Things to consider when looking at residency/fellowships

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AndyDufrane

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Asks lots of questions, look for red flags, like obvious stuff
-ask if any trainees have left/dropped out/changed their mind in the last year, and the big follow up, Why?
-turnover of junior faculty
-did he program fill out all the slots, if not, why
-turnover at leaderships positions(if both PD and chair are new within a short period, say 4 years) might be rough with alot of changes in the program over short period, and u might be the gunieu pig
-if subspecialty training, how many of the graduating fellows are actually practicing in the subspeciality after graduating in the last 5 years, if able to, get emails of recent graduates, say last 5 years, ask them point blank, would they do the program over, try to contact the people who drop out to see why they dropped out
-financial solvency of program, generally perks lie paid parking, book money, paid conferences even if not presenting, are signs of financial health

As I think more will post more
 
nice keep em coming
 
-ask if any trainees have left/dropped out/changed their mind in the last year, and the big follow up, Why?

Good luck getting a straight answer on that one.

-turnover of junior faculty

Young docs relocate and find new positions all the time as they figure out what they really want to do with their careers. What's your benchmark for acceptable turnover?

-did he program fill out all the slots, if not, why

WHY is a question you will not get a straight answer about, other than a statement about commitment to improving. You can find out from match data who did not fill. Don't apply there.

-turnover at leaderships positions(if both PD and chair are new within a short period, say 4 years) might be rough with alot of changes in the program over short period, and u might be the gunieu pig

That is the straight truth. But it could be a good thing. Not likely in the first few years, but could be.

-if subspecialty training, how many of the graduating fellows are actually practicing in the subspeciality after graduating in the last 5 years, if able to, get emails of recent graduates, say last 5 years, ask them point blank, would they do the program over, try to contact the people who drop out to see why they dropped out

If you apply to 8 programs, with an average of 6 residents each year, you're gonna send an email to 240 people?

Good luck either finding out who dropped out or how to contact them. Most likely the program would be sued if they revealed this information.

-financial solvency of program, generally perks lie paid parking, book money, paid conferences even if not presenting, are signs of financial health

If you ask to much about that, people might assume you will base your decision on who has the best fringe4 benefits.
 
Also about perks, you'll also have to remember that residency programs EVERYWHERE and across specialties are cutting back perks and extras residents used to get because the economy is bad. Usually the first things to go are resident perks.

Also, I dont know that I know of any place that pays for conference time if you are not presenting, thats probably a rarity if anything. Also, it is not likely that during your PGY-2 year that youll be hitting the conferences (unless you manage to present something, and logistically you have to hit the ground running in the first month or two of residency). I mean, someone has to cover the clinics/floors :meanie:
 
-ask if any trainees have left/dropped out/changed their mind in the last year, and the big follow up, Why?

Good luck getting a straight answer on that one.

-turnover of junior faculty

Young docs relocate and find new positions all the time as they figure out what they really want to do with their careers. What's your benchmark for acceptable turnover?

-did he program fill out all the slots, if not, why

WHY is a question you will not get a straight answer about, other than a statement about commitment to improving. You can find out from match data who did not fill. Don't apply there.

-turnover at leaderships positions(if both PD and chair are new within a short period, say 4 years) might be rough with alot of changes in the program over short period, and u might be the gunieu pig

That is the straight truth. But it could be a good thing. Not likely in the first few years, but could be.

-if subspecialty training, how many of the graduating fellows are actually practicing in the subspeciality after graduating in the last 5 years, if able to, get emails of recent graduates, say last 5 years, ask them point blank, would they do the program over, try to contact the people who drop out to see why they dropped out

If you apply to 8 programs, with an average of 6 residents each year, you're gonna send an email to 240 people?

Good luck either finding out who dropped out or how to contact them. Most likely the program would be sued if they revealed this information.

-financial solvency of program, generally perks lie paid parking, book money, paid conferences even if not presenting, are signs of financial health

If you ask to much about that, people might assume you will base your decision on who has the best fringe4 benefits.

Ok, obviously you did not read my statement clearly enough, I am taking about contacting former fellows, not residents, and no,I have not heard of people applying to 8 fellowships, , I am talking about contacting people who graduate from a fellowship, I don't think there is anything wrong with contacting former fellows of programs, I think you are better informed about how fellows end up doing after doing fellowship, which I think is a BIG deal, since you are giving up a year or two of an attending salary to do a fellowship

the whole point of the post is that if you are seeing 3-4 red flags popping up in a particular program, not just an isolated trainee dropping out or not filling a slot, your index of suspicion should go up, I am trying to give the uninitiated an index, having recently finished a residency/fellowship in the last 2 years, people can take what they want from the statements, it is my impression/opinion,
 
Ok, obviously you did not read my statement clearly enough, I am taking about contacting former fellows, not residents, and no,I have not heard of people applying to 8 fellowships, , I am talking about contacting people who graduate from a fellowship, I don't think there is anything wrong with contacting former fellows of programs, I think you are better informed about how fellows end up doing after doing fellowship, which I think is a BIG deal, since you are giving up a year or two of an attending salary to do a fellowship

the whole point of the post is that if you are seeing 3-4 red flags popping up in a particular program, not just an isolated trainee dropping out or not filling a slot, your index of suspicion should go up, I am trying to give the uninitiated an index, having recently finished a residency/fellowship in the last 2 years, people can take what they want from the statements, it is my impression/opinion,

You are correct on all those points.

And I should read more clearly before being cynical. I'll still be cynical, but at least it'll be more appropriate... 😀
 
Greetings!

Here's my 2 cents. PMR4MSK is correct in saying that you may not always get a straight answer. Try to read between the lines. Here are somethings I picked up along the way which may be of use to you:

1. Figure out on your interview day who is REALLY running the program.
Before I begin, keep in mind that there is a difference between a PM&R department and a residency program. I'm referring here to the residency program. In some programs the chair is heavily involved and in others the chair is aloof while the program is run by the PD.

Once you figure out who is in charge consider asking what the vision/goals etc.. of the program is. Based on this answer you'll get a feel for what the next three years of your life is going to be like. Also, see if you would get along fine with the person in charge.

Not all programs have a single person in charge. There may be other attending's or staff who take a cut of the power pie.

Figure out how much involvement each person has in the program and how that will affect you. i.e. you want to do certain research projects and possibly external rotations who will be approving that?

2. Who is interviewing you?
Many people may be a sign of a good democratic program. It may also reveal a power struggle in which everybody wants a piece of the pie. Too few a people interviewing may reflect a concentration in power within the program (people you need to be extra nice to for the next three years) or simply that the program just wants candidates with high scores. Ask yourself if the people interviewing you appropriate for interviewing? Others may feel otherwise, but a program coordinator on the interview list is a red flag. Unless you can gauge the PC has a brilliant people reading skill set or something that is critical for the PC to be involved; the PC has absolutely no role in interviewing.

3. Go to the interview dinner.
You're spending the next three years with these people. See if you like them. Also you get to ask certain questions. See below

4. Questions for residents:
General questions about call set up and coverage. Given that PM&R hospitals serviced by a program may be spread you should figure out how much driving you'll have to do. Driving means time and money both of which come out of your pocket. Similarly gauge geographic spread of clinics as you might not enjoy driving an hour each way everyday for 30days.

Hope that helps
 
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