m4 here. I fell way down my rank list on match day. Was a weak applicant with red flags... applied broadly to FM, IM, and psych. The program I matched at is known as a 'workhorse program' in a big city. Most of the residents are foreign grads, some Caribbean grads too. q4 24 hour in-house call, high patient volumes, weak teaching, little supervision. I spoke to some of the senior residents and they seem pretty burnt out and unsatisfied. Theyre literally just there to perform labor, not to learn and become better docs.
With hindsight I can say that it might of been better to soap than to match at this program. but not much i can do about it now lol. What can i do to mentally prepare for 3 years of hell and make the most of it? how can somebody still become a competent physician at a program where labor is heavily prioritized over learning?
This could be both a blessing and a curse.
I have encountered docs that trained at âsweatshopsâ like this (Cook County) and often theyâre very good - theyâve been drilled until theyâre blue in the face with things. They also had to learn how to get their **** together quickly in an environment with little guidance or supervision. All of this pressure can (sometimes) make diamonds. This type of experience is closer to how the doctors of old trained vs most modern university programs.
The downsides are everything you mentioned, including the fact that fellowship matching probably sucks and youâll have to really âwork itâ if you want to match something competitive.
Tips:
- All that is described above in terms of wellness will be extremely important. Take care of yourself. Off duty, your major priority should be sleep, followed closely by exercise and diet.
- Be careful at a place like this with regards to getting placed on probation, fired etc. Places like this already have a bad reputation and, unlike most university programs, arenât too concerned with preserving goodwill in the eyes of applicants. This means itâs probably easier to get fired - and when we hear stories on here of malignant PDs, residents in trouble, etc itâs not entirely surprising that most of those stores seem to come from places like this. What that means is this: get your act together, keep your nose clean, watch your back, donât do anything stupid and also donât talk back to attendings, even if theyâre truly malignant people and you feel the criticism is unfounded. At a place like this, your response to criticism is âsir yes sir, that wonât happen again sirâ. And then make sure it doesnât.
- Remember that at the end of the day, no matter how awful the experience seemsâŚit really is only a small segment of your career and life, and after itâs over you
will be able to make a lot more choices about how and where you want to work. I thought a lot of residency and fellowship sucked, but now that Iâm about 5 years out, it seems to be little more than a distant memory of a time and a place long gone. One thing that was helpful during residency was to remember that no matter how bad all of this was, some other jobs out there are much worse. You could be mining coal miles underground, working 3 minimum wage jobs to try to make as much as a resident makes, getting shot at by the Russians, etc etc. As much as residency sucks, some jobs are still way worse.
To end, Iâm going to quote Vergil:
âPerchance some day the memory of this sorrow
Will even bring delightâ.
