Hmm. OK, no love for my thread. I guess I will just let you all know what I'm thinking.
BIDMC positives: Nice call schedule, good amount of autonomy with upper level backup, great computer system, great emphasis on house staff education, affiliated with HMS, in Boston (I'm already in Boston so wouldn't have to move if I match there.)
BIDMC negatives: "lesser" of the HMS hospitals based on reputation (but does this translate to teaching, etc?), small-ish hospital, less of the population I want to work with.
Columbia positives: NYC!!, reputation I think may be better than BIDMC? (do you agree?), Good fellowship placement, patient population I like
Negatives: ancillary staff not that great, a little too much autonomy for my liking during intern year.
guess a lot of people this year are struggling with where to rank the BI. i'm no exception. however, i think too much stock is being placed on the BI being the "lesser" of the harvard hospitals. if you put just about any hospital in the country next to the brigham and mgh, it would be the "lesser" of the 3 hospitals as well. the BI has a great reputation in its own right and countless faculty members have commented to me that the BI produces "excellent" physicians.
i wouldn't underestimate the impact of poor ancillary services can have on your training. not only does it provide for poor patient care (i.e., finding your patient in respiratory decompensation with their last vital sign check 4 hours ago when you ordered them to be q 1, etc.) but the daily battle with nursing just gets in the way of your education and adds unneccessary stress. i'm having a hard time deciding to rank the NYC programs at all b/c of this.
as far as fellowship goes, if you're a good resident in any top academic program, you'll have no problem getting a fellowship as i've been told. i think many would agree that training at the BI will not close any doors that columbia would have opened otherwise (all else being equal).
I didn't look at Columbia, but I interviewed out at the BI and had some concerns before I visited. Luckily I ran into some nice HMS students who took the time to chat with me about this. I also spent a lot of time talking with residents, who were amazing people. It sounds like the Beth Israel and Deaconess merger in the 1990's was a train wreck and really damaged the place for a while, but things seem well put together now.
- yes, it's the "lesser" of the 3 Harvard hospitals, but so is almost everywhere else compared to BWH and MGH. It's in the top 3 of NIH funding to hospitals in the US (guess who the other two are...yup, BWH and MGH), and if BIDMC were a medical school it would be in the top 10 of NIH funding.
- Ancillary and nursing services seem to be among the best in the East Coast. From what I've seen, ancillary services in NYC tend to be atrocious compared to other places
- some of the HMS students explained that each hospital has it's own niche, and we've all heard how BWH is the warmer and fuzzier of the 3, and MGH is a little more hard core. These are debatable, but it seems BIDMC has staked its residency reputation on teaching. Teaching may not be sexy, and it's hard to judge (but BID faculty have won the most teaching awards from HMS), but would you prefer to be rounding with a world famous researcher who knows jack about clinical medicine and may not be able to teach, or somebody who's made it his/her career to teach? The famous researchers have their place, but I'm going to residency for the teaching primarily (despite my research focus). I definitely do not think great research or reputation necessarily translates into great teaching. I was impressed with the formal resources BID has in place to develop teachers. If I wanted a career focused on medical education I think BID would have to be one of my top picks in the country, hands down.
- Private patients are a drawback. The number of privates is decreasing considerably with the growing hospitalist movement, but you still work with private attendings.
- Are the residents upset in any way that they're the "lesser" of the 3 programs? Not that I could tell, and I asked a lot of residents. I think the MGH and BWH residents look better on paper and their match lists are better, but the BID residents were among the friendliest, warmest, and supportive group I've seen anywhere. I'm not sure I'm cool enough to join such a group!
- one of the best EMRs anywhere
- BID's call schedule is probably the "cushiest" (read: most humane) in Boston.
- BID has an awesome Chair and a great PD.
- Three words: "House of God." One of the characters was pointed out to me during my tour. Need I say more?
I feel fortunate to have interviewed at some good places. BID is clearly one of the places that I could go and be very happy, productive, and move on to the next stage of my career a a better doctor. I felt lucky when I got my BID interview, but after seeing the place I felt really lucky to even be considered!