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Discussion in 'Internal Medicine and IM Subspecialties' started by wooo, Nov 23, 2002.
Is there a web page that has a list of good IM programs?
Why is no one answering? I am also interested in how people rank IM programs...is it just general knowledge...I know university hospitals will always be above the rest, but how do we rank these university places? ABIM pass rate? ABIM scores? NIH funding? Weather? Scutwork? Research output? Quality of fellowships? Is percent AMGs really an indicator, as some would claim?
Just would like to know if there is any august body that says...this place is number 1, number 2...We all know the top US hospitals rankings per (sub)/specialty, but I think that ranking is more for services and reputation, not training.
Scutwork.com rating is too subjective.
I don't think there is any such ranking, formal or informal. I think there are probably 15 top programs in the country, and within those, it's personal preference as to which is best.
The "top" training programs are also sometimes the most harsh, so they may not be considered "top" by some. Reputation is important, but so are other factors.
I gotta brag about my home program (University of Nebraska) a little bit...
**100% board pass rate for the past 6 years.
**Small-to-mid sized program with WONDERFUL faculty.
**Plenty of time and opportunity for research.
**q8 call as an intern on the wards, q5 on the unit.
**Residents are all very happy, well-adjusted folks who are getting a great education.
**All residents get to spend a month in South Africa at no cost to them. About 1/2 the time is in a clinic, the other 1/2 on a safari.
The only downside as far as I'm concerned is that it's in Omaha. Don't get me wrong, it's a great town. I'm just ready to see someplace new for a while, I think. It's an excellent program, though. I seriously think it's hard to do better in terms of happy programs that also offer a great education and relatively good work hours.
here's my opinion as to the top 15, just for fun. Everyone will have their own.
In their own class: MGH, Hopkins
Next tier: UCSF, Duke, Wash U
Next tier: UPenn, Columbia, Brigham
Next: Stanford, UW, Cornell, Yale, UCLA, U Mich, Mayo, and maybe a couple more
This is just rank of them academically....not how I would rank them as to personal preference.
Don't forget Univ of Chicago
not that I have anything against what the previous "nylee" posted, I just wanted to make it known that the last "nylee" was not me. This is the real nylee.
The real nylee doesn't know about internal medicine or any specialties because nylee is still a first year in med schooL!
But I do think that Hopkins is in a league of its own.
And I won't ever forget university of chicago--half of my heart is still there.
Any input on how Case Western - University Hospitals IM program fares? Top 20?
Do you feel that this program would be conducive to gaining a well regarded fellowship?
I have to disagree with Nylee's (or whoever) ranks above. There's no list, it's all word of mouth, and it's partially based on what you look for in a program and what region you are from as to which are the best programs. Here's my list (based on her categories):
In their own class: MGH/Harvard, UCSF, Johns Hopkins
Next tier: Duke, Wash U, U of Washington, Mayo
Next tier: UAB, Cornell, UCLA, U of Chicago
Next: Vanderbilt, UT-Southwestern, Northwestern, Stanford, Columbia, NYU, CWRU, Penn, UCSD
If I missed any places, sorry (by the way, Yale was purposely left off, it is overrated). This is completely unscientific by the way.
does that mean stanford is technically less competitive and easier to get in? i'm from the area so i would like to know.
well, how good they actually are is different from how good they think they are....for example, when I was interviewing at Northwestern, they bluntly said they believe they are the best program in Chicago, although most people I've talked to both inside the city and out say U. of Chicago is the best program. That having been said, no, Stanford is not any easier to get into, they consider themselves top tier.
Duke... Second tier? C'mon guys, give me a break.
Duke is definitely a top IM residency. I've heard it's malignant, but they train some of the best clinicians. For those concerned with the rankings, the hospital is ranked higher than MGH.
Northwestern has great facilities, but I don't think that it's even the 2nd best medicine program in Chicago. It's a bit over-rated.
we're talking purely Internal Medicine, Duke is not on the same level as Mass General, Hopkins, or UCSF. Any of those names inspire awe no matter where you are in the country, and Duke just doesn't have that. Actually, within the Southeast, UAB is considered by most to have equalled if not slightly surpassed Duke in IM (unless you ask a Duke person of course), although Duke is a more nationally recognizable program.
my 2cents on the rankings:
Agree on the top-tier programs:
2nd tier: Duke, WU, UW, (Mayo????), Penn,
3rd tier: Columbia, UCLA, Chicago, UT-SW, Michigan
rest of the tops: Stanford (definitely more competitive than reputation), Cornell, Vandy, etc.
Any opinions on Colorado's place on this?
IMO, UCSF is way over-rated as an IM program. If we're talking tiers, I would definitely not put it in the 1st tier (maybe 3rd or possibly 2nd in my book ...). Don't forget about Brigham and Women's -- many people, including myself, consider it a better program than MGH. UCLA is also a very over-rated program, especially with their malignant program director. In fact, I think that UCLA-Harbor, a county hospital (*gasp!*), should rank higher than UCLA itself. My last bit of 0.02, Stanford tends to be under-rated in the internal medicine area. IMHO, it ranks somewhere along the lines of UW or WU.
Okay, here's really my last 0.02. Every region has their top IM programs, and what I learned last year going through the Match is that it's easiest to figure out which region you want to live, and then there will be several "top tier" programs in which to choose from in that region. In reality, people in IM don't break down the academic programs into such precise groupings. Instead, the top 20 or so academic IM programs are generally considered more or less equivalent in quality. Some programs will be stronger in, say, pulmonary, while others will be strong in oncology, and so on. Personal rankings tend to depend on your own preferences, such as where you want to live, what subspecialties you're interested in, how residents do in fellowship matching in the specialty of your choice, the patient population you want to work with, and how you like the residents.
Careful using USNews Rankings to distinguish small differences. Hospitals where all the services fall under one name will do better (i.e. Duke, JHU, etc.) Whereas areas where their are multiple hospitals will look poorer. If you were to consider the HMS entities as one, you would include MGH, Brigham with the Women's portion, Boston Childrens, Massachusetts Eye and Ear, and Dana Farber.
Does your residency certificate say MGH or HMS?
If it says HMS, then I could see the recognition. Fact of the matter is that MGH doesn't carry the prestige that the Harvard name does when you get outside the New England area. Come to the Southeast, Southwest, or the Pacific Northwest, and I can guarantee you that MGH won't be as recognized as you think.
The person who mentioned getting a program for where you want to practice was right on target. If you want to practice in New England, then yea, MGH is the place to do your residency. In the South, then MGH is pretty much another hospital.
I think no matter where you go Johns Hopkins seems to be well recognized.
Wow, that's surprising. I'm from Texas with no ties to New England, and I know very much about the MGH name. Many of our higher ups trained there. At any rate, my point is that when you are speaking of programs such as Hopkins and MGH, USNews rankings probably won't be that helpful.
I would consider Southwestern a top 10 program for IM.
While a great program, there is no way UAB is in a tier above Parkland/UTSW. Nor would I put any of the California programs except UCSF and Stanford on par with the training and quality of people at Southwestern.
Southwestern suffers from the "not on the coast" problem that plagues other programs like Chicago and Wash U. Northwestern, while with amazing facilities and physical plant, is not yet in the same league as the above programs. In my opinion, too private, and too sheltered a place to get good training. Amazing hospital though.
I agree with UT-SW being among the top 10. UCLA - Harbor is only average.
This is a ridiculous conversation. Whoever said MGH is not highly regarded in the South is delusional. I wish they'd given me an interview. I hope that anyone organizing programs in tiers has at least visited the ones they are talking about. IM is such a broad "specialty" anyway, what are you looking at when you make your calls? Do you really think US News and World Report knows what they are talking about either? You probably are the same person who bought First Aid for the Wards.
Oh yeah, and Summertime, UAB higher than Duke. OK, sure. In what, adolescent tropical rheumatology?
Nope, didn't buy it dude, but I have been in the 90+ percentiles for my shelf tests though.
chis, as far as Duke v. UAB, I'm not sure where you're from, so that may affect your view of it. Duke is a better national name UAB is still only a regional name. I would say, based on what I've seen and heard Duke has a better surgery program, but UAB has a better medicine program. Duke is also supposed to be much more heavily research oriented (I think their med students still do only 1 year of basic science and 1 year of lab research), which is why I didn't apply there, so I admit, I don't have an insider's view. UAB has a better balance of research and clinical training and is an all-around better residency program. Everything I know is based on talking to faculty, program directors, residents, and other med students/applicants, as well as the little bit I've seen firsthand. I've been to UAB, Wake Forest, Tulane, and Florida so far and still have Vanderbilt, Emory, and Baylor left to go, and I've heard a lot of talk about the Carolina programs (UNC, CMC, MUSC, etc.), Virginia and MCV, UT-Memphis, and UTSW, but I haven't heard many people on the interview trail so far talking about Duke. Just doesn't seem to be a trendy program this year (based completely on word of mouth and the people I've come across, of course). And like you said before, this is all totally subjective anyway, if you're happy at East Tennessee State then you've still found the best program for you.
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.
From bob3's reply, it sounds like these so called rankings are biased toward academic medicine. Am I correct to say if you are not all that interested in academia that reputation of a program does not matter much? I would rather go to an "underrated" program if it's a better fit than an "overrated" one.
well it all depends on if you want to do fellowships sunflower... if ya do then better go to a big name university program -- because that will open doors for you over small community programs (esp if you are interested in cards, gi)
What about the Cook County Hospital program. Their hospital is the biggest in the world sleeping 2000 patients a night, plus where else are you going to get such great pathology than a community like Chicago. I mean SF is a tiny little city compared to Chicago and is just more or less a white collar playground, so how could UCSF be even as close to as good as Cook County for medicine?
Cook County is not a 2000 bed hospital. It has approximately 400 beds. Yes, you see a lot of pathology there, but that alone does not equal unparalleled education. There are a lot of problems with county and these affect education there in many ways.
San Francisco is NOT a "white collar playground"-have you ever been there? There are many many reasons why UCSF is one of the premier medical institutions in the united states.
What about the Cook County Hospital program. Their hospital is the biggest in the world sleeping 2000 patients a night, plus where else are you going to get such great pathology than a community like Chicago. I mean SF is a tiny little city compared to Chicago and is just more or less a white collar playground, so how could UCSF be even as close to as good as Cook County for medicine? [/QUOTE]
Hmm, I thought I read somewhere that Cook slept 2000 a night. I didn't realize it was such a small hospital and only had 400 beds.
So maybe I don't know anything about Cook, but I lived in SF in the 70s and 80s (the first 18 years of my life) until I went to college. We lived in North Beach, and my neighbors back then were immigrants, a delivery man,a HS teacher, and other working class people. Now my parents neighbors are millionaires. Give me a break! To buy a house in the dumpy Richmond district costs 700,000-1,000,000 now. Docs can barely afford that. SF is nothing more than a white collar playground now. It has lost all its old charm and character.
So, I seriously question if you know what you are talking about.
I suggest you take a tour of San Francisco General Hospital so that you may see that your idea of San Francisco being a 'white collar playground' can be tested. You should not equate North Beach (and its real estate) with the rest of San Francisco. UCSF's hospitals serve more than just their immediate surroundings. Moffit-Long sees a lot of complicated pathology from all over central and northern California. San Francisco General is an amazing hospital, and much of its patient population suffers from the difficulties of drug use and poverty. The last thing that I think of when I spend time at the General is that it is a hospital for white collars. I think you need to come back to the city and spend some time in the Mission District, the Tenderloin, Bay View/Hunters, etc. The VA might be cush (as far as hospitals are concerned), but I don't think the majority of the patients seen by UCSF are white collar.
And as far as charm and character are concerned, I still witness plenty of both, everyday.
1. I think pretty much everyone in medicine knows what Mass General Hospital is.
2. pathstudent has no idea who he is because evidently lived in SF in the 70s and 80s and went to college but is now back in high school as a junior if you read the surgery board here.
So, I guess you didn't get my joke pretending to be a HS student wanting to go into ENT.
But I do know SF. born and raised. Graduated for Galileo in 92. Moved there after college from 96-2000 and I have had an operation at SFGH in 97. Applied to medical school in 2000, and for sure SF is a giant white collar playground. And although I have only seen Cook once. SFGH has nothing on Cook. Chicago is a monster compared to little SF.
The average house in SF costs over a half million. That tells you about who lives there now.
You seem pretty lost neo. The board that you linked us to was obviously a spoof, and you are the first person to bring up Mass Gen in this thread.
For the record, cook county was a 2000 bed hospital, which was shut down because it was a mess of a hospital. I remember reading on their web site that it was described back in the 50's as having third-world standards, so I can imagine that it is pretty darn run down by now. It does have a long history of serving the large indigent communities of chicago, and continues to do so in a spiffy, albeit smaller, new hospital building. I think they're gonna turn the old one into a museum or something.
It's remarkable that a lot of people on the board cannot even tolerate someone questioning the traditional heirarchy of residency programs. It's as if they're being paid by these programs. Or maybe it's a source of their self-esteem... Suggesting cook county for residency has become apostasy. How dare you suggest that cook county even remotely challenges UCSF, when cook county isn't even ranked by USNEWS & World Reports!?! You will be immediately shamed as an academic doctor. All this passionate debating of who's "better", who has the bigger "name", the more presitgious reputation leads a lot of people away from the purpose of training -- to become a competent doc, which can easily be found at cook county, SFGH, almost wherever.
TY for the above post. So it was a 2000 bed hospital at one time. That is huge.
Ironically how I first heard about cook was from an a UCSF attending who said it was "one of the very most famous hospitals in the world". That inspired me to go look it up. I doubt SFGH falls into that category. Although SFGH probably has residents with a higher step 1,2 score and from more prestigous programs.
What is even better about Cook is that it is free of charge. SFGH is on a sliding scale. (i.e. Cook is full of idealists. Can you imagine a 2000 bed hosptial that costs patients nothing!)
1. mass general or MGH has been mentioned about 10 times in this thread.
2. of course that other post was a lie and im sure everyone realizes that high school students are unlikely to be here, just makes me take everything else he says with a grain of salt.
neo, the immediate debate was between SFGH and cook county. If you meant SFGH, that's fine, just say so, but don't make things up.
You need an MRI. There might be some frontal lobe malfunction if you can't differentiate between a "lie" and a "parody". The post was meant to mock us pre-meds, medical students, residents who are forever worrying about what to do next to go where we want.
Didn't you meet some premeds in junior who already "knew" they want neuroradiology when they probably had never seen an x-ray, and they would be in a constant state of panic about the 89% they got an exam. Well I was just taking it one step further pretending to be a HS student who is freaking about his 1560 on his SAT.
perhaps you dont realize that this thread has two pages. on the first page, MGH was mentioned by nylee, summertime, geek medic, rigomortis and was alluded to in other posts. my original post was in reference to geek medic's post that MGH is not very well known outside of new england and that in the south, it is just another hospital.
even if you didnt know this thread was two pages, the second post on this page is from chris who also states that MGH is well known in the south.
read and know what you're talking before you post.
you should worry less about my brain function and worry more about your startling ignorance evidenced by your suggestion that cook county would provide a better education in internal medicine than UCSF.
true, that was in page 1, that was yesteryear's discussion, more than 20 posts back. The immediate discussion was about SFGH and cook county. If you can't be relevant, then be quiet.
abu foolishly interjects
"you are the first person to bring up Mass Gen in this thread."
obviously not the case and since i'd never been to this board before, the first post was a result of me reading the whole thread. you want to debate the relevance of what i write, then do it. don't say things that are patently wrong and make you look like an idiot.
Whatever your beef is with San Francisco, that's totally OK. Too many people are clamoring to get to UCSF anyway. Let's all get off Pathstudent's case and leave SF to those who appreciate it.
It's not for everyone.
My beef with SF is that it is too small of a city once you have been to NY, Chicago or London. It is incredibly provincial, there are no univeristies of any significance in the city's confines (other than UCSF but a medical instution doesn't have much to offer in the way of intellectual culture and say Harvard, Columbia or the University of CHicago do), there are no museums of significance, there isn't a decent nightlife. It is just a small urban area packed with people that have way too much money to go out and spend at dinner.
The once great counter culture there is dead.
It is a boring white collar town.
But I guess doctors don't care about that kind of stuff anyway, for the most part.
with all honesty what the hell are you talking about? MGH and Brigham are SEPARATE hospitals, across town from each other and have their own clinical units. JHU and Duke hospitals on the other hand, are a single entity in a single set of connected buildings. Big difference. The reason those services "fall under one name" as you put it is because they are 1 hospital; they are not spread across multiple hospitals. the US news ranking is a list of HOSPITALS, not hospital aggregates for each med school affiliation.
You cant compare Hopkins Hospital as a unit vs MGH + Brigham; MGH and Brigham share the harvard name but function as separate hospitals. The US News rankings are lists of the best HOSPITALS, not a ranking of hte aggregate hospitals in a whole city.
If the US News rankings were by city, instead of by hospital, then of course Boston would trump both Durham and Baltimore, because Boston is about 5 times larger than those cities and has more total hospitals.
by the way, both baltimore and durham have more hospitals than just the JHU/Duke hospitals. So your comment about multiple hospitals looking poorer doesnt make any sense. Every medium to large city in america has multiple hospitals besides the ones affiliated with the med schools.
again your logic is strange.
You can say that the rankings are bogus, and dont apply to ANY hospitals in the whole country, but to put a different spin on the rankings for just JHU and MGH is wrong.
MGH is one hospital; JHU is one hospital. You seem to be suggesting either that MGH plus all the other affiliated harvard hospitals are one cohesive unit which shares resources; not true at all, they are not even in the same neighborhood.
I would agree that the Texas Medical Center in Houston is shortchanged by the rankings though, since all their hospitals are within walking distance and interconnected. But MGH is unaffected by this because they occupy their own unit on the east side of boston.
But then again, SF does have a quaintness to it.
And it is my hometown.
You thrash your hometown, everyone IN it, and then bash on your future profession as well. You have issues that this forum can't help you with.