GI Fellowship Rankings

[#Future.MD.12]

Going into IM and will be matching in March with an interest in GI. Is there a ranking of GI Fellowships? Interested to see what programs are the best, especially in the South, specifically between UTSW, UAB, Vandy, MUSC, Emory, and UF?

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[JLC]

Going into IM and will be matching in March with an interest in GI. Is there a ranking of GI Fellowships? Interested to see what programs are the best, especially in the South, specifically between UTSW, UAB, Vandy, MUSC, Emory, and UF?

Based off my personal interview experiences (on the program's reputation, clinical and research productivity, awards) and the feedback from interview impressions shared by other above:

Tier 1:
UCSF/Penn/MGH
Tier 2:
Brigham/UCLA
Tier3:
Hopkins/Duke/Columbia/Mt Sinai/ BIDMC
Tier4:
UMich/ NMH/UChicago/ NYU/ UWash/Emory/UPitt/UNC/Cornell/Stanford

Penn/MGH/UCSF are insanely strong in all areas of GI with very well funded departments. All 3 hold among the most NIH funding of any GI divisions in the country and are their respective region referral center. 2 of MGH's Chief have been AGA presidents, 5 of their fellows go on to become AGA presidents. 4 of Penn's GI Chiefs have been AGA presidents. There is small difference between tiers 1 and 2 but there is a much bigger difference after the top 5 programs. Hopkins has been suffering for a while and many Hopkins residents would choose to go other other programs (ie UNC) than stay which is telling. Columbia is similar as well for many reasons. In the South, Duke and UNC are def the best programs, the difference between the two is very subtle. Emory would probably the next strongest followed by Vandy.

 

[Daodejing]

Where is mayo

 

[JLC]

Where is mayo

I would put mayo below tier 4. Honestly, after tier 4, there's probably 30+ programs that are largely equivalent.

 

[#Future.MD.12]

Anyone know anything about UTSW, UAB, or MUSC GI programs? Thanks

 

[IM2GI]

These are not my own, but I had saved them a few years ago from posts on SDN:

GI:

Hopkins
MGH
UCLA
Michigan
Pitt
Wash U./Stanford/Northwestern/Oregon
Florida/Virginia/Southwestern

Boston has a little bit more to offer as a city than Baltimore, though Baltimore's image has changed over the years. It depends on how interested in basic science you are as MGH is a very research oriented place and the GI fellowships are often extended an extra year to accommodate the research. UCLA is truly a top-notch program and has the benefit of being in LA, but with that comes significant cost of living that is difficult to afford with fellow salaries. Michigan and Pitt are both phenomenal programs in their own right and both have a good balance of the different GIspecialties. The others are all great programs, but I feel less able to distinguish between them.

For academic prestige (CV booster):
Hopkins
MGH
UCLA
Michigan

I'm single and want to date (i.e. desirable cities, lots to do):
MGH
UCLA
Northwestern
Southwestern (tons of people in TX)

For low-cost of living:
Pittsburgh
U. Florida
Southwestern
Virginia

I love the outdoors:
Oregon
Michigan

GI:
Not a top 10 list by any means, but rather a partial list of programs that my colleagues and I liked last year and would strongly recommend a visit... They all have their strengths, relative weaknesses, and idiosyncracies, but really all are very good programs. YMMV obviously, depending on your career goals. I would say that my colleagues and I mostly looked at academic programs, though some of us wanted research tracks while others looked at clinician educator pathways.

Grouped by region and in no particular order (other than what popped into my head first):

North: Penn, Johns Hopkins, Mt. Sinai, all 3 Harvard programs, Yale, Pittsburgh
Midwest: Wash U, Michigan, Mayo Rochester, U Chicago, Cleveland Clinic
South: Duke, UNC, UT Southwestern
West: U Washington, UCSF, UCLA

There are many other programs with good-to-excellent reputations such as Florida, MUSC, Indiana, Stanford, Columbia, etc. but unfortunately I have neither first- nor second-hand knowledge of them.

 

[#Future.MD.12]

Anything similar to Doximity for fellowship rankings? Just curious.

 

[gutonc]

Anything similar to Doximity for fellowship rankings? Just curious.

Do you mean is there something as lacking in quantifiable data?

Mercifully, no.

 

[IM2GI]

The concept of rankings in general is funny once you get to fellowship.

Are you really the true believer who is going to be going for a research career, applying for a K, etc? Maybe rankings matter in that case. Even then, its more tiers of academia and not a real ranking 1, 2, 3.

So many "high achievers" are so used to getting good test scores, going to the "best" undergrad, "best" med school, etc, etc. It can be hard to change that way of thinking.

Fellowship (unless you want to do a fourth year), is your terminal training and all you need to do is parlay that into a job.

 

[JP2740]

The concept of rankings in general is funny once you get to fellowship.

Are you really the true believer who is going to be going for a research career, applying for a K, etc? Maybe rankings matter in that case. Even then, its more tiers of academia and not a real ranking 1, 2, 3.

So many "high achievers" are so used to getting good test scores, going to the "best" undergrad, "best" med school, etc, etc. It can be hard to change that way of thinking.

Fellowship (unless you want to do a fourth year), is your terminal training and all you need to do is parlay that into a job.

Are you going to do a 4th year? What kind of career do you think you're going to have at the end of fellowship?

 

[liverpancreas]

Where is mayo

I would put mayo below tier 4. Honestly, after tier 4, there's probably 30+ programs that are largely equivalent.

I would disagree with JLC.
I think Mayo (Rochester) program can be placed in the top tier (Tier 1) along with other excellent programs. The GI division is arguably one of the strongest divisions in the country (for what its worth...US news ranks it #1 for last 28 years). They seem to do a fair amount of basic science research, but if you are a clinical researcher its tough to beat Mayo..Also, unlike other top tier traditional programs, the "scut work" is minimal at Mayo where the fellows are there only for their education. This hospital can run without fellows and the secretarial work is done by the secretaries..

 

[Gastrapathy]

#1 fellowship in city where your spouse wants to settle down
#2 fellowship in city where u want to live
#3 San Diego. Because it's San Diego.

 

[Nephro critical care]

I would disagree with JLC.
I think Mayo (Rochester) program can be placed in the top tier (Tier 1) along with other excellent programs. The GI division is arguably one of the strongest divisions in the country (for what its worth...US news ranks it #1 for last 28 years). They seem to do a fair amount of basic science research, but if you are a clinical researcher its tough to beat Mayo..Also, unlike other top tier traditional programs, the "scut work" is minimal at Mayo where the fellows are there only for their education. This hospital can run without fellows and the secretarial work is done by the secretaries..

Mayo's problem is that they have lot of staff so fellows and residents are short on procedures. And this is a problem across the board across all specialities. I met a cardio fellow who had done 4 caths by his 3rd year and was really nervous about now going to an interventional fellowship in a more hands-on program. Similarly a CC fellow who had 20-25 lines in his CC fellowship maybe. I had probably 350 lines , 150 intubations and 150 bronchs.
The Mayo trained GI guys who came to our place have the same issue they are clinically competent but not the most bad ass hands-on physicians that you will get.

 

[liverpancreas]

Mayo's problem is that they have lot of staff so fellows and residents are short on procedures. And this is a problem across the board across all specialities. I met a cardio fellow who had done 4 caths by his 3rd year and was really nervous about now going to an interventional fellowship in a more hands-on program. Similarly a CC fellow who had 20-25 lines in his CC fellowship maybe. I had probably 350 lines , 150 intubations and 150 bronchs.
The Mayo trained GI guys who came to our place have the same issue they are clinically competent but not the most bad ass hands-on physicians that you will get.

I am not well acquainted with the cardiology program. However, in GI most fellows end up doing 400 odd colonoscopies which is what trainees in most good academic programs do. Also, since the hospital is way more efficient fellows don't end up wasting time doing scut work.
However, I agree this is not close to community hosiptal programs or lower tier academic hospital programs which are more "procedure focused" where trainees end up doing >1000 procedures. I would argue that a strong academic program should provide you the breadth and depth of clinical experience and training and opportunities for research, and not just procedures "without actual clinical education and training"

 

[ShiShiMD]

#1 fellowship in a city where your spouse wants to settle down and likes (if this applies)
#2 fellowship in a city where you see your self-being able to live
#3 Mayo (rank number one)

 

[Earl Simmons]

I know there are rankings above and there are personal preferences that go into it as well. However, is there a list (or word of mouth) of programs which aren't necessarily the most academic/top-ranked by name or prestige but provide tremendous volume? For example, I know in the cardiology world there are some programs which have fellows hitting level 3 numbers in whatever they want without having to go much out of their way to do so. Wondering if there are programs out there like that in GI that aren't necessarily community programs.

 

[Acoustic]

I know there are rankings above and there are personal preferences that go into it as well. However, is there a list (or word of mouth) of programs which aren't necessarily the most academic/top-ranked by name or prestige but provide tremendous volume? For example, I know in the cardiology world there are some private-academic programs which have fellows hitting level 3 numbers in whatever they want without having to go much out of their way to do so. Wondering if there are programs out there like that in GI that aren't necessarily community programs.

The impression I got from UC Irvine was similar to that. Not sure how accurate that info is as it’s all word of mouth.

 

[funkreatitis]

Not sure GI has an equivalent since the numbers needed for EGD/ colonoscopy are ridiculously low to get certified, and thats all you need for credentialing. A generalization, but I think most places that are academic but not in the MGH/ UChicago etc tier of programs will give you robust clinical/ scope volume that is only marginally lower than a high volume community prog. Where this may apply similar to Cards are places that will let you get advanced numbers to allow you to get credentialed without doing an extra year. In the past USF Tampa did this but have moved away from this as far as I know, Wright State still might. If this interests you others have mentioned this before, might be worth searching the archives. I'm about to start fellowship myself and don't know how it works for other procedures, eg double balloons and the rare ilk

 

[Earl Simmons]

Not sure GI has an equivalent since the numbers needed for EGD/ colonoscopy are ridiculously low to get certified, and thats all you need for credentialing. A generalization, but I think most places that are academic but not in the MGH/ UChicago etc tier of programs will give you robust clinical/ scope volume that is only marginally lower than a high volume community prog. Where this may apply similar to Cards are places that will let you get advanced numbers to allow you to get credentialed without doing an extra year. In the past USF Tampa did this but have moved away from this as far as I know, Wright State still might. If this interests you others have mentioned this before, might be worth searching the archives. I'm about to start fellowship myself and don't know how it works for other procedures, eg double balloons and the rare ilk

Thanks for the reply!

Do fellows pick up skills such as bariatric, TIF, POEM, etc during general fellowship or when are those skills picked up? Doesn’t seem like there are specific fellowships for those types of procedures unless I’m mistaken.


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[Redpancreas]

Thanks for the reply!

Do fellows pick up skills such as bariatric, TIF, POEM, etc during general fellowship or when are those skills picked up? Doesn’t seem like there are specific fellowships for those types of procedures unless I’m mistaken.


Sent from my iPhone using SDN mobile

These are most likely advanced endoscopy skills.

 

[Gastrapathy]

Those skills aren’t taught in most adv endo fellowships. You’d have to go somewhere specific to learn that stuff and then good luck putting it into practice.

 

[chalamilasidney]

what about Memorial Sloan Kettering?

 

[aafisahar]

Go to the program that meets your goals. Similar to cards, not every major academic program is aligned with your goals.

If you want to do private practice and scope all day, going to somewhere where it's expected you do 12-18 months of research and only a few months scoping doesn't make sense. You aren't gunning for anything anymore, it's time to make a decision.

 

[gutonc]

Go to the program that meets your goals. Similar to cards every single specialty in medicine, despite what your med school/residency advisors/grandma told you, not every major academic program is aligned with your goals.

If you want to do private practice and scope all day, going to somewhere where it's expected you do 12-18 months of research and only a few months scoping doesn't make sense. You aren't gunning for anything anymore, it's time to make a decision.

FTFY