Any other MS4s struggling with residency prestige vs fit with their rank lists?

[Maybedoc1]

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MS4 applying DR with less than 3 weeks till rank lists are due. I’m in the very fortunate position to have several great options for my rank list. I think I’ve narrowed my top 7ish to Mass Gen, Stanford, UWashington, Colorado, Utah, Mayo Minnesota, and UCLA in no particular order.

I enjoy live music, skiing, hiking, biking, camping, and photography (mainly landscape, but also wildlife, portraits, street, etc). Not big on going out or night life really anymore. Long term I see myself living somewhere in the mountain west or PNW, but I have no idea if I want to do academics, PP, entrepreneurship, or what with my career. So going off of that Colorado, Utah, or Washington seem like the obvious top choices, but I’ll admit that I’m getting a little woo’d by big names like Mass Gen, Mayo, and Stanford even if they may not be the perfect fit for me. To be clear I think I would be more than fine living in Boston, Rochester, or the Bay Area for 4 years even if I don’t see myself there long term. I wouldn’t choose a place I’d be miserable in just for the name.

As my advisor said it’s reasonable if part of you feels like you “owe it to yourself” to try and match one of these top programs and there’s nothing wrong with feeling this way, even if it probably doesn’t matter at the end of the day. I’d get great training at any one of these programs, but that big name will follow me for the rest of my career for whatever it’s worth and as a mostly clueless MS4 I don’t know what that’s worth.

I’m just finding it very hard to decide on where to rank things and wondering if anyone else is struggling/has struggled with this.

Hopefully this doesn’t come across as a humble brag as I’m genuinely struggling a bit with making a rank list 🙃

 

[Lost in Translation]

Go somewhere where you’ll be happy outside of the hospital. Any of the programs on the list you gave us would be able to provide the research opportunities required for subspecialization.

Unless you want to be a department chair or heavily involved in a national society leadership position, [perceived] prestige means little after graduation as your “patients” will never know or care where you got trained.

 

[ACSurgeon]

MS4 applying DR with less than 3 weeks till rank lists are due. I’m in the very fortunate position to have several great options for my rank list. I think I’ve narrowed my top 7ish to Mass Gen, Stanford, UWashington, Colorado, Utah, Mayo Minnesota, and UCLA in no particular order.

I enjoy live music, skiing, hiking, biking, camping, and photography (mainly landscape, but also wildlife, portraits, street, etc). Not big on going out or night life really anymore. Long term I see myself living somewhere in the mountain west or PNW, but I have no idea if I want to do academics, PP, entrepreneurship, or what with my career. So going off of that Colorado, Utah, or Washington seem like the obvious top choices, but I’ll admit that I’m getting a little woo’d by big names like Mass Gen, Mayo, and Stanford even if they may not be the perfect fit for me. To be clear I think I would be more than fine living in Boston, Rochester, or the Bay Area for 4 years even if I don’t see myself there long term. I wouldn’t choose a place I’d be miserable in just for the name.

As my advisor said it’s reasonable if part of you feels like you “owe it to yourself” to try and match one of these top programs and there’s nothing wrong with feeling this way, even if it probably doesn’t matter at the end of the day. I’d get great training at any one of these programs, but that big name will follow me for the rest of my career for whatever it’s worth and as a mostly clueless MS4 I don’t know what that’s worth.

I’m just finding it very hard to decide on where to rank things and wondering if anyone else is struggling/has struggled with this.

Hopefully this doesn’t come across as a humble brag as I’m genuinely struggling a bit with making a rank list 🙃

Prestige matters if you’re comparing a solid academic program to a low ranking community program with poor track record for matching fellowships.

Beyond that, prestige only matters if you intend on making your entire career and even life about academic and prestige. If you want to be the doctor who keeps mentioning where they trained, and wants to climb the academic ladder, then you should aim for prestige. I think people who train at the most prestigious of places fall into the trap of always “feeling like they owe it to themselves” to chase prestige which means a busy academic job and being underpaid and overworked.

Otherwise, go somewhere with good training and fellowship options, take a better paying community job with better work/life balance and never look back.

 

[lalalaaaaaa]

Colorado Utah and Washington are huge academic medical centers with huge names, especially in their respective regions. You'll very quickly find that name doesn't matter, especially in procedural specialities. The best surgical attending during my residency was a Caribbean grad who trained at a community program. Fancy academic surgeons who trained at brand name hospitals called him for help. Get good training, leave your ego in medical school.

 

[Maybedoc1]

Go somewhere where you’ll be happy outside of the hospital. Any of the programs on the list you gave us would be able to provide the research opportunities required for subspecialization.

Unless you want to be a department chair or heavily involved in a national society leadership position, [perceived] prestige means little after graduation as your “patients” will never know or care where you got trained.

Thank you for your reply and advice. It feels weird ranking less name brand programs over a couple of these giant names, but I really should just choose based off location. I’m finding it helpful to not think of it in terms of UCLA vs MGH vs Mayo, but rather Los Angeles vs Boston vs Rochester

 

[Maybedoc1]

Prestige matters if you’re comparing a solid academic program to a low ranking community program with poor track record for matching fellowships.

Beyond that, prestige only matters if you intend on making your entire career and even life about academic and prestige. If you want to be the doctor who keeps mentioning where they trained, and wants to climb the academic ladder, then you should aim for prestige. I think people who train at the most prestigious of places fall into the trap of always “feeling like they owe it to themselves” to chase prestige which means a busy academic job and being underpaid and overworked.

Otherwise, go somewhere with good training and fellowship options, take a better paying community job with better work/life balance and never look back.

Thanks for your reply! That all makes sense. I could see someone chasing the dragon of prestige throughout their career if they get into that mindset. At this point I don’t want my whole career to be about academic prestige, but at the same time I don’t know what I want my career to look like. It sounds like none of my top choices would hold me back though if I did want to take the academic route.

As an aside radiology is interesting too as even community grads can match into top fellowships pretty easily. Getting into residency seems to be the biggest hang up.

 

[Maybedoc1]

Colorado Utah and Washington are huge academic medical centers with huge names, especially in their respective regions. You'll very quickly find that name doesn't matter, especially in procedural specialities. The best surgical attending during my residency was a Caribbean grad who trained at a community program. Fancy academic surgeons who trained at brand name hospitals called him for help. Get good training, leave your ego in medical school.

That is very true on both fronts. Part of me feels like the training may be a little superior at Colorado/Utah/Washington when compared to bigger names, because they have such large referral areas and they are the only tertiary place in a multi state region. Plus they get the combination of University Hospital/Social Safety Net Level 1/Free Standing Peds/VA/and dedicated cancer hospital. They also probably have less fellows when compared to bigger names. Of course places like MGH and Mayo get referrals from literally around the world though.

One of the best radiologists I know went to a Caribbean med school.