Best residencies...yes..again...hopefully this will be different...

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Bostondp

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The questions about emergency medicine residency rankings and who has the best residency have been asked many times. However, nobody ever answers the question. There is one post on all of SND I could find where someone actually answered.

Please take a moment to put down 3, 5 or even 10 programs you think are really excellent. We all know they are very different...some academic, some community, some large county. You can put down a ranking of what you think are the 5 best programs, some programs you think have good reputations, or even ones you think are excellent but are underrated. I think it is very interesting to see which programs people feel are the strongest and why.

I hope to get some specific programs list on here...instead of what has happened in the past.
 
The "best" program is truly where you feel like you fit in with the people and location.
I'm holding off on any list until I see programs for myself
 
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I should preface this by saying I have little idea what I am talking about, and there are a ton of great programs. I am junior in the field and did not interview at all of these. That said, in no particular order:

Highland
Harbor
Denver
Cincinatti
Vanderbilt
Pitt
BIDMC
Cook
Carolinas
Indiana
Hennepin

Very different programs with different styles but always seem to come up when I ask faculty about places. Take it or leave it.
 
I'm surprised the FMcFP posts have not come yet...

Look, as a 2nd year resident, my suggestion to applicants is that rather than finding a list of rankings, look at some of these criteria:

1) location- if you want to work in the community, this is important as most graduates will practice in the same region as their residency

2) type of residency- almost every program has a combination of county, community, and tertiary/quadenary care. Get an idea of how each differs, and then which combination would fit you best.

3) how does surgery or medicine interact with emergency medicine? how are trauma codes run?

4) what extra-institutional or curricular experiences/electives are available? have residents done interesting things? gone to interesting places?

5) where have recent graduates gone, in terms of type and location? in private/community settings? in fellowships? in academic positions?

6) lastly, your gut feeling! It matters!

You'll find that many programs are similar in these respects, but there will be a few that standout--and this group will be different for everyone--so look closely at these places.

Good luck!
 
I should preface this by saying I have little idea what I am talking about, and there are a ton of great programs. I am junior in the field and did not interview at all of these. That said, in no particular order:

Highland
Harbor
Denver
Cincinatti
Vanderbilt
Pitt
BIDMC
Cook
Carolinas
Indiana
Hennepin

Very different programs with different styles but always seem to come up when I ask faculty about places. Take it or leave it.

I should preface this by saying that I DO know what I'm talking about, and the best residency is:

_ _ 'n _ _ _

and the best residency director is:

_ _ T T _ _ _ _ _ T T _ _ _ _ T _
 
I should preface this by saying that I DO know what I'm talking about, and the best residency is:

_ _ 'n _ _ _

and the best residency director is:

_ _ T T _ _ _ _ _ T T _ _ _ _ T _


I get where you're coming from. But this response is getting old. Sure there is parity among the programs. Excellent training all around. However, as in all fields there are stand-out programs and people should be able to share their opinions.
 
Looks like this will go just like the previous ones. The point was to provide no criteria because programs are great for different reasons to different people. I thought it would just be an opportunity for people to just put down what programs seem great to them. Anytime people have tried this in the past, it always ends with people saying why they won't write a specific program. I am acknowledging that fit is individual. However, some people have overlap. I was just looking for opinions about what people think are good programs...regardless of reason. People have seemed unwilling to do so in the past.
 
Whenever you start lists like this, it is pure conjecture on the part of largely ignorant people. In general, the longer a program has been around, the more well respected, and established it is. However, a good set of motivated attendings can and do put together solid programs with phenomenal training.

Really, the only person who can give an accurate assessment of a program is a person who trained at and graduated from that program. Realistically, that person should not currently be working there and have no stake in the success or failure of said program. Any other time, you are going to get biased, inaccurate information about a program. Usually, lists like this just contribute to self fulfilling prophecies whereby "Big Name Programs" get ranked higher on the list, purely because they are percieved by med students to be "Big Name Programs".

Invariably, you get an over-excited med student making either glowing remarks or scathing assessments about a program that they spent a few days at, or are basing their opinion on second-hand information gleaned from websites such as studentdoctor and scutwork.com.

The best advice I could give you is to decide where you would be willing to live, and apply to the programs in that area.
 
First, no. I won't (and can't) provide a list of the best programs in EM. Such a list doesn't exist for reasons that have been well stated in every single one of the millions of similar threads.

I will, however, make a list of the programs I interviewed with which I felt would have been a great match for me. After reviewing them, you'll likely be able to tell what I was looking for (with perhaps one exception).

In absolutely no particular order:

Scott & White/Texas A&M
Mayo
Christiana
Palmetto
UNM

The other programs I interviewed with were all outstanding, could have (and likely were) at the top of other folks lists. These are the programs that still stick out in my head as places I would have enjoyed going when I think about such things. I went with what I wanted and where I wanted to live. You should consider doing the same.

BTW, the longer I've been away from the match, the less I care about where someone did residency. I suspect others here feel the same. This is why I have posted smart assed replies to similar threads in the past and while you'll get more of the same in this thread.

Take care,
Jeff
 
The group in which I work has graduates from all over the country, and as far as I can tell we have very similar training despite the variety of backgrounds. I think this is partially why the "pick the place you think is best for you" is probably a pretty accurate answer.
 
Looks like this will go just like the previous ones.

So, as MANY people have stated, it's an individual thing. Why do you think your thread would be ANY different from any of the others? Do you think all of us attendings would be lying, repetitively, and continuously, when we say that the best program is the best fit for you?

What the hell benefit would we get from that?

And, moreover, if you were to peruse other threads, people will have a mythological list of "what they heard", like Denver and Harbor and Cincinnati, but want to know "really what are the best". So why would you want a biased, anonymous list from people you don't know? If you did your own research, or asked "why did you go to the program you did?", you honestly would find more cogent and salient answers.
 
I agree with the above posters that subjective rankings of prestige are probably not going to be helpful (really for any field).

That being said, it is hard to make a list of 30+ places to apply to within a region without knowing a little about each program. I think most people get this from talking with residents and advisors at home and away programs and websites.

I think most people who post on this site take this knowledge for granted.

It might be useful for people without home EM depts to have a list of one liners for what each program thinks is its single defining strength. For example

Emory: county experience with lots of autonomy
Denver: Academic 4 yr program
Indiana: 100k county and 100k academic center in same city

I know a lot of programs don't easily fit into a one line description, but it'd be nice for the ones that do. For example, it'd be great to know what programs put a significant emphasis on U/S (pretty measurable with the presence of fellowship trained attendings, presense/absence of a dedicated U/S month, and presence of a fellowship) or PEDS (also pretty measurable) or what programs are more county type vs academic.

OK, I know I just tried to post a serious reply to a best programs thread - let the flaming begin.
 
I know it's frustrating for med students to encounter resistence to the urge to list. The lists have always been there before from US News and other sources but now we're talking about something with a narrow enough base that they're not out there.

That said the reason that past posts about the "best Em residency" have always gone so badly (in addition to the previous points) is that they often devolve into really pretentious chest thumping exercises with people crowing about how they are way too superior of an applicant to every think of applying to program X and why wouldn't everyone at least try to get into their favorite program Y in it's tower on the hill. That kind of jackassery usually annoys EM people.

That said I hear what you're saying about tossing out a few good programs. I repeat that this usually goes better with some criteria to narrow it down because comparing two good programs that are as different as say Maine Medical and Grady are a bit useless. So here's a few I like although as I've said before my knowledge is really out of date:

UC Davis- My alma mater. Great faculty. An inner city blunt trauma heavy medical center in a great town where you can live near the hospital but not put bars on the windows. Good community experience.

Temple- My med school alma mater. Great faculty. Great PD, great chair who is nationally known. Hard core inner city penetrating trauma center with the depth of pathology only North Philly can provide. You can't live near the hospital but the city is really cool.

Einstien Med Ctr in Philly- Another hard core inner city Philly penetrating trauma heavy place like Temple (It's just up the road). Great faculty and PD. It started out as a DO program but is now dual accredited. It's 4 years and the first year counts as a general year for the DOs and that 5 state thing. If I was a DO I'd do anything to get this program. I'm an MD and I ranked it very highly (chose UCD over it based on geography).

I also really liked:

Wake Forest
Scott & White
Kalamazoo
Main Med Ctr
Vandy
 
...I repeat that this usually goes better with some criteria to narrow it down because comparing two good programs that are as different as say Maine Medical and Grady are a bit useless...
How about programs with a history of producing strong researchers and clinicians? In addition, where residents rotate through several different hospitals. Urban. EM runs trauma. Graduates -> academia. Preferably below the 40th parallel.

Don't care about: international med, wilderness med, 3 vs 4 yrs, size of residency class.
 
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You know what, I'll treat this one a bit differently.

I'll give you the top 5 programs I listed for my match, these are all programs I would be very very happy to be at and feel I'd get a great education for my own personal goals:

St Lukes Roosevelt
SUNY Stony Brook
University of Pittsburgh
SUNY Downstate
Christiana (in Delaware)
 
You know what, I'll treat this one a bit differently.

I'll give you the top 5 programs I listed for my match, these are all programs I would be very very happy to be at and feel I'd get a great education for my own personal goals:

St Lukes Roosevelt
SUNY Stony Brook
University of Pittsburgh
SUNY Downstate
Christiana (in Delaware)

I like this approach. FWIW, here were my top 5 (as i remember them, 2 yrs out):

Univ of Utah
Univ of Maine
Univ of New Mexico
OHSU
Highland
 
Whenever you start lists like this, it is pure conjecture on the part of largely ignorant people. In general, the longer a program has been around, the more well respected, and established it is. However, a good set of motivated attendings can and do put together solid programs with phenomenal training.

Really, the only person who can give an accurate assessment of a program is a person who trained at and graduated from that program. Realistically, that person should not currently be working there and have no stake in the success or failure of said program. Any other time, you are going to get biased, inaccurate information about a program. Usually, lists like this just contribute to self fulfilling prophecies whereby "Big Name Programs" get ranked higher on the list, purely because they are percieved by med students to be "Big Name Programs".

Invariably, you get an over-excited med student making either glowing remarks or scathing assessments about a program that they spent a few days at, or are basing their opinion on second-hand information gleaned from websites such as studentdoctor and scutwork.com.

The best advice I could give you is to decide where you would be willing to live, and apply to the programs in that area.

I totally agree with the bolded part above.
Most of the program "reviews" are from people who have limited to no first hand knowledge of a program. I do think some feedback on programs is very useful, but you have to know how the person formed this opinion. It would be great if some current and past residents, listed out some specific strengths and weaknesses; as well as criteria for what is important to look for in a program.

I do also understand why people want just a list. With so many programs out there, you can't realistically look at them all. You have to start somewhere.
 
when i was interviewing along the EM trail two years ago, my advisor, who was a former trauma chief at a large academic center made the argument that while EM got its start in "less known/lower tier" (at least by IM and surg) places that had ridiculous volume, now that EM has "come into its own"....and is seen by many other colleagues as a mature field, the traditional "powerhouse" academic institutions with high volume/acuity (such as UCSF, harvard MGH/brigham, cornell-columbia, hopkins) are going to slowly move the center of EM back to these areas and pull away from the earlier outstanding programs that got EM started. if you look at the demographics of where the residents come from for a traditional top program like denver, you see that the majority of those residents (nowadays) came from the midwest/southwest/rocky mountain area....way more parochial compared to 15 years ago, when EM people descended from around the world to train at denver. look at the where the residents at places like harvard (mgh/brig) come from and you see a huge range of diversity in terms of east/west/midwest. while i think the earliest programs that helped get our field up and running will always have a special place in the lore of the field, i believe that as our specialty comes into its own....you'll probably see the best academics come from the conventional big dogg hospitals....like penn, mgh, ucsf, etc. all of those places have outstanding medical schools, intelligent off service people, and high volume and acuity to provide the challenging environment to thrive in our field.

the big caveat of course is i'm talking about "academic EM" rrankings...for community EM perhaps the best places still are the programs that give you high volume and broad exposure. this can be done at many place far removed from the ivory tower of academic medicine
 
You know what, I'll treat this one a bit differently.

I'll give you the top 5 programs I listed for my match, these are all programs I would be very very happy to be at and feel I'd get a great education for my own personal goals:

I can't remember who I ranked 5th, so I'll give you my top 4:

Yale
Cincinnati
Michigan
Vanderbilt
 
I agree that giving the top of your rank list is useful so here was my southern flavored top 5:

1) Univ of Alabama in Birmingham
2) Vandy
3) Carolinas
4) UNC
5) UVa
 
my top 5 were:

1) Duke
2/ UTSW/Dallas
3/ UIowa
4) Wake Forest
5) Emory
 
So, as MANY people have stated, it's an individual thing. Why do you think your thread would be ANY different from any of the others?

This reminds me of what I tell patients several times a day. You've been to 15 different EDs around the state over the past 4 months, all for the same chronic complaint. Each time the EP tells you you need to see a specialist and that you won't find one in an ED. Yet you keep coming back just because the ED is "free" and the specialist demands payment.

You're lack of ability to pay doesn't equal an EP being a gynecologist/neurologist, etc. If you keep coming to the same place hoping for a different answer you're just beating a dead horse.

Similarly, your overwhelmingly neurotic need for a list of the top EM residences doesn't equal there actually being such a list. If you keep posting the same threads in the same forums hoping for a different answer you're beating a dead horse.

BTW, don't feel bad about being overwhelmingly neurotic. You're a medical student applying for a residency. It's expected. We were all there, too, and just as neurotic. It'll pass.

As for the top 5 list, I already posted mine further up.

Take care,
Jeff
 
Ditto what is being echoed. This has been answered many many many times. The answer is pretty much always the same: there is no 'top' list. If you go back and read the threads, you will see why. There are lots of reasons why there isn't a magical top ten list. Because there is no such thing. Each person is going to have different priorities.

And please view comments on RRC and emergency medicine.
 
RxnMan,

You might want to check out Henry Ford. It has a big 95K/year ED, rotate through a couple of smaller community hospitals (one in Oahu), EM residents run traumas and get all procedures during trauma, and lots of grads going into academics. Manny Rivers and H. Bryant Nguyen trained there, for starters. It is unfortunately north of the 40th, but is only 3 years long and the winters aren't *that* bad.
 
Man, I have to think just to remember where I interviewed once upon a time. My rankings were all based on geography - which is hysterically ironic, because I ended up scrambling to a place that could not be further away from everyone I wanted to be close to. Yay.

I think it was:
1. OHSU
2. Stanford
3. UCSD
4. Harbor-UCLA
5. UCLA/OV

Now that I'm where I am...it feels like even more of an impossible task to compare programs, and there are so many factors that work into whether you're a good fit somewhere, and most of those issues aren't things you could possibly even recognize as a 4th year medical students. I'd still pick based on location/non-program-related factors and just make the best of wherever you are, because all the opportunities are there for you everywhere.
 
This was my top rank-list:

1. Vanderbilt
2. Mayo
3. Utah
4. Rochester New York
5. New Mexico

(Yes, I flew all over the place)

The common theme for me was smaller cities. I had a family at the time and was looking for places that might be a little more affordable, and less likely to get shot in.

This all ended up being useless for me as well, as I matched at my number 9 choice (That was a kick in the nuts). In retrospect, I'm really happy that I trained at the place I did. I don't think a better fit would have been possible.
 
my rank list last year:
1. Christ
2. Carolinas
3. UCSF
4. USC
 
University of South Florida #1

and some other programs I can't think of right now...🙂
 
The best residency is the one you work at. Because if you don't get one, it sucks more than working at a ****ty one. Trust me on this. 3 years at a place you graduate from is infinitely better than a lifetime of settling for "something else".
Also, go where it's warm.
 
The best residency is the one you work at. Because if you don't get one, it sucks more than working at a ****ty one. Trust me on this. 3 years at a place you graduate from is infinitely better than a lifetime of settling for "something else".
Also, go where it's warm.

No way! Winter is awesome.
 
Similarly, your overwhelmingly neurotic need for a list of the top EM residences doesn't equal there actually being such a list. If you keep posting the same threads in the same forums hoping for a different answer you're beating a dead horse.

BTW, don't feel bad about being overwhelmingly neurotic. You're a medical student applying for a residency. It's expected. We were all there, too, and just as neurotic. It'll pass.

As for the top 5 list, I already posted mine further up.

Take care,
Jeff

I'm amazed how much flak people get for just asking this question. Yes yes, we all know the standard line "the best program is the one that is a good fit for you" and "well a top 5 list will get you nowhere."

At the same time, you're all being remarkably disingenuous if you're saying that all programs are equal and the only diference is fit!

There has to be SOME objective criteria to stratify SOME of the programs. I'm sure there are some red flags that should potentially warn you away from some programs, and sure that there are some reliable markers of excellence.

We all realise that noone is going to hand us some reliable ranking list, but we're all looking for some things to differentiate all of these programs that we're still learning about.

It's not easy to tell what's going to be a great fit for you in the course of a 6 hour interview day, a dinner and maybe a second look day, so anything objective would help.
 
...There has to be SOME objective criteria to stratify SOME of the programs. I'm sure there are some red flags that should potentially warn you away from some programs, and sure that there are some reliable markers of excellence.

We all realise that noone is going to hand us some reliable ranking list, but we're all looking for some things to differentiate all of these programs that we're still learning about.

It's not easy to tell what's going to be a great fit for you in the course of a 6 hour interview day, a dinner and maybe a second look day, so anything objective would help.
Objective criteria - location, pay, COL, board pass rate, numbers of graduates going on to fellowship, going to academic place X, going into PP, etc.

Red flags - Most people on this forum are not *that* anonymous. Most residents have a problem with coming forward to say something bad about a program they're in - if the program finds out or loses accreditation, the resident is screwed. And programs that were bad in the past may not be now.

One can talk about things to look out for on the trail that may be indicative of bad traits in a program, and you're the first person to ask for that. I would be interested in knowing those myself.
 
RxnMan,

You might want to check out Henry Ford. It has a big 95K/year ED, rotate through a couple of smaller community hospitals (one in Oahu), EM residents run traumas and get all procedures during trauma, and lots of grads going into academics. Manny Rivers and H. Bryant Nguyen trained there, for starters. It is unfortunately north of the 40th, but is only 3 years long and the winters aren't *that* bad.
I've looked into Henry Ford, and it's on the list. It probably wouldn't be just 3 years as CC training is also in consideration (thank you KG).

BTW, good choice of screen name - a true genius, father of all things electrical. Also a nutball. The battle over AC/DC is a fascinating part of US history.

Or it could be after the band which is cool too, I guess (never listened to them).
 
I'm amazed how much flak people get for just asking this question. Yes yes, we all know the standard line "the best program is the one that is a good fit for you" and "well a top 5 list will get you nowhere."

At the same time, you're all being remarkably disingenuous if you're saying that all programs are equal and the only difference is fit!

There has to be SOME objective criteria to stratify SOME of the programs. I'm sure there are some red flags that should potentially warn you away from some programs, and sure that there are some reliable markers of excellence.

We all realize that no one is going to hand us some reliable ranking list, but we're all looking for some things to differentiate all of these programs that we're still learning about.

It's not easy to tell what's going to be a great fit for you in the course of a 6 hour interview day, a dinner and maybe a second look day, so anything objective would help.


As I said before the problems with asking about "the best program" has more to do with the pretentiousness of it and the usual resulting crap hurling that follows. That tornado of feces is always heavily laden with ignorance and suppositions and is troll bait.

That said the stuff about fit is actually pretty important. Just to use my program as an example so that I'm not calling anyone else out (that'd be UC Davis) it is generally agreed upon as being an excellent program. There were other residents I encountered who were excellent candidates and matched in this excellent program. However excellent candidate + excellent program did not equal happiness, global domination and Marcus Welby in the ER. A few (very few but a few) really would have done better to look for a place that fit them better. Everyone involved would have been happier.

So look, I'm telling you, everyone on the board who has been through the process is telling you and especially the EM faculty are telling you: fit matters.
 
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At the same time, you're all being remarkably disingenuous if you're saying that all programs are equal and the only diference is fit!

Nobody said all programs are equal. I'm pretty sure we've been saying the opposite all along. There is a diversity of programs, that is clear. What you're failing to realize is that what may suck for you may be my top pick.

It's not easy to tell what's going to be a great fit for you in the course of a 6 hour interview day, a dinner and maybe a second look day, so anything objective would help.

I understand it isn't easy. It is one of the most stressful parts of your whole journey toward attendinghood. Everyone realizes this (well, at least all of us who've been through it). Again, I understand very well the need and desire for a list of top programs. Please understand what we're saying:

Your need for a list doesn't mean there actually is such a list. At least not a reliable one.

I wish you well as you prepare your list. I'll even toss in a recommendation that worked well for me while preparing mine.

Shiner Bock + a hobby.

What the hell, it wasn't like I was doing anything else productive during 4th year. 🙂

Take care and good luck,
Jeff
 
I should preface this by saying I have little idea what I am talking about, and there are a ton of great programs. I am junior in the field and did not interview at all of these. That said, in no particular order:

Highland
Harbor
Denver
Cincinatti
Vanderbilt
Pitt
BIDMC
Cook
Carolinas
Indiana
Hennepin

Very different programs with different styles but always seem to come up when I ask faculty about places. Take it or leave it.

Great list. It DOES matter where you train. You must have great attendings, large patient volumes AND autonomy as a resident. You have to work ALOT as a resident if you want to be good taking care of patients. If as a resident you aren't allowed to really act like a junior attending, you will pale in comparison to your future colleagues who did.
 
Your right. It does matter where you train. It matters that you find a program that fits you, that has the right mixture of things that are important to you.

Unlike other fields, the RRC for emergency medicine is VERY strict. It is one of the major reasons that unlike surgery or IM or even FP, when it comes to the core EM training, there isn't that much difference.

its why, as an EM applicant, you can really focus on those subtler yet incredibly important things like fit, location etc.

Truth of the matter? there is no magic program that is going to gaurantee success (again, nebulously defined! does that mean academics? being a director in 5 years? working part time in vail? ) What will give you the best leverage? Picking a program that you are happy at, that has people that are doing interesting things and support thier residents. Why? because if you are happy and faculty are happy, you will do things. (ie your CV will grow) and this is what ultimately will get you where you want to be.
 
Nobody said all programs are equal. I'm pretty sure we've been saying the opposite all along. There is a diversity of programs, that is clear. What you're failing to realize is that what may suck for you may be my top pick.



I understand it isn't easy. It is one of the most stressful parts of your whole journey toward attendinghood. Everyone realizes this (well, at least all of us who've been through it). Again, I understand very well the need and desire for a list of top programs. Please understand what we're saying:

Your need for a list doesn't mean there actually is such a list. At least not a reliable one.

I wish you well as you prepare your list. I'll even toss in a recommendation that worked well for me while preparing mine.

Shiner Bock + a hobby.

What the hell, it wasn't like I was doing anything else productive during 4th year. 🙂

Take care and good luck,
Jeff



Actually, I'm not one of the ones requesting a list. I understand why people are having a hard time coming up with that. I also get that the best program for one person isn't going to be great for everyone.

What I'm not getting is the hostility that asking the question has engendered, and with a few exceptions, the lack of "these are things that you might want to consider in finding a program that is a good fit, and here are potential red flags to look for to indicate their program may not be for you."

My apologies if my opinion is coming across so one dimensionally.
 
What I'm not getting is the hostility that asking the question has engendered, and with a few exceptions, the lack of "these are things that you might want to consider in finding a program that is a good fit, and here are potential red flags to look for to indicate their program may not be for you."

I suspect the reason you see the responses you see is that, after several years and several interview seasons of the same questions and lots of answers, it just gets old. Sort of like explaining to mom why the 101 fever in her viral infested yet otherwise healthy child isn't going to kill them and should be treated symptomatically. After the 900th time, it gets a bit stale.

I grant you it isn't stale for the applicant (nor the mom), yet is it still stale for us. Not a great answer, I'll grant you, but at least an honest one.

Take care,
Jeff
 
I am probably wrong, but when I read these posts, or ones similiar--that try to "rank" something that is essentially unrankable, I understand that there are many different factors and reasons that go into choosing a residency; which lead to the essential failure of these threads. However, it seems to me that it is not that an individual is trying to apply, or match into, the absolute best programs they can, but rather to gage competitiveness of thier application. An average applicant may want to apply to a few "reach" progams, a few "average" programs and a few "safety" programs. With the information that is out there, it seems difficult to estimate your chances, to know where a program stands. I think people are simply trying to apply "smarter" and seem to be hit with some resistance here. Just a guess from an M2. Good reading, none the less.
 
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