Opinion wanted: Cornell vs. Mayo Rochester

[shocksigns]

Hello all,

I was wondering if you could give me your opinion about those two places. Interviewed at both and really liked the programs, residents, vibe and attitude - now I'm kind of stuck. Since I know that these decisions are pretty much dependent on the individual person, I hope that people, especially students/residents/fellows from those programs could comment on the following questions:

What do you think about and how would you rank Cornell vs. Mayo in terms of...
1.) Formal education, bed-side-teaching
2.) Clinical training (how comfortable will a graduate be in managing a broad variety of cases of different complexity levels; heard that Cornell has a strong emphasis on Heme/Onc, how about the rest?)
3.) Autonomy (Cornell - private attendings (gotten better I guess)? Mayo - attendings supposedly are very involved in decisions?)
4.) Hands-on-training (Mayo protects patients from inexperienced interns?)
4.) Research opportunities (basic vs. clinical; I guess both should be pretty good at both places?)
5.) fellowship placement (I'm interested in Heme/Onc or Pulm/CC; for Heme/Onc the Sloan-Kettering connection should be awesome but Mayo had some impressive placements too)
6.) Resident happiness, work atmosphere (presumably, Mayo might trump Cornell in this area?)

Location is not a big factor for me...

Thanks!

---

Members don't see this ad.

 

[mirrortest7]

MS4 at Mayo here. I'll comment where I can.

1) Education at Mayo is excellent. Vast majority of attendings do lots of teaching on rounds, some more at the bedside, others more during "sit down" rounds. Either way, though, frequency/quality of clinical teaching is very good. Formal education is also strong. Lots of worthwhile conferences (that residents, including interns, actually have time to regularly attend), emphasis and formal curriculum on evidence-based medicine, quality improvement project/curriculum, etc. From what I've heard, Mayo is one of the very best programs in the country in terms of education.

2) I don't have any concerns about the "products" I've seen at Mayo; the senior residents I've worked with have universally been not only quite capable of managing a wide variety of patients, but also solid teachers. I know someone made a comment on another thread recently about being concerned that Mayo's recently-implemented service caps (which result in interns typically carrying fewer patients than they did a couple years ago) may adversely effect maturation as a clinician, or at least change the timeline. I can't really comment on that, as that system hasn't been around long enough to see what the product is. I believe the person who made the comment, though, is a Mayo resident, so he/she probably knows more about this issue than I.

3) Hard to comment on autonomy as I have not worked at other institutions that I can compare to Mayo. In my experience, it's attending- and resident-dependent. The older attendings tend to be more hands-off, and let the senior residents run the service, whereas some new attendings tend to be more hands-on. The interns are of course the primary managers of their patients, and from what I've seen the degree of autonomy they have is reasonable. Certainly not a "trial by fire" sort of mentality that you might get at some other programs, though, so if that's what you're looking for, you likely won't find it here.

4) From what I've seen, this isn't true. During my gen med months, when a procedure needed to be done, it was always the interns (with a senior supervising...i.e. watching) who did it. For example, when I admitted a patient with SBP as a sub-i, I did the paracentesis. I think the procedures are there if you want to do them, but if you want to avoid them, you probably won't be forced to do a ton either.

5) Research opportunities are fantastic. Mayo residents have the most publications during residency, on average, of any program in the country. As has been mentioned before, research probably tends more toward the clinical side, but lots of basic science stuff going on, too.

6) I think Mayo's recent Cards and GI matches have been posted here on another thread. I don't have any details about hem/onc. While Mayo probably does not send as many residents to the top-tier prestigious fellowships every year as some other programs, I do know that people for the most part go where they want to (which, believe it or not, is not always MGH, BWH, or Hopkins...*gasp*).

7) Mayo is wonderful in the happiness domain. Everyone is super collegial and the work schedule is manageable.

 

[shocksigns]

Thanks @mirrortest for the detailed answer! Got a really great vibe from Mayo in terms of education, resident well-being and research opportunities. The only concern I have is regarding the new service caps and the effect on clinical training.

Any Cornell people out there that could comment on their program? Thanks!

 

[Friendly]

Hello all,

I was wondering if you could give me your opinion about those two places. Interviewed at both and really liked the programs, residents, vibe and attitude - now I'm kind of stuck. Since I know that these decisions are pretty much dependent on the individual person, I hope that people, especially students/residents/fellows from those programs could comment on the following questions:

What do you think about and how would you rank Cornell vs. Mayo in terms of...
1.) Formal education, bed-side-teaching
2.) Clinical training (how comfortable will a graduate be in managing a broad variety of cases of different complexity levels; heard that Cornell has a strong emphasis on Heme/Onc, how about the rest?)
3.) Autonomy (Cornell - private attendings (gotten better I guess)? Mayo - attendings supposedly are very involved in decisions?)
4.) Hands-on-training (Mayo protects patients from inexperienced interns?)
4.) Research opportunities (basic vs. clinical; I guess both should be pretty good at both places?)
5.) fellowship placement (I'm interested in Heme/Onc or Pulm/CC; for Heme/Onc the Sloan-Kettering connection should be awesome but Mayo had some impressive placements too)
6.) Resident happiness, work atmosphere (presumably, Mayo might trump Cornell in this area?)

Location is not a big factor for me...

Thanks!

I think your post regarding Cornell is spot on (I interviewed there). I actually canceled my Mayo interview for the sole reason that they are very weak in most areas of basic research. For clinical research and translational research, Mayo is very strong. Keep that in mind. Good luck!

 

[dragonfly99]

Both of those are good places.
If you want to do hem/onc somewhere in the Midwest then Mayo is probably fine. If your goal is to end up in the northeast then I would think that Cornell might make that easier, if for no other reason than having attendings who probably know other attendings in NYC and Boston, etc. Also, it's always good to go somewhere well known in the area you want to pursue, so if Cornell has a great hem/onc division, that may positively affect where you end up in the hem/onc match. Trying for hem/onc, you should do well from either place, though.

 

[CANE4LIFE]

Any Cornell residents out there that can comment about the program?

 

[WMC08?]

Hi all, longtime lurker here, but since I'm a Cornell MS4 applying in medicine, I thought I might be able to help a bit.

The most important thing to know about Cornell is that while it is already a pretty strong program, it is improving significantly thanks to the new chairman, who is working with the longtime and beloved PD to maintain the old themes while modernizing the logistical details.

1. Formal education. Cornell has the standard conferences, which are pretty well attended. I admit that as a subI, I only went 1/4 of the time, but attending is a priority for the R2/3's, and they tend to make it much more often. The highlights, though, include bedside physical diagnosis rounds with some really experienced folks (at least one of whom is over 80 and brilliant) and one of the few autopsy-based M&M's left in the country.

2. Clinical Training. People see a lot of patients at Cornell, because it's in NYC, which is a very overworked system. Caps are respected, but there is a lot of turnover, and by the time people do their NF blocks as R3's, they are comfortable managing a lot of situations. Whenever I felt way over my head as a subI, there was always a junior or senior around to calmly back me up, and they always knew what to do.

3-4. Autonomy. The PD's philosophy is clear on interview day. Residents are supervised at NYH, and attendings make the final calls on mgmt decisions most of the time, but not before the residents make a plan and defend it. I can say, however, that there is no "protecting" patients from interns or residents. There are a very small number of medicine beds (maybe 5?) that are populated by super-wealthy patients, usually hospitalized for UTIs or chemo, that I guess could fall into this category, but they are absorbed by the hospitalist/NP/PA services and if anything it makes the housestaff experience better not to deal with these pts. Otherwise, the faculty mentality is that this is a teaching hospital and pts who feel otherwise are welcome to go to Lenox Hill up the street. Additionally, the new chair's philosophy on private attendings is that if they are not teaching the residents well, then their patients will be handled by the emerging hospitalist services, which are still hiring more hospitalists despite the economy.

4. Research. There is not a lot of time for research at NYH. Residents do it, mainly to get exposure to their fields of interest and to meet faculty, but there is not a ton of very productive work being done by residents here. The resources, however, are rich, particularly on the clinical side. Basic research is available (especially at MSK) but I don't think it's Cornell's strong-suit.

5. Fellowship. Cornell contributed half of Memorial's fellows this year. This was an exceptional year, but our residents certainly have the inside track, both because of faculty/research connections and the number of rotations that Cornell house staff do there. Otherwise, people seem generally happy with their placements. I have to admit I don't know too much on this topic.

6. Resident happiness. Mixed bag here. Especially with the ongoing changes, Cornell residents are a lot happier than they were a few years ago. They are getting more sleep than they used to, enjoying the diversion of patients and respect for caps that the hospitalist/PA services has brought, and appreciating the improved computer system (which, as a side note, is now superior to the "most wired" hospitals in the country like Vandy or BIDMC). It's an overworked system and the residents have their gripes, but the leadership is still working on the program to improve it.

Anyway, that's the best I can do for you. I honestly feel like Cornell is a strong and improving program, and that its connection to Memorial makes it an outstanding choice for someone who wants to do heme/onc in the long term. The other disciplines are strong as well, but I think heme/onc is particularly so. It is not a city hospital, but the residents do take care of their patients while learning from their attendings, and there is a very familial feel that develops among the residents, of which it is great to be a loosely affiliated part (as an MS4). It is NYC training, which is distinct from elsewhere, with a subspecialized emphasis and high patient volume, but people seem to enjoy it and learn a lot, so what more can you ask for?

Hope that helps.

 

[DarthNeurology]

Both of those are good places.
If you want to do hem/onc somewhere in the Midwest then Mayo is probably fine. If your goal is to end up in the northeast then I would think that Cornell might make that easier, if for no other reason than having attendings who probably know other attendings in NYC and Boston, etc. Also, it's always good to go somewhere well known in the area you want to pursue, so if Cornell has a great hem/onc division, that may positively affect where you end up in the hem/onc match. Trying for hem/onc, you should do well from either place, though.

Mayo is a very academic place and has a reputation for producing excellent clinicians, I am sure that northeastern programs would look very favorably on a Mayo IM resident, and I am sure that Hem/Onc folks in the northeast know Mayo's Hem/Onc faculty and would be impressed by letters from them.

 

[CANE4LIFE]

Thanks WMC08

I am laid back and somewhat interested in Cards. I am looking for a supportive program, I like the idea of some autonomy but by no means sink or swim. Overnight call as an intern w/out signifigant resident backup would concern me, how is the overnight call at Cornell. Based on your experiences and what you hear from you friends, how would you seperate Cornell from Sinai and Columbia. Do most people from Cornell stay at Cornell or do they prefer Sinai or Columbia.

Once again thanks for your help

 

[WMC08?]

Call: reasonable mix of support and autonomy. NF residents back you up on all admissions (then keep admitting when you're done), and while they can sometimes be a little over-involved in the admission process, you can also take control and be independent as you feel comfortable. The NF's also back you up if you get calls from the floor for cross-coverage issues and need help.

Historically, people tend to stay at Cornell. We usually send a few people to NYU, a couple to Columbia, and rarely send one to MSSM.

The question of how to differentiate the NYC programs is a bit of a challenge, but I'll do my best at delivering a concise response. Just keep in mind that I don't know the other places as well as I know my home institution.

The different programs have different strengths, and I think these strengths are reflected in the house staff. Columbia has heart and liver transplant, while Cornell has MSK, a huge international/ID program, and a primary care track. These different resources tend to make different people excited about each place, and this leads to different personalities being predominant. It's not to say that Cornell doesn't generate great cardiologists or that Columbia doesn't produce wonderful oncologists, but rather that the house staff interests are weighted toward different specialties, and that different types of people tend to like those different specialties (e.g. procedural vs. not), which means that the residents at Cornell tend to be a little different than those at Columbia, as a sweeping generality to which there are likely tons of exceptions. I would also venture that fellowship placement tends to reflect these relative strengths, though obviously people go to lots of great places from both.

You may be interested in cardiology but still prefer the feel of Cornell, and that's fine (great, even). I'm only talking about the broadest brush strokes here.

As far as Sinai and NYU, I don't know the programs as well. NYU, I think, tends to draw more service-minded people who don't mind being in the trenches at Bellevue, but teaching seems to suffer as a result of all the service, while Sinai seems to draw people interested in more of the teaching/learning side of things. Otherwise, I have little insight to offer.

Overall, I think your comfort level from interview day is the most important element of your decision. If you felt equally comfortable at all of these places, then I would suggest that people wanting to do cards would probably do well to consider Columbia first, while those liking onc should lean toward Cornell, and those with an inclination toward the underserved would probably prefer NYU, but you do get all of these things at all of these places (that's right, we have poor patients here too), so I wouldn't let these shadings overshadow any gut feelings about where you'd be happiest.

Alright. That's the best I can do for now. Hope I've avoided offending anyone at the other schools.

 

[valsalva09]

Just wanted to add a few words about comparing the NY programs. I think that each program in terms of fellowship placement has relative strengths. If you want to do Cards, you are more likely to have your choice of fellowship from Columbia. Heme/Onc, Cornell. Gastroenterology, Sinai for sure. For primary care, I was really impressed by Monte/Einstein and I think there is an extra emphasis for primary care that isn't elsewhere. If you aren't sure, then go where ever you feel you will fit in best, be happiest and get the most support.

Something that is a bit overlooked in this thread is program leadership. The PD and Chair set the tone and environment of the program. You want people who will challenge you but also have your back and really go to bat for you when it comes time for fellowships. In this regard, I'd say Sinai has the best PD in NY (perhaps in the country) and a Chair who runs morning report and is deeply invested in making sure his residents get top training. I'd say the next best program leadership in NY is at Cornell since the track record at Columbia is too short (relatively new PD and Chair).

Quick note: Sinai and NYU are the only programs where you get to rotate through 3 hospitals which is a valuable experience in terms of autonomy and added patient diversity.

I think the "rankings" of these programs from outside NY is Columbia>Cornell>Sinai>NYU>Monte. But within NY I'd say it's more like Columbia >/= Sinai > Cornell > NYU = Monte. Whatever the case, you'll do great at any of these places.

 

[CANE4LIFE]

Thanks for the help.

I have gotten the sense that you may be right about Sinai being underated. Why do you feel that within NYC, Sinai is on par w/Columbia and superior to Cornell? Based on your interview experiences, how would you differentiate the 3 programs