residency programs with different styles

[Duon89]

what is better? and why is there such difference?
Share your experience on your residency: no need to mention which program.

I have only been to 3 programs before starting residency.
And I realized my program is so different than the ones I have been to.

1. Some programs have stroke vs gen service when other has team A and B which has mix of patients.
2. Some programs do admit by interns (including regular IM interns) while the others only allow PGY2s.
3. Some has nights done by interns where the others don't.
4. Some programs, PGY2 carries only 4-5 patients along with interns, where other programs have PGY2s more like senior overlooking 10-20 patients.
5. some programs has psych resident helping out neuro wards, where as others psych resident only does neuro consults.
6. Some programs have ED doc rotate through neuro, whereas others do not.

These points, I just did not even realize to ask during the interview. Wondering how your program is set up.

Share your experience.

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[kchan99]

I didn't ask these questions. I don't think these features really matter in the end. The better questions to ask are whether senior residents do home call or in-house call, and amount of autonomy. If juniors are on call without a senior (usually toward the end of PGY-2), then there is less hand-holding. If there is in-house call, are seniors allowed to recommend discharge from the ED, with final authority resting with the ED attending? The neuro attending should be available by phone. In my previous program and my current fellowship, I've seen fellows who are less comfortable with independent decision making while on-call as attendings. Although developing autonomy is necessary, it important to learn one's weak areas.

 

[oopsy]

I did not realize the degree to which programs were so different, even when I interviewed. Now that I have some perspective in residency, I am struck by how different my program is from others. The core ACGME requirements are pretty minimal, and there is tremendous latitude for programs to figure out how they want to prioritize education.

For instance, some places do not prioritize inpatient care in the same way as others do. ICU exposure ranges from 1 month to 4-5 months across different programs. Conversely, people routinely graduate from certain programs very adept at reading EEG and EMG studies, and other places, completely bewildered.

It is really important to consider what your priority is, even big picture questions like outpatient clinic doctor versus intensivist, do you want to have more or less supervision as a junior resident, do you want to be in a fellow run hospital or a resident run hospital, and you want to be in a big department where you may get lots of opportunities but lost amongst a shuffle or a small department where you may get great mentorship, but not find the right match for you. All of these things are way more important than the minutia that I focused on as a medical student (q4, night float, number of overnight calls, etc).

 

[NWwildcat2013]

For instance, some places do not prioritize inpatient care in the same way as others do. ICU exposure ranges from 1 month to 4-5 months across different programs.

What are some programs with really heavy inpatient/ICU exposure?

 

[barzan]

I believe my program (Case western) is heavy in NeuroICU we get 8 weeks as PGY2, 4 weeks as PGY3 and if youre interested you can get more.