Rank list thoughts: reputation vs location?

[ophtho101]

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Would I be crazy to rank Stanford above Bascom and Wills? The residents seemed equally happy at all three programs so that isn't something I'm worried about. Stanford's location is the most ideal for me when taking into account my wife's job and our family. I know that it is better to err on the side of quality of training vs location...but looking at the fellowship match list from Stanford, which lists about the last 10 years or so, the residents placed at all top-tier programs. So would going to Stanford really place me at a disadvantage for fellowship and getting a decent job afterwards?? Am I shooting myself in the foot?

 

[Eyefixer]

Would I be crazy to rank Stanford above Bascom and Wills?

No, you have to take quality of training AND your family circumstances into account before making ranking decision.

The residents seemed equally happy at all three programs so that isn't something I'm worried about.

My 2 cents (my info is few years dated):

Quality of training: Bascom>Wills>Stranford
Resident happiness: Stanford>Wills>BAscom
Program difficulty: Bascom>Wills>Stanford
Fellowship opportunities: Bascom>Wills=Stanford

Stanford's location is the most ideal for me when taking into account my wife's job and our family. I know that it is better to err on the side of quality of training vs location...

See above

So would going to Stanford really place me at a disadvantage for fellowship and getting a decent job afterwards?? Am I shooting myself in the foot?

In my opinion, no. You should be fine with any of these places.

Hope this helps.

 

[Visionary]

I essentially agree with Eyefixer. The big name programs, while no doubt offering outstanding training, are most beneficial if you are looking for an academic job. If not, the fact that Stanford's residents are happy and feel they are receiving good training should make you comfortable with ranking them higher. The fellowship match history is also promising, if you intend to pursue fellowship training. For those of us who have families, they are definitely a strong consideration when making these decisions. Back when I submitted my rank list, I had other programs ranked above Wilmer, the biggest name program on my list, for exactly that reason.

 

[VikingFavre]

It's funny that you posted this because I was thinking just this about the exact same programs.

 

[WhiteDots]

My two cents is ... and this is what I've been telling other friends,
that the most important thing to rank, when ranking programs is,
1) where you will be happy (location, weather, family reasons)
2.) where you will fit in (personality of the program)
3.) breadth and depth of overall comprehensive training

I would not go to one place because you think you want to go into retina and they have an allstar retina program or another place for glaucoma because they have an allstar glaucoma program. You should go to a place that is strong in multiple subspecialties because residency is the ONLY time you'll ever be exposed to comprehensive ophthalmology and you want to be competant in all areas-- especially afterwards when you are fellowship trained and consulting subspecialists outside of your expertise.

Along the same lines, I would tell friends that research should be seen more as icing on the cake but not a primary decision in choosing a residency. If a place has strong clinical training in all areas and then has great research on top of it, having research is icing on the cake. In the same way, having an allstar retina group in a overall strong program is icing on the cake. However, just because you've done research in one areas does NOT guarantee you'll match into a great fellowship if you're clinical training is spotty. Fellowship programs want competant clinicians (because attendings will be entrusting their patients to the fellows and they don't want to have to always be worrying about the fellows clinical decision making).

So, choose a place where you'll be happy, fit in, and provide a solid foundation to your future career. You're not and should not be a subspecialty expert at the end of residency (that's what fellowship is for). Residency is a time to get a great base foundation down (because you wont' have that opportunity ever again).

 

[4ophtho]

So to paraphrase, if you think there is a chance that you may want to enter academics at some point, then going to a top tier program is important.

What about if you are looking at doing a fellowship and then entering private practice? WIll you be at a disadvantage trying to enter a competitive market in a large city if you went to a smaller program that is less nationally well known as opposed to one of the top tier programs?

I am in a similar situation, having a wife and young child. It is hard to pass up a chance to train at one of the top programs in the country. But even if the lifestyle is not as good as another program, and it would be more stressful on your family, its only 3 years.

I would appreciate more people that have already gone through this process to weigh in on the subject. If you aren't ineterested in academics, is it better to choose quality of life or quality of training (especially for those of us with a family to consider)?

 

[JMK2005]

I would appreciate more people that have already gone through this process to weigh in on the subject. If you aren't ineterested in academics, is it better to choose quality of life or quality of training (especially for those of us with a family to consider)?

What programs are you choosing among?

 

[4ophtho]

BPEI, Emory vs UAB, DMEI kind of represents the best training but harder transition for family vs still great training but more family friendly

 

[icaramba]

So to paraphrase, if you think there is a chance that you may want to enter academics at some point, then going to a top tier program is important.

I'm a fellow applicant but I just spoke to my advisor about a similar situation (different schools) and I figured I'd share his advice. He pointed out faculty and fellows at the top programs don't all come from the same places/the top ranked programs. He stressed that while going to a top ranked program opens some doors, your performance in residency is the most important factor (as long as the program has at least a couple of well known faculty). Your performance will be the basis of your letters and phone calls and your performance will likely be highly correlated with your overall happiness. Thus, he recommended family/personal happiness as the #1 criteria when ranking the programs. 3 years fly by when your family and you are happy, but can really drag on if your family and you are not happy.
I hope this helps others -- it definitely helped me put things in perspective with my rank list. Good luck everyone!

 

[ophtho101]

I'm a fellow applicant but I just spoke to my advisor about a similar situation (different schools) and I figured I'd share his advice. He pointed out faculty and fellows at the top programs don't all come from the same places/the top ranked programs. He stressed that while going to a top ranked program opens some doors, your performance in residency is the most important factor (as long as the program has at least a couple of well known faculty). Your performance will be the basis of your letters and phone calls and your performance will likely be highly correlated with your overall happiness. Thus, he recommended family/personal happiness as the #1 criteria when ranking the programs. 3 years fly by when your family and you are happy, but can really drag on if your family and you are not happy.
I hope this helps others -- it definitely helped me put things in perspective with my rank list. Good luck everyone!

This is why I'm torn. Yes, family is very important, but I feel like quality of training is also very important. Putting fellowship placement consideration aside, these 3 years will lay the foundation for the rest of my career. So it would make sense to go to a program that provides the strongest training possible, that allows exposure to all sorts of pathology and subspecialties, so when I'm out in the real working world without any backup, I know how to handle any sort of complicated cases. The 3 programs I'm considering, I would be happy at any of them...so moving my family would just be a disruption temporarily for 3 years. With that being said though, I feel like I would be the happiest at Stanford because of location and my family would be content without having to go through any relocation/job disruptions. I am completely torn on which factor to weigh higher.

If I am interested in settling in Northern CA after fellowship, whether it be academics or private, (haven't decided) is it better to do residency that's local (Stanford) so there's some sort of connection to the area, or is it better to go to a better training program? Especially taking into account the competetitive job market in northern CA?

 

[dos palomas]

im just an applicant, but wouldnt you pretty much call your shot to a cali fellowship from bascom palmer or wills?

 

[eyelander]

Rank with your gut. That should be above all your number one factor. All of the programs you are discussing are top notch. When you submit your rank list, you should do it without reservation. There will always be a Monday Morning QB discussion after you have submitted, but again if you rank with your gut at least you can sleep at night. Best of luck.

 

[VikingFavre]

im just an applicant, but wouldnt you pretty much call your shot to a cali fellowship from bascom palmer or wills?

I guess the question is whether it is worth going through BP or Wills type intensity of training in order to get that cali fellowship when Stanford may be a better and happier option for the original poster.

 

[DKofLV]

Rank with your gut. That should be above all your number one factor. All of the programs you are discussing are top notch. When you submit your rank list, you should do it without reservation. There will always be a Monday Morning QB discussion after you have submitted, but again if you rank with your gut at least you can sleep at night. Best of luck.

COMPLETELY agree. When you are in residency you better be where you want to be. If you're at a place you hate being, then that 3am RD you have to see is going to be a whole lot less painful if you dont mind going to work the next morning.

Yes, it is only 3 years...but if you are happy, you will thrive. I am at a place that is not a Top 3 or Top 5 program by reputation numbers (which I disagree with...this place is AWESOME), but I love where I am so it makes it exciting to go to work. Had I gone elsewhere based on reputation alone, this would be a MISERABLE experience. Also as they said, if you go where you want and do well...you will get your fellowship...really

 

[Visionary]

If I am interested in settling in Northern CA after fellowship, whether it be academics or private, (haven't decided) is it better to do residency that's local (Stanford) so there's some sort of connection to the area, or is it better to go to a better training program? Especially taking into account the competetitive job market in northern CA?

I remember a stat, right or wrong, that the majority of physicians will end up practicing within 200 miles of someplace they trained, be it medical school, residency, or fellowship. I've found that to be fairly accurate among those I know--myself included. I made good connections and developed a good reputation in the ophthalmology community during residency that opened the door for a job. If you're set on northern Cali, that should definitely be a consideration.