So...when I consider residency programs, it seems that there's a clear dichotomy--

On one hand I could pick the place that's familiar, close to family, near lots of babysitting support/grandmas/friends/husband's job, etc, etc, etc.

On the other hand, there are lots of other residency programs that would be a better fit for me philosophically, and that seem to be more family-friendly, better pay (slightly), and a better reputation overall.

How did you decide on your residency program? Do you think it hurt your career (job/fellowship opportunities) to choose a less desirable residency for its location? Or do you regret moving away because of the toll on your family, etc.?

Nothing in the match is ever a sure thing. It's a scary thought, but it's true.

I agonized over my top 3, reorganizing them dozens of times, partly because they were in such different parts of the country.

Ultimately, it didn't matter as I matched at my #4. It was perfect for me. The match just knew, I guess.

If you really click with a program, remember that. Take notes. Notice at which programs the residents seem genuinely happy. Absolutely consider your resources - with a family, that's a big deal.

When I uprooted my soon-to-be-ex, he never worked again. Not a good plan. But it was ultimately good for me. I love my current practice, and I'm sure I'd never, ever have up and moved here if I hadn't trained nearby.

It's a balance. Program is more important... if you're going to do something for 80+ hours a week, you need to be happy there. On the other hand, the world's best program located in a city where you can't live due to safety/ cost/ severe allergies/ whatever, is ultimately not going to be good either. Basically, eliminate any place where you truly CAN'T live, and after that rank the programs.

OOh, that is hard! Ideally the most prestigious program is also the one you jive with philosophically and feel at home at and is ALSO the one near family and husband's work!

I matched at my first choice but even so there were compromises. My second and third choices were in nicer towns which my husband preferred. We landed up staying here after I finished residency so it is now our home but I sometimes wish we were in the nicer areas of my second and third ranked programs...after all, residency was only three years! I guess we could always have moved after residency but it is so much easier to stay where you know everyone in the medical community and my husband was settled in his work.

Good luck!

Exactly! I have a pretty good chance of matching near my home school, but there are some programs out there that seem more family-friendly AND with better reputations....I still don't know if that's worth taking my family away from Grandmas for 3-4 years...

asunshine, a few thoughts rereading your initial post.

I think ready , willing, andable Gparent care makes almost any program family friendly.

You don't write whether you LIKE the program nearby, just that it's not as family friendly and not as prestigious.

If you uproot your family, you might feel responsible to love every minute of your training (which you won't).

Any residency program will be less family friendly than medical school (okay, I know I asked for a challenge from someone out there!)

I'm sure less prestige can hurt your chances some places, but not everywhere. If you're a solid resident at a good program (maybe even with an away block? it can be done), you'll be fine. If you're a great resident at a so-so program, and a good prgram director, you'll shine.

The most freeing decision I ever made was to rank the lower prestige program with less call. Match however, put me at a different (better) program with more call--- but just knowing I'd been able to make that decision has made these years more balanced.


good luck. not easy, as we're not very good at fortune-telling as a profession :-)

Thanks, ohio. The nearby programs are all intense hours-wise, and the residents don't seem particularly happy...more like, they complain about the hours and administration a lot, but maybe this is true everywhere. I absolutely think I could like it even if it's only for the fact that it would keep my family close to the rest of my family. I mean, residency is going to be hard and frustrating regardless.

I guess it's more me thinking to myself "what if I tried for this stellar program that everyone raves about with better lifestyle, etc etc etc, but is it worth moving my family?" Is there anyone out there that regretted moving?

I would give anything to have a residency near my family. My medical school was 3 states away and now residency is as well. I think if the program is in the same town as your family, go with it. Its only 3 years. There are a lot of components that factor into "family friendly." To me, its difficult to call something that if you are across the country from your family.

There are a few points to consider. If you plan to apply for a competitive fellowship (GI or cardiology or maybr pulmonary/critical care) then pick the place with the best reputation to better facilitate your progress through the fellowship match. The people there will have many more connections and it makes a big difference.

On the other hand - if you are interested in the less competitive specialties (endocrine, geriatrics, palliative care, rheumatology, allergy) - you could go anywhere.

Family nearby is key. You don't realize it until you're away from them. Holidays/celebrations are more difficult. Child care is expensive and worrisome if its someone other than your family, and the agony of scheduling every vacation around going home to see family versus living around them and vacationing somewhere different is priceless.

There are no programs near my fmily (in the frontier). I picked my residency to be a days drive but no more from home. The decision was based on people around me (wanted other residents with kids), commute time/cost of living, some mark that the education is okay, and somewhere new. I've been on the road to endocrinology since I started college. It will be slightly more competitive but I organized a rotation with a renown expert in the field. AND there' are dozens of residents/fellows competing for things so I can do as much or as little as I want (right now 3 committees and a prospective study). Its great.

Residency is a stinker no matter where you go.

As for your question about "is it worth moving my family?" I faced a similar challenge with med school. Accepted to a place in the bordering state. Also accepted in several other locations. Elected to go with one a great distance away because it was a nicer program, prettier area, and I thought that's what would suit me. However, after my son was born I really regretted not going to the school closer to home. Don't get me wrong, I loved my training - but you don't have to BE residency. Its a job or an apprenticeship. Your priorities should always be preserved and guarded or it/they will leech them away one by one.

I chose based on location. After living all over the country for a good 10 years, I really wanted to move back closer to my family on the East Coast. So I made the commitment to myself that I would rank all of the programs in my target city before all others. It was hard to stick to that at times because I really loved the residency program at my med school, would have had a guaranteed match there, and I loved living in the city I was in. In the end though, I'm glad I stuck to my guns and moved back here. I'm really happy in my program and in my personal life. I love seeing my family more than just a few times a year.

A good friend of mine went the opposite route. She ranked programs based on reputation and how well she liked them, and decided not to factor in geography. She ended up having to move 4 hours away from her fiance, who she had been living with for 2 years. She likes her program, but overall, she's pretty miserable and lonely. But she says she would probably make the same decision again because program reputation/prestige is important to her.

I think it's a really personal decision, and a difficult one. Good luck!