MS4 Interested in Pain: MGH or Brigham for Residency?

[Temeraire]

In short: Does it matter which one I go to if I want a (probably academic) career in pain?

Hi everyone, I'm a 4th-year med student applying to anesthesia residencies, and I've been phenomenally fortunate to have received interviews at MGH and Brigham this year. As I'm putting together my rank list, I'm having trouble deciding which one to rank first. I really liked both programs, though I noticed a bit of "personality" difference between the two. MGH came off as "intense" with lots of autonomy, while Brigham came off as "warm" with more didactics and supervision. I'm a fairly adaptable person, and I'm sure I would thrive in either environment.

My concern is figuring out which program would provide a better clinical foundation and/or connections for someone pursuing a career in pain. I hear that MGH has a slightly better brand name which will get me places, but on the other hand, Jim Rathmell just moved over to Brigham last year to serve as the residency chair. There has been some muttering on this forum that the pain fellowship at MGH is withering away while Brigham appears to have the best pain fellowship in the country. Is this true? Does this difference matter at all to an anesthesia resident?

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[101N]

In short: Does it matter which one I go to if I want a (probably academic) career in pain?

Hi everyone, I'm a 4th-year med student applying to anesthesia residencies, and I've been phenomenally fortunate to have received interviews at MGH and Brigham this year. As I'm putting together my rank list, I'm having trouble deciding which one to rank first. I really liked both programs, though I noticed a bit of "personality" difference between the two. MGH came off as "intense" with lots of autonomy, while Brigham came off as "warm" with more didactics and supervision. I'm a fairly adaptable person, and I'm sure I would thrive in either environment.

My concern is figuring out which program would provide a better clinical foundation and/or connections for someone pursuing a career in pain. I hear that MGH has a slightly better brand name which will get me places, but on the other hand, Jim Rathmell just moved over to Brigham last year to serve as the residency chair. There has been some muttering on this forum that the pain fellowship at MGH is withering away while Brigham appears to have the best pain fellowship in the country. Is this true? Does this difference matter at all to an anesthesia resident?

If you honestly feel you are interested in a career in academics you should pick a program that is strong in
fMRI research for pain. That's not Rathmell.

 

[lobelsteve]

If you honestly feel you are interested in a career in academics you should pick a program that is strong in
fMRI research for pain. That's not Rathmell.

Mackey. Stanford.

 

[101N]

Mackey's better. But Northwestern - Apkarian - is better yet.

 

[drusso]

In short: Does it matter which one I go to if I want a (probably academic) career in pain?

Hi everyone, I'm a 4th-year med student applying to anesthesia residencies, and I've been phenomenally fortunate to have received interviews at MGH and Brigham this year. As I'm putting together my rank list, I'm having trouble deciding which one to rank first. I really liked both programs, though I noticed a bit of "personality" difference between the two. MGH came off as "intense" with lots of autonomy, while Brigham came off as "warm" with more didactics and supervision. I'm a fairly adaptable person, and I'm sure I would thrive in either environment.

My concern is figuring out which program would provide a better clinical foundation and/or connections for someone pursuing a career in pain. I hear that MGH has a slightly better brand name which will get me places, but on the other hand, Jim Rathmell just moved over to Brigham last year to serve as the residency chair. There has been some muttering on this forum that the pain fellowship at MGH is withering away while Brigham appears to have the best pain fellowship in the country. Is this true? Does this difference matter at all to an anesthesia resident?

When I interviewed at MGH, albeit over a decade ago I was very impressed. However, living in Boston was not something I wanted to experience. I think that they have an excellent, well-rounded program. You will also have access to everything that an institution like MGH can offer--research in other divisions and departments. fMRI is a good research tool, but you want exposure to molecular genetics/immunology, regenerative medicine, and precision/personalized medicine and their applications to pain. This is where we're the future of the specialty is heading on the therapeutic side.

 

[nvrsumr]

All the harvard programs have ridiculous research opportunities. Don't go somewhere based on one faculty member. That person may very well move on up to a harvard program and take all their grants with them.

Bwh takes alot of in house applicants. U will get a fellowship spot there if you are a resident.

 

[Temeraire]

All the harvard programs have ridiculous research opportunities. Don't go somewhere based on one faculty member. That person may very well move on up to a harvard program and take all their grants with them.

Bwh takes alot of in house applicants. U will get a fellowship spot there if you are a resident.

It does seem a bit silly to pick a residency based on a single faculty member or a single research modality (e.g. fMRI). However, it is valuable to know BWH has a history of taking many of their own... If, let's say, in the future I wanted to find a pain fellowship outside of New England, would it be better to have trained at MGH or BWH? My hunch is that it probably doesn't matter much, but I don't want to miss anything and make it an uphill battle for myself.

Any other considerations? Thanks for your inputs everyone

 

[101N]

Times they are a changing. Take cLBP as an example, arguably the most costly CNP condition in the US.
If you look at the predictive value of lumbar imaging for determining who will chronify it's less than 1%. (1)
Conversely, the predictive value of fMRI is about 80%. (2) Which way do you think this field is going to
move? If you are really interested in academic pain learn about BOLD rs-fMRI because it's going to change they way we do things, soon.

1. http://www.ncbi.nlm.nih.gov/pubmed/14697378
2. http://www.ncbi.nlm.nih.gov/pubmed/14697378

 

[Temeraire]

Times they are a changing. Take cLBP as an example, arguably the most costly CNP condition in the US.
If you look at the predictive value of lumbar imaging for determining who will chronify it's less than 1%. (1)
Conversely, the predictive value of fMRI is about 80%. (2) Which way do you think this field is going to
move? If you are really interested in academic pain learn about BOLD rs-fMRI because it's going to change they way we do things, soon.

1. http://www.ncbi.nlm.nih.gov/pubmed/14697378
2. http://www.ncbi.nlm.nih.gov/pubmed/14697378

I think you posted the same link twice.

I am definitely aware of the tantalizing promise that fMRI holds in possibly becoming the "objective" pain-detecting holy grail that medicine is desperately in need of. Without revealing too much about myself, I have done related research in this field, so I know the lay of the land and who the big dogs are. However, I know that my research interests may change over time, and I might, for example, turn to developing pain therapeutics instead of pain diagnostics. For that reason, I don't feel comfortable choosing a residency based on a single research topic. I interviewed at Stanford as well (Sean Mackey's home base), and I may actually end up ranking them #1 when all is said and done. However, my question here is asking which would be a better place: MGH or BWH? Correct me if I am wrong, but you seem to imply that Jim Rathmell isn't as "up to date" with pain research as you would like. Does that mean I should pick MGH then? I am confused by your answers, though I really want to understand and pick your brain some more.

 

[Phyzicz]

Hands down, MGH anesthesia much stronger than BWH anesthesia, and BWH pain much stronger than MGH anesthesia. Would not go to a residency program for their fellowship though, as you might change your mind. Then what? Go to the best for each.

 

[paintrain]

Hands down, MGH anesthesia much stronger than BWH anesthesia, and BWH pain much stronger than MGH anesthesia. Would not go to a residency program for their fellowship though, as you might change your mind. Then what? Go to the best for each.

IMO:

MGH is the best anesthesia residency in the country.
BWH is the best pain fellowship in the country.

Phyzics is right, ideally you'd go to the best for both.

BWH Pain does take more internal applicants but so do many other fellowships because they are more familiar with internal residents (makes sense). In the past few years, BWH Pain has accepted a few MGH residents so it's not impossible. As a potential applicant to both programs, you could contact the program coordinator and ask if they have the contact info for residents who have matched into Pain from both MGH/BWH to get the best advice.

 

[Temeraire]

you could contact the program coordinator and ask if they have the contact info for residents who have matched into Pain from both MGH/BWH to get the best advice

Yeah, I think I might do that.

 

[Phyzicz]

Lol save a step. You're welcome.

And the whole BWH warmness and MGH isolated thing is over sold big time... Brigham is VERY good, but they cannot compete with big brother so they need to sell that and scare applicants. "Hey, be a man."

MGH anesthesia #1
BWH pain #1

Paintrain your analysis is so perfect I don't know if we have met personally yet....

 

[Tenesma]

agree with the above --- got to MGH for the anesthesia - it will open pain fellowship doors everywhere.