In private practice, how much does region of your residency matter when getting your first attending job?
For example will doing residency in southeast make it an uphill battle to find a job in the PNW one day? I have no family or relation to PNW either.
Depends. If you're talking about private practice general neurosurgery (i.e. >75% degen spine), you can find a job almost anywhere. Using a recruiter can be helpful for a region where you don't have contacts.
That said, it's a different story finding the right private practice neurosurgery job for you (compensation, autonomy, mid-level/ancillary support, call, payer mix, case mix, helpful senior partners, equipment, etc.). Obviously, it's helpful to do residency in the geographic region where you want to eventually end up since you can pull for your attendings' contacts.
Private practice jobs vary widely and there is a HUGE difference between a good one and bad one. The good private jobs are just as competitive as any academic job out there.
Last year trainee here. All training has been in Southeast. Have interviewed all over the country for mix of academic and PP with a subspecialty focus. Happy with the offers I have, problem I have now is deciding which to take.
I would say what matters more than geography of training is reputation of your program or specific faculty/mentors at your program. Connections matter (e.g., your chairman is friends with so and so in PP/academics and may hear about a possible job there before it goes to recruiters etc) as does potential practices/departments knowing the average quality of trainee a particular program tends to graduate.