Cornell versus MGH for psychiatry training

[saxboychair1]

Hi guys, I am trying to build my psychiatry residency rank list right now. Cornell and MGH are both at the top of my list. I think both would have strong opportunities for psychotherapy training which is important to me, as well as opportunities for mentorship in my areas of interest.

I would really like to live in NYC both for the diverse patient population and because it seems like a great city to experience, especially for a defined time of the four years of residency. However I am struggling in terms of the prestige difference between MGH and Cornell. Do you think that there is a substantial difference between the two, and will it impact future career options down the line? Am I giving up too good of an opportunity by not ranking MGH 1?

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[psyspy]

What were your stats lol

 

[comp1]

Psych jobs are not hard to get. I think you'll be more than fine with either and unless you have some bizarrely specific niche thing you want to do that only one of them has, it's not going to matter. Maybe base it on the quality of resident life?

 

[Celexa]

First, 'prestige' really only matters if you're going for an academic career.

Second, the difference between the 'prestige' those two programs is going to be largely meaningless, if you even perceive there to be one.

I would base your decision on where you want to live (both short and long term), the people you'll be working with, and the learning opportunities you'll have.

I say this as someone who did not rank MGH first on my list. I have no regrets. Don't let other peoples perceptions color your own values in making your rank list. There's a lot of people who need the prestige of certain institutions for their ego function. In no small part that's why the salaries are worse at those places. If the name isn't serving a very specific purpose for you (ie, getting your grants funded), it has very little meaning.

 

[TexasPhysician]

Both are good programs. Neither will effect your job prospects which are great regardless.

I’d argue that historically, you can’t beat MGH. If you want a low paying academic career, I’d consider MGH over Cornell.

I like Boston better, so location Id choose MGH.

If psychotherapy is your goal, I’d probably rank Cornell higher.

 

[Dr. ADT]

MGH

 

[saxboychair1]

Thanks for the really helpful replies so far! I definitely appreciate the point about prestige for ego function. I think I will double check that both institutions will have good mentors for me in the area I'm focused in on, and then make my choice based off the factors y'all described like quality of life and city preference among other things.

 

[Monocles]

Prestige is stupid. Unless you are dead set on academics (even then it's questionable whether or not you need it) or have high aspirations to be a "future leader of psychiatry" (whatever that means) then it doesn't matter whether you choose MGH vs Cornell.

It sounds like you prefer NYC. If you have family or social support there I would absolutely recommend Cornell over MGH. Residency is hard and you'll need all the support you can get.

Also, prestige aside if you find that you really want a strong psychotherapy experience, why not looking into Cambridge Health Alliance? Sure they are not "Man's Greatest Hospital" but they are also harvard affiliated and I would argue probably offer the best work-life balance out of all the harvard residencies.

 

[silkrhodescholar]

Hi guys, I am trying to build my psychiatry residency rank list right now. Cornell and MGH are both at the top of my list. I think both would have strong opportunities for psychotherapy training which is important to me, as well as opportunities for mentorship in my areas of interest.

I would really like to live in NYC both for the diverse patient population and because it seems like a great city to experience, especially for a defined time of the four years of residency. However I am struggling in terms of the prestige difference between MGH and Cornell. Do you think that there is a substantial difference between the two, and will it impact future career options down the line? Am I giving up too good of an opportunity by not ranking MGH 1?

I have a different take. I'll try to be as real as possible. I interviewed at Cornell, but ended up training at MGH.

Disagree strongly with the "prestige doesn't matter" or "prestige is stupid crowd" because they are only 90% right. A lot of their opinions seem like cope because they didn't train at an elite place or have some sort of psychological hang up about prestige. Prestige is a very real thing, but it doesn't matter for 90% of psychiatrists who work in community, hospital, or privately in most cities. In my opinion prestige matters in the two scenarios below

1) Niche Academia: Access to experts, funding, other peripheral benefits. I'm not in academia because the pay is horrible. Most of the people I know or trained with who do full time academia are either married to other doctors or someone wealthy, too autistic to care about money, or come from a wealthy family/have a trust fund.

2) High End Private Practice: If you want to run a full cash based ($500 or more) an hour private practice in a major city (NYC, Boston, LA, Miami) then prestige absolutely does matter because Prestige= marketing. Anyone who is skilled in marketing and consumer psychology knows this. Most ultra high net worth people who go to private and concierge practices are prestige and status conscious. I don't necessarily think that training at Harvard or Cornell makes you that much better of psychiatrist in practice. In fact I know some pretty average people at MGH and I know some brilliant psychiatrists who trained at state school affiliated medical centers. However, most cliental assume that because you have Harvard by your name that translates to better results/care. Harvard/MGH is a more prestigious brand than Cornell I know a lot of people here will disagree with this take, but I've seen it up close personally and with colleagues and have absolute conviction it is true. There is a reason why luxury goods (Gucci shirts, Rolex watches, sports cars, etc) are a separate market than 90% of consumer goods. It is not that functionally they are that much better, but that there is a certain group that perceives it as such. People who pay that much for mental health care want to perceive that they are getting the best. Absent of any other data will choose the person with the better brand training than the other person. So

FYI: when I lived in a major city I did 20 hours of a week of this type of practice. When I started a family I moved out of the city to a small coastal community and closed this practice to work at a community hospital where I make the same as a guy who trained at a unknown IMG factory. It was a personal values (family) > money decision and I'm very happy.

 

[Mad Jack]

I have a different take. I'll try to be as real as possible. I interviewed at Cornell, but ended up training at MGH.

Disagree strongly with the "prestige doesn't matter" or "prestige is stupid crowd" because they are only 90% right. A lot of their opinions seem like cope because they didn't train at an elite place or have some sort of psychological hang up about prestige. Prestige is a very real thing, but it doesn't matter for 90% of psychiatrists who work in community, hospital, or privately in most cities. In my opinion prestige matters in the two scenarios below

1) Niche Academia: Access to experts, funding, other peripheral benefits. I'm not in academia because the pay is horrible. Most of the people I know or trained with who do full time academia are either married to other doctors or someone wealthy, too autistic to care about money, or come from a wealthy family/have a trust fund.

2) High End Private Practice: If you want to run a full cash based ($500 or more) an hour private practice in a major city (NYC, Boston, LA, Miami) then prestige absolutely does matter because Prestige= marketing. Anyone who is skilled in marketing and consumer psychology knows this. Most ultra high net worth people who go to private and concierge practices are prestige and status conscious. I don't necessarily think that training at Harvard or Cornell makes you that much better of psychiatrist in practice. In fact I know some pretty average people at MGH and I know some brilliant psychiatrists who trained at state school affiliated medical centers. However, most cliental assume that because you have Harvard by your name that translates to better results/care. Harvard/MGH is a more prestigious brand than Cornell I know a lot of people here will disagree with this take, but I've seen it up close personally and with colleagues and have absolute conviction it is true. There is a reason why luxury goods (Gucci shirts, Rolex watches, sports cars, etc) are a separate market than 90% of consumer goods. It is not that functionally they are that much better, but that there is a certain group that perceives it as such. People who pay that much for mental health care want to perceive that they are getting the best. Absent of any other data will choose the person with the better brand training than the other person. So

FYI: when I lived in a major city I did 20 hours of a week of this type of practice. When I started a family I moved out of the city to a small coastal community and closed this practice to work at a community hospital where I make the same as a guy who trained at a unknown IMG factory. It was a personal values (family) > money decision and I'm very happy.

And yet the prestigious academic places seem to be quite keen on taking people I trained with in the sticks lately because few that train in prestigious institutions seem to have the poor sense to take the pay cut required to stay there at graduation, but people lacking in pedigree seem drawn to fancy appointments like moths to flame. For high-end private practice and working your way to the very top of the academic ladder you will be better served with shiny credentials, but even then your path is far from guaranteed.

 

[Monocles]

Disagree strongly with the "prestige doesn't matter" or "prestige is stupid crowd" because they are only 90% right. A lot of their opinions seem like cope because they didn't train at an elite place or have some sort of psychological hang up about prestige.

Oh piss off with that. I've been in the bloody harvard system for 7 years and I'm current mass gen faculty. I'll double down and die waving the flag that prestige is utter ****e

 

[TexasPhysician]

Oh piss off with that. I've been in the bloody harvard system for 7 years and I'm current mass gen faculty. I'll double down and die waving the flag that prestige is utter ****e

Only a Harvard faculty would look down upon others using the British slang of a curse word. Lol

 

[G Sheb]

I have a different take. I'll try to be as real as possible. I interviewed at Cornell, but ended up training at MGH.

Disagree strongly with the "prestige doesn't matter" or "prestige is stupid crowd" because they are only 90% right. A lot of their opinions seem like cope because they didn't train at an elite place or have some sort of psychological hang up about prestige. Prestige is a very real thing, but it doesn't matter for 90% of psychiatrists who work in community, hospital, or privately in most cities. In my opinion prestige matters in the two scenarios below

1) Niche Academia: Access to experts, funding, other peripheral benefits. I'm not in academia because the pay is horrible. Most of the people I know or trained with who do full time academia are either married to other doctors or someone wealthy, too autistic to care about money, or come from a wealthy family/have a trust fund.

2) High End Private Practice: If you want to run a full cash based ($500 or more) an hour private practice in a major city (NYC, Boston, LA, Miami) then prestige absolutely does matter because Prestige= marketing. Anyone who is skilled in marketing and consumer psychology knows this. Most ultra high net worth people who go to private and concierge practices are prestige and status conscious. I don't necessarily think that training at Harvard or Cornell makes you that much better of psychiatrist in practice. In fact I know some pretty average people at MGH and I know some brilliant psychiatrists who trained at state school affiliated medical centers. However, most cliental assume that because you have Harvard by your name that translates to better results/care. Harvard/MGH is a more prestigious brand than Cornell I know a lot of people here will disagree with this take, but I've seen it up close personally and with colleagues and have absolute conviction it is true. There is a reason why luxury goods (Gucci shirts, Rolex watches, sports cars, etc) are a separate market than 90% of consumer goods. It is not that functionally they are that much better, but that there is a certain group that perceives it as such. People who pay that much for mental health care want to perceive that they are getting the best. Absent of any other data will choose the person with the better brand training than the other person. So

FYI: when I lived in a major city I did 20 hours of a week of this type of practice. When I started a family I moved out of the city to a small coastal community and closed this practice to work at a community hospital where I make the same as a guy who trained at a unknown IMG factory. It was a personal values (family) > money decision and I'm very happy.

I agree with some of this, but I disagree that marketing is the most important part of PP. I am affiliated with one of those 'ZoMg elite institutions in a big city' and the biggest names don't do any marketing or branding. They don't even have websites. They get tons of referrals and most of the heavyweight referrals are essentially an inside job. I also think in general reputation trumps name.

Even if OP wants to do PP, if he is interested in working in NYC in the future, I would actually recommend Cornell. Getting an edge on the market, connections with all the important people in the NYC market (which is dominated by the big four in the city) trumps the Harvard name. Both Cornell and Columbia are seen almost on equal footing and they have an edge over the other two, and Cornell has even the better location. For NYC, Cornell is top notch. And btw I despise the brooding elitism in those institutions, but this is how it is.

In general, I totally agree that prestige in itself is absolutely not worth it. Unless you're passionate about it, academic jobs suck, and as another poster mentioned, if you want to be assistant clinical professor at x institution, you can probably get it from anywhere. The job market is so good out there. Prestige can be a tool to get what you want, but it's only useful in a very few cases, as even your case shows.

 

[Celexa]

Oh piss off with that. I've been in the bloody harvard system for 7 years and I'm current mass gen faculty. I'll double down and die waving the flag that prestige is utter ****e

Hahaha love this. I can't get much more specific about my credentials without being more identifiable than I want to be but.... Yeah. I ain't saying prestige has little meaning in the long term for most people out of jealously.

It is true that the above poster names the areas in which it can matter. Namely, research academics and the hoity-toitiest of cash pay practices. If you want to be a clinical person at these places and be paid much less, you as Mad Jack said you can come in from much less 'prestigous' places bc it's not actually easy to hire people for more work and less money. I see this first hand.

Regarding high end cash practice, I doubt very much that the MGH name would trump the local advantage of Cornell in the NYC area. And you also would need to decide if that particular slice of clientele is worth catering to when with a decent hustle anyone can get a good cash practice going.

I also will die on the hill that unless you can point to something VERY SPECIFIC that the name of an institution will get you, other factors outweigh it in nearly every dimension of decision making.

(one of those very specific things is getting grants funded. Sad fact of life. But so few people are actually on that path, and even for them the presence of the right mentor usually trumps the relative power of the name)

 

[Psychresy]

Hahaha love this. I can't get much more specific about my credentials without being more identifiable than I want to be but.... Yeah. I ain't saying prestige has little meaning in the long term for most people out of jealously.

It is true that the above poster names the areas in which it can matter. Namely, research academics and the hoity-toitiest of cash pay practices. If you want to be a clinical person at these places and be paid much less, you as Mad Jack said you can come in from much less 'prestigous' places bc it's not actually easy to hire people for more work and less money. I see this first hand.

Regarding high end cash practice, I doubt very much that the MGH name would trump the local advantage of Cornell in the NYC area. And you also would need to decide if that particular slice of clientele is worth catering to when with a decent hustle anyone can get a good cash practice going.

I also will die on the hill that unless you can point to something VERY SPECIFIC that the name of an institution will get you, other factors outweigh it in nearly every dimension of decision making.

(one of those very specific things is getting grants funded. Sad fact of life. But so few people are actually on that path, and even for them the presence of the right mentor usually trumps the relative power of the name)

What about if one wants to do cash pp but is coming from way out of region? I go to a solid mid tier Univ program. If I stayed in this region I'd do very well but I want to go home to Los Angeles after graduation. Wondering if it would make sense to do a year at UCSF or UCLA to network and have the attached name.

 

[silkrhodescholar]

Oh piss off with that. I've been in the bloody harvard system for 7 years and I'm current mass gen faculty. I'll double down and die waving the flag that prestige is utter ****e

"Looks don't matter" -Cindy Crawford
"Wealth is overrated" -Jeff Bezos

Why is it that people with the very most of something desirous find virtue in denying that it is important?

But seriously I'm not trolling. Are you in academia or run a high end cash practice of substantial size? Have you ever worked in any other institutions or cities outside the Boston academia bubble? I have. The OP asked for advice so I'm trying in good faith to give it because I want young doctors to make it and be aware of all the options. I think it is either disingenuous or naive to suggest that prestige doesn't matter at all or in any situation. When I was training at MGH I got some good/some bad advice from faculty there. It was useful to talk to people practicing outside the bubble to get more data and have a more fully formed and less biased opinion. I'm not really interested in debating the point because I'm not personally invested in being perceived as right. DM's are always open to young trainees trying to find their way in the game.

 

[silkrhodescholar]

Hahaha love this. I can't get much more specific about my credentials without being more identifiable than I want to be but.... Yeah. I ain't saying prestige has little meaning in the long term for most people out of jealously.

It is true that the above poster names the areas in which it can matter. Namely, research academics and the hoity-toitiest of cash pay practices. If you want to be a clinical person at these places and be paid much less, you as Mad Jack said you can come in from much less 'prestigous' places bc it's not actually easy to hire people for more work and less money. I see this first hand.

Regarding high end cash practice, I doubt very much that the MGH name would trump the local advantage of Cornell in the NYC area. And you also would need to decide if that particular slice of clientele is worth catering to when with a decent hustle anyone can get a good cash practice going.

I also will die on the hill that unless you can point to something VERY SPECIFIC that the name of an institution will get you, other factors outweigh it in nearly every dimension of decision making.

(one of those very specific things is getting grants funded. Sad fact of life. But so few people are actually on that path, and even for them the presence of the right mentor usually trumps the relative power of the name)

Agree with this point. Local networks matter a lot. Sometimes regional brands/prestige can be more powerful than national brand/prestige. I'm not an NYC person, but my peers who practice there say the Cornell network is very strong and get a lot of referrals through it. Agree with other factors sometimes dictating outcomes. If you are truly a hustler, have insane work ethic, and people skills you'll likely overcome most training prestige limitations anywhere you go.

 

[Celexa]

What about if one wants to do cash pp but is coming from way out of region? I go to a solid mid tier Univ program. If I stayed in this region I'd do very well but I want to go home to Los Angeles after graduation. Wondering if it would make sense to do a year at UCSF or UCLA to network and have the attached name.

A short stint to build up a network is potentially a good reason to drop anchor at a name for a little while. Just don't let on you view them as a stepping stone at the time of interview, haha. And read your contract and the likely non-compete very carefully. There might also be part time or hourly opportunities that would allow you to build a cash practice on the side under a different contract than the full timers have.

Others would definitely be in a better position to speak to how much additional hustle would be needed starting a cash pay practice without local knowledge or networks. I'm sure it can still be done with the proper application of effort.

 

[silkrhodescholar]

What about if one wants to do cash pp but is coming from way out of region? I go to a solid mid tier Univ program. If I stayed in this region I'd do very well but I want to go home to Los Angeles after graduation. Wondering if it would make sense to do a year at UCSF or UCLA to network and have the attached name.

I have a few friends who practice in LA full-time in cash practices ($500k-$1million +) a year. LA is at very status/brand sensitive place as you would imagine. If you don't have a high status pedigree either locally (UCSF, UCLA, Stanford) or nationally (Harvard, Columbia, Yale, etc) then you should probably figure out how to get it. Most fellowships except for child psych are poor economic decisions due to the opportunity costs or the relative lack of salary increase with the training. The two easiest ways that come to mind are try to get a low paying faculty position at UCLA so you can say you are "on staff at UCLA" and build the practice on the side. Not sure how UCLA teaching faculty works but you could probably look into teaching lectures at the residency or medical school just to say you are on the "teaching faculty at UCLA". In Boston there are a lot of people in high end private (some of which you have no idea who they are) teach 1-2 hours a semester at the various Harvard hospitals just to say "Clinical Instructor of Psychiatry at Harvard Medical School" on their websites. Signaling and marketing is not always about competence or objective value.

 

[saxboychair1]

Wow, really helpful discourse, I am very much appreciating this thoughtful dialogue. Regarding cash pp, I am not sure if I want to do that yet but it's a possibility on the horizon. I am not really interested in the research/academic ladder longer term. I guess I have two related questions based off what you all have shared:

1) For a private practice, do you think the Cornell brand would not have enough sway outside the NYC region and/or the intuitional inside referrals would be wasted if I left NYC? I am interested in NYC for residency but not sure yet if I would want to stay there longer term. In that case if I moved back home to LA and wanted to set up a pp would the Cornell name not hold the same weight? And in the reverse, if I were to rank for example UCLA #1 but go East Coast for an attending job/pp, does that brand not set me up well enough on the East?

2) Somewhat tangential but related to cash practice, is it possible to set one up so that you can see poorer/underserved patients too (ie with a sliding scale)? Like charge some patients the full amount but for patients who can't pay charge like $50 or something? Do people do this in real life/is it possible?

This is kind of hard for me because I'm trying to gauge the cultural impact of name brand to a degree but you guys are definitely helping. Thanks again for the amazing responses.

 

[Celexa]

Wow, really helpful discourse, I am very much appreciating this thoughtful dialogue. Regarding cash pp, I am not sure if I want to do that yet but it's a possibility on the horizon. I am not really interested in the research/academic ladder longer term. I guess I have two related questions based off what you all have shared:

1) For a private practice, do you think the Cornell brand would not have enough sway outside the NYC region and/or the intuitional inside referrals would be wasted if I left NYC? I am interested in NYC for residency but not sure yet if I would want to stay there longer term. In that case if I moved back home to LA and wanted to set up a pp would the Cornell name not hold the same weight? And in the reverse, if I were to rank for example UCLA #1 but go East Coast for an attending job/pp, does that brand not set me up well enough on the East?

2) Somewhat tangential but related to cash practice, is it possible to set one up so that you can see poorer/underserved patients too (ie with a sliding scale)? Like charge some patients the full amount but for patients who can't pay charge like $50 or something? Do people do this in real life/is it possible?

This is kind of hard for me because I'm trying to gauge the cultural impact of name brand to a degree but you guys are definitely helping. Thanks again for the amazing responses.

In a cash practice where you don't take insurance you can do basically whatever you damn well please*. You certainly could offer sliding scale to a select group of patients if you wanted to.


*there are some weird rules about Medicare patients. which I am not expert enough to speak to.

 

[calvnandhobbs68]

I have a few friends who practice in LA full-time in cash practices ($500k-$1million +) a year. LA is at very status/brand sensitive place as you would imagine. If you don't have a high status pedigree either locally (UCSF, UCLA, Stanford) or nationally (Harvard, Columbia, Yale, etc) then you should probably figure out how to get it. Most fellowships except for child psych are poor economic decisions due to the opportunity costs or the relative lack of salary increase with the training. The two easiest ways that come to mind are try to get a low paying faculty position at UCLA so you can say you are "on staff at UCLA" and build the practice on the side. Not sure how UCLA teaching faculty works but you could probably look into teaching lectures at the residency or medical school just to say you are on the "teaching faculty at UCLA". In Boston there are a lot of people in high end private (some of which you have no idea who they are) teach 1-2 hours a semester at the various Harvard hospitals just to say "Clinical Instructor of Psychiatry at Harvard Medical School" on their websites. Signaling and marketing is not always about competence or objective value.

Yeah a lot of places will give you some kind of status for just giving some lectures at the med school/residency (I know that happened for sure at the places I went for med school/residency/fellowship), which people will utilize just for that reason, to say you're a "clinical associate/instructor" or something at "big name med school/hospital". It's not actually a bad tradeoff for a few hours of your time every year.

 

[Celexa]

Yeah a lot of places will give you some kind of status for just giving some lectures at the med school/residency (I know that happened for sure at the places I went for med school/residency/fellowship), which people will utilize just for that reason, to say you're a "clinical associate/instructor" or something at "big name med school/hospital". It's not actually a bad tradeoff for a few hours of your time every year.

Also can sometimes be used for access to uptodate and the university library... Def worth a few hours of teaching a year.

 

[G Sheb]

Wow, really helpful discourse, I am very much appreciating this thoughtful dialogue. Regarding cash pp, I am not sure if I want to do that yet but it's a possibility on the horizon. I am not really interested in the research/academic ladder longer term. I guess I have two related questions based off what you all have shared:

1) For a private practice, do you think the Cornell brand would not have enough sway outside the NYC region and/or the intuitional inside referrals would be wasted if I left NYC? I am interested in NYC for residency but not sure yet if I would want to stay there longer term. In that case if I moved back home to LA and wanted to set up a pp would the Cornell name not hold the same weight? And in the reverse, if I were to rank for example UCLA #1 but go East Coast for an attending job/pp, does that brand not set me up well enough on the East?

2) Somewhat tangential but related to cash practice, is it possible to set one up so that you can see poorer/underserved patients too (ie with a sliding scale)? Like charge some patients the full amount but for patients who can't pay charge like $50 or something? Do people do this in real life/is it possible?

This is kind of hard for me because I'm trying to gauge the cultural impact of name brand to a degree but you guys are definitely helping. Thanks again for the amazing responses.

Cornell is a big name and well known everywhere. I mean frankly the whole 'branding' thing has little to do with how good the residency program is, but more about how well known the undergraduate school is. I doubt it will hold you back. Harvard though will land with bigger punch. In general, I believe long term reputation trumps the name, and more importantly connections. Most people stay where they went to residency for this reason. I think it's very helpful to know if you want to be somewhere after you finish, though flexibility and adventure is important in life as well.

You can set your fees to whatever you wanted. It's something I also struggle with because of the guilt of abandoning patients from poorer backgrounds. But on principle, nothing stops you from charging $10 a session and some people in PP do indeed have a sliding scale and offer lower fees for patients who can't afford to pay.

 

[TexasPhysician]

Wow, really helpful discourse, I am very much appreciating this thoughtful dialogue. Regarding cash pp, I am not sure if I want to do that yet but it's a possibility on the horizon. I am not really interested in the research/academic ladder longer term. I guess I have two related questions based off what you all have shared:

1) For a private practice, do you think the Cornell brand would not have enough sway outside the NYC region and/or the intuitional inside referrals would be wasted if I left NYC? I am interested in NYC for residency but not sure yet if I would want to stay there longer term. In that case if I moved back home to LA and wanted to set up a pp would the Cornell name not hold the same weight? And in the reverse, if I were to rank for example UCLA #1 but go East Coast for an attending job/pp, does that brand not set me up well enough on the East?

2) Somewhat tangential but related to cash practice, is it possible to set one up so that you can see poorer/underserved patients too (ie with a sliding scale)? Like charge some patients the full amount but for patients who can't pay charge like $50 or something? Do people do this in real life/is it possible?

This is kind of hard for me because I'm trying to gauge the cultural impact of name brand to a degree but you guys are definitely helping. Thanks again for the amazing responses.

This is my opinion coming from somewhere not on a coast. Cornell has significantly less weight than Harvard. I’m not sure that many of my cash pay patients could tell you what state Cornell is in. However we have good state schools in UT and A&M and a popular private option in Rice. Many are of the mentality that it is pointless to go out of state unless to maybe Harvard or Stanford or MIT.

I’d expect that Cali has a strong allegiance to Cali schools as well.

I still disagree that prestige matters all that much. I doubt many peers no where I went to school or care. I return counselors phone calls and help get patients in. When someone is searching on the internet, they don’t search “Harvard trained psychiatrist in Ft Worth”. They might search “Ft Worth Psychiatrist”. Your SEO for that term means a lot more than where you trained. If patients can’t find you quickly online, nothing else matters.

 

[tr]

Importance of local network cannot be overstated. If you want to be in NYC for the long term, choose Cornell. If you want to be in Boston for the long term, choose MGH. It's easiest and most efficient to train where you would like to stay.

I would advise against choosing to train someplace because you want to experience the city for a limited amount of time. I would suggest you focus on where you would like to settle down. It's a huge PITA to move and difficult to get a foothold in an unknown market as a fresh grad from elsewhere.

 

[FlowRate]

Unless something changed since all the people I knew at MGH/McL graduated, it's probably one of the highest workload psychiatry programs in the country. They were worked harder than my own already high-workload program. Just an additional piece of info if that matters to you. You can get the Harvard name and excellent therapy training from several other programs with a somewhat lighter (or much lighter in the case of CHA) workload, if that's what you're interested in. It's only very well informed people who would really know that MGH/McL was considered more prestigious.

 

[J ROD]

I get all the prestige I need in the eyes of my kids. Each of us have different ideas on prestige and perceived value. So, find "your" prestige.

 

[AClassicRisetotheOccasion]

I love the responses and agree with them. I myself am interested in setting up PP. I am not sure how long it takes to build up a decent pp practice. Also, would having a virtual office suffice or do we need brick and mortar?

 

[Monocles]

Unless something changed since all the people I knew at MGH/McL graduated, it's probably one of the highest workload psychiatry programs in the country. They were worked harder than my own already high-workload program. Just an additional piece of info if that matters to you. You can get the Harvard name and excellent therapy training from several other programs with a somewhat lighter (or much lighter in the case of CHA) workload, if that's what you're interested in. It's only very well informed people who would really know that MGH/McL was considered more prestigious.

Seriously. A couple of years back MGH interns were sometimes working until nearly midnight on Blake 11 (inpt psych) and residents were bonding over their 9pm late night snack run to the cafeteria. Things are supposedly better now but that is still excessive. Inpatient psych work should be done by like.. 4pm not midnight

 

[Psychresy]

Seriously. A couple of years back MGH interns were sometimes working until nearly midnight on Blake 11 (inpt psych) and residents were bonding over their 9pm late night snack run to the cafeteria. Things are supposedly better now but that is still excessive. Inpatient psych work should be done by like.. 4pm not midnight

Honestly what are they doing there for that long? We have days when we leave by 1...

 

[Mad Jack]

Importance of local network cannot be overstated. If you want to be in NYC for the long term, choose Cornell. If you want to be in Boston for the long term, choose MGH. It's easiest and most efficient to train where you would like to stay.

I would advise against choosing to train someplace because you want to experience the city for a limited amount of time. I would suggest you focus on where you would like to settle down. It's a huge PITA to move and difficult to get a foothold in an unknown market as a fresh grad from elsewhere.

Plus just learning new systems and legal structures is an enormous pain. Having spent time in three separate states, learning all of the local agencies, referral networks, community resources, legal procedures, etc is absolutely the worst part of every transition

 

[clozareal]

Honestly what are they doing there for that long? We have days when we leave by 1...

One of the reasons is constantly being paged by utilization management to change nitpicky things in the notes so they can bill better.

 

[Candidate2017]

One of the reasons is constantly being paged by utilization management to change nitpicky things in the notes so they can bill better.

Tell the utilization people the pager is for clinical matters, and offer them a spreadsheet they can fill out to communicate needed changes.

 

[Candidate2017]

OP, you should go wherever you want to build your practice and where you feel most comfortable. It's not like you're trying to decide between two bad programs. You will do fine professionally and financially. There's no guarantee you'll make $500K+, but even psychiatrists from mediocre programs can charge high fees on the coasts.

 

[friendlygiant]

What about if one wants to do cash pp but is coming from way out of region? I go to a solid mid tier Univ program. If I stayed in this region I'd do very well but I want to go home to Los Angeles after graduation. Wondering if it would make sense to do a year at UCSF or UCLA to network and have the attached name.

How would you do JUST a year? fellowship? transition year?

 

[mistafab]

Half of residents stay where they train geographically.

I would think of where you’d rather be. If you want to be in NY after training, then 4 years of networking will be very helpful for that.

I will say that all the 4th years in my program intended to train and leave. Most are staying on as faculty… so definitely something to consider.

 

[friendlygiant]

Half of residents stay where they train geographically.

I would think of where you’d rather be. If you want to be in NY after training, then 4 years of networking will be very helpful for that.

I will say that all the 4th years in my program intended to train and leave. Most are staying on as faculty… so definitely something to consider.

Well he mentioned that he was interested in just training 1 yr at UCSF or UCLA, so I wasn't sure how he would spend 1 year rather than a whole 4 years