Question from applicant: how to choose a residency??

Dear Residents-

I'm currently applying for ortho residency and have been lucky enough to be invited to some pretty amazing places. I'm humble, I'd be happy at any of them because I'm just happy to be here and considered. To my point, knowing what you know now, after being a resident for a while, if you had to do it again how would you go about choosing your residency? Would you pick a place based on reputation, operative volume, lifestyle, location (examples of a few factors), or maybe something you never considered? Sincere responses from residents, fellows, or attendings would be greatly appreciated. It's a fun, exciting time of year, albeit nerve racking. Thank you.

I'm also interested to hear some answers to this question.

Go where residents are happy, excited to be there every day, and are rested and have lives outside of the hospital. A lot of residency, like medical school, is up to you to make your experience. Make sure you go to a place where there is plenty of attendings so that you get enough surgical exposure as well as the oppurtunity to see the same problem approached multiple ways so when you get out you can use the way you like most for you...not just "I only learned one way to do it."

Just food for thought....

Look at things like subspecialty coverage, resident comraderie, case volume, how comfortable the PGY-5's are operating, and what the surrounding city is like. These heavily outweigh reputation/rankings.

Well, I was probably lucky to get into ortho in the first place. Beggers can't be choosers and all that. However, knowing what I know now I definitely think that my priorities would be different in terms of making a rank list. (And obviously, this is only one opinion of a million differing opinions, so take it for what it's worth).

First of all, I've come to realize that reputation and name mean very little. Sure, it looks good on a diploma, but if fellows take the cases or the attendings don't let you have autonomy, what good is that institution's name? I think that a program that gives you an appropriate number of the appropriate level cases is a good one. By appropriate level I mean, it's cool to brag about scrubbing a tab as an intern or doing a complex joint revision, but if you've never done elementary fracture work or a basic joint case, usually the learning points of the case elude you. And as far as proper autonomy goes, if you have to have the circulator turn the pages of Campbell's and it takes you 2 1/2 hours to do a bimal because the attending isn't around, well, that's not good. Conversely, if you feel like you're the star of the movie "Resident Retractor Hands" because that's all you do in a case, that's not good either.

I think another big thing to look for is well roundedness. In this day in age it may becoming more and more a moot point, but, in my opinion, a residency should prepare you to do any case if you had to. Most of us will end up specializing in some way or another, but in my mind I want to be the most well rounded resident I can be.

I also would place importance on resident camaraderie and overall happiness as mentioned in the previous post. If the residents are slashing each others tires and are generally miserable, odds are you will be too. This, however, is a tough quality to gauge from a 3 hour interview. Attending the pre interview mixer may help.

Ability to have a social life is less important in my opinion because I think that residency is five (or six in some cases) years for the rest of your life. With the 80 hour work week you'll always have some free time, but residency is the time to learn, because patients (and their lawyers) won't care if you've "only done the procedure a couple of times."

That was really long winded, but hoped that this one a-hole's opinion may help you out.

Well, I was probably lucky to get into ortho in the first place. Beggers can't be choosers and all that. However, knowing what I know now I definitely think that my priorities would be different in terms of making a rank list. (And obviously, this is only one opinion of a million differing opinions, so take it for what it's worth).

First of all, I've come to realize that reputation and name mean very little. Sure, it looks good on a diploma, but if fellows take the cases or the attendings don't let you have autonomy, what good is that institution's name? I think that a program that gives you an appropriate number of the appropriate level cases is a good one. By appropriate level I mean, it's cool to brag about scrubbing a tab as an intern or doing a complex joint revision, but if you've never done elementary fracture work or a basic joint case, usually the learning points of the case elude you. And as far as proper autonomy goes, if you have to have the circulator turn the pages of Campbell's and it takes you 2 1/2 hours to do a bimal because the attending isn't around, well, that's not good. Conversely, if you feel like you're the star of the movie "Resident Retractor Hands" because that's all you do in a case, that's not good either.

I think another big thing to look for is well roundedness. In this day in age it may becoming more and more a moot point, but, in my opinion, a residency should prepare you to do any case if you had to. Most of us will end up specializing in some way or another, but in my mind I want to be the most well rounded resident I can be.

I also would place importance on resident camaraderie and overall happiness as mentioned in the previous post. If the residents are slashing each others tires and are generally miserable, odds are you will be too. This, however, is a tough quality to gauge from a 3 hour interview. Attending the pre interview mixer may help.

Ability to have a social life is less important in my opinion because I think that residency is five (or six in some cases) years for the rest of your life. With the 80 hour work week you'll always have some free time, but residency is the time to learn, because patients (and their lawyers) won't care if you've "only done the procedure a couple of times."

That was really long winded, but hoped that this one a-hole's opinion may help you out.

Thank you. Yes it is very helpful!

Keep them coming... the input is valuable!