where you do residency=where you will practice?

[jjy2103]

i am wondering if where you do your residency impact where you will end up practicing....

i am considering opthamology and anesthesiology...in applying for residency programs, should i only choose places i want to live in full time whether it is in private practice setting or in a hospital?

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[staylor21]

Statistically, the geographic area where you do residency is likely where you'll end up practicing. The degree to which this is a selection effect (so that people tend to choose residencies located near where they want to practice) versus a treatment effect (so that where you do residency directly affects your likely prospects--for example, if you do a residency at a place with less of a national reputation, you may find it harder to get a job in another area) would be an interesting idea for research.

As for what you should do, for sure you should only apply to areas for which you'll be willing to live for the entirety of your residency period--my guess is that this list of areas and the list of areas where you want to practice wil be closely correlated.

 

[glamqueen]

Statistically, the geographic area where you do residency is likely where you'll end up practicing. The degree to which this is a selection effect (so that people tend to choose residencies located near where they want to practice) versus a treatment effect (so that where you do residency directly affects your likely prospects--for example, if you do a residency at a place with less of a national reputation, you may find it harder to get a job in another area) would be an interesting idea for research.

As for what you should do, for sure you should only apply to areas for which you'll be willing to live for the entirety of your residency period--my guess is that this list of areas and the list of areas where you want to practice wil be closely correlated.

I would say that they aren't correlated actually. Depending on how competitive of a field you are going into - some people would sacrifice the years of their life during residency to live in a less-than-desirable location (according to them) in order to become the type of doctor they want to be. Others may live in a lower cost of living type destination that may not be where they eventually want to settle, but may have the right combo of a non-malignant program plus affordable location plus good schools for their family. Then again, others may want to spend residency trying out an area of the country knowing they will probably move closer home to family in the end, but at least will have had "the experience" of living such a place - NYC comes to mind for many people.

Just my two cents...

 

[staylor21]

I would say that they aren't correlated actually. Depending on how competitive of a field you are going into - some people would sacrifice the years of their life during residency to live in a less-than-desirable location (according to them) in order to become the type of doctor they want to be. Others may live in a lower cost of living type destination that may not be where they eventually want to settle, but may have the right combo of a non-malignant program plus affordable location plus good schools for their family. Then again, others may want to spend residency trying out an area of the country knowing they will probably move closer home to family in the end, but at least will have had "the experience" of living such a place - NYC comes to mind for many people.

Just my two cents...

It's an empirical question. To say they aren't correlated is a strong statement though. All of the things you mention are true, but I don't think in aggregate they apply to the majority of candidates.

Again, it's a fact that people tend to end up practicing in the area where they did residency. This can be due to selection (they chose the residency area bc it's where they wanted to practice) and/or treatment (the program changed their preferences/made it harder for them to get jobs elsewhere). I imagine selection plays a large role, and note that selection (by definition) implies that these lists are somwhat correlated.

 

[Law2Doc]

i am wondering if where you do your residency impact where you will end up practicing....

i am considering opthamology and anesthesiology...in applying for residency programs, should i only choose places i want to live in full time whether it is in private practice setting or in a hospital?

It won't have much of an impact -- I wouldn't dismiss a better fit residency because of where you plan to relocate. I do agree that there is a certain amount of self selection going on -- lots of people get settled during a 3+ year residency and decide not to move again, so you will see plenty of people ending up practicing in the area where they did their residency, but it generally has nothing to do with their ability to get a job in another region.

Staying local could make your references mean more if the places you are applying actually know the attendings you work under, and so in smaller geographic areas where everybody in the field knows each other this could be advantageous. Bear in mind that in many fields you may end up doing a fellowship and thus have another opportunity to move, post-residency before looking for a job.

 

[jjy2103]

well i guess i should add this to my question...

my step 1 score is sort of in borderline for getting ophthalmology...but high enough to get anesthesiology in locations i want...
i am considering both but prefer ophthalmology...

i was weighing whether i should apply to less competitive locations in order to get ophthalmology in hopes of being able to get a job in california later or if i should apply to california anesthesiology (i.e. take a second choice residency in order to secure my future in my hometown.)

i fear if i take the less competitive residency it would be hard for me to get a job in california once i finish...

thanks for the advice...

 

[peppy]

I think a big reason why people don't move after residency is because you put down roots during residency (many people buy a house, a lot of people have kids during that time, the spouse finds a job in the area, you make friends, etc.) and for most people it isn't worth the hassle to pick up and move across the country. Very few specialties of docs have a hard time finding work where they want to live. I'd pick the specialty you like most and see where you wind up. Remember that you are never guaranteed to match into the location you like best even if your scores are above average for them. A lot of people get surprised (or even disappointed) on Match Day buit then manage to make the best of it.

 

[45408]

opthamology

ophthalmology...

Which one is it?

I agree with peppy that it's because people put down roots after being their for 3-7 years and don't want to leave.

 

[Donkeykiss]

Faculty in some places purposefully select candidates from far away...hoping they leave afte residency...thus keeping the supply of their specialty low..there's a monkey wrench for you

 

[shopsteward]

If getting a job (or getting the kind of job you particularly want) post-residency depends on the contacts you have made, then the location of your residency could affect where you work, because the majority of the contacts you make in residency are likely to be in that area.

 

[Arcan57]

Restricting where you apply based on geography can backfire, especially if you misjudge your competitiveness in the field. Only applying to CA programs (regardless of whether its optho or anaesthesia) can be a fine way to scramble into a prelim in any number of states where the temp is below freezing for >1mo at a time. Decide where you cannot tolerate living for 3-5 years, and apply to everywhere that doesn't meet that criteria.

 

[Law2Doc]

well i guess i should add this to my question...

my step 1 score is sort of in borderline for getting ophthalmology...but high enough to get anesthesiology in locations i want...
i am considering both but prefer ophthalmology...

i was weighing whether i should apply to less competitive locations in order to get ophthalmology in hopes of being able to get a job in california later or if i should apply to california anesthesiology (i.e. take a second choice residency in order to secure my future in my hometown.)

i fear if i take the less competitive residency it would be hard for me to get a job in california once i finish...

thanks for the advice...

If you prefer optho, apply for optho. Do your prelim in california (to create more nexus to the region) and once you finish residency, try to get a job in cali. You don't want to do what you enjoy less just because you hope to end up in a geographic region. Things change, your life will be different in 4+ years. You may have roots, your reasons for wanting to be in cali may have moved on, etc. You have to focus on what will make you happiest for the next 40 years of your career.

 

[JackADeli]

This is my 5 cents...
If you (or you family/significant other) will not be able to tolerate the geography of a particular training program for the 3-5+ years of training, you shouldn't train there. But....

aside from above, you should not choose a training program based on geography. You should seek the best possible training opportunity in whatever state it takes. Yes, you may not plan to stay in said state after your training. However, the higher the quality of training you get will often lead to higher quality job opportunities elsewhere.

 

[mig26x]

I did my residency in MA and started my first job in FL. All my family was in FL so it was the best move.

 

[deleted109597]

The real world is not like graduate medicine. You get a job because you're qualified, and you interview well. Having someone know someone helps, but as a doctor, you can work almost anywhere you want. Sure, desirable places pay less on average, but that's because they have more people applying.

If you want to work on eyes, do ophthal. If you want to pass gas, do anesthesia.
Or, apply to both. They are different matches.