HELP: Categorical outside offer vs. Prestigious Prelim

[albinolion]

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Hey everyone,

I am new to this forum, and to any forum for that matter. I have been moved to seek your advice regarding my rank list due to my absolute confusion. I am from Europe and I interviewed for categorical positions at: UVA, Duke, Tuts-NEMC, St. Vincent's, and Georgetown. I also interviewed for a 2-year preliminary position at Johns Hopkins. Hopkins interview went very well and they were excited by my application. Tufts-NEMC were equally excited and said that they were going to rank me highly. UVA offered me a categorical position outside the match. I loved the city of Boston the best. I suppose the question is would I be crazy to rank a Hopkins prelim above a categorical in the match rank? or should I just say to hell with it and accept the offer from UVA? I am not from the states and so the ins and outs of the programs are a bit alien to me. My ideal would be Hopkins but everyone is telling me not to go for the prelim. I told the RD that I was thinking about ranking them first and he said that he would be honoured to have me but he would caution me from ranking any prelim above a categorical. He also said I should think about it carefully before becoming 'infatuated with hopkins'. I don't know what to do. Any advice? I am thinking (1) Hopkins Prelim (2) Tuft NEMC (3) UVA (4) Duke etc am I as crazy as everyone says?
THANX

 

[Celiac Plexus]

I am thinking (1) Hopkins Prelim (2) Tuft NEMC (3) UVA (4) Duke etc am I as crazy as everyone says?
THANX

yeah.

the climate in general surgery these days is increasingly competitive. it would be a bad decision to take a prelim spot over a categorical spot. a prelim spot offers no security whatsoever. how would you like to work your nuts off at hopkins only to be jettisoned after 2 years? are you willing to face the real possibility that in 2 years you will have no job?

hopkins is a great name, but comparing prelim positions to categorical positions is comparing apples to oranges. in my humble opinion, you should rank categorical positions first. also, if you are a foreign medical graduate, you will be fortunate to match in a categorical position... even if you rank the prelim position last, you might wind up there anyway... or go unmatched altogether.

if you're so enamored of hopkins that you would throw away chances for a categorical spot elsewhere, why don't you ask the hopkins program director what has happened to the other 2 year prelims that have gone before you. do they eventually get a categorical spot at hopkins, or do they wind up going through eras again in 2 years, hoping to land a categorical position?

good luck.

 

[surg4me]

If you are really interested in going into general surgery, I would highly recommend ranking categorials first. A prelim year is just that...a prelim year, without any guarantee of advancing or getting a future categorical spot. Your prelim year will mean nothing, even if it's from Hopkins if you do not eventually get a categorical spot. Every year, there are open spots even after the match for prelim interns at some of the nation's most competitive programs...honestly, prelim spots are relatively easy to obtain for someone applying to general surgery (at least for US grads...probably a bit challenging for foreign grads). Unless you have your heart set on going to a certain program (and only that program), I would rank categoricals first, then prelims. By the way, the "promise" of an outside match should not be taken seriously. Many applicants each year are told that they will have a spot at a program only to find out that they do not match there or anywhere for that matter...just a word of caution. It will be difficult to land a categorial spot as a foreign grad, but it's great that you were able to interview at those good programs...best of luck in the match...only a few weeks remaining until we need to certify our rank list! 🙄

 

[albinolion]

Thanks guys,

The UVA offer is a real out of match offer....with contract...entering as year 2 for the categorical position. SHould I count my blessings and go for it since, as you say, it is relatively difficult to get categorical through the match? UVA wants me to withdraw from the match if I sign. How is UVA as a program?
Thanks again !

Albinolion

 

[SteadyEddy]

Albino...If you really want the skinny on UVa, I urge you to get in conctact with JMattwilson. He's a great resource for all of the Virginia programs...especially UVa. Being a 4th year, I've done my research on several schools on the east coast and found that UVa is definitely one of the best academically. Also, if you go in as a 2nd year, you won't have to fill out that BS secondary application 🙂. And for advice on the prelim/cat decision. Don't leave your nuts in the guillotine for two years wondering if the blades gonna come down...you're getting an offer from a darned good program. Take the offer and run!
Welcome to the US

Thanks guys,

The UVA offer is a real out of match offer....with contract...entering as year 2 for the categorical position. SHould I count my blessings and go for it since, as you say, it is relatively difficult to get categorical through the match? UVA wants me to withdraw from the match if I sign. How is UVA as a program?
Thanks again !

Albinolion

 

[GucciMD]

If you really desire gen. surgery then rank the cat. over prelim. Some people do prelim. then they reapply for EM, Urology, ENT, and so forth.

Of course about 50% of surgery prelim. do get a gen. surgery spot the following year.

I have a friend who did prelim. surgery and is now a pgy1 in Internal Medicine, so he feels that he wasted a year.

Good Luck

 

[PFunkAllStar]

UVA is a great program (friendly residents, great chair and PD, great research opps etc.) and you would be doing yourself a disservice by not taking a categorical spot there. Everyone else is right, a two year spot at Hopkins may be great, but what happens at the end of those two years...you could then find yourself an intern again at a place you may hate just to have a categorical position.

 

[Foxxy Cleopatra]

I'm assuming that you must have completed some surgical training to be offered a 2nd year position at UVA. I tend to be a risk-taker, but overwhelmingly, even *I'd* say take this position outside of the match. You must be a pretty strong candidate to be offered a position outside of the match considering that many good candidates went completely unmatched over the past few years, not to mention that UVA is pretty well-respected. I have a few friends who are in the prelim-predicament and it's not a good position to be in. Take the spot.

 

[albinolion]

Thanks for all your help....helpful advice.
Indeed I have completed about 2 years of general surgery training in Europe thus the offer for year 2.
Two more questions:
(1) How does UVA compare to Tufts NEMC? Is one obscenely better than the other?
and
(2) if I wanted to search for other programs that have openings in the second year of residency, how do I do that?

Cheers!
Albinolion

 

[Celiac Plexus]

Thanks for all your help....helpful advice.
Indeed I have completed about 2 years of general surgery training in Europe thus the offer for year 2.
Two more questions:
(1) How does UVA compare to Tufts NEMC? Is one obscenely better than the other?
and
(2) if I wanted to search for other programs that have openings in the second year of residency, how do I do that?

Cheers!
Albinolion

for what it's worth...

Duke>UVA>Tufts-NEMC...

Duke is 1st tier with far-reaching name recognition.

UVA is probably 1st tier as well, but with less recognition than Duke.

Tufts-NEMC is middle tier, with much less name recognition.

Take the categorical spot at UVA and be thankful.

 

[surg]

Have to agree with the others here. Take the UVa spot!
Though I did not train at UVa, I have had the privilege to interact with some of their grads over the years, and they have always been well trained. Academics seem strong there and their fellowship placements have been strong from what I hear. Used to have a reputation for malignancy (due to high amount of q2 call) but I assume that this has resolved with the 80 hr work week. They did have one bad match year some years ago due to a secretarial snafu, but other than that year, my understanding is that they generally do well in getting who they want through the match.

It would be difficult to recommend taking the prelim spot at Hopkins over a decent categorical spot somewhere else. While the Hopkins pedigree can occasionally be helpful, the stress that I see in prelim's eyes as the year wears on and they have to wait for a PGY-2 position to open up somewhere is not something I'd wish on anyone. While in most years, there are plenty of good spots that open up somewhere, the problem is, you never know where. Yours could be the year that the best available spot is at a terribly malignant program or a terrible educational experience. They you have to decide whether to sit out a year, do more prelim time or take it. All of which are bad options for someone trying to get done in Gen Surg someday.

To your other questions:
UVa in my mind is far and away a higher caliber than Tufts-NEMC, but that is on reputation alone. I've never visited Tufts-NEMC or had an in-depth converstion with any of their recent grads, so I really don't have a good basis for personal comment

To find other PGY-2 spots coming available for next year, generally these are found via word of mouth, by someone interviewing for a PGY-1 spot there and getting offered (as you did with UVA), or via the apds.org website which is the association of program directors in surgery.

Whatever you decide, congrats and good luck!

 

[scutpuppy]

Take the spot at UVa. It's a fantastic program, with great residents and faculty. Remember, however, that UVa is a mandatory 7 year program (or in your case 6) with 2 years dedicated research. You should try PM'ing a user named njbmd. I think she is a catagorical there now. Good luck to you.

 

[Bo Hurley]

Never turn down Hopkins. Even if it's for a prelim janitorial job with a promise for transfer into a categorical janitorial job.

Hopkins > all other Gigantic Standardized Medical Institutions (GSMI)

 

[sara_surgery]

I have to concur with the general sentiment. Yes, you would be crazy to give up a GUARANTEED spot at UVA (especially considering you could skip the intern year - which is hell at every program in the country). UVA is an amazing program. I wish I had gotten an interview there! I did not however. I was denied an interview. Giving up a guaranteed spot at what is most certainly a "top" program to consider a prelim spot at Hopkins, or to consider a categorical spot at Tufts (starting at PGY1) is insane. You asked if one is insanely better (UVA vs. Tufts). Well, the answer is "Yes". UVA is far superior in terms of clinical training. A hopkins prelim wouldn't even be an option. I personally didn't even apply there for prelim, and would much rather go to a categorical program than to hopkins-prelim. And, the programs at which I interviewed were no where near the level of UVA!

 

[GSorBust]

Fact #1 - You are a FMG (albeit clearly very qualified having received interviews at some great programs)
Fact #2 - GS will be very competitive this year. Many US grads will go unmatched. Far more FMGs will go unmatched.
Fact #3 - UVA is a top-notch program (I was denied an interview and I am a US grad with good scores)
Fact #4 - A prelim spot has no guarantee of getting a categorical spot. There are hundreds of prelim surgery spots open every year.
Fact #5 - PGY1 year sucks (you being able to skip that would really be of a benefit to you at UVA)
Fact #6 - Boston is a great place to live. But, a program like UVA is MUCH more highly regarded and has better name recognition than Tufts-NEMC.

Given these facts, I would 10000% take the guaranteed PGY2 spot at UVA, and do so ASAP before they offer it to someone else and he/she takes the spot.

 

[albinolion]

Hey everyone.
You guys are great.
You have answered a lot of questions.
UVA baby!

 

[akg1974]

Take the Friggin' UVA spot!!! There are many here amoung us who would kill for such an opportunity. FMG or not.

 

[orthohand]

Take the Friggin' UVA spot!!! There are many here amoung us who would kill for such an opportunity. FMG or not.

I talked to a lot of people and thought everybody has to do the intern year for any baord.
there is no exception to this.
any credit for previous surgical training is given after the PD has seen you work for 6 months and then recommends to the ACS for your abilties and recommends that you be given credit of one year.
than you can jump from PGY1 to PGY3 directly.
I am really surprised my the offer you got because it is too good to believe.
You must be exceptionally gifted to get this.
best of luck

 

[orthohand]

Hey everyone,

I am new to this forum, and to any forum for that matter. I have been moved to seek your advice regarding my rank list due to my absolute confusion. I am from Europe and I interviewed for categorical positions at: UVA, Duke, Tuts-NEMC, St. Vincent's, and Georgetown. I also interviewed for a 2-year preliminary position at Johns Hopkins. Hopkins interview went very well and they were excited by my application. Tufts-NEMC were equally excited and said that they were going to rank me highly. UVA offered me a categorical position outside the match. I loved the city of Boston the best. I suppose the question is would I be crazy to rank a Hopkins prelim above a categorical in the match rank? or should I just say to hell with it and accept the offer from UVA? I am not from the states and so the ins and outs of the programs are a bit alien to me. My ideal would be Hopkins but everyone is telling me not to go for the prelim. I told the RD that I was thinking about ranking them first and he said that he would be honoured to have me but he would caution me from ranking any prelim above a categorical. He also said I should think about it carefully before becoming 'infatuated with hopkins'. I don't know what to do. Any advice? I am thinking (1) Hopkins Prelim (2) Tuft NEMC (3) UVA (4) Duke etc am I as crazy as everyone says?
THANX

check this link and you find that the pgy1 exception promised to you is not valid.

 

[fourthyear]

I have know a surgery resident from Duke who was extremely unhappy with his residency expereicne - beat down every time I see him, always crabbing on and on about how much it sucks there. Also know a similar story of a friend of a friend at Hopkins. I'm not trying to deter you, but some people above seem to think big name=big opportuinity and that is worth everything, but it's not worth your happiness in my opinion. There is absolutely no way you should think of a prelim spot at hopkins as any better than any other prelim spot. It may raise some eyebrows, but it won't get you as far as you think in securing a categorical spot and it may be the most miserable 2 years of your life.

UVA on the other hand - I met quite a few interviwees from there back when I was on the interview trail and they all had awesome things to say about the place. This place has the name and the reputation of being a place people are happy at. You're lucky they seem so interested in you.

 

[surg]

check this link and you find that the pgy1 exception promised to you is not valid.

It looks like it would work to me:

from the link you posted

Regardless of an individual’s professional attainments
here or abroad, no credit will be granted directly to an
applicant for surgical education in a foreign country. The
Board will consider granting partial credit only upon the
request of the Program Director of an accredited program
who has observed the applicant as a junior resident
for nine to twelve months and wishes to advance the
applicant to a higher level in that program. The credit
granted will not be valid until the applicant has successfully
completed that program. If the applicant moves to
another program, the credit is not transferable and must
again be requested by the new Program Director.


From my read of this: you can get partial credit to move up after spending about a year at your program and if your PD will remember to jump through that hoop and you finish the program.

Not having ever had to do this, I am willing to be corrected however.

 

[orthohand]

What i could understand is that , you have to be doing the PGY1 year and the PD should then based on your perfomance request for credit for 1 year.
The thread for this post , the guy who got offered at UVA ,what i understand from the post , has never done any ACGME accredited training here in USA . HOw can PD offer him to skip first year and take him in PGY2.
To me certain things dont add up.

It looks like it would work to me:

from the link you posted

Regardless of an individual’s professional attainments
here or abroad, no credit will be granted directly to an
applicant for surgical education in a foreign country. The
Board will consider granting partial credit only upon the
request of the Program Director of an accredited program
who has observed the applicant as a junior resident
for nine to twelve months and wishes to advance the
applicant to a higher level in that program. The credit
granted will not be valid until the applicant has successfully
completed that program. If the applicant moves to
another program, the credit is not transferable and must
again be requested by the new Program Director.


From my read of this: you can get partial credit to move up after spending about a year at your program and if your PD will remember to jump through that hoop and you finish the program.

Not having ever had to do this, I am willing to be corrected however.

 

[Pilot Doc]

What i could understand is that , you have to be doing the PGY1 year and the PD should then based on your perfomance request for credit for 1 year.
The thread for this post , the guy who got offered at UVA ,what i understand from the post , has never done any ACGME accredited training here in USA . HOw can PD offer him to skip first year and take him in PGY2.
To me certain things dont add up.

The question is not what the ACGME will consider him the first year - he'll probably be an intern on paper. The question is what he will be DOING in the hospital. Sounds like he will go into the roation with the PGY2's. If, for whatever reason, he doesn't get credit, he'll just have to spend an extra year as a mid-level resident before graduating. Clearly a better deal than having to repeat an internship.

 

[hans19]

I'd take the UVa spot.
Another issue, correct me if I'm wrong, but isn't UVa a 7 year track? I thought it was as recently as a few years ago?

 

[albinolion]

Hey everyone.
I want to thank all of you again for all of your kind advice.
I appreciate the time and effort a lot of you have given in response to my query.

You are correct about the ACGME, my year exemption would be dependent on my performance in the first year. However, I would be working at a 2nd year level (I have already done 3 years general surgery in Europe). Thanks for looking it up and giving me heads up about it.

Furthermore, UVA is still a 7 year program however, in rare circumstances, my understanding is that they allow you to complete the 5 years clinical if they know you are a foreigner on a J1 visa. The problem with the J1 visa is that it limits you to 7 years in the USA ONLY. SO that is 5 years clinical and 2 years fellowship. Some people who are only interested in general surgery would do the 5years + 2 years research. I know of certain circumstances where J1 visa holders at Duke, Hopkins, etc are 'excused' from doing the 2 years research because of visa constraints. However, if I get my one year exemption, that allows me to spend a year in the lab which still gives me time to finish my fellowship.

Thanks again for all of your help. Almost all of you said UVA is the way to go. Would that have changed were UVA not offering the chance for one year exemption?

Warmest Regards
Albinolion

 

[Winged Scapula]

I'm a bit confused - in 1 post you say you've done 2 years Gen Surg in Europe and then later, say its 3 years. Not that it matters much, but it can create a fair bit of misunderstanding.

I'll add my agreement to the clarion call for UVA. Rotated there as a medical student and was quite impressed, although obviously a student's experience doesn't compare with that of a resident.

I cannot imagine a situation in which I would encourage someone to take a Prelim position over a guaranteed Prelim one, unless there was such a large gradient of difference in quality of education...even then, I'm not sure I would.

Hopkins is well known, even internationally; UVA less so. However, it is still a very highly respected program in the US, you will be well trained, live in a much safer environment and will be capable of obtaining any fellowship you want (all else being equal) should you decide to pursue one.

In my short time here, I've seen 2 FMGs at other big name places come to Hershey after not being offered a Categorical position despite 2 clinical years and another year or more in the lab. Nothing against big name places; but there "word" or even the promise of a potential categorical spot is no better than Joe Blog's University in Podunk.

Take the UVA spot.

 

[GSorBust]

Hey everyone.
I want to thank all of you again for all of your kind advice.
I appreciate the time and effort a lot of you have given in response to my query.

You are correct about the ACGME, my year exemption would be dependent on my performance in the first year. However, I would be working at a 2nd year level (I have already done 3 years general surgery in Europe). Thanks for looking it up and giving me heads up about it.

Furthermore, UVA is still a 7 year program however, in rare circumstances, my understanding is that they allow you to complete the 5 years clinical if they know you are a foreigner on a J1 visa. The problem with the J1 visa is that it limits you to 7 years in the USA ONLY. SO that is 5 years clinical and 2 years fellowship. Some people who are only interested in general surgery would do the 5years + 2 years research. I know of certain circumstances where J1 visa holders at Duke, Hopkins, etc are 'excused' from doing the 2 years research because of visa constraints. However, if I get my one year exemption, that allows me to spend a year in the lab which still gives me time to finish my fellowship.

Thanks again for all of your help. Almost all of you said UVA is the way to go. Would that have changed were UVA not offering the chance for one year exemption?

Warmest Regards
Albinolion

No. Even if UVA was not offering the one year exemption, I would still 100% have recomended that you take the UVA spot outside of the match. The only other program on your list that is a "top tier" program is Duke. Duke is a great program, but the residents that I've spoken with at that program are not happy, in general. They went to Duke for the name, am many regret this now. UVA is certainly as good of a program, but the residents appear FAR happier. The other programs you interviewed at are inferior relative to those two. Plus, it is a guaranteed spot for a FMG (though clearly a very qualified one). UVA is an amazing training program - and I would certainly place it #1 on your list - if you were matching. Given the opportunity to sign outside of the match at what is probably the best program for you is something that I could not possibly turn down. People on this forum would absolutely kill for a guaranteed spot at UVA (even without the one year exemption). I would recommend taking the UVA spot, period. The one year exemption is a bonus, but even without that, you would be stupid to turn down the offer at what is, in my opinion, as well as several others who have interviewed at all of the same programs, the top program at which you interviewed (the only other program close is Duke). Take the UVA spot. No regrets. And never look back!

 

[albinolion]

Sorry about the confusion regarding my training.
The training system is a little different in Europe.
I did one year internship (during which you rotate through 6 months medicine and 6 months surgery). After that you apply for a 2 year basic surgical training residency throught the national match. I finished the one year internship (half of which is surgical) and the 2-year basic surgical residency. Most people go on to do 2 years research, and then to apply for a 6 year Higher surgical residency in the specialty of their choice (ie cardiothoracic).
When I say 2 years surgical training I am referring to the 2 years formal basic surgical residency....when I said 3 years later on, I was including my internship year.

 

[Winged Scapula]

Sorry about the confusion regarding my training.
The training system is a little different in Europe.
I did one year internship (during which you rotate through 6 months medicine and 6 months surgery). After that you apply for a 2 year basic surgical training residency throught the national match. I finished the one year internship (half of which is surgical) and the 2-year basic surgical residency. Most people go on to do 2 years research, and then to apply for a 6 year Higher surgical residency in the specialty of their choice (ie cardiothoracic).
When I say 2 years surgical training I am referring to the 2 years formal basic surgical residency....when I said 3 years later on, I was including my internship year.

Although I am personally quite familiar with the European training scheme (having trained in Australia which has many similarities), I'm sure others appreciate the clarification as I do.

 

[s204367]

I interviewed there 5 years ago. It was then a q2 program. It is however a great program. Hurly is a *****, certainly turn down a prelim year at Hopkins for UVA. There is a chance that if someone dropped from Hopkins they may take you into a categorical spot..but remember, the program gets reimbursed less for a foreign grad so you would have to kiss some seriously uptight asses at Hopkins to get the spot. I ranked UVA ahead of Hopkins straight up because 1.)baltimore is a ****hole, but mostly because UVA is a great program. You will get just as good of a fellowship out of UVA. A close friend is a PGY5 in neurosurg there, said he loved the GS folks. Sign that contract....now.....

 

[passlineandodds]

i met an fmg on the interview trail who was interviewing for a categorical spot but was talking up how badly he wanted to be a prelim at hopkins. he did say that he would pass over a categorical spot at a program that was less well regarded in favor of the prelim position at hopkins. i thought this was a little off the wall, but i could see where he was coming from given that jhu has an international reputation and so much history in surgery. the thing that burned me up was how he acted like he was above being a categorical at a program without the same pedigree as jhu. he just seemed so indignant about even being at the interview that day. i didn't say anything, but i thought to myself that he must really be overestimating the leverage he has to think that jhu would take him after his prelim years and underestimating how much the residency system is set up to benefit US grads (remember, our gov't subsidizes residencies). it reminded me of that old saying, "beggars can't be choosers."

 

[jmattwilson]

I am a fourth year at UVa and I can definately say there will be an extra spot open in the second year class. We just got approved for another resident slot by the RRC. The OP never said what he decided to do about the offer, could you tell us?

 

[albinolion]

It was a no brainer really.
UVA rocks and I loved it.
Its gonna be UVA baby!

 

[OldGeezer]

i met an fmg on the interview trail who was interviewing for a categorical spot but was talking up how badly he wanted to be a prelim at hopkins. he did say that he would pass over a categorical spot at a program that was less well regarded in favor of the prelim position at hopkins. i thought this was a little off the wall, but i could see where he was coming from given that jhu has an international reputation and so much history in surgery. the thing that burned me up was how he acted like he was above being a categorical at a program without the same pedigree as jhu. he just seemed so indignant about even being at the interview that day. i didn't say anything, but i thought to myself that he must really be overestimating the leverage he has to think that jhu would take him after his prelim years and underestimating how much the residency system is set up to benefit US grads (remember, our gov't subsidizes residencies). it reminded me of that old saying, "beggars can't be choosers."

It takes a lot to rile the OldGeezer, but by' gummit I'm riled....*hack!*....

What person would pin their hopes and dreams on a prelim spot over a categorical spot, even if that prelim. spot is at JHU? JHU is a good program, yes, but does anyone think for a second that, even on the almost zero chance that a JHU cat resident would drop out, JHU would advance a prelim (US or FMG) to an open categorical position? Are you nuts?.....*wheeze!*....

I am glad to hear Albinolion has selected the categorical spot at UVA, despite . For anyone out there who has not spent 10 minutes doing a little research about graduating chiefs from GS at UVa, let the 'geezer enlighten you about what kind of product this little program in VA turns out:

Graduating Chiefs: 2000
1. USC-----CT Surgery
2. U of Penn-----CT Surgery
3. U of Washington-----CT Surgery
4. Stanford-----CT Surgery

Graduating Chiefs: 2001
1. U of Colorado-----CT Surgery
2. U of Virginia-----CT Surgery
3. U of Virginia-----Surg Onc.

Graduating Chiefs: 2002
1. Washington U (St. Louis)---CT Surgery
2. U of Michigan-----CT Surgery
3. Vanderbilt-----Trauma/CC
4. Stanford-----CT Surgery

Graduating Chiefs: 2003
1. U of Tenn, Memphis-----Trauma/CC
2. U of Virginia-----CT Surgery
3. U of Michigan-----Xplant
4. U of Virginia-----CT Surgery

Graduating Chiefs: 2004
1. MGH-----CT Surgery
2. Emory----CT Surgery
3. U of Penn---CT Surgery
4. US Army obligation

Would someone please remind me again how UVa is not as "esteemed" as a JHU or a Duke?

 

[passlineandodds]

i've got a lot of love for uva. the people i talked to this year were putting it on the same footing (and some people even put it above) jhu. there's no dissin' the cavs here.

 

[Celiac Plexus]

For anyone out there who has not spent 10 minutes doing a little research about graduating chiefs from GS at UVa, let the 'geezer enlighten you about what kind of product this little program in VA turns out:

Graduating Chiefs: 2000
1. USC-----CT Surgery
2. U of Penn-----CT Surgery
3. U of Washington-----CT Surgery
4. Stanford-----CT Surgery

Graduating Chiefs: 2001
1. U of Colorado-----CT Surgery
2. U of Virginia-----CT Surgery
3. U of Virginia-----Surg Onc.

Graduating Chiefs: 2002
1. Washington U (St. Louis)---CT Surgery
2. U of Michigan-----CT Surgery
3. Vanderbilt-----Trauma/CC
4. Stanford-----CT Surgery

Graduating Chiefs: 2003
1. U of Tenn, Memphis-----Trauma/CC
2. U of Virginia-----CT Surgery
3. U of Michigan-----Xplant
4. U of Virginia-----CT Surgery

Graduating Chiefs: 2004
1. MGH-----CT Surgery
2. Emory----CT Surgery
3. U of Penn---CT Surgery
4. US Army obligation

Would someone please remind me again how UVa is not as "esteemed" as a JHU or a Duke?

To "the 'geezer"...

No one here was dissing UVA. In fact, I think everyone here agrees that UVA is a top-tier program.

From the looks of it, UVA is very successful placing its graduates in prestigious fellowships... though (and this is NOT a knock on UVA) ct surgery, transplant, and trauma are 3 of the less competitive fellowships. Further, it looks from the list you posted that UVA is geared toward CT surgery... great if you want to be a CT surgeon, but unimpressive if you don't care about CT.

About the OP being in love with JHU... I think we have all helped albin see that a cat spot at UVA is a better option than being a prelim at JHU.

best of luck to everyone in the match.