An Unopposed Residency Means
An unopposed residency means that residency is the only one at the primary hospital.
A lot of teaching institutions will have many residency programs at the same hospital, and this is pretty typical of larger academic institutions.
For Family Medicine, unopposed programs are popular because then you’re not competing with other residents for things like procedures or interesting patient encounters.
Essentially an unopposed residency means that those residents are the only ones in the primary hospital of that residency location.
It also means you as the resident get more procedures, sole exposure to the attendings, and more interesting cases.
Be sure to read on to get more details on what an unopposed residency means and how to evaluate opposed residency programs.
Opposed Residency means
In the most simple terms, opposed residency means that there are other programs at the primary hospital.
You will find opposed residency programs at primarily academic institutions.
You will also find community hospitals that have developed multiple residency programs, and those institutional programs are considered opposed as well.
Opposed residencies can be either good or bad.
Lets dive into the good, bad, and overall how to evaluate opposed residencies.
Good things about opposed programs
There are a few good things that come with having multiple residencies in the same hospital.
- The hospital is used to it
- Attendings are all used to teaching and expect it if they work there
Lets expand on these a bit now.
Hospitals get used to having residents around when there are multiple different kinds of residents running around. This is nice because with a few different residencies it is easy for there to be a resident at any given spot in the hospital at all times.
The nurses, staff, administration, and all other people begin to just function with the residents. The residents really become a part of the overall function of the hospital, which can be good and bad as we will go over.
Now, this can happen with unopposed residencies as well, like at mine. It just takes longer and some areas of the hospital may forget about the residents if they haven’t been there for a while.
It can be nice when the hospital needs the residents to function because you are more directly involved and are depended on for patient care.
On the flip side, it can be nice to only have the responsibility of your education and not the overall function of the hospital, so there are ups and downs to both kinds of residencies as we will keep discussing.
Attendings are used to teaching. With opposed programs, no matter where you go in the hospital the attendings are likely expected to teach if they take a job there.
This can be nice because you don’t have to encourage the teaching or anything like that. The hospital attendings just know that a resident will be working with them on occasion and they are expected to teach.
Having that expectation really makes everyones job a little easier, and helps you learn more.
Still though, unopposed residencies lead to more overall learning which we will touch on below.
Good things about Unopposed Residency Programs
There are so many good things about unopposed residencies, but I am a little biased since that’s how I trained.
The few we will focus on are:
- More procedures/patients to be seen
- Your education is most important
Lets dive deeper into these.
More procedures and patients to be seen.
If there are only 20 residents in the entire hospital and they are all in the same program, then this leaves a lot more patients and procedures for you to do.
If you are in a family medicine residency, then there won’t be any ICU fellows doing the central lines, no ED residents running codes, and no IM residents doing all the admits.
You get to do those.
Because you get to do those, you end up learning more and having more opportunity.
Your education is most important
Not only do you get more opportunities with an unopposed residency in terms of patient encounters and procedures, but the focus is more on your education.
If there are multiple residency programs at one hospital, this leads to residents being depended on for the hospital to function.
This can lead to the slog of making sure you are doing the charts, patient encounters, and billing. All those things the attending does, that we are learning, but it is coming at a time when the focus should be on our education.
Opposed residency hospitals typically depend on the residents to function. This leads to the stress to basically be functioning as the attending, and can at times take the attention away from focusing on just leaning.
Training at an unopposed program is awesome. You get more opportunity and patient encounters in my opinion.
Also, the focus is centered on your education, where as that may or may not be true in an opposed program.
Problems with Opposed Residencies
We have alluded to it a little bit, so lets simplify it and just put it out there in this section.
- Less focus on your education
- Less opportunity
These are the two big things that come up with opposed residencies are discussed.
It has been talked about above, so we won’t dive super deep into it.
Ultimately with more residents running around the focus for residents becomes making money for the hospital and performing attending duties. Which, that is our ultimate goal to be an attending, but during residency our focus is still on education.
Then having more residents/fellows running around means less opportunity for interesting cases and ultimately procedures.
Getting around the problems
There is one main way to get around the issues that pop up with opposed residency programs.
You can always work hard and make a name for yourself.
If there are multiple residencies at the hospital and you are in a Family Med residency, then go out of your way to work with everyone and to be the eager resident that is always prepared for patient encounters and procedures.
Judging an Opposed FM program
Make sure to look at what other specialties are there.
If there are primarily surgical programs, then your education won’t suffer hardly at all as a FM resident.
- Ask the current residents. Try and get them to tell you the honest truth about it.
- Ask them if there are any issues with the other residents?
- See if they have issues getting certain procedures you are interested in?
In all honesty it becomes pretty easily apparent by the end of your interview day and dinner if the program is friendly to your wants and needs.
If you get a bad vibe about your opportunity there, and it is because of the fact that they are opposed and have a lot of other programs, then be sure to nail this down and ask your specific questions to the residents of the program you are applying to.
In general choosing a residency program is tough. Check out this article that will help guide you through choosing the right one for you.
Here is a good link to another article on helping you choose the right Family Medicine Residency.
Final Call Opposed vs Unopposed programs
I hope it has been clear what an “unopposed” residency means throughout this article.
When it comes down to it, I am very partial to unopposed residency programs as that is where my training was/is done.
The experiences are much better in my personal opinion, in terms of procedure options and overall patient interactions, simply because there are more of those things to be done.
The more you see, the more you do, the better prepared for life as a practicing physician in my opinion.
I would choose unopposed every day again, but if you want to be in a specific location that only offers opposed then there is nothing wrong at all with applying to those.
Other Related FAQ’s
Can you apply to two different specialties?
Say, you are not sold on one specialty and you would practice it or another one, and you are wondering if you can apply to two or more different specialties.
The answer is absolutely 100% yes, you can apply to as many specialties as you want.
The trick is just keeping it straight.
Within the application portal there is so much going on and if you add multiple specialties, it adds a lot more to it.
Have yourself a personal statement for every specialty that you apply to, and make sure to get letters of recommendation from each of the specialties you are applying to.
Can a Doctor do more than one residency
Absolutely, but who would want to?
If you are unhappy with your specialty choice, or your residency choice then you could transfer.
If you want to do more than one specialty, seriously ask yourself if you think you can accomplish this in practice.
If you are dead set on the idea of doing more than one residency, then you should check out dual residencies that get you board certified in more than one specialty.
How many residencies should you apply to
This is the loaded question right?
It differs so much based on the specialty you are applying to, your competitiveness, and if you are locked into a specific geographical location.
I applied to way to many in my year, but it is hard not to because its your future and you really want to improve your options right?!
I hope this has been helpful for you, if you have any questions about the residency application process feel free to leave them in the comments and I will try to answer them as quickly as I can.
Thanks for reading
Sean Kiesel, DO, MBA