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[quote]
Just like colleges and medical schools, residency programs vary in terms of reputation -- which naturally affects the number and caliber of the medical students who apply to get in. But does training at a prestigious hospital mean residents will become good doctors? Maybe not.
Are these factors: A hospital in a large cit may accept sicker patients and also has more need to play “defensive medicine.” (More law suits in a large city.)</p>
<p>In my state, there is also only one Level 1 medical/trauma center to serve most of the state plus chunks of 2 other states. The sickest and most critically injured patients all end up here. (No where else for them to go.) Yet this hospital has the second best (lowest) HCI index in the country. </p>
<p>I assure you there is no shortage of lawyers here either. If people wanted to sue, they certainly could.</p>
<p>As for “defensive” practice, the hospital serves some of the poorest & least educated and some of the most educated populations in the US. (Highest per capita number of PhDs for any state in the US.) Both receive the same exact level of care in the hospital.</p>
<p>How is the number of patients with uncontrolled diabetes a good proxy for the quality of care? Whether or not a patient’s diabetes is controlled is controlled an awful lot by the patient.</p>
<p>Are all the people who come out of top residencies top doctors? Of course not. Is the average doc coming out of a top residency a better doctor? Probably. Is that because of the residency training or because they were a better future doctor to begin with? Don’t know. Probably a mix of course.</p>
<p>Sone specialties are so selective. Isn’t a primary goal to get into any residency for this specialty? Or any residency for selective specialty is considered to be prestigious? Based on D’s previous decisions, I do not believe that D. would be looking for any kind of prestige. She probably will look for location and personalities, but that is if she would have choices. In regard to residency, it might not be the case at all. It never occurred to her to question if any program produces better results than another. Isn’t it more up to an individual, what he/she gets out of any residency program? I might be wrong in regard to making conclusion about residency based on previous experiences with academic programs. Just curious if it is still more up to a resident or lots depends on a place.</p>
<p>We still need to know answer to a big looming question about specialty. Still very wide open or shut down whichever way is preference and it does not look like rotations will give any indication as all of mandatory once are not in a area of interest. Academic interests might not be a good indication either. Well, some narrow down will occur after Step 1, I imagine. Not a superior test taker here, but a very hard worker bee with test results that are usually lower than grades. Will see. But she is lining up Research in a great area of interest that seem at least on a surface to match her goals perfectly.</p>
<p>If you read the all the tables and data associated with the Dartmouth project, it measures things like how well patient pain is controlled, the number of return visits per same problem, whether patients are instructed on after care, whether patients are instructed on how to take their medications, number of patient falls [at home] and other avoidable accidents, whether the patient’s immunizations are brought up to date before their discharge, number of elective joint replacements in the last year of life.</p>
<p>Mostly it’s about patient-centered medicine and how well physicians listen their patients.</p>