Applicant question
It seems like the trend in anesthesia programs is moving away from only offering advanced positions, toward having more categorical positions. Do you see Stanford offering categorical in the future. Why only advanced?
Response
Another great question. Thank you! The short answer is that we are currently planning to have categorical positions but not until the 2010 NRMP match.
Historically we have believed that applicants liked the geographical flexibility and the content flexibility of being able to do an internship that was not affiliated with the main residency program. In the past, applicants told us they preferred being able to choose where they did their internship — such as staying in the city they were in for medical mchool for an additional year, if their significant other is there for example finishing med school. I, as another example, interned in Philadelphia at a University of Pennsylvania affiliate hospital, even though I went to medical school in Rochester and did my Anesthesia residency here at Stanford. The other reason applicants traditionally have preferred an internship separate from the residency is that it gives them a lot of options in terms of what type of internship they choose such as; preliminary medicine, transitional, surgery, pediatrics, or even obgyn for instance.
However, this sentiment appears to be changing, probably for several reasons. Applicants tell me they want to not have to learn a new hospital system and electronic medical record system for example, so by doing internship at the same hospital as residency they have a running start on the learning curve on how to get things get done within the hospital. Also, applicants want to start getting to know their classmates, and the housestaff in other specialties that they will be working with, earlier during internship. Another item is that with categorical slots they have to interview at less places. This makes sense to me although I worry that applicants will start competing against each other for the categorical slots at one residency, even if the advanced position are more easily available. We will see how that evolves.
73% of residencies now offer some categorical anesthesia positions, and these categorical positions usually are half of the total slots. This is up quite a lot from just a few years ago when less than 20% of anesthesia positions were categorical. We are currently working on putting together a clinical base year so that Stanford will offer categorical positions for the 2010 match. This willnot help you or the other applicants this year, but we do have many good internship opportunities in the San Francisco Bay Area. These include the Santa Clara Valley County hospital which has both transitional and preliminary spots. Many of our current residents were interns there.