Which is best, a new program or an established one?

[ddjamb]

---

Members don't see this ad.

Beside going into the unknown, what are the advantages/disadvantages to train in a new, unopposed residency program?
I am looking at 2 Family residency programs in same area, serving the same populations, both unopposed. Program A has been well established (14 years, with board pass rate above 96% in the last 5 years) and Program B, just started this year.

If anyone can share his/her experience with a new program....thank you

 

[gutonc]

Established. No question.

 

[DrElliotReid]

Agree with @gutonc. Definitely go with the established program with a good track record since you have the choice. A new program will come with unexpected hiccups/issues along the way. If you had no choice then you'd have to deal with it, but since you do have a choice...

 

[GoSpursGo]

There are no advantages and multiple disadvantages associated with going to a new program.

 

[GoSpursGo]

There are no advantages and multiple disadvantages associated with going to a new program.

 

[ddjamb]

Thank you all for your comments.

 

[hamstergang]

Beside going into the unknown, what are the advantages/disadvantages to train in a new, unopposed residency program?

What were you thinking would be an advantage of a new program? What is it that makes you debate this decision?

 

[mvenus929]

Established > New > Not matching

 

[ddjamb]

What were you thinking would be an advantage of a new program? What is it that makes you debate this decision?

I was thinking that with a new program you get a different experience, you get to help shaping the program, training will be directly from attending and not from upper class interns. Because nothing is established, you will have to work harder, be on top of your game all the time so ultimately become a better doctor. @DrElliotReid was talking about hiccups/issues along the way, but isn't that what we call experience?

 

[rokshana]

I was thinking that with a new program you get a different experience, you get to help shaping the program, training will be directly from attending and not from upper class interns. Because nothing is established, you will have to work harder, be on top of your game all the time so ultimately become a better doctor. @DrElliotReid was talking about hiccups/issues along the way, but isn't that what we call experience?

no those hiccups are impediments to you actually receiving the education and training you are supposed to get...in reality, 3 years is not a long time to go from an untrained med student to a competent physician, ready to practice with no safety net... do you really want to spend it somewhere where they are trying to figure things out?

there is no such thing as an upper class intern...there are senior residents who frankly are going to be important to you in training you as a physician...my fellowship was a 3:0, meaning that we had no senior fellows...while i fell that I had great training and my attendings were very available, there is something to having the guidance of a senior that an attending can't give you.

and realize those attendings at the new program... they are not used to having residents to teach...you will be the test subject...and its not like just because you are an attending, means you know how to teach residents.

and you are just an intern and a resident...you will have little say in how the program will be "shaped".

since all other things are equal, go with the established place.

 

[Crayola227]

yeah that all sounds like party line, and it all sounds great, but it's hardly an advantage compared to going somewhere with a track record of success. how could it be?

I mean, yes, if you go to such a program that is what you would get, but that doesn't make it a better choice

 

[mvenus929]

I was thinking that with a new program you get a different experience, you get to help shaping the program, training will be directly from attending and not from upper class interns. Because nothing is established, you will have to work harder, be on top of your game all the time so ultimately become a better doctor. @DrElliotReid was talking about hiccups/issues along the way, but isn't that what we call experience?

I formed pretty close relationships with some of my attendings in residency, because there were no fellows to serve as a go-between. When I had a question for the consultant, I called the attending directly. I still can’t imagine going through intern year without second and third years to guide me. As a new class, especially at a program where there haven’t been residents before (there was a new peds program within the past few years that has had residents forever, they just decided to open up their own program, which I think it a bit different), no one is going to know what to do with you. The attendings will all have their way of doing things, and will have you along for the ride.

I wonder sometimes how good it is to have a service dependent on trainees to run it vs have it able to function without them. Cause if the service is dependent on the residents, they will learn by doing. But if it’s not, they may not have to deal with as much fluff.

 

[ddjamb]

@mvenus929, that is what I was thinking...forcing yourself to be hands on, so you learn, especially in unopposed program...but I see everybody's point.
@rokshana, I agree, not everybody can teach
@Crayola227 how do you measure a program's success? Board pass rate?

 

[Crayola227]

@mvenus929, that is what I was thinking...forcing yourself to be hands on, so you learn, especially in unopposed program...but I see everybody's point.
@rokshana, I agree, not everybody can teach
@Crayola227 how do you measure a program's success? Board pass rate?

The first way I measure a program's success is by what percent of people starting the program finish it. Resignations or transfers are less concerning than terminations, but either way, less is more here. Not getting into any questions of malignancy or fault with this. Just, it's a good sign if just about everyone who matches graduates. But that's me.

Board pass rate depends on so many things, I would just say it's more that I would be alarmed if it was exceedingly under what is considered average for more than what seems like a fluke year.

I think, at least in one specialty I might speak to, that it was something that had to be recorded and tracked and averaged over a certain number of years (I want to say 3 or 5 in this case) so a fluke year can bring it down. I think this was related to the program's standing as far as probation or accreditation. So this is all to say it's something that doesn't matter until it matters, if you get my meaning. Obviously the thing about averaging and tracking and accreditation is going to be looked at differently for a brand new program.

I interviewed at a few brand spanking new programs, so I'm not totally off my rocker here. And one PD during my interview discussed the issue with board pass rates I'm telling you here.

Do people finish the program, does the program have accreditation/good standing/ACGME violation type issues, and if people try hard will they pass the boards, if the pass rate is seriously sucky, is it because the program doesn't prepare you decently enough or do they pick idiots? Both are bad.

Well, so that addresses that the most basic definition of "success": will it make you a practicing attending.

People will say, well that is hardly a way to measure a program's success. But, well, hardly. Because those are precisely a few of the questions that can't be answered well if at all by newer programs, and yes, there are a small handful of outlier programs that you may fortunately exclude from your Match list as a result of asking these questions.

 

[AdmiralChz]

This one isn’t hard. In addition to what is said above, I have a couple additional “cons” to add to the mix.

A couple of years ago there was a new FM residency that closed after 2 years after it started since it didn’t meet ACGME standards. New programs get preliminary/probationary approval but not full accreditation.

At Carney Hospital, regret at family medicine program’s end - The Boston Globe

Also program alumni can be a huge help to finding a job, particularly if you are interested in a competitive marketplace. If you want to join a group, for example, they will have no way of knowing how your training was and you could get passed over if there are other applicants. Same thing is true for fellowships.

Also, at the risk of sounding borderline xenophobic... look at the rolls of brand new programs out there. I hate to say it, but usually they don’t have US MD/DO or Big 3 Carrib grads... I’ll be willing to wager these aren’t the competitive relative superstars with stats required to match in established programs. But that is pure, pure speculation.

 

[GoSpursGo]

how do you measure a program's success? Board pass rate?

Board pass rate is an important one. For certain specialties, how they do in terms of matching for fellowships could also be important. Opportunities for research and publications, again if relevant to your specialty.

The first way I measure a program's success is by what percent of people starting the program finish it. Resignations or transfers are less concerning than terminations, but either way, less is more here. Not getting into any questions of malignancy or fault with this. Just, it's a good sign if just about everyone who matches graduates. But that's me.

Do people finish the program, does the program have accreditation/good standing/ACGME violation type issues, and if people try hard will they pass the boards, if the pass rate is seriously sucky, is it because the program doesn't prepare you decently enough or do they pick idiots? Both are bad.

People will say, well that is hardly a way to measure a program's success. But, well, hardly. Because those are precisely a few of the questions that can't be answered well if at all by newer programs, and yes, there are a small handful of outlier programs that you may fortunately exclude from your Match list as a result of asking these questions.

Um. Yeah, if a program has a lot of residents resigning, getting fired, or transferring away, that's a pretty big red flag. That's the very, very minimum baseline that a program should be measured by, but if the OP is looking at such programs then they're probably desperate and can't be picky.[/user]

 

[ddjamb]

Desperate no, worried maybe. Thank you all for your input. it was very interesting.

 

[pgy0246]

As a corollary, even among establish programs, avoid matching to a residency with a brand new program director. You do not know what's his/her management style is.
I have seen a couple of cases, where a benign program turned into a malignant one over a few months.