Help ranking these

[LieutenantKone]

UT Houston
Cincinatti
UMaryland
UF Gainesville
UNebraska

Any ideas? Trying to get best stroke exposure. If you were content with living in any of the above cities how would you rank them?

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[Postictal Raiden]

Cincinnati>UF Gainesville = UT Houston > Maryland > Nebraska

 

[LieutenantKone]

Ok thanks I had a feeling Cinci was gonna be at the top

 

[Thama]

Cinci has the most well-known stroke program on that list. But honestly any half-decent academic center will provide all the stroke exposure you want and then some.

 

[LieutenantKone]

I wanted to rank UT higher but can’t bother to learn Spanish. I liked Cincinatti but a resident said fellows take most of the acute stroke cases except when at their VA.

 

[Pseudotumor cerebri]

UT has volumes, variety, a large tele stroke network & the first Mobile Stroke unit in the country, and a good number of Interventional faculty from Neuro, Radiology & NSGY. Definitely get a lot of exposure as residents, and though there are Spanish speaking patients, interpreters are easily available

 

[Thama]

Or you could just learn Spanish. Most common 2nd language in the country, an easy language to learn, and you'll use it the rest of your life no matter where you are in the US in both medical and non-medical contexts.

 

[xenotype]

I wanted to rank UT higher but can’t bother to learn Spanish. I liked Cincinatti but a resident said fellows take most of the acute stroke cases except when at their VA.

Crazy that some programs minimize PGY2/resident exposure to the highest acuity/volume for acute stroke, but I've heard of a few other big programs doing this too. Would not recommend any program that does this regardless of prestige/reputation. You have to cover stroke call in many non-academic jobs, and having to do a stroke fellowship to feel comfortable taking this call really limits what else you'll be able to do like EEG/EMG/movement/botox etc.

My metric would be simpler if you can just ask the residents, especially if you care about stroke. Approximate thrombectomies each one orders per month/per call night, # tPA per month/per call night, %tPA overall for stroke alerts. My residency was about 1 thrombectomy per call day/night, 1-2 tPA per night, 20% overall tPA rate at our hospital, and like most places about half the consults were stroke, with 60-70% of those being acute questions. Some places I interviewed for residency tPA'd once a month or less- not the best training.

 

[Thama]

Crazy that some programs minimize PGY2/resident exposure to the highest acuity/volume for acute stroke, but I've heard of a few other big programs doing this too. Would not recommend any program that does this regardless of prestige/reputation. You have to cover stroke call in many non-academic jobs, and having to do a stroke fellowship to feel comfortable taking this call really limits what else you'll be able to do like EEG/EMG/movement/botox etc.

My metric would be simpler if you can just ask the residents, especially if you care about stroke. Approximate thrombectomies each one orders per month/per call night, # tPA per month/per call night, %tPA overall for stroke alerts. My residency was about 1 thrombectomy per call day/night, 1-2 tPA per night, 20% overall tPA rate at our hospital, and like most places about half the consults were stroke, with 60-70% of those being acute questions. Some places I interviewed for residency tPA'd once a month or less- not the best training.

Yeah this is weird to me. Stroke was 100% resident-run at my program. Fellows and attendings wouldn't even know tPA was being given until rounds the next morning. Don't know how programs consider themselves to be adequately educating their residents without providing some degree of autonomy in acute stroke care.

 

[mrbreakfast]

I liked Cincinatti but a resident said fellows take most of the acute stroke cases except when at their VA.

Like others, I find this pretty hard to believe. Especially with the VA system transitioning to telestroke.

Based on stroke exposure alone, I'd probably agree with Cincinnati > UF Gainesville = UT Houston > Maryland > Nebraska.

 

[NEApplicant]

Cinci has the most well-known stroke program on that list. But honestly any half-decent academic center will provide all the stroke exposure you want and then some.

Where can I learn more about well-known stroke programs?

 

[Thama]

Where can I learn more about well-known stroke programs?

By asking stroke neurologists about specific places you're interested in. There's no list I'm aware of. Cinci is well known because they had a large role in the early trials in tPA. That doesn't necessarily mean they will provide better training or do anything special now, just that they have a name recognition in that field.

 

[Chibucks15]

Can I hijack?

Iowa
Minnesota
Indiana
Wisconsin
Med College Wisconsin
UIC - Chicago

I think I have them in roughly the right order already just was curious what the consensus was on here. I'm from Chicago so I'm debating how much location matters when I have chances at programs I got better vibes from. Thanks!