Should You Commit to Working for a Company in Exchange for Getting a Residency?

The Devil’s Advocate summarizes my feelings on this issue.

In my opinion: no.  If you want a more detailed, analysis, read on.

The first time I encountered this concept, UGA had taken a radiology resident from VCA.  We later took a surgery resident from the military. We also took a surgery resident from another university.  The essential premise is the same: the sponsoring organization (university, company, military, etc.) pays for the resident’s salary (including benefits) and then the resident contractually owes that organization a certain number of years of service after they finish the residency.  Why would anyone do this?

The training institution benefits because they get an ‘extra’ resident.  Resources to find residency positions are limited, but services need to meet their caseload demands.  Residents are an effective way to enhance service delivery. Universities see residents like this as “free” residents- they get the labor of a resident without having to pay for it themselves.  So it’s a good deal for the training institution.

The sponsoring institution benefits because they get a committed specialist for a certain period of time.  Institutions that have a hard time attracting specialists may choose this route so they have a guaranteed specialist at the end of the program.  One problem is that it takes 3 years to train a resident, so if they need someone NOW, this won’t help much. Another problem is that the specialist may not stay once their contract is up, which puts the institution right back in the same position they were before.  So it may be a good deal for certain sponsoring institutions, but may not be a long-term benefit for others.

The individual doing the residency benefits because they get a residency position which they may not have otherwise gotten.  For example, if someone does not get a position through the Matching Program, and they desperately want to do a residency, they could find a sponsoring organization and then get to do a residency.  These positions exist OUTSIDE The Match and are spots in addition to the existing spots offered by training institutions. They then HAVE to work for the sponsoring organization, usually for about 3 years, after finishing the residency.  So it may be a good deal if the individual would have wanted to work for that organization anyway, or if they are basically fine working for them until the contract is up.

Naturally, my idealism clashes dramatically with this free market approach.  I don’t believe anyone should have to sell their time as a specialist in order to get a residency.  It just strikes me as unfair. In an ideal world, these organizations would have to change so that people would WANT to work for them, rather than forcing desperate residency-seekers into a deal with the devil.  In an ideal world, those most deserving of residencies would get them, and those who don’t would be happy with a different life path.

I understand it isn’t an ideal world, and the free market allows for these kinds of contracts.  As long as there are applicants desperate to get a residency, who will do almost anything to get one, these kinds of contracts will persist.  I wish people wouldn’t make these deals, because then organizations would have to improve and actually ATTRACT specialists. But I’m not in charge of the world, and you’re an adult, so you can make your own choices. Just make sure you’ve taken all the benefits and drawbacks into serious consideration before making that choice.

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