Top/Mid/Low Tier Programs

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Haole

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For those of us applying to anesthesia this year who are interested in applying to some "reach", some middle of the road, and perhaps a couple of "safety" programs...but have no idea which category each program would fall into...would those of you with more knowledge please add programs as you know them to their corresponding category?


Top Tier:


Middle Tier:


Lower Tier:
 
Haole said:
For those of us applying to anesthesia this year who are interested in applying to some "reach", some middle of the road, and perhaps a couple of "safety" programs...but have no idea which category each program would fall into...would those of you with more knowledge please add programs as you know them to their corresponding category?


Top Tier:


Middle Tier:


Lower Tier:
Click to expand...


I would recommend trying to narrow it down first by region - where do you want/need to live? With few exceptions, you can find programs of all tiers pretty much all over the country.

If you start with location, you can begin to narrow your search from there.

Otherwise...this topic has been covered in the FAQs, albeit they are a couple of years old.
 
Arch Guillotti said:
The FAQ dude read the FAQ!
Click to expand...

I did, I promise. Is there something there I'm missing? All I saw was a debate on top tiered programs that was from 2002. I think an updated list including top, middle and low tiered programs would be a good resource. If I'm missing this info in the FAQ's, please let me know.
 
This is what I was given by the PD at my school, but it is definitely just a random list. Reputations are based on what people know of other programs. MGH, UCSF, Hopkins will always be considered the top 3. They probably have the best academic programs with tons of research and best faculty. Whether or not they truly put out the best anesthesiologists is questionable.


Top Tier:
Mass General (MGH)
UCSF
Hopkins
Brigham & Women's
U.Penn
Duke
UAB
Emory
Wash U.
UFlorida
Columbia
Michigan

Middle Tier:
Cornell
NYU
BIDMC
UCLA
UCSD
Baylor
Vanderbilt
UVA
UNC-Chapel Hill
Northwestern
UChicago


Lower Tier:
most others.
 
Haole said:
I did, I promise. Is there something there I'm missing? All I saw was a debate on top tiered programs that was from 2002. I think an updated list including top, middle and low tiered programs would be a good resource. If I'm missing this info in the FAQ's, please let me know.
Click to expand...

Honestly, I thought the list was pretty good and I wouldn't change much about it. There's no objective data that any of us can use to help us update the list -- that is all opinion (but fairly good opinion and a very helpful list).

The above list by MS4 is pretty good too.
 
i will respectively disagree with your list on two accounts: UFla being top tier, and my program, CCF, being absent.
 
This thread is pretty old but has lots of good info:

http://forums.studentdoctor.net/showthread.php?t=48717

Here's a cutout from it:

1) Best of the best: JHU, MGH, UCSF

2) Considered to be Elite programs: Alabama, Brigham, Columbia, Duke, Mayo, Michigan, Penn, Stanford, Wake Forest, U. Washington

3) Other excellent academic programs: Beth Israel, Cornell, Dartmouth, MC Wisconsin, Mt. Sinai, Northwestern, Penn State, UC Irvine, UCLA, UCSD, U. Chicago, U. Colorado, U. Florida, U. Iowa, UNC Chapel Hill, U. Pittsburgh, U. Rochester, U. Texas Galveston, Utah, UVA, Vanderbilt, Wash U, Yale



I doubt things have changed much since then. Just find an area of the country that you like and apply to a bunch of programs. Don't go somewhere that doesn't fill on a regular basis or somewhere that lets everybody flunk the boards or that works you like a sweatshop. Most places will teach you what you need to do well.

I wouldn't expect a whole lot more info. out there for you because as a brand new member you are asking an age old question. Plenty of info. is out there using the search function.

Some people go for the brand name, but I say go to a decent place where you like living.
 
I saw a post on the FAQ where someone wrote:


"I went through the interviews last year and I would say that you need to add 15 points to each catagory to make it accurate.

>230 top accademic programs
215-229 - Most mid and upper tier programs
200-214 -Lower tiered
<200 - g/l I hope you have something good on your resume"

Is this a pretty accurate assessment of competitive board scores for the different tiers?
 
Haole said:
I saw a post on the FAQ where someone wrote:


"I went through the interviews last year and I would say that you need to add 15 points to each catagory to make it accurate.

>230 top accademic programs
215-229 - Most mid and upper tier programs
200-214 -Lower tiered
<200 - g/l I hope you have something good on your resume"

Is this a pretty accurate assessment of competitive board scores for the different tiers?
Click to expand...

I guess, I don't really know. They are just guidelines after all. I may be the exception to the rule but I scored an even 200 on Step I and interviewed at JHU and Penn, two traditional powerhouses. I matched at a place w/ a "cutoff" well above my score. Somehow I got lucky and managed to actually "rock STEP II" (for me at least).
 
This type of thread comes up EVERY year when people start looking at where to send their applications.

The short answer is the best program is the one that is best for you. That's geographically and, probably most importantly, in an area where you're likely to intend to practice. The reason for the latter is mostly for licensure and connections. Otherwise, if you're board-eligible and ready at the end, you're golden. Any other way you slice it, you're an indentured servant the 3/4 years you do your residency. And, it pretty much really starts to suck by the end of it. Be in a geographic area where you are going to be most happy during that suckitude.

-copro
 
coprolalia said:
This type of thread comes up EVERY year when people start looking at where to send their applications.

The short answer is the best program is the one that is best for you. That's geographically and, probably most importantly, in an area where you're likely to intend to practice. The reason for the latter is mostly for licensure and connections. Otherwise, if you're board-eligible and ready at the end, you're golden. Any other way you slice it, you're an indentured servant the 3/4 years you do your residency. And, it pretty much really starts to suck by the end of it. Be in a geographic area where you are going to be most happy during that suckitude.

-copro
Click to expand...




this is the ONLY answer to this ******ed thread.
 
People debate all the time which programs are the best, top tier, highest ranked etc.. but the fact is, it is all subjective. The best program is the one that is the best fit for YOU...your personality, your learning style, and your life outside the hospital. I have never heard anyone say....."Wow I loved where I lived and the people I worked with, but I really wish I had gone to a program with a bigger better reputation." Here is my advice for researching programs.

1. Look at geography location.

2. Contact grads from your school who are residents at the program you are interested in. Check out old match lists. They are a great resource.

3. If you have no luck with grads from your school. Contact peeps here on SDN or seach old threads. Take a look at match threads from years gone by and PM a couple questions for current residents.
----Find out about attendings, work enviroment, work hours, didactics, board pass rates, and fellowship placement/ job oppertunities after residency.

----Ask specific questions about things important to you. If you are into bow hunting ask about it. If you can't live without Kaeng Khiao Wan Kai find out if they got a good Thai place in town etc.

4. Talk to your SO (if you have one) because if the SO isn't happy you're not going to be happy.

5. Don't worry about stuff like, if the program you like has a USMLE "cut off" or if they are DO friendly. Apply widely but apply where you want to go. Not where you think you have the best chance of getting in.

6. Relax you'll match. Even the village idiot still matches with very few exceptions.
 
Looks like while I was writing my rant Copro summed it all up.
 
Trisomy13 said:
this is the ONLY answer to this ******ed thread.
Click to expand...

Why is this thread ******ed? I didn't mean to ask any stupid questions. Please give me a break as this is my first time through all of this.
 
RickKane said:
People debate all the time which programs are the best, top tier, highest ranked etc.. but the fact is, it is all subjective. The best program is the one that is the best fit for YOU...your personality, your learning style, and your life outside the hospital. I have never heard anyone say....."Wow I loved where I lived and the people I worked with, but I really wish I had gone to a program with a bigger better reputation." Here is my advice for researching programs.

1. Look at geography location.

2. Contact grads from your school who are residents at the program you are interested in. Check out old match lists. They are a great resource.

3. If you have no luck with grads from your school. Contact peeps here on SDN or seach old threads. Take a look at match threads from years gone by and PM a couple questions for current residents.
----Find out about attendings, work enviroment, work hours, didactics, board pass rates, and fellowship placement/ job oppertunities after residency.

----Ask specific questions about things important to you. If you are into bow hunting ask about it. If you can't live without Kaeng Khiao Wan Kai find out if they got a good Thai place in town etc.

4. Talk to your SO (if you have one) because if the SO isn't happy you're not going to be happy.

5. Don't worry about stuff like, if the program you like has a USMLE "cut off" or if they are DO friendly. Apply widely but apply where you want to go. Not where you think you have the best chance of getting in.

6. Relax you'll match. Even the village idiot still matches with very few exceptions.
Click to expand...

Thank you and everyone here for the advice. I am honestly not looking for a program with the best reputation so I can feel better about myself. I am just trying to be as informed as possible so I can apply to a variety of programs in places I would be happy and at places I would have a chance to match, regardless of reputation. Just thought the information might be useful in comparing programs as I am getting my application together.
 
Copro is right on this one. The best one for you might be someone else's worst one. Most programs will give you good training and just because there is name recognition of a program does not mean it is one of the best programs. I can think of several examples of programs with big time name recognition that I would never recommend.
What every student needs is an advisor that will help them sort through the mess.
But the key is to go to the program that you like best; not the one that you think you should like the best.
BTW, everyone is in luck, because 2/3 of the best of the best did not fill through the match last year. But that is a whole different thread about match list / interview strategies for different programs that has been covered here before.
 
There are a ton of great programs out there. I have no doubt you can find what your looking for.

I would only add, the top/ elite programs are well funded. If you have any notions of research I would try and get into many of the programs listed above. These are the folks cranking out research and such. This is where people are getting good grants and have enough support to get projects done. If you could care less about research then go where ever you want.
 
Haole said:
Why is this thread ******ed? I didn't mean to ask any stupid questions. Please give me a break as this is my first time through all of this.
Click to expand...

Because '******ed' has nice alliteration with 'ridiculous', 'redundant', 'risible', re-donculous, and if obsessive-compulsive started with 'r', I'd write that, too.

Oops.
 
Haole said:
Why is this thread ******ed? I didn't mean to ask any stupid questions. Please give me a break as this is my first time through all of this.
Click to expand...

Any list is too subjective to defend. Thus, any list is mostly worthless. If we all tell you that MGH, JHU and UCSF are the top three, and you interview there and realize you despise the attendings/residents/program, where did that get you?

Bottom line, you should be going to a program where you fit in and enjoy the atmosphere/town. Perceived program tiers shouldn't really play a role. There will always be big, recognizable names that can get your foot in the door, and those are pretty obvious. Check out some of the old discussions on "top tier programs" or "most competitive program", and see how the discussion deteriorates into a pissing contest.

If this thread continues to next week, there will be a dozen more like amyl wondering why their program wasn't listed on this magical list supposedly passed forth by everyone's program director. The list will be endlessly revised, and in the end you will be more confused than when you started.
 
Leverage said:
I would only add, the top/ elite programs are well funded. If you have any notions of research I would try and get into many of the programs listed above. These are the folks cranking out research and such. This is where people are getting good grants and have enough support to get projects done. If you could care less about research then go where ever you want.
Click to expand...

The reality is that most US MD residents -- even those who are interested in doing a little research on the side -- can only fit in 1-2 small projects during their residency. As a resident, you will be busy learning clinical anesthesiology and you will not be expected to make significant research contributions. My residency does have a few funded "research resident" spots which include a few paid months of dedicated research (I think it's 6 months during CA-3). So if you are interested in research and have a strong research background (previous publications, PhD, etc), this is probably the exact thing you're looking for -- a well funded program which allows you not only the money but also the dedicated time.

For those who probably will not take advantage of dedicated research time, however, funding still makes a difference. A well funded program or hospital is more able to provide a large educational allotment, pay for travel to conferences, etc. Here is what I'm currently discovering my residency and hospital will pay for:
- Up to $1000 educational allotment. ($500 guaranteed annual educational allotment per resident, plus an additional $500 if you choose it for your annual winter holiday gift instead of an iPod, bike, stereo system, etc.)
- All expenses paid travel to any conference you present at. (If you are just attending, it is deducted from above mentioned educational allotment.)
- One attempt at ABA boards.
- Unlimited bar tabs or dinner at a local bar/restaurant several times a year, excluding the weekly interview dinners.
- Free movie tickets went around sometime last month.

At the community hospital where I did my internship, there was a $500 educational budget -- which had to be divided up among ALL the residents and went so far as to buy a couple books for the resident lounge. And someone over here in this book stipend thread http://forums.studentdoctor.net/showthread.php?t=548984 is trying to figure out how to blow their annual $150 on one book when I just went out and bought all the mentioned books last year, got them to pay for my Step 3, and still had money left over that I couldn't spend.

So there is huge variation among programs in terms of available funds for perks such as books, boards, and social activities, and 😀this will probably be much more relevant to most residents than research opportunities!
 
Last edited:
Any words or comments on U of Chicago and Northwestern programs? Please message me if you want. I especially would like to hear any negatives such as attending attitude. I seem to not be able to get a sense of the degree of malignancy if present. Thanks.
 
It really is hard to answer this question. I understand the reason behind why its hard now that i'm in my residency rather than when I was a student. As a student, you're used to trying to see which tiers the colleges fall into, which tiers the medical schools fall into, its all you know.

Enter residency: Now medicine becomes much more what it will be for the rest of your life, a JOB. True, you will still learn, and you will be taught, but the JOB factor is always in there.

No matter WHERE you go, when you are done with residency, you WILL NOT HAVE SEEN IT ALL. . That being said, a "top tier" program will likely expose you to the zebras more often than those that are lower tier. However, Ultimately, YOU make the residency what it is, and no one else. If you're the type of person who wants longer hours to work and learn more in house, then those programs which do that are the "top tier" for you. If you're the type of person that needs to study and read for long periods of time, then the top tier becomes the programs which offer that as well.

I remember it was hard coming from a student's perspective trying to figure out which program is good and which was not so good, but its all a matter of perspective, what you like, who you like, and where you wanna be.
 
I agree with RickKane's post above. I'm preliminarily considering the following when deciding where to apply:
1. Location of the program
2. How well that program gets you to your goals, whatever they are
3. Happiness with the work load/teaching/resident-friendliness etc.
 
I was told that there are
30 top programs that are a cut above the rest and worth going out of your way for
60 programs in the middle
10 programs you definitely want to avoid
 
Given the number of spots, location is always important, whether to you, to your SO or to your family. If it is not, you are
1) in denial, which is bad;
2) academically oriented, and there's your answer on which programs to apply (but you should still have some options with respect to location);
3) desperate, then apply widely.

I doubt anyone except current M4 will give you a tiered list. The old threads are still valid. Talk to your home PD about programs on the rise and programs to avoid. Off the top of my head, UW, MGH and Hopkins just had new chairs, which may impact a program's standing.

Same questions every year. Same advices every year. "Just look for a personal fit." But we are all med students once and have to re-invent the wheel every year. Best of luck.

Remember, it never hurts to get your application in ASAP.
 
I agree with the above - go where you fit in, rankings are stupid, however, I will point out one thing - the whole top 3 - UCSF, MGH, Hopkins - this was from a while back and is definitely not the case anymore and as someone said, they may have the big name, but would you want to go there.

UCSF and Hopkins did not fill last year. MGH did not fill the year before that - thats your top 3 - what does that tell you (personally I feel this is because they did not plan well and did to not interview or rank enough also - they are all behind in regional anesthesia, probably the largest growing in demand anesthesia at this point and what many programs are trying to play catch up in right now - in my region some practices are offering up to 30% more for significant training in regional).

Great programs still and with the top of the top, however this top is no longer 3 programs, its 5-10-15, just stating that there are alot of great programs - if your deciding within this class, pick where you feel the most comfortable
 
For those of you touting "location" as the most important thing, I think you're spot-on. That's the one thing I didn't believe when I was starting to apply that I found out to be most true. Here's what I wrote, this is from a document I made regarding the whole application process and posted on our school's Anesthesia Interest Group secure site:

Where to apply –
Location, location, location. Read that again. I GUARANTEE you that at the end of the day, most – if not all – of the reasons you pick your top 2-3 programs will be due to location. Even though you probably don’t believe me now (Lord knows I didn’t believe it myself this time last year), just remember I said something about this and come and read this again after you’ve done a couple of interviews. Save yourself the time, expense, and trouble (especially the trouble) and be honest with yourself (and spouse/significant other) about where you want/need to go. Interviewing somewhere where you would never really want to live is going to help nobody, least of all yourself.

If you have geographic wants/needs, pay special attention to those. In general, people with children (or who may be planning on them during residency) will prefer smaller towns with good schools, safe locations, etc. (Interestingly enough, most of the residency programs at these locations are filled with….people with children compared to the big cities. Hmm…).


Conversely, single people and those without children tend to gravitate towards larger cities. It goes without saying that you will generally fit in better with fellow residents who are in situations similar to yours. I myself would not (and did not) fit in very well at programs where 80% of the residents had children. There is nothing wrong with the programs (and nothing wrong with children), it was just not a good fit for me. I would venture to guess that the converse is also true. If you think about this early on and find out the information about the locations before you apply/schedule an interview, you can save yourself some time and trouble during interview season.

Regardless, think long and hard before you apply to places (or wait and think long and hard before scheduling an interview once you get an invitation). There may be excellent programs out there that you like (Mayo was a good example for me), but would NEVER go there because of the location, or because you don’t fit in with the residents (who are more-often-than note predominately made up of one of the demographics described above).

Don’t think of the interviewing process as some sort of quest for the Holy Grail. There are probably 10-15 programs (or more) out there that would be an excellent fit for you. There are certainly tons of programs that provide great training in anesthesia (for academics, private practice, mixture of both, etc). I would think of them more as being in “tiers” of programs, and many programs in similar tiers will be, for all intents and purposes, reasonably similar.

Your job is now to decide 1) what type of location you desire; and 2) if you fit in with the other residents or not. You will quickly figure out what “tier” of programs you should be looking at by which places give you interviews (of course you should probably have backups in “lower” tiers as well as “reach” schools in higher tiers).
 
MS4SoonToBeMD said:
This is what I was given by the PD at my school, but it is definitely just a random list. Reputations are based on what people know of other programs. MGH, UCSF, Hopkins will always be considered the top 3. They probably have the best academic programs with tons of research and best faculty. Whether or not they truly put out the best anesthesiologists is questionable.


Top Tier:
Mass General (MGH)
UCSF
Hopkins
Brigham & Women's
U.Penn
Duke
UAB
Emory
Wash U.
UFlorida
Columbia
Michigan

Middle Tier:
Cornell
NYU
BIDMC
UCLA
UCSD
Baylor
Vanderbilt
UVA
UNC-Chapel Hill
Northwestern
UChicago


Lower Tier:
most others.
Click to expand...

My buddy and I compared notes on our programs. He is in one of the "Lower Tier" programs according to that list. Half of his class passed the written boards after their CA-1 year. 90% passed the perioperative TEE boards. He's 30 minutes from half a dozen world class ski resorts. Dude knows his stuff.

Go where you'll be happy--where you like the location, the people, and you'll get sufficiently good training to pass your boards, and don't put too much stock in lists.
 
agree with above. I also go to a "lower Tier" program on this list. I interviewed at some of those elite programs and picked a lower tier has my first choice. I wouldn't do it differently either. My class had three 99 percentiles and 75% of my class passed as CA1s. not bad for a lower tier. also all of us get great jobs.
 
amyl said:
i will respectively disagree with your list on two accounts: UFla being top tier, and my program, CCF, being absent.
Click to expand...

Create 20-50 user id's and post tons of messages about how wonderful CCF is. Pretty soon everyone will be saying that MGH, UCSF, and CCF are clearly the best followed by everyone else. :laugh:
 
i don't have to create more accounts - i have met enough CCF grads and discussed their exposure and they should be considered a top-tier program for many reasons (too many to list) - of course who wants to live near CCF??!! yikes...

there are certain experiences that you will get at the top programs that you will NEVER get anywhere else --- (ie: anesthesia for mom's undergoing fetal surgery, double lung transplants, etc...)

BUT will those experiences make you a better anesthesiologist - i doubt it...

i would argue that >70% of programs turn out good anesthesiologists...
 
fakin' the funk said:
I was told that there are
30 top programs that are a cut above the rest and worth going out of your way for
60 programs in the middle
10 programs you definitely want to avoid
Click to expand...

Ummm... what about the other 30 programs?

-copro
 
Tenesma said:
i don't have to create more accounts - i have met enough CCF grads and discussed their exposure and they should be considered a top-tier program for many reasons (too many to list) - of course who wants to live near CCF??!! yikes...

there are certain experiences that you will get at the top programs that you will NEVER get anywhere else --- (ie: anesthesia for mom's undergoing fetal surgery, double lung transplants, etc...)

BUT will those experiences make you a better anesthesiologist - i doubt it...

i would argue that >70% of programs turn out good anesthesiologists...
Click to expand...

Pardon my ignorance, but what does CCF stand for?
 
rsgillmd said:
Pardon my ignorance, but what does CCF stand for?
Click to expand...

Cleveland Clinic Foundation. I'm in cleveland, interviewed there for gas, and I still didn't figure this one out for a while as well so don't worry.
 
These tiers are worthless. For example, OHSU is nowhere on here. They must be low tier. Others *cough* are "top tier". Please. It is all a bunch of trash no matter how new or old the lists are.
 
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