The Value of Location

[apples2]

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I was hoping some current or recent residents could comment on this question:

How important is/was the location of your residency to your happiness during it? I'm not talking about proximity to family/friends, but more wondering if living in a great or not so great area impacted your happiness more or less than you expected when you were constructing your rank list. I've heard different opinions: go for the best location and then consider program qualifications vs. program quality should be the primary concern and then location as more an afterthought. I know you work a ton in residency, so you don't have the time to enjoy the area as you might otherwise. I'm curious what people's experience has been....I'm deciding between a program I LOVE in a location I don't and a program I'm ok with in a location I LOVE. Any input is appreciated!


Disclaimer: I am aware that the importance of LOCATION varies from person to person and it's all about what is important to the individual...however I am trying to get a broad idea of how much of an impact this has had on people and how it compared to their expectations going in. Thanks!

 

[JacobMcCandles]

If you work 50 hours a week, you'll be spending ~30% of your time in the hospital. How important is the place where you spend the other ~70% of your time to you?

 

[apples2]

Working on figuring that out.... it's hard to anticipate what residency will be like and I'm curious to hear what current or past residents thought once they were there.

 

[iridesingltrack]

I was hoping some current or recent residents could comment on this question:

How important is/was the location of your residency to your happiness during it? I'm not talking about proximity to family/friends, but more wondering if living in a great or not so great area impacted your happiness more or less than you expected when you were constructing your rank list. I've heard different opinions: go for the best location and then consider program qualifications vs. program quality should be the primary concern and then location as more an afterthought. I know you work a ton in residency, so you don't have the time to enjoy the area as you might otherwise. I'm curious what people's experience has been....I'm deciding between a program I LOVE in a location I don't and a program I'm ok with in a location I LOVE. Any input is appreciated!


Disclaimer: I am aware that the importance of LOCATION varies from person to person and it's all about what is important to the individual...however I am trying to get a broad idea of how much of an impact this has had on people and how it compared to their expectations going in. Thanks!

My thoughts on this are that residency is a relatively brief period in your life when you get a once-in-a-lifetime opportunity for training in EM. I always recommend going to the program that provides that synergy of fit and training that will optimize your education. However, if the location is such a bad fit for you that you believe that it will lead you to a place of isolation and unhappiness I would avoid it; but, if it is just not the "ideal" location I'd go for the training, everytime. Then, once you are done with residency go for the location for the remainder of your life.

Good luck,
iride

 

[iridesingltrack]

Apologies, I don't think I answered your question directly...I made a decision based on my affinity for a program despite location. I have been very happy and have actually come to enjoy my city more than I expected. The city has, for me, had little bearing on my overall satisfaction. Other experiences will vary.

iride

 

[gutonc]

Working on figuring that out.... it's hard to anticipate what residency will be like and I'm curious to hear what current or past residents thought once they were there.

Think about what you do with your spare time right now. Then imagine how that will fit into the locations you're thinking about.

If you spend your "alone time" watching Netflix DVDs, playing games on your Xbox, going to see the latest blockbuster at the local monsterplex, grocery shopping at Costco and consider Red Lobster a fine dining experience then it probably doesn't matter where you go...you can get that anywhere.

If you would kill yourself if you couldn't get out for a 4 hour epic mt bike ride/hike/backcountry ski excursion/sail/climb on your days off... Or if you spend time checking out a thriving local music/theater/art scene... Or if the only time you've eaten at Applebee's was that one time you broke down driving across Colorado and needed a place to kill 6 hours while your car got fixed (true story)...then you need to take location into consideration.

Figure out how you live now and how you could/would live in various locales. When my wife and I go out, we go see live theater, dance and music. That's something we can't do just anywhere and played an important part in the way we chose locations for residency and fellowship (at the application process though...I didn't bother applying in places I couldn't live). If we were more like my sister and her husband, we could probably live just about anywhere.

Also, the (very, very close) proximity to family has probably been the biggest downside to where we ended up.

And just so we're clear...I don't really care how anyone spends their time. But if you're the Netflix/Xbox/Red Lobster person, living in LA or NYC or Chicago (or any major metropolitan area frankly) is going to be a massive waste of money and energy. Likewise, if you're the outdoors/local music/hottest new restaurant person, living in any of a number of rural/exurban areas is going to be painful.

 

[WildMed16]

Think about what you do with your spare time right now. Then imagine how that will fit into the locations you're thinking about.

If you spend your "alone time" watching Netflix DVDs, playing games on your Xbox, going to see the latest blockbuster at the local monsterplex, grocery shopping at Costco and consider Red Lobster a fine dining experience then it probably doesn't matter where you go...you can get that anywhere.

If you would kill yourself if you couldn't get out for a 4 hour epic mt bike ride/hike/backcountry ski excursion/sail/climb on your days off... Or if you spend time checking out a thriving local music/theater/art scene... Or if the only time you've eaten at Applebee's was that one time you broke down driving across Colorado and needed a place to kill 6 hours while your car got fixed (true story)...then you need to take location into consideration.

Figure out how you live now and how you could/would live in various locales. When my wife and I go out, we go see live theater, dance and music. That's something we can't do just anywhere and played an important part in the way we chose locations for residency and fellowship (at the application process though...I didn't bother applying in places I couldn't live). If we were more like my sister and her husband, we could probably live just about anywhere.

Also, the (very, very close) proximity to family has probably been the biggest downside to where we ended up.

And just so we're clear...I don't really care how anyone spends their time. But if you're the Netflix/Xbox/Red Lobster person, living in LA or NYC or Chicago (or any major metropolitan area frankly) is going to be a massive waste of money and energy. Likewise, if you're the outdoors/local music/hottest new restaurant person, living in any of a number of rural/exurban areas is going to be painful.

Great advice there 👍

 

[dotcb]

Residency can be a lot of hours - 50-80/wk. If you're doing that for 3-4 years, dissatisfied with your residency but psyched about where you live - you'll be bummed. Ideally go for great training and a great location. Don't live somewhere terrible if you can avoid it. There are too many great programs. If I had to choose one over the other, I'd pick residency by a hair because your happiness as a resident will be closely tied to the residency experience itself. You (hopefully) only do residency once.

 

[Arcan57]

Think about what you do with your spare time right now. Then imagine how that will fit into the locations you're thinking about.

If you spend your "alone time" watching Netflix DVDs, playing games on your Xbox, going to see the latest blockbuster at the local monsterplex, grocery shopping at Costco and consider Red Lobster a fine dining experience then it probably doesn't matter where you go...you can get that anywhere.

If you would kill yourself if you couldn't get out for a 4 hour epic mt bike ride/hike/backcountry ski excursion/sail/climb on your days off... Or if you spend time checking out a thriving local music/theater/art scene... Or if the only time you've eaten at Applebee's was that one time you broke down driving across Colorado and needed a place to kill 6 hours while your car got fixed (true story)...then you need to take location into consideration.

Figure out how you live now and how you could/would live in various locales. When my wife and I go out, we go see live theater, dance and music. That's something we can't do just anywhere and played an important part in the way we chose locations for residency and fellowship (at the application process though...I didn't bother applying in places I couldn't live). If we were more like my sister and her husband, we could probably live just about anywhere.

Also, the (very, very close) proximity to family has probably been the biggest downside to where we ended up.

And just so we're clear...I don't really care how anyone spends their time. But if you're the Netflix/Xbox/Red Lobster person, living in LA or NYC or Chicago (or any major metropolitan area frankly) is going to be a massive waste of money and energy. Likewise, if you're the outdoors/local music/hottest new restaurant person, living in any of a number of rural/exurban areas is going to be painful.

I had started to reply to this thread and got interrupted last night. This post says exactly what I was thinking, although more elequently.

 

[deleted109597]

There are very few caveats to what the great fellow said.
You may be better able to land your "dream job" if you do residency near it and are able to network. Also, you may learn your "dream job" really isn't a dream. Of course, neither of these are absolutes, and you have the unique (among medical specialties) ability to jump ship and move wherever pretty much at the drop of a hat.
Ssecondly, if your spouse has a job that isn't as able to move around, you can get them established in an area. Although, honestly, unless they're making 33% of your combined income or more, you'll be able to afford to wait.
Third, it may be able to prevent you from having two mortgages if you're able to keep living at your house.

In the end, its a crapshoot. Go where you want to for residency. Plenty of people are less than orgasmic about their residencies and do just fine. You'll get a job regardless.

 

[DreamingTheLive]

Agree with many of the thoughts above. Unless you utterly can't stand the location, I'd think that Residency "fit" and/or training trumps location 9/10 times. Of course, different strokes for different folks though.

 

[gman33]

Do you have a significant other?
If so, his/her happiness about location is a major factor.

If not, I'd say pick the program you like best.
If two places are very close, pick the place you want to live.

 

[TheBlueBlazer]

If you have a significant other, and plan to stay together, I might might suggest that location is THE most important factor. I have seen this go really horribly in a couple who was rock solid before they went in. Before submitting that rank list, take the time to find out how he/she REALLY feels about where you're going, drilling down past the "we'll do what's best for you" that I, and I imagine many others, got as the first response when I approached the subject.. FWIW, one program actually acknowledged and spoke about what their program would be like for my SO, and how they will be able to help with that transition. Coincidentally or not, they're my #1.

Do you have a significant other?
If so, his/her happiness about location is a major factor.

If not, I'd say pick the program you like best.
If two places are very close, pick the place you want to live.