Columbia vs. Mount Sinai

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nycRads17

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After a lot of thinking, I am having a difficult time deciding on Columbia vs Mount Sinai. Here is a summary of what I'm thinking for each program. If anyone has additional input please message me or post. I would really appreciate it! Gluck to everyone else finalizing their list.

Columbia:
+ Research seems stronger. Affiliated with a very strong university.
+ New chair who has recruited some strong faculty.
- Location not ideal for NYC.
- Some people have told me that the lectures/teaching/environment was not ideal.
- R1/PGY2 has a more demanding call (perhaps this could also be a pro?).

Sinai:
+ The lecture I saw during interview day was strong.
+ IR is a very strong fellowship (however only 2/4 positions for internal residents).
- Less research emphasis.
- Recently lost the chief of IR (not sure if this is very significant).
- Currently use NightHawk for CT reads (but I heard this would change soon).

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I specifically don't know about these programs but:

- If you don't want to do academics don't even think about research. It means nothing. Less research emphasis is not necessary bad thing, esp if the energy and time is spent for more clinical education. Once you are in pp, nobody cares whether you have had 10 publications or nothing. But for Academics, it matters big time.

- New chair or loss of the chief of IR can be good or bad depending on the situation.

- If you don't want to do IR, strong IR fellowship does not matter.

- Choosing between in house night attending or no attending, I choose no attending any time of the day. Not reading CTs during night is very bad for your education. Since one is not MGH and the other is not a low tier program in the middle of nowhere, I choose the one that has more resident autonomy during night.
 
Shark, thanks for your input and continuous contribution to SDN. If any residents/fellows familiar with these programs could add their perspective or message me that would be appreciated!
 
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I can't speak for Columbia but, as a current resident, I can say the residency program at Mount Sinai is very, very strong and continues to grow every year. The fine print: I'm biased but I believe I have good reason to be.

A few points:

-As previously mentioned, IR is very strong. While ~2 of 4 stay for fellowship, typically others choose to go elsewhere to get a more diversified experience. Residents who are interested in IR do many of the procedures that fellows perform, including radial artery chemoembolizations, UFE's, percutaneous nephrostomies, ablations, etc., in addition to usual set of lines, ports, and drainages. The attendings have strong connections to IR programs across the country. Out of the 5 people who applied to IR from Sinai last year, 2 are staying at Sinai and the others are going to Stanford, USC and UCLA - all top notch programs. The current head of IR who took over when the last one left is very, very well-known in IR (as are all of the attendings at Sinai) and the program continues to get even stronger.

-IR is not the only strong division at Sinai. Neuro is very well known at Sinai and body is quickly becoming one of the strongest programs in the country. The latter is partially due to the body MRI program. Sinai now does almost as many body MRI's as CT's, which is probably how many places will look in about 10 years. There are 9 clinical (not research) MRI's (there are several more research magnets) and the caseload includes liver (Sinai is a very busy transplant center), prostate (the new head of GU has the busiest prostate CA practice in NY), MR enterography (Sinai has one of the busiest IBD centers in the country - Crohn himself was at Sinai), and more. Residents interested in MSK have gotten top-notch fellowships (e.g., HSS, Beth Israel in Boston, UCSD, etc.) and section, while small, is very, very good.

-Historically, Sinai had less research emphasis but some divisions are research powerhouses now. There are Sinai residents now at every major IR conference with presentations/posters and Sinai residents have published original research in JVIR, CVIR, AJR, JACR, etc. The head of body MRI is one of the most well-known researchers in the field and several residents and fellows have worked with him and his Ph.D.-filled lab on projects. Residents have also published with body attendings on projects in ultrasound and CT. In neuro, residents have attended and published in AJNR and written textbook chapters. Also, I've heard our MSK attendings are kickstarting a research program. All of the national buzz on CNN, NBC, Fox News about low-dose chest CT screening? All out of Sinai. Nearly half the residency attends RSNA every year with projects. Several senior residents are PI's running project teams filled with residents, med students, etc.

-Nighthawk did take away from CT volume for awhile but 2 major overhauls have changed/will likely change that (1 has been implemented, the other will likely be implemented shortly). The first is the creation of a 3-11 pm shift for senior residents - I'd guess that about 60-75% of the CT volume is during these hours and residents have no shortage of CT's to read with this shift. While a body attending is present, peds, MSK and vascular CT's are read by the resident with no attending read until the morning. You will be forced to make a call and feel very comfortable taking responsibility for a radiology department. The second change is with regard to Nighthawk - there are rumors that the new ER radiology section will be taking over all night work and this will likely lead to a very positive resident experience. By the way, Sinai is one of the few places with no ultrasound tech on overnight despite a busy service and Sinai residents feel very comfortable performing ultrasounds (all 1st trimester ultrasounds, for instance, are handled by radiology).

Both are likely strong programs and you likely won't go wrong either way. I've been very happy with my program (as have my co-residents it seems).
 
Thank you. I really appreciate your post MSResident.
 
I can't speak for Columbia but, as a current resident, I can say the residency program at Mount Sinai is very, very strong and continues to grow every year. The fine print: I'm biased but I believe I have good reason to be.

A few points:

-As previously mentioned, IR is very strong. While ~2 of 4 stay for fellowship, typically others choose to go elsewhere to get a more diversified experience. Residents who are interested in IR do many of the procedures that fellows perform, including radial artery chemoembolizations, UFE's, percutaneous nephrostomies, ablations, etc., in addition to usual set of lines, ports, and drainages. The attendings have strong connections to IR programs across the country. Out of the 5 people who applied to IR from Sinai last year, 2 are staying at Sinai and the others are going to Stanford, USC and UCLA - all top notch programs. The current head of IR who took over when the last one left is very, very well-known in IR (as are all of the attendings at Sinai) and the program continues to get even stronger.

-IR is not the only strong division at Sinai. Neuro is very well known at Sinai and body is quickly becoming one of the strongest programs in the country. The latter is partially due to the body MRI program. Sinai now does almost as many body MRI's as CT's, which is probably how many places will look in about 10 years. There are 9 clinical (not research) MRI's (there are several more research magnets) and the caseload includes liver (Sinai is a very busy transplant center), prostate (the new head of GU has the busiest prostate CA practice in NY), MR enterography (Sinai has one of the busiest IBD centers in the country - Crohn himself was at Sinai), and more. Residents interested in MSK have gotten top-notch fellowships (e.g., HSS, Beth Israel in Boston, UCSD, etc.) and section, while small, is very, very good.

-Historically, Sinai had less research emphasis but some divisions are research powerhouses now. There are Sinai residents now at every major IR conference with presentations/posters and Sinai residents have published original research in JVIR, CVIR, AJR, JACR, etc. The head of body MRI is one of the most well-known researchers in the field and several residents and fellows have worked with him and his Ph.D.-filled lab on projects. Residents have also published with body attendings on projects in ultrasound and CT. In neuro, residents have attended and published in AJNR and written textbook chapters. Also, I've heard our MSK attendings are kickstarting a research program. All of the national buzz on CNN, NBC, Fox News about low-dose chest CT screening? All out of Sinai. Nearly half the residency attends RSNA every year with projects. Several senior residents are PI's running project teams filled with residents, med students, etc.

-Nighthawk did take away from CT volume for awhile but 2 major overhauls have changed/will likely change that (1 has been implemented, the other will likely be implemented shortly). The first is the creation of a 3-11 pm shift for senior residents - I'd guess that about 60-75% of the CT volume is during these hours and residents have no shortage of CT's to read with this shift. While a body attending is present, peds, MSK and vascular CT's are read by the resident with no attending read until the morning. You will be forced to make a call and feel very comfortable taking responsibility for a radiology department. The second change is with regard to Nighthawk - there are rumors that the new ER radiology section will be taking over all night work and this will likely lead to a very positive resident experience. By the way, Sinai is one of the few places with no ultrasound tech on overnight despite a busy service and Sinai residents feel very comfortable performing ultrasounds (all 1st trimester ultrasounds, for instance, are handled by radiology).

Both are likely strong programs and you likely won't go wrong either way. I've been very happy with my program (as have my co-residents it seems).

You mentioned research many times. If someone wants to go to pp, it means nothing.

To me the big red flag is the call system. Having attending coverage is not a good idea. A very top notch body MR service (which may or may not be read mostly by fellows), Low does CT, top notch body research or being on CNN or Fox news can not replace the confidence and experience needed to handle body CT cases on your own and it only comes with being on call on your own. CT body is the backbone of radiology and to me this is a red flag to read it with an attending or not read it at all when you are on call.

Sorry, I don't have any beef with your program or you. But you are apple polishing your program. It may be an excellent program, but call it one of the strongest in the country is definitely an overstatement. I understand your passion about your program, but if you ask people about top Neuro, MSK, Body, mammo or IR programs in the COUNTRY it does not come into mind. Probably in New York it is a considered a top notch program.
 
You mentioned research many times. If someone wants to go to pp, it means nothing.

To me the big red flag is the call system. Having attending coverage is not a good idea. A very top notch body MR service (which may or may not be read mostly by fellows), Low does CT, top notch body research or being on CNN or Fox news can not replace the confidence and experience needed to handle body CT cases on your own and it only comes with being on call on your own. CT body is the backbone of radiology and to me this is a red flag to read it with an attending or not read it at all when you are on call.

Sorry, I don't have any beef with your program or you. But you are apple polishing your program. It may be an excellent program, but call it one of the strongest in the country is definitely an overstatement. I understand your passion about your program, but if you ask people about top Neuro, MSK, Body, mammo or IR programs in the COUNTRY it does not come into mind. Probably in New York it is a considered a top notch program.

I'm sure you're aware, but every ED in the country is pushing for 24 hour attending coverage. This was a big topic this year during interview season, and no fewer than three programs I interviewed at currently have attending coverage at night. I wouldn't be surprised if this number continues to grow.
 
top Neuro, MSK, Body, mammo or IR programs in the COUNTRY it does not come into mind. Probably in New York it is a considered a top notch program.

Does Columbia have any very regionally strong fellowships?
 
I would tend to agree that Mt. Sinai in New York has a top notch IR section and the IR fellowship is one that is highly sought after through out the country. Some consider them the strongest IR department in New York City. They have aggressive leadership and have a high volume of complex peripheral vascular and oncology interventions. Their IR attendings run or speak at the national VIR meetings and it would be a great place to have the new IR residency, as they have the volume of cases, clinical mindset etc that would be necessary to succeed as a clinical interventionalist.
 
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