO, a competitive residency may benefit you in obtraining a competitive fellowship BUT that is a big MAY...

1) while the name of your program isn't a significant factor, it does lend some sheen to your application

2) a competitive residency at a place where no one goes into your fellowship of choice, or where the department is really weak, or you don't get much time with the attendings is not likely to be helpful

Consider that you may change your mind about your future specialty down the road. Therefore, you want to pick the residency which fits your geographic needs, needs of you and your (potential) family, where you feel comfortable and where you feel that should you choose to pursue a competitive fellowship, that there will be assistance in the form of electives, research and letters, calls from faculty on your behalf.

 

[deleted109597]

Not sure what a ROAD specialty is. Please enlighten. At any rate, Peds is competitive because there are only a small number of spots.

Rads/Opthal/Anesthesia/Derm

 

[Tired]

Rads/Opthal/Anesthesia/Derm

For the life of me, I don't understand why anesthesia is always on this list. It's so cyclical in terms of competitiveness; it doesn't seem like the Gas folks really have things locked down the way film/eyes/skin do . . .

 

[Apollyon]

Why go to a "prestigious" residency program? It's twofold.

One is that the training from such a place may be fundamentally better, due to why the program/hospital has prestige. If it's a big educational place with leaders in the field, at the forefront of medical education, and the research dollars are there, they can attract the best faculty, and the prospective applicants are drawn to that. Harvard can thumb it's nose at Medicare, since they have so much money they don't need it. Residency is what you put into it, but, if you have the same raw materials, and one set is going to North Korea and the other to Dingolfing, Germany, when you're done, you get two cars that will get you where you need to be, but one is a rip-off Volkswagen Beetle and the other is a BMW 5-series.

Now, as I say "residency is what you put into it", if you start out as polyester, you can end up with something good - but, if you start with silk or cashmere, it's that much easier to end up with something just as good, or something outstanding. That's what attracts the "best" people to the "most prestigious" residency programs - the people that finish 50th in their "first ranked" medical school class, and the people that finish 1st in their "50th ranked state medical school". That propagates it.

The second thing is when a reputation is maintained, even though what made the program "great" is gone. That comes down to perceptions. If I trained at Duke, and it was great when I was there, later, when a former trainee from Duke comes looking for a job, I say, "Hey, that's power" (even if, today, there is no power left). The name carries the weight, even if it's not warranted any more.

 

[Winged Scapula]

Rads/Opthal/Anesthesia/Derm

Ahh...thanks!

 

[Trepp]

Why go to a "prestigious" residency program? It's twofold.

One is that the training from such a place may be fundamentally better, due to why the program/hospital has prestige. If it's a big educational place with leaders in the field, at the forefront of medical education, and the research dollars are there, they can attract the best faculty, and the prospective applicants are drawn to that. Harvard can thumb it's nose at Medicare, since they have so much money they don't need it. Residency is what you put into it, but, if you have the same raw materials, and one set is going to North Korea and the other to Dingolfing, Germany, when you're done, you get two cars that will get you where you need to be, but one is a rip-off Volkswagen Beetle and the other is a BMW 5-series.

Now, as I say "residency is what you put into it", if you start out as polyester, you can end up with something good - but, if you start with silk or cashmere, it's that much easier to end up with something just as good, or something outstanding. That's what attracts the "best" people to the "most prestigious" residency programs - the people that finish 50th in their "first ranked" medical school class, and the people that finish 1st in their "50th ranked state medical school". That propagates it.

The second thing is when a reputation is maintained, even though what made the program "great" is gone. That comes down to perceptions. If I trained at Duke, and it was great when I was there, later, when a former trainee from Duke comes looking for a job, I say, "Hey, that's power" (even if, today, there is no power left). The name carries the weight, even if it's not warranted any more.

Well said! Great post.