What to look for in residencies?

[podsicle_stick]

I'm currently a second year student and I want to get started on researching residency programs. Beyond cost of living and pay, what are some other factors that I should consider?
Would you recommend reaching out to programs that I'm interested in this early on or is that trying too hard? Thanks in advance!

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[DexterMorganSK]

I think it's a little too early to reach out to programs during the 2nd year. Your focus should be more on preparing and passing Part 1.
During your 3rd year, you should start looking over the list on CASPRWeb and possibly making a list of your future externship sites. If somehow you cannot get to extern at a location of your choice, then send them an email asking for a visit. It makes more sense to visit a program in your Junior/Senior year because you will know enough to answer a question (if pimped) and mature enough to know the ins/outs of that particular program.

Also, IMO, the resident salary shouldn't be a deciding factor; instead, the type and the number of cases the current residents are doing is far more vital. In addition to their academics, clinic work, research, etc., all factor into making a program worthwhile for an externship. Look over the program evaluations from your school and decide if program A is better/worst than program B.

That said, I would focus more on grades/part 1 prep during the 2nd year. You will have enough time to visit/extern from the 3rd year.

 

[heybrother]

So here's my joke on the salary thing - a classmate of mine told me - that when he made his list he dropped all programs that paid less than ... it was like $45-50k. He still had no shortage of good programs to choose from. Show me a historically good program that pays less than $45K. A few years ago that would have dropped West Houston off the list, but even they now they pay $43-47K. They used to be pay like $37 which I feel like would have been tight.

 

[Feli]

... the resident salary shouldn't be a deciding factor; instead, the type and the number of cases the current residents are doing is far more vital. In addition to their academics, clinic work, research, etc., all factor into making a program worthwhile for an externship. Look over the program evaluations from your school and decide if program A is better/worst than program B.

That said, I would focus more on grades/part 1 prep during the 2nd year. You will have enough time to visit/extern from the 3rd year.

I agree with everything said above.^

Salary of $55k at one mediocre/poor Atlanta program vs $50k at another good/great Atlanta one is only $15k over three years. You can play that game for any state/metro. That difference is nothing in the grand scheme. If the first program has hundreds fewer cases, lower quality teaching docs, and less academics and mediocre peer residents to the point where you might struggle or fail boards unless you put in mega work/reading on your own (where you would've passed easily at the latter due to the culture/teaching/peers), then may have let 10k or 20k cost yourself hundreds of thousands of dollars over the next few decades of your career. That's not to mention you have more to offer your patients if you get the highest quality training you are able to match.

Be reasonably flexible on residency location and very flexible on salary. Be greedy and pretty rigid on getting good training volume and quality.

 

[air bud]

I'm currently a second year student and I want to get started on researching residency programs. Beyond cost of living and pay, what are some other factors that I should consider?
Would you recommend reaching out to programs that I'm interested in this early on or is that trying too hard? Thanks in advan

So here's my joke on the salary thing - a classmate of mine told me - that when he made his list he dropped all programs that paid less than ... it was like $45-50k. He still had no shortage of good programs to choose from. Show me a historically good program that pays less than $45K. A few years ago that would have dropped West Houston off the list, but even they now they pay $43-47K. They used to be pay like $37 which I feel like would have been tight.

but no state income tax....yeah that sucked

 

[iridocyclitiss]

I visited a few programs in my second year and I loved it! It is A LOT of work and I would agree with everyone above. Passing part I should be your number 1 priority and visiting great programs won't matter if you can't pass boards. I feel like visiting programs was a good break and helped me not get burnt out of the 2nd year study grind. They didn't expect a ton from me (just basic LEA questions and reading simple x-rays). I think its helpful to see how the residents interact with each other, attendings, seeing their caseload, etc.

Alternatively you can always email programs and ask if they have virtual academics/case review. It's less pressure than an all day visit, but you can see what kind of cases they get. Great learning experience.

 

[Weirdy]

What above posters said.

You do not even know what you should be looking for. Pay does not matter if you get **** training and are stunted from growth by the time you graduate residency.

Have already written about this. Search for it. Break the program down into 2 sections:

A) Hard skills. How many cases are the residents able to do? How many surgeries can they scrub? How much clinic time do they have? What is their work schedule? Are they taking enough call to be competent to manage anything that comes through the ED? When do they meet their numbers? Are they triple scrubbed for even the smallest surgery cases? How many attendings do they get to work with? Are they seeing a good volume of rear and forefoot numbers? Are they seeing multiple pathology with different demographics? How many residents are there per year and does this diminish your surgery volume?

B) Soft skills. Are they seeing complications and learning how to manage them? Do the attendings treat the residents with respect and teach them? Do the residents get along with each other? Do the attendings let residents hold the knife instead of retracting? Are the attendings teaching or just doing all cases and running clinic by themselves? Are the residents backstabbing each other or do they work for the team? Are the attendings pushing the residents to be better? Are the residents just doing scut work and not actively learning how to manage patients and complications?

The 3rd section comes last and is purely for personal preference. Location? Will your significant other be happy? Does the training compensate for the high/low cost of living in the area?

C) other things to keep note of from student standpoint while interview/ranking: Does this place have adequate training for what you want to do when you get out? Does the program actually want you? Do you have what they are looking for? Do the residents want you there? Is it a place you can see yourself fitting in? Is it a place you will be able to get along with and learn from the attendings? Do the characteristics of the current residents there fit you? Will you be able to get along and suffer with them for 3 years? Does your wife/husband to a certain degree- happy with the location for the most part?

Edit: Gave up a desirable location for myself and wife knowing place I ranked 1st had better training. Would do it again if I had to- its just the right thing to do.

 

[MrFahrenheit]

I would agree.... to finish off your first year strong and focus on that before adding more to your already filled up plate.

 

[NobodyDPM]

People are basing their choice of residency on what the salary is? Really?

 

[iridocyclitiss]

People are basing their choice of residency on what the salary is? Really?

I made spreadsheets for highest salaries for lowest COL. It ended up not playing as big of a factor when it came to choosing clerkships. There are a few classmates of mine have who maxed out on all of their student loans exclusively chose places based on COL and Salary.

 

[OblivionDPM]

Please don't forget that while the majority of the graduating body are single. Some of us have kids and are married. As a result, it's definitely not something that I solely base my decisions on, but I take into consideration 45k vs 62k, for example.

At the end of the day, the training is #1, full stop.

For my family size, I require at minimum 2 bedrooms, with 3 bedrooms being ideal. Depending on the location of the program, that is a big spike in prices (especially given the current market + COVID).

The nice thing is that the majority of the "Average/Above average/Excellent programs" offer a decent cost of living and salary so this doesn't really become an issue, thankfully.

 

[NobodyDPM]

Please don't forget that while the majority of the graduating body are single. Some of us have kids and are married. As a result, it's definitely not something that I solely base my decisions on, but I take into consideration 45k vs 62k, for example.

At the end of the day, the training is #1, full stop.

For my family size, I require at minimum 2 bedrooms, with 3 bedrooms being ideal. Depending on the location of the program, that is a big spike in prices (especially given the current market + COVID).

The nice thing is that the majority of the "Average/Above average/Excellent programs" offer a decent cost of living and salary so this doesn't really become an issue, thankfully.

True, but hopefully your spouse/partner can add to the family pot by working while you are in residency. Which helps A LOT.