MGH vs BWH in 2013 - recent grad/current resident perspective?

[serialsevens]

Hi all! I'm an MS4 in the thick of the interview season and these two places are at the top of my ROL. I've interviewed at both and would be excited and grateful to train at either institution. I'm still deciphering the differences between the two and was hoping that either recent grads or current residents at either BWH or MGH could speak about their experiences. I know there are a lost of past posts regarding this topic, but it seems that both residencies have made some major changes in the past few years in light of some constructive ACGME accreditation reviews (e.g. MGH says their balance between education and service is more equal than in the past and BWH says they have more didactics than in previous years).

I (and maybe others struggling with this issue?) would appreciate any and all insight you have to offer. I have a few preferences regarding the "specs" of a residency but thought it would be better to start out broad. As a prompt - perhaps you could talk about pros/cons of the residency, what you wish you looked for or cared about during your interview season, what's important to you as a resident, what you want to do after residency (academic/PP) and anything else you think would be relevant to know.

Thanks so much in advance!!

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[anesthapplicant]

not a resident at either, but have to say, my interview at MGH last year scared me away from ranking that place top 5 (from their perspective, they probably say 'good, he wouldn't have cut it here then' and that would be fair enough)

two interactions stand out:
asked charnin 'any kind of resident, personality or otherwise, that you have seen not do well here typically?' - he told me he would advise residents with kids not to come there - said it's a program where they work long, hard hours and those with kids have sometimes been depressed at not seeing family enough - appreciate the honesty, and i don't have a kid anyway, but looking for more work/life balance than that - even if that type of program might make you a great anesthesiologist

and asked baker in the group QandA - 'any things you guys are focusing on improving in the coming years?' in a totally neutral non-judgmental tone - and he went in to this crazy lawyer-esque defense of their accrediation cycles and how they were being arbitrarily picked on for minor issues that really didn't have significant impact on resident experience or need improving - if the program director can't answer that question in a non-insane manner i'll train elsewhere

i'm sure many MGHers will chime in, it doesn't have the name it has for nothing and many would give anything to train there, but think folks should ask some real questions there and investigate what the program leadership and training environment is really like, not just a perfect program

 

[step213]

i have to say i was blown away by both places. i found it interesting that mgh residents say that they are out at 5pm everyday- maybe a recent change to work hours?

 

[POW16]

What's the word on BIDMC ?

Sent from my SAMSUNG-SGH-I537 using Tapatalk

 

[BCM]

I trained at BWH and I would definitely choose it again. The program has taken the ACGME recommendations seriously. I think they were even awarded the maximum accreditation cycle after the site visit this year. The residency director is a good guy and has changed to culture to improve resident education and didactics. Most will tell you the best part of the program is the residents and I would definitely agree. I really enjoyed working with my classmates and would hire or work with any of them in the future. Feel free to send a PM if you have specific questions.

 

[Gasoholic]

I'm basically stuck between Stanford, BWH, and MGH. Stanford and BWH had similar feels to me, with MGH being a bit more old-school and intense. I think total hours aren't going to be so different, but the flavor of the hours you do spend will be pretty distinct. I think MGH is probably the strongest in research, Stanford having the strongest research track.

My concerns about MGH were the 'deal with it' atmosphere, the uneasy transition to CRNAs as midlevel providers, malignant cardiac surgeons, few liver transplants and trauma cases (and generally splitting the catchment basin), and the loss of Ogilvy (big neurosurgeon) to BID. Concerns about BWH is that it's still in transition from the probationary period, no CRNAs, less renowned CC, no liver transplants/little trauma (and generally splitting the catchment basin), and a reputation for slower/less graduated responsibility with clingy/over-involved young faculty. Concerns for Stanford are that Kaiser is starving them of cardiac caseload (mostly going to Kaiser SF, though they just poached a new CT surgery chair from Penn), weak regional, high case mix index but low population density catchment basin, housing is as expensive as Boston but you get much less city, and going there requires a car per adult (with the possibility of having to commute different directions to SF and Stanford daily).

Anesthapplicant, I agree about that morning Q&A. I went to a lecture by Dr. Baker and loved it; he's a great teacher. Then we sat down with Dr. Wiener-Kronish, and it's like she couldn't answer a question straight.

 

[deleted9493]

I'm basically stuck between Stanford, BWH, and MGH. Stanford and BWH had similar feels to me, with MGH being a bit more old-school and intense. I think total hours aren't going to be so different, but the flavor of the hours you do spend will be pretty distinct. I think MGH is probably the strongest in research, Stanford having the strongest research track.

My concerns about MGH were the 'deal with it' atmosphere, the uneasy transition to CRNAs as midlevel providers, malignant cardiac surgeons, few liver transplants and trauma cases (and generally splitting the catchment basin), and the loss of Ogilvy (big neurosurgeon) to BID. Concerns about BWH is that it's still in transition from the probationary period, no CRNAs, less renowned CC, no liver transplants/little trauma (and generally splitting the catchment basin), and a reputation for slower/less graduated responsibility with clingy/over-involved young faculty. Concerns for Stanford are that Kaiser is starving them of cardiac caseload (mostly going to Kaiser SF, though they just poached a new CT surgery chair from Penn), weak regional, high case mix index but low population density catchment basin, housing is as expensive as Boston but you get much less city, and going there requires a car per adult (with the possibility of having to commute different directions to SF and Stanford daily).

Anesthapplicant, I agree about that morning Q&A. I went to a lecture by Dr. Baker and loved it; he's a great teacher. Then we sat down with Dr. Wiener-Kronish, and it's like she couldn't answer a question straight.

Dude, you're over-thinking this. Yeah there are differences between these programs but will the differences affect your training in a meaningful way? Probably not. Where will you be happiest living?

 

[thinkorswim]

You're honestly splitting hairs when deciding between MGH and BWH. Nothing that anyone says on this message board is going to convince you one way or another, and it shouldn't. The decision is ultimately yours to make.

You'll receive phenomenal training at either program and will be in a position to land any fellowship or job you desire upon graduation. Don't over think it. Go with your gut feeling.

 

[Sonny Crocket]

There is no right decision. Only a decision. Good luck.

 

[Gasoholic]

Dude, you're over-thinking this. Yeah there are differences between these programs but will the differences affect your training in a meaningful way? Probably not. Where will you be happiest living?

Yeah, you're right. The training will be excellent at any of these, it's really about flavor of the program and minor differences in emphasis/strength. The 'where do you want to live' question isn't much easier. Warmer CA vs colder Boston, but the suburbs vs the city. I have family near both. It's a tough call.

 

[saratoga733]

Yeah, you're right. The training will be excellent at any of these, it's really about flavor of the program and minor differences in emphasis/strength. The 'where do you want to live' question isn't much easier. Warmer CA vs colder Boston, but the suburbs vs the city. I have family near both. It's a tough call.

i had a similar decision to make as well, boston vs sf. ultimately it boiled down to proximity to family. i happen to like my family and being away for all those years in college and med school i realized my parents were not getting any younger. i was single back then, both cities offered great dating scenes. i ultimately chose mgh mainly based on reputation, their strength in research, and track record in producing leaders in the field. i had lofty aspirations of becoming a clinician scientist but ended up in PP. the offer i was given after residency/fellowship was too good to pass up. work hard in residency, make friends not enemies, and the connections you establish in residency (at all the places you mentioned) will certainly help in landing you a nice gig.

 

[harvardanesthesia]

Long time lurker, first time poster. I graduated from MGH 2 years ago and can address any concerns you may have about MGH. First things first, apart from Hopkins, I don't believe there will be another program out there that will bring as much prestige and opportunity as Massachusetts General Hospital. I say this because when you say Harvard, the majority of people (medical and lay), will think of MGH. In the job market, you will never have to explain what type of candidate you are, your work ethic, your intelligence, or anything else for that matter. It will be assumed that you are top notch. The alumni network is far and wide. You will secure a job in any market you want and fellowships are for the taking. Whether you are from California, Texas, New York, Colorado, Podunk, you will be fine if you come to MGH.

In terms of what the above poster said about Charnin suggesting you not have a family or that there is a tension between service and education, I'll say that more than half the residents are in families and have kids. He does have an eccentric sense of humor so maybe you missed something. Every few months, there is another resident that is delivering at MGH or has a spouse that delivers. This does not interfere with their education. You will always be out of the OR by 5pm without fail. There is a call team, several PM CRNAs, and countless junior attendings trying to make extra cash by doing "night incentives" (working nights to make extra $$). Usually several of these attendings are turned away because there are not enough cases to go around towards the end of the day. So there is definitely no shortage of people to take over your case at 5pm. In terms of didactics, also no shortage. There are advanced lectures on Mondays, basic lectures on Tuesdays, case conference and board review on Thursdays, and again more board review (with free pizza) on Fridays. You can go to as many or as few of these as you would like. And ALL of these are protected times so even if you are working nights in the ICU, you will be allowed to attend these lectures.

In terms of our other leadership, both Baker and Weiner-Kronish are awesome. Weiner-Kronish is one of the editors of Miller's Anesthesia. Our emeritus chief, Warren Zapol is one of the editors to Longnecker. And Baker was just awarded the 2014 best program director in the country by the ACGME (https://www.acgme.org/acgmeweb/Portals/0/PDFs/Awards/ACGME_Award_Recipients2014.pdf). So they all have nothing to hide. But also, they are very approachable. They knew my name within the first week I was there and knew it in the hallway 6 months later when I hadn't seem them in awhile. They will take you out to dinner, stay late to meet with you. They will support you in any endeavor that you believe will enrich your training including basic research, going abroad, clinical research, international meetings, publications/posters, anything. And the residents have a HUGE say in what happens in the department. Baker is constantly imploring the residents to give usable feedback to make changes in the residency. I will give you a good example. There was an attending who the residents did not feel like was a good teacher and he consistently received bad evaluations from residents throughout the past year. He was a perfectly capable and knowledgeable attending but he was let go this year because of resident input.

In terms of MGH vs. BWH, you can see that there has been a shift in the past few years of where Harvard Medical Students have been ranking 1st. The MGH residency may have been overworked 10 years ago, but now it is very strict on hours and very educational. The majority of HMS (who rotate both at BWH and MGH) are coming to MGH when you look at the match results. And they have the best insight into both programs. As an MGH resident, I did rotate at BWH fpr a rotation and found that they are a very nice group of people. But IMO, they were not as sharp and efficient as MGH. There is just nothing that compares to the rigor and education of MGH. It will test you to your limit, but you will survive, and you will be a better anesthesiologist for it in the end. When I worked with BWH attendings who had graduated from MGH, they voiced at how refreshing it was to work with an MGH resident again who was quick on their feet and had great attention to detail.

All in all, you can't go wrong. As someone who has seen many different programs and finished at MGH, I will say that the differences between programs like MGH, BWH, Mayo, Hopkins, UCSF are marginal. There is more alike than different between these programs and in the end, it really won't matter. But I have first hand experience with MGH (and a little with BWh) and I will say that you will at the top of your game when you graduate, you will enjoy your residency (as much as residency can be enjoyed), you will enjoy the company of your co-residents (MGH likes to pick residents that are smart but also very down-to-earth), and you will always have the name "MASSACHUSETTS GENERAL HOSPITAL" in your resume. And few things can ever beat that. Good luck to all you guys.

 

[BWHGasMan]

It has been quite some time since I posted on SDN. I was recently inspired to post my experiences since I’ve met a number of applicants interviewing at the Brigham Anesthesiology program and they all seem to have similar questions comparing Brigham to the other top tiered programs, especially MGH. Let me begin by saying that I am currently a CA3 resident at Brigham and I’ve loved every moment of training here.
I interviewed broadly for my residency and in all honesty, I was very impressed by Stanford, MGH and Vanderbilt. I tried to like Hopkins but soon realized that the personality of the program and the city was not the best fit.For me, it became apparent that clinical training was comparable at all of the top programs. Since being at the Brigham I’ve beenexposed to trainees from MGH, Beth Israel, BMC and Tufts as we shared clinical experiences at Boston Children’s Hospital and the residents universally performed at a very high level with very few exceptions. There are a few misconceptions about my program that I would like to use this opportunity to clarify.
While we are indeed very happy, well-balanced and emotionally intelligent residents, we also have exceptional academic, research and clinical credentials that rival anywhere in the country. We have the MOST competitive cardiothoracic anesthesiology fellowship of all departments. We receive more applications for each position than any other program does. At the Brigham, our interventional pain program literally places TRIPLE the number of intra-thecal pumps and spinal cord stimulators than any of the top programs in the country. As a matter of fact, as a resident I get more exposure to interventional pain procedures than MGH pain fellows do. Our OB department has been our flagship for many, many years with the highest number of “high-risk” obstetric consultations and deliveries daily. We are partnered closely with the Boston Adult Congenital Heart (BACH) program and we routinely manage pregnant women with congenital heart diseases who rarely survived the first decade of life 20 years ago and certainly would have died during the physiological changes of pregnancy. We even perform several EXIT (ex uterointrapartum treatment) procedures annually where a fetus with tracheal compression is partially delivered via c-section but remains attached to the placenta while a pediatric ENT surgeon establishes an airway for the fetus to breathe. Our OB anesthesia experience is so unique that residents from MGH, Tufts and SUNY rotate with us to gain exposure to these miracles of science. Our thoracic surgeons continue to pioneer techniques in advanced lung cancer treatment involving intraoperative heated chemotherapy that create numerous challenges for the anesthesia team. Furthermore, we perform numerous double lung transplants, heart transplants and I almost forgot…faceand bilateral limb transplants! (http://www.cnn.com/2014/11/25/health/boston-double-arm-transplant/). These are cases with resident involvement, they are not reserved for fellows and special high-ranking attendings.
As it pertains to research and pioneering medicine, Brigham Anesthesia is home to the titans in the field. OmidFarokhzad who leads the Laboratory of Nanotechnology and Biomaterials has successfully created nanoparticle-based drug delivery systems that has led to several patents and a few multimillion dollar publicly traded health technology companies. Danny Muehlschlegel is a principal investigator in the CABG Genomics study group and has won numerous national awards for his work. Angela Bader in our preoperative testing center continually examines ways to improve the perioperative experience for our patients by conducting outcomes research based on preemptive interventions. She has positioned the Brigham anesthesia department to thrive in the future as the US healthcare system explores new models of care delivery i.e. Perioperative Surgical Home. All of these clinician/scientists were trained at the Brigham and found that their unique passions were nurtured by an organization that gave them the springboard to succeed. I might add that they are also some of the most approachable and resident-friendly faculty since they have mentored countless trainees who have since went on to lead departments across the country and the world.
Finally, we pride ourselves on being extremely happy and collegial residents. We have diverse professional and recreational interests that the Brigham values and encourages us to explore. Our program leadership led by our PD Rob Lekowski fully understands that happy, well adjusted residents are more productive in the OR, more focused in the labs and more fulfilled with their family lives. We make every effort to ensure that call-schedules are created with the input of each individual resident making known their requests for weekends off. It is routine practice at the Brigham for our chiefs to ensure that whenever we schedule 5-days of vacation…we are granted the preceding and following weekends off usually leading off with a post-call day the Friday prior to the start of the vacation. In effect we get 10 days off whenever we use 5 vacation days. My classmates and I have gone to weddings together, rented lake cabins together, spent ski weekends in Vermont together and even traveled internationally together. We have several championship intramural athletic leagues comprising of faculty and residents that participate in local volleyball, soccer and softball tournaments. We have been the champions in volleyball and softball for the past 2 years. All that being said...there is nowhere else that I would rather be!

 

[Anes_CC_lady]

Current Brigham anesthesia resident, and I agree with the post above mine.

 

[imfrankie]

Long time lurker, first time poster. I graduated from MGH 2 years ago and can address any concerns you may have about MGH. First things first, apart from Hopkins, I don't believe there will be another program out there that will bring as much prestige and opportunity as Massachusetts General Hospital. I say this because when you say Harvard, the majority of people (medical and lay), will think of MGH. In the job market, you will never have to explain what type of candidate you are, your work ethic, your intelligence, or anything else for that matter. It will be assumed that you are top notch. The alumni network is far and wide. You will secure a job in any market you want and fellowships are for the taking. Whether you are from California, Texas, New York, Colorado, Podunk, you will be fine if you come to MGH.

In terms of what the above poster said about Charnin suggesting you not have a family or that there is a tension between service and education, I'll say that more than half the residents are in families and have kids. He does have an eccentric sense of humor so maybe you missed something. Every few months, there is another resident that is delivering at MGH or has a spouse that delivers. This does not interfere with their education. You will always be out of the OR by 5pm without fail. There is a call team, several PM CRNAs, and countless junior attendings trying to make extra cash by doing "night incentives" (working nights to make extra $$). Usually several of these attendings are turned away because there are not enough cases to go around towards the end of the day. So there is definitely no shortage of people to take over your case at 5pm. In terms of didactics, also no shortage. There are advanced lectures on Mondays, basic lectures on Tuesdays, case conference and board review on Thursdays, and again more board review (with free pizza) on Fridays. You can go to as many or as few of these as you would like. And ALL of these are protected times so even if you are working nights in the ICU, you will be allowed to attend these lectures.

In terms of our other leadership, both Baker and Weiner-Kronish are awesome. Weiner-Kronish is one of the editors of Miller's Anesthesia. Our emeritus chief, Warren Zapol is one of the editors to Longnecker. And Baker was just awarded the 2014 best program director in the country by the ACGME (https://www.acgme.org/acgmeweb/Portals/0/PDFs/Awards/ACGME_Award_Recipients2014.pdf). So they all have nothing to hide. But also, they are very approachable. They knew my name within the first week I was there and knew it in the hallway 6 months later when I hadn't seem them in awhile. They will take you out to dinner, stay late to meet with you. They will support you in any endeavor that you believe will enrich your training including basic research, going abroad, clinical research, international meetings, publications/posters, anything. And the residents have a HUGE say in what happens in the department. Baker is constantly imploring the residents to give usable feedback to make changes in the residency. I will give you a good example. There was an attending who the residents did not feel like was a good teacher and he consistently received bad evaluations from residents throughout the past year. He was a perfectly capable and knowledgeable attending but he was let go this year because of resident input.

In terms of MGH vs. BWH, you can see that there has been a shift in the past few years of where Harvard Medical Students have been ranking 1st. The MGH residency may have been overworked 10 years ago, but now it is very strict on hours and very educational. The majority of HMS (who rotate both at BWH and MGH) are coming to MGH when you look at the match results. And they have the best insight into both programs. As an MGH resident, I did rotate at BWH fpr a rotation and found that they are a very nice group of people. But IMO, they were not as sharp and efficient as MGH. There is just nothing that compares to the rigor and education of MGH. It will test you to your limit, but you will survive, and you will be a better anesthesiologist for it in the end. When I worked with BWH attendings who had graduated from MGH, they voiced at how refreshing it was to work with an MGH resident again who was quick on their feet and had great attention to detail.

All in all, you can't go wrong. As someone who has seen many different programs and finished at MGH, I will say that the differences between programs like MGH, BWH, Mayo, Hopkins, UCSF are marginal. There is more alike than different between these programs and in the end, it really won't matter. But I have first hand experience with MGH (and a little with BWh) and I will say that you will at the top of your game when you graduate, you will enjoy your residency (as much as residency can be enjoyed), you will enjoy the company of your co-residents (MGH likes to pick residents that are smart but also very down-to-earth), and you will always have the name "MASSACHUSETTS GENERAL HOSPITAL" in your resume. And few things can ever beat that. Good luck to all you guys.

 

[imfrankie]

"First things first, apart from Hopkins, I don't believe there will be another program out there that will bring as much prestige and opportunity as Massachusetts General Hospital. I say this because when you say Harvard, the majority of people (medical and lay), will think of MGH. In the job market, you will never have to explain what type of candidate you are, your work ethic, your intelligence, or anything else for that matter. It will be assumed that you are top notch."

And for me, this type attitude is a reason I would choose not to train in "Boston."

"Weiner-Kronish is one of the editors of Miller's Anesthesia"

And I just can't resist the obvious that Jeanine and Ron are from UCSF.

 

[ether23077]

What's the word on BIDMC ?

Sent from my SAMSUNG-SGH-I537 using Tapatalk

I am a recent graduate of the BI anesthesia program. From my experience, I would tell you not to rank this program highly. When working in the OR you will have to get there early to set up your own room, the techs there are useless and do not set up anything. On most days you will be lucky if you have the basics available in the room, the blue bells at times run empty and you have to go looking for equipment like LMAs. Not only are the techs lazy they also stop working early in the evening, leaving you to turn over the room and set it up. The people who run the department only care about maximizing the volume of cases done in a day, so the residents are used as work horses to complete cases that are booked until late hours of the evening, a lot of the time I stayed past 6pm. Turn over times are horrendous there so no matter how efficiently you work you still get stuck late. Many times the call team is usually stuck doing non-emergent cases in the middle of the night. When I trained there, the department used to have us record our work hours, but the secretary in the department kept track, and sent an email if you admit to violating hours then asking you to change the numbers. The culture is for the residents to be scutmonkeys and subordinates to surgeons, nurses, and other ancillary staff. Many attending cannot be trusted, if there is a bad outcome usually the resident is thrown under the bus and expected to present at the weekly morbidity and mortality conference. The program had to scramble for spots last year, and apparently has accepted a DO as well as a few foreign graduates over the last few years. As a first and second year you will be doing a lot of work and it will be hard to have a balanced life outside of work. The last year gets much easier. The lectures (other than those at Boston Children's) are not that great. The attending put very little effort into making them educational. They spend a lot of time lecturing us about the importance of thoroughly learning anesthesia but spend way more time using lecture time to go over practice exam questions instead of teaching us the material. They program also picks their favorites, the over-achieving, suck-up personalities that the program director and administrators really want to become chief, and give these specific residents the best cases, research projects, and rotation schedules. If you are not part of the "it" team they will treat you like a crna, you have no chance of any leadership roles or responsibilities. Use this information to make an informed decision, if I can go back in time I would have gone to BWH or MGH. The only part of my residency that I enjoyed at BI was Boston.