How important is prestige of residency program?

[jungianANAL]

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I'm leaning toward academics or some kind of privademic set-up. How important would it be to go to, say, a Harvard-affiliated program or name brands like Mayo or Hopkins vs a place like University of Michigan or Emory, which also have great research and training but have less sticker appeal? I know the conventional wisdom is that goodness-of-fit is the most important factor to consider in the match, but I don't want to be kicking myself for the rest of my life for not ranking the big shot household name Ivy League program #1. Thanks!

 

[MacDonaldTriad]

There is a long thread about this about a dozen threads below, but the reader's digest answer is that this is the time to be more Jungian and less anal and do what you want. It is more about how awesome you do and less about where you do it.

 

[Chimed]

As much as I hate to say it, it is true that coming from a well known institution does carry some weight. If you're going into academics, you want to go somewhere they will support your interests and where you can get publications. But getting those publications are typically going to be easier in the place that offers a lot of research support to their residents. So a place like Emory or Michigan is going to be solid for an academic career. In the end your body of work in the most important.

 

[wolfvgang22]

Here's some food for thought:
I did residency at a busy community psychiatry program after deciding to go for best fit for over big names in the Match. At the community program, it was easy to get support for doing research, present posters, etc. There was even a full time statistician that visited with us frequently and loved to help with projects.

I decided to change things up for fellowship at a "big name" program where the faculty are leaders in research and put out a lot of publications. If I wrote their names here, you would recognize them if you read much. Unfortunately, the researchers were not at all interested in helping fellows with research. They were interested in asking us to do uncredited scut work. I learned a lot there, but published nothing.

So my advice is go where they are interested in you, and you fit in. If it's a big name, great.

 

[Bartelby]

I think it's very hard to know because most of us only went to one residency program and have worked with at most a handful since. In contrast to wolfvgangs experience when I was a resident at a "big name" program a national leader in my area of interest served as my research mentor. I published several papers and a textbook chapter with him (and others in his group) and know he was very invested in helping me launch a successful career. I had a great experience, though it had so much more to do with individuals willing to mentor me than with the program name.

If you see a place fostering scholarship and supporting its residents, and you seek out a faculty mentor who really cares about helping residents, then I think you can thrive. There are certainly more than a few such programs, and places like you the ones you mentioned as having less "sticker appeal" could certainly be among them.

 

[Doc1401]

I'm leaning toward academics or some kind of privademic set-up. How important would it be to go to, say, a Harvard-affiliated program or name brands like Mayo or Hopkins vs a place like University of Michigan or Emory, which also have great research and training but have less sticker appeal? I know the conventional wisdom is that goodness-of-fit is the most important factor to consider in the match, but I don't want to be kicking myself for the rest of my life for not ranking the big shot household name Ivy League program #1. Thanks!

I think you may be confused about these institutions when it comes to psychiatry. Applicants frequently choose Emory over most other psychiatry programs (yes, Harvard and Hopkins) - if they can get an interview. Some may feel a better fit at any of those individual institutions and should decide their rankings based on that. Mayo is not even in the same league when it comes to psychiatry.

 

[jungianANAL]

I think you may be confused about these institutions when it comes to psychiatry. Applicants frequently choose Emory over most other psychiatry programs (yes, Harvard and Hopkins) - if they can get an interview. Some may feel a better fit at any of those individual institutions and should decide their rankings based on that. Mayo is not even in the same league when it comes to psychiatry.

Well yeah basically all I have to go on is doximity ratings.

 

[Monocles]

From personal experience prestige is dumb.

I can't remember the number of times I've had supervision or lectures by "the #1 researcher or world expert in [insert subject here]" and it turns out they are pathological narcissists who basically spend the whole time recounting their own academic pedigree and accolades instead of giving helpful teaching points.

 

[NickNaylor]

I agree with the above in that, in general, "prestigious" institutions are typically flush with cash and resources. This will typically, though not always, make it easier to get involved in scholarly activity if that's something that's important to you and/or important to developing your future career trajectory.

I'm not particularly convinced that you get a markedly better training experience by being at a "prestigious" institution from a clinical perspective.

 

[MacDonaldTriad]

If you get along well with people who suffer fools poorly and have an inappropriately exaggerated amount of self confidence, prestigious programs may be for you. If you find arrogance insufferable, maybe not. I acknowledge that I'm generalizing and there are many exceptions, but generalizations are generally true.

 

[671002]

I'm not particularly convinced that you get a markedly better training experience by being at a "prestigious" institution from a clinical perspective.

I realize residency to a large degree is what you make of the training but for someone wanting to get the best clinical training possible, how does an applicant discern which program will provide that if prestige is apparently meaningless unless you are pursuing a career in research? Are US News and World Report/Doximity rankings worthless for picking programs to receive the best clinical training? I guess “best training” is relative and interest dependent. It seems like these rankings lack objectivity/data to back up them up.

 

[NickNaylor]

I realize residency to a large degree is what you make of the training but for someone wanting to get the best clinical training possible, how does an applicant discern which program will provide that if prestige is apparently meaningless unless you are pursuing a career in research? Are US News and World Report/Doximity rankings worthless for picking programs to receive the best clinical training? I guess “best training” is relative and interest dependent. It seems like these rankings lack objectivity/data to back up them up.

Of course there is a lack of objectivity. USNWR rankings are essentially useless, as are hospital rankings. There perhaps may be some appreciable differences at the ends of the bell curve (both good and bad), but for the most part I doubt that there are huge, significant differences among programs.

IMO, trying to identify a program that offers the ability to get training in things that you're interested in, is culturally compatible with what you're looking for, and is somewhere you want to live are way more important than "prestige." This is especially true if you have no interest in academics - for 99% of people, it just isn't going to matter.

I'm not trying to make the argument that all programs are identical, just that "prestige" is not a particularly useful proxy for identifying programs that are the best places to train. They may or may not be depending on what your goals are and what's important to you. A lot of the "quality" of programs comes from word of mouth. This is where having a mentor who is in the know is helpful.

 

[Bartelby]

For good clinical training look for:

-working with a range of poor to wealthy patients
-good therapy supervision, preferably with some PGY2 exposure
-connection with a tertiary care center for CL
-options for ECT, TMS
-specialty clinics (DBT, eating disorders, forensic, etc) or at least good exposure
-good didactics (ask current residents)
-appropriate workload (keeping you busy but still having time to read)

 

[OldPsychDoc]

Well yeah basically all I have to go on is doximity ratings.

I got one of those surveys once.
Worse than US News (which at least factors some objectivity like test scores and research $$ into their med school rankings).
Doximity ratings are based on emails to subscribers asking them to list programs in their area that they think are good. So entirely subjective name recall from people who bother to take the time to respond.

 

[wolfvgang22]

There are threads on this forum about which programs are "prestigious" if that is what you are after. I will refrain from listing them again here because there is always some disagreement.

 

[TexasPhysician]

I realize residency to a large degree is what you make of the training but for someone wanting to get the best clinical training possible, how does an applicant discern which program will provide that if prestige is apparently meaningless unless you are pursuing a career in research? Are US News and World Report/Doximity rankings worthless for picking programs to receive the best clinical training? I guess “best training” is relative and interest dependent. It seems like these rankings lack objectivity/data to back up them up.

The rankings are all worthless. Most places will provide exposure to everything. It’s rather difficult to rank faculty teaching skills, time for electives, ease of involvement in research, quality of journal clubs, etc. The most important factors can’t be ranked. The brand names may provide assistance with academic jobs, but I’ve also been offered academic jobs without an Ivy name.

In a cash only practice, I’ve never been asked my board certification status. I’ve been asked about my training programs about 5x. Prestige or lack of it has yet to make a difference in my career.

 

[NickNaylor]

The rankings are all worthless. Most places will provide exposure to everything. It’s rather difficult to rank faculty teaching skills, time for electives, ease of involvement in research, quality of journal clubs, etc. The most important factors can’t be ranked. The brand names may provide assistance with academic jobs, but I’ve also been offered academic jobs without an Ivy name.

In a cash only practice, I’ve never been asked my board certification status. I’ve been asked about my training programs about 5x. Prestige or lack of it has yet to make a difference in my career.

For the most part, I've found that the average layperson doesn't understand the training process of becoming any kind of physician, much less a psychiatrist. It's a crapshoot if they even know that psychiatrists are a branch off of the same tree other physicians come from.