How should I rank the following programs?

[Aldertonghen]

My goal, atleast right now is to become an academic neurologist involved in funded research. As a foreign medical graduate I’m pretty okay with moving to any of the places I’ve interviewed at location-wise, although warm places would be nice. So I’m wondering how I should rank the following programs, especially because I’ve never been to a number of these places:

U of Miami
U of Mass
USF
Houston Methodist
U of Maryland
U of Connecticut
U of Minnesota

US News and Doximity have pretty differing views on the above programs (as well as NIH funding data), so I would be grateful if I could get some input on these programs. In terms of subspecialty, I'm undecided, although fields involved in neuromodulation (epilepsy, movement and to a lesser extent pain) are interesting to me at this point in time.

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[Thama]

For your specific interests, I'd rank Minnesota #1. They have a particularly great neuromodulation/DBS group and their chair, Jerry Vitek, is among the better scientists in the US in this field.

 

[Aldertonghen]

For your specific interests, I'd rank Minnesota #1. They have a particularly great neuromodulation/DBS group and their chair, Jerry Vitek, is among the better scientists in the US in this field.

With Minnesota they have a lot of research but their fellowship placements seem to be mostly in Minnesota or private practice. There’s very few going to MGH/UCSF/Wash U etc. Would you view that something to be concerned about, or are their in house fellowships just really good?

Thanks!

 

[Thama]

In-house fellowship placements aren't a bad thing if the fellowships are good. If you're going all the way up there for a particular subspecialty, you're probably planning to stay for fellowship training in that subspecialty. Also a program only does so much for you in landing those tough to get fellowship spots outside your institution - those placements often reflect more of the type of applicant that program is able to match than anything else.

 

[Aldertonghen]

In-house fellowship placements aren't a bad thing if the fellowships are good. If you're going all the way up there for a particular subspecialty, you're probably planning to stay for fellowship training in that subspecialty. Also a program only does so much for you in landing those tough to get fellowship spots outside your institution - those placements often reflect more of the type of applicant that program is able to match than anything else.

I see, that makes sense. I will end up doing fellowship in Minnesota most probably if I match there. They have a research track that starts in residency with the goal of getting NIH funding by the end of fellowship, which I thought was pretty neat.

Apart from Minnesota, how should I rank the rest of the programs?

 

[Thama]

The other 2 that stand out to me are Miami and Maryland - both very reputable training programs. Maryland in particular has very strong movement disorders (Stephen Reich, Paul Fishman, and Lisa Schulman in particular) though I'm not sure how big they are in DBS and neuromodulation. The others on the list I don't know much about good or bad. I personally had a bizarre and very negative experience with USF when setting up interviews, but that probably reflects a couple of individuals rather than the program as a whole.

 

[xenotype]

My goal, atleast right now is to become an academic neurologist involved in funded research. As a foreign medical graduate I’m pretty okay with moving to any of the places I’ve interviewed at location-wise, although warm places would be nice. So I’m wondering how I should rank the following programs, especially because I’ve never been to a number of these places:

U of Miami
U of Mass
USF
Houston Methodist
U of Maryland
U of Connecticut
U of Minnesota

US News and Doximity have pretty differing views on the above programs (as well as NIH funding data), so I would be grateful if I could get some input on these programs. In terms of subspecialty, I'm undecided, although fields involved in neuromodulation (epilepsy, movement and to a lesser extent pain) are interesting to me at this point in time.

In 2-3 of those programs your only day off that week will occur on a sunny day with the daytime temperature around 75 degrees F in January- personally this drowns out any other consideration. Miami probably has the best overall reputation of the list not subspecialty specific but you better brush up on your Spanish- also has great NCC if you might be into that. If you want the option of pain USF is the only place I know that could deliver in that list.

 

[Aldertonghen]

In 2-3 of those programs your only day off that week will occur on a sunny day with the daytime temperature around 75 degrees F in January- personally this drowns out any other consideration. Miami probably has the best overall reputation of the list not subspecialty specific but you better brush up on your Spanish- also has great NCC if you might be into that. If you want the option of pain USF is the only place I know that could deliver in that list.

As someone who’s having to deal with the winter in Rochester, Minnesota right now (and previously never had to deal with snow in his home country), this hit differently lol. Miami, Tampa and Houston are awesome for this, and I think Baltimore doesn’t get too cold as well. But at the same time I am worried that my opportunities would be way too less in a place like USF compared to, say Minnesota, and in that case I’d choose the latter even if it means experiencing harsh winters every year.

How much more difficult would the path to an academic career be if one chooses USF or Houston Methodist instead of, say Minnesota?

 

[Aldertonghen]

The other 2 that stand out to me are Miami and Maryland - both very reputable training programs. Maryland in particular has very strong movement disorders (Stephen Reich, Paul Fishman, and Lisa Schulman in particular) though I'm not sure how big they are in DBS and neuromodulation. The others on the list I don't know much about good or bad. I personally had a bizarre and very negative experience with USF when setting up interviews, but that probably reflects a couple of individuals rather than the program as a whole.

In terms of interview impressions Maryland was my favourite program. Everyone was super nice, honest and not trying to boast about the program which I really liked.

 

[Thama]

In terms of interview impressions Maryland was my favourite program. Everyone was super nice, honest and not trying to boast about the program which I really liked.

Your gut matters here.

 

[xenotype]

As someone who’s having to deal with the winter in Rochester, Minnesota right now (and previously never had to deal with snow in his home country), this hit differently lol. Miami, Tampa and Houston are awesome for this, and I think Baltimore doesn’t get too cold as well. But at the same time I am worried that my opportunities would be way too less in a place like USF compared to, say Minnesota, and in that case I’d choose the latter even if it means experiencing harsh winters every year.

How much more difficult would the path to an academic career be if one chooses USF or Houston Methodist instead of, say Minnesota?

Your gut matters here.

Gut impression is most important factor. Any of these will be similar in terms of academic opportunities, again with Miami the best known and largest.

 

[Aldertonghen]

Gut impression is most important factor. Any of these will be similar in terms of academic opportunities, again with Miami the best known and largest.

So I would have a fair chance of going into academic research even if I say go to USF, or Houston Methodist?

 

[xenotype]

So I would have a fair chance of going into academic research even if I say go to USF, or Houston Methodist?

As we've discussed elsewhere this depends if you want NIH funding or industry funding, and NIH funding is extremely competitive and difficult to get even if you were going to partners or Columbia. None of these programs are in that caliber so you will be in a struggle to get NIH funding regardless in any of these places if thats what you ultimately want. Not to say it can't be done but based on your other posts you don't seem to know what you really want and are trying to have your cake and eat it too in terms of pay/loan repayment. Industry funding is way easier to get and places like USF have a lot of clinical trials/industry funding that you could essentially walk into with a faculty position relatively easily. The typical person that gets a K grant and into an R01 already did a phd, has a 5 year and 10 year plan, and doesn't care so much about flexibility or how much they'll get paid. This NIH route isn't the typical track for the overwhelming majority of residents at these programs you list (check how many MD PhD at any of these programs).

I guess what I am saying is you could be placing vastly too much importance on the idea of getting an NIH grant/research when you seem to have a lot of competing goals that would suggest a very low likelihood (<10%) you'll end up as an independent investigator with a big grant. It is one thing to have this embellished vision of what being an academic neurologist is like, and then it is a completely different reality to slog through residency and then start looking at jobs, tabulating dollars and cents, a call schedule, and your loan balance. The NIH money is unlikely to be there even if you did muster up the energy to try to get it. Go with your gut feeling about whether the programs will support you/you'll be happy there instead of some vague idea about whether they can get you a grant. The 80hr weeks, your patient list and coresidents will be all you can really focus on.

 

[Aldertonghen]

As we've discussed elsewhere this depends if you want NIH funding or industry funding, and NIH funding is extremely competitive and difficult to get even if you were going to partners or Columbia. None of these programs are in that caliber so you will be in a struggle to get NIH funding regardless in any of these places if thats what you ultimately want. Not to say it can't be done but based on your other posts you don't seem to know what you really want and are trying to have your cake and eat it too in terms of pay/loan repayment. Industry funding is way easier to get and places like USF have a lot of clinical trials/industry funding that you could essentially walk into with a faculty position relatively easily. The typical person that gets a K grant and into an R01 already did a phd, has a 5 year and 10 year plan, and doesn't care so much about flexibility or how much they'll get paid. This NIH route isn't the typical track for the overwhelming majority of residents at these programs you list (check how many MD PhD at any of these programs).

I guess what I am saying is you could be placing vastly too much importance on the idea of getting an NIH grant/research when you seem to have a lot of competing goals that would suggest a very low likelihood (<10%) you'll end up as an independent investigator with a big grant. It is one thing to have this embellished vision of what being an academic neurologist is like, and then it is a completely different reality to slog through residency and then start looking at jobs, tabulating dollars and cents, a call schedule, and your loan balance. The NIH money is unlikely to be there even if you did muster up the energy to try to get it. Go with your gut feeling about whether the programs will support you/you'll be happy there instead of some vague idea about whether they can get you a grant. The 80hr weeks, your patient list and coresidents will be all you can really focus on.

It does seem pretty difficult to go down the NIH route. I’m currently doing research at Mayo, and even here most of the attendings rely on extramural grants and charities rather than NIH. If I had to exclude academic opportunities, then the next thing on my list would probably be the location, and the residents/work environment. The problem I have is it’s insanely difficult to assess a program based on a zoom meeting. It’s much easier to hide deficits in a 1 hour virtual session, and we don’t even get a virtual tour of the hospital and work areas in most cases. I guess that’s one reason why I’d decided to prioritise other factors more.

Thank you for providing a realistic outlook on NIH, and academia in general. I came to the US, excited to work hard and start a nice research career, but it seems that there’s a lot of luck (and recommendations) involved in this beyond just hard work. That’s frustrating, but understandable I guess.

 

[xenotype]

It does seem pretty difficult to go down the NIH route. I’m currently doing research at Mayo, and even here most of the attendings rely on extramural grants and charities rather than NIH. If I had to exclude academic opportunities, then the next thing on my list would probably be the location, and the residents/work environment. The problem I have is it’s insanely difficult to assess a program based on a zoom meeting. It’s much easier to hide deficits in a 1 hour virtual session, and we don’t even get a virtual tour of the hospital and work areas in most cases. I guess that’s one reason why I’d decided to prioritise other factors more.

Thank you for providing a realistic outlook on NIH, and academia in general. I came to the US, excited to work hard and start a nice research career, but it seems that there’s a lot of luck (and recommendations) involved in this beyond just hard work. That’s frustrating, but understandable I guess.

Academic research anywhere is a hustle to find someone to pay for it (including overseas but the US has proportionally much more funding). Not to say you can't make it work, but I think you might be happier overall in a clinically based faculty position somewhere with a high quality of life. You can do clinical trials and smaller data review type studies pretty easily in these type of positions, retain a good $200k+ salary and a relatively nicer clinic/call schedule than private practice could afford along with plenty of teaching opportunities. This is a more realistic view of what you can get in academics than expecting an NIH grant to be there for you. You can still try to angle towards an NIH grant, but knowing if you don't make it as many don't there's a reasonable, livable job waiting for you where you can still have an impact. An additional factor I always remind everyone about- Texas and Florida have no state income tax. This makes a $50k resident salary the same as a $60k+ resident salary in most NE states/California etc. Additionally, everyone is getting squeezed right now on housing/rent costs pretty badly regardless of location so you need as much money as possible during residency.

 

[Aldertonghen]

Academic research anywhere is a hustle to find someone to pay for it (including overseas but the US has proportionally much more funding). Not to say you can't make it work, but I think you might be happier overall in a clinically based faculty position somewhere with a high quality of life. You can do clinical trials and smaller data review type studies pretty easily in these type of positions, retain a good $200k+ salary and a relatively nicer clinic/call schedule than private practice could afford along with plenty of teaching opportunities. This is a more realistic view of what you can get in academics than expecting an NIH grant to be there for you. You can still try to angle towards an NIH grant, but knowing if you don't make it as many don't there's a reasonable, livable job waiting for you where you can still have an impact. An additional factor I always remind everyone about- Texas and Florida have no state income tax. This makes a $50k resident salary the same as a $60k+ resident salary in most NE states/California etc. Additionally, everyone is getting squeezed right now on housing/rent costs pretty badly regardless of location so you need as much money as possible during residency.

I guess that’s true. I will push for a research heavy career and try for grants, but if I fail having a nice job in an good place with decent money is a pretty decent landing spot. Met with the residents today at Tampa and I really liked them. They focused a lot on well being- they have two weekends off a month even in PGY2, which was nice. Maybe I should focus on this instead. I wish I could visit these places for a second look, as I think that really helps in forming a gut feeling. Most programs on zoom start to blend in.

 

[johnwandering]

Personally I say U Miami is head and shoulders above the rest of the list. Neuromodulation is admittedly not my specialty but I do have a friend who finished their residency from U Miami who is on an academic track at one of the best movement fellowships on the continent.

Keep an open mind that unless you're going in with significant prior experience in your interest (for example one of my colleagues entered residency having been a researcher in epilepsy, with several published papers on the subject), your interest likely will significantly change. I wanted to be an academic stroke physician going into residency, but ended up going into epilepsy as a private neurohospitalist (I love my career and wouldn't have it any other way). U Miami is the largest and (in my opinion) most well regarded program on that list (in the southeast Vanderbilt and Emory are the other academic powerhouses, with UAB and UFlorida probably following, USF further behind—all in general terms), and may help give you the most opportunities for the best fellowship match you can have -> which is important when pursuing a career in academics (unless you are wanting to stay at Maryland or Minnesota specifically for any reason).

U Maryland likely is the second for me on that list. Then the rest.

 

[Aldertonghen]

Personally I say U Miami is head and shoulders above the rest of the list. Neuromodulation is admittedly not my specialty but I do have a friend who finished their residency from U Miami who is on an academic track at one of the best movement fellowships on the continent.

Keep an open mind that unless you're going in with significant prior experience in your interest (for example one of my colleagues entered residency having been a researcher in epilepsy, with several published papers on the subject), your interest likely will significantly change. I wanted to be an academic stroke physician going into residency, but ended up going into epilepsy as a private neurohospitalist (I love my career and wouldn't have it any other way). U Miami is the largest and (in my opinion) most well regarded program on that list (in the southeast Vanderbilt and Emory are the other academic powerhouses, with UAB and UFlorida probably following, USF further behind—all in general terms), and may help give you the most opportunities for the best fellowship match you can have -> which is important when pursuing a career in academics (unless you are wanting to stay at Maryland or Minnesota specifically for any reason).

U Maryland likely is the second for me on that list. Then the rest.

Thank you for the insight. Yes, it seems Miami is the best overall place, with Maryland coming second, while Minnesota has the best in-house movement department if that’s the only thing I’m interested in (which I’m not atm).

Does a PhD potentially help in academics? I recently talked to a fellow at UAB who will complete a 3 year movement fellowship and earn a PhD simultaneously. The PhD was built into his PGY3 and PGY4 of residency, and the 3 years of fellowship (UAB movement is a 1-2 year fellowship otherwise). In his specific case, he will also be running a lab as PI and will be funded internally (which I didn’t know was a thing- I thought NIH, charities and pharmaceuticals/industry were the only sources). The reason I am asking is because UMass also potentially has this weird track that ends in a PhD, and being in Massachusetts could help me get in touch with the big names.

Regarding prior exposure, I have some research (and patents) in autoimmune neurology, but this is probably not the field I want to go into in the future.