Pre-residency Fellowship

[Guest]

^a common excuse from someone you might get into the field by dirty means. People who went to sh*tty colleges without any personal awards or outstanding scores have gotten into top-tier schools because they are good players by manipulating the system, sabotaging colleagues, networking, etc. Guess what ? They already have a spot in a top Neurosurgery program. They must have the neurosurgeon gene, right???

[Guest]

What a dumb take. Lots of kids match only because of family connections. I guess they have the gene

[Guest]

Mentalities like that dumb “tier and genes” reply is why racism is still a topic in this day and age

[Guest]

Why would a pre residency fellowship decide to keep someone multiple years? You would think if they are good enough for that job to be kept, then they would be good enough for residency. I’ve worked with fellows in the past, and in fact some have been better and harder working than the acgme residents (and I had coresients that agreed), but somehow they are not picked up by a residency.

[Guest]

^true. A few factors include:

-the spot was planned to be filled.
-hard workers can opaque other residents (especially, those who want to complete the bare minimum workload).
-APPs, techs, or nurses might not like you. They might not like foreigners, or simply they don’t like you. Their opinion can heavily influence the PD decision if he is biased towards their opinion.

[Guest]

Because they want to keep them around as slave labor, but don’t actually think they’re good enough for a residency spot. These programs are not interested in helping ur career, they’re simply looking for someone to do scutwork cheap.

[Guest]

What does "good enough" mean? I have seen some fellows rock on seeing consults, doing surgery, research, etc. In fact, the fellows that I have seen have out-shined many of the residents, to the point where some of the "out- shined" residents are jealous and use their position of power to abuse the fellow - make up rumors, etc. It seems to me that there is a bias.

They need to either count the time of fellowship towards ACGME time or get rid of these programs, because it just seems like a waste of time if one were to not match. And the match is solely on the discretion of politics or if you were "liked" and not as much on objective criteria.

[Guest]

I couldn’t agree more. Professional jealousy is probably the root cause.
We have a friendly and gentle foreign resident that outshines the other ones to the point that some of their co-residents start making up stories to denigrate their reputation with the chair, attendings, and OR team.
Although not clinical positions, same applies to research fellows who spent year after year publishing dozens of papers for the minimal chance of a vague letter of recommendation. By the time of application comes some residents start making up stories, specially those who have less pubs than the applicant.

If you are a foreign MD or student, I would encourage you to research the trajectory of the team you are about to join. Reach out to previous pre residency or research fellows. Don’t join a program blindly! It can cost you years of “unproductive” career.

[Guest]

Keys to autonomy:

-County hospital—some homeless person or illegal immigrant is not going to have the resources to sue, autonomy is generally really high
-VA—good culture of teaching, and vets are a chill non/litigious group of people
-Demographics—a place with uneducated/poor people like Pittsburgh or Tuskaloosa middle of nowhere, but you pay the price for living there, and the research generally isn’t as good

Otherwise finding places where autonomy exists seems like it depends on the attendings and culture of department. Like Barrow and Mayo are flagship academic medical centers but have good autonomy. But of course, don’t believe everything you hear on the trail, see it for yourself before you rank

[Guest]

Barrow is attached to a 150 bed community hospital. 100 of the beds are neurosurgical. You get the autonomy to be your own ID doctor their too