Competitive Market - Denver CO or Souther California - Advice

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helodoc

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I'm a soon to be grad of a very reputable midwestern powerhouse EM residency and based on partner's preference am planning on moving to either Southern California (LA area, preferably Santa Monica) or Denver Colorado, and was hoping for advice on getting a good, sustainable job in either. We love the outdoors lifestyle (hiking, climbing and trail running), the food and drink culture, and the general vibe of both places.

I've done a 4 year program, so feel as though a fellowship isn't needed, and I should be a pretty desirable hire coming from such a reputable place. My goal is working in a good group, preferably democratic, but am willing to work for a larger corporation as long as the hourly is $$$ and it's not USACS. Anyway, few faculty members or people where I'm coming from seem to think this is a reasonable goal this year, but I'm set on moving out immediately after residency, and really am set on getting a 'unicorn job', which again, as such a strong hire coming from a 4 year, known program, I feel as though I should be well prepared for. Any help or tips would be appreciated. Thanks!

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I would go anywhere the money is best right now. Be it Kansas.
 
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Generally speaking no one cares about the powerhouse nature of your residency.
 
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No desire to drive to Kansas much less live there, grew up in the midwest, went to med school and residency there, tired of corn fields haha. Very set on getting a good job next year that I can learn and stick with in a place I see myself living for the rest of my life. I think a lot of people from other less well established residencies, and 3 year residencies probably have some issues transitioning to attending practice, but as a 4 year grad from a well known and powerhouse program, I will be a pretty desirable hire. That's helpful to know which Denver Jobs to look for, totally no interest in USACS. Looking at real estate in Denver now, WOW! Will need a good, high paying community job to afford a place.
 
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The fact that he or she says "I've done a 4 year program, so feel as though a fellowship isn't needed" when discussing community jobs is very illuminating
 
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No desire to drive to Kansas much less live there, grew up in the midwest, went to med school and residency there, tired of corn fields haha. Very set on getting a good job next year that I can learn and stick with in a place I see myself living for the rest of my life. I think a lot of people from other less well established residencies, and 3 year residencies probably have some issues transitioning to attending practice, but as a 4 year grad from a well known and powerhouse program, I will be a pretty desirable hire. That's helpful to know which Denver Jobs to look for, totally no interest in USACS. Looking at real estate in Denver now, WOW! Will need a good, high paying community job to afford a place.

The bolded phrase is a very, very, dangerous one to speak.
 
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I mean I'm not going to debate the merits of a 3 versus 4 year program, I was asking for career advice not an argument. I think my program's job placement speaks for itself compared to most other programs. We are very prepared both due to the 4 years and the rigorous nature and hired preferentially over other places, given that I didn't train in this area, I was just hoping to get some inside knowledge for who to talk to. This St Joseph's place sounds promising, thanks for the help!
 
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This isn't a dig on 4 year programs. I went to a 4 year program. Its the fact that you think that a fellowship would even help you get a community job (vs academic job). It won't. Coming from a 4 year "powerhouse" program won't either (it might help you get academic job). Networking will, working just outside these cities and working your way in will. The point is to help you understand what will help you get the job you want with realistic understanding of how the job market works.
 
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I mean I'm not going to debate the merits of a 3 versus 4 year program, I was asking for career advice not an argument. I think my program's job placement speaks for itself compared to most other programs. We are very prepared both due to the 4 years and the rigorous nature and hired preferentially over other places, given that I didn't train in this area, I was just hoping to get some inside knowledge for who to talk to. This St Joseph's place sounds promising, thanks for the help!

Dude, you're graduating into the Great Depression of Emergency Medicine, so I would temper your expectations a little. The only advantage your 'powerhouse program' possibly offers is the alumni network, but it sounds like that's not helping you too much.
 
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I can't speak towards the regions you mentioned but I can speak towards the hiring process for 'unicorn jobs'. Your '4 year powerhouse' residency isn't going to help you much. Your interview (I say interview loosely as we basically just want to get to know you and just talk to you in a casual setting) and how likely you are to stick around the area will be much more important factors. Your CV is going to get thrown into the same pile as someone from a no-name 3 year program. Judging by how desirable you feel you are, I can't help but think you're going to end up disappointed. Getting a unicorn job is a lot more about luck and timing and not about where you did residency.
 
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Helodoc, sorry to burst your bubble but with your attitude you have almost no chance. If I interviewed you, and you used words like "powerhouse" I would immediately not consider you. You come off as arrogant and entitled, and finding a job with that impression is going to be hard. As someone who also has "an attitude problem" I can tell you that life is difficult in EM. The more desirable the program/location, the more competition there is for spots. That means these places can select for the most compliant, non-confrontational, meek physicians they can get. Modern CMGS don't want an individual with a strong personality or a sense of self worth. They want beaten-down, terrifed physicians who will accept any level of torture to keep their jobs. That is amplified 10-fold in places like Socal or Denver.

You love outdoorsy stuff? Great, so do 90% of other EPs. Get ready to sacrifice almost everything to get that.
 
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Helodoc, sorry to burst your bubble but with your attitude you have almost no chance. If I interviewed you, and you used words like "powerhouse" I would immediately not consider you. You come off as arrogant and entitled, and finding a job with that impression is going to be hard. As someone who also has "an attitude problem" I can tell you that life is difficult in EM. The more desirable the program/location, the more competition there is for spots. That means these places can select for the most compliant, non-confrontational, meek physicians they can get. Modern CMGS don't want an individual with a strong personality or a sense of self worth. They want beaten-down, terrifed physicians who will accept any level of torture to keep their jobs. That is amplified 10-fold in places like Socal or Denver.

You love outdoorsy stuff? Great, so do 90% of other EPs. Get ready to sacrifice almost everything to get that.

Veers wins the thread with this one.

Quoted for truth.
 
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Helodoc, sorry to burst your bubble but with your attitude you have almost no chance. If I interviewed you, and you used words like "powerhouse" I would immediately not consider you. You come off as arrogant and entitled, and finding a job with that impression is going to be hard. As someone who also has "an attitude problem" I can tell you that life is difficult in EM. The more desirable the program/location, the more competition there is for spots. That means these places can select for the most compliant, non-confrontational, meek physicians they can get. Modern CMGS don't want an individual with a strong personality or a sense of self worth. They want beaten-down, terrifed physicians who will accept any level of torture to keep their jobs. That is amplified 10-fold in places like Socal or Denver.

You love outdoorsy stuff? Great, so do 90% of other EPs. Get ready to sacrifice almost everything to get that.

Loaded gems.... all true. Where I'm at, I heard things are going to get pretty nasty in the ED with further cuts in daily physician staffing requirements.

OP is classic millenial. Expects a unicorn job with good pay and good long-term working conditions in two of the most competitive, sought-after markets in the country. Thinks posting on an online message board is going to point the way..... smh. Even if we this wasn't pan-COVID, those would be two tough markets to crack. But good luck!
 
I mean I'm not going to debate the merits of a 3 versus 4 year program, I was asking for career advice not an argument. I think my program's job placement speaks for itself compared to most other programs. We are very prepared both due to the 4 years and the rigorous nature and hired preferentially over other places, given that I didn't train in this area, I was just hoping to get some inside knowledge for who to talk to. This St Joseph's place sounds promising, thanks for the help!

I think you are underestimating just how different the job market is this year vs. years past. Your program's track record in securing jobs for it's grads honestly means nothing when there aren't that many jobs to go around. I went to a shiny name brand medical school and am graduating from a shiny, very well known residency and my class is having trouble getting solid offers in our own geographic market.
 
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I mean I'm not going to debate the merits of a 3 versus 4 year program, I was asking for career advice not an argument. I think my program's job placement speaks for itself compared to most other programs. We are very prepared both due to the 4 years and the rigorous nature and hired preferentially over other places, given that I didn't train in this area, I was just hoping to get some inside knowledge for who to talk to. This St Joseph's place sounds promising, thanks for the help!

Listen, I'm going to give you the benefit of a doubt considering that most (or select few?) graduating residents are woefully naive and have an overinflated sense of self worth and have been sung soothing lullabies by their academic attendings (most of which have been working in academics their entire career) about how great their residency program is compared to all the rest. You are soon to have a very large wake up call about how well trained 90% of all the other graduating residents are compared to you. All were gunners, all have great personalities, all love the outdoors and 50% of them want to live in the two states you mentioned and are competing with you for a spot which...guess what....drives the salaries down 50% or more.

Here's what you need to do and even this is difficult in the current climate. Find a second tier city with a direct flight to one of the areas that you mentioned. Find a job within 45 mins of that city. Bonus points if it's a non income tax state. Your cost of living, real estate, taxes will all be lower. Your job security and salary will be higher. You will be able to pay of your loans much more efficiently and you can still take relatively easy vacations to your outdoor locations.

If you limit yourself to those two areas you are incredibly foolhardy and quite possibly committing long term financial suicide. Please don't give me a song and dance about how money isn't important and it's the quality not the quantity, etc..

If you're still as stubborn as my dog, then fine... move there. However, your only responsible and realistic option will be to commit the rest of your career to travel locums.
 
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Would not hire OP at my powerhouse
 
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I think a lot of people from other less well established residencies, and 3 year residencies probably have some issues transitioning to attending practice, but as a 4 year grad from a well known and powerhouse program, I will be a pretty desirable hire
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He/she posted "powerhouse" on here, LOL....give this kid an A for self confidence.

Powerhouse residency...looking for a job in Denver and/or Southern CA.... LMAO. I'm still laughing... I'd love a count for how many eyes rolled when they read this post.
 
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Lol I think you guys are being trolled but if not they're going to be very disappointed after graduation.
 
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It's clear your powerhouse alumni connections haven't been able to connect you to those very desirable terribly-paying areas.

Have you at all considered those areas already have powerhouse residencies of their own? UCLA/Harbor/USC? Denver Health?

You've overestimated your worth, but I'm hopeful for your future as you'll be checked heavily in your first few years of practice within "The Great Depression of EM"
 
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Lol I think you guys are being trolled but if not they're going to be very disappointed after graduation.

You know what? You're completely correct!

This is a troll post without a doubt. There's too much evidence. Using "powerhouse" twice, purposely choosing two Millennial Meccas as a desired place to work, using an oft-used term around here to describe the perfect job ("unicorn"), playing into the 3 vs. 4 year argument, the "outdoors lifestyle" cliché with three of the most common activities etc.

This is perfectly calculated to get the response seen in this thread. Even I was fooled with my initial post above!
 
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Should be emphasized that the learning curve post-residency is greater than the learning curve between medical school and residency. There are no clear guideposts either. At least you have SDN.

Medicine is a business and not unusually at odds with patient care—which is why a “powerhouse” residency means very little unless you’re going into academia.
 
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You know what? You're completely correct!

This is a troll post without a doubt. There's too much evidence. Using "powerhouse" twice, purposely choosing two Millennial Meccas as a desired place to work, using an oft-used term around here to describe the perfect job ("unicorn"), playing into the 3 vs. 4 year argument, the "outdoors lifestyle" cliché with three of the most common activities etc.

This is perfectly calculated to get the response seen in this thread. Even I was fooled with my initial post above!

It's a great post for sure. I know so many Millenials who talk and think like this. He/she/zhe perfectly encapsulated how they view the world.
 
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He/she posted "powerhouse" on here, LOL....give this kid an A for self confidence.

Powerhouse residency...looking for a job in Denver and/or Southern CA.... LMAO. I'm still laughing... I'd love a count for how many eyes rolled when they read this post.

No, no, no.
"Kid A" was an awful album. Nothing but computer noises.

Wait... What were we talking about?
Oh yeah.

OP Amigo: no joke; the two places you listed are always ridiculous to crack, and on top of that, they woefully underpay.
 
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Clearly this is a hostile place to ask real questions. I just wanted to know some job options for those areas, yeah this is a hard year, hence the questions. Any other year I'd call up on 3-5 alumni contacts and be hired by now, but the 2021 hiring season is crazy. I didn't mean to come off as arrogant, I'm just very proud of my success at my program, and really want to live someplace a little more consistent with my current lifestyle.
 
Clearly this is a hostile place to ask real questions. I just wanted to know some job options for those areas, yeah this is a hard year, hence the questions. Any other year I'd call up on 3-5 alumni contacts and be hired by now, but the 2021 hiring season is crazy. I didn't mean to come off as arrogant, I'm just very proud of my success at my program, and really want to live someplace a little more consistent with my current lifestyle.

Don't confuse hostility with honesty. Even in normal years, you aren't calling up residency alumni and getting the job you describe in the areas you're looking just like that. There are a ton of places in the US for the outdoorsy type besides the two areas you mentioned. Nobody will care where you went to residency once you're an attending. Just like nobody cared where you went to high school in college, nobody cared where you went to college in medical school, etc.
 
I don't think s/he is a troll; I have heard similar sentiments from others.

OP, if you are looking for jobs in the community, nobody really cares where you come from. If you know someone who can vouch for you and get you an interview, then that helps. Reach out to your network. I did not come from a "powerhouse" program, but my connections got me interviews. Once you have an interview, they want to know if they can work with you and will you be a good business partner. That's it,

Nobody cares 3 vs 4 years; if anything, the only thing people cared about after I graduated was moonlighting experience. Patients don't care where you went to residency nor does the hospital. Academics is the only area that may care a bit if you are new. If you present yourself as better than 3 year grads and that coming from a powerhouse program is a big deal, then everyone will roll their eyes and move on. You may even be the best EM graduate in the country, but again, nobody cares in the "real world".

There is nothing special to SoCal either. The market is saturated and unless you know someone, you likely won't get a "unicorn job" right away or for awhile unless you are lucky. There are jobs, but the pay is not as good as other markets and the higher paying gigs ($200-$230/hour) make you really work for it. Once you get in a partner track somewhere the pay goes up, but those jobs are few and far between for new grads period and especially so in SoCal/Denver. Apply now to groups that are advertising, reach out to any contacts you have, if you want academics, reach out to those programs, and apply for a job just like every other American; there is no secret.
 
Clearly this is a hostile place to ask real questions. I just wanted to know some job options for those areas, yeah this is a hard year, hence the questions. Any other year I'd call up on 3-5 alumni contacts and be hired by now, but the 2021 hiring season is crazy. I didn't mean to come off as arrogant, I'm just very proud of my success at my program, and really want to live someplace a little more consistent with my current lifestyle.

You are not unique. Every other EP is proud of their residency accomplishments and wants to live in a place with a good job and good lifestyle. Most of us can't have that. SDN may be hostile we give a dose of reality to everyone, which is something residency never provides.
 
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Dude literally 50% of people that do EM would love to work in those places pre pandemic. Airplanes are a thing. We will work far less as attendings even with flips included. Time to get a travel credit card if you haven't. At this point I just want a good job anywhere, but really just a job period. You sound like someone expecting to be a C level at Goldman day 1 out of Wharton.
 
Dude literally 50% of people that do EM would love to work in those places pre pandemic. Airplanes are a thing. We will work far less as attendings even with flips included. Time to get a travel credit card if you haven't. At this point I just want a good job anywhere, but really just a job period. You sound like someone expecting to be a C level at Goldman day 1 out of Wharton.
What's a C level? Not an investment banker here.
 
Clearly this is a hostile place to ask real questions. I just wanted to know some job options for those areas, yeah this is a hard year, hence the questions. Any other year I'd call up on 3-5 alumni contacts and be hired by now, but the 2021 hiring season is crazy. I didn't mean to come off as arrogant, I'm just very proud of my success at my program, and really want to live someplace a little more consistent with my current lifestyle.

I will try to give you a serious answer. Those are very tough markets. The set of conditions you are looking for (which everyone is looking for) is probably not obtainable. You will not find good pay--particularly pay relative to the higher cost of living--in those cities, with good work conditions, with a benign SDG (note some SDGs can be extremely predatory towards new grads, and it's not so simple as CMG bad, SDG good).

The question is, what are your priorities?

If you are willing to sacrifice pay, work condition, and autonomy/administration to live in SoCal or Denver, so be it.

The alternative is to live somewhere else with better pay, better practice climate, and live close to an airport with non-stop flights to SoCal/Mountains.

Is building wealth important to you? When do you want to retire? Do you already have substantial assets (family money, less school debt, etc.). Is being able to go surfing or skiing within an hour of a shift important to you?

None of us can answer that for you.

Here is my view. Bear in mind I am from SoCal (and love it) and now live in Texas. The decision I made was better pay, practice, and lower cost of living with frequent vacations (10-12/year) to mountains and oceans. I feel I will have the option to retire early if I want, and feel much less financial strain currently.

The bottom line is, when you are working, you're working. It's always 68 and fluorescent in the ER whether you're in Los Angeles, CA or Beaumont, TX. But when you have time off, in this day and age, you can be where you want to be pretty easily. We are ER Physicians, most jobs will give you 14-18 days off a month that can easily be clustered in to 7-10 days off at a stretch. You will have the money (particularly if you choose a LCOLA with higher pay) to get there. Get a credit card with good travel rewards.

I cannot tell you which course of action is right for you, but I think the important thing is to be realistic and understand there is going to be a trade off. Because of the high number and mobility of EP physicians the market is relatively efficient in an economic sense compared to other specialties, so pay and benefits tend to be fairly inversely commensurate with the desirability of a location. The practicing staff physicians on this board who have figured that out are not being jerks to you, they just have more experience and know the game.
 
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Clearly this is a hostile place to ask real questions. I just wanted to know some job options for those areas, yeah this is a hard year, hence the questions. Any other year I'd call up on 3-5 alumni contacts and be hired by now, but the 2021 hiring season is crazy. I didn't mean to come off as arrogant, I'm just very proud of my success at my program, and really want to live someplace a little more consistent with my current lifestyle.

You're nervous. That's ok; you'd be crazy not to be. Every step up to this point has had "guarantees." Get the right MCAT score and GPA and you get into medical school. Get the right STEP scores and SLOES and you get into a good residency program. You ultimately chose a "name brand" academic EM program for 4 years. It was probably your favorite and top ranked program. I'm sorry that the fourth year of residency may not offer any financial benefits in community medicine. You will certainly be "more experienced" than a 3 year program graduate, but not more than a 3 year graduate with a year's worth of community experience when it comes to getting the kind of community job you're looking for.

And that's not fair. You went into that old, 4 year residency program with the knowledge that you had a huge alumni network that would get you into the job of your dreams. They probably even had a slideshow of recent graduates and showed where they were working after residency. Probably didn't tell you what they were being paid, though.

It's not fair. You're not going to go straight into the job of your dreams. You can blame COVID-19 or the cantankerous old guys on SDN who are obviously just jealous of your academic accomplishments :whistle:. All that really matters is what you do now.

So the real advice. If you/your SO are adamant about living in Denver/So Cal because of the same lifetime of delayed gratification that every other high achieving physician experienced, you will ultimately have to take more lumps. Most likely you will move there and take a USACS/Kaiser/other CMG job. You will not be paid very well. But you will be living where you want to live and maybe more importantly you'll have the opportunity to network locally and start trying to get your foot in the door at a better job. Alternatively, you can utilize this 4 year residency a little better and apply for an academic job. This is obviously a very different career choice but in your position I would be giving it a lot of thought. If "stability" is of paramount importance, there may be nothing better. For me and many of the others, we have decided that we would rather make more money living in a decent sized city in a flyover state with easy access to an airport to take us to the places we want to go when we aren't working. Bonus; my flyover state has some of the best climbing and hiking opportunities on my half of the nation. But if the SO wants to move to Denver/So Cal and you told her you could definitely do that, you're probably SOL.

Best wishes!
 
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As I've always said, living in a no-tax or low tax state has it's benefits. The $30K per year I save on not paying CA taxes allows me to take 3-4 very expensive, very luxurious international vacations a year. Alternatively I could afford to go to CA every weekend, stay at a nice hotel, enjoy the weather, and still save money vs living there.
 
If you have to live in those areas prepare to fly out and do locums.

Even the Facebook EM docs job Had a board-certified physician at 14 years of experience who is living in Durango, Colorado who is begging for jobs on that group. With no luck.

All the sky falling crap that the sport states is now reality. Also a lot of groups think that flu season will see a spike in volumes but we never do masks and social distancing during the flu season so this flu season will probably be the weakest we’ve ever had.
 
The irony is there is probably someone out there who graduated a 3 year residency in 2020 and is about to start a unicorn job because they just spent the last year skiing or trail running with a community physician whose group is hiring this year.
 
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LOL this thread...what great entertainment during my shift today.

OP reeks of entitlement.

4 year program means nothinggggg in the community. I went to a "powerhouse" 4 year program. No one cares.

Go get your $125/hr in Denver from U-SUCK rofl
 
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Having lived in Denver previously I can tell you it’s at least an hour to get to the mountains to do anything, more like 2 if you want to get to the ski areas or out where there aren’t a ton of people. And this assumes traffic patterns from 10 years ago when it was not as crowded. Surely you could get a little more creative with your “outdoors” lifestyle? What about small cities in Utah? Arizona? Grand Junction? Idaho? Small town Montana? Tons of great places out there... but I have a feeling it’s more than just “outdoors” for you. No matter, you can take a shyte job in Denver for much less than your worth, who cares. You are an adult
 
I don't think any of you are factoring in the fact that the OP went to a powerhouse residency.
 
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And no one else was? They seemed rather earnest, at least, to me.

I was kind of late to the thread, some of the later posters were implying it was a troll thread. To be sure, there were many serious/earnest responses as well.
 
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I find the "4 year powerhouse" talk as snooty as most commenting on this thread but I find it hard to believe that major programs that have been around for decades and have extensive alumni networks have equal success in finding their graduates good work as the newest rural HCA program. Pedigree and networking is vital to career success in just about every other field of work. The "prestige" of the program may not mean much to a 20 year veteran community doc on its own, but if a community group has a history of hiring grads from a particular residency program who have turned out to be quality attending physicians and good team players it would certainly seem prudent to continue hiring from that residency rather than taking a chance on hiring an unknown quantity, all else being equal.

James Dahle had a response in an old thread as to the question of "does it matter where I do residency" that I think encompasses my points above:

Yes. It matters. When we hire, we want the best.

So we prefer an MD residency over a DO one.
We prefer a harder to get into residency over an easy to get into one.

Why? Three reasons. First, you were a more competitive applicant pre-residency. Second, you were surrounded by more intelligent and accomplished peers for 3-4 years and that probably rubbed off. Third, you might have even gotten better training.

But there is also an element of residencies we know. We're more likely to take someone who went to a residency one of us went to or one that is close enough to us that we know their reputation. But something in New York City or Florida? We have no idea if it is any good even if it enjoys a great reputation on the East Coast.

These kinds of things may not matter for CMG sweatshops looking for warm bodies at the lowest price, but for sought after SDG jobs I would think it will play a larger and large role going forward.
 
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As a long time medical director in an extremely competitive city, I can say that I don’t care where you did your residency. Four year vs three? Who cares! What’s important is how well we get along when we meet, how you do on your interview dinner with your potential future colleagues, and sometimes references. Of course, that was all pre-covid. Hiring is waaaaay down now. I’d probably only pick docs who aren’t fresh out of residency now. Except we’re not hiring now or for the foreseeable future.

Having said that. . . . Does seem a bit like a troll post.
 
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You guys are a bunch of negative trolls when OP had a genuine question and just wanted to genuine guidance. Maybe it is a troll, but I will give you the honest answer.

Given what you described, I think I know which program you went to. If you really did go to this or some other powerhouse program, you are essentially guaranteed whatever job is available in whatever city you want. You don't really need any connections either because once they see where you trained, they will fly/wine/dine you just to get you signed. These groups, CMG or SDG are always looking for Named program residents to make them stand out. This is what CMGs like to do and you are another ALL star in their portfolio.

B/c you came from an All Star powerhouse program, the benefits you and the doctor group gets is symbiotic.

1. You get to go where ever you want
2. You get to ask for a 6 figure signing bonus
3. Immediate partner track
4. I would throw in no Nights too.

The SDG or CMG (TH, EMCARE, USUCK) gets a strong portfolio of docs where they can go to the hospitals and leverage
1. Better rates and stipends
2. Stronger hold on the contract
3. Dictate to the hospital terms
4. Dictate to the insurance carriers 2-5x typical reimbursements
5. Dictate to CMS metrics they want to follow

I came from a powerhouse too back in the day and was able to go to the most sought after city in the South without issues.
 
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You guys are a bunch of negative trolls when OP had a genuine question and just wanted to genuine guidance. Maybe it is a troll, but I will give you the honest answer.

Given what you described, I think I know which program you went to. If you really did go to this or some other powerhouse program, you are essentially guaranteed whatever job is available in whatever city you want. You don't really need any connections either because once they see where you trained, they will fly/wine/dine you just to get you signed. These groups, CMG or SDG are always looking for Named program residents to make them stand out. This is what CMGs like to do and you are another ALL star in their portfolio.

B/c you came from an All Star powerhouse program, the benefits you and the doctor group gets is symbiotic.

1. You get to go where ever you want
2. You get to ask for a 6 figure signing bonus
3. Immediate partner track
4. I would throw in no Nights too.

The SDG or CMG (TH, EMCARE, USUCK) gets a strong portfolio of docs where they can go to the hospitals and leverage
1. Better rates and stipends
2. Stronger hold on the contract
3. Dictate to the hospital terms
4. Dictate to the insurance carriers 2-5x typical reimbursements
5. Dictate to CMS metrics they want to follow

I came from a powerhouse too back in the day and was able to go to the most sought after city in the South without issues.


I get that you're joking and I understand that a lot of three year grads are probably upset to hear this but my program places grads at plenty of competitive areas. I saw 3.5 pph during my 3rd year and I’m sure most community shops wouldn’t pass up those types of RVU’s
 
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