Biggy
Forum Junior
Topics: 11
Posts: 90
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This is something that has come to my attention recently and has me curious. Could anyone here give some ideas on the advantages and disadvantages between a small program - say 15 new interns each year, vs a much larger program - say 40 new interns each year? For simplicity sake, lets just say that both programs serve in big cities.
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| criticaldoc
Forum Senior
Topics: 9
Posts: 147
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well biggy:
that depends on ur experience, i mean if u are one who is only looking for a residency and strength of program doesnt matter (Not being rude) u can project on that. I can tell one thing the amount of work and teaching is not that much affected by strenght of program there are parameters that determine it. I know u will need some one else's opinion on that. I am too eager to listen to that.
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it all came from Darvin's theory "Survival of Fittest"
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| hypomanic
Forum Senior
Topics: 11
Posts: 153
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One thing I have heard that sounds plausible:
big Program- more interns- easier to find people to cover for you during vacations- If there are only 10 interns it will be tougher due to fewer options
What follows is pure speculation/ my personal opinion
very large programs /very small - if I had a choice I would stay away from both- very large- tends to make you feel like you are in factory- just another cog in a machine, nobody knows you and the attendings probably would not know you personally
Very small also can be strange if you are stuck with only a few strange residents- and you have to get along with them whether you like it or not - for the entire residency- much worse when theres is not much choice
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Life is short, the Art long,opportunity fleeting experience treacherous, Judgement difficult - Hippocrates
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| mph
Forum Elite
Topics: 19
Posts: 341
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Totally agree, but the best programs generally r sooooooooo big. Also, these programs tend to have so much work, which is confusing to me as so many people there can share the load.
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| ea
Forum Senior
Topics: 15
Posts: 142
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My personal opinion: I need a visa, so
Big programs have lot of work to do and the end of residency at BEST I will still end up with less competitive fellowship positions.
In smaller but DECENT hospitals, I will have less work, nice relations with attendings, less competition with peers, more chance for poster presentations, good LORS and at the end of residency I will get into those less competitive fellowship programs.
So, at the end of residency..... if all my luck favors, I will still end up with some nephro/onco/geriatric fellowship... so why do all that donkey work in big county hospitals?? I hate the fact that american grads don't take those hospitals and we IMG's crave like a dog for such shitty positions..... why should I clean the shit of US?? I will rather prefer smaller set ups!
If someone says, in big hospitals we get lot of exposure..... I will not agree..... things are changing... no one can master medicine.... we have to focus on fellowships..... so good to do fellowships and being confident in smaller areas.
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| hypomanic
Forum Senior
Topics: 11
Posts: 153
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Well -donno if I should do this- but looks like I have nothing else to do:
ea- your point on the advantages of smaller programs is well taken BUT
was it necessary to go on 
Lets face the facts- we as IMGs shouldnt expect to be treated on par with AMGs - if you want further clarifications on why, then... wait till your visa interviews to get an idea  then you'll be happy if you are treated like a human being 
And yes, we as IMGs precisely fulfil the need in the US where AMGs dont want to go- whether its doing "donkey work in big county hospitals" or working in "underserved" areas for visa waivers
So actually "why should I clean the shit of US??" because thats where the opportunities are and well, you know , somebody has got to do it 
As an IMG i share your frustrations, but cursing the situation doesnt help anyone
And its precisely the situation that even gives us a chance
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Life is short, the Art long,opportunity fleeting experience treacherous, Judgement difficult - Hippocrates
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| GOGETA
I'm Dr. GOGETA
Topics: 298
Posts: 2,617
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What about the chance to get into a Fellowship after the residency?
Also the % and grades the program have in passing the board of that specialty.
I have seen some hospitals that people want to get in like crazy and theire passing % is in the 80's compare to the other programs that are in the high 90's.
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As a general rule, the better it felt when you said it, the more trouble it's going to get you into.
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| ea
Forum Senior
Topics: 15
Posts: 142
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@hypomaniac,
Thanks dude for those views. yeah, I agree to what you say, but its just that we are in the middle of interviews and you get on those bad nerves once in a while. You are true, we are here to get a position and realty is always tougher than imagination.
Given the amount of compitition, I wish we get matched some where.
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| Biggy
Forum Junior
Topics: 11
Posts: 90
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wow, been a few days since I came on here and I really appreciate all your views on the matter!
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