gut vs. reputation?

[path4]

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Would anyone rank a program that has a worse reputation over one that is considered good because of a gut feeling?
Both are academic programs - one is ivy league and the other isn't - and residents from both get good fellowships. I am just wondering how realistic it is to rank on gut feeling, especially when the programs being ranked vary in reputation.

 

[b&ierstiefel]

Reputation is important but ONLY to a certain extent. If you hate a certain place that has a very good reputation and you know you will not be happy there, what's the point of ranking it high?

On the other hand, I place a lot of emphasis on gut feeling. A lot of my friends are using extravagant worksheets, flowcharts, and tables to give each program a numerical score thereby determining their rank list. Although I think this is nifty, surely this approach will be fraught with bias that has its origin in gut feelings. Hence, gut feelings should not be underestimated.

What you need to ask yourself is this. What do you want for yourself? And do you need to go to a good reputation program to achieve that goal? I think your gut tells you that the answer to the latter question leans towards no. I have a feeling that you want to trust your gut feelings. As for fellowhips, you will most likely do the fellowship at the same institution as your residency (my impression is that there is not too much movement--plus, it's only a year and do you wanna move yourself and your family just for one year?). If both institutions have that fellowship then I'd say you're fine.

Again, if you really don't like the higher reputation program, I see no point in ranking them above the program that gave you a good gut feeling. On the other hand, if you liked the higher reputation program just a tad more than the "good gut feeling" program, then the choice becomes trickier. How you weigh these factors is up to you in this case.

 

[PathOne]

I'd go with gut feeling. You are more likely to get a good training experience at a program you instinctively like, than a program with lots of famous people you may not instinctively "click" with. Also, note that reputation is largely based on:
1. Past performance. A program with a great reputation may not be as good today or tomorrow. The people that made it famous do, over the long run, tend to A) Move. B) Get too old to be at the top of their game. C) Die, or D) All of the above.
2. Academic orientation. The programs with the greatest reputation almost invariably get that reputation through research and publications. But save for a few new immunohistochemical stains, the basics of pathology diagnostics have changed remarkably little over the past many years. So I don't think you *need* to be in a research-oriented program to become a good pathologist.

However, that being said, I wouldn't want to choose a program with a "worse" reputation. But a "lesser" reputation is OK by me.

 

[PathOne]

Damn. AndyM beat me to the punch. But that's ok. Agree with him 🙂

 

[path4]

Thanks for the advice - its a hard decision to make. The program with the good reputation has a better schedule, more electives, etc. but I got a weird feeling while there - not sure why. Its as if my brain is telling me to go there, and everyone else for that matter, but my gut just won't agree, I'm not sure it disagrees, I just didn't get a 'i-definitely-want-to-come-here' feeling.

 

[b&ierstiefel]

Damn. AndyM beat me to the punch. But that's ok. Agree with him 🙂

I think we said similar things.

I think it's good for multiple people to chime in...that's what I like about this forum; you usually have several people chiming in to help out.

 

[deschutes]

A lot of my friends are using extravagant worksheets, flowcharts, and tables to give each program a numerical score thereby determining their rank list. Although I think this is nifty, surely this approach will be fraught with bias that has its origin in gut feelings.

Exactly. Scoresheets IMO are an attempt to intellectualize the gut feeling.

I think the key to decision-making is to be aware of what will sway your decision.

Consult your mentor!

 

[Mrbojangles]

Would anyone rank a program that has a worse reputation over one that is considered good because of a gut feeling?
Both are academic programs - one is ivy league and the other isn't - and residents from both get good fellowships. I am just wondering how realistic it is to rank on gut feeling, especially when the programs being ranked vary in reputation.

What Ivy league program is it? PM me so we can discuss. I have mixed/bad gut feelings about two Ivy league programs I applied to. They are two very good programs: great format, great fellowships, great exposure, yada yada yada. But I got weird vibes from both of them and I had a confrontational interview at both (I should have walked out on one of them).

I'm having a hard time putting smaller programs (and they really aren't that much smaller) ahead of these programs. I don't want to ignore these gut feelings and I doubt my career goals will be influenced by choosing between the better reputation vs the lesser reputation program. These next few days is going to be tough 😕.

 

[jeff2005]

Thanks for the advice - its a hard decision to make. The program with the good reputation has a better schedule, more electives, etc. but I got a weird feeling while there - not sure why. Its as if my brain is telling me to go there, and everyone else for that matter, but my gut just won't agree, I'm not sure it disagrees, I just didn't get a 'i-definitely-want-to-come-here' feeling.

I felt that way about Wash U. My mind said,"This place is so awesome!!" My gut was saying," Prepare for projectile vomiting!!""

 

[pongo]

I did not study this process as intensively as some of the posters on here seem to, but both my "gut" and "reputation ranking" pointed towards the same place. Now that I am here and have learned more what an "old boys network" pathology is, I am glad I ended up at the place with the best reputation. The seniors I observed hunting for jobs/fellowships all relied on either a connection with a program graduate or a phone call from a faculty member that happened to edit the potential employer's surgpath textbook. It helps me relax about the future, and I would probably be willing to make minor sacrifices (location, gut reaction, tougher work load) for that for reassurance.

 

[b&ierstiefel]

I felt that way about Wash U. My mind said,"This place is so awesome!!" My gut was saying," Prepare for projectile vomiting!!""

I can't agree more. Hence, I'm ranking them near the bottom of my list.

 

[Mrbojangles]

Seems like there are alot of GI issues right now... projectile vomiting, ulcers... we need to set up a clinic.

I've been having mild on and off epigastric pain since I put together my ROL yesterday for the first time. Could be exacerbated because I haven't eaten much.

I feel like our year is sort of a fluke in terms of competitiveness. At least next year, according to another poster, there will be Pgy5 and Pgy4 positions open for the incoming applicants.

 

[ddx]

i think it really depends on what you wanna do. definitely, if you wanna specialize in something in particular you should go where you'll have a better chance doing that. if you have no idea, then go to a well rounded program with fellowships in most things. to think that you can just get a fellowship anywhere and settle for a program that doesn't have fellowships may be a bad career move. you never know what your life is gonna be like in 4 years and you may not want to move. having something as a backup will definitely help you sleep better at night. of course, if the thought of going to a program makes you wanna puke, trust that as well. there's a lot to be said for peace of mind. but if both programs will take you where you wanna go, i'd go with gut. i think you'll ultimately be happier.

 

[pathdawg]

What Ivy league program is it? PM me so we can discuss. I have mixed/bad gut feelings about two Ivy league programs I applied to. They are two very good programs: great format, great fellowships, great exposure, yada yada yada. But I got weird vibes from both of them and I had a confrontational interview at both (I should have walked out on one of them).

I'm having a hard time putting smaller programs (and they really aren't that much smaller) ahead of these programs. I don't want to ignore these gut feelings and I doubt my career goals will be influenced by choosing between the better reputation vs the lesser reputation program. These next few days is going to be tough 😕.

From my own personal experience, if you had a confrontational "red flag" interview in which you regret not walking out, it would be best to run, not walk, away.

 

[Doctor B.]

My view has already been posted: go with your gut. You want to go somewhere where you will be happy. At most academic programs, you'll get good training and most of them have at least one well-known faculty member whom you can name drop when the time comes for job hunting. Unless there are red flags at the more well-known place, go with your gut feeling.

 

[b&ierstiefel]

My view has already been posted: go with your gut. You want to go somewhere where you will be happy. At most academic programs, you'll get good training and most of them have at least one well-known faculty member whom you can name drop when the time comes for job hunting. Unless there are red flags at the more well-known place, go with your gut feeling.

Word! Plus, from what I have seen, there aren't many pathology departments that has world-renowned experts in every single field. For instance, one program might have THE guru of bone & soft tissue whereas another program may have the GI demigod. If you know what subspecialty or subspecialties you are leaning towards, try to let your ROL reflect that while putting reputation aside somewhat.

 

[Pookies]

Go with the Gut.

 

[Mrbojangles]

From my own personal experience, if you had a confrontational "red flag" interview in which you regret not walking out, it would be best to run, not walk, away.

Good point. Sometimes when impressions aren't so fresh and the emotions wear off I need a reminder.

 

[cytoborg]

Thanks for the advice - its a hard decision to make. The program with the good reputation has a better schedule, more electives, etc. but I got a weird feeling while there - not sure why. Its as if my brain is telling me to go there, and everyone else for that matter, but my gut just won't agree, I'm not sure it disagrees, I just didn't get a 'i-definitely-want-to-come-here' feeling.

Had the same experience at a big-name place - on paper it looks like a dream program, and my intellectual self is telling me it's a better choice, but when I visited, I felt "blah," and I just can't motivate myself to want to go there. I truly feel neutral about it. In contrast I absolutely clicked at a lesser known place. But for some reason I don't feel good about ranking it higher than the "blah" place because its reputation just isn't there. I'm still stumped over it.

 

[toby2]

Had the same experience at a big-name place - on paper it looks like a dream program, and my intellectual self is telling me it's a better choice, but when I visited, I felt "blah," and I just can't motivate myself to want to go there. I truly feel neutral about it. In contrast I absolutely clicked at a lesser known place. But for some reason I don't feel good about ranking it higher than the "blah" place because its reputation just isn't there. I'm still stumped over it.

I had a similiar experience with another "Ivy League" place, Yale. Supposedly great reputation, good volume, huge funding for research etc, and I was really looking forward to checking it out. But man, when I got there, my gut feeling was, get me outta here! There were a couple residents who seemed pretty cool, but one of them actually told me he wished more "normal" people to work with. Then I asked another resident if he had much time to preview slides, and he said "not really." Then the chief resident said "on surgpath, 13 hour days are more common than 10 hour days." The final straw was when a staff said, "no, there is no time specifically set aside for you to preview your slides." Yeeouch!!

Bottom line is, I'm not even ranking the place because my gut told me I may really regret it if I ended up there. The question to ask is, regardless of the name/ reputation of a place, would you be happy in this place, with these people and is this the environment you can thrive in and learn best in? If the answer is no, move on. I know it's not always straightforward, but more often than not, your gut is right.

 

[yaah]

The gut reaction is important to consider - but don't forget to ask your brain as well. The one you have to avoid listening to is the ego. Don't go somewhere simply because it "will be better for your career" because you simply don't know that. It may work out, and often does, that a place that is well known becomes your favorite. One place I interviewed at I just did not like, didn't get along with the residents I met, thought the attendings were too standoffish, and didn't even like the hospital very much, but still I actually considered it for a time because I thought it was prestigious.

Then I woke up and realized that you make your own prestige, you don't have it given to you.

 

[cytoborg]

The gut reaction is important to consider - but don't forget to ask your brain as well. The one you have to avoid listening to is the ego. Don't go somewhere simply because it "will be better for your career" because you simply don't know that. It may work out, and often does, that a place that is well known becomes your favorite. One place I interviewed at I just did not like, didn't get along with the residents I met, thought the attendings were too standoffish, and didn't even like the hospital very much, but still I actually considered it for a time because I thought it was prestigious.

Then I woke up and realized that you make your own prestige, you don't have it given to you.

That's very good advice. Thank you.

Just when I thought I didn't have to worry about my...um...the e-word...I'm staring at my ROL and it rears its ugly head. Must....not....change...ranklist.