Middle-tier Programs

[eyeeye_captain]

Since we're getting into application season, and we tend to get some "will I match" threads that almost invariably say to apply broadly and with mid-tier programs, I thought it might be nice to discuss these spots since the last thread is almost 8 years old. For the sake of simplicity, I took the middle third of Doximity's rankings from last year. A few surprises for me, I'll add my thoughts in the near future.

Also, here's last year's applicants' spreadsheet discussing programs, pretty helpful:

41. UAB
42. Tufts
43. Cook County
44. Indiana
45. UT-Houston
46. UChicago
47. Loyola
48. Beaumont
49. NYU
50. Rush
51. Rutgers
52. UNC
53. Loma Linda
54. MCW
55. CPMC
56. Arkansas
57. USF
58. Albany
59. Boston U
60. SUNY Upstate
61. Minnesota
62. Sinai Baltimore
63. Kentucky
64. Wayne State
65. Yale
66. Case Western
67. Saint Louis U
68. Tennessee
69. Texas Tech
70. Temple
71. SUNY Downstate
72. UTMB
73. Georgetown
74. Penn State
75. San Antonio USHEC
76. UT San Antonio
77. Missouri-Columbia
78. Rochester
79. Albert Einstein
80. LSU

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[eyeeye_captain]

*Disclaimer: All thoughts are my own based on prior interviews, colleagues, the spreadsheet, and looking at program websites. As usual, I may not be correct. I have no financial disclosures as I couldn't find any programs willing to pay me.

41. UAB - Very surprised they're this low. Excellent clinical program, surprising amount of NIH funding for research, retina exposure is so busy they have 2 separate semi-private fellowships associated with them. Eye ER is a plus/minus for some, and I'd guess the location is too, but really solid program.
42. Tufts - Well-regarded, especially for retina. If you can't get into MEEI, it's a very solid spot in Boston.
43. Cook County - Having trained in a couple of county hospitals, I'm sure they get a ton of good pathology. It looks like they do rotate outside of Cook, but it's still in the same system. Think it would be a culture thing - can you handle a county hospital for basically all of your training?
44. Indiana - Busy clinical program. Very strong Peds department if that's your thing, weak glaucoma and retina. I've heard good things about fellowship matches through the grapevine.
45. UT-Houston - Busy, more-or-less Baylor-light
46. UChicago - Fancy hospital, sounds like they do a lot of shadowing. Drive to the North Side to get cataracts. No VA or county.
47. Loyola - Kinda like UChicago but with better numbers because they have a VA. Edit: decent number of faculty after reviewing the website, though I’ve heard there’s been turnover
48. Beaumont - Semi-private. Has one of the top retina fellowships in the country, hear that residents do get some interaction there. Probably insulated from some of the Detroit craziness with multiple other programs closer into town.
49. NYU - Bellevue has a reputation for a reason. Crazy pathology. Know a few former residents who were all happy with the training, and nobody complains about NYC.
50. Rush - Semi-private. Expanded recently, used to only be 2 residents per year. Really cool facilities, continuity clinic, different sub-specialties depending on the day.
51. Rutgers - Didn't know they existed.
52. UNC - Relatively small department, don't know much.
53. Loma Linda - Large department, I would guess pretty busy. Would have to be down with their big-time religious affiliation, looks like they mostly take their own med students.
54. MCW - Surprised they're so low. Very busy program, have a VA. Have at some points had among the best plastics and retina fellowships in the country. Big-time research spot. If you can stomach the weather, definitely try to get an interview.
55. CPMC - Looks like they finally got rid of the weird staggered start for the residents, good for them.
56. Arkansas - Peds heavy
57. USF - They were on probation for a while, sounds like they shaped up.
58. Albany - Pretty well-rounded, has an ASOPRS fellowship.
59. Boston U - Kinda the county hospital-ish experience among the Boston programs
60. SUNY Upstate - Syracuse is cold.
61. Minnesota - Big, well-rounded department, VA and county as well. Seems under-ranked like a couple others above.
62. Sinai Baltimore - No clue.
63. Kentucky - Busy, the retina guys are pretty cool.
64. Wayne State - Reputation dropped off some over the last decade or so. Still pretty good clinically, handle a lot in the middle of Detroit.
65. Yale - To me has always kind of been the definition of middle-tier, ok clinical training, ok research. Seems like they change department chairs a lot.
66. Case Western - Has a VA.
67. Saint Louis U - Don't know how their faculty situation is going, they were trying to hire for years. Rougher part of St. Louis.
68. Tennessee - Busy clinically, I'd guess they've got a pretty good peds and onc program with St. Jude in town.
69. Texas Tech - I've heard good things
70. Temple - Not much better than Drexel was, though it wasn't Drexel's fault they shut down
71. SUNY Downstate - Low numbers and driving.
72. UTMB - Bunch of trauma, though maybe that will slow down with UT-Austin opening up. Pretty good fellowship matches.
73. Georgetown - Busy. I haven't heard the nicest things about the program.
74. Penn State - Small program.
75. San Antonio USHEC - Military only.
76. UT San Antonio - No clue.
77. Missouri-Columbia - Small, family-style residency. Heard the numbers are good.
78. Rochester - Had some faculty turnover but I think they're moving back in the right direction. Does its best to block Syracuse from the cold.
79. Albert Einstein - No clue.
80. LSU - A LOT of driving.

Random thoughts on the lower tier:
- I'd heard Augusta/MCG did a decent bit of prison work, but I didn't know they actually do cataracts INSIDE the prison. Interesting.
- How upset must UVA be to be 2 spots behind West Virginia?
- Dartmouth and especially UT-Austin will be interesting cases going forward as new programs. I'd imagine UT will have a strong preference for Texans
- I haven't heard a good thing said about any of the prior DO programs

 

[dantt]

Tufts - the chairman is no longer retina
Beaumont - retina group sold to pe

 

[Musty Goose]

Great idea for current applicants. Would appreciate input from others.

 

[Gonio5]

Some of the comments in the chart are overly positive. If looking for negative information, most programs have something wrong with them as perfection is impossible.

 

[mjohnsonets]

I'm not a surgeon but interviewing residents every year as part of what I do. I can't attest to their hands but from a numbers, diverse experience, and general personality standpoint here are some residencies that stand out each year that aren't top 10 residencies:

UAB
University of Missouri
University of Tennessee
University of Louisville

I like UAMS as well but they don't get multi-focal experience generally. That's my only real hold up about that program. Overall, good everywhere else though.

 

[Slide]

For the incoming applicants, remember that the rankings are somewhat arbitrary and are based on metrics that may not truly reflect what the residency brings. Some programs are good for securing more academic fellowships, while others are good for creating comprehensive ophthalmologists that are ready to go day 1. Just remember, most programs will train you well enough, the more important thing is to stay away from programs you think have red flags.

 

[Gonio5]

UAB
University of Missouri
University of Tennessee
University of Louisville

I like UAMS as well but they don't get multi-focal experience generally. That's my only real hold up about that program. Overall, good everywhere else though.

I disagree with that ranking. I rank them as:

1. UAB (interviewed there, did an away rotation later in a different specialty)
2. University of Tennessee (know someone well that interviewed there)
2.3 (better than 3) UAMS Arkansas (interviewed there, knew someone who did their residency there, seems like a decent place to do residency)
4. University of Missouri (interviewed there, talked with two of their faculty after I started ophthalmology residency, may be higher choice for someone with for specific reasons)
8. (worse than 5th place) University of Louisville (interviewed there, did an away rotation there, that place is not very impressive, teaching is poor)

 

[Pink Eye]

I’d rank Texas Tech way higher than that! I went there and graduated with 272 cataracts as a primary. I had Friday mornings off 4 months of the year. Attending’s were very chill and it’s the opposite of malignant. Little to no scut work. Never fought for cases. Call was not that bad. Done by 5 most days. Lots of time to study. It’s a very clinical program. Only down sides were you’re stuck in Lubbock and there’s virtually no research. I hated research so that was not a problem for me.

 

[mjohnsonets]

I disagree with that ranking. I rank them as:

1. UAB (interviewed there, did an away rotation later in a different specialty)
2. University of Tennessee (know someone well that interviewed there)
2.3 (better than 3) UAMS Arkansas (interviewed there, knew someone who did their residency there, seems like a decent place to do residency)
4. University of Missouri (interviewed there, talked with two of their faculty after I started ophthalmology residency, may be higher choice for someone with for specific reasons)
8. (worse than 5th place) University of Louisville (interviewed there, did an away rotation there, that place is not very impressive, teaching is poor)

I wasn't ranking them in any particular order, just stating I have always generally liked the residents here and their reported experience in residency.

 

[beijing67]

Anyone known of programs that offer good work-life balance (or at least as good as residency can get)?

 

[Slide]

Anyone known of programs that offer good work-life balance (or at least as good as residency can get)?

Wrong attitude to have. The better question is what programs make the best use of your time to train you. Doing scut work like calling back all of your attendings' patients or being a glorified medical student shadowing attendings is not useful. Spending 10 hours in the hour as primary or true first assistant in surgery, or having several long nights doing open globes? That's a better use of time.

From my anecdotal experience being at an academic center (I'm a millennial too), the pendulum of "work-life balance" is swinging too much to the opposite side of not working enough. I'm not too far away from graduating residency to say that residents have way more protections and benefits than years past; the current focus of "work-life balance" doesn't apply when you're a resident because these four years are what will make or break you as a good doctor. I've seem some recent batches of residents who was all about the "work-life balance", and I would never trust them to take care of anyone I care remotely about after seeing their handiwork as senior residents.

 

[mjohnsonets]

I found that the worse residency go overboard in saying how their residency is the best or one of the best in the country. I heard that for 2 really bad residencies. One claimed they were the absolute best in the country when they were near the rock bottom. Another was really weak but not the worse. They claimed to be one of the best in that part of the country.

In contrast, Stein Eye UCLA is a strong program but didn't brag at all during interviews.

I've seen a trend like that before as well.

Stein Eye produces strong residents in my opinion - I like the "don't talk about it, just be about it" attitude you mention here too. I didn't mention other strong residencies in my original post on this thread because they are a little more sought after, like Stein Eye.

 

[eyeeye_captain]

As above, programs will (usually) only put their best foot forward on an interview day so feedback on the spreadsheet is rosey. There're going to be some used-car sales programs to try to get people in, and if you get a ton of talk about how great a program is instead of them just telling you who and what they are, buyer beware. Additionally, working hard isn't a bad thing as long as it's useful. I trained at a meat-grinder, but culture/red flags is a big thing.

If we're getting off-topic a touch, Stein is a great example of an excellent program with a reputation for being on the border of malignant with volume and culture. OHSU is also a top program but the other end of the spectrum where your fingers might get broken with all the handholding. Even with mid-tier programs, it's finding the fit for you.