What makes or breaks residency?

[kbrown]

So I'm halfway through the interview trail...and have been impressed by most programs equally thus far. Everyone keeps telling me that I will know THE PLACE when I get to it. I'm just not finding that to be the case. I have three things that I consider important for me in a residency: 1) teaching, the faculty must be available and willing to provide their wisdom and pearls but not dictate the flow of your patient care, 2) the people/patients, I want to see the sick pts, I want to know how to manage/stabilize that crappin' out CHF'er when I'm stuck in the middle of a comm hospital in a smaller community, 3) I want whatever off-time that I have to be in a place that has a lot to offer (entertainment, outdoor activities, diversity, etc...)

So, back to the original statement. All of the programs have managed to come up with 2/3 of my things (various combos of the three). Not one has "won me over" yet. I am beginning to wonder if what I want in a program is really what matters at the end of three years. For all of you who have gone through this process, what have you found to be the most important qualities of a program that really do impact your training and life outside residency (oxymoron???).

Thanks for the feedback.

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[turtle md]

If, at the end, they all still seem the same, play pin the student on the residency. If you pin one, and find you were hoping for another, then you will have you answer.

 

[NinerNiner999]

Don't underestimate how important the people you work with will be. Take a good look at the residents you meet as you interview, as it is likely you will be working with them (and they will supervise you) as you train. A program can offer everything you mentioned, but if you dislike the people you are going to work with, it will be a long residency...

 

[highdesert]

Don't underestimate how important the people you work with will be. Take a good look at the residents you meet as you interview, as it is likely you will be working with them (and they will supervise you) as you train. A program can offer everything you mentioned, but if you dislike the people you are going to work with, it will be a long residency...

I would second this. The residency I attended attracted me for several reasons: Excellent mix of pathology, tremendous access to outdoor activities, a moderately sized city, and good people to work with. It turns out that the people I worked with (attendings and fellow residents) had the largest impact on my experience. You will work lots of hours with these people, and whether you feel you have something in common with them or not will have a huge impact on how you manage day to day stressors. In my case I did feel like I had found the *one* perfect program for me, though I imagine I would have been equally happy at a number of programs.

Highdesert

 

[DrQuinn]

For me, it was "where do I want to live for 3 years." We just had our RRC visit, (it went great, btw), and they are pretty strict on education for residents... so, honestly your training is roughly going to be the same no matter where you go. We all take the same written and oral boards after we graduate. So, go where you want to live!

Q

 

[The White Coat Investor]

I didn't find any residency that gave me everything I wanted (by the end of the interview trail I had found A LOT that I wanted. So I picked as best I could. Don't expect perfection, cause none of them are. People are important, location is important...quality of programs is awfully similar, although there may be a handful of programs out there that are woefully inadequate. It won't take you long to figure out which ones those are.

 

[basementbeastie]

go where you spouse tells you to go.....

 

[totalbodypain]

Hot nurses/staff. For good gods sake you have to stare at these people for 3 or 4 years. You better look for good eye candy.....Good coffee in the nurses lounge helps also.

 

[bulgethetwine]

Hot nurses/staff. For good gods sake you have to stare at these people for 3 or 4 years. You better look for good eye candy.....Good coffee in the nurses lounge helps also.

Absolutely, positively, 100%, the most important factor should be the PEOPLE YOU ARE WORKING WITH. I can't tell you how many times I've had a *great* shift vs. an absolute **** shift, and after I do my post-mortem it turns out the shifts were really the same in terms of difficulty, patient load, amount of teaching, etc. and the only difference is the interaction on a personal level with one or more people. This is also been my experience between a ho-hum (or even downright painful) off-service rotation vs. an off-service rotation which is enjoyable and applicable to my primary specialty.

I would say this is followed closely by geography/things to do in the location.

Oh, and the stuff about the hot nurses and good coffee should count for something, too!

 

[kbrown]

thanks guys your input is appreciated

 

[roja]

I think I am going to be redundant. (we had our xmas party last night AND I had to work at 7am today!)

But people DEFINATELY are a huge issue. You absolutely have to make sure that the culture of the poeple you are going into is a fit for you. If you are a swinging single, like to go out alot and end up at a program full of married suburbanites, you are most likely not going to be uber happy.

Likewise, location is vitally important. You need to really like wher eyou are going to live.

You are only half way done. Don'tn give up home. My very last interview ended up being my top choice. I knew at the end of the day EXACTLY where I wanted to be. It was leagues above my other choices. I knew I would be happy at the other choices but i LOVED my first choice.

Wait and see.

 

[humberthumbert]

For me, it was "where do I want to live for 3 years." We just had our RRC visit, (it went great, btw), and they are pretty strict on education for residents... so, honestly your training is roughly going to be the same no matter where you go. We all take the same written and oral boards after we graduate. So, go where you want to live!

Q

speaking of that , hows tampa. im in chicago right now and it was the begining of december when i realized that i hated being cold. im definetly thinking about usf for residency. how is the program, and where are some other good/warm programs

 

[saffron]

speaking of that , hows tampa. im in chicago right now and it was the begining of december when i realized that i hated being cold. im definetly thinking about usf for residency. how is the program, and where are some other good/warm programs

yeah im also considering tampa and want some opinions on how it is to live there. some ?s : is it too small? how is the singles scene? is it too conservative (someone told me it has a hick-ish feel to it and there is not much diversity in both the program or the city...not sure how accurate this is)?

 

[corpsmanUP]

I have 2 more interviews but I have essentially made up my mind what my number 1 is. I won't mention here until after ROL is required to be submitted by all parties, but I think it will surprise some people. Ultimately I did not choose my number 1 based on it being the end all best EM program in the country. I mean don't get me wrong, I feel it is an incredible program, but it certainly does not stand out like my number 2 program. My number 2 would be many people's number 1, but I had to find a balance. For me it started with fine people, a livable place, and a well rounded education that included rotations outside the ED. I literally made a spreadsheet and created values for many different categories, and graded the programs on this scale. In the end, I even surprised myself with some of the results. The only complicating factor is the last 2 interviews I have remaining but based on this grading scale it will be very easy to figure out where they get put on my list. I think the hardest part is to come up with the grading system, because it is different for all of us. I graded categories for 1) People, 2) City, 3) Kid's schools, 4) Ancillary things like parking, health benefits, and even pay. Some categories had subcategories like city, where I deducted big time for traffic, commute, polution, weather, sports, etc.... Some things were worth only a few points while others were worth tons (like People...which was 40% of each program's grade). In the end, it has helped me to be at peace now to know that I was not just choosing based on some "feeling". I caution anyone not to judge something on a "feeling" you got while you were there for one day, because it might have just been gas!!

As I said in another post, I did a 2nd look at a place last week that gave me the "feeling" before on my interview day, and during my 2nd look the wheels came off!!! I found things I could never have found without a 2nd look, and it was somewhat sad. I took my wife all the way there all excited and ended up leaving with my tail between my legs. Fortunately I did a 2nd look at 2 places in 2 days and one of them ended up being much better even than the original first look interview.

So I know I said a lot, but I think you would be selling yourself short to just judge all these places on a whim and a "feeling". Really lay out a system of grading them because there are so many important factors in choosing a program. Now I just wish these last 2 interviews were over and that match day was next week. I have a feeling the last month is going to be grueling for all of us. Luckily we are entering a specialty where none of us are going to end up in some crappy program, because I don't believe one exists. Good luck to everyone!