Harbor vs. Highland

[jigga_what]

I know I'm probably one of 80 or 90 people putting these two at the top of my list, but as I've had a couple of conversations in the past couple of weeks re: strengths/weaknesses of the two, I thought I'd put it out to the general forum. Still trying to determine order..... Though the two are very different in many respects, they're both obviously strong. Makes a head to head a little difficult.

Harbor:
3 years
great patient population: diverse, many languages
pathology galore
fun, single residents who love volleyball
live at the beach
-not much time for research
-questionable faculty teaching
-ED is the usual county setup: madness, few resources, paper charts, etc..

Highland
4 years
great pathology
residents were cool, but didn't strike me as close as Harbor ressies
more time for other EM interests, 4 months elective 4th year
awesome, new ED, they US everything!
-no beach living, though SF is a great city
-didn't really get to know Dr. Snoey- any insights?
- "4th year mistake" stuff, but w/ moonlighting 4th years make 100+

any other impressions? we're all this together...

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[LuvbugMD]

Hey Jigga-

Yeah, you are right. Harbor and Highland are my two favorite programs, but I am a LA girl so you can guess which one is a little higher on my list. I totally agree with all of your observations about the two. Here are a few additional observations that I have about the programs.

Harbor:
-3 year program, but many residents opt to do a 1-2 year fellowship afterwards. I believe the Harbor fellows also hold junior faculty positions
-strong lean towards research
-residents tend to have good relationships with each other and also with residents in other programs
-formal "mini" didactic lectures during each shift (this was a huge plus for me!)

Highland:
-extremely diverse faculty with diverse interests
-residents seemed a little "cliquish" in my opinion (but I was only there for a short period of time)
-rotate at UCSF (great exposure to other strong programs)

Overall, I think the Cali "H"s are some of the strongest programs in the country. You will receive an amazing training at each program. Did you have any gut responses to either of the programs?

 

[jigga_what]

Herbie-

Great points. The didactics at both were good. As you mentioned, I did like the shift-change case at Harbor - informal, but informative. As an aside, Chris Lampe is a huge asset to the program; it's too bad he won't be around next year, because he sells the program. Anyone know who the chief will be next year?
As far as my gut.... as a so-cal native beach bum, I think the applicant dinner at Lampe's place in Hermosa was tough to beat. I didn't realize how much location would factor into my decision, but having been in the cold for 5 years, the beach beckons. All that being said, I'm still not completely convinced, hence the thread.... And with the near impossible match at the "H's", the rest of my list is a whole separate beast.

But, please continue the thread - good stuff.

Specifically, any opinions on the off-service rotations and intern year?

 

[debtridden]

Herbie-

Great points. The didactics at both were good. As you mentioned, I did like the shift-change case at Harbor - informal, but informative. As an aside, Chris Lampe is a huge asset to the program; it's too bad he won't be around next year, because he sells the program. Anyone know who the chief will be next year?
As far as my gut.... as a so-cal native beach bum, I think the applicant dinner at Lampe's place in Hermosa was tough to beat. I didn't realize how much location would factor into my decision, but having been in the cold for 5 years, the beach beckons. All that being said, I'm still not completely convinced, hence the thread.... And with the near impossible match at the "H's", the rest of my list is a whole separate beast.

But, please continue the thread - good stuff.

Specifically, any opinions on the off-service rotations and intern year?

Chief will be Dan Chavira.

I'm leaning towards Highland personally because I agree to a great extent that Chris Lampe was a big part of what made the program seem so pleasant, but he won't be there next year, so he shouldn't factor in. In terms of location, at the end of the day I'm putting being in San Fran or the southbay beaches in the similar regard in that both are desirable places to be in. In fact San Fran is a bit more "happenin", if that's what you're looking for, and with fewer annoying people than LA.

Either one will be great for three or four years, and after that both will give you the reputation to go pretty much anywhere. But that's a differentiating point perhaps: Highland as a four-year program may have a slight advantage in the first job you look for. After that it doesn't really matter. I also think the attendings would bearound a lot more at highland than at harbor, though you can't go wrong with either. I personally thought the teaching at highland was amazing.

Regardless, both are awesome, and hence the tough choice, but a good touch choice to have. Congrats.

I don't know...I guess I think Highland's pretty bad ass. Good luck.

 

[EMApplicant]

Both are stellar programs in stellar locations. You won't go wrong either way. That said, i'd give the edge to Harbor. It is easily one of the best programs in the country and probably enjoys a slight edge in terms of reputation.

I don't think you'd go wrong either way though. Go with whichever feels right to you.

 

[dlung]

I think it'd basically come down to...

--3 vs 4 years
--warmer beach vs Half Moon Bay
--crummy ski slopes vs Tahoe (I don't see how you can even compare Big Bear and Summit to Tahoe)
--LA smog vs SF fog (the Bay Area is gorgeous)
--South Bay (my favorite part of LA) vs Bay Area

both are really friendly/happy programs... all the people I've met from both hospitals have been super cool.

... err... and maybe I shouldn't get myself into trouble, but I think the women are generally more attractive in LA than the Bay Area...

 

[dlung]

I

 

[dlung]

I think it'd basically come down to...

--3 vs 4 years
--warmer beach vs Half Moon Bay
--crummy ski slopes vs Tahoe (I don't see how you can even compare Big Bear and Summit to Tahoe)
--LA smog vs SF fog (the Bay Area is gorgeous)
--South Bay (my favorite part of LA) vs Bay Area

both are really friendly/happy programs... all the people I've met from both hospitals have been super cool.

... err... the last thing (uh, maybe I shouldn't get myself into trouble) is I think the women are generally more attractive in LA than the Bay Area...

 

[Sessamoid]

I think it'd basically come down to...

--3 vs 4 years
--warmer beach vs Half Moon Bay
--crummy ski slopes vs Tahoe (I don't see how you can even compare Big Bear and Summit to Tahoe)
--LA smog vs SF fog (the Bay Area is gorgeous)
--South Bay (my favorite part of LA) vs Bay Area

It's quite a drive from Highland to Half Moon Bay.

Geographically the Bay Area beats LA in natural beauty, but Oakland has air pollution to match LA.

 

[tiene dolor?]

Harbor.

 

[hello23]

How could anyone forget to mention USC/LAC EM program when talking about the best program in the country?

120 bed ER in 2007--> largest ER in the country. Pathology? you name it.

2nd oldest program in the country? Alright I don't know whether Hennepin or Univ of Chicago are really the 2nd oldest.

Harbor only have admitting priviledge to family med and internal med, whereas USC/LAC has priviledge to every service in the hospital. This translates into how much respect or trust other programs of the whole hospital pay to the ER program.

Stability of the hospital? USC is getting its new 1-billion dollars hospital built (about 60% done) while Harbor has tofight the battle of being closed down by LA Board of Supervisors every 3-4 years. Everyone in LA who cares know about this.

But I must warn you. USC/LAC's reputation on the street is "Zoo" or "war-zone"
USC/LAC is definitely not for anyone.

 

[Flopotomist]

It's quite a drive from Highland to Half Moon Bay.

Geographically the Bay Area beats LA in natural beauty, but Oakland has air pollution to match LA.

As somebody that lives in Oakland (and works at Highland) I question whether you have ever been here! The air here is fine - nowhere near LA air. I have never seen smog here - I think you are grossly mistaken.

 

[EMApplicant]

How could anyone forget to mention USC/LAC EM program when talking about the best program in the country?

120 bed ER in 2007--> largest ER in the country. Pathology? you name it.

2nd oldest program in the country? Alright I don't know whether Hennepin or Univ of Chicago are really the 2nd oldest.

Harbor only have admitting priviledge to family med and internal med, whereas USC/LAC has priviledge to every service in the hospital. This translates into how much respect or trust other programs of the whole hospital pay to the ER program.

Stability of the hospital? USC is getting its new 1-billion dollars hospital built (about 60% done) while Harbor has tofight the battle of being closed down by LA Board of Supervisors every 3-4 years. Everyone in LA who cares know about this.

But I must warn you. USC/LAC's reputation on the street is "Zoo" or "war-zone"
USC/LAC is definitely not for anyone.

USC/LAC is a great program, no doubt. The new ED is sure to be great as well. Unfortunately, IMHO, it's a 2-4 format. Who wants to go through the learning curve of 2 hospitals in 2 years? Not me. Meanwhile, as many of the country's 2-4 programs start to look at becoming 1-4 year programs and integrating their intern year, this is unlikely to happen at USC. Swadron, in fact, tells his applicants to do their transitional year internships at Harbor and not at USC/LAC. The reason given is that the other services are so much stronger there than at USC/LAC. Harbor's medicine and surgery programs are considered top-notch and nationally respected. Still, EM is probably the strongest program in the hospital. That says a lot. Personally, I would want to train at a program where you work with top-notch consultants.

As for EDs, Harbor's is like many county programs - overcrowded and stretched to max capacity (amd then some). Luckily for Harbor, the new ED was finally approved by the county this year. This is great news for those lucky future residents who will have access to the new surgery/ED tower. Obviously that's a few years down the road though.

LAC/USC does have a reputation for being a bit of a zoo, etc. Unfortunately, this extended to the residents lacking a bit in terms of attending supervision and resulted in the program getting dinged by the RRC. Fortunately, LAC/USC has been able to find the funds to hire several new clinical attendings in the last year. This is good news and should keep the program out of future trouble.

Personally, IMHO Harbor is the best California program (obviously a subjective thing). I'd put UCLA-Oliveview, LAC/USC, and Highland next, in that order. Bottom-line, however, is that they are all great, first-tier programs. I'd be very happy to train at any of them.

 

[Snacker]

How could anyone forget to mention USC/LAC EM program when talking about the best program in the country?

120 bed ER in 2007--> largest ER in the country. Pathology? you name it.

2nd oldest program in the country? Alright I don't know whether Hennepin or Univ of Chicago are really the 2nd oldest.

Harbor only have admitting priviledge to family med and internal med, whereas USC/LAC has priviledge to every service in the hospital. This translates into how much respect or trust other programs of the whole hospital pay to the ER program.

Stability of the hospital? USC is getting its new 1-billion dollars hospital built (about 60% done) while Harbor has tofight the battle of being closed down by LA Board of Supervisors every 3-4 years. Everyone in LA who cares know about this.

But I must warn you. USC/LAC's reputation on the street is "Zoo" or "war-zone"
USC/LAC is definitely not for anyone.

From my interview experience and from talking with PDs from some of the top programs all over the country (Pittsburgh, Carolinas, OHSU, Arizona, etc.), Harbor may even enjoy the reputation of being "The" program in Emergency Medicine.

After attending the didactic session during my interview, I was blown away by the faculty. Many of won ACEPs teaching and lecturing awards, and you have on faculty there national leaders from ACEP, SAEM, and research leaders as well. Despite these honors, they take the time in the ED to do one-on-one teaching in a very effective way.

Despite the not so sexy building, I would say that Harbor is the most impressive program in the country in many respects.