How about starting to talk about our 2017 rank lists?

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And Duke had the resident commit suicide 6 months ago. While they said they've created a new resident wellness committee and are doing things to address the issues, its still a bit of a red flag.
I would dismiss things like that as outliers and not include them into my decision to rank a program. Same thing with diversion.

And WRT a "wellness" program being a plus ... coming from the Navy, where we get mandatory suicide awareness training and related "help" endlessly and often, be careful what you wish for.

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I would dismiss things like that as outliers and not include them into my decision to rank a program. Same thing with diversion.

And WRT a "wellness" program being a plus ... coming from the Navy, where we get mandatory suicide awareness training and related "help" endlessly and often, be careful what you wish for.

Mandatory anything is bound to be a negative. If it were useful, you wouldn't need to coerce people into coming.
 
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Thanks for sharing everyone- this is all very useful information. I'll do a little write up of my own later.
Personally, I have a hard time coming to grips that I will likely rank some of the "top tier" Eastern programs below some mediocre west coast programs due to family/location reasons

Agreed. Feel torn about putting programs I really liked but below some programs I kinda like only because of location. The feelings change day by day haha. "Yeah I'd love to program X!.... but will I be happy away from family?..."
 
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Agreed. Feel torn about putting programs I really liked but below some programs I kinda like only because of location. The feelings change day by day haha. "Yeah I'd love to program X!.... but will I be happy away from family?..."
I have this internal battle on the daily. Every. Single. Day.
 
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I'm starting to lean:
1.) Duke
2.) Pitt
3.) Vanderbilt

In terms of location, I think they're all pretty great places. Nashville is loads of fun, but has gotten a bit big for its breeches, has awful traffic, and is becoming pretty expensive. Pittsburgh has way too many Steeler fans and somewhat worse weather than the other two. Durham is the smallest but has changed so much even over the past 5 years. Definitely gentrifying- new restaurants, breweries, bars. Still inexpensive, and good weather.

I think Duke probably has the edge in terms of prestige, particularly in the area of perioperative medicine and enhanced recovery. Plus I love the affiliation with University College London Hospital- I'm actually doing a rotation there after match. Pitt definitely has the edge in regional and in intern year. And I really like both the former and current PD at Vanderbilt, I think they're really exploring new and interesting things.

The things kind of giving me pause is that I liked the people at Pitt and Vandy a little more than at Duke (residents, I mean). And Duke had the resident commit suicide 6 months ago. While they said they've created a new resident wellness committee and are doing things to address the issues, its still a bit of a red flag. Though, of course, there are so many things that go into that situation, and my understanding is that she had a lot of personal struggles coming in.

Be careful judging residency programs based on the residents you interview with, since other than the CA-1s, you probably won't interact with them at all. Each class tends to have their own personality and it varies year to year. I went to Duke, and when I was a CA1, the CA3 class was hilarious and mostly single, the CA2 class was married and fairly bland, and my class was a mix. The two years after me were pretty good, also.

You also don't know who of your co-interviewees are going to end up matching with you, and that's really who you care about the most, since they're going to be in the trenches with you.

I wouldn't say to discount resident interactions, especially the objective details they give you about call schedules, work hours, etc, but if everything else checks out, I wouldn't let some grumpy residents on interview day dissuade you from making your choice.
 
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Tentative list as follows:

1- Duke Univ Med Ctr-NC
2- Vanderbilt Univ Med Ctr-TN
3- U Washington Affil Hosps
4- UPMC Medical Education-PA
5- Oregon Health & Science Univ
6- University of Virginia
7- Yale-New Haven Hosp-CT
8- U Colorado SOM-Denver
9- B I Deaconess Med Ctr-MA
10- Virginia Mason Med Ctr-WA
11- Barnes-Jewish Hosp-MO
12- Penn State Hershey Med Ctr-PA
13- Cleveland Clinic Fdn-OH

I had some unique geographical constraints/considerations and certain schools moved up or down on my list based on spousal preference. Spots 7-11 might move around more but I'd say list is 90% done.
 
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Tentative list as follows:

1- Duke Univ Med Ctr-NC
2- Vanderbilt Univ Med Ctr-TN
3- U Washington Affil Hosps
4- UPMC Medical Education-PA
6- Oregon Health & Science Univ
7- University of Virginia
8- Yale-New Haven Hosp-CT
9- U Colorado SOM-Denver
11- B I Deaconess Med Ctr-MA
13- Virginia Mason Med Ctr-WA
14- Barnes-Jewish Hosp-MO
15- Penn State Hershey Med Ctr-PA
16- Cleveland Clinic Fdn-OH

I had some unique geographical constraints/considerations and certain schools moved up or down on my list based on spousal preference. Spots 7-11 might move around more but I'd say list is 90% done.
Did you intentionally skip 5, 10, and 12?
 
Tentative list as follows:

1- Duke Univ Med Ctr-NC
2- Vanderbilt Univ Med Ctr-TN
3- U Washington Affil Hosps
4- UPMC Medical Education-PA
5- Oregon Health & Science Univ
6- University of Virginia
7- Yale-New Haven Hosp-CT
8- U Colorado SOM-Denver
9- B I Deaconess Med Ctr-MA
10- Virginia Mason Med Ctr-WA
11- Barnes-Jewish Hosp-MO
12- Penn State Hershey Med Ctr-PA
13- Cleveland Clinic Fdn-OH

I had some unique geographical constraints/considerations and certain schools moved up or down on my list based on spousal preference. Spots 7-11 might move around more but I'd say list is 90% done.

1.) What did you hate about the Cleveland Clinic?

2.) What did you like about UVA and Yale?
 
1.) What did you hate about the Cleveland Clinic?

2.) What did you like about UVA and Yale?


1- For CCF, just didn't enjoy my interview day (and pre-interview dinner). Dinner was huge and I found that off-putting. I wasn't really impressed with the resident at my table and at several times he was weirdly defensive. Interview day itself was just ok. I didn't really come out of any of my interviews feeling like I made a connection or anything. Also, I stayed an extra day in Cleveland and didn't like it. While the cost of living is low, I just didn't like it.

2- For Yale, it was the exact opposite. I had my best interview day there. I thought it was well-run and my interviewers were wonderful. The residents I interacted with the night before were super nice and friendly. New Haven wasn't a plus and it was more pricey than I liked. Honestly, if I was going purely by gut I would have ranked them higher but my spouse wasn't keen in New Haven.

UVA was about location, COL, and lifestyle. Residents and interviewers were all good. I think I would get fine clinical training there but I am aware it isn't one of the most prestigious programs and all that. My spouse liked Charlottesville and found it quaint and pretty affordable/get a lot for your money once you are 10 mins out of the town. I had it lower initial list but it bumped a couple on my most recent for the reasons above.
 
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1- For CCF, just didn't enjoy my interview day (and pre-interview dinner). Dinner was huge and I found that off-putting. I wasn't really impressed with the resident at my table and at several times he was weirdly defensive. Interview day itself was just ok. I didn't really come out of any of my interviews feeling like I made a connection or anything. Also, I stayed an extra day in Cleveland and didn't like it. While the cost of living is low, I just didn't like it.

2- For Yale, it was the exact opposite. I had my best interview day there. I thought it was well-run and my interviewers were wonderful. The residents I interacted with the night before were super nice and friendly. New Haven wasn't a plus and it was more pricey than I liked. Honestly, if I was going purely by gut I would have ranked them higher but my spouse wasn't keen in New Haven.

UVA was about location, COL, and lifestyle. Residents and interviewers were all good. I think I would get fine clinical training there but I am aware it isn't one of the most prestigious programs and all that. My spouse liked Charlottesville and found it quaint and pretty affordable/get a lot for your money once you are 10 mins out of the town. I had it lower initial list but it bumped a couple on my most recent for the reasons above.

Interesting. CCF seems to be a very strong program as a general rule but I did get the sense that you can get lost in the fray. My interview there was decent. I agree with what you said about UVA: Loved the people, beautiful location, very strong clinical training, etc. Only issue that I could see was research infrastructure. It didn't seem that research was that valued all things considered, which is kind of an issue for me. Yale had strong clinical and research opportunities, but New Haven wasn't my favorite place and it's kind of expensive to live in.
 
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Here's my list so far, but very subject to change. Right now, Duke and UNC are tied for 1st. Any opinions welcome!

1. UNC- Excellent training; residents work hard; Good mix of trauma/transplants/peds/OB/regional; great people; didactics seem excellent but not overbearing, a good amount of learning-by-doing (which is a + for me); lack of cardiac fellows means that residents get the ‘big’ cases and do a bunch of TEE; culture seems very supportive. Also a growing research emphasis.
1. Duke- Also excellent training, particularly thoracic/cardiac. A possible drawback seems the culture—I had two residents imply on interview day that there is a systemic disrespect for Anesthesiology (they said residents are often yelled at by surgeons in the OR); Otherwise seems like great cases, good didactics, and planty of research opportunities.
3. UPMC— Great training all-around; Plenty of research; PD is great. Pittsburgh is a great city and is affordable. Possible drawback is the commuting to several clinical sights, but not a big deal
4. Virginia Mason- Smaller department, residents work very hard, but also LOTS of focus on resident education. Exceptional regional, but also good exposure in other areas with rotations at Harbourview/Childrens/Swedish. Faculty are very close-nit and invested in residents.

5. Johns Hopkins
6. Stanford (Would have been higher, but $$ cost of living, and traffic is horrendous. Also, my wife wants to get her MPH, and the nearest program is Berkeley, which is a pretty bad drive.)
7. Wake Forest (Exceptional training all around, no fellows, serious focus on resident education--Would have been higher, even #1, but Winston-Salem also doesn't have an MPH program)
8. UMD
9. UW
10. GWU
11. Baylor
12. UT-H
 
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Here's my list so far, but very subject to change. Right now, Duke and UNC are tied for 1st. Any opinions welcome!

1. UNC- Excellent training; residents work hard; Good mix of trauma/transplants/peds/OB/regional; great people; didactics seem excellent but not overbearing, a good amount of learning-by-doing (which is a + for me); lack of cardiac fellows means that residents get the ‘big’ cases and do a bunch of TEE; culture seems very supportive. Also a growing research emphasis.
1. Duke- Also excellent training, particularly thoracic/cardiac. A possible drawback seems the culture—I had two residents imply on interview day that there is a systemic disrespect for Anesthesiology (they said residents are often yelled at by surgeons in the OR); Otherwise seems like great cases, good didactics, and planty of research opportunities.
3. UPMC— Great training all-around; Plenty of research; PD is great. Pittsburgh is a great city and is affordable. Possible drawback is the commuting to several clinical sights, but not a big deal
4. Virginia Mason- Smaller department, residents work very hard, but also LOTS of focus on resident education. Exceptional regional, but also good exposure in other areas with rotations at Harbourview/Childrens/Swedish. Faculty are very close-nit and invested in residents.

5. Johns Hopkins
6. Stanford
(Would have been higher, but $$ cost of living, and traffic is horrendous. Also, my wife wants to get her MPH, and the nearest program is Berkeley, which is a pretty bad drive.)
7. Wake Forest (Exceptional training all around, no fellows, serious focus on resident education--Would have been higher, even #1, but Winston-Salem also doesn't have an MPH program)
8. UMD
9. UW
10. GWU
11. Baylor
12. UT-H

Great list. I'd give Duke an edge over UNC because of research and name recognition. The thing you said about anesthesia getting yelled at isn't unique to Duke, I assure you. Duke is a wonderful program and I would have gladly ranked it 1 had I gotten an interview. UPMC is fantastic too. Stanford is another program that I've heard really cares about their resident education, but like you said the area is very expensive.
 
What is the consensus on Sinai for peds? I am thinking a peds fellowship and I know they don't have one and looking at where people have gone in the past it is good but not great imo. I know Columbia has peds but the residents there seemed so unhappy and only went there for the Columbia name wheras the Sinai residents all seemed genuinely happy.

Would I be able to get a top Peds fellowship at Sinai anywhere in the country (aka west or east coast) or am I limited to east coast if I put it above Columbia?
 
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What is the consensus on Sinai for peds? I am thinking a peds fellowship and I know they don't have one and looking at where people have gone in the past it is good but not great imo. I know Columbia has peds but the residents there seemed so unhappy and only went there for the Columbia name wheras the Sinai residents all seemed genuinely happy.

Would I be able to get a top Peds fellowship at Sinai anywhere in the country (aka west or east coast) or am I limited to east coast if I put it above Columbia?


I think you'll be fine if you want to do Peds. We've had people do Peds fellowships at Stanford and Children's Hospital of LA. Plus, there's a good chance that you won't want to do Peds at all, so why rank a residency that you're 'meh' on, spend four years there wishing you had gone somewhere else, and then do a completely different fellowship?
 
I think you'll be fine if you want to do Peds. We've had people do Peds fellowships at Stanford and Children's Hospital of LA. Plus, there's a good chance that you won't want to do Peds at all, so why rank a residency that you're 'meh' on, spend four years there wishing you had gone somewhere else, and then do a completely different fellowship?

I saw that in the past people have gone there but that was 5+ years ago so I wasn't sure if it was still an option now that more people are doing fellowships. I know Sinai's peds department is growing.
 
Here is my list -- I stayed pretty much in the southeast except for NYU and Temple:

1. Duke -- strongest program in the southeast
2. Vanderbilt -- great periop, becoming more of a leader
3. UNC -- friendliest residents of the bunch
4. UAB -- great moonlighting. residents friendly. Birmingham sucks.
5. UF -- too intense. Residents not happy
6. GW -- not great clinical exposure, but DC rocks and residents friendly.
7. MCG -- blah program overall. Residents happy. close to Atlanta which is nice.
8. NYU -- too cold, but a great program. I'm a southern person.
9. Tulane -- fun crowd. NOLA is rough. Training appears subpar. Residents nice.
10. Temple -- good trauma. That's it. UPenn gets good stuff. Rough part of town.
11. Emory -- worst of the bunch. PD is a DO (!). On probation (probably). Only Advanced.

I know my comment about the PD is bad for Emory. As people stated before, even DO applicants stay away from DO heavy programs.
 
Here is my list -- I stayed pretty much in the southeast except for NYU and Temple:

1. Duke -- strongest program in the southeast
2. Vanderbilt -- great periop, becoming more of a leader
3. UNC -- friendliest residents of the bunch
4. UAB -- great moonlighting. residents friendly. Birmingham sucks.
5. UF -- too intense. Residents not happy
6. GW -- not great clinical exposure, but DC rocks and residents friendly.
7. MCG -- blah program overall. Residents happy. close to Atlanta which is nice.
8. NYU -- too cold, but a great program. I'm a southern person.
9. Tulane -- fun crowd. NOLA is rough. Training appears subpar. Residents nice.
10. Temple -- good trauma. That's it. UPenn gets good stuff. Rough part of town.
11. Emory -- worst of the bunch. PD is a DO (!). On probation (probably). Only Advanced.

I know my comment about the PD is bad for Emory. As people stated before, even DO applicants stay away from DO heavy programs.
As a DO student, having a DO as the PD isn't the problem. I would have no concern about that. It's when >40% of the residents are DO's (an over representation), it suggests that they are having a hard time getting MD applicants. There must be a reason right?
 
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I would also be iffy about having a do as a pd

As a graduate of a US News top 15 medical school, that's insane. Medical students care more about medical school than anybody else. Once you are have completed training, people only care about your recent (last few weeks/months) performance. Where you went to medical school years ago is completely irrelevant. She is probably a badass pediatric anesthesiologist/intensivist. She's quadruple boarded. I've known a few. They are a breed apart. Her CV puts most MDs to shame.
 
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I would also be iffy about having a do as a pd

Oy, this is a horrendous statement to make. Discriminatory, would only be slightly worse if you pointed out gender or race. I'll assume you say this because you basically aren't exposed to many of them up north. There simply aren't very many DOs (schools or doctors) in the mid-Atlantic to NE part of the country, but there are plenty here in the SE. It's been eye opening and refreshing for me to work with them. In general they have to work harder and get better scores to get into competitive residencies, the ones we have at our program are often military who go for our advanced spots after their dedicated service time (which we are now phasing out). I can assure you, a doctor is a doctor and we have some strong physicians at our program. They get excellent fellowships as well - we've sent our DO graduates to CHOP/Boston Children's for Peds and Peds Cardiac, Duke/Michigan etc for CCM and other solid places.

That CV will be stronger than mine will probably ever be, c'mon man.
 
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You have a choice in the degree which you don't with gender or race. What a ridiculous comparison. The ones you see are good because you're at a good program. Most of them are not good. This is all slightly off topic.
 
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You have a choice in the degree which you don't with gender or race. What a ridiculous comparison. The ones you see are good because you're at a good program. Most of them are not good. This is all slightly off topic.
You think the ones that become PDs aren't good ones? Choice in degree often comes down to choice in school/location.
 
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You have a choice in the degree which you don't with gender or race. What a ridiculous comparison. The ones you see are good because you're at a good program. Most of them are not good. This is all slightly off topic.

This is a bit elitist. Not everyone has a choice. Not everyone has the support, the network, or sure, the undergrad grades to get into an allopathic school (do you really think a 3.9 gpa vs a 3.6 in undergraduate coursework automatically equates to being a better Doctor?). So what you're implying to me is if you wouldn't have gotten into an allopathic medical school you'd have quit and done something else? That says more to me than your miscellaneous top whatever Med school degree ever can.

A DO that has risen to the top in a well known allopathic residency program is literally a certified badass if for no other reason than they did it despite these widely held opinions.
 
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I saw that in the past people have gone there but that was 5+ years ago so I wasn't sure if it was still an option now that more people are doing fellowships. I know Sinai's peds department is growing.

It's still an option if you want to do it... If you want to do it IFYOUWANTTODOIT ifyouwanttodoit

Lol, but seriously, no stress. Go where you think you're going to be happy (or at least not unhappy).
 
Which programs are known to provide the most mentorship? As in the faculty look at you as more than a workhorse?
 
FMGs are not caribbean grads. They're people who were attendings in other countries and came here to get those sweet dollars. This group doesn't include the people who couldn't get into a us school and went caribbean, those are IMGs. They're not considered foreign grads because many of them are US or Canadian citizens. Some DOs are good, others aren't.

Some USMD are good, others aren't.
 
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Some of my best residents and colleagues have been DO's. Some states have multiple MD schools and others have very limited options, so the competitiveness to get into a particular school in a particular state may vary widely from state to state. My general feeling is that top 1/4 at an established D.O. school is equivalent to a really good MD candidate. I believe that students who are lower half of their class in a DO school are likely far inferior candidates than the lower half of allopathic schools, so I generally steer clear. But top 1/4 students are often superstars. I agree that filling a program with mostly DO's sends a bad message to potential MD students. The right mix needs to be sought out, but there are some dang good DO candidates out there.
I know of an Emergency Medicine program that got a DO program director and he filled the program with 75% DO's. It was terrible for the overall ability of the program to be able to attract the best and brightest and it took several years for them to bounce back. So, with a DO as program director, I think the key is to continue to fill the program with a good ratio of MD to DO applicants. Based on the credentials mentioned above, she seems highly qualified.
The osteopathic stigma still exists, but seems to be fading somewhat (except for surgical specialties, it seems). Although, I worry that they are over expanding their numbers far too fast with uncontrolled proliferation of osteopathic, for profit med schools that seem to be popping up everywhere. Without an increase in available GME spots, they are simply creating more graduates that will not be able to find residency positions. In addition, these new schools lack the infrastructure and hospital affiliations to take care of the large class sizes. Therefore, many of them are farmed out to remote areas and are forced to fend for their own education, which can vary widely and lacks adequate quality control. I trust the established DO schools based on a long track record. The jury is still out on many of the new ones.
If I had one warning to give to potential med students, it would be to be very skeptical of any osteopathic school that is not more than a decade old.
 
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Some of my best residents and colleagues have been DO's. Some states have multiple MD schools and others have very limited options, so the competitiveness to get into a particular school in a particular state may vary widely from state to state. My general feeling is that top 1/4 at an established D.O. school is equivalent to a really good MD candidate. I believe that students who are lower half of their class in a DO school are likely far inferior candidates than the lower half of allopathic schools, so I generally steer clear. But top 1/4 students are often superstars. I agree that filling a program with mostly DO's sends a bad message to potential MD students. The right mix needs to be sought out, but there are some dang good DO candidates out there.
I know of an Emergency Medicine program that got a DO program director and he filled the program with 75% DO's. It was terrible for the overall ability of the program to be able to attract the best and brightest and it took several years for them to bounce back. So, with a DO as program director, I think the key is to continue to fill the program with a good ratio of MD to DO applicants. Based on the credentials mentioned above, she seems highly qualified.
The osteopathic stigma still exists, but seems to be fading somewhat (except for surgical specialties, it seems). Although, I worry that they are over expanding their numbers far too fast with uncontrolled proliferation of osteopathic, for profit med schools that seem to be popping up everywhere. Without an increase in available GME spots, they are simply creating more graduates that will not be able to find residency positions. In addition, these new schools lack the infrastructure and hospital affiliations to take care of the large class sizes. Therefore, many of them are farmed out to remote areas and are forced to fend for their own education, which can vary widely and lacks adequate quality control. I trust the established DO schools based on a long track record. The jury is still out on many of the new ones.
If I had one warning to give to potential med students, it would be to be very skeptical of any osteopathic school that is not more than a decade old.


how does PD manage the ratio of DO/MD in the incoming class in terms of ROL ?
 
Which programs are known to provide the most mentorship? As in the faculty look at you as more than a workhorse?
I felt like U of Michigan and WashU both had very good, well structured mentorship systems (Michigan > WashU)
 
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As a graduate of a US News top 15 medical school, that's insane. Medical students care more about medical school than anybody else. Once you are have completed training, people only care about your recent (last few weeks/months) performance. Where you went to medical school years ago is completely irrelevant. She is probably a badass pediatric anesthesiologist/intensivist. She's quadruple boarded. I've known a few. They are a breed apart. Her CV puts most MDs to shame.

That's the take-away lesson here for all of you: No matter how smart you are right now a weaker, dumber (yes, that is the right word) physician can surpass your credentials by putting in the time and effort. Hence, it's better to go somewhere and do a fellowship or two (yes, two) than match at a prestigious program then skip the fellowship year or years. Private practice opportunities are drying up. One could have a great academic career and out-earn the vast majority of your colleagues in practice by obtaining 1-2 extra pieces of paper.

In my day only the truly committed academic types or FMG/IMGs typically did a fellowship year. The best and brightest chose to go to work rather than "waste" a year. The world has changed and now you can climb the ranks of academia as a "DO" or IMG by putting in those extra 2 years. With the CRNA encroachment on the bread and butter combined with the AMCs taking huge market share those who decide on 2 fellowships may end up being the smart ones in 10 years.

The DOs and IMGs more than most MD applicants are prepared to go the extra mile; the key is finding the upper 1/4 of them and then giving them the chance to shine.
 
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Would it be dumb to rank a top 10 program behind mid- to low-tier programs for location alone?
 
Would it be dumb to rank a top 10 program behind mid- to low-tier programs for location alone?

Depends on the programs and other reasons why but in general I think no. Fit is the most important, most programs will teach you to be a decent anesthesiologist but it's up to you to become great.
 
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That's the take-away lesson here for all of you: No matter how smart you are right now a weaker, dumber (yes, that is the right word) physician can surpass your credentials by putting in the time and effort. Hence, it's better to go somewhere and do a fellowship or two (yes, two) than match at a prestigious program then skip the fellowship year or years. Private practice opportunities are drying up. One could have a great academic career and out-earn the vast majority of your colleagues in practice by obtaining 1-2 extra pieces of paper.

In my day only the truly committed academic types or FMG/IMGs typically did a fellowship year. The best and brightest chose to go to work rather than "waste" a year. The world has changed and now you can climb the ranks of academia as a "DO" or IMG by putting in those extra 2 years. With the CRNA encroachment on the bread and butter combined with the AMCs taking huge market share those who decide on 2 fellowships may end up being the smart ones in 10 years.

The DOs and IMGs more than most MD applicants are prepared to go the extra mile; the key is finding the upper 1/4 of them and then giving them the chance to shine.
which two would you do?
 
Sometimes I think I want to have an impressive resume. But sometimes I just want a job and have a life.

The idea of doing research to me has usually been dreadful. People suck and don't really research meaningful things. But I want to teach and be involved in academia and do research on things I find meaningful. I don't believe all hope is lost on that front, but it's certainly not a rosy outlook.

My idea has always been to keep the most doors open.

Based on your post a fellowship year is essential. The pain and suffering of that one extra year is more than worth it IMHO.
 
Based on your post a fellowship year is essential. The pain and suffering of that one extra year is more than worth it IMHO.

I've actually found fellowship to be more enjoyable than residency. I wasn't exactly miserable as a resident, but fellowship is better. The hours are long, but the minutes are pretty good. It's really kind of nice to have zero responsibility for anything except my cases and my own education. It's a little weird being a powerless trainee again, but on the whole I feel like I'm treated very well. On the rare occasions when I'm not, and I'm bewildered and exasperated by how unbelievably obtuse and unfit for human contact some people are, it helps to take a step back and remember what I'll be leaving with: greatly expanded knowledge, new skills, a certificate, eligibility for subspecialty board certification, and a valuable network of references for future jobs. What's not to like? (Besides a year of lost income ....)
 
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Back to the rank list: Most of you have done your home work and really have a good list. I hope you all haven't forgotten about that "extra year" which more than 50% of you will be doing after residency.
 
That's the take-away lesson here for all of you: No matter how smart you are right now a weaker, dumber (yes, that is the right word) physician can surpass your credentials by putting in the time and effort. Hence, it's better to go somewhere and do a fellowship or two (yes, two) than match at a prestigious program then skip the fellowship year or years. Private practice opportunities are drying up. One could have a great academic career and out-earn the vast majority of your colleagues in practice by obtaining 1-2 extra pieces of paper.

In my day only the truly committed academic types or FMG/IMGs typically did a fellowship year. The best and brightest chose to go to work rather than "waste" a year. The world has changed and now you can climb the ranks of academia as a "DO" or IMG by putting in those extra 2 years. With the CRNA encroachment on the bread and butter combined with the AMCs taking huge market share those who decide on 2 fellowships may end up being the smart ones in 10 years.

The DOs and IMGs more than most MD applicants are prepared to go the extra mile; the key is finding the upper 1/4 of them and then giving them the chance to shine.

2 fellowships??? wouldnt this box you into academia....what if you you just want to get a job and work, wouldn't one fellowship suffice to secure a job in private practice...even circa 2027
 
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2 fellowships??? wouldnt this box you into academia....what if you you just want to get a job and work, wouldn't one fellowship suffice to secure a job in private practice...even circa 2027

Yes. 2 fellowships would be for an academic career. But, in this day and age who could argue with that choice as a career path? Why not do 2 and get a leg up on those around you (academia )?

Again, one fellowship is all you need for insurance and even for the vast majority of academic careers.
 
Returning to the main topic.

I'm from the mountain west. Med school in the Midwest. My end goal is to end up practicing in the West/Mountain West. I've got a wife and kids so that affects my decisions a lot. Always open to thoughts, input, and opinions. I'll honestly be stoked to end up in any of my top 6. Still happy about the rest. One program I didn't like that I'm not ranking.

1. WashU
Pro: I live in STL already. Did a rotation here and loved it. Really just excellent program, happy residents, stellar in-house moonlighting opportunities.
Con: none for me.

2. U of Michigan
Pro: Loved nearly everything about the program. Ann Arbor seems nice. Huge alumni network.
Con: so fetching cold

3. Loma Linda
Pro: for me the location is my #1. More rock climbing than I know what to do with, can hit the ski slopes and the beach on the same day. Disneyland (for my kids) and sunshine. Have extended family in the area, and much closer to immediate family.
Con: higher COL. A good program but seems like not as strong of reputation as others.

4. CCF
Pro: Great surgical variety and all the hearts (I'm interested in cardiac). I like the structure of the rotations.
Con: Cleveland seems nice enough, but not great. No in-house trauma. Seems like CCF as a whole is empowering advanced nurses.

5. U of Utah
Pro: Closest to home. Best local job prospects. Utah is gorgeous (outdoors, climbing, camping, mountain biking, mountaineering). Awesome ultrasound and echo training (significant portion of residents are taking and passing the advanced exam for TEE every year).
Con: mostly advanced positions. just didn't get "the vibe" from most of the residents.

UNMC
U of Iowa
San Antonio
Arizona
Oklahoma
Well, after hashing it all out with my wife and completing my final interviews, this has changed a bit.

1. U of Michigan
2. WashU
3. Loma Linda
4. U of Kentucky
5. U of Nebraska
6. U of Utah
7. Cleveland Clinic
8. U of Iowa
9. U of Arizona
10. UT San Antonio
11. U of Oklahoma

It's funny because I used to always be surprised when I saw "top" programs low on people's lists. After going through all this, location has played a far more significant role than I'd planned. Otherwise, gut feeling was another major factor. Way more than all the nitty gritty little stuff that I was so worried about coming into it all. I'll be stoked to end up at any of my top programs and very pleased at any of the other programs to be completely honest. The only program I couldn't see myself at, just didn't get ranked at all.
 
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See, this is where the whole fellowships are required thing falls apart for me (and I'm a fellow);

Doom and gloomers (realists?) will say that everyone will be an employee in 10-20yrs. So if the inevitable is to be a cog supervising 4 rooms for Sheridan or miscellaneous other venture capital firm why in the F would most residents do a fellowship to lose another year of substandard 250-300k? The AMCs are going to need far more generalists than cardiac or peds etc. Fellowships like Regional are nice I guess but the avg PP group expects a generalist to be able to do the standard blocks for joints anyways.

Now in regards to academics I can see it. And more and more residents are going to sign up for academics when they see, as is already the case in a good portion of areas, that the academic jobs pay just as well if not better while having better benefits. Why anyone would join Sheridan etc for 250k base when you could sign on at an academic place for 280-320k base, unless purely for family or location reasons, is beyond me. In this setting Fellowships will set you apart for academic jobs.

Just my 0.02 but I wouldn't even apply or look at these AMCs starting people out in the low to mid 200's. That's insulting.
 
Well, after hashing it all out with my wife and completing my final interviews, this has changed a bit.

1. U of Michigan
2. WashU
3. Loma Linda
4. U of Kentucky
5. U of Nebraska
6. U of Utah
7. Cleveland Clinic
8. U of Iowa
9. U of Arizona
10. UT San Antonio
11. U of Oklahoma

It's funny because I used to always be surprised when I saw "top" programs low on people's lists. After going through all this, location has played a far more significant role than I'd planned. Otherwise, gut feeling was another major factor. Way more than all the nitty gritty little stuff that I was so worried about coming into it all. I'll be stoked to end up at any of my top programs and very pleased at any of the other programs to be completely honest. The only program I couldn't see myself at, just didn't get ranked at all.


Your top 2 programs are outstanding residencies.
 
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Need help with the middle of my list as well:

9. Case Western UH: seems like a good program clinically. Residents work hard. Not strong on research. Cold winters. Was just put on warning (not sure of reason).
10. University of Tennessee - Knoxville: Smaller program. Little research. Smaller college city. Not as diverse.
11. George Washington University: small program, weaker on research. Big city but expensive. Not as clinically varied (as far as I can tell).
12. Jackson Memorial: huge program, opportunities for research seem to be available but residents work very hard, heard that it's malignant.
13. Henry Ford: small-medium sized program, not much name recognition.
 
Well, after hashing it all out with my wife and completing my final interviews, this has changed a bit.

1. U of Michigan
2. WashU
3. Loma Linda
4. U of Kentucky
5. U of Nebraska
6. U of Utah
7. Cleveland Clinic
8. U of Iowa
9. U of Arizona
10. UT San Antonio
11. U of Oklahoma

It's funny because I used to always be surprised when I saw "top" programs low on people's lists. After going through all this, location has played a far more significant role than I'd planned. Otherwise, gut feeling was another major factor. Way more than all the nitty gritty little stuff that I was so worried about coming into it all. I'll be stoked to end up at any of my top programs and very pleased at any of the other programs to be completely honest. The only program I couldn't see myself at, just didn't get ranked at all.

Your top 2 are solid. I'm curious why CCF and Iowa aren't up there with them. Both are stellar programs that put resident education first. I don't know much about Loma Linda and Kentucky. Utah is a beautiful location, but I think they might not have CRNAs, leaving you to be the main workforce rather than being a primary learner. Every case is not a good learning case, no matter how many times they repeat that. Also, what stood out about Nebraska to you? I noticed you have them talked pretty high.
 
I perceived my list to be clinically equivalent so I cared more about location, QoL, CoL, culture fit. Really having trouble flip flopping #2 and 4 which could be significant.

1. Mt Sinai
+PD is THE MAN and ultimate resident advocate, culture fit, epic moonlighting (residents have made 6 figures), best subsidized housing of NY 4, chief is going to MGH without fellowship so you know job placement is legit here, dept is well respected in hospital
-older facility, not a research powerhouse, weaker peds

2. NW
+singles culture, downtown location in Chicago (honestly only reason why it's #2), strong clinical experience all around
-less warm/friendly residents than UChicago, heavy OB experience (reason for ACGME warning)

3. WashU
+research, all-around clinical powerhouse, smaller resident size better case selection, really loved the residents here, low CoL
-midwest, STL is just ok

4. U Chicago
+absolutely loved the chief residents (good sign of program culture), facilities, tight knit group, higher QoL than NW, more geographically diverse fellowship matches
-basically have to drive to work, perceived to be less clinically strong than NW (but I'm not sure about this)

5. U Michigan
+culture of excellence, research/clinical powerhouse, huge alumni network, college sports
-Ann Arbor, too family oriented (can you tell I'm single)

6. Cornell
+tri institutional model, strong regional experience, strong leadership, location
-perceived to be longer hours, housing choices limited due to CoL, "innovative" curriculum seemed to be more hype than reality

7. UPMC
+very strong and diverse clinical experience, didactics, research
-awkward interactions with program on interview day suggest a poor culture fit

8. NYU
+QoL, location
-QoL, interview day was odd and didn't feel like I learned that much about the program then it was over

9. Columbia
+research clinical blah blah blah
-probably the best all-around program on my list but I get the feeling that I would be happier while achieving the same career goals at the above programs (prestige ****** are overrated)
 
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