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Discussion in 'Internal Medicine and IM Subspecialties' started by wooo, Nov 23, 2002.
How can I find a list of competitive IM programs?
I am not sure about figuring out ranking, but there is an all inclusive list at acponline.org/residency/. It breaks the programs down by state, length, and focus.
Before you look for the "highest ranked" program, you need to consider what you want to be doing after residency. If you want to become the head of MGH one day or you want to match into a very prestigious fellowship(Sloan-Kettering for Heme-Onc for example), you want to go to the most prestigious residency possible. If you just want to become a community hostipal general practioner, all programs will be ok. Now you may want to go to a university program to get a more diverse experience, but a community residency will be adequate if that is not important. If your set on getting into a fellowship, then a larger university hospital with the fellowship you are interested in is helpful.
I think what you may be asking are what are the prestigious internal medicine residencies. Basically, the Harvard hospitals, Stanford, UCSF, Duke, etc.. are top tier. But programs like Emory, Penn, UCLA are strong as well. I think that a fellowship program may care that one person trained at lets say, a MGH vs. some one from NYU. A fellowship program will not care whether you trained at UCLA or UCSD, eventhough UCLA is a more "highly ranked" program(ie. US News, etc..). Also, the training you will get will probably be about the same.
Thanks for your help. You picked up on what I really wanted to ask. "If I am interested in doing a fellowship, then what steps are needed." I think you answered it quite well, but if you have more to add, then I would appreciate it.
Depending on what fellowship you want and where you want to end up, you may want to consider several stratagies.
For instance, let's say that you want to be a Beverly Hills Cardiologist. You may then want to do your cardiology at Ceders Sinai in Los Angeles, which is a top cardiology program, and many of the attendings there are cardiologists to movie stars. If you do your internal medicine residency in Ceders Sinai, then your chances of getting a cardiology spot there is much easier, although you may be competing for one spot against many others in the program who may be interested in the same spot. On the other hand, if you do your IM at Cedars Sinai and you find that you don't like cardiology and you'd rather do something like rheumatology, then that program may not be the best for you. A larger university program may have been better for you. It's really hard to know when you're a medical student. One rotation in cardiology will not really allow you to know what it is really like to be a cardiologist.
Maybe if you can tell me what field you're interested in, what type of IM program you can realistically be expected to get into, and what you see yourself doing in 10 years, I may be able to give you more specific advice.
Is that more helpful?
I agree with joe.
My own ranking of the top programs (if you are fellowship-bound):
Completely in a class of their own:
Beth Israel Boston
Washington St Louis
Ever use where your doctor went for residency as a deciding factor for whether you will use him/her? I haven't. Who cares...go where you'll be happy.
Lets say that I am wanting to get a competitive fellowship. I have heard that you need to go to a good IM program. I have also heard that you can get "any" fellowship that you want if you are not picky about where the fellowship is located. Which of these two points holds true?
1. Good IM programs give you a better chance to get a "competitive" fellowship.
2. If you are not too picky, you can get any fellowship that you want.
or 3. Somewhere in between.
Both are true. A highly ranked program will probably offer you a better shot at a fellowship, but they are also easy to come by if you don't mind going to certain places. For example, I know a guy who wanted a GI fellowship, and had a hard time finding one in the cities he desired, but there were a boatload in the Midwest that offered him positions. I think there are in-betweens, that are good programs that, if you do your research, you'll find have good fellowship match data. Aslo, some programs show heavy preference for their own residents, almost assuring you a spot in their fellowship (if you don't mind staying).
I need to reiterate that the above 1st and 2nd tier lists don't include one program that I'm sure IM PDs far and wide, as well as many fellowship PDs consider to be (easily) one of the top 10 places to train in IM -- UT Southwestern (Parkland). Also, I think U Chicago is another program that easily fits into the top 10. BI in Boston, UCLA and the Mayo I wouldn't put into this company. Just an opinion, however.
I would like to recommend a great book written by Stephen Hoffman about his internship at MGH. You can buy it used at Amazon for $1.99. I read it as a fourth year medical student and found myself feeling the same way at times the next year.
Oh! The title of the book is "Under the Ether Dome".
dude, you must go to UTSW or something, it's definitely not top 10 in the country. It's good, probably top 20-25, but not better than UCLA or Mayo. I've heard it's a fairly malignant medicine program, which may or may not be true, but if enough people hear the rumor, it scares away some applicants. Dallas is not the most exciting place to live either (it's big, but that's about it). Some people would even argue with you that it's not the best program in the state - and Baylor would have a very good argument. In any case, no program that interviews 80 applicants at a time on only 5 days for its medicine program will ever be a top 10 medicine program - how do you possibly choose the best candidates in a method like that?
UTSW is far better than Baylor in Houston. I think Baylor is also more malignant. Baylor University program in Dallas is very strong, particularly in GI.
I agree with UTSW being in the top twenty-five and perhaps the top ten. IM at UTSW is king. Lots of big names there. As far as it being malignant...it all depends on what you call malignant. Residents at UTSW work their ass off. Do not consider this program unless you are welling to put in some hard time. Most of the attendings I have come across are excellent teachers and very approachable. Residents from there get great fellowships (this tells you what fellowship PDs think about UTSW). A couple of years ago 2 or 3 residents of the same class did Heme/Onc fellowships at Sloan Kettering. I think you would be hard pressed to find a better trained IM doc than one from UTSW.
Baylor college of medicine (houston) is a great medical school (perhaps better than UTSW medical school) but their IM program is not on the same level as UTSW.
Baylor University medical center (BUMC)- Dallas has a small IM program, I think it takes 5-6 residents per year. From what I have heard the residents there have it very nice, but have no autonomy (due to the large # of private patients and private physicians). BUMC is very good for GI, and Cards as well. If anyone has any more inside scoop about BUMC, I would appreciate it. This is a program I am considering- I am just not man enough to handle UTSW/Parkland.
I guess you go to UT-SW? Since you seem to at the very least rotated through the IM program, could you tell me exactly how hard they work (i.e. what time the interns come in, the call schedule, and what time everybody leaves post-call)? Everybody says the residents work there ass off there, I'm just really curious hard how they work as far as raw hrs are concerned and post-call days...
any other info to share about what's "bad" about the program...i'm really considering ranking UT-SW pretty high - i'll be interviewing there in Jan...
thanks and good luck!
Being from Texas and not from UTSW, IMHO UTSW is hands down the best medicine program in Texas. Like Crypt Abscess says, IM is the focus at UTSW. At other programs such as Baylor, this is not the case. The chairman interacts with the housestaff in a way that I have not seen anywhere yet (and it doesn't hurt that he knows people...as an aside he apparently was on the short list of Hopkins chair recruits both times it came up within the last decade). The leadership and program in general just seem to have a idea and vision of what residency training should be. The potpourri conference they take interviewees to is like nothing I've ever seen before.
I never know how to rank these things, but I would say that the quality of UTSW training seems it would stack up with any place in the nation. What it gives up a bit is name. But people match into Hopkins, Duke, and Brigham fellowships amongst others, so it doesn't seem like it's much of a problem.
for those interested in research: this is a ranking of nih funding status in dept of medicine in FY2001. to others this doesn't tell you anything about quality of teaching or residency program.
1 UNIV OF CALIFORNIA SAN FRAN SCH OF MED
2 JOHNS HOPKINS UNIVERSITY SCH OF MEDICINE
3 UNIV OF PENNSYLVANIA SCH OF MEDICINE
4 UNIV OF CALIFORNIA SAN DIEGO SCH OF MED
5 UNIVERSITY OF WASHINGTON SCH OF MEDICINE
6 UNIVERSITY OF ALABAMA SCH OF MEDICINE
7 U OF CALIFORNIA LOS ANGELES SCH OF MED
8 UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
9 DUKE UNIVERSITY SCHOOL OF MEDICINE
10 CASE WESTERN RESERVE UNIV SCH OF MED
this may be a purely west coast perspective, but i think any discussion about the country's most competitive IM programs should at least mention the university of washington. they were recently ranked number one in primary care, number three in nih funded research and number seven in internal medicine. they have a three-hospital system (county, VA and tertiary center) as well as residents who get very competitive fellowships. while it certainly isn't mass general or johns hopkins, it should at least be mentioned in a discussion of great IM residency programs.
It's not just a West Coast thing, you're right, UW deserves to be mentioned among the best IM programs.
Along with Crypt Abscess, I'd also really like to know more about BUMC, especially as it pertains to GI.
Do you miss out going to a community program, even though it's good? Why is it considered strong in GI? Anyone know anything else about BUMC in general?
Thanks for the input.
Attendings/chairmen will tell you a lot about how a program is viewed in the profession. I have several personal friends who sit on boards having to do with residency reviews/accreditation. I also know quite a few fellowship chairs. In a nutshell Yale Internal Medicine is rated as "top tier" by the physicians I have dealt with. These particular directors have been known to preferentially interview Yale residents for residency positions. I don't go to Yale, and would rather put a plug in for my institution, but I'm just telling you what I heard. Yale is extremely competitive to get into ao it's not suprising that some may try to downplay it since they didn't get an interview (one of my friends wrote that Yale is not good...well, he was actually trying to go there, and was not offered an interview...sorry Phil, but we should post honest info on these boards). Many subspecialists prefer Yale for the unparalleled research and facilities. Four out of five Yale residents I know personally have been offered heafty postions at the end of their 1st year. One was actually offered to join the faculty of U Wash-Seattle upon completion of his residency. NO one that I know of at any of the Boston hospitals were given such offers. I'm at one of the "big" Boston hospitals, and I have yet to be offered something like this. I am second guessing my choice of residency and if I were to do it again, would have spent the time at Yale. Most faculty there are pioneers in their respective fields and therefore their recs hold suprising weight. Yale all the way for residency.
I actually have to disagree with you about Yale. I recently completed the interview circuit and match and I have to tell you, Yale's IM program isn't even on the radar screen of top IM programs. For those wishing to remain in the Northeastern US, The top Boston and NY programs are very much more desired than Yale. At my med school, Yale was ranked low and often not at all by the top IM candidates (those who went on to match at great places). At my school, only the mediocre students matched there and even they weren't too thrilled with their luck.
I was quite unimpressed with Yale when I interviewed there. The hospital is small and kind of dumpy. They have local draw for patient base (Connecticut), but for anyone outside the area, NY or Boston hospitals are preferred. They do have dynamite research there, but that's a function of how great a university Yale is, not necessarily how great a hospital it is.
Their fellowship list is also nothing to brag about. It is completely outclassed by the top NY and Boston hospitals.
I would have to second that almostMD. Not to say that it is not a great residency training program but from a reputation standpoint it does not compare to the top-tier programs. Ask any chair or residency program director and I am sure that they would have to agree.
how about ppl at the bottom like score of 75 where do they end up?
end up re do the medical school. like me hahaha....
I'm an md/phd and have seen my friends/classmates/students go through the IM process that I'm about to embark on. From my end on the west coast, UCSF is THE place (if you're staying west). In terms of sheer selectivity at my school- the Brigham has been traditionally THE most difficult to match at, followed by UCSF and MGH. Hopkins is stellar, but suffers because of its location, which not everyone finds desirable. None of this necessarily reflects how GOOD these places are relative to each other- I think trying to find a quality difference between the BIG FOUR is kind of silly... but their reputation is a step above any other programs.
just my two cents- we're lucky to have such a huge number of great training programs in this country, it's hard to go wrong...
top: MGH, Brigham, Hopkins
next: Stanford, UCLA, UCSF, Cornell, Columbia
next : Mayo, Yale, Wash U, Brown, Mt Sinai, U of Wash, BID
respectfully disagree with your ranking of BIDMC.. I was once a huge fan and still respect the place and faculty that I know greatly.. Still, the lack of availability of the PD cited by many residents there and on the scutwork board is troubling, esp. for those wanting to do competitive fellowships.. And many of their fellowship positions seem to be filled w/grads of other programs, so don't count on being guarenteed a space there. Nonetheless a great program.
Best thing to do IMO is find out where a program's grads go for fellowship in your area of interest over at least a few years' time.. Some programs may surprise you with how well they do or do not do in this regard... I thought my program ("average" university-based) did beautifully this past year, 7 Cards matches (~40 incl. Chief Residents and Med Peds), 4 GI, 5 Renal, 1 Endo (UCLA), 1 Critical Care, and a few others. Not too bad for a program known for "excellence in primary care!" I can only imagine how the fellowship placements for MGH, BWH, etc. look, but you should still be able to get a good fellowship if you don't get into one of those programs..
for IM, it's the big four, like someone already mentioned: MGH, hopkins, brigham, UCSF
there's not much difference between the four in terms of quality or reputation. MGH and hopkins are more "thrown into the fire" programs, where interns immediately take on a lot of responsibility. UCSF and the brigham are considered the "hand-holding" programs, where there's closer supervision. yeah, baltimore's not as nice as boston or san francisco, but to say that hopkins suffers because of its location is an overstatement. a good friend of mine is a hopkins med grad and recently finished her first year of IM at MGH, and she wishes she were back at hopkins.
I would strongly disagree with that negative assessment of the Yale program. I will be at a major New York City program, but I must say that based on what respected faculty members have told me in terms of their impressions of Yale, (and my own experience interviewing at Yale as well as the rest of the Northeast circuit), Yale is a fantastic program with fantastic fellowship matches year after year.
There is enough funding there to undertake virtually anykind of research project (I think Yale's $15 billion total endowment is second only to Harvard's endowment), they are in the process of investing another $1 billion into their facilities (out of which $430 million is for a new cancer center alone), and the faculty members are quite reknowned.
I think the only other institution pumping in as much new money into their medical center is Hopkins which is also about to embark on a nearly $1 billion project.
The only thing that *might* hurt Yale a little is the fact that the major Boston programs have Boston to offer, and the major NYC programs have NYC to offer, whereas Yale is in New Haven.
In my case, geography made me rank one of the major NYC programs higher, but in all honesty Yale is a fantastic program and for some reason some people are giving less than accurate perspectives on Yale because perhaps their info is lacking.
Wow, talk about thread CPR.
Go to US News and World Report's website. They have a listing for all top med schools and grad schools. Type it in the search engine. If you buy the premier edition (like $14), you get the top 60 in the country. With this comes the rankings for internal medicine, women's health, and a couple of other things. The med schools can be sorted according to research-based and primary care based. The money is worth it if you want to go to a ranked program. The 2006 edition just came out. They also have an edition for top 100 hospitals, but htat is a separate fee. I think it's worth it if you will be spending the next few years of you life working there.
you realize the OP is probably dead by now, given the age of this thread.
Yes, well, the interesting thing is that since I have joined there is always some thread running and people discussing which programs outrank which. The discussion never dies, and some people had replied to the "dead" thread yesterday also. I thought it would be nice to put into the thread that there actually is a formal list, not just one made of opinions. Decisions should always be made on where one will be happy. And that everyone has to pretty much live in that hospital for 3 or more years.
It seems that every IM applicant nowadays is looking at residency only as a stepping stone to fellowship, and that getting into a "competetive fellowship" means getting a big name on one's resume so that their ego feels good.
Look, having gone through the fellowship application process in GI, let me tell you what I've learned:
1) If you want to go to a fellowship at a big name school (UCSF, UCLA, MGH), you better love being a lab monkey or a hard-core clinical researcher. These places are not interested in cranking out clinicians, they want people who will be doing research 60-80% of their time.
2) You need to do research. If you're at a big name program or not, you still have to do the leg work.
3) Having a program director who will go to bat for you is key. Fellowships are more political than you can imagine, so someone who is willing to "sell" you is invaluable.
4) Name of a program does help, but it won't guarantee you crap. There was a year when not a single UCLA resident matched into GI. The problem: if you want to get into a fellowship, esp cards, GI, apply broadly. If you've done your leg work, you will get in.
5) Be a good internist first. My advice: go to a program where you'll be happy and feel like you'll receive an excellent training. Not all university programs fit this bill BTW.
my 2 cents
Well, that was a good 2 cents.
These ranking list threads always ends up in some sort of fight between students/residents as they defend their home programs. Other than looking at US News and World Report or NIH rankings of medicine programs it is very hard to rank programs 5-30. The debate is rarely what the top 5 programs are in terms of academic prestige. The debates seem to center on what the top 5-30 programs are and their relative ranking to each other.
I think Mayo would go above Cornell/Columbia/UCLA in terms of prestige. Competitiveness isn't the same as prestige, as competitiveness is often artificial due to location and things like that. However, I can only speak from a cardiology perspective. I'm also going off of the impressions offered me by the chairman of cardiology at one of the big NYC hospitals, the director of cardiac EP at UCLA, and some other big name cards people, who might be wrong but whose opinions I'd trust with regards to the perception of training quality (they may be totally wrong, but we discriminate quality of applicants based on where they attend school, residency, etc. all the time).
As BStein mentioned, that's one of the biggest problems with these rankings outside of MGH/Brigham/Hopkins/UCSF. People have coast biases, location biases, etc. Also, people often mistake prestige for how difficult it is to obtain an interview. A qualified applicant who doesn't get an interview at Columbia may get one at WashU or Mayo only because so many people want to be in NYC. I don't think that the quality of applicants between these institutions varies by much and that one really delivers a better trained product than the other.