(Sorry to be pedantic: 1650 outpatients, 750 inpatients. The rules as of last year:
https://www.acgme.org/Portals/0/PDF...FAQs_2017-07-01.pdf?ver=2017-06-30-140058-287)
Here are some questions that can help narrow things down. You should be able to email or call with these questions if you already interviewed. Don't expect any one individual faculty member or resident to know what's going on with everything. I'm coming from mid-tier mixed MD/DO/IMG full spectrum west coast.
1. Ask faculty or PD: Are there parts of the curriculum where it's challenging to meet ACGME requirements?
Answer should be a yes, with an honest disclosure of trouble spots and what the program is doing to address them.
2. Ask a chief resident: Tell me something that has been challenging in working with the faculty and staff.
You should get something that isn't entirely positive, which indicates that the residency at least involves the chiefs in how it is run.
3. Ask residents: Tell me about the best clinical teacher here.
You should ask multiple residents and get multiple answers, indicating there are attendings who want to teach and should. If no FM faculty are mentioned (yellow flag), ask which FM attending is the best teacher. People should be honest if great teachers are leaving/retiring. If the residents talk about who used to be great more than who is great, that's not good.
4. For
unopposed programs, ask residents: What kind of patients or illnesses do residents not automatically see in the hospital or in the community?
You should be told about the "private" patients that specialists don't allow residents to see, any services that aren't staffed with residents (for us it's trauma...until we do a dedicated elective), any patients that go elsewhere such as cards/onc/pedsED/prisoners/people with money, any missing specialties like endo/rheum/ID. It would be bad if the residents don't know what they're missing.
5. For opposed programs, ask residents: Which of the other residencies make it hard to get experience?
You should be told that the obgyn residents are bitchy (universal), the surgery residents won't give up cases (universal), and what accommodations have been made to get FM residents experience such as time at external facilities. It would be bad if the FM residents just accept that they're low priority or if they're cool with not getting experiences.
6. Ask a resident or two: how many of the people in your class would you invite to your wedding?
If more than one resident makes it seem like fewer than say 75% of their classmates would be welcome, that's uncomfortable.
7. Pay attention to whether the residents are happy to see each other. In my program we can go MONTHS with two individuals not being in the same room/building, and we generally get excited to see each other again. The free food at interviews attracts residents; this will sound crazy, but residents should have a hard time hiding from you that they're more excited to see other residents than they are to see today's batch of interviewees. This is you next year, this is what your support group will be, this is what it should look like to be on a team you like being on.
8. Ask a group of residents, like at lunch or the social: Where are the last graduating class members now?
It shouldn't be at all mysterious - the current R3's and R2's should have been friends with, and interested in, the graduating class just 6 months ago, and the graduating class should have been open with the juniors about recruitment and fellowship.
9. Ask R3's: what are you doing next year?
You should get everything from "I have no idea" to "hoping to hear from Big Fat Fellowship this week" to "I just signed with..."
From the above you should get a sense of:
- is there a culture of support and friendliness among the residents?
- are the hospital and the clinic supportive and inclusive of the FM residents?
- are the FM faculty competent and engaged?
- are soon-to-be-graduates totally burned out or are they excited about what they get to do next?
You should also directly see and hear residents involved impressively in patient care. While you're getting the tour you should see residents everywhere in the hospital. Get shown, not told, that the residents are deeply engaged, getting up and leaving fast for a delivery, letting a staff member interrupt your conversation for patient care, etc. It's a lot worse for a resident to seem bored or uninterested, than to seem tired or stressed. It's unacceptable for residents to be shadowing in their home facility.
Hope this helps.