From an academic perspective...

BlackNDecker · Dec 13, 2011

I think we should clarify what "from an academic perspective" really means. We spend a lot of time comparing and contrasting IM residencies using this as the foundation and core principle.

When someone on SDN begins a sentence with, "From an academic perspective"...this generally translates to, "what I'm about to tell you is really beyond my area of personal knowledge and largely refers to amount of NIH funding."

Does training at a program with an incrementally higher "academic perception" mean you will be rapidly promoted to Dept Chair, a $500,000 salary, and movie star status in the glamorous world of medical societies? No.

It does, however, mean that you will have access to NIH funded basic research, labs, and lab equipment (desks, computers, light bulbs, pipettes, etc)...and if you're really lucky and work really hard (including days "off") you may get the chance to stay on as junior faculty and continue your work and earn a small fraction of your community practice colleagues.

So, what is the difference between two programs separated by 8-10 positions on an arbitrarily created IM program ranking "from an academic perspective?" Nothing that you would ever recognize or notice.

How bout programs separated by 10-20 spots? Well, at this point you might notice fewer NIH funded basic research labs and probably less NIH funded lab equipment and materials (again computers, desks, light bulbs)...but then again, there are likely fewer researchers using the equipment so the difference is relative. Also, there would likely be fewer residents looking for projects or labs in which to do their work so, again, the difference would be relative.

What about alternative sources of funding? Like endowments, wealthy benefactors, etc? Well, things like this don't lend themselves to numerical ordering so they are often left out of silly rank lists "from an academic perspective."

So what are the implications of neglecting private funding? Well, you may cross a program off (or rank it lower down) the list that ironically offers more "relevant research projects" for your career development. It also means less of a publish or perish mentality.

jdh71 · Dec 14, 2011

BlackNDecker said:
I think we should clarify what "from an academic perspective" really means. We spend a lot of time comparing and contrasting IM residencies using this as the foundation and core principle.

When someone on SDN begins a sentence with, "From an academic perspective"...this generally translates to, "what I'm about to tell you is really beyond my area of personal knowledge and largely refers to amount of NIH funding."

Does training at a program with an incrementally higher "academic perception" mean you will be rapidly promoted to Dept Chair, a $500,000 salary, and movie star status in the glamorous world of medical societies? No.

It does, however, mean that you will have access to NIH funded basic research, labs, and lab equipment (desks, computers, light bulbs, pipettes, etc)...and if you're really lucky and work really hard (including days "off") you may get the chance to stay on as junior faculty and continue your work and earn a small fraction of your community practice colleagues.

So, what is the difference between two programs separated by 8-10 positions on an arbitrarily created IM program ranking "from an academic perspective?" Nothing that you would ever recognize or notice.

How bout programs separated by 10-20 spots? Well, at this point you might notice fewer NIH funded basic research labs and probably less NIH funded lab equipment and materials (again computers, desks, light bulbs)...but then again, there are likely fewer researchers using the equipment so the difference is relative. Also, there would likely be fewer residents looking for projects or labs in which to do their work so, again, the difference would be relative.

What about alternative sources of funding? Like endowments, wealthy benefactors, etc? Well, things like this don't lend themselves to numerical ordering so they are often left out of silly rank lists "from an academic perspective."

So what are the implications of neglecting private funding? Well, you may cross a program off (or rank it lower down) the list that ironically offers more "relevant research projects" for your career development. It also means less of a publish or perish mentality.

Look, man, I see your point and we all do, in fact most of us agree, but you're being kind of pedantic about it all don't you think?

BlackNDecker · Dec 14, 2011

jdh71 said:
Look, man, I see your point and we all do, in fact most of us agree, but you're being kind of pedantic about it all don't you think?

I realize you see the point of all of this, that's why this thread was intended for a different audience. I actually don't have any intention to drone on about this...this was more or less intended to be a one time reminder during the interview season that, despite our best efforts, most of us are full of hot air. I wouldn't trust anyone's opinion of a program except their own (and even then with a grain of salt).

quepatho · Nov 23, 2012

jdh71 said:
Look, man, I see your point and we all do, in fact most of us agree, but you're being kind of pedantic about it all don't you think?

In his defense (and I have not followed his posting history), I think it's a valid point that some of us might not have considered, or at any rate might not have considered the various points that were made.

I'd be interested in knowing more about the implications of NIH-funding-based-ranks. Especially as they affect trends from cycle to cycle.

twright · Nov 23, 2012

BlackNDecker said:
What about alternative sources of funding? Like endowments, wealthy benefactors, etc? Well, things like this don't lend themselves to numerical ordering so they are often left out of silly rank lists "from an academic perspective."

So what are the implications of neglecting private funding? Well, you may cross a program off (or rank it lower down) the list that ironically offers more "relevant research projects" for your career development. It also means less of a publish or perish mentality.

It is really hard to land private donor funding, either from well-known foundations (e.g., BMGF) or from wealthy philanthropists, if you are not at a 'top 10' institution.

jdh71 · Nov 23, 2012

quepatho said:
In his defense (and I have not followed his posting history), I think it's a valid point that some of us might not have considered, or at any rate might not have considered the various points that were made.

I'd be interested in knowing more about the implications of NIH-funding-based-ranks. Especially as they affect trends from cycle to cycle.

B-n-D is a good guy. Doesn't post too much anymore. We went through the same residency match cycle way back in the day. He ended up at Mayo - I say that because he has personally outed himself as a mayo guy before - and landed a cards fellowship (I do not know where and he did not share). So he's not unfamiliar with well recognized places and landing a nice fellowship.

His point is a good one sure. But it kind of exists in the abstract, because on the practical level, even if we were all agree this "ranking" business is largely bull****, EVERYONE still pays attention to it.

What you really need to figure out is how this game plays into your overall career strategy. How the best to use it to your advantage or forget about it entirely. There were more than a few people last year who PM'd me and were very concerned that they were not ranking the most well regarded programs that they visited higher on their list than places they actually seemed to like, and I was proud of them that they went with that the liked over what "everyone" told them was the ranking and I've heard back from many of them and they are VERY happy at their residencies.

tallash · Nov 25, 2012

jdh71 said:
B-n-D is a good guy. Doesn't post too much anymore. We went through the same residency match cycle way back in the day. He ended up at Mayo - I say that because he has personally outed himself as a mayo guy before - and landed a cards fellowship (I do not know where and he did not share). So he's not unfamiliar with well recognized places and landing a nice fellowship.

His point is a good one sure. But it kind of exists in the abstract, because on the practical level, even if we were all agree this "ranking" business is largely bull****, EVERYONE still pays attention to it.

What you really need to figure out is how this game plays into your overall career strategy. How the best to use it to your advantage or forget about it entirely. There were more than a few people last year who PM'd me and were very concerned that they were not ranking the most well regarded programs that they visited higher on their list than places they actually seemed to like, and I was proud of them that they went with that the liked over what "everyone" told them was the ranking and I've heard back from many of them and they are VERY happy at their residencies.

I want to reinforce both points here - the "strongest" residency I interviewed at on my list ended up 3rd to last based on my gut feeling there and a residency that was decidedly in the middle based on reputation was my #1 pick (and where I'm now extremely happy). It takes a lot of self-awareness (and confidence) to pick against the rankings but the further you get in your training the more you realize how these things tend to be generally overblown.

disorder · Nov 26, 2012

tallash said:
I want to reinforce both points here - the "strongest" residency I interviewed at on my list ended up 3rd to last based on my gut feeling there and a residency that was decidedly in the middle based on reputation was my #1 pick (and where I'm now extremely happy). It takes a lot of self-awareness (and confidence) to pick against the rankings but the further you get in your training the more you realize how these things tend to be generally overblown.

this. remind of this later. 👍

i keep being told "train at the best place possible", and while yes, this is generally true... it the program fit has to go both ways.

gutonc · Nov 26, 2012

disorder said:
this. remind of this later. 👍

i keep being told "train at the best place possible", and while yes, this is generally true... it the program fit has to go both ways.

"The best place possible" doesn't necessarily mean "the program that the rest of the world considers to be the 'best'." And I absolutely agree with jdh that, in the list of the Top 10 things you should be paying attention to when ranking programs, 4-5 of them should be "your gut."

That said, having recently come through all this and finding myself in a much different place than I originally envisioned, I think you need to consider what your future career goals are. If you want to have an independent research (basic or clinical) career where you spend the vast majority of your time doing research, you need to take into account the mentoring/funding opportunities available in addition to the clinical training (which is what most people focus on during interviews, both for residency and fellowship). If you want to be a FT clinician (academic or otherwise), this is less of an issue.

staup · Nov 26, 2012

This isn't rocket science. Or brain surgery, or even rheumatology.

If you want to do research, you have to go where people are doing research. It's almost impossible to learn how to do research, get a good research related letter of recommendation, get a grant, or produce any worthwhile research by going to a place that doesn't conduct research.

Most people don't want to do research, but they don't know that yet when doing their interviewing, or they just want to have gone to the place that produced a lot of great research.

If you don't want to do research, you can learn to be an amazing clinician by going to any of the top 50 to 100 ranked programs, possibly more.

From an academic perspective...

BlackNDecker

Paid da cost 2 be da bo$$

jdh71

Grim Optimist.

BlackNDecker

Paid da cost 2 be da bo$$

quepatho

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twright

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jdh71

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tallash

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disorder

isrdero

gutonc

No Meat, No Treat

staup

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