Monday 11 February 2013

What Makes A Training Program Good: Factor To Consider When Ranking Programs For The Match – Education And Teaching.

This is part 1 of 4 in a series of articles about what makes a program a good one.

education in residency training
Teaching and education: This is without doubt an important aspect in choosing the program, but often overlooked because in the rush to get an interview done, the applicant is often shown only the best parts of the institution. As an interviewee it is hard to assess how good the program is as far as education is concerned but a good metric to check it out is asking the current residents what they think, looking up the ABIM pass rates for the institution and getting an idea how many residents graduated and went on to do fellowships. Let me touch upon the above subtopics is brief,

Current resident satisfaction about the educational aspect of program: this one is easy to ask when you are interviewing. If you missed the chance to ask the residents, then make sure you write to them, emails or even phone calls to go back and ask about how well they think the program prepares them for future life as a physician. Also, if you have been invited for a second look this may be a good opportunity for you to delve into this a little deeper. Ask for how many didactic sessions there are, ask for what is expected of a resident when they present cases in noon or morning conference. Are they encouraged to present cases or abstracts to scientific and medical meetings? All of these will be important clues as to how committed is the program to education of the. Some of the things to ask are
  1. How often and when are morning reports
  2. What is taught in noon conferences
  3. Is there active teaching on rounds
  4. Is there an opportunity to teach and interact with medical students and other medical staff (RN, PA, Pharm etc)
  5. Are residents encouraged to present cases and present in meetings?
  6. What is the level of research support for residents?
Successful fellowship transitions and post graduation careers: Another rough metric to see if there is a good amount of research, didactic and educational support at the program is to see how may residents end up getting into a fellowship from the program. This would be another question to ask the program coordinator or even look up on the program website. If the program is on top of things and updates its home page each year then they will usually also indicate what the recent graduates of the program are doing. See if any recent graduates have made it to top rates institutions (Harvard, Mayo, Johns Hopkins etc) for fellowships. Also, you can do some research about the medical subspecialties from about number of fellowships based on the subspecialty.

Residency program pass rates: a fair (I am not saying the best or even the most important) indicator of how well the residents are trained in program is looking at the pass rates for the residency program. Each specialty like internal medicine, pediatrics, radiology, family medicine etc have their own American board of __, which oversees the certification exam. Dig a little deeper and find out how the program did in these certification exams. For example, the program pass rates for family medicine based on the programs are here and the ABIM pass rates are here. If the residents are not given enough teaching and do not have time to study on their own in view of continued patient care or just scutwork then it is going to be reflected on poor exam scores and thus may be an indirect assessment of the education provided.

The above sources and information should be able to provide the applicant with a fair to decent idea about the nature and quality of education being provided at the institution. If you think of any other metrics to assess the education being provided by the program please leave a comment!


  1. often, the graduates entering fellowship is misleading. especially as an international medical graduate, if I see someone matching in gastroenterology into harvard, I never know if it was a visa requiring person or a green card holder. also some of the applicants have additional training like MPH, residency or fellowship in their home country which would have helped them to get into competitive fellowships. these days even many indians and pakistanis are green card holders, so even knowing the name of the person is not helping. unless otherwise I ask about this to a current resident, it is often difficult to know

    1. Hello Dr. Indikar, you bring up some excellent points. However, the quality of education provided should not have any direct bearing on the green card status or visa requirements programs but I agree with your point and as alluded to in the article, fellowship flow from residency is a crude method of assessing the quality of training/education.

  2. also one more thing that seems to affect is the size of the program. typically in a community program, there are 12 to 15 residents. about half go to hospitalist service and rest to fellowships. so if you look back at 5 year graduates, we can see hardly 2 or 3 entering competitive fellowships like cardio, gi which may be because of the small size of program. compare that to a program with 45 residents, obviously they send more people into competitive fellowships. that is a potential bias I noticed.

  3. having sub speciality fellows is a point I would like to add. I observed in a place where the residents worked with the GI fellows. the amount of teaching the resident got from the fellow was astonishing, sometimes highlighting important board questions, sometimes testing interesting vignettes and also giving home work assignments. I felt it helped the residents in a great way


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