Best Community Programs?

Akron and grand rapids are both good programs. Dont know anything about the others. Another good community program close to grand rapids is the one in Kalamazoo.

I think it kinda depends on what you're looking for in your training. I visited Greenville, which I thought was a very well rounded program (I think the only specialty they are lacking is tumor-but I don't remember for sure) with friendly faculty and residents. This program is really a hidden gem. Great Peds exposure with the attached Shriners Hospital (CMC and Duke also use this facility). I can't really comment on Greenville as a city though. I was told by the faculty that they are quite selective in who they invite for interviews, because compatible personalities seem to be quite important to them.
The Akron programs (General and Summa) are both very strong (at least from the impression I got from the interview day and word of mouth). Summa's interview day consists of a few hour long interviews (again the personality compatibility issue), and the opportunity to scrub cases with the residents. I don't think Summa sees a whole lot of trauma compared to General, in fact they have to travel 10 minutes or so over to Akron City Hospital to evaluate any traumas, despite the fact that most of their work occurs at St. Thomas Hospital (their home base facility). This could potentially become more of a lifestyle issue than anything else if you are making this trip 5 or 6 times a night while on call (and Akron is not the warmest place in the U.S.) Akron General sees Level I trauma at their home hospital. Supposedly, Summa residents operate more than General's, however this is mostly by word of mouth. Plus, if you want solid training in Peds, then both programs (and Cleveland Clinic) use Akron Childrens Hospital at which the residents seem to have a great and busy experience. And I don't remember there being much (if any) home call during the 5 years.
Mt. Carmel is also quite well rounded, but has a similar predicament with trauma as Summa does. Mt. Carmel is only a Level II facility, they receive their heavy polytrauma over at Grant Medical Center (also where OSU receives a portion of their trauma experience). Probably one of the best groups of residents I've met on the trail. Faculty seem pretty approachable, maybe slightly more rigid than some other institutions. Mt. Carmel also is very difficult to match into (2spots/yr) if one did not rotate or at least spend a day or two revisiting the program. This is information the Chairman openly volunteered. I'm not sure how many non-rotator interviews they offer, but it was hinted that there are few. This program also has the benefit of 5 years of home call which varies in how busy you are and you only cover the home institution. When doing trauma at Grant, you only take call at Grant which can be busy season permitting so at either place it is possible (but not always the case) to have light call nights. This program also allows its residents to moonlight over at the sister facility, Mt. Carmel East, and make a substantial amount of money.
My impression concerning these particular community programs is that you get great operative experience, and the residents as a whole are very, very well taken care of and tend to be pretty cohesive groups of people. In general, these programs tend to be in smaller metropolitan markets, Mt. Carmel is probably the exception. And finally, I think that how well your personality fits with the program is a high priority with these training centers as they tend to be smaller groups of residents. So it definitely depends on what an applicant is looking for in a training program (and to an extent lifestyle). Hope this helps.

What about Hamot in Erie, PA?

Thanks for the input IMnailer!

I interviewed at Grand Rapids and Akron General and I don't think there is anywhere in the country where you will get better training than either of these places. There are places that you will get as good of training, but these places are top notch community programs. As a city, Grand Rapids is probably a little nicer than Akron, but you have cleveland 40 minutes away.

I didn't make it to Mt. Carmel or Greenville, but I have heard nothing but great things about either program. A few guys I met along the trail from the SE said that Greenville is definitely the best program in SC, maybe the best program in the SE, including CMC and Duke.

As IMNailer said, it will all depend on what are looking for in a program, but the programs you mention are at the top of my rank list.

Is this list still accurate? I wanted to get some discussion about great community programs, and why someone would want to go to a community program at all, rather than a heavy academic program?

I am a resident at Hamot in Erie PA. Here are a few things about our program...

First off, community programs are very similar and very different than academic programs. If you are wondering about this difference, I think that "bonedoc" described very well how to consider this under "less competitive residencies" in a very eloquent post. Basically, I think the generalism that academic programs are far more in touch with research and the very highest level/newest innovations in orthopaedic surgery. Community programs are usually very focused on surgical technique, with higher levels of experience earlier, and more surgical technique enphasized in your training. As bonedoc suggested, this is not to say that you won't get innovative/new technology from a community program or technically trained at an academic center. Another generalism is that there is a higher resident to atteding ratio at academic centers, giving you more access to cases at community hospitals. Finally, you probably get better "treatment" as far as respect from the staff, quarters, meals, perks from a community program.

Now about Hamot-
Hamot is exceptionally strong in Hand, Peds, and sports, and strong in trauma and joints, moderate in Tumor. Our weakness is spine, because we have to do it with neurosurgeons (we have 2 attendings who have done fellowships in spine, but they only do a few cases a month opting to do other stuff instead). We have 2 residents per year. We have a great deal of early operative experience

Working here is a real joy. I say that because I came from a very academic school, where residents are treated like slaves, not even having their meals paid for. Whereas here, I have my own call room that I only share with my coresident, with a bathroom; A well-filled library at the end of the hall; A lounge nextdoor stocked with food; free food at the cafeteria; we are treated very much like attendings by the nurses and other staff at the hospital- mostly because there are not a lot of residents at this hospital- they think we are attendings. The attendings treat us very well, many of them go by first name. Almost every one of them cares a great deal about teaching; and they know us very well as individuals.

As residents- we get along very well. Most of us are married, some have kids. Morale is very high, and we hang out together often. We take a large portion of our time each day and devote it to conferences and case presentations, etc. which have become increasingly academic. We have a number of research projects going, and our chairman is very supportive of research.

I think that the type of person that would thrive here is one who wants to become good friends with your coresidents, wants to have attendings who become more of a mentor to you rather than a figurehead, someone who is starving to have early operative experience, because we have a lot of it. And someone who does not want to go to a completely non-academic place.

From reading the post by "adaman" it sounds as though the erie program is quite similar to ours here in kalamazoo. I expressed my opinion on the matter of community vs academic in . I also second the recommendation of the akron programs as well as the one in dayton, OH. I liked all of those.
Also consider the witchita Kansas program. They are like ours in that they have a university name attatched (KU @witchita) but only 2 or 3 of the staff are KU employees whereas thre rest of the staff are in private practice

Anyone interested in smaller programs (2 a year) should check out Union Memorial in Baltimore. I don't say community, because even though we are not at a big academic hospital there's emphasis on teaching and time spent at Hopkins and Shock Trauma.

There are other posts about Union and feel free to email me with questions

[url=mailto][email protected][/url]

Another positive about community programs is the intern year.

At some programs the interns take ortho call all year round (or as in my case, except the 3 trauma/gen surg months). Furthermore, many community programs the interns go to ortho fracture conference and morning conferences every morning all year round despite being on other services. Finally, some programs have interns go to ortho clinic say 2 afternoons per week year round. While it may seem insignificant, it allows you to be an 'ortho resident' for an extra year... in a way, extending your residency by a year. These same programs are designed so that the interns are "owned" by the orthopaedic surgery department rather than general surgery- like at many places. Your ortho chiefs are in charge of you... and you get to hang out with your friends more.

Thanks for the great responses,
What do all you other applicants think of community programs as an option for training? And what are your biases for and against them?

since you're throwing around places in the area, i'll give my pitch for allegheny general in pittsburgh. somewhat academic as it's affiliated with drexel/hahnemann but mostly a big community program. chiefs last year left with nearly 2500 cases. recent fellowships (last 3 years) include HSS (sports), NYU (sports), kerlin jobe (sports), mass general (trauma), rochester (sports), beth israel (spine).

Any applicants out there willing to share your opinions of community programs?

Akron General is great program with a good balance of faculty expertise, operative experience, laid back program and research experience. They are truly one of those University programs with a community feel. One of their shoulder specialists is an editor of the textbook The Shoulder and they have had several publications in the last two years with a resident as first author (JOT, Clin Biomech, AM J Orthop). The training is exceptional and residents have attained some top notch fellowships in the last several years - 2 San Diego (Peds), 1 Cleveland Clinic (FNA) 1 Scripps (Joints) 1 Taos (Sports) 1 Kentucky (Sports) 2 Harvard (Spine) 1 Carolinas (Spine).

I rotated at Mount Carmel earlier this year and I must say I was pretty impressed. Even though they are a level II trauma center, the guys there had some busier summer nights thrown in there. Even the PGY-2's (who take solo call from the start of their 2nd year!!) were able to handle the open fractures and other stuff coming in. They do take 5 months of ortho call their 1st year though. However, it wasnt like that every night, which was also nice.

Even though they are a "community" program, they had more didactics than the other two "academic" programs I rotated at. Usually 4/5 days a week we had conference and Wednesday mornings are usually 3-4 conferences deep.

It was also nice to see that they were operating a ton, as they cover something like 20+ attendings. The PGY-2s I was working with were doing TKA's and basic fracture ORIF's by themselves already without much, if any, assistance. They all got along with the attendings and usually spent quite a bit of the cases joking around with them.

The residents get a bunch of perks too, ranging from free lead vests, food, parking, 3 weeks vacation, $1500 conference money/yr, home call all 5 years (except when on gen surg) and probably some other stuff I can't remember. The 2nd years went to Switzerland on their conference last year!!!!

I'm rambling on now, but just wanted to make a comment about Mt Carmel, as I was very pleasantly suprised rotating there. Even though I havent been on any interviews yet, they are sitting #1 for me right now. Anyone know when they send out interview offers? The only negative is that they only have 2 spots right now and they get around 300+ applicants/yr (at least thats what the secretary told me).

I've also heard great things about SUMMA, Kalamazoo and Greenville, SC from residents at everywhere I've been.

I am PGY-4 in Fort Wayne. You pretty much described our program as well. With exception that our conferences are bundled all into one day (thursday). So if you are interested in this type of program i encourage all of you to give us a look. Please ask me any questions that any of you have. I'll be happy to answer them.