Another help with my ROL thread

[kaynedkroe87]

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Yale vs Baylor vs NYP Cornell vs UPenn

Any thoughts or input would be greatly appreciated. PM me if you like. Thanks.

 

[TUGM]

I didn't experience every place on that list, but I would say UPenn > NYP Cornell > Baylor... as for where Yale stands on the list, I'm honestly not sure. UPenn is considered consistently in the top 10, and is an excellent program on all fronts, and especially strong in stroke. Philly is a nice city, and the cost of living is relatively low. Cornell has some excellent teachers and faculty, and the location is obviously awesome (if you're a city guy), albeit expensive. Baylor is a pretty inpatient heavy program, but I didn't get the impression that residents were overworked. I really liked the program, though not completely sure about Houston. They mentioned that they had an unusual situation where one resident transferred after PGY-1 to be with his SO in Michigan, and two of their other PGY-2 residents got pregnant around the same time, contributing to some increased workload for a previous class.

 

[Jubears09]

I didn't interview at Baylor, but can share my notes on the other three. Objectively, I couldn't tell a difference in where the recent residents from Yale, Penn, and Cornell ended up for fellowships and whatnot and K award rates seemed similar allowing for year to year fluctuations. The only difference I noted about the training themselves is Cornell doesn't have a VA but does have MSK (if i was thinking hard about neuro oncology Cornell would be my runaway top choice)

It would help if you gave us an idea of what's important to you. If you go by pure reputation to a layperson over the past 20 years Penn probably has an advantage though all 4 are big named institutions. Cornell is in the nicest metro location. Houston's a great balanced city and imo one of the best places to practice as an attending ( based on avg salary, col, etc) if you are thinking long term. Yale had everything you could want academically as well, though New Haven can be kinda shady.

 

[2heavy]

Penn >>>>Cornell/Yale>Baylor. Easy choice for number one. #2 is going to come down to personal preference.

 

[TUGM]

Cornell also has Dr. Isaacson... one of the most prominent names in Alzheimer's disease, and an AWESOME, AWESOME PD. He's from my home institution, so I had to brag a bit about him.

 

[kaynedkroe87]

Yes, Dr. Isaacson is awesome! He has a great vision for Cornell that involves diversifying the program which is much needed.

currently, I am torn whether to rank programs based on prestige or "gut feeling." overall, I like Yale more than all of the programs. the PD, dr greer, is super awesome and very supportive of the residents. yale offers a ton of research that fits in with my interests, and the program doesn't seem to overwork the residents. however, i find it very difficult to rank yale over places like penn and cornell, because it doesn't seem to compare in terms of name or location... I hate being such a label *****, but i've been that way throughout my entire academic career 🙁

 

[Jubears09]

Yes, Dr. Isaacson is awesome! He has a great vision for Cornell that involves diversifying the program which is much needed.

currently, I am torn whether to rank programs based on prestige or "gut feeling." overall, I like Yale more than all of the programs. the PD, dr greer, is super awesome and very supportive of the residents. yale offers a ton of research that fits in with my interests, and the program doesn't seem to overwork the residents. however, i find it very difficult to rank yale over places like penn and cornell, because it doesn't seem to compare in terms of name or location... I hate being such a label *****, but i've been that way throughout my entire academic career 🙁

I think you might be overthinking this. Yale is one of the most prestigious universities in the world and the "name" is there for anyone not intimately knowledgable of the neurology field, possibly even more so than Penn or Cornell. Even within the field, it would take a special kind of stuck up to look at "Yale" on your resume unfavorably. Also neuro fellowships are not exactly competitive unless you're set on interventional, so in many ways the prestige factor matters less.

There was an article in the Times recently about the chase for money driving addiction like behavior/thought processes within wall street that IMO absolutely applies to prestige in medicine. Timely for it to come during ranking season, but still doesn't maker easier to rank the programs you have the best "gut feelings" about over traditional powerhouses.

 

[TUGM]

In the end, that is a big decision. We are all "label ******" to a certain degree. The one thing that I have learned over the course of the entire training process thus far is that if you are committed and dedicated, you can make anything happen. I think it's very hard to shake the feeling of "OK if I go to Harvard, then I have the best everything, and I'll get everything I want career wise, and I'll be the best everything" Every neurology program has its strengths and weaknesses, but most of the programs have the resources to help you TURN YOURSELF into an excellent physician (some have more than others). Regardless of the program you train at, you make yourself. I think, practically speaking, if you enjoyed your time at Yale, and it really stands out in your mind, you shouldn't have qualms ranking it higher than a "more prestigious" program. Your situation is picking between Yale, Cornell, and Baylor, which makes me think that you have been doing productive things and working hard... I think you'll do well if you keep it up, regardless where you end up.

That being said, I keep hearing people tell me... GO WITH YOUR GUT!

 

[Thama]

Kinda depends on the environment you want to be in as well. Penn is the biggest name on that list but if the working environment isn't one where you'll be comfortable then you might not do as well. Any of the other programs on that list will give you good training, research opportunites, and shots at the best fellowships, so I tend to think that program culture should be priority #1. You're not comparing elite programs with marginal ones here, you're comparing really good to really, really good.

Per your last post, if your gut is saying Yale, you liked the people at Yale the best, and Yale offers everything that you want and need in a residency program, then I think you've told everyone here the correct answer.

 

[2heavy]

I think you might be overthinking this. Yale is one of the most prestigious universities in the world and the "name" is there for anyone not intimately knowledgable of the neurology field, possibly even more so than Penn or Cornell. Even within the field, it would take a special kind of stuck up to look at "Yale" on your resume unfavorably. Also neuro fellowships are not exactly competitive unless you're set on interventional, so in many ways the prestige factor matters less.

There was an article in the Times recently about the chase for money driving addiction like behavior/thought processes within wall street that IMO absolutely applies to prestige in medicine. Timely for it to come during ranking season, but still doesn't maker easier to rank the programs you have the best "gut feelings" about over traditional powerhouses.

The general public may all know the name "Yale" but within our field it is NOT considered top-tier by any objective measure (volume, faculty number, sub-speciality representation, fellowship placement, hospital size/catchment, research/funding, it goes on. Some people might not know Penn but everyone in neurology does. Now if your gut tells you one thing that's a different story and you should really go where you fit. If Yale "clicked" then that's awesome that you found the right program. Don't make the mistake of choosing programs based on their college ranking.

 

[Jubears09]

The general public may all know the name "Yale" but within our field it is NOT considered top-tier by any objective measure (volume, faculty number, sub-speciality representation, fellowship placement, hospital size/catchment, research/funding, it goes on. Some people might not know Penn but everyone in neurology does. Now if your gut tells you one thing that's a different story and you should really go where you fit. If Yale "clicked" then that's awesome that you found the right program. Don't make the mistake of choosing programs based on their college ranking.

If it's that clear to you, please show us these objective measures that make Penn head and shoulders better than Yale, Baylor, and Cornell. It'll help me immensely because one of the big disappointments of my interview trail was finding little/no discernable difference between these 5 "elite" programs and the so called "second" tier, especially at the residency level.

The fellowship match list of some of these places (Cornell among them) looks arguably better to me the past few years than Penn's. OP can judge for him/herself and these do fluctuate, but again neurology fellowships are not exactly competitive (with the caveat that every institution likes to promote internally first) and there's little objective evidence here Penn is superior. The R25 used to be a distinguishing factor, but that's been explanded to more than a handful of programs now.

http://www.brimr.org/NIH_Awards/2012/NIH_Awards_2012.htm
This is the latest available NIH award rates by NEUROLOGY dept. Not comprehensive but as you can see both Cornell and Yale neurology received more NIH funding than Penn in 2012. These things fluctuate, but there's no objective evidence Penn is "clearly" better than the others. (Props to UCSF though... damn)

Upenn's hospital has 776 beds plus VA. That's definitely smaller than Baylor and (I don't have the numbers in front of me) not likely to be significantly larger than Yale +VA or WCMC + MSK.

I don't mean to knock on Penn or any of the top 5 because they're all elite residencies that have everything one can ask for, but aside from common perception (Which is important to a degree) I saw very little actual evidence of their clear superiority compared to many of the second and possibly high third tier programs, Yale being one of them. Basically I'm saying the difference between the elite and non-elite programs are being way overblown in their forums (and our field). All else being equal, I personally think Philly is nicer than New Haven and Penn has a more convenient location, but if OP felt better about Yale, s/he definitely won't be valuing "gut feeling" way above every other criteria to rank Yale above Penn

 

[2heavy]

Does the PGY-2 give TPA at Yale/Baylor/Cornell? Because they do all the TPA at Wash U for example, and this is huge. Those are the things that help separate programs at the top and have a huge impact on your training. Long, unnecessary story short, there is a difference and it was striking to me when I went on the interview trail. OP wanted a rank order and that's my opinion. It's always a delicate subject to try and rank/debate programs but it's all in good fun because hopefully you pick based on your personal experience.

Some general advice is to pay close attention on interviews to what aspects directly affect your training, such as a large inpatient neuro floor, dedicated neuro ICU, diverse faculty/subspeciality representation, TPA decisions, and fellowship placement/alumni careers. Most importantly, the program needs to be resident run. I think this will ultimately define a great program outside of the debates for which is number 1,2,3, etc.

 

[neglect]

If it's that clear to you, please show us these objective measures that make Penn head and shoulders better than Yale, Baylor, and Cornell. It'll help me immensely because one of the big disappointments of my interview trail was finding little/no discernable difference between these 5 "elite" programs and the so called "second" tier, especially at the residency level.

I second this. There is no perceptible difference because there IS no difference. I'm years out now, so feel free to disregard me. But I have a strong opinion that this won't matter much. Your life will not be lessened if you don't get into Penn's residency and have to settle for one of the many, many fine institutions that are listed. You'll still have a job when you get out. You'll get a fellowship if you want one.

I mean, seriously, badmouthing Yale or Cornell as not being good, or as good? Both are freaking Ivy League schools which attracts tons of researchers in many areas, strong neuroscience, etc. They have worldwide names. The people who work there are just as inspired, idiotic, foolish, crazy, fun, and boring as anywhere else. I'm sure both rest on their names >>>> actualities.

Here's a question. When I think of real advances that have come out of neurology departments, I never think of Penn. Their pathology department spun out Amyvid, but that's useless and PIB out of U Pitt was there first. UCSF paved the way for B-cell modulation in MS. I know Yale is starting a trial of B-cell modulation for Myasthenia. UCSD did the early work on tPA. What actual advances have most of these departments made? How many patients do they enroll into trials that matter? (And sorry UCSF, hard to imagine that another plavix trial matters much, but wasn't it Alpers at Stanford who showed that heparin was useless in acute strokes?)? And Nature Neurosci papers don't count. My point is just a side point - that all these millions of dollars are being spent on work that's useless.

 

[2heavy]

I second this. There is no perceptible difference because there IS no difference. I'm years out now, so feel free to disregard me. But I have a strong opinion that this won't matter much. Your life will not be lessened if you don't get into Penn's residency and have to settle for one of the many, many fine institutions that are listed. You'll still have a job when you get out. You'll get a fellowship if you want one.

I mean, seriously, badmouthing Yale or Cornell as not being good, or as good? Both are freaking Ivy League schools which attracts tons of researchers in many areas, strong neuroscience, etc. They have worldwide names. The people who work there are just as inspired, idiotic, foolish, crazy, fun, and boring as anywhere else. I'm sure both rest on their names >>>> actualities.

Here's a question. When I think of real advances that have come out of neurology departments, I never think of Penn. Their pathology department spun out Amyvid, but that's useless and PIB out of U Pitt was there first. UCSF paved the way for B-cell modulation in MS. I know Yale is starting a trial of B-cell modulation for Myasthenia. UCSD did the early work on tPA. What actual advances have most of these departments made? How many patients do they enroll into trials that matter? (And sorry UCSF, hard to imagine that another plavix trial matters much, but wasn't it Alpers at Stanford who showed that heparin was useless in acute strokes?)? And Nature Neurosci papers don't count. My point is just a side point - that all these millions of dollars are being spent on work that's useless.

How is this relevant to resident level training? I don't think drug discovery has anything to do with learning fundamentals of clinical practice. As residents, we see patients and learn how to practice medicine.

 

[neglect]

How is this relevant to resident level training? I don't think drug discovery has anything to do with learning fundamentals of clinical practice. As residents, we see patients and learn how to practice medicine.

I did get off on a tangent. But how is training with guys who know how to get bull**** nonsense funded and keep a routine going going to affect you against people who are pushing against the boundaries of medicine? No clue.

 

[Jubears09]

As residents, we see patients and learn how to practice medicine.

Which is no different between any of the hospitals above. Correct me
If Im wrong because I didn't ask this at all my interviews ( and thought it was irrelevat because I've yet to meet a resident at any place who felt they were not giving enough tPa) but the tPa thing is WashU specific.

The hospitals at Yale and Cornell are not any smaller or less of a referral center than Penn or Columbia or SF. All of the residents at the places I interviewed at told me they were happy and resident run programs. The fellowship lists are just as good too. Honestly I looked hard for objective differences between these top and "second" tier programs and couldn't find any.

If you know what they are please share them. I value other people's opinions but also am interest in knowing what they are based on especially when something dramatic like program x is >> program y is said and both are programs I liked and am considering. I mean if your dad was cured of leukemia at Penn so you'll always idolize it or if your personal role model went there so you have to be there is not going to affect the way I think about my rank list the same as if there is actually objective data to back this up.

 

[Gnocchi Monster]

Sorry to piggyback on this thread, but I had question that probably isn't worth starting a new thread on. To me it seemed like Baylor and many other TX schools have a lot of FMGs/IMGs based on their websites. It was my impression (correct me if I'm wrong) that residency programs preferentially take AMGs so I would expect those with a high ratio of FMG,IMG/AMG to be less competitive. Is this completely a wrong way to look at things? Maybe Texas just has a favorable policy toward IMGs or the climate is nice or something?

Just here on my OB rotation trying to figure things out for coming years..

 

[Jubears09]

Sorry to piggyback on this thread, but I had question that probably isn't worth starting a new thread on. To me it seemed like Baylor and many other TX schools have a lot of FMGs/IMGs based on their websites. It was my impression (correct me if I'm wrong) that residency programs preferentially take AMGs so I would expect those with a high ratio of FMG,IMG/AMG to be less competitive. Is this completely a wrong way to look at things? Maybe Texas just has a favorable policy toward IMGs or the climate is nice or something?

Just here on my OB rotation trying to figure things out for coming years..

I think that general rule is true (I know there are exceptions about IMGs but that argument is well hashed out in these forums and off topic here)

But Im not sure competitiveness of residents is a valid measure of program strength in a field like neurology with a very low Amg applicant to spots available ratio. Programs like Baylor and Cleveland Clinic that are strong across in board are unlikely to have forgotten how to run a good residency coincidentally in the less competitive fields. Would they really do anything different for the residents if they came from American med schools instead? On the other hand it does matter who your co residents are both for life during residency and connections purposes... but there are plenty of IMG leaders in our field, so it probably still comes down to your impression of individuals on the interview trail.

 

[Thama]

Also kind of depends on where the IMGs come from. English or German trained =/= unknown caribbean school trained. Partners has IMGs on their roster, but look at where they're from.

 

[neglect]

Here's something a resident could get in on. http://m.us.wsj.com/articles/SB10001424052702303743604579351261144315256?mg=reno64-wsj

 

[typhoonegator]

Be careful comparing NIH dollars between institutions. Often that money comes in under separate or multiple headings, so some programs look like they're swimming in NIH dollars while others don't simply because of the paths the money follows. Harvard is a good example of this -- their NIH outlay looks smaller because HIM, MGH, BWH, BIDMC, Harvard College, etc. all represent distinct funding streams.