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General Surgery Residencies
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There is no such thing as formal residency rankings.
If you do a search, you can find several threads on popular GS programs in the US.
You can actually get very good training at most programs. There are no rankings and if there were they probably wouldn't be valid. Also remember that how a program really is lags a few years behind word of mouth on the interview trail.
To partially address what you were likely getting at with your first question, it seems that a dozen or so programs make claims as a top 5 program, for example. If you ask 10 surgeons the question of who is top five then you will get 10 different answers.
The programs that consistently seem to attract top residency candidates and top faculty members include, in no particular order, MGH, Duke, WashU, Penn, Brigham. Other elite programs include Hopkins, Michigan, UCSF, Vanderbilt, UWashington, Northwestern, Stanford. Some of these would consider themselves top 5. Many programs would consider themselves in that second top 12 group. There are some excellent programs in NYC but I have not had enough experience with them to tease apart who is better at what, perhaps another SDN member practices in the city and can help with that.
To partially address what you were likely getting at with your first question, it seems that a dozen or so programs make claims as a top 5 program, for example. If you ask 10 surgeons the question of who is top five then you will get 10 different answers.
The programs that consistently seem to attract top residency candidates and top faculty members include, in no particular order, MGH, Duke, WashU, Penn, Brigham. Other elite programs include Hopkins, Michigan, UCSF, Vanderbilt, UWashington, Northwestern, Stanford. Some of these would consider themselves top 5. Many programs would consider themselves in that second top 12 group. There are some excellent programs in NYC but I have not had enough experience with them to tease apart who is better at what, perhaps another SDN member practices in the city and can help with that.
I guess you could always check out the Scutwork/SDN reviews. The posted reviews at least comment on a broad range of things.... sometimes. Take them with some salt. But, keep in mind, just as reliable as opinions on an anonymous chat forum.
Never been there. Have no personal knowledge.... But found the following on SDN review.... see the link for the entire posted review:
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=928&d=1Scutwork/SDN poster said:
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As far as top 5 programs, the other posters pretty much hit the nail on the head. Basically, anyone you've heard of probably lays claim to a top 5 program. I wouldn't even bother trying to formulate any kind of ranking.
You're second question is a bit humorous, if only because of its pairing with your first question. The "ranking list" of program reputation probably correlates perfectly inversely with the ranking list of "treats residents well." Most community programs (outside of the NY/NJ, SoCal, and Chicago areas) treat their residents very well, while most big name academic programs treat there residents like crap (because, well, they can).
I would simply apply to a relatively long list of places you deem acceptable, feel them out at interviews with respect to how they treat their residents/how happy the residents are, and rank accordingly.
You're second question is a bit humorous, if only because of its pairing with your first question. The "ranking list" of program reputation probably correlates perfectly inversely with the ranking list of "treats residents well." Most community programs (outside of the NY/NJ, SoCal, and Chicago areas) treat their residents very well, while most big name academic programs treat there residents like crap (because, well, they can).
I would simply apply to a relatively long list of places you deem acceptable, feel them out at interviews with respect to how they treat their residents/how happy the residents are, and rank accordingly.
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Out of curiosity, do you guys think California's top three programs on the same level (UCLA, UCSF, Stanford)? I've been hearing that Stanford's general surgery program isn't as strong as it used to be
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From what I've heard it's UCSF > UCLA = UCSD >> Stanford
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Does anyone have a idea about community programs that still are good surgical programs? Community sounds like viable option but only if you're still getting a great training.
Northwestern has some mentorship rotations. At lots of other programs you have rotations where you do clinic, OR, everything with one attending in a mentorship fashion. In order to stay under hours and have days off, residents cover for each other so you don't have a pure apprenticeship so to speak.
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Agree with above. The only two programs I'm aware of with a formal mentorship approach are Mayo and Northwestern.
I'm not sure how I feel about this concept overall. It sounds great in theory, but it almost completely eliminates residents working with each other, and you lose the associated camaraderie.
Even more important, you lose a lot of your resident to resident teaching, which is where most people pick up a significant amount of their training. There are a lot of things you can learn from a senior resident that you can't learn from a practicing surgeon.
When I interviewed at Mayo, I remember that the residents weren't really socializing with eachother at the pre-interview social. After that experience plus the interviews, I felt that the residents generally didn't know each other very well.....that's a bad situation when you're training in a tough work environment for 5-7 years....especially in BFE, Minnesota.
ahhhh, but they aren't working together as it appears, thus they don't really need to know each other.
There is something to be said about apprenticeship. Instead of necessarily being beat down by x-number of senior residents, awaiting your opportunity to beat down your juniors, the "unity" of hazing that is residency.... I think it could be a very different paradigm. I found those few rotations where I worked with one primary attending and answered to him/her as opposed to a gaggle of novices trying to flex was quite a nice change. Those few occassions seemed to have... shall I say, a degree of dignity often lacking on the other "resident run" services. Working with a "master", seeing patients pre-, intra, post-op. Being taught in theory by a master as opposed to being "taught" by a more experienced novice. In retrospect, while some interesting memories.... I am not sure I found all the high drama, back stabbing, and fumbling through procedures "taught" by residents as an important component to be cherished and preserved in modern surgical education.... With all this "team work", I am surprised at how little team work and true partnership occurs in numerous private practices...
I can not say I have the answers or I know the best model. I am in support of testing different models.
JAD
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I don't know. Your complaints seem sort of institution-specific to me, rather than a representation of senior residents everywhere. I agree that there are plenty of places to train in the conventional method that are unhealthy, unproductive, and unpleasant. However, I think that a program with strong resident to resident teaching and camaraderie would be easier to tolerate than the 1-on-1 apprentice system.
I also think you set a record for most quotes in a paragraph. I can't talk, though, because I frequently abuse the bold and italic options, and I've set the record for most self-righteous statements in a paragraph before.....
N
njbmd
I did a fellowship at Mayo and ranked it #2 overall (behind UVA) when I was ranking because I found the teaching outstanding. There are some services that are covered by teams and we definitely had plenty of socialization (attendings, residents and medical students). The department is quite social and extremely close bonds develop between faculty masters and apprentices in addition to between fellow residents. Several of the graduates came back to talk about practice and the adjustments post residency which were minimal for them. The apprentice model allowed more autonomy at an earlier PGY level. Also, I found that I loved the apprentice model because it is quite close to practice. Now, the MN weather was something else totally.
