Med Peds community programs

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eimaise

eimaise
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Hi all, I'm a 3rd year DO student on the east coast planning on applying to med-peds this fall. I am excited about going this route and I don't really have an interest in pursuing a fellowship afterwards. My career goals include hospitalist work, primary care, and missions work at different points in the future.

I don't see many people discuss or review community programs on this sub forum and was curious if they are generally considered "weaker" than the university programs out there.

I know a few of the community based/university affiliated programs are considered strong (I see good things about Baystate, Christiana, and Banner Good Samaritan) by people on this forum, but what about other programs like the ones in Tulsa, Wichita or Peoria? I also have an old list I am working from that says the programs in Louisville and Greenville, SC are community as well... is this still true?

Is there a perceived disadvantage about these types of programs that anyone would like to share? What advantages can you see to attending a community program? I'd especially love to hear from any med-peds residents in a community program.

From what I can tell, it seems university programs may offer a broader range of pathologies for residents to see and learn about. I did 50% of my third year clerkships at a large university based hospital. 20% was at a VA hospital and the other 30% were at community hospitals or nursing homes/outpatient settings. I liked all the settings, but saw a lot more unusual at the university based hospital. Will I miss out on a lot of these things at a community program?

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The main differences that I've perceived between community programs and large academic programs are the presence of fellowships and therefore fellows in the hospital, the opportunity for fellowships (which you've said youre not interested in), and possibly the presence/teaching of medical students.

However, the thing with most medpeds programs are that they are usually associated with a certain university. For example Baystate with Tufts, Christiana with Jefferson, Good Sam with U of Arizona, etc. therefore they aren't exactly "community" programs by the typical definition. That means they usually have some of the things I listed above.
 
Louisville is not a community program. It's 100% a university program.
 
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The main differences that I've perceived between community programs and large academic programs are the presence of fellowships and therefore fellows in the hospital, the opportunity for fellowships (which you've said youre not interested in), and possibly the presence/teaching of medical students.

However, the thing with most medpeds programs are that they are usually associated with a certain university. For example Baystate with Tufts, Christiana with Jefferson, Good Sam with U of Arizona, etc. therefore they aren't exactly "community" programs by the typical definition. That means they usually have some of the things I listed above.

From what I understood, Banner Good Sam is not actually affiliated with a university, but does have students from three med schools rotate there. That being said, the Med-Peds program struck me as very academic (as in residents get among their top fellowship choices, there are medical students, etc.) even though they would technically be a community program.
 
Ok, so is there a real quality difference then between a small to mid size university-affiliated community program and a large university program? For example OU-Tulsa vs. Indiana? I understand the presence of fellowship programs may be the main distinguishing difference, but I wonder if the larger centers have more varied pathology and more resources available to residents. I am interested in both types of programs at this time, mainly for geographical reasons.
 
For medpeds specifically, I would look more at the quality of peds training compared to the medicine. I think you can get a solid medicine training at almost any university affiliated program. A strong peds training however is different. Of reason for this is volume. Another is that most peds specialties tend to concentrate at larger tertiary childrens hospitals. So important factors to look at are is there a stand alone childrens? If not, is it large enough or just one floor in the main hospital? Is it a referral center or is there another larger childrens hospital nearby that will take all the zebras. Something else to look for is the level of the NICU training (I, II, or III) because you'll see vastly different things at each of these levels.

Then again if your ultimate goal is primary care and not hospitalist or subspecialty training, you need to pay more attention to the clinic experience. Is it a combined medpeds clinic where you'll see both kids and adults in one day or separate clinics? Is the clinic community or university based (you'll see different type of patients in each).

As you can see its difficult to gauge medpeds program compared to IM or peds program because there are other factors in play. In the end i think it comes down to how you feel when you are at each program and how well you get along with everyone there. You'll likely get a solid medpeds program almost anywhere you go. You just need to find the right fit for you based on what each program offers.
 
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