WEST
CEDARS-SINAI - the CCF of the west, big name on the west coast but less known nationally, a top tier community program with elite inhouse cards but fellowship match can't quite compare to academic places. 4+1, 10k housing, would be pretty cush. The hospital is super fancy but you mostly take care of under/uninsured so it's not entirely concierge medicine. If you are sure you want to live in California, and not dead set on GI/cards, this is probably an ideal spot.
USC/LAC - seems to have good culture and autonomy, 3+1 schedule with $30 daily for meals, lots of underresourced sick Spanish-only patients. No housing stipend though east LA still pretty expensive, while being far from the beach. Drip schedule which isn't my favorite. I've heard it's somewhat cutthroat if you're trying for GI/cards as many of the class is, while also being geographically restricted to SoCal.
UCLA - Will be ranking highly. Seems to have good culture and qol (very nice benefits). huge program, with four inpatient sites including what looks like a rough commute into the valley to a county hospital, but you only do that for 2mo total. Probably more of a bougie patient mix - Santa Monica is their "community" hospital lol - similar to Northwestern. Great match list, feels like the only socal institution with a name brand that carries nationwide should you want to leave after residency.
UCSD - Will be ranking highly, however I wanted to like this even more than I did. Clearly a good culture, lots of autonomy, pretty intense/frontloaded intern year that gets a lot better for PGY2/3. PD is very warm and supportive, possibly overly so. Decent amount of driving as the two main campuses are 15mi apart (though SD traffic isn't as bad as LA, can still foresee some annoying mornings.) $6k/year housing lump sum. Fellowship match overly skewed towards UCSD, obv people love the area but it makes me wonder whether this name is respected as much outside of SoCal.
SOUTH
EMORY - seems to have good culture with lots of autonomy due to the clinical workload / social mission of Grady. Four sites somewhat spread out = battle with Atlanta traffic (Atlanta is a great city though). Recently switched to 4+1 which seems to have gone well. Awesome PD. Within the SE, it didn't feel like this program was quite at the tier of Duke/ UTSW/ Vanderbilt but I don't have very rigorous reasons for that.
UTSW - almost didn't apply, glad I did. will be ranking highly. Seemed to have a really strong culture; the residents do work hard but have a very high level of clinical competence to go with that. The only MR where I really felt like I was learning a ton. Dallas would be chill; lots of vibrant neighborhoods within 1-2mi of medical center that are pretty affordable. 4+1 with a firm system, so you mostly hang with the same subgroup of the program. Lots of 28s in the ICUS but you get q4d off in addition to post-call so some may prefer this - fewer hours/week than drip system. PD awesome, a very interesting guy. Probably mostly known for cards/pulm than the other fellowships. Huge shiny hospitals serving a wide cachment area, very strong range of pathology as UTSW is the major player for miles
BAYLOR - didn't make as strong of an impression on me as SW though you would clearly get great training here. four hospitals at TMC, wide range of pathology. Seems to have good culture. Pretty intense/frontloaded intern year that then goes into a 4+4 system for 2/3.
DUKE - will be ranking highly. Seems to have a great culture, great PD, would not call it a malignant vibe - I think that rep is outdated. 4+2 but they do work hard - lots of 28h ICU resinterning as a PGY2. Clearly builds great clinical competency. Elite fellowship match. Durham would be really livable in terms of CoL / outdoors opportunities, but if you are a big city person it's probably not the move. Residents seemed cool. Great fellowships esp cards and onc. One of those places like Hopkins where I think fellowship PDs really value the name and the level of training that it implies.
VANDERBILT - Will be ranking highly. Just seemed to have a really solid culture from the PD on down. Very similar to Duke honestly, 4+2 (2+2+2) but you work hard while inpt, great fellowships and match list. Hard to really differentiate these programs. Nashville would be fun though it's surprisingly expensive - my quick Zillow search was finding basically LA prices. DOM has tons of research funding and churns out leaders for many other hospital systems. Lots of specialty inpatient services for whatever reason.
MIDWEST
CWRU/UH - really impressed me tbh, seems to have one of the best cultures out of the academic programs, they do a lot of things outside the hospital together. Full night float program, no 28s. PD is long tenured and clearly a legend among his trainees. Cleveland is pretty underrated imo esp on a trainee salary. I don't think UH is quite at the level of these other "top 20" programs but I would think it is one of the best of the next group.
UCHICAGO - Great program, another one with that strong "autonomy" vibe. SIngle hospital program, though their academic center also serves as a safety net for the south side. No VA which may be a plus for many. 4+2 with early sign out to call teams which is nice. Somewhat less glamorous area of the city though also more affordable - but lots of residents just live downtown and reverse commute. Great fellowships.
NORTHWESTERN - Also a great program, equal to Uchicago imo in terms of fellowship match and outcomes, but very different culture. Traditional schedule with frontloaded intern year and cushy 2nd year that gives them plenty of time to produce research. Heavy cards/GI culture with somewhat of a Mag Mile vibe to the residents.. don't know how else to put it. If you are all in on cards or GI, it is hard to think of a better place to go while still maintaining good QoL in residency.
MICHIGAN - Again great program, I think these three places are essentially equivalent programs, but Michigan is just the small town version of them. Also on traditional schedule but residents like it, say they usually get their clinic days totally off from wards so usually have a half day to themselves. One of those places where everyone constantly emphasizes the culture. For whatever reason, this place didn't make as huge of an impression but it's objectively a good place to train. Ann arbor would be a very nice place to live if you're not a big city person.
WASH U - Will be ranking highly. For some reason everyone on the spreadsheet was disappointed by this program but to me they're objectively pretty great. When you look at that fellowship match and then think about the fact that it's 4+2+2 and you're getting every other month of full weekends.. hard to see a downside. Maybe St Louis? Honestly though there's some pretty cool vibrant neighborhoods near the medical center that are pretty affordable so even that sounds good to me. Not sure what I'm missing. PD seems like she really cares. They got some bad press with the vaccine rollout but I don't have the illusion that any of these places' hospital leadership actually cares about residents.
CCF - Another one that gets a lot of controversy on the spreadsheet. Not sure why. I mean it's a community program, and so it takes some DOs and IMGs and so on, but it's prob one of the best community programs. 4+1, incredible facilities, decent fellowships (I don't think they take a lot of in-house for cards though). Would be a perfectly good place to train. One red flag though, they have an interim PD who didn't even show up on my interview day. But I think this is a great program esp if you're coming from lower tier/ DO school and trying to make your way into academics.
