I listened to a podcast about this before picking an institution where they listed a bunch of studies saying how being a big fish in a small pond was better for happiness. So I picked a small IM residency program that is on the lower side of competitiveness to work at, with 20 other residents total. It's been a year since I began but as time went on I was discouraged by my peers' lack of enthusiasm/interest for the field. Being a small program I had direct access to all the attendings, but I couldn't learn anything from more senior residents. Almost every other resident looked at residency as a job and not as a learning opportunity. Last month I applied to the top IM program in my country and was fortunately accepted. Hopefully I will start there next month and I'm excited to see the differences. The building confidence thing you mentioned is so true. My confidence is off the charts right now with no real accomplishments behind it. I will probably feel a shock in the next few months. Nice video as always.
Thank you for the comment - I could definitely seeing that as a problem, going to a place where people seem less motivated/enthusiastic or interested in really trying hard in general. Let us know how the new program is, curious to hear! :)
My thoughts: 1. I think there might be some conflation between the SIZE of a program and the PRESTIGE of a program. The two aren't necessarily the same, even if they often overlap. 2. I think the video might risk committing something close to a false dichotomy (e.g. some big prestigious programs do nurture their residents quite well, some smaller less prestigious programs don't). 3. If you want a competitive fellowship (e.g. GI, cards), I agree a less prestigious program may nurture you better in many cases. Also, I agree you have a better chance of getting the fellowship in-house if it's offered at your program since (good) programs will usually prefer their own. However, the problem is that this is only really true in-house or at most in your region (e.g. if PDs or aPDs can make calls for you), but it's not necessarily true outside your program or in other regions. That's where a more prestigious program is better for your chances of matching into a competitive fellowship. I'm not saying this is fair, in fact I'm inclined to say it's unfair, but the sad fact is that prestige of program still matters TONS to many programs - especially if the program doesn't know you when you're applying to them. 4. If you're interested in a competitive fellowship, one way to gauge a program is see how many of their own residents match into competitive fellowship spots like GI or cards at their program. Do they take their own? Generally speaking, a good program will take their own, barring certain exceptional circumstances. 5. Of course, none of what I've said matters a lot if you don't want to do a fellowship, if you want to be a hospitalist or PCP. In that case, I'd say just go to where you'll be happiest, based on whatever factors you most value in determining happiness (e.g. location, climate, affordability, social life, family). One thing to keep in mind, though, is it seems to me most people tend to get their first job in the same or at least nearby place where they did their residency if they didn't do residency at a brand name place.
I listened to a podcast about this before picking an institution where they listed a bunch of studies saying how being a big fish in a small pond was better for happiness. So I picked a small IM residency program that is on the lower side of competitiveness to work at, with 20 other residents total. It's been a year since I began but as time went on I was discouraged by my peers' lack of enthusiasm/interest for the field. Being a small program I had direct access to all the attendings, but I couldn't learn anything from more senior residents. Almost every other resident looked at residency as a job and not as a learning opportunity.
Last month I applied to the top IM program in my country and was fortunately accepted. Hopefully I will start there next month and I'm excited to see the differences.
The building confidence thing you mentioned is so true. My confidence is off the charts right now with no real accomplishments behind it. I will probably feel a shock in the next few months.
Nice video as always.
Thank you for the comment - I could definitely seeing that as a problem, going to a place where people seem less motivated/enthusiastic or interested in really trying hard in general. Let us know how the new program is, curious to hear! :)
The best situation is:
1, Big Fish in a Big Pond
2, Medium fish in a Medium pond
3, small fish in a small pond
😂😂
My thoughts:
1. I think there might be some conflation between the SIZE of a program and the PRESTIGE of a program. The two aren't necessarily the same, even if they often overlap.
2. I think the video might risk committing something close to a false dichotomy (e.g. some big prestigious programs do nurture their residents quite well, some smaller less prestigious programs don't).
3. If you want a competitive fellowship (e.g. GI, cards), I agree a less prestigious program may nurture you better in many cases. Also, I agree you have a better chance of getting the fellowship in-house if it's offered at your program since (good) programs will usually prefer their own. However, the problem is that this is only really true in-house or at most in your region (e.g. if PDs or aPDs can make calls for you), but it's not necessarily true outside your program or in other regions. That's where a more prestigious program is better for your chances of matching into a competitive fellowship. I'm not saying this is fair, in fact I'm inclined to say it's unfair, but the sad fact is that prestige of program still matters TONS to many programs - especially if the program doesn't know you when you're applying to them.
4. If you're interested in a competitive fellowship, one way to gauge a program is see how many of their own residents match into competitive fellowship spots like GI or cards at their program. Do they take their own? Generally speaking, a good program will take their own, barring certain exceptional circumstances.
5. Of course, none of what I've said matters a lot if you don't want to do a fellowship, if you want to be a hospitalist or PCP. In that case, I'd say just go to where you'll be happiest, based on whatever factors you most value in determining happiness (e.g. location, climate, affordability, social life, family). One thing to keep in mind, though, is it seems to me most people tend to get their first job in the same or at least nearby place where they did their residency if they didn't do residency at a brand name place.
Love this take! And I agree with the nuance you have behind all of your points. Thank you :)
Hey there, thanks so much per anki
Sir how much is your resident doctor salary after taxes? Plz reply. Thanks a lot.