Torn between Univ vs. Community program for #1

[docscience]

Advertisement - Members don't see this ad

Hey all,

Long term goals: hospitalist medicine, nephro, cards, or ICU fellowship

Both programs gave me strong feedback and said I would probably match if I ranked them #1.

1) University program - mid tier program...but the city kinda sucks. It is a very small town....slow pace of life and the weather has some summer extremes. (100 + weather for 3-4 months). But the program has way more options to subspecialize...NCI cancer center, decent cardiology matches in the past, and decent pulm/cc matches also. BUT THE TOWN IS GOING TO SUCK FOR 3 YEARS OF IM...or will I be too busy to notice?

2) Community program - PNW. Program is great....no fellows...more procedures for residents. Much cooler city. The weather is dark and gloomy 6-8 months of the year, but with GORGEOUS SUMMERS. But the program doesn't do as well with fellowship matches....it is still very possible, but much harder with this residency.

Ultimately I think I will want to be a hospitalist...but don't want to close that door on fellowships just in case. But I feel like the community program might make me a better hospitalist....
So basically....3 years in crappy city for career vs. 3 years in cool city for connections/fun and eventual employment I can't make up my mind...

What would look better on my resume? Or does it really matter?
When say Virginia Mason is hiring a hospitalist/teaching hospitalist, would they consider the applicant from the University program over the community based resident/physician?

Thanks again yall!

 

[Leukowhat]

i am in the same exact situation. no fellowships for me though. just hospitalist. anyone?

 

[docscience]

i am in the same exact situation. no fellowships for me though. just hospitalist. anyone?

Then I would definitely go to the cooler city even if it is a weaker program/community program!! I don't think most hospitals care too much where you did you residency if you want to be a PP hospitalist...they care more about how you fit their needs, how long you will work, team player, good letters/references, etc.

Except if you wanted to be an academic hospitalist....then you should probably do an academic fellowship in a "crappy town."

Does that logic make sense?

 

[Neuro or Derm]

1) University program - mid tier program...but the city kinda sucks. It is a very small town....slow pace of life and the weather has some summer extremes. (100 + weather for 3-4 months). But the program has way more options to subspecialize...NCI cancer center, decent cardiology matches in the past, and decent pulm/cc matches also. BUT THE TOWN IS GOING TO SUCK FOR 3 YEARS OF IM...or will I be too busy to notice?

If you're talking about Tucson its not that bad. you'll be in the hospital for the hours that it is hottest, and there's a lot of outdoors stuff to do there. besides, Phoenix is 2hrs away if you really crave the city life. but i guess if you're from a large busy city it's not what you're used to. if you are thinking about fellowship it's probably better to rank university programs higher especially if they have in-house fellowships and tend to take their own. its a tough decision, and it seems like your gut may be pulling you more toward the community program, so really you have to decide whether or not you're willing to work that much harder to get a fellowship, and if its no big deal to you then go with your gut.

 

[docscience]

If you're talking about Tucson its not that bad. you'll be in the hospital for the hours that it is hottest, and there's a lot of outdoors stuff to do there. besides, Phoenix is 2hrs away if you really crave the city life. but i guess if you're from a large busy city it's not what you're used to. if you are thinking about fellowship it's probably better to rank university programs higher especially if they have in-house fellowships and tend to take their own. its a tough decision, and it seems like your gut may be pulling you more toward the community program, so really you have to decide whether or not you're willing to work that much harder to get a fellowship, and if its no big deal to you then go with your gut.

Well there is no way that I would get a cards/GI/hemeonc fellowship from the community program and I would be essentially shutting myself off from these fellowships.
However, from the University program, I should have more access to basic science research, big names in specialties, etc. making me more competitive for fellowships. I would eventually like to move out after 3 years....and live somewhere more vibrant....but I am scared that I will be "stuck" doing my residency at the same place for another 2-3 years.

What do you all think?

Enjoy one's life at 27 and move to a nice city?


(OR)


Put career prospects ahead and try to match at a good program before moving to a nice city? It is only a 3 year residency...I suppose I could be mobile after that.

 

[gutonc]

Put career prospects ahead and try to match at a good program before moving to a nice city? It is only a 3 year residency...I suppose I could be mobile after that.

Congratulations! It only took posting the same question about a dozen times in different threads but you finally got some perspective and basically answered the question for yourself.

 

[less]

The same is happening to me!!! Although my community programs have affiliations with university (i really dont know if this help that much) and i want ID for fellow(no competitive one). Is so difficult!!!

 

[infarct]

lol

 

[Boba Q Fett]

From my experience, if you're thinking about any fellowship go academic. TBH, if you're not sure about your future plans, it's probably better to go academic and leave all doors open vs community.

 

[Leukowhat]

i am in the same exact situation. no fellowships for me though. just hospitalist. anyone?

Then I would definitely go to the cooler city even if it is a weaker program/community program!! I don't think most hospitals care too much where you did you residency if you want to be a PP hospitalist...they care more about how you fit their needs, how long you will work, team player, good letters/references, etc.

Except if you wanted to be an academic hospitalist....then you should probably do an academic fellowship in a "crappy town."

Does that logic make sense?

any more thoughts on my particular situation? i only want to be hospitalist. no fellowships. not interested much in research. would like to practice in community hospitals after residency.

 

[infarct]

Well there is no way that I would get a cards/GI/hemeonc fellowship from the community program and I would be essentially shutting myself off from these fellowships.
However, from the University program, I should have more access to basic science research, big names in specialties, etc. making me more competitive for fellowships. I would eventually like to move out after 3 years....and live somewhere more vibrant....but I am scared that I will be "stuck" doing my residency at the same place for another 2-3 years.

What do you all think?

Enjoy one's life at 27 and move to a nice city?


(OR)


Put career prospects ahead and try to match at a good program before moving to a nice city? It is only a 3 year residency...I suppose I could be mobile after that.

it's the naija way to go for the best...suck it up and do it. just 3 years!

 

[docscience]

Congratulations! It only took posting the same question about a dozen times in different threads but you finally got some perspective and basically answered the question for yourself.

Thanks!

I thought the point of these message boards was to be a sounding board...just trying to figure out what I want to do with the rest of my life and using others perspectives to consider.

Sorry if I annoyed you. Glad you found heme/onc as an exciting specialty!

 

[onc2b]

I am a resident that was in a very similar situation 2 years ago. I would completely disagree that you cannot match competitive fellowships from a community program.

I thought I wanted to be a hospitalist and chose the community program route but have now decided to apply to heme/onc. Currently I have received 3 excellent interviews at western united states programs and am very excited about them. My program has also matched multiple candidates in G.I. fellowships and infectious disease.

The drawbacks of a community program are that research oriented programs will not likely give you an interview. But if you are research oriented then you should want to go to a research oriented program anyways. And if you do go to a research oriented program I would recommend doing research (going there is not enough).

Although the "prestige" of university based programs is present there are benefits to being at a Community program. In particular you have much greater opportunities to get to know your attendings and receive much more personal and overall better rec letters; which is the main reason I was able to get good interviews.

Good luck with your choice, no matter what it will be right because what we do is awesome.

 

[docscience]

I am a resident that was in a very similar situation 2 years ago. I would completely disagree that you cannot match competitive fellowships from a community program.

I thought I wanted to be a hospitalist and chose the community program route but have now decided to apply to heme/onc. Currently I have received 3 excellent interviews at western united states programs and am very excited about them. My program has also matched multiple candidates in G.I. fellowships and infectious disease.

The drawbacks of a community program are that research oriented programs will not likely give you an interview. But if you are research oriented then you should want to go to a research oriented program anyways. And if you do go to a research oriented program I would recommend doing research (going there is not enough).

Although the "prestige" of university based programs is present there are benefits to being at a Community program. In particular you have much greater opportunities to get to know your attendings and receive much more personal and overall better rec letters; which is the main reason I was able to get good interviews.

Good luck with your choice, no matter what it will be right because what we do is awesome.

Very nice. I am glad you matched! Congrats!
Did your program have a history of heme/onc matches?

Is the program associated with any university programs? Did you match where you wanted to match?

 

[gutonc]

Thanks!

I thought the point of these message boards was to be a sounding board...just trying to figure out what I want to do with the rest of my life and using others perspectives to consider.

Sorry if I annoyed you. Glad you found heme/onc as an exciting specialty!

I'm only annoyed by the fact that you keep posting the same question over and over.

 

[Instatewaiter]

If you want to do a fellowship, especially Cards, you should go to a university program- especially if that community program doens't have a great history of putting people in fellowships. Cards is very competitive. If the community program doesn't have a cards program, go somewhere else.

 

[docscience]

I'm only annoyed by the fact that you keep posting the same question over and over.

Sorry again.
But I think a few people are in a similar situation (look above) and benefited from the post.

 

[docscience]

If you want to do a fellowship, especially Cards, you should go to a university program- especially if that community program doens't have a great history of putting people in fellowships. Cards is very competitive. If the community program doesn't have a cards program, go somewhere else.

Yep. I am down with that.
Problem is if I do a fellowship it will probably be in nephro or P/CCM.

 

[docscience]

it's the naija way to go for the best...suck it up and do it. just 3 years!

woop woop!

 

[docscience]

I am a resident that was in a very similar situation 2 years ago. I would completely disagree that you cannot match competitive fellowships from a community program.

I thought I wanted to be a hospitalist and chose the community program route but have now decided to apply to heme/onc. Currently I have received 3 excellent interviews at western united states programs and am very excited about them. My program has also matched multiple candidates in G.I. fellowships and infectious disease.

The drawbacks of a community program are that research oriented programs will not likely give you an interview. But if you are research oriented then you should want to go to a research oriented program anyways. And if you do go to a research oriented program I would recommend doing research (going there is not enough).

Although the "prestige" of university based programs is present there are benefits to being at a Community program. In particular you have much greater opportunities to get to know your attendings and receive much more personal and overall better rec letters; which is the main reason I was able to get good interviews.

Good luck with your choice, no matter what it will be right because what we do is awesome.

Anyone else have thoughts on this?

 

[LindaLuv]

you have faculty advisors, research mentors??? what do they say??? I think it depends on the type of person you are. If you already have a strong research background, with pubs in the field, already have contacts....you can likely get away with going to virginia mason. I believe the PD from UCSD is from there. But, you you don't have all of that... odds are if you want fellowship....go to the university program. if you don't want fellowship go to the other program. Iowa is not that bad, although seattle is a fun town. good luck!

 

[km11]

The difference in training between the two types of programs for making you a hospitalist probably isnt that different. You might see more bread and butter medicine in the community program but you really only need to treat community acquired pneumonia so many times to know it. I personally think its better to go to an academic program thats a quaternary referral center, so you get a chance to see as much crazy stuff as possible. So on the off chance some random zebra train wreck ends up in your hospital, you can recognize the important things.

And if you're even remotely interested in a competitive fellowship and care about location, I would go to the academic program. Community programs and low tier academic programs love to point to how they match their residents into "fellowships" while good academic programs can say they can match their residents into the best spots for those fellowships. It never hurts to keep your options as open as possible.

 

[docscience]

The difference in training between the two types of programs for making you a hospitalist probably isnt that different. You might see more bread and butter medicine in the community program but you really only need to treat community acquired pneumonia so many times to know it. I personally think its better to go to an academic program thats a quaternary referral center, so you get a chance to see as much crazy stuff as possible. So on the off chance some random zebra train wreck ends up in your hospital, you can recognize the important things.

And if you're even remotely interested in a competitive fellowship and care about location, I would go to the academic program. Community programs and low tier academic programs love to point to how they match their residents into "fellowships" while good academic programs can say they can match their residents into the best spots for those fellowships. It never hurts to keep your options as open as possible.

Keeping my options open is the biggest priority of mine followed by location.

I feel like 3 years is not a long time anywhere you end up. Some say that 3 years is a very very long time.
What do you all think? Worth it to sacrifice 3 years in a crappy city so that future career plans are better?
Or live in a cool city, see bread and butter medicine at a community program, etc????

The community program does have some connections with the University program in town and is usually able to find their residents spots somewhere around there.

Anyone have any suggestions??

 

[sunset823]

Keeping my options open is the biggest priority of mine followed by location.

I feel like 3 years is not a long time anywhere you end up. Some say that 3 years is a very very long time.
What do you all think? Worth it to sacrifice 3 years in a crappy city so that future career plans are better?
Or live in a cool city, see bread and butter medicine at a community program, etc????

The community program does have some connections with the University program in town and is usually able to find their residents spots somewhere around there.

Anyone have any suggestions??

I know this negates what I said in response to the same question in the social life thread, but UI's location is not THAT bad, and while it would be tough for me in your situation since I really like Seattle, I would probably go with UI. It really all depends on your priorities. For me, my #1 priority is to be in an academic career, and location, social life, and everything else can take a back seat to that. 3 years is not that long a time to me, and right now I'm in med school in a city close to UI, which is even smaller, with even less to do, but I don't really mind it that much, you learn to like it. And as a university town, at least you'll have good restaurants and a fun undergrad culture and such. And a big advantage at UI is cost of living is cheap (Seattle is pretty pricey), which with copious loans could be very helpful.

I guess the reason I said you should go to Seattle in the social life thread is because in that thread you really seemed concerned about, well, social life and dating options, and you'll have nada for that at UI, most people there are already in serious relationships or married. But if you put career ahead and don't mind being single (I'm only a med student, but from what I've seen, as a resident you probably wouldn't notice your lack of a social life much anyway), then being at a solid university program (and UI is a really well respected program in the midwest and I'm sure translates well across the country) will help you a lot long term.

 

[docscience]

I know this negates what I said in response to the same question in the social life thread, but UI's location is not THAT bad, and while it would be tough for me in your situation since I really like Seattle, I would probably go with UI. It really all depends on your priorities. For me, my #1 priority is to be in an academic career, and location, social life, and everything else can take a back seat to that. 3 years is not that long a time to me, and right now I'm in med school in a city close to UI, which is even smaller, with even less to do, but I don't really mind it that much, you learn to like it. And as a university town, at least you'll have good restaurants and a fun undergrad culture and such. And a big advantage at UI is cost of living is cheap (Seattle is pretty pricey), which with copious loans could be very helpful.

I guess the reason I said you should go to Seattle in the social life thread is because in that thread you really seemed concerned about, well, social life and dating options, and you'll have nada for that at UI, most people there are already in serious relationships or married. But if you put career ahead and don't mind being single (I'm only a med student, but from what I've seen, as a resident you probably wouldn't notice your lack of a social life much anyway), then being at a solid university program (and UI is a really well respected program in the midwest and I'm sure translates well across the country) will help you a lot long term.

That is very true. That is what I am trying to figure out.
Iowa City vs.
Tucson vs.
Seattle vs.
Portland

Obviously Iowa City and Tucson are University programs and will lead to better fellowship availability if I choose to in the future. It will also keep the academics door open for me.

Seattle and Portland have very strong community programs that I am applying to...V Mason and Portland St. Vincent. Both are excellent programs, but a little more limited as far as fellowships go.

So I am confused with career choices/geography/weather/culture in the city. I am not sure if I want to specialize yet, but want to keep that door open and have access to research/in house fellowships. My goals include hospitalist medicine, P/CCM, or nephrology.

I really like Portland and Seattle, but as far as career, perhaps Tucson or Iowa City fit the bill better. I am 27 years old, burnt out by med school a bit...though I am finishing up now! Woohoo!
Is 3 years a long time to sacrifice living in a "crappier" city with less social outlets/culture/etc? Will I even have time for all that stuff?
3 years too much to sacrifice for a career when you are 27????
P.S. newly single...bf dumped me after 5 years...so ready to restart my life in one of these cities professional and romantically.

What are your thoughts??
Thanks!!

 

[gutonc]

That is very true. That is what I am trying to figure out.
Iowa City vs.
Tucson vs.
Seattle vs.
Portland

Obviously Iowa City and Tucson are University programs and will lead to better fellowship availability if I choose to in the future. It will also keep the academics door open for me.

Seattle and Portland have very strong community programs that I am applying to...V Mason and Portland St. Vincent. Both are excellent programs, but a little more limited as far as fellowships go.

So I am confused with career choices/geography/weather/culture in the city. I am not sure if I want to specialize yet, but want to keep that door open and have access to research/in house fellowships. My goals include hospitalist medicine, P/CCM, or nephrology.

I really like Portland and Seattle, but as far as career, perhaps Tucson or Iowa City fit the bill better. I am 27 years old, burnt out by med school a bit...though I am finishing up now! Woohoo!
Is 3 years a long time to sacrifice living in a "crappier" city with less social outlets/culture/etc? Will I even have time for all that stuff?
3 years too much to sacrifice for a career when you are 27????
P.S. newly single...bf dumped me after 5 years...so ready to restart my life in one of these cities professional and romantically.

What are your thoughts??
Thanks!!

I was previously under the impression you've been talking about the Prov Portland program, not St. V's. St. V's should be way at the bottom of that list, especially re: fellowship options. Virginia Mason is a much better program than St. V's and UA and Iowa are both light years better than VM.

It's not like you're talking about Rapid City, SD, Tucson and IC are pretty decent places. There will be plenty for you to do socially and culturally in your time off. I will note that I have a lot of friends who took hospitalist gigs in Portland for a year or two after finishing residency (before moving on to fellowship or to the place they really wanted to live for the long term) because they didn't have the time to actually do all the things there are to do in Portland while they were residents.

I'd personally rank them:
Iowa > UA >>> VM >>>>>>> St. V's