Rank list help

[BDV]

Hi everyone, I'm a current 4th year med student who's been having quite a bit of trouble figuring out the first 3 residencies on my rank list. They seem to flip flop every week for me for different reasons. I'm leaning towards neurorehab and am interested in an inpatient/outpatient practice, but still not positive so I want to get a well-rounded experience. Of course it's a personal decision but would definitely appreciate any insight. Thank you in advance!!

Here they are in no particular order with some info I've been considering:
Thomas Jefferson University
Good neurorehab exposure with vented patients and disorders of consciousness at an elective site, connection with MossRehab, awesome anatomy course. Used to be an SCI model system but no longer?

Jefferson-Moss-Magee (Mossrehab)
Good neurorehab exposure as well, TBI model system, CMLA accredited gait lab. Facilities leave a little to be desired.

University of Minnesota
Now an SCI model system, has a polytrauma unit in their VA that has exposure to disorders of consciousness, CMLA accredited peds gait lab, faculty and residents all seem super supportive.
Though, will a lesser known name in the field make it more difficult for me to get an academic position? Program also emphasizes work-life balance and wellness quite a bit, but I'm worried it might be too chill - I'm not sure if I should be worried about that though.

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[Dansk2011]

I think you should stress less on what place will theoretically give you a better shot at academics and focus on what your interest are and which would give you better exposure. From my experience most people don't want to go into academics. And I don't think name is going to keep you from getting an academic job. More over most people going into PM&R seem to want to do more outpatient work (pain, sports, etc). So if you're thinking you want to do neurorehab you'll be in the minority. You should have no problem matching into a TBI/peds/SCI fellowship regardless of where you do your training, if you choose to do so. At least when I trained, those fellowships were not competitive. Maybe that's changed, but I doubt it. Gait labs and those things are interesting but not sure how practical they are in regard to translating to the real world. Maybe I'm wrong. Clinical care exposure is king in my opinion. And honestly look for the most well rounded program, because even though you think you want to do neurorehab, that may change, so don't want to short change yourself. You should be able to find research opportunities everywhere for the most part if that's what you want to do. It's a big decision, I get it, but don't over think it. Because the things you think are important to you now likely won't be as you go through you training. Personal fit is big. Where I trained our exposure was good to everything, but lacking in some areas compared to smaller programs and no fellowship in what I ended up pursuing. But I had a lot of electives that I could do outside my program which was huge. Plus the fit with the residents was unreal. Some of my best friends still to this day. Plus I got to be closer to family while I did my training. Looking back that's what was the best part. Nothing is going to be perfect, just like jobs after training. It's a hard decision but ultimately you make the decision so go with your gut. Also working that hard during residency isn't necessarily a bad thing haha.

 

[j4pac]

You have a lot of good options. The good news is that fellowship is very obtainable right now. There are elite SCI fellowships not filling. I work at a place tied to one of the largest IRF in the country, with one of the highest volumes of traumatic SCI. We’ve had discussions of brain/SCI fellowships but it’s difficult to justify opening one of those programs when the current ones don’t fill. I’d be careful assuming the programs with fellowships have the best residency exposure…often it is just an indication of an older program. I’d also not perseverate too much on Model systems. They fluctuate, and there are a ton of good programs in specific neuro subspecialty without “Model” systems.

If you want to work in academics in SCI one day, the chances are good…regardless of the residency you go to. Again, these places aren’t filling…most PM&R residents don’t want them. I’d imagine an SCI trained physician would have a good chance of work in academics given the reducing number of SCI trained physicians and COVID resulting in retirements of current SCI doctors