Things to look for out of residency

[Propofol17]

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Besides the usual stuff (i.e. geography, resident satisfaction, etc) - what are things to look for in a program (i.e. curriculum)?

Thanks

 

[rayofdiana]

1. Volume - I didn't appreciate this until I got to residency. Even if you don't do the 1 in a million case, if someone else in your program does it you will hear about it and learn from it. If some complication happens 1/20,000 pregnancies and your program does 3500 deliveries, you might never see it. But if you have 10,000 deliveries...might see two!

2. Number of hospitals you cover. Less is more.

3. Balance of OB and GYN time in curriculum. Is it redundant or educational? What you prefer will vary on your personal career goals.

4. Not only resident satisfaction, but also resident culture. Do they support each other? Pick up calls for each other? Rearrange schedules so people can drop everything to travel to sick relatives/new babies/etc? Because my program does and it makes a huge difference!

Always listen to your gut.

 

[Propofol17]

What program/s have ~ 10K deliveries/year? Most of the programs I've applied/looked at have about 3500-5000 deliveries. No, I'm not applying to high-end programs though.

Anyone know anything about the programs at Lankenau and/or Carilion? I've applied to programs mainly in the southeast except Lankenau.

 

[missylee]

1. Volume - I didn't appreciate this until I got to residency. Even if you don't do the 1 in a million case, if someone else in your program does it you will hear about it and learn from it. If some complication happens 1/20,000 pregnancies and your program does 3500 deliveries, you might never see it. But if you have 10,000 deliveries...might see two!

2. Number of hospitals you cover. Less is more.

3. Balance of OB and GYN time in curriculum. Is it redundant or educational? What you prefer will vary on your personal career goals.

4. Not only resident satisfaction, but also resident culture. Do they support each other? Pick up calls for each other? Rearrange schedules so people can drop everything to travel to sick relatives/new babies/etc? Because my program does and it makes a huge difference!

Always listen to your gut.

I would agree with most of these and add a few things:

1. Volume is definitely important, but it's also important to have the right amount of autonomy. I know some places may boast high numbers but you need to look at the quality of the experience for the residents. Are they managing the patients pre- and post-operatively? You want to have as much hands on experience.

2. I think going to different hospitals helps to open your horizons and see how different hospitals/attendings do things. If you stay in just one place, you have a very skewed view of the field.

3. I totally agree with #4. Super important. Also, try and see how they view the interns. Do they nurture them during the transition of medical student to residency or are they held to the same standards as the other more experienced residents? For example, are they yelled at for not knowing something or not doing what they were told?

4. I would add that if you're planning on doing fellowship, you should go to a place where the faculty are actively involved in research so you can be involved in their projects. If you go to a place where not a lot of research is being done currently, then it's difficult to be productive enough on your own while in residency.

5. Another important thing to note is how invested the residents are in the program itself. Is it the PD running the whole thing or does he/she work with the residents? How much input and ownership do the residents have on the program?

It's really tough to know what a program is like when you interview. I agree with the previous poster, you should always follow your gut. I think it's also a good sign if you feel like you connected with some faculty and/or residents while you are there. Good luck

 

[anonperson]

Besides the usual stuff (i.e. geography, resident satisfaction, etc) - what are things to look for in a program (i.e. curriculum)?

Thanks

1. Good Gyn experience- The vast majority of programs have more than enough obstetrics for residents to gain good experience in. Programs generally struggle with the gynecological surgery experience which is really key. You want that exposure early and often.

Ask if interns are scrubbing in and doing their sides of hysterectomies etc. It's also important to see what the experience is in terms of minor procedures (Tubals-Laparoscopic vs Post partum mini laps etc, Endometrial Ablation therapies, Essures, etc)

2. Reasonable work load- Are residents doing a lot of crap work without the benefit of getting to the OR or doing deliveries? Residency is hard work but the reward should be getting to do a lot.

3. Reasonable clinic schedule

4. Covering less hospitals- Usually this means that they need the other numbers to boost the resident numbers in terms of certain procedures. This is a pain. More hospitals means more travel time, getting used to a new system etc.

The less hospitals you deal with, the better.

5. Perks- It's nice when the hospital gives residents free food and free parking.


The vast majority of hospitals will train you well to be honest. As far as volume goes, only a couple of hospitals will have the insane volume of 10,000+ deliveries (Parkland, Winnie Palmer in Orlando etc). Even if you're hospital "only" has 3000 deliveries or so, you will get a good experience.

My program has 3000-4000 deliveries and a good amount of GYN stuff. After 2 months of L and D, I have seen a uterine rupture, managed HIV in labor, Hep C patients, numerous twins, and have personally delivered a couple of 29 week babies with me being the only one scrubbed.

My program is the run of a mill community program and the experience has been very good so far.