hey, just wondering if people who have been through the process/are currently training have thoughts on pros/cons of IM at UCLA, UCSF, and Stanford. Specifically, i've heard that of course Stanford is cushy and places you well, but actual training may be inferior to other highly ranked places. And of course a place like SF will train you excellently, but with the worsening budget crunch, this may have an effect on the amount of time you dedicate to scut vs. actually learning/caring for patients? Any thoughts from people actually in these programs whether these impressions i've gotten from senior classmates are actually true? To be honest, i'd be honored to have the opportunity to train at any of these places, but i'd just like to hear some opinions from you all. thanks so much!!!

hey, just wondering if people who have been through the process/are currently training have thoughts on pros/cons of IM at UCLA, UCSF, and Stanford. Specifically, i've heard that of course Stanford is cushy and places you well, but actual training may be inferior to other highly ranked places. And of course a place like SF will train you excellently, but with the worsening budget crunch, this may have an effect on the amount of time you dedicate to scut vs. actually learning/caring for patients? Any thoughts from people actually in these programs whether these impressions i've gotten from senior classmates are actually true? To be honest, i'd be honored to have the opportunity to train at any of these places, but i'd just like to hear some opinions from you all. thanks so much!!!

I'm interested as well - responses can be brief!

I'm also interested, but also interested in UCSD and Davis programs as well.

Here are some of my thoughts.

Stanford - yes, there are rumors of this program not having good clinical training, however I have found that these rumors are perpetuated by people who have never been to Stanford or had any experience there. While these rumors were probably true 15 years ago, they certainly are not now. The hospital is constantly bursting at it's seams with patients, the faculty are top-notch and interested in teaching, and the residents are very high quality and enthusiastic. The program also places a lot of emphasis on training residents to be effective teachers in academic medicine. In my personal experience, I'd say the actual quality of clinical training at Stanford is on par with any of the top name academic programs. And the program is not cush by any means -- if you go there you should expect to work very hard. Residents from Stanford also do extremely well in fellowship placement.

UCSF - Excellent program, but more malignant than Stanford, probably more because they have less resources, lower salary and fewer ancillary services at UCSF. Pros of UCSF include it's strong reputation, excellent fellowship placement, and strong clinical training. Major con in my mind other than the resource issue is that they are one of the few training hospitals left in the country with an open ICU, which will make your life miserable as an intern.

UCLA - has gone through a number of changes since they have a new program director. Overall a good program, but not as strong a rep as Stanford or UCSF. They are very strong in some specialties and relatively weak in others, so it can help your decision if you know what subspecialties you are interested in. Can't say too much more about the program...

Sorry, don't know much about UCSD and Davis.

UCSF - Excellent program, but more malignant than Stanford, probably more because they have less resources, lower salary and fewer ancillary services at UCSF. Pros of UCSF include it's strong reputation, excellent fellowship placement, and strong clinical training. Major con in my mind other than the resource issue is that they are one of the few training hospitals left in the country with an open ICU, which will make your life miserable as an intern.


Oddly enough, I like the open ICU. I went to medical school at a closed-ICU, so this was a big switch for me. The SF VA and the SF General are closed, but the main academic hospital (Moffitt) is open. I'm there now. I'm carrying 5 floor patients at the moment, along with 2 in the unit, and it works fine. However, I have heard that the day of the open ICU at UCSF may be ending soon.

I've interviewed at both UCSF and Stanford and felt that they were about equal in terms of the quality of the attendings and their dedication to teaching, but I felt that UCSF was superior when it came to the personality of the residents, clinical training, and hospitals. A quaternary center is a quaternary center so I won't split hairs between Moffit and Stanford. SFGH blows the doors of Santa Clara. If you have any interest in caring for the underserved, UCSF shines in comparison. While the Palo Alto VA is very pretty, I think the quality of the medicine department and medicine subspecialty departments are stronger at UCSF.

Stanford wins with $ and if you like the cozy country club feel. Yeah, their residents work hard, but residents work hard everywhere. UCSF is only open ICU for Moffit, not at the VA or the county. It really isn't that bad. I really don't think UCSF is malignant. The ancillary services are fantastic at Moffit, plus/minus at SFGH, and well...the VA is a VA. The residents get treated with a ton of respect at UCSF, the interns have protected time (hand over pagers to the residents) for didactics, and there is a great emphasis on teamwork that holds true as much for interns and residents as it does for most of the hospitalists that attend. If UCSF was malignant most students graduating from UCSF wouldn't be trying to stay. The majority of my classmates desperately want to stay. It is not b/c of reputation, for those that don't stay end up in beantown, Stanford, UCLA, Udub, etc. They want to stay b/c of the environment, the hospitals, and the personality of the residency department.

I've interviewed at both UCSF and Stanford and felt that they were about equal in terms of the quality of the attendings and their dedication to teaching, but I felt that UCSF was superior when it came to the personality of the residents, clinical training, and hospitals. A quaternary center is a quaternary center so I won't split hairs between Moffit and Stanford. SFGH blows the doors of Santa Clara. If you have any interest in caring for the underserved, UCSF shines in comparison. While the Palo Alto VA is very pretty, I think the quality of the medicine department and medicine subspecialty departments are stronger at UCSF.

Stanford wins with $ and if you like the cozy country club feel. Yeah, their residents work hard, but residents work hard everywhere. UCSF is only open ICU for Moffit, not at the VA or the county. It really isn't that bad. I really don't think UCSF is malignant. The ancillary services are fantastic at Moffit, plus/minus at SFGH, and well...the VA is a VA. The residents get treated with a ton of respect at UCSF, the interns have protected time (hand over pagers to the residents) for didactics, and there is a great emphasis on teamwork that holds true as much for interns and residents as it does for most of the hospitalists that attend. If UCSF was malignant most students graduating from UCSF wouldn't be trying to stay. The majority of my classmates desperately want to stay. It is not b/c of reputation, for those that don't stay end up in beantown, Stanford, UCLA, Udub, etc. They want to stay b/c of the environment, the hospitals, and the personality of the residency department.

I concur! UCSF is not malignant at all, the residents seemed to be among the warmest, friendliest, and most satisfied I have met. They all seem very happy and all say things like "internship can be really fun" which is not something I have seen at other programs. I felt UCSF to be the most passionate place I have been to, both in housestaff and faculty. And considering I did a clerkship there, I think my opinion comes from more depth than just the interview day. Besides, UCSF offers the most diverse patient population anywhere in the country. Stanford is great, but it was echoed from the housestaff that UCSF is "malignant" and Stanford residents are happier...I don't believe it, I think they both are great programs and have different philosophies about teaching...you just need to pick which works best for you. I think UCSF has the substance to back their reputation as a top 5 medicine program and the residents come out very strong.

As for UCLA...see my "UCLA anyone thread" and please reply to it. I think UCLA is on par with Stanford as far as reputation...I know US NEWS is worthless, but they do tally reputation scores from faculty...and UCLA killed Stanford in this ranking system (5th verses 16th best hospital). As for training, UCLA is probably the most difficult out of the 3 schools, only because the patient population is the sickest of the 3. They are very quatenary care based, not so much bread and butter, though they do rotate at VA/County facilities too, but not as much time as at UCSF. The fellowship placement is about the same as it is for both Stanford and UCSF...so lets not split hairs. I think of three programs, the UCLA residents seemed to be the most confident with their ability to do anything. Unfortunately, anything often involves transplant patients.

Stanford seemed to have the most "family" feel of the three programs. It's very evident that the program director is heavily involved and passionate. The housestaff are very very well taken care of, and the learning activities are excellent. The camaraderie and support among housestaff and faculty is clearly this program's stength. If you like tough love, this is not the place, but if you want lots of support and guidance, you will fit in here.

[QUOTE=ucla2usc]
I think of three programs, the UCLA residents seemed to be the most confident with their ability to do anything. Unfortunately, anything often involves transplant patients.

[QUOTE]

I have to disagree with this statement. When I interviewed for fellowship at UCLA, a fellow there told me one of the downsides of the fellowship was that the residents were simply not up to par with Stanford residents in terms of clinical acumen. They seemed to need a lot more handholding and reassurance than programs from NorCal, according to this fellow, making the fellow's life harder.

P Diddy

I've interviewed at both UCSF and Stanford and felt that they were about equal in terms of the quality of the attendings and their dedication to teaching, but I felt that UCSF was superior when it came to the personality of the residents, clinical training, and hospitals. A quaternary center is a quaternary center so I won't split hairs between Moffit and Stanford. SFGH blows the doors of Santa Clara. If you have any interest in caring for the underserved, UCSF shines in comparison. While the Palo Alto VA is very pretty, I think the quality of the medicine department and medicine subspecialty departments are stronger at UCSF.

Stanford wins with $ and if you like the cozy country club feel. Yeah, their residents work hard, but residents work hard everywhere. UCSF is only open ICU for Moffit, not at the VA or the county. It really isn't that bad. I really don't think UCSF is malignant. The ancillary services are fantastic at Moffit, plus/minus at SFGH, and well...the VA is a VA. The residents get treated with a ton of respect at UCSF, the interns have protected time (hand over pagers to the residents) for didactics, and there is a great emphasis on teamwork that holds true as much for interns and residents as it does for most of the hospitalists that attend. If UCSF was malignant most students graduating from UCSF wouldn't be trying to stay. The majority of my classmates desperately want to stay. It is not b/c of reputation, for those that don't stay end up in beantown, Stanford, UCLA, Udub, etc. They want to stay b/c of the environment, the hospitals, and the personality of the residency department.

I'll provide the counterpoint to souljah's impressions, which are necessarily biased due to his education at UCSF, as are mine from having spent time at Stanford.

Santa Clara has ample opportunity to care for the underserved. a large portion of the population is homeless or lacking insurance, and most of my time as an intern was spent dwelling on social issues. SCV's not an inner city population, but how exactly does SFGH 'blow the doors' off of SCV? underserved care is underserved care, and I don't think anyone benefits from stating 'my patient population is poorer and less well cared for than yours', least of all the person making that statment. interns at Stanford spend 1-2 months at SCV and usuall a month as residents, so it is possible that UCSF residents spend more time in the county system than their Stanford counterparts.

it's too bad you (Souljah) got the impression that Stanford is like a country club, but you may not have met a representative cohort of Stanford residents. also, being at UCSF you've met a broader spectrum of UCSF residents which increases the opportunity you'll find some you like. At Stanford we worked hard and weren't pampered. we had fun on wards, but I don't think that makes us a country club. we like to rock climb, bike, hike, rave and even golf. some of us wear preppy clothes, and some of us never wear ties in the hospital. ever. please expand on your country club comments which I feel are a disservice to students considering stanford.

there is such a thing as malignant, however, and UCSF has a reputation for being malignant. when I was an intern, I had a friend at UCSF who was also an intern and was always complaining about being sleep deprived and never having time to read. she stated that many of her classmates felt the same. this may have changed somewhat after the institution of 80/30, but attitudes are hard to change. I think it's the attitude that you should 'suck it up' and 'be a team player' that leads to medical errors, as we all know, but it also leads to a disparaging attitude toward those who don't share a 'malignant' mindset, such as those at Stanford. I think that's why Stanford gets labeled a country club, because other 'malignant' programs look down on it, unfairly, for not sharing the same unfortunate mindset. also that's one reason UCSF students/residents stay at UCSF, because they're already ingrained in that mindset and instructed by their superiors that other programs not sharing the same 'malignant eye' are not worthy of their consideration. one resident at Stanford who was a UCSF student was actually asked why they chose Stanford since UCSF would have taken this person for IM, implying in addition that Stanford was noit worthy bc it was too 'cush'.

I'll write more later, running out of time on this computer.

P Diddy

[QUOTE=ucla2usc]
I think of three programs, the UCLA residents seemed to be the most confident with their ability to do anything. Unfortunately, anything often involves transplant patients.

[QUOTE]

I have to disagree with this statement. When I interviewed for fellowship at UCLA, a fellow there told me one of the downsides of the fellowship was that the residents were simply not up to par with Stanford residents in terms of clinical acumen. They seemed to need a lot more handholding and reassurance than programs from NorCal, according to this fellow, making the fellow's life harder.

P Diddy

anectodotal evidence vs interview feeling...yeah this would make a great court case. Who the hell knows which residents are stronger, more confident, etc.? I just got a feeling after talking to a bunch of UCLA residents that they were very confident, many said something along the lines that taking care of the sickest patients around (pre-transplant) makes you feel like you can take care of anything. I also rounded with them and thought they were very polished during rounds. I am sure Stanford/UCSF residents are equal or better, not here to argue...just didn't have the same "feeling" at those places. Hope nobody's "feelings" are hurt.

Confidence does not equal competence. (sorry, I just couldn't resist saying that....) :D

Really, I don't know much about UCLA, other than what I learned at my interview day and by general hearsay. I don't think I've met any UCLA residency graduates recently....

I'll echo pdiddy's comments that Stanford is definitely not a country club. The residents work very hard and get excellent and diverse clinical training. I've worked closely with Stanford residents, as well as with residents at MGH and the Brigham, and I have to say that the clinical knowledge and skills of Stanford residents are on par with, if not better, than the residents at MGH and BWH. In fact, Stanford residents get more transplant experience than at the other two programs, especially in liver and lung, plus they train at a busy county hospital (which the residents don't even have the option of doing at MGH or BWH). In addition, they do more procedures and therefore become more proficient at them than the BWH or MGH residents. BTW, I'm not trying to knock BWH or MGH -- both programs are outstanding.

I also want to emphasize that underserved is underserved is underserved. The underserved in San Jose (or LA or Boston or wherever) need medical care just as much as the underserved in SF. If you would like to care for the underserved during residency, IMO it is sufficient to go to any residency program that spends time in a county hospital. If you want, these programs will also let you have your clinic through a county system (Stanford has this, and I'm sure that UCSF does, too). If you make sure whatever program you go to knows that you are dedicated to this, they will make sure that you get that experience....

Oddly enough, I like the open ICU. I went to medical school at a closed-ICU, so this was a big switch for me. The SF VA and the SF General are closed, but the main academic hospital (Moffitt) is open. I'm there now. I'm carrying 5 floor patients at the moment, along with 2 in the unit, and it works fine. However, I have heard that the day of the open ICU at UCSF may be ending soon.

Interesting.... I didn't know anyone who liked the open ICU, but that might have been because everyone I knew going through it was there during the pre-80-hour workweek days. But I think it would be great if the Moffitt ICU transitioned to a closed unit -- IMO it's better medical care, and lends itself to better ICU training.

I've always had a major beef with the open ICU system. This became more of an issue for me when I was applying for pulm/cc fellowships -- it seemed that the pulmonary fellows rotating through the UCSF ICU had been relegated to just giving advice on ventilator management. Because of this I definitely got the feeling that the critical care training (for the fellows) was not as good as at other programs.... but who knows -- maybe it'll improve once it's changed?

I also want to emphasize that underserved is underserved is underserved. The underserved in San Jose (or LA or Boston or wherever) need medical care just as much as the underserved in SF. If you would like to care for the underserved during residency, IMO it is sufficient to go to any residency program that spends time in a county hospital. If you want, these programs will also let you have your clinic through a county system (Stanford has this, and I'm sure that UCSF does, too). If you make sure whatever program you go to knows that you are dedicated to this, they will make sure that you get that experience....

As a person who has done all of medical school at a large academic county facility and then did a rotation at SF General...I would say that the only things in common with underserved places is the late stage of disease presentation, lots of social dilemmas, and poor ancillary services. However, I found my UCSF experience to be vastly different than USC. For one, the faculty at SF General are all full time academic professors at UCSF, some who are quite famous (like ex-Editor in Chief of Circulation). They all seem to love to be at SF General and they teach a lot and seem passionate about taking care of the underserved. The supervision at SF General far exceeds USC, and the culture is...LESS MALIGNANT!!! Not that USC is malignant, but I found the faculty at SF General to be easier to approach and the system less hierachial than at USC. Of course USC has its gems, but I am talking in gerneralities here. The other "special" thing about SF General is that it is probably the biggest reason why UCSF is #1 in Infectious disease and #1 in HIV. 20% of their patients have HIV!!! At least this is what I was told while I was there.

I also have heard that UCLA's county facilities (Olive View and Harbor) are vastly different...i.e. Olive view is more cush and lower volume while Harbor has stronger academics and some very accomplished faculty. The residents seem to like both but for different reasons. So my point is, underserved places differ just like tertiary hospitals differ just like residency programs differ.

As for SF general vs SCV (Stanford's county). I don't know much about SCV but I heard it was a great place to train from some Stanford residents. I do know that UCSF residents spend about 1/3 of their inpatient training at SF General and Stanford spends about 1/12 of their in patient training at SCV, so that's 4x's as much "underserved" for UCSF. This may be a plus for Stanford if you don't like County training and all its social/ancillary problems or a plus for UCSF if you enjoy underserved medicine and infectious disease gallour.

As an applicant interested in Stanford among the other places mentioned here, I am curious, does SCV have Stanford professors attending? If not, what are the attendings/culture like at SCV? What's the scut load like at SCV? What about the work load in general at SCV? Can you go to SCV more than the required time (1 month/yr) if you like it there? Do residents value their time their as much as at the other hospitals at Stanford?

I'm a resident at SCV and I can answers some of these questions. It definitely is a great place to train - and our patients are typical county, i.e. underserved. However because the Santa Clara is a rich county and this is a rich county hospital, the ancillary services are amazing. You will not have to do blood draws, transport patients, make case management calls etc here. In other words, while our patients are poor, our hospital is not.
The attendings here are wonderful. They are the reason I came here and I have not once been disappointed. It's terrific teaching and a close-knit casual atmosphere. The Valley attendings have Stanford appointments, but they are fulltime Valley faculty. Many of them did part of their training at SCV and returned as faculty because they liked it so much. I hope to return here after fellowship.

I have known Stanford residents who specifically requested to be at santa clara more than one month of the year, but it is difficult to arrange because many stanford residents enjoy coming down to the valley and there are limited spots.
Let me know if you have other questions.

I'm a resident at SCV and I can answers some of these questions. It definitely is a great place to train - and our patients are typical county, i.e. underserved. However because the Santa Clara is a rich county and this is a rich county hospital, the ancillary services are amazing. You will not have to do blood draws, transport patients, make case management calls etc here. In other words, while our patients are poor, our hospital is not.
The attendings here are wonderful. They are the reason I came here and I have not once been disappointed. It's terrific teaching and a close-knit casual atmosphere. The Valley attendings have Stanford appointments, but they are fulltime Valley faculty. Many of them did part of their training at SCV and returned as faculty because they liked it so much. I hope to return here after fellowship.

I have known Stanford residents who specifically requested to be at santa clara more than one month of the year, but it is difficult to arrange because many stanford residents enjoy coming down to the valley and there are limited spots.
Let me know if you have other questions.


Great to know...that makes SCV sound like an amazing place. Can't belief you can combine underserved patients with great ancillary services. That kind of doesn't make them as "underserved" anymore! Sounds awesome.

To respond and elaborate about my comments about sfgh and scv. I do think SFGH cannot be compared. The residents here spend a large amount of their time at SFGH, whereas the residents at Stanford spend some time at SCV - but not nearly as much time is devoted to training and caring for the underserved at Stanford. There is arguably no better place to learn ID than at SFGH (maybe Bellvue) given that 20% are HIV+, 40% HepC+, and of the 50% that aren't marginally housed or homelss, 30-40% are immigrants. In addition to that, the faculty at SFGH are UCSF attendings who have special clinical/research interests in social medicine, infectious disease, etc. so teaching rounds are incredibly well suited to the care of your patients. The ancillary services aren't all that great, that is true. It can be major pain in the ass. But I'd take a ward month with Chip Chambers as my attending and ****ty ancillary services any day. I'm not dissing SCV for I think it is great. I just think SFGH is in a class of its own.

was wondering how much of a chance ppl have at getting interviews at primary care ucsf programs. i am at at a medical school in boston , not harvard, and scored 207 step one... super into underserved.. hp and some honors .. do i even have a chance?

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