Choosing between culture vs prestige for residency

[Tollats]

I'm graduating from a "top tier" school and applying to IM, hoping to do academic GI down the line.

I'm having trouble deciding between 2 IM programs, mainly between prestige vs culture. Features of each below:

IM Program #1 (my school):
- "top" program, academic focused
- sicker patients
- amazing city, lots to do, would like to settle down here in the future
- program reputation for being less supportive, residents seem overworked

IM Program #2:
- slightly smaller program, more tight knit
- mix of academic and community vibe, strong research but less breadth compared to #1
- closer to family
- boring city, not as much to do
- very supportive of residents, responsive to feedback

Both programs have strong subspec match rates

I'm torn between choosing the big city program where I'd like to eventually settle down in vs. the smaller program with better culture. Wellness is important to me but I also don't want to limit the connections I can make by going to a smaller program.

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[operaman]

Program 1, hands down.

The closer to family would have made 2 a contender, but if you’re planning to settle away from family anyhow then I don’t see any reason not to pick 1.

There’s also the benefit of knowing the area and building connections locally where you would ultimately like to land. Coming out of that GI fellowship, you’ll have local connections even if you do your fellowship elsewhere. So many people I know landed their jobs via word of mouth and connections, and most of those come through your training programs.

Having a fun place to enjoy your off time is also a great plus.

 

[M&L]

Go with the program in the area where you are planning to settle down

 

[DO2015CA]

1 hands down based on the factors you listed above. Even more important if the first one controls the GI show in town. You may be working for them in the future.

 

[GoSpursGo]

Agree program 1 is obviously the choice.

 

[aldol16]

No one can answer this question except for you. This is a question that boils down to whether you value culture or prestige more. Some might excel at a program with the right culture fit but do poorly in a program where the culture does not fit their personality. Others might be able to do well in both cases and go for the prestige. It really depends on the person and requires a lot of introspection.