To what extent does residency program determine future employment options

[tdod]

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I am trying to Decide between several programs on my rank list. One is well-established, whereas another one is a very new HCA program.

The benefit of the new HCA program is that it gives my wife and I a much better chance of ending up in the same place during residency. My concern is Whether or not completing residency at the newer program could Limit my future employment opportunities. I don’t have to work in a prestigious hospital, but I do want to work somewhere with a high volume of very sick patients, and the necessary resources to provide high-quality care at the institution. Additionally, being a competitive employment prospect would be beneficial given that my wife will be a pathologist, and the pathology job market is very rough. I would like to avoid long commutes to work.


TLDR; To what extent does my residency program determine my future employment opportunities?

Thanks!

 

[Rekt]

I am trying to Decide between several programs on my rank list. One is well-established, whereas another one is a very new HCA program.

The benefit of the new HCA program is that it gives my wife and I a much better chance of ending up in the same place during residency. My concern is Whether or not completing residency at the newer program could Limit my future employment opportunities. I don’t have to work in a prestigious hospital, but I do want to work somewhere with a high volume of very sick patients, and the necessary resources to provide high-quality care at the institution. Additionally, being a competitive employment prospect would be beneficial given that my wife will be a pathologist, and the pathology job market is very rough. I would like to avoid long commutes to work.


TLDR; To what extent does my residency program determine my future employment opportunities?

Thanks!

I would not even rank the HCA program unless you're short on ranks. With unemployed ED docs on the horizon, I won't be surprised to see many shops not even consider HCA grads when there's a surplus coming from established residencies.

 

[carbonizedeyesockets]

For CMG jobs, having graduated any residency and having a pulse will usually do no matter what, but the following generally apply if a large number of applicants. Other jobs, knowing someone or someone working there that trained at your residency is helpful. Also helpful is if a faculty member is known to someone at the job you are applying. You can come from the most prestigious residency (whatever that really is) and not be as competitive as a graduate of some much smaller, less known (nationally) residency if it is were known locally. With that said, I suspect that aside from CMGs, coming from a CMG-sponsored residency (especially if at an HCA hospital) may have negative implications when the market becomes saturated.

TLDR: avoid any HCA or CMG shop if you can.

 

[DeadCactus]

Training at the HCA hospital will not give you enough of a leg-up on employment there to outweigh the career and training benefits of a more established program. Additionally, life can be unexpected and you never know when you may be looking for a job somewhere other than that one hospital. Finally, I would argue there is a reasonable chance that you would be more desirable to hire even at that program (let alone other hospitals)after training from a traditionally well regarded institution than as one of the dozens of residents they churn out over the course of your residency whom also want to stay in the area.

 

[miacomet]

If your residency is in EM, your employment options will be limited indeed. As you may need to do another residency or a fellowship, I would go to an established, respected residency which will allow you to do an established, respected fellowship.

 

[DocEspana]

for once im not going to be contrarian. I know people from CMG programs. They are *really* good. But I view that as a function of who *they* are and that they were quite atypical people on paper (dont strike me as the "amazing score on the USMLE" sort of guys) who really, really, get clinical medicine and have a knack for this job. So I'd say that if youre good, you'll be good anywhere and I have clear evidence that great clinicians can come from CMG programs. But I myself am someone who greatly benefits from riding name brand recognition of my program (its not even an elite program in any way, it just has that name brand despite being at the median for the city its in). It has let me get easily into any job I applied to because every director wants to talk to me about all the stuff I saw there and all the people they know/heard of who I trained with.

Plus things will be dynamic in the next few years. I am optimistic about what the market will look like in 2024/2025. Most people here are morbidly pessimistic. But we both agree that *its not clear* what it will be. And if its that in flux, dont take chances that people will look down their nose at your education if there becomes an impetus to start discriminating based on random things. Where you went to becomes a very easy random thing to discriminate by.

 

[HemorrhagicShock]

Plus things will be dynamic in the next few years. I am optimistic about what the market will look like in 2024/2025. Most people here are morbidly pessimistic. But we both agree that *its not clear* what it will be. And if its that in flux, dont take chances that people will look down their nose at your education if there becomes an impetus to start discriminating based on random things. Where you went to becomes a ver

I'm genuinely interested in your thesis regarding the positive outlook.

I've been reading SDN for more than a decade now and something about this current EM "doom and gloom" seems far more real and imminent (if not already here). I've been trying to seriously change jobs now for the last 2-3 months but there's simply nothing out there.

 

[Groove]

Everyone likes to think their residency program somehow made them "special" and opened doors that they wouldn't have had otherwise or gave them Batman level training whereas everyone else received a Robin level EM experience. I was no different right after I graduated. After awhile, you notice that, for the most part, anyone coming from an accredited residency program is pretty damn well trained. You get a few lemons in the barrel but even the lemons are competent and that's more a reflection of the individual than the training institution. CMG's by and far do not care whatsoever where you were trained. In fact, most jobs don't care in the slightest. The only jobs that "might" care would be if you had some local SDG unicorn jobs with connections to one or two of your faculty who could put in a good word for you. Even then, the chances of that happening are slim. Just go to the program that you like the best or that works out for your family situation. Your training will be more than adequate I would wager and the job situation will work out just fine.

 

[Torsion]

For what its worth, my senior class has for the most part found employment by now that they are happy with in an overall tough state for the job market. I believe that coming from a well established residency has certainly helped many of them obtain employment through available networking.

 

[dadaddadaBATMAN]

Of the class below me 80% have a job. The other 20% are restricting a geographical search to a very narrow market.

This is nearly identical to the layout from previous 5 years I tracked in our program.

There is definitely a narrower market than before, but it’s still there. As long as things rebound after Covid I think therell be a couple more years to make hay before things become problematic.

It’s all bs though, it’s impossible to predict markets like this for any length of time.

To op, I’d probably not want to train in that environment, and I would point out that almost no matter what you do you’re not going to see each other much intern year. New residencies can be a pain, don’t have alumni to network with, and an hca place may not be great to train at, but to each their own

 

[Vandalia]

To answer the question that is the subject of this thread, not much.

It is not like the hospital will advertise an EM physician and their residency program, unlike, "Have knee pain? Come meet our new Mayo-trained Orthopedic Joint Surgeon!"

If we exclude hard-core academia, initially it boils down to a program's local reputation and reach. We like(d) to hire graduates from programs where we knew the faculty and we knew they would give us honest evaluations. I really don't know the best programs in Washington state, or Florida. So here in the midwest I would almost certainly go with the "bird in the hand" than take someone from the coasts where there is not a personal connection with the references.

Note that this changes once you have a couple jobs behind your back and that performance will always trump residency program.

With all that said, I would be incredibly suspicious of an HCA residency program at a small community hospital that just popped up. That can be overcome with excellent performance as an attending physician. But you will have to work you way up the ladder with jobs.

So as the bottom line:
1) An EM residency trumps everything. A graduate of the worst residency in the country will be viewed more favorably than someone without EM training.
2) In the long term, good training is the most important; this doesn't necessarily correlate exactly with the strength of the residency program.
3) Early on, residency location is more important than abstract prestige. Outside of academia. If you want a job in Omaha, train at UNMC.

 

[Rekt]

Everyone likes to think their residency program somehow made them "special" and opened doors that they wouldn't have had otherwise or gave them Batman level training whereas everyone else received a Robin level EM experience. I was no different right after I graduated. After awhile, you notice that, for the most part, anyone coming from an accredited residency program is pretty damn well trained. You get a few lemons in the barrel but even the lemons are competent and that's more a reflection of the individual than the training institution. CMG's by and far do not care whatsoever where you were trained. In fact, most jobs don't care in the slightest. The only jobs that "might" care would be if you had some local SDG unicorn jobs with connections to one or two of your faculty who could put in a good word for you. Even then, the chances of that happening are slim. Just go to the program that you like the best or that works out for your family situation. Your training will be more than adequate I would wager and the job situation will work out just fine.

You should probably caveat your post that you're a big CMG simp so the OP knows your bias.

 

[RustedFox]

You should probably caveat your post that you're a big CMG simp so the OP knows your bias.

Duuude, calmate.

 

[Groove]

You should probably caveat your post that you're a big CMG simp so the OP knows your bias.

Are you calling me fat?

What’s a CMG simp?

 

[Apollyon]

Are you calling me fat?

What’s a simp?

Simp - simpleton. Developmentally challenged.

 

[Groove]

Simp - simpleton. Developmentally challenged.

Ah. @Rekt who desecrated your cheerios this morning buddy? My reply wasn’t even aimed at your earlier post. I can’t even figure out what was inflammatory. I’ve worked for both CMG and SDG during my career and am just saying it like I see it. We’re all entitled to our opinion on here last time I checked. Good grief. You do realize that most of us work for CMGs right?

 

[Franzd'Epinay]

Simp - simpleton. Developmentally challenged.

Currently on the internet it means something along the lines of "pathetic subservient guy [in the hopes of getting together with someone]". In a non-romantic context, you can probably substitute it for "shill".

 

[Apollyon]

Currently on the internet it means something along the lines of "pathetic subservient guy [in the hopes of getting together with someone]". In a non-romantic context, you can probably substitute it for "shill".

I'm old. I was going for the original, insulting thing.

But, honest, thank you for the current info!

 

[Groove]

"shill"

an accomplice of a hawker, gambler, or swindler who acts as an enthusiastic customer to entice or encourage others.

That doesn't seem very similar to "simp" or simpleton.

Seriously though guys, I'm glad that an insult aimed at me on this board warranted this much detailed etymological analysis, lol.

 

[turkeyjerky]

So I signed with a new group recently but I'm still getting alerts and emails from job boards. I've noticed an interesting thing that a fair number are specifying that they require 1-2 years of post-residency experience. These are CMG postings. Seems like a pretty troubling trend...

 

[partypantss]

"shill"

an accomplice of a hawker, gambler, or swindler who acts as an enthusiastic customer to entice or encourage others.

That doesn't seem very similar to "simp" or simpleton.

Seriously though guys, I'm glad that an insult aimed at me on this board warranted this much detailed etymological analysis, lol.

Yeah I don't know how it started, but these days "simp" on the internet is no longer used to mean "simpleton" at least not by 20-somethings and younger. It's most often used to describe a guy that will suck up and do anything for a potential romantic partner, in a pathetic, lacking self-respect sort of context. It's now been expanded to include "simping" for things beyond romantic partners, like companies. It's a weird slang.

 

[deleted941485]

I dont think it matters now as much but in the future with all these crappy HCA residency programs popping up everywhere...your only option will be the company trough when you are finished.

 

[Rekt]

I dont think it matters now as much but in the future with all these crappy HCA residency programs popping up everywhere...your only option will be the company trough when you are finished.

The end game is worse than that. Open up as many residencies as possible because it's free cheap labor. I'm seeing tons of post from HCA grads looking for jobs right now. HCA/CMGs do not care about you.

 

[RustedFox]

The end game is worse than that. Open up as many residencies as possible because it's free cheap labor. I'm seeing tons of post from HCA grads looking for jobs right now. HCA/CMGs do not care about you.

Quoted for truth.

 

[Fox800]

If you go to an HCA program you should plan on having a tough time finding a job. Your program is suspect, as are the graduates that choose to go there, unfortunately.

Caveat emptor with the job market in its current state. Even docs with experience are having a hard time finding decent work.

Groups and hospitals will understandably take someone from an old, well-known program over some random HCA program in Florida, any day. That's just the way it is.