What to look for in a peds residency program?

[meggielou]

Hi. I haven't posted in several years, but with residency applications coming up, I have a few questions. I did a search but didn't find too much.

My question is: What exactly should I be looking for in terms of simply applying to programs? I've looked at boards pass-rates and numbers of residents in each program, but beyond that and geography, I don't know what other factors to use to apply. I plan to stay in the NY/NJ area.

Is this just one of those things where I'll have to take a stab at applying and then let the interview be the judge? Any suggestions are welcome!

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[Lee Ik-jun MD]

Came across this, since i have some students getting ready for the 2017 Match.
and i gave them this advice.
Decide where you want to be ( which state)
for me it was California>Boston>Rhode Island> New York
and i'm glad i matched in my number 2 choice in Cali.

When you narrowed down the state, then you pick the programs.
word of mouth still works, so it's best to talk residents from your medschool.

 

[mvenus929]

Size of the program
Freestanding hospital vs hospital within a hospital
Fellows vs no fellows
Availability of as many sub specialties as possible with regular teaching opportunities
Mix of rotations--a certain number of everything are required by ACGME, but there's a lot of little variations, especially with the amount of inpatient vs outpatient and ICU time.
Support for QI and research projects

Everyone is going to have slightly different priorities, and no one can give you an idea of what your priorities are or should be. That's why you apply to a variety and compare them directly.

Edited to add some things I've thought of in the last 24 hours--
- The fellows vs no fellows thing--I go to a program that does not have many fellows at all, and that means I get to work directly with attendings. But you have to be careful, because sometimes no fellows means that there isn't a large enough patient population to support them, so you lose some variety of cases (that's not the case at my program--the attendings just actively choose not to have fellows and prefer working with residents). And for the programs that DO have fellows, you want to know how much interaction you do have with the attendings, since if you choose to subspecialize, they will be the ones giving you letters.

- Not everything happens at even all of the large children's hospitals. We don't do bone marrow transplants. There is a turf war going on with cardiothoracic surgery in our region. Burns get sent out. Ask what gets sent away vs what stays in house--if the things you are interested in get referred out, it might be better to look at a different program.

- In general, patient population is a good thing to ask. What's the socioeconomic make-up of the patients you serve? Are they primarily urban or rural? How does your continuity clinic differ from the other pediatric practices in the area?

- Then, some of the little things that are good to know--how much commuting do you have to do? Do you have to frequently go to different locations during the day, and if so, how is traffic? How is housing around the hospital and where do most residents live?

 

[Pedsdoc13]

I agree with mvenus. When I was applying, the general mantra from my attendings was "all programs are basically the same with same ACGME requirements". But, now that I've finished residency and talked with people in other programs, I don't think this is entirely true. Things to look for that may be very different among programs include:

- support of residents by chief residents and program directors
- schedules, particularly in junior and senior year, some will be 90% inpatient with q4 call for the majority of the year, and others will be primarily outpatient with a mix in between, these will provide different learning experiences and you have decide what you prefer and what works best for you
- fellow presence/teaching vs not
- quality and happiness of senior and co residents, in truth the majority of what I learned, I learned from them. So, it's nice to hear that they go out their way to teach and support you as an intern
- teaching offered, both formal and informal
- ability to personalize program to your interests, i.e. sub speciality clinics, time working with government to advocate for your project, time to complete research/QI project, etc
- what do most of the graduating fellows do? If 90% go into primary practice or vise versa into subspecialities, that tells you the focus of a program
- mentorship- what do they offer, how approachable are the attendings?
- and most importantly- are you going to be happy there? What goes into this decision varies by individual, but for me it included location, weather, finances, clicking with people, and my SO's opinion and thoughts on moving.

 

[ssttrrbbk]

Location is big. I think size is big--> too small a program and everyone is in everyone elses business. Additionally small programs can limit exposure to things. I really think that the EMR can change your happiness. if its cumbersome and causes a lot of extra work every am that will strain you. How receptive is the fellowship to change. Is the fellowship supportive in your particular goal (academics, learning to be a great outpatient private practice physician, a particular research interest).

The residency should fit your goals.

Mentoring is so critical and I think again why a bigger place may be better. More mentors to chose from and more diversity of mentors.

Happiness of the residents.

Are they focused on residents or fellows. --- this ultimately didn't matter to me so much as I'm in an outpatient subspecialty so I didn't care if a fellow was there to do a PICU, EM procedure. My residency actually had few fellows and so I didn't experience that. My med school had tons of fellows so they sometimes got preference especially in early months for procedures over residents

 

[ChipperChop]

I am an IMG but I really wanted to end up near my hometown in the NE. I was also torn with prestige. In retrospect, the biggest reason I was happy was because I was close to family and long time friends. Also, I am with a smaller program which makes for more tight knit friends and better relationships with attendings. These things will make your time in residency more tolerable.

But now that I am applying to fellowship, I neglected the challenge of coming from a program without a great fellowship pursuit/match rate. It's hard to tell whether a program isn't matching its residents or they are just not interested. Either way, it makes the process harder in terms of advice and guidance. But hey, maybe you want primary care

Regardless, I wouldn't change my choice in residency