How important is going to a top 20 program in securing a job at an academic medical center post-residency?

[MilleniumFalcon30]

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How important it is to go to a top 20 program to get a job at an academic medical center – I am not really talking about an attending job at a top 10 program, but a faculty position at a less prestigious university hospital.

The reason I have this dilemma is because I am couples matching, which complicates my rank list.

Let's say I go to a program like University of Cincinnati, University of Minnesota, University of Rochester, University of Kentucky, Penn State, etc. for residency. The residents seem to get great training at places such as these and I got a good "vibe". Would I have trouble getting jobs at university hospitals approximately in that “tier” after residency?

Or do I need to be at a top 20 program in order to do that? Would a program like Hopkins, WashU or Cleveland Clinic open up infinitely more doors?

I know that the aforementioned non-top 20 hospitals will take some of their own grads, but if I wanted to move around for a better job or family reasons or whatever the future holds, how limited would I be by not going to a top 20 place?

I know that some of you will likely encourage PP, but I really like teaching and I am willing to take a pay cut to do that.

Thank you for any advice.

 

[deleted697127]

How important it is to go to a top 20 program to get a job at an academic medical center – I am not really talking about an attending job at a top 10 program, but a faculty position at a less prestigious university hospital.

The reason I have this dilemma is because I am couples matching, which complicates my rank list.

Let's say I go to a program like University of Cincinnati, University of Minnesota, University of Rochester, University of Kentucky, Penn State, etc. for residency. The residents seem to get great training at places such as these and I got a good "vibe". Would I have trouble getting jobs at university hospitals approximately in that “tier” after residency?

Or do I need to be at a top 20 program in order to do that? Would a program like Hopkins, WashU or Cleveland Clinic open up infinitely more doors?

I know that the aforementioned non-top 20 hospitals will take some of their own grads, but if I wanted to move around for a better job or family reasons or whatever the future holds, how limited would I be by not going to a top 20 place?

I know that some of you will likely encourage PP, but I really like teaching and I am willing to take a pay cut to do that.

Thank you for any advice.

Kentucky and Rochester have great reputations. Kentucky in particular has a strong reputation for education in anesthesia with a video series some residents use on YouTube. Neither should limit your prospects. Your threshold should be a major academic center.

With that said, the top programs certainly do open up doors. It is much easier to get fellowships. The big cities have multiple fellowship programs all right there. This makes it much easier to go to interviews and have options.

 

[AdmiralChz]

Not important at all - if you want to work in academia, plan on a fellowship. Many are not competitive at all - CCM, peds, regional, ob... all have open spots after the match each year and often at top places.

Even in competitive fields like cardiac and pain it is not heinous difficult to be able to secure a high-level fellowship out of a standard university-level residency with some work (strong ITE scores, good letters and case reports taken to subspecialty society meetings). It may be harder to secure such a spot if you come from more community-based programs but the ones you listed are of much higher caliber.

Academic jobs, in general, aren’t terribly competitive (typically because of decreased pay compared to PP all things being equal), so you have that going for you.

 

[psychbender]

Pretty much what he said. Most run of the mill academic programs don't turn their noses up at applicants from the same tier. Also, in this day and age, many programs have maybe a one or two line bio listing med school and residency/fellowship (and maybe research or clinical interests) for most of their faculty on their website. Try looking up some places that you want to be and see where their faculty trained.

Sent from my SM-G930V using SDN mobile

 

[kidthor]

I work at one of those "top 20" programs and we have people from all sorts of backgrounds.

We have MDs, DOs, Caribbean med school grads, international grads... and people then did residency and fellowship at all sorts of places. Some fancy, some not.

Note almost all did a fellowship.

I doubt my employer would turn their nose up at any place you mentioned. Have a good personal reputation with a good potential for research and you'll be golden.

 

[Zekchar]

I work at one of those "top 20" programs and we have people from all sorts of backgrounds.

We have MDs, DOs, Caribbean med school grads, international grads... and people then did residency and fellowship at all sorts of places. Some fancy, some not.

Note almost all did a fellowship.

I doubt my employer would turn their nose up at any place you mentioned. Have a good personal reputation with a good potential for research and you'll be golden.

I'm an academic and concur. Long as you're a warm body, can get along with people, and are not socially awkward you are awarded the opportunity to try and make it work.

 

[MilleniumFalcon30]

Thank you for your responses - I really appreciate the insight. This has substantially eased the rank list agony my SO and I have been having.

 

[deleted171991]

Thank you for your responses - I really appreciate the insight. This has substantially eased the rank list agony my SO and I have been having.

You should NOT focus on becoming an academic body. There is little difference between a big academic center and a management company, except the latter pays better. You will be just one of the many instructor/assistant professors who don't even get to teach, but rather work solo or cover 3-4 CRNAs, many times at just slightly higher level of importance than a resident (as in you get the crappiest assignments every day). There are fewer and fewer incentives for one to remain in academia.

If you think teaching is your calling, you're f-cked, because nobody really cares about your talents, but about the amount of garbage you can put out as "research" and the grants you can attract. Academia nowadays has (almost) nothing to do with teaching and everything to do with money; they have departments of 100 people around 50-60 residents (that says it all - only "the chosen" 30% get to teach). You're there to work your butt off and make them profits, so that the chosen few can get "academic" and "administrative" days while being paid better than you. If you're not at the table, you're on the menu.

And I haven't even mentioned the politics yet. If you can make it in some big academic centers, you can make it in Congress. Academia, like any big corporation, is about knowing how to work the system. Merit has little to do with your advancement and quality of life. Especially since residents can't even appreciate an academic who teaches the future instead of the local Gospel (as we turn into a quasi-nursing specialty, every generation seems to be dumber and of lower quality).

What should you focus on? Finding a short partnership track job with a reputable small PP group. Unless you're just another brown-nosing lazy bastard who likes to hide in the crowd.

 

[kidthor]

You should NOT focus on becoming an academic body. There is little difference between a big academic center and a management company, except the latter pays better. You will be just one of the many instructor/assistant professors who don't even get to teach, but rather work solo or cover 3-4 CRNAs, many times at just slightly higher level of importance than a resident (as in you get the crappiest assignments every day). There are fewer and fewer incentives for one to remain in academia.

If you think teaching is your calling, you're f-cked, because nobody really cares about your talents, but about the amount of garbage you can put out as "research" and the grants you can attract. Academia nowadays has (almost) nothing to do with teaching and everything to do with money; they have departments of 100 people around 50-60 residents (that says it all - only "the chosen" 30% get to teach). You're there to work your butt off and make them profits, so that the chosen few can get "academic" and "administrative" days while being paid better than you. If you're not at the table, you're on the menu.

And I haven't even mentioned the politics yet. If you can make it in some big academic centers, you can make it in Congress. Academia, like any big corporation, is about knowing how to work the system. Merit has little to do with your advancement and quality of life. Especially since residents can't even appreciate an academic who teaches the future instead of the local Gospel (as we turn into a quasi-nursing specialty, every generation seems to be dumber and of lower quality).

What should you focus on? Finding a short partnership track job with a reputable small PP group. Unless you're just another brown-nosing lazy bastard who likes to hide in the crowd.

Dang... my experience in academia has not been so bleak. I'm sure there's a lot of variation.

I work with fellows, residents, CRNAs, and do some solo time. Usually I'm 1:2, rarely 1:3. I teach occasional lectures to our fellows, participate in some CME workshops, do some sims, go to a speciality meeting here and there. Sometimes I go give a talk somewhere and meet new people. I've got plenty of time off... I publish here and there and there isn't undue pressure for me to do so. My benefits are overall good and it's unlikely I'd ever lose this job if I wanted to stay forever (there are, for better or worse, many lifers where I am).

Certainly I'd make much more in a proper PP job. But there actually aren't any in my area. It's all AMCs or academics. FWIW the people I work with grumble at times but very few jump ship to PP in my area.

For OP couples matching then later finding two physician jobs, I don't think the goal of an academic job is a bad one.

But yes, one should carefully evaluate what's on offer. There are good and bad versions of all anesthesia practice types.

 

[MoMoGesiologist]

I work at one of those "top 20" programs and we have people from all sorts of backgrounds.

We have MDs, DOs, Caribbean med school grads, international grads... and people then did residency and fellowship at all sorts of places. Some fancy, some not.

Note almost all did a fellowship.

I doubt my employer would turn their nose up at any place you mentioned. Have a good personal reputation with a good potential for research and you'll be golden.

Is this “The Clinic”?

 

[deleted171991]

Dang... my experience in academia has not been so bleak. I'm sure there's a lot of variation.

I work with fellows, residents, CRNAs, and do some solo time. Usually I'm 1:2, rarely 1:3. I teach occasional lectures to our fellows, participate in some CME workshops, do some sims, go to a speciality meeting here and there. Sometimes I go give a talk somewhere and meet new people. I've got plenty of time off... I publish here and there and there isn't undue pressure for me to do so. My benefits are overall good and it's unlikely I'd ever lose this job if I wanted to stay forever (there are, for better or worse, many lifers where I am).

Certainly I'd make much more in a proper PP job. But there actually aren't any in my area. It's all AMCs or academics. FWIW the people I work with grumble at times but very few jump ship to PP in my area.

For OP couples matching then later finding two physician jobs, I don't think the goal of an academic job is a bad one.

But yes, one should carefully evaluate what's on offer. There are good and bad versions of all anesthesia practice types.

I think bad markets tend to have bad academic jobs, too, because if they can get away with abusing people in PP or AMCs, why would academia be an exception?

 

[2Fast2Des]

Is this “The Clinic”?

The Holy Grail, the Bee's Knees, Second to None!

 

[IlDestriero]

My academic job is better than most (all?) AMC jobs. Never 1:3, sitting my own cases often. One call a month. >$400k, actual good benefits. Desirable city. Decent vacation, academic/admin time.
If the academic job sucks, keep looking.
This job wasn’t even my highest paying academic offer, but it was the best money for time worked job in a real city.

 

[coffeebythelake]

My academic job is better than most (all?) AMC jobs. Never 1:3, sitting my own cases often. One call a month. >$400k, actual good benefits. Desirable city. Decent vacation, academic/admin time.
If the academic job sucks, keep looking.
This job wasn’t even my highest paying academic offer, but it was the best money for time worked job in a real city.

Nice