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AlexRusso said:Chiefs/attendings at programs that are not 'big name' are always gonna "piss all over" the fellows coming out of big name places. They gotta distinguish themselves from the 'big name' programs somehow and get you interested in coming to their program. If they are so "upset" with these fellows who according to them have two left hands growing out their ass, why do they accept them into their fellowship programs? Shouldn't they know better?
-- i don't disagree here. there are likely a fair number who are using these tactics to lure applicants, which is why as applicants we don't believe everything we here on the interview trail. however, when said info is brought up at multiple programs by multiple attendings in a multitude of positions (from chair to junior faculty), it merits thinking about.
regarding accepting fellows, i believe this is largely political. EVERY program i interviewed at made it a point to name drop as part of their "we place our residents at great, competitive fellowships" speech. ability in the OR is not nearly as important as who your chair is.
Surgery is a pretty tight knit community. Wouldn't you think if word on the street was that residents from prestigious program X can't operate, presitgious X chiefs would have trouble placing into top notch fellowships? Doesn't seem to be the case.
-- not necessarily, see above opinion that fellowship placement is largely political. the fact that so many applicants vie for the coveted 'big name' programs for their ability to place fellows tends to favor this method of thinking. of course, one might also think that the big name programs get better candidates, produce better research and better surgeons, who then go on to the better fellowships. i tend to think it's a bit of both.
Can you explain to me why residents from 'big name' programs place at good fellowships and, more importantly, go on to be leaders in their fileds despite their apparent lack of skill in the O.R.?
-- you're basically stating that one cannot be a chair/leader in the field unless a wonderful surgeon. i would argue that in this day and age, where the research dollar is mightier than the bard parker, OR ability is not all that important. truthfully, i believe some chairs and leaders are likely not as accomplished in the OR as other surgeons (especially general private practice guys who do nothing but cut all day).
This is not to say that I think that the name or reputation of a program is the end-all, be-all reason for choosing one residency over another. A look at my rank list should suffice in proving that I believe there are a host of other factors to consider. I just do not believe that the case load should be a major consideration, for the above reasons. One caveat though, if you don't have aspirations of being a leader in the field and are not considering fellowships but would be quite content being "the" community surgeon in a small town then case load is something you should give more weight to. There are plenty of applicants like this out there and plenty of programs for them. Thats the beauty of this system. There are tons of programs, each offering something a bit different, allowing each candidate to rank the ones most closely geared towards their personal goals and values.
-- i never meant to insinuate that you were placing 'name' as the prime factor for ranking. i believe those who do this do so at their own peril. my list ended up being quite different at the end of this process than i had ever thought, as the 'name' factor became less and less important. having said that, i ranked academic institutions based on ability to get a large numbers of cases, not only for surgical training but for patient management and breadth of pathology. i do aspire to be part of an academic institution as a 'surgical scientist' and think any opportunities afforder to me as a resident will only enhance my ability as a fellow and later as an attending.
as has been said, we're all different candidates each looking for the 'perfect' fit. i just wanted to weigh in with some info that i used in making my decision. in no way was i attempting to slander any programs, especially considering i didn't even look at programs outside of the southeast/midwest.
with that, here's my list
01. CMC
02. Indiana University
03. Univ Louisville
04. Baylor (Houston) - Academic
05. Baylor (Houston) - Clinical
06. WashU
07. Univ Arkansas
08. UTexas-Southwestern
09. UTenn-Memphis
10. MUSC