To Switch or Not To Switch

[xpxn]

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I am currently a peds intern at a county program (not a children's hospital) with not the best reputation. I can see myself excelling there because there are not tons of patients so I have time to study and I feel like a big fish in a small pond, but I would like to do fellowship or be an attending at a busy well-known children's hospital in a big city in after I am done. I am wondering if it would be worth the effort to switch to another program to try for a children's hospital with a better name, or if I should stay on and maybe try to become chief to plump up my resume so I at least have a chance. Many of the graduating residents here chose to stay in this small town after they are done and not many venture out into the more prestigious programs so I don't really know who to ask about this (I just started, so I don't want to be "that person" that wants to leave the program), so any advice would be helpful! ..And by the way, what DO residency programs look at anyway??

 

[oldbearprofessor]

I am currently a peds intern at a county program (not a children's hospital) with not the best reputation. I can see myself excelling there because there are not tons of patients so I have time to study and I feel like a big fish in a small pond, but I would like to do fellowship or be an attending at a busy well-known children's hospital in a big city in after I am done. I am wondering if it would be worth the effort to switch to another program to try for a children's hospital with a better name, or if I should stay on and maybe try to become chief to plump up my resume so I at least have a chance. Many of the graduating residents here chose to stay in this small town after they are done and not many venture out into the more prestigious programs so I don't really know who to ask about this (I just started, so I don't want to be "that person" that wants to leave the program), so any advice would be helpful! ..And by the way, what DO residency programs look at anyway??

You matched here presumably as the highest ranked place that you wanted that also wanted you. What has changed in 2 weeks as an intern that makes you feel like you are "better" than what you got in the match? What have you accomplished in these two weeks that will make PDs who didn't rank you highly before want you now?

If you are at a small program, then leaving, either mid-year or at the end of intern year will leave your fellow interns high and dry as they won't have as many others to call on for night call after you go. That doesn't mean you can't do it, but, talking about it now won't win you a lot of friends two weeks into internship.

I've seen lots of residents from small programs go to prestigious programs for fellowship. It may be a bit harder to get to the 5-10 biggest children's hospitals, but there are plenty of other children's hospitals or other good programs that will be interested in what you accomplished via letters of rec, etc than the name of the program you did your residency in.

My suggestions:

1. Quit thinking you are "a big fish in a small pond".

2. Work hard over the next 6 months and impress your attendings with your abilities, compassion and knowledge. Then befriend them and see what they say, especially any subspecialty attendings, about changing programs.

Good luck!

 

[Giic]

I am currently a peds intern at a county program (not a children's hospital) with not the best reputation. I can see myself excelling there because there are not tons of patients so I have time to study and I feel like a big fish in a small pond, but I would like to do fellowship or be an attending at a busy well-known children's hospital in a big city in after I am done. I am wondering if it would be worth the effort to switch to another program to try for a children's hospital with a better name, or if I should stay on and maybe try to become chief to plump up my resume so I at least have a chance. Many of the graduating residents here chose to stay in this small town after they are done and not many venture out into the more prestigious programs so I don't really know who to ask about this (I just started, so I don't want to be "that person" that wants to leave the program), so any advice would be helpful! ..And by the way, what DO residency programs look at anyway??

Do you mind clarifying the "big fish in a small pond" comment...i.e. in what way do you feel that you are "bigger" than what you ended up with? Why did you rank this program to begin with? Were you maybe expecting something different?

My advice to you would be to stay in the program, excel, and apply to a good strong fellowship program (if interested).... No guarantees you would be chief resident, so I wouldn't make that goal my priority. But if you do excel, you may be selected if you're lucky.