2014 Rank List Advice Thread

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Linaculous

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Hi all, I'm a semi-regular poster but created a new account to start this thread. I figured I can't be the only one struggling to put my rank list together, and while I'm definitely talking to mentors at my home institution, I thought I'd bounce ideas off the forum here. So here's my dilemma.

-Program A: solid program ( in the "excellent" category if you will) in the part of the country in which I would like to end up. It's a so-called "desirable" location that is supposedly difficult to break into. I don't love the program, but I think I would be happy there and receive adequate training.

-Program B (actually represents several programs): "better" programs (not big 3, but just below) located in cities where I'd be fine living for 4 years, but not close to where I'd like to end up. I do prefer these programs to program A (more modalities/disease sites, better research, etc) .

So at what point does location (not for residency itself, but for an eventual job) and the potential for local networking outweigh prestige and program preference? I realize there's no right answer to this type of question, but I'd love to get some thoughts. Thanks all.

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Maybe its the fact that I've been working with cancer patients for the past 4 years...

I think it's very important to live, every day, for each day. Not for what might be in 5.5 years, or later. With that in mind, I'd recommend choosing the program you think you'll be happiest at, for the 4 years of residency.
Networking is just one aspect of the job hunt, and if all else is equal, go for the program in the location you think you want to end up at. Based on your question though, it seems that Program Bs is where you would rather "B". In which case, rank them higher.

Just my 2 nickels.
 
It sounds like you know where you should go. Just because you do residency in a desirable place doesnt by any means guarantee you a job in that place. It helps, but it's not the be all end all. Unless you have a super compelling reason to be near place A, like wife can't get a job anywhere else or ex wife and kids live there and will never leave etc then I don't see why chose place A. Sounds like worst case would be going to A and then not getting a job there. With B you could be happy now and then who knows what will happen later. You could still end up anywhere :)
 
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I agree with the above posters. I ended up going with what you've listed as Program B. It is where I know my family and I will be happy for the four years. I guess I technically interviewed at "better" programs, but in the end, I chose where I would be happiest. I guess the only lingering fear is if during the job hunt I'll be able to get a job in a different part of the country, but I am continually reassured that while exact cities can be challenging if you expand the search to a larger region you can generally find something.

So yes, go with your happiness!
 
Thanks for the thoughts everyone, I've got some soul-searching to do.

Maybe its the fact that I've been working with cancer patients for the past 4 years...

I think it's very important to live, every day, for each day. Not for what might be in 5.5 years, or later. With that in mind, I'd recommend choosing the program you think you'll be happiest at, for the 4 years of residency.

So on one hand, maybe it's a good idea to take the known quantity by going straight to where I want to live and enjoying that, at least for now (program A).

It sounds like you know where you should go. Just because you do residency in a desirable place doesnt by any means guarantee you a job in that place. It helps, but it's not the be all end all. Unless you have a super compelling reason to be near place A, like wife can't get a job anywhere else or ex wife and kids live there and will never leave etc then I don't see why chose place A. Sounds like worst case would be going to A and then not getting a job there. With B you could be happy now and then who knows what will happen later. You could still end up anywhere :)

Or maybe I've overestimated the importance of residency location on local job opportunities and should go to the "best" program I can, especially if I prefer the program itself (if not the location).

I agree with the above posters. I ended up going with what you've listed as Program B. It is where I know my family and I will be happy for the four years. I guess I technically interviewed at "better" programs, but in the end, I chose where I would be happiest. I guess the only lingering fear is if during the job hunt I'll be able to get a job in a different part of the country, but I am continually reassured that while exact cities can be challenging if you expand the search to a larger region you can generally find something.

So yes, go with your happiness!

Another vote for going with where I'll be happy for 4 years, although that would probably be program A > program B for the location, with programs B being "better." I realize that wasn't clear from my OP, and to be honest it's not exactly clear in my head yet either.
 
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Oh okay, that makes more sense. In that case, I would vote for Program A. Too much emphasis is placed (or so I've been lead to believe) on the "top ten-ness" of a program. If Program A is just outside the top 10 but a great program in the right location, go with that hands down over a program B in the top 10 in the wrong location. My 2 cents.
 
Oh okay, that makes more sense. In that case, I would vote for Program A. Too much emphasis is placed (or so I've been lead to believe) on the "top ten-ness" of a program. If Program A is just outside the top 10 but a great program in the right location, go with that hands down over a program B in the top 10 in the wrong location. My 2 cents.
Let's ask another question. How much should "gut feeling" from interview day play into decisions? For instance, say we're talking about a top 3, top 5 or top 10 program where we perhaps didn't feel as comfortable at the interview day for one reason or another - be it the residents, the PD, or something we can't quite put our fingers on. Should we trust the reputation of the program versus another perhaps lower ranked place where we felt very comfortable and impressed?
 
Let's ask another question. How much should "gut feeling" from interview day play into decisions? For instance, say we're talking about a top 3, top 5 or top 10 program where we perhaps didn't feel as comfortable at the interview day for one reason or another - be it the residents, the PD, or something we can't quite put our fingers on. Should we trust the reputation of the program versus another perhaps lower ranked place where we felt very comfortable and impressed?

I faced this exact question myself. Sometimes even though a program gets rave SDN reviews, your personality and preferences may not jive with the department on interview day. In my opinion, thats okay! I was torn between chasing the SDN top 10, and following my gut. In the end, I think a balanced approach should work. I think ignoring program reputation would be unwise, but should be part of a balanced decision.

Example: Probably my best interview by feel was at a mid to low tier program. Why was it the best? I really don't know, everything just clicked. Personality, the city, all of it. However, it was a much lesser name. Conversely the highest ranked program I interviewed at was an amazing program, and while I definitely saw its merits in person it just didn't click, no gut feel. However, the there was a huge spectrum in between. I ended up going with one that is well known, with a solid reputation AND had the great gut feel. I felt like this balanced the importance of my gut feel and the reputation of the program.
 
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