Advice on potential Peds residency

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tjo422

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I'm hoping some of you in this forum can give me some advice. I'm currently in the MD app cycle, and applying to an accelerated program. For this program, I would interview for my choice of residency at that school (peds) after being accepted for regular admissions but before matriculation. If you get accepted, you complete your MD in three years, essentially dropping the fourth year where you'd be doing residency interviews and you get an automatic match to the residency program at that school.

If you were interviewing someone that went through the above program for a fellowship spot, would the accelerated program be a detriment?

**redacted personal details for privacy**

Thoughts?

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This is an interesting program. I've heard of combined undergrad and medical school with condensed schooling (6 to 7 years) and I've heard of fast tracks in pediatric residency through PSTPs with guaranteed fellowships with a research focus, but I've never heard of this type of program. Interesting.

The pros you stated all seem reasonable.

To address the cons:
- Although it's a great school, there are other peds programs in the same city that are more competitive than this one, and I'm not sure how this would influence my potential for fellowship apps.
I will say that were you come from in residency can impact your application, but the reality is it doesn't really matter. If you are serious about research and get something publishable out of it, that will do far more for you are far as applying to fellowship than where you went. Of the applications I've seen for PICU fellowship this year, I would say only about 30% to 40% actually have a published paper in Pubmed. More than 1 published paper, it is probably in the 5% range. Thus, by doing research and getting a paper out of it, you've already differentiated yourself from more than 1/2 the applicants. And even going through this research program makes you unique and desirable to have (on top of the fact that you are completing a PhD). An applicant with a clear career goal will always be ranked over an applicant without one.
- Negative of having one less year of med school compared to other applicants (again, not sure if this actually a con or not).
Again, I'm unfamiliar with this program (it is almost like a European model of training). Are things just condensed? What is lost? I would think it would be okay, except that your may lose clinical experiences that may help you in the future. Children can have surgical, psychiatric, even OB related issues, too and those experiences may be helpful to you. Granted if what you missed were adult experiences but got to keep the pediatric ones that would be fine (ie, you're not going to see Alzheimer's or prostate cancer in pediatrics, but you do need to know about depression and hernias). Anyway, I suppose that choice is personal but it is hard to know if it is a good thing or bad thing without knowing how the program is structured.
 
This is an interesting program. I've heard of combined undergrad and medical school with condensed schooling (6 to 7 years) and I've heard of fast tracks in pediatric residency through PSTPs with guaranteed fellowships with a research focus, but I've never heard of this type of program. Interesting.

The pros you stated all seem reasonable.

To address the cons:

I will say that were you come from in residency can impact your application, but the reality is it doesn't really matter. If you are serious about research and get something publishable out of it, that will do far more for you are far as applying to fellowship than where you went. Of the applications I've seen for PICU fellowship this year, I would say only about 30% to 40% actually have a published paper in Pubmed. More than 1 published paper, it is probably in the 5% range. Thus, by doing research and getting a paper out of it, you've already differentiated yourself from more than 1/2 the applicants. And even going through this research program makes you unique and desirable to have. An applicant with a clear career goal will always be ranked over an applicant without one.

Again, I'm unfamiliar with this program (it is almost like a European model of training). Are things just condensed? What is lost? I would think it would be okay, except that your may lose clinical experiences that may help you in the future. Children can have surgical, psychiatric, even OB related issues, too and those experiences may be helpful to you. Granted if what you missed were adult experiences but got to keep the pediatric ones that would be fine (ie, you're not going to see Alzheimer's or prostate cancer in pediatrics, but you do need to know about depression and hernias). Anyway, I suppose that choice is personal but it is hard to know if it is a good thing or bad thing without knowing how the program is structured.

Thanks for the reply! The school has a 1.5 year pre-clinical curriculum regardless of track. Years 1-3 are largely the same otherwise, the differences are mandatory research and clinical experience during the summers before and after M1. Because of this, they fit all required clinicals and sub-Is in the last 1.5 years. What's missing is mostly the time they give M4s to do interviews and apps for residencies and some extended time for individual projects (but again, this is compensated for by those extra summers). None of the actual requirements (pre clinical or clinical) are skipped over or anything like that. It is definitely a research heavy institution, and I have a prestigious research fellowship to my name and the experiences that come along with that (plus a PhD) so I'm hoping that is one area where I can shine on my potential application for fellowships.


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Thanks for the reply! The school has a 1.5 year pre-clinical curriculum regardless of track. Years 1-3 are largely the same otherwise, the differences are mandatory research and clinical experience during the summers before and after M1. Because of this, they fit all required clinicals and sub-Is in the last 1.5 years. What's missing is mostly the time they give M4s to do interviews and apps for residencies and some extended time for individual projects (but again, this is compensated for by those extra summers). None of the actual requirements (pre clinical or clinical) are skipped over or anything like that. It is definitely a research heavy institution, and I have a prestigious research fellowship to my name and the experiences that come along with that (plus a PhD) so I'm hoping that is one area where I can shine on my potential application for fellowships.


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Sounds good then. I hope they give you some time to study for Step I and II in all of that, as those will matter for fellowship applications too.
 
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Sounds good then. I hope they give you some time to study for Step I and II in all of that, as those will matter for fellowship applications too.

Yes, that's built in. The school has a decently high Step I score average, and they claim it has an upward trend because they block off time after 12 months of clinicals to take Step I. For the three year pathway, Step I is in the middle of M3, and Step II at the end of M3.


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I'm hoping some of you in this forum can give me some advice. I'm currently in the MD app cycle, and applying to an accelerated program. For this program, I would interview for my choice of residency at that school (peds) after being accepted for regular admissions but before matriculation. If you get accepted, you complete your MD in three years, essentially dropping the fourth year where you'd be doing residency interviews and you get an automatic match to the residency program at that school.

Here's my thing: I 100% know I want to do Peds. I'm a non-trad, and I've worked in 5-6 different hospitals at this point in different specialties. I love kids, can't really imagine working with adults, and loved the few months I got to spend at a children's hospital. I'm open to sub-specialty (or lack there of) within Peds, but my interests right now are in NICU and Cards. I love fetal medicine, but don't know if I'd prefer an intensive care setting or to specialize on a particular system, as I've enjoyed my experiences in both settings. I'm at the end of a PhD program, and both fields would allow me to incorporate my research interests in my career.

If you were interviewing someone that went through the above program for a fellowship spot, would the accelerated program be a detriment? Here are the factors I'm considering, maybe you can shine some light on things I may be missing from the picture:

Pros:
- Early mentorship comes with the accelerated program. You start in your department a few months earlier than the other med students on the traditional track, and have additional opportunities to form relationships with faculty and explore potential research projects. More time to learn the ropes, more opportunity to excel and get great letters/honors.
- Saving a year of med school tuition and living expenses and gaining an additional year of income. I'm not super concerned about having a crazy large salary, but considering my interest in Peds this could be helpful in avoiding debt.
- This particular school is opening a new pediatric hospital this year (I'm assuming this is a pro, since most of the great residency programs are at dedicated children's hospitals, but maybe that's a bad assumption).
- I get a guarantee for 6 years of living in the city where my future spouse already has established his career.
- I've talked to a student in this program in Peds, and he expressed that not only is he really enjoying his experience, but it seems that the faculty in the department really enjoy their jobs and teaching students.

Cons:
- Although it's a great school, there are other peds programs in the same city that are more competitive than this one, and I'm not sure how this would influence my potential for fellowship apps.
- Negative of having one less year of med school compared to other applicants (again, not sure if this actually a con or not).

Thoughts?

ETA - I already interviewed at this school and it is easily one of my top choices. I got a great impression on interview day and have a close friend that goes there and raves about his experience thus far. If accepted, there is a good chance I will attend regardless of the accelerated program, but I just want to see if it's worth applying for in the first place.


This sounds interesting. I have never heard of it but don't feel that it would be bad. My medical school (I graduated in 11) recently switched to 1 years pre-clinical and then 3 years of clinical rotations, research. I really don't think a three year program would miss much. From a fellowship perspective it depends on what you want to match in. Some programs take a lot of their own and some don't. I've heard two different fellowship programs discuss their matches and people really do it differently. Fellowships and sub-specialities are small communities and what they decide is important can vary on the small sub communities in pediatrics. You could ask some fellowship directors in the sub-specialty of your choosing what they find most important. Really though joining national organizations, being involved in that sub-specialty could compensate for a program that may not be big in the field you want to go into.


It's also really nice that you can guarantee you will be living in the city of your spouse. Family drama is something that makes the match horrible. I don't think you will hurt yourself and saving the debt and a guaranteed place to live is a nice perk.
 
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This sounds interesting. I have never heard of it but don't feel that it would be bad. My medical school (I graduated in 11) recently switched to 1 years pre-clinical and then 3 years of clinical rotations, research. I really don't think a three year program would miss much. From a fellowship perspective it depends on what you want to match in. Some programs take a lot of their own and some don't. I've heard two different fellowship programs discuss their matches and people really do it differently. Fellowships and sub-specialities are small communities and what they decide is important can vary on the small sub communities in pediatrics. You could ask some fellowship directors in the sub-specialty of your choosing what they find most important. Really though joining national organizations, being involved in that sub-specialty could compensate for a program that may not be big in the field you want to go into.


It's also really nice that you can guarantee you will be living in the city of your spouse. Family drama is something that makes the match horrible. I don't think you will hurt yourself and saving the debt and a guaranteed place to live is a nice perk.

Thanks for the advice. My other top choice is the next major city over and would probably be better for a career in Peds, but the prospect of uprooting his career and social life is daunting.

I've looked at my dream fellowship programs, and it seems to be half and half from internal or external residents. Lots of factors in making a decision, but at least it doesn't sound like I'd be at a disadvantage taking this opportunity if it's offered.


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I think this sounds like an awesome program. Wish I could've done something like this. I'm a current resident, so I can't comment on fellowship competitiveness, but I can say that the people that I've seen struggle most in residency had significant personal issues that impacted their academics. So, from a touchy-feely perspective, don't underestimate the importance of being in a location close to people who can support you during this stressful time. Work hard, get noticed for doing the right thing when the $hit hits the fan, and hopefully the rest will fall into place. :)
 
I think this sounds like an awesome program. Wish I could've done something like this. I'm a current resident, so I can't comment on fellowship competitiveness, but I can say that the people that I've seen struggle most in residency had significant personal issues that impacted their academics. So, from a touchy-feely perspective, don't underestimate the importance of being in a location close to people who can support you during this stressful time. Work hard, get noticed for doing the right thing when the $hit hits the fan, and hopefully the rest will fall into place. :)

Noted, thank you. We could make it work in any of the cities I've applied, but it would sure be nice to have family and friends close by.


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Fellowships won't care and the absence of a fourth year won't make a long-term difference as a resident. The biggest downfall to these programs is the loss of flexibility. Sounds like you are tied to the area already anyway so the geographic flexibility may not be as much of an issue. Being locked into a specialty as a pre-med is a big gamble. There's a lot about the medical specialties that is hard to appreciate prior to grinding out months of clinical time as an MS3. Many people with strong pre-med clinical exposure end up changing their mind. That being said, pediatrics is probably one of the lower risk specialties to commit to because there is abundant opportunity to become a pediatric [blank] through fellowship or a second residency if you do end up changing your mind.

The new pediatric hospital could be a good thing or a big red flag. If this is a well established program just moving into a new facility, it's a good thing. Especially since you'll start residency a few years into it when the transitional pains are likely done.
 
Fellowships won't care and the absence of a fourth year won't make a long-term difference as a resident. The biggest downfall to these programs is the loss of flexibility. Sounds like you are tied to the area already anyway so the geographic flexibility may not be as much of an issue. Being locked into a specialty as a pre-med is a big gamble. There's a lot about the medical specialties that is hard to appreciate prior to grinding out months of clinical time as an MS3. Many people with strong pre-med clinical exposure end up changing their mind. That being said, pediatrics is probably one of the lower risk specialties to commit to because there is abundant opportunity to become a pediatric [blank] through fellowship or a second residency if you do end up changing your mind.

The new pediatric hospital could be a good thing or a big red flag. If this is a well established program just moving into a new facility, it's a good thing. Especially since you'll start residency a few years into it when the transitional pains are likely done.

The program is certainly established, so I'm leaning towards thinking that the new hospital 2-3 years in might be a benefit. The good thing about the program is that you can opt out up until graduation if you think you'd want to apply elsewhere for residency or if you change your mind about the specialty.
 
If it's a reasonable quality school, I'd go for it then. One less year of medical school is one less year of tuition and one more year of attending salary. You can financially argue your medical school is now $150k-200k discounted relative to your peers. People commit to a lot more for that kind of financial help.
 
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I wouldn't even worry about competitiveness for fellowship if you are going to do pediatric residency and fellowship. Peds fellowships aren't very competitive, and even the top programs that are, it's really your research and academic promise that sets you apart. Fourth year of medical school is useless in hindsight. I think the main con of the model above is having to prematurely choose your residency specialty. Many medical students are still undecided on a specialty. Therefore, if you already know you want peds, I don't see the downside. Since fellowship programs barely care about your training during peds residency, they definitely don't care about your medical school experience. They care most about your letters of rec, your step scores, your research experience and plan, where you went to residency, and what you're like in person on the interview day.
 
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