Does perceived prestige of a program really matter?

[SaintFrances]

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Well, I have finished all of my interviews and am deep in the trenches of trying to formulate my rank list. One major question I am wrestling with is how to compare two programs that are both very strong but COMPLETELY different. My major issue in comparing these two choices boils down to this: does perceived prestige matter? Will I be professionally shooting myself in the foot if I decide to train at a smaller, lesser-known program rather than a very prestigious institution? Here is a further catch: I am a D.O. I struggle with feeling like there is already somewhat of a discrimination against my background; seeing this as a chance to possibly improve my CV for future employment options by training at a well-known institution. However, I also wonder if I am making too big of a deal about all of this. I know what many will say though - do you want to work in academics or private practice? The problem is that I simply don't know yet and want to keep my options open.

I know that no one can make my decisions for me, but I would appreciate your input nonetheless.

 

[Noyac]

Hardly at all. Yes, some will hold the D.O. thing against you and you will never be able to get past that unless you get the opportunity to work with them and show them.

So a big prestigious program only helps if you want to remain in academics. Otherwise, go for the program that offers the most diverse types of case (does everything under the sun) and has no fellows.

 

[huktonfonix]

Hardly at all. Yes, some will hold the D.O. thing against you and you will never be able to get past that unless you get the opportunity to work with them and show them.

So a big prestigious program only helps if you want to remain in academics. Otherwise, go for the program that offers the most diverse types of case (does everything under the sun) and has no fellows.

Sorry Noy, gotta disagree on this one. Theres often a reason a program may be more prestigious. Often these are the bigger centers with a great caseload and more resources. Now, this doesnt necessarily equate to better training, but it can give more opportunities. Depending on where you want to work, the name of the program can also be a factor. Some of the major private practices in my training area would only look at residents from the "more prestigious programs". Im not saying that I agree with this policy, but thats how it was. Also, we rotated with residents form other smaller programs at certain sites, and there were regular attending comments regarding the higher quality of residents from the major programs.

The more prestigious programs may also be able to help you more in terms of connections for landing that job. once you land that dream job though, it doesnt really matter where youre from.

 

[DO4lifer]

SF, i am in your shoes. i keep changing around my rank list. but check it, if you go to a big name institution, you can't go wrong because
a) if you want to do fellowships, very likely they have what you want and you can get it...or the one you want is a phone call away
b) if you enter academics in the future, the bigger name will beat out other applicants
c) if you do private practice, the case load variety will give you the chance to be a stellar physician.

you got some sweet interviews, and so you definitely have some big decisions to make. if you want to talk more about it, PM me. 👍

 

[Buckeye Anes]

Well, I have finished all of my interviews and am deep in the trenches of trying to formulate my rank list. One major question I am wrestling with is how to compare two programs that are both very strong but COMPLETELY different. My major issue in comparing these two choices boils down to this: does perceived prestige matter? Will I be professionally shooting myself in the foot if I decide to train at a smaller, lesser-known program rather than a very prestigious institution? Here is a further catch: I am a D.O. I struggle with feeling like there is already somewhat of a discrimination against my background; seeing this as a chance to possibly improve my CV for future employment options by training at a well-known institution. However, I also wonder if I am making too big of a deal about all of this. I know what many will say though - do you want to work in academics or private practice? The problem is that I simply don't know yet and want to keep my options open.

I know that no one can make my decisions for me, but I would appreciate your input nonetheless.

To quote an opnion once given to me along the same lines "It only matters at the extreme ends of the spectrum." There are a ton of big academic programs that will give you all the variety and experience you need to do well in private practice or academics. People who say you can only get competitive fellowships by going to the "elite" program(s) are simply wrong. Residents from all sizes and prestige levels of programs get spots every year. As long as you go to a decent mid tier program you can do whatever you want afterwards. I would say to go with which program you feel you fit best at.

 

[coprolalia]

I would pick the prestigious program #1. Put the other one you're wrestling with at #2. Prestige always wins. Trust me on this one.

Chances are you're not going to match at your #1 anyway. Not trying to be a dick, but if it's that prestigious then the application pool is probably stronger and you're less likely to get a spot there. Just the way this game works. Either way, you won't be disappointed, especially if you have a high chance of getting your #2 spot. And, you won't be second guessing yourself later.

I wrestled with my rank list four years ago. I'm still wrestling with it today. I was in a similar position. I matched at my #2 spot.

Oh, and of course I told everyone at the program I matched into that they were my #1. Kinda like going out with a pretty nice looking girl and telling her she's your favorite when you'd really rather be dating her much-hotter roomate. Either way, you're still getting laid. And, though you're gonna date her for a while, you already know you're probably not gonna marry her.

-copro

 

[Pilot Doc]

does perceived prestige matter?

There is no perceived prestige. Prestige is perceptions. Doesn't mean it's not real.

Now "Does prestige matter" is a fair question, but calling it perceived prestige slants the discussion in a way that ignores how prestige can matter.

 

[fakin' the funk]

a) if you want to do fellowships, very likely they have what you want and you can get it...or the one you want is a phone call away
b) if you enter academics in the future, the bigger name will beat out other applicants
c) if you do private practice, the case load variety will give you the chance to be a stellar physician.

Possible benefit I would like to hear opinions about: if you go to "Elite" program and then into PP you not only have a "bigger name" on your CV but also a bigger alumni network out there in PP since the name programs tend to have big classes.

 

[amyl]

prestige matters. top programs have a reputation for turning out solid anesthesiologists. the name matters. coming from a top program makes you a known entity, or at least more of one.

 

[RickKane]

I have never heard of a resident trying to switch programs because they felt their current program was not prestigious enough. Go where you will be happy.

 

[jetproppilot]

A graduating resident's clinical judgement, technical skills, and people skills FAR EXCEED where you train.

My previous practice just let go a fellowship trained dude from an ivy league residency. A 600K W-2 annual gig.

Dude couldnt keep up with the pace.

And he pissed off surgeons more than was necessary.

Pick a program that you'll be well trained at that you think FITS YOU.

I've been on the interviewing side of this scenerio....I've got buddies in lucrative practices who are interviewers....

AND THE MOST IMPORTANT ATTRIBUTES WE LOOK FOR WHEN INTERVIEWING A POTENTIAL LOW ROUND NFL SALARY PARTNER IS:

wait for it......wait for it....

1) IS THIS PERSON NICE? CAN HE/SHE GET ALONG WITH PEOPLE? This, my friends, is one of the most important attributes in our profession. Think about a successful anesthesia practice like owning a hardware store. We've got good stuff in here, but we've also got customers. Yeah, ya gotta be a good doctor, but if you're a good doctor but you're a D ICK, thinking not about how you can get this case done safely but how you can obstruct it, carrying your individualism too far, leaving surgeons/partners shaking their heads, WE'LL PASS. I can't emphasize this enough.

2) CAN THIS PERSON HOLD THEIR OWN? Are you well trained? If you're a little weak on something, are you willing and able to learn? We don't expect you to come outta residency an ace at our trade. We do expect that you'll catch on quickly with a good attitude.

3) CAN WE CALL A BUNCHA STAFF/RESIDENTS YOU TRAINED WITH AND GET OVERALL POSITIVE COMMENTS?

If you sail thru 1), 2), and 3),

where you trained is irrelevant to me (and my buddies) as long as you are from an accredited residency and are board eligible.

This is of course in reference to private practice.

 

[jetproppilot]

prestige matters. top programs have a reputation for turning out solid anesthesiologists. the name matters. coming from a top program makes you a known entity, or at least more of one.

Sorry.

Your opinion is just not true.

Prestigious residencies of course turn out stellar residents.....some of them.

There are also individuals that come outta those same residencies that I'd pass on.

Where you did your residency does not guarantee your future partners in private practice that you're DA BOMB.

 

[climbingdocs]

I am going for friendly, solid (99% written pass rate), no fellows, hill billy country, awesome climbing, where I can get cheap houses and call is not Q4 😀
Good name will not make me happy.

 

[Noyac]

A graduating resident's clinical judgement, technical skills, and people skills FAR EXCEED where you train.

My previous practice just let go a fellowship trained dude from an ivy league residency. A 600K W-2 annual gig.

Dude couldnt keep up with the pace.

And he pissed off surgeons more than was necessary.

Pick a program that you'll be well trained at that you think FITS YOU.

I've been on the interviewing side of this scenerio....I've got buddies in lucrative practices who are interviewers....

AND THE MOST IMPORTANT ATTRIBUTES WE LOOK FOR WHEN INTERVIEWING A POTENTIAL LOW ROUND NFL SALARY PARTNER IS:

wait for it......wait for it....

1) IS THIS PERSON NICE? CAN HE/SHE GET ALONG WITH PEOPLE? This, my friends, is one of the most important attributes in our profession. Think about a successful anesthesia practice like owning a hardware store. We've got good stuff in here, but we've also got customers. Yeah, ya gotta be a good doctor, but if you're a good doctor but you're a D ICK, thinking not about how you can get this case done safely but how you can obstruct it, carrying your individualism too far, leaving surgeons/partners shaking their heads, WE'LL PASS. I can't emphasize this enough.

2) CAN THIS PERSON HOLD THEIR OWN? Are you well trained? If you're a little weak on something, are you willing and able to learn? We don't expect you to come outta residency an ace at our trade. We do expect that you'll catch on quickly with a good attitude.

3) CAN WE CALL A BUNCHA STAFF/RESIDENTS YOU TRAINED WITH AND GET OVERALL POSITIVE COMMENTS?

If you sail thru 1), 2), and 3),

where you trained is irrelevant to me (and my buddies) as long as you are from an accredited residency and are board eligible.

This is of course in reference to private practice.

Looks like Jet and Noyac are on the same page. How about the rest of you? How many of you actually interview candidates? I do. Jet does. And we are preaching the same gospel here.

You must fit in the practice well. If you are arrogant, obstructionistic, lazy (many higher prestige residents come out this way as do others), poor judgement, poor attitude, lack personality, etc etc. Then it doesn't make one bit of difference where you trained.

 

[ucsfgaspain]

Does prestige matter? Of course it does. If it didn't, it wouldn't be called prestige. Is it the only deciding factor? of course not.

Do crappy clinicians come from prestigous programs? Of course. I had fellow residents that I wouldn't let anesthetize a corpse. In another post, I've stated that the clinician that I really admire never came from a high prestige program. Can you make it, land the big job, make big bank from a less prestigous program (if that is what you use as your metric of success)? Of course.

What does prestige buy you? It buys you a foot in the door. What you do with it afterwards is up to you.

I can speak for the SF Bay Area. You definitely have a heads up if you come from a big name program in getting a job with the good groups. Why? B/C most of the groups around have the majority of the partners from the big name programs i.e. UCSF, Boston programs, Hopkins, Stanford etc. They can pick up the phone and talk to their buddies (their co residents that are attendings at these prestigious programs and vette the candidate) . I can't pick up the phone and call a lesser prestigous program and trust what they say since I didn't go to that program. Do we have partners from lesser known programs of course. But when seven of the partners are from the prestigious program and 1 is from the lesser known, and they interview candidates, who are they going to take a chance on? The kid from the big name program who is a solid clinician or the kid from the smaller name program who is also a solid clinician? It's going to be the one from the better known program since it is a numbers game.

Prestige is the tie breaker. It isn't the the main decider. The cream will always rise to the top. So if you are solid...you will make it. It may just take a little longer in areas like the SF Bay Area.

Another point is that given the macro economic view of the future of medicine and anesthesia i.e. new administration, economic crisis, companies looking to cut health care costs. You better have something that differentiates you from the rest of the pack when you graduate from residency. I know that the SF Bay Area hiring pool has definitely tightened up. There aren't many open spots any more at the primo practices. You've got to have something special about you i.e. chief resident, fellowship, married or related to one of the partners🙂 Not to rain on anyones parade but times do look tighter in the future.

 

[amyl]

Sorry.

Your opinion is just not true.

Prestigious residencies of course turn out stellar residents.....some of them.

There are also individuals that come outta those same residencies that I'd pass on.

Where you did your residency does not guarantee your future partners in private practice that you're DA BOMB.

where you did your residency does not guarantee that you are awesome. you are right there are *******s from everywhere. there are people in my program i wouldn't hire. but you more likely to get a stellar resident from a stellar program. more likely to get a good anesthesiologist from a program that does 100 hearts or peripheral nerve blocks vs the obligatory 20.
i worked with a few residents at many different programs as a med student and now as an intern. the difference is huge.... i mean scary difference in the quality knowledge, skill, etc. between the different programs residents. reputation matters because clinical experience matters. the difference is SCARY...this is something for all of you to think about as you choose the going home at 3pm residency.
proof of it for me was asking the leaving ca-3s how much they were getting as starting salaries....and it was higher from here at ccf then it was at the other places i rotated or new a ca-3 well enough to ask.
i guess we will just have to agree to disagree.😍

 

[Buckeye Anes]

where you did your residency does not guarantee that you are awesome. you are right there are *******s from everywhere. there are people in my program i wouldn't hire. but you more likely to get a stellar resident from a stellar program. more likely to get a good anesthesiologist from a program that does 100 hearts or peripheral nerve blocks vs the obligatory 20.
i worked with a few residents at many different programs as a med student and now as an intern. the difference is huge.... i mean scary difference in the quality knowledge, skill, etc. between the different programs residents. reputation matters because clinical experience matters. the difference is SCARY...this is something for all of you to think about as you choose the going home at 3pm residency.
proof of it for me was asking the leaving ca-3s how much they were getting as starting salaries....and it was higher from here at ccf then it was at the other places i rotated or new a ca-3 well enough to ask.
i guess we will just have to agree to disagree.😍

You are confusing two completely different things in clinical exposure versus prestige. There are high prestige programs that let you out at 3 everyday and have very mediocre numbers but there is a lot of research going on. Then there are middle tier programs that get great clinical experience but don't do a lot of research so they don't have the big name. As for difference in knowledge, skills, etc between residents at different programs...I find it hard to believe you got enough exposure as a med student/intern to make a statement like that. I have actually been suprised to find how similar the level of skills, knowledge, etc are between different programs as is supported by the vast majority of residents passing their boards and finding jobs.

 

[bigdan]

How many of you actually interview candidates? I do. Jet does. And we are preaching the same gospel here.

Jet and Noy -

I was gonna PM you guys with this very same question; I know there's a sticky somewhere on what it takes in private practice, but both of you guys have a couple more years under your belt. The Match program will take care of the program name for me. My mom and dad (hopefully) took care of the play-nice-in-the-sandbox thing for me. What do I need to work on in residency? What is absolute need to do/know? What will get someone the boot fastest from your PP gigs?

Nice thread, btw.

dc

 

[Noyac]

Jet and Noy -

I was gonna PM you guys with this very same question; I know there's a sticky somewhere on what it takes in private practice, but both of you guys have a couple more years under your belt. The Match program will take care of the program name for me. My mom and dad (hopefully) took care of the play-nice-in-the-sandbox thing for me. What do I need to work on in residency? What is absolute need to do/know? What will get someone the boot fastest from your PP gigs?

Nice thread, btw.

dc

I can tell you that you will get the boot fastest from me if you can't do the work safely and at a good pace. If you can't perform these two things then the burden falls to the rest of the group. If it falls to the others then you have just increased their work. We don't bring in new folks to just increase our work as you are aware. Another thing that will hurt someone in a new group is being inflexible. You have to bend a little at first b/4 you resist. Coming out of residency you know what is safe and what is not. If its not a pt safety issue then it is usually safest to be flexible at first until you know the ropes and everyone is familiar with you. Also remember that you learned one way to do anesthesia for the most part but that there are many many other ways.

So, be safe, efficient, flexible and be friendly to everyone including the crna's. One of the best ways to get in good with your new group and the other OR staff including surgeons is to mingle with them outside the OR when invited. Go to the happy hours or the gatherings or whatever if thats you cup of tea. If not, make it your cup of tea. People communicate much better in my opinion when they know each other socially as well as professionally.

So this is a little bit of me rambling but mostly its true. Some things you guys have heard over and over from us and some may be new. Now just wait for Jet to lay down the truth.

 

[nutmegs]

where you did your residency does not guarantee that you are awesome. you are right there are *******s from everywhere. there are people in my program i wouldn't hire. but you more likely to get a stellar resident from a stellar program. more likely to get a good anesthesiologist from a program that does 100 hearts or peripheral nerve blocks vs the obligatory 20.
i worked with a few residents at many different programs as a med student and now as an intern. the difference is huge.... i mean scary difference in the quality knowledge, skill, etc. between the different programs residents. reputation matters because clinical experience matters. the difference is SCARY...this is something for all of you to think about as you choose the going home at 3pm residency.
proof of it for me was asking the leaving ca-3s how much they were getting as starting salaries....and it was higher from here at ccf then it was at the other places i rotated or new a ca-3 well enough to ask.
i guess we will just have to agree to disagree.😍

you're an intern at a program you're very proud of (made some sacrifices for for the name, perhaps). he's been doing this a long time. just something to consider. as an intern I had NO idea how good the residents I was with were, and if you're willing to go anywhere you can have the starting salary of your choice. 's all I'm sayin.

 

[aredoubleyou]

I can tell you that you will get the boot fastest from me if you can't do the work safely and at a good pace. If you can't perform these two things then the burden falls to the rest of the group. If it falls to the others then you have just increased their work. We don't bring in new folks to just increase our work as you are aware. Another thing that will hurt someone in a new group is being inflexible. You have to bend a little at first b/4 you resist. Coming out of residency you know what is safe and what is not. If its not a pt safety issue then it is usually safest to be flexible at first until you know the ropes and everyone is familiar with you. Also remember that you learned one way to do anesthesia for the most part but that there are many many other ways.

So, be safe, efficient, flexible and be friendly to everyone including the crna's. One of the best ways to get in good with your new group and the other OR staff including surgeons is to mingle with them outside the OR when invited. Go to the happy hours or the gatherings or whatever if thats you cup of tea. If not, make it your cup of tea. People communicate much better in my opinion when they know each other socially as well as professionally.

So this is a little bit of me rambling but mostly its true. Some things you guys have heard over and over from us and some may be new. Now just wait for Jet to lay down the truth.

What are examples of bieng inflexible and inefficient that you have seen. We can all think of extreme examples - looking for more grey area examples

 

[Muadib]

going to a well respected and known program will definitely help you in a variety of ways. first the bigger prestigious places are doing some of the most cutting edge cases and/or working on some of the most difficult patients. you'll end up feeling way more comfortable no matter what gets thrown at you in the real world when you're on your own. second the prestigious programs usually have fellowships in just about anything your interested in and if they don't or don't have room for you their name will greatly help you get a fellowship in your desired speciality in the places you'd want to go. finally like so much else in life the stronger your resume the more job opportunities will be available to you, that means the stronger and better respected your residency program the better your chances to land the job you want.

 

[Trisomy13]

going to a well respected and known program will definitely help you in a variety of ways. first the bigger prestigious places are doing some of the most cutting edge cases and/or working on some of the most difficult patients. you'll end up feeling way more comfortable no matter what gets thrown at you in the real world when you're on your own. second the prestigious programs usually have fellowships in just about anything your interested in and if they don't or don't have room for you their name will greatly help you get a fellowship in your desired speciality in the places you'd want to go. finally like so much else in life the stronger your resume the more job opportunities will be available to you, that means the stronger and better respected your residency program the better your chances to land the job you want.

I can say pretty much the same for going to a small program that is not "prestigious". We do cutting edge procedures and work on the sickest patients in our state and surrounding area. Enough to make healthy patients a walk in the park. We have no fellowships at the moment, which just means we get to do those said cases that are cutting edge, and with the sickest patients, the smallest babies, etc. We have no problem placing residents in fellowships (note to the wise here, anesthesia fellowships aren't exactly the most competitive - most people choose to start making money). Regarding the name on the resume, it might matter to some degree, but as Jet and Noyac made clear above, there's more to being a desirable colleague than just the name on your certificate.

I guess my point is to not get too caught up in the hype during interview season, and pick programs that you actually feel are a good fit for you. That is where you will be happy, and if you are happy, you are more likely to excel. I interviewed at plenty of prestigious programs and the majority of them fell to the bottom half of my list for one reason or another (location, unhappy residents, gut feeling), and I have had no regrets.

 

[Bertelman]

second the prestigious programs usually have fellowships in just about anything your interested in and if they don't or don't have room for you their name will greatly help you get a fellowship in your desired speciality in the places you'd want to go.

I guess it depends on your perspective. I go to a place with no fellows. That means when I do my heart rotation, I'm the only one in the room with the attending. As long as I'm efficient, I place every line. We also carry a smallr number of residents, so I am more likely to see the cool/difficult cases. And no, from what I've seen we have no problems getting fellowships, thanks to the strong faculty support and connections they have with former colleagues at well-known institutions.

I'm not here to profess a small program gives you identical exposure and opportunities as a large, "prestigious" academic center. I really don't know. I really don't think anyone here knows, unless they've completed residencies at both. My unprestigious program stands alone covering a large geographical area, so we see a nice variety of cases. It's quite rare we send anything to the prestigious center down the road. If you think a "prestigious" academic center has better learning opportunities than a run of the mill academic center, you may just be blinded by the name.

From what I read here, landing a fellowship doesn't seem too difficult (aside from maybe pain). I would suggest that if you are having problems nailing down a fellowship, it may reflect your own app, not the hospital where you trained. Having said that, I am sure training at a prestigious program could cause some fellowship directors to look past a less-than-stellar app and offer you a spot.

Read what Jet and Noy have to say. You probably won't get hired in PP because you saw a couple of whacked-out cases you'll never see at an ASC. You'll get hired because you're a nice person that plays well with others and knows how to move cases. That's typically independent of the "prestige" of the program. It's intrinsic, and it's tough to teach.

Edit- I was composing while Trisomy posted, but I see we have similar sentiments.

 

[jennyboo]

Well, I have finished all of my interviews and am deep in the trenches of trying to formulate my rank list. One major question I am wrestling with is how to compare two programs that are both very strong but COMPLETELY different. My major issue in comparing these two choices boils down to this: does perceived prestige matter? Will I be professionally shooting myself in the foot if I decide to train at a smaller, lesser-known program rather than a very prestigious institution? Here is a further catch: I am a D.O. I struggle with feeling like there is already somewhat of a discrimination against my background; seeing this as a chance to possibly improve my CV for future employment options by training at a well-known institution. However, I also wonder if I am making too big of a deal about all of this. I know what many will say though - do you want to work in academics or private practice? The problem is that I simply don't know yet and want to keep my options open.

I know that no one can make my decisions for me, but I would appreciate your input nonetheless.

Unless your two programs are a tiny community hospital struggling to meet ACGME case numbers vs a world famous cream of the crop hospital (most of which don't interview DOs), there is probably not very much perceived prestige difference between the two. So go where you are happy, where you'll have a pleasant working experience and where you want to live.

If your programs are really on those two extremes, then the answer is obvious (go to the better program).

 

[narcusprince]

How do you private practice docs(Jet/Noy) view military service? Is this a potential positive or negative? Would it outweigh a candidate from a not so prestigous program?

 

[jetproppilot]

How do you private practice docs(Jet/Noy) view military service? Is this a potential positive or negative? Would it outweigh a candidate from a not so prestigous program?

certainly wouldnt be a negative.

The only positive I'd see from an "interview-er" position would be sentimental.

Say you interviewed at MilMD's group.

Seems military time would be a positive.

My oldest son is an MP in the Army so I'd haffta admit I'd look at your app, if not glowingly-more than others, because of sentimental issues.

I don't see military work working for or against you unless one of the interviewers has some link to the military.

 

[Noyac]

certainly wouldnt be a negative.

The only positive I'd see from an "interview-er" position would be sentimental.

Say you interviewed at MilMD's group.

Seems military time would be a positive.

My oldest son is an MP in the Army so I'd haffta admit I'd look at your app, if not glowingly-more than others, because of sentimental issues.

I don't see military work working for or against you unless one of the interviewers has some link to the military.

Ditto.

neither positive nor negative.

 

[veetz]

Its not always where you trained!

One of our attendings trained at arguably the best program in the country. He's the most disliked, arrogant, & careless anesthesiologist on staff and has been suspended at least once for compromising patient safety. I was shocked when I found out where he trained.

 

[AnesCoord]

The following is a direct quote from a resident who graduated from our program several years ago, which I received just a few months ago. This resident initially entered private practice, but has since moved on to a position in academics. It's one of the most satisfying and heart-warming thank-you's I've ever received, be it from a residency applicant, a resident, a faculty member, etc.

"Just an update, I took the job at the University of take-a-guess. They are starting me out at as an assistant professor. I'll mostly be teaching Cardiothoracic, TEE, and Regional Anesthesia, but they are also a big level 1 trauma, neuro, high risk OB, and regional burn center.

All the training I got at (your program) is the perfect fit for a job like this. I can't say enough about the training and education I received at (your university). I appreciate it more and more as the years go by. Your residents don't know how lucky they are right now, but one day they will. It is not something one can easily understand until they have experiences to compare it to. Dr Bag-O-Donuts told me something like this, when I was there. I didn't know what to make of it then. But how right she was!

Something else she told me was that all CA-3's go through senioritis and can be somewhat full of themselves now that they "know everything". Kind of like teenagers I guess. I am sure I will see that on the flip side soon. But before I am too badly embarrassed seeing a reflection of myself as a CA-3, I'd like to say sorry to everyone who had to put up with ME as a CA-3. SORRY!"

I think the major advantage of small programs (certainly ours) is the early and continuous exposure to BIG cases. Our CA1's do craniotomies and thoracotomies and major traumas just a few months into their training. And they don't just do their heart rotation and then never another heart case; they get continuous exposure throughout their three years of training.

And when it comes to the interview, Jet nailed it. Your ability to play in the sandbox is key. If you're perceived (or even worse, confirmed by checking references) as someone who will be high-maintenance, you can bet it will count against you.

Lastly--military service. I will be the first to admit I'm a little biased since I retired from the Air Force, but most of the time it will work in your favor. The reason is because it's assumed that you possess a fair amount of self-discipline, and can hoepfully be a positive influence on others.

 

[desflurane]

This thread has taken a simple question and twisted it into a pile of garbage. The question was posed by someone deciding where program reputation fits in when looking for a job. The answer is simple...YES it matters a lot.

Why? Number one, the network. If you plan on staying local the best way to get a good job isn't gaswork, it's networking. Whether it be former residents or current attendings who open doors, more of them will open, the better the reputation of your program.

We all know that solid programs don't always produce solid gas-passers. Thanks for stating the obvious though. Yes, vice versa too.

Yes, Sally the market is still good. It won't always be so choose the best rep program you interview at. It usually is warranted. Most of the people here trying to dissuade you of that are bitter they didn't go to those programs. I went to a small program so I know.

 

[Trisomy13]

This thread has taken a simple question and twisted it into a pile of garbage. The question was posed by someone deciding where program reputation fits in when looking for a job. The answer is simple...YES it matters a lot.

considering some of the other threads on this forum, this one is actually quite tame and presents some interesting and opposing perspectives.

Why? Number one, the network. If you plan on staying local the best way to get a good job isn't gaswork, it's networking. Whether it be former residents or current attendings who open doors, more of them will open, the better the reputation of your program.

We all know that solid programs don't always produce solid gas-passers. Thanks for stating the obvious though. Yes, vice versa too.

I think networking is really more useful if you are looking outside your local area, but that's just my experience.

Yes, Sally the market is still good. It won't always be so choose the best rep program you interview at. It usually is warranted. Most of the people here trying to dissuade you of that are bitter they didn't go to those programs. I went to a small program so I know.

With all due respect, it sounds like you are the bitter one here. Stop projecting 😉 The people from small programs representing in this thread seem to be giving honest opinions, and an alternate to the typical trumpeting of big names. I attended prestigious undergraduate and graduate programs and agree that the name can get you a foot in the door, if the person reviewing CVs is impressed by that. But in a residency where clinical exposure and your baseline day-to-day satisfaction with your work environment can influence your outcome, it's wise to take more into consideration than a name, especially if your intuition is telling you something else.

 

[Bertelman]

This thread has taken a simple question and twisted it into a pile of garbage. The question was posed by someone deciding where program reputation fits in when looking for a job. The answer is simple...YES it matters a lot.

Why? Number one, the network. If you plan on staying local the best way to get a good job isn't gaswork, it's networking. Whether it be former residents or current attendings who open doors, more of them will open, the better the reputation of your program.

We all know that solid programs don't always produce solid gas-passers. Thanks for stating the obvious though. Yes, vice versa too.

Yes, Sally the market is still good. It won't always be so choose the best rep program you interview at. It usually is warranted. Most of the people here trying to dissuade you of that are bitter they didn't go to those programs. I went to a small program so I know.

If those of us at the small programs are bitter, then just maybe some of the folks at the prestigious programs thought dropping the name of a prestigious program could open doors they couldn't walk through on their own merits.

Maybe I chose my small program because the clinical experience is very strong, the instructors are intelligent and approachable, and I prefer the smaller atmosphere. Maybe the prestigious programs wouldn't give me the time of day. Either way, don't assume the prestigious programs are the only ones with strong connections. The faculty at my facility had to train somewhere, and believe me, most of them spent some part of their education at very prestigious programs. Those connections are still valid.

This is no different than the discussion regarding prestige of med school. There are people who think the name means everything. There are people who would wither and die in that highly competitive atmosphere, but will eventually become superb clinicians nonetheless. Most of us are in between.

My gut tells me if the OP has to ask if prestige is terribly important, it probably means he doesn't buy into the hype. Most people don't. The ones that do probably bought into the prestige when they were training, and are thus perpetuating the stigma.

I'll never fault anyone for choosing a "prestigious" program because they think that is the avenue to the absolute best education. I would, however, warn against choosing a "prestigious" program you aren't crazy about over another strong one just because you think the name will help you.

 

[Bertelman]

Trisomy, we really need to stop meeting like this 😉

 

[desflurane]

Actually re-reading my post I do sound bitter. Dang, I'm getting old and crotchety.

With all due respect...from your identifying info you are residents and young and stupid JK. There is a level of naivete in these threads that I try and address at times. The real world awaits you.

I went to a tiny tiny program which had a lot of the advantages that tiny programs do: No fellows, I chose what cases I did...all big for two years straight...etc etc. I feel like I got great training because I looked for it, hard.

Networking matters both locally and otherwise. My group now pretty much ONLY hires based on personal experience with the candidate. When we do hire unknowns they aren't from podunk anesthesia residency. Bigger programs=more chances.

Look, in a perfect world you'd all be hired no matter where you trained based on your personality and skills with a blade. The reality is when I'm in China and I want a cup of coffee my best chance of getting what I want is at Starbucks not the little man with the pushcart.



BTW-can we ban the use of MDA in all forums. Pretty please.

 

[Trisomy13]

Actually re-reading my post I do sound bitter. Dang, I'm getting old and crotchety.

With all due respect...from your identifying info you are residents and young and stupid JK. There is a level of naivete in these threads that I try and address at times. The real world awaits you.

I went to a tiny tiny program which had a lot of the advantages that tiny programs do: No fellows, I chose what cases I did...all big for two years straight...etc etc. I feel like I got great training because I looked for it, hard.

Networking matters both locally and otherwise. My group now pretty much ONLY hires based on personal experience with the candidate. When we do hire unknowns they aren't from podunk anesthesia residency. Bigger programs=more chances.

Look, in a perfect world you'd all be hired no matter where you trained based on your personality and skills with a blade. The reality is when I'm in China and I want a cup of coffee my best chance of getting what I want is at Starbucks not the little man with the pushcart.



BTW-can we ban the use of MDA in all forums. Pretty please.

I might be a resident, but I'm neither young nor am I stupid, and I've been in the real world and understand it all too well 😉

I'm with you on the banning MDA usage though. It always sounds like "NBA" in my head, and the only thing I can dunk is a donut.

 

[IlDestriero]

Hi,
Just as the quality of your undergraduate University and MCAT scores affects the competitiveness of your Medical School application and the quality of your medical school and USMLE scores affects the competitiveness of your residency application, the quality/prestige of your residency training will affect your job search and marketability. Prospective employers want to know that you can handle the workload in their practice and that you will pass your boards on the first attempt, and not become a thorn in their sides down the road. For many reasons it is in your best interest to train at the best program that you can get into. By the best program I mean a program which does very complex cases on a regular basis, easily exceeds all of their numbers and has a reasonably happy and stable resident class. If everyone that you talk to at the interview is unhappy because they are worked to death every day, given infrequent or poor lectures, and/or feel unprepared to handle challenging cases, you too will be miserable and poorly trained and would likely do better at a different (though still strong) program. Even worse would be a program where everyone barely meets their numbers or requires "creative accounting", having to send you to other hospitals for several out rotations, etc. It is one thing to say that the ICU training or pain clinic is weak and send you to another hospital for this small component of your education, it is quite another if many of your cases at your home program are ASA 1 or 2 or outpatient (or ASA 3/4 eyeballs!) and you are going out for hearts and vascular or trauma and peds cases.
However with regards to post residency competitiveness for jobs, if you are certain that you want to live in a particular area of the country you would probably increase your likelihood of finding a job there by attending the best residency program that you could in that region, unless you can match at an elite program with national name recognition. Why? Because your future employers/partners will be personally familiar with graduates of your residency program, if not graduates themselves.
One last caveat- if you are planning to relocate across the country to go to an elite program primarily for the name but intend to relocate again after residency is over, be sure that the program that you think is "elite" is actually NATIONALLY recognized as an elite program and not just regionally recognized as a superior program. It is difficult to come up with a good example but Vanderbilt or UNC may have extraordinary anesthesia programs, but coming from New England and now California, I don't know anything about them, as opposed to Mass General, Mayo, Hopkins, or Stanford who's names are known worldwide.
The fact is that pedigree, and being selected as a Chief Resident, will open doors for you. You will get an interview where others will not. You may not get the job and you almost certainly will not get a better offer, but you will get an interview just because you have Harvard Medical School or a Mass General residency on your CV. This bias will likely decrease as ones career goes on. I will not deny however that an elite degree is probably overrated. Trust that I know about that of which I speak as I was an attending for several years before returning to academia for a fellowship and I was on the job interview circuit again myself not that long ago. The network of the prestige programs is real and can only help you, now and in the future. If you've got "it" all you need is an interview to show it off.
Good luck with your difficult ranking decisions and trust your judgement. Wherever you end up, make the most of your opportunities and be a star and you will succeed.

 

[treasurefull2]

any more thoughts?

 

[Bertelman]

36 responses not enough?

Try looking in the archives. You are bound to find this topic discussed ad nauseum.