What's so important about the ranking of a program?

[realruby2000]

I'm interested in em....

i read somewhere that there are aobut 1100 em programs available to us med school grads....

what i wanna know is whats the difference in doing an em residency at a highly reputable place like duke vs a "not so popular" place like some random city/suburban hospital...?
I know duke might offer more/better training....but in the end, arent you going to end up as an Emergency Physician able to practice medicine whereever u want? what are the real benefits of going to a big name program besides prestige? do residents from "no name" programs have a lower salary or have a harder time finding a job?

thanks

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[PMPMD]

Originally posted by realruby2000
I'm interested in em....

i read somewhere that there are aobut 1100 em programs available to us med school grads....

what i wanna know is whats the difference in doing an em residency at a highly reputable place like duke vs a "not so popular" place like some random city/suburban hospital...?
I know duke might offer more/better training....but in the end, arent you going to end up as an Emergency Physician able to practice medicine whereever u want? what are the real benefits of going to a big name program besides prestige? do residents from "no name" programs have a lower salary or have a harder time finding a job?

thanks

Duke's EM residency program is brand new. The first residents started in June of this year, so the EM program couldn't really have developed a reputation yet. But you have a good point, since there are 120+ programs, does it really matter if you're in the top 5-10? I would think as long as you're not in a program that has any negative stigma attached to it you'd be fine.

 

[DrQuinn]

Like the previous poster said... Duke has a brand new residency with no alumni... so their reputation is still up in the air... I just think its funny (and a coincidence) that you picked Duke as your example for EM. Anyways, I don't think it really matters where you do your residency, as long as it prepares you for what environment you will go into...

Example... I know a DO who did a DO residency at a no-namer DO hospital... and he is now one of the big wigs at a Level II Trauma center ED with a couple of non-EM residencies... I saw patients with him and he definitely knew his stuff, and I was VERY impressed (more impressed with some of the MDs I've seen graduate from "Duke-like" prestigious residencies. Something to think about. I think in the end, its more important that you find a residency YOU like and that you think will prepare you well.

 

[tonem]

The best argument for going to a place like Duke or Harvard or (insert high powered elite institution here) is that even if their EM residency is new and maybe mediocre your off service rotations (ie: Medicine, Surgery, OB/Gyn) will be on some pretty well-known, well-respected services. If they also happen to rotate through large county hospitals (like Stanford does), you'll get a pretty well rounded education and more bang for you buck.

 

[Wheazer]

First of all EM residencies have never had an official ranking, unlike many of the other specialties ranked by various groups like US News and reports. The residencies are regarded among the prefesion with a spectrum of opinions based entirely on who you talk to and where they have been. So any comments on rank should be taken as merely subjective. However several residencies always come up in discussions of top programs.
As you research you will find that different programs have variable atmospheres socially, academically and obviously geographically. They also vary in focus. Some programs are known for ultrasound, others for trauma, some for EMS.... So the point is that someones opinion of a programs national status should be qualified and your interests and goals should coincide with that residency.

A more generic hospital reputation may carry some weight among the NONEM and the lay public. However, within the relatively small world of EM, we all are farely familiar with most programs and have some insight into the strengths and weakness of the residencies. A big name hospital does not neccesarily have a reputable or rather quality training program in EM. A national reputation among EM physicians can give you an edge for competetive positions But EM residents are not suffering for job opportunities.

Finally, matching with a particular residency is based on many very individual factors. If your goal is to fill an academic position in EM and practice at a large University or academic hospital, a smaller community hospital based residency is an unlikely stepping stone along your path (but not imposible). Likewise if you plan to practic in podunk hickorystum the rigors of a malignant academic residency with extensive research and endless browbeating may also be a poor fit. And if you have no clue other than gee EM see fun then go somewhere that can expose you to all the posibilities.

Whew I got carried away, time for bed.

 

[DoubleDoctor]

The EM program at the University of Cincinnati is the oldest in the country. Highly competetive though.

 

[jpgreer13]

Some programs are definitely more academic and research-oriented than others, so if you're wanting to go into academic medicine, it might benefit you to try and maneuver into these high-powered programs solely for research opportunities and name recognition and grant money and all that. Also, when you look at a residency program, one think to ask is how well will that residency's didactic program prepare you for your board exams, because EMs take a pretty extensive board certification. I read somewhere on the web that, for example, no Vanderbilt EM resident has ever failed the board exam.

Other than that, though, the RRC ensures that when you graduate from any accredited residency, you will be prepared to practice emergency medicine. It's a question of how much you choose to put in, and that generally determines what you get out of it. Also, consider what you want to see a lot of - if you plan to do urban work, then you need to be at an urban trauma center where you'll have lots of knife and gun club stuff all the time. Different programs are suited for different people, and just because a program's prestigious, that neither guarantees you will be happy there nor that you will be optimally prepared personally for what you plan to do in your career.