RANKING

[nacholibre]

To those of you who have gone before...

For some reason, I have been really lucky and got some "positive feedback" from 2 programs that I really like for very different reasons. I know that I can't assume that I'm ranked to match or that they didn't contact 50 other applicants too, but it has definitely added some serious weight to the decision of which I will rank first.

One program is top-tier, has a fantastic reputation, research funding galore, etc. This program will be very busy and demanding (I'm considering this a good thing), but it's crappy location and intensity won't be great on my wife and son. Furthermore, I didn't feel a great vibe among the residents and with the attendings.

The other program is much less renowned. It has a solid and well-rounded but much less established faculty, little to no research funding/resources, and it was apparent that it "demands" less of its residents. This program, does however have a great surgical volume and an amazing camaraderie among faculty and residents (best I saw on the trail) among other things. It is also in a location that my wife loves, where she has friends and it's much closer to family.

I'd love your input on this situation (I think it may be helpful to others as well).

I am currently planning to rank the smaller program higher for the following reasons.
-I would love to be in a happy/positive/sympathetic environment during residency
-I know from my experiences during med school that I function better and am able to give more energy to my work when I know my wife is happy and stable
-I am a great self-starter and feel that a strong motivation to study and read during residency could make up a good bit of ground that might be lost with the less rigorous program

My end goal is fellowship and academics, so do you all think that passing up an opportunity to train at a premier program is a mistake?? (again I realize I'm being quite persumptious here, so consider it a hypothetical question)

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[Pir8DeacDoc]

You'd be wise to keep your wife happy. My general opinion is most all programs will train you well. Some better than others at certain things. But the overall product will be very solid at most places. What will you miss by not being as busy? A mandible in the ER. Oh well. You only need so many of certain things. Also most all of our fellowships aren't competitive. You should be able to secure a good one without much trouble.

 

[resxn]

Boy is this a great question. Ultimately, it's a personal choice. What's more imporant, family or career? If you focus on either too much you'll lose the other, so which priority is greater for you, personally, is the question. For me, that's a no brainer. Family first.

If you know what kind of subspecialty in ENT you want, even if you're at the less-prestigious program, if you have a strong advocate with good connections there, you'll get the fellowship you want and it will very likely be a prestigious fellowship that will get you the great academic appointment. That will hold more sway IMO than will the name on the residency.

 

[DrBodacious]

To those of you who have gone before...

For some reason, I have been really lucky and got some "positive feedback" from 2 programs that I really like for very different reasons. I know that I can't assume that I'm ranked to match or that they didn't contact 50 other applicants too, but it has definitely added some serious weight to the decision of which I will rank first.

One program is top-tier, has a fantastic reputation, research funding galore, etc. This program will be very busy and demanding (I'm considering this a good thing), but it's crappy location and intensity won't be great on my wife and son. Furthermore, I didn't feel a great vibe among the residents and with the attendings.

The other program is much less renowned. It has a solid and well-rounded but much less established faculty, little to no research funding/resources, and it was apparent that it "demands" less of its residents. This program, does however have a great surgical volume and an amazing camaraderie among faculty and residents (best I saw on the trail) among other things. It is also in a location that my wife loves, where she has friends and it's much closer to family.

I'd love your input on this situation (I think it may be helpful to others as well).

I am currently planning to rank the smaller program higher for the following reasons.
-I would love to be in a happy/positive/sympathetic environment during residency
-I know from my experiences during med school that I function better and am able to give more energy to my work when I know my wife is happy and stable
-I am a great self-starter and feel that a strong motivation to study and read during residency could make up a good bit of ground that might be lost with the less rigorous program

My end goal is fellowship and academics, so do you all think that passing up an opportunity to train at a premier program is a mistake?? (again I realize I'm being quite persumptious here, so consider it a hypothetical question)

"Well-rounded" is the key to program #2. Example: If one program doesn't have a plastic surgeon, there is no chance you are going to be doing any plastics cases out of residency.

Camaraderie can change as classes come and go, but overall, that is important. It is so much of a crap shoot with the match and the limited time you have for you and the programs to get to know each other.

I know some of the "premier programs" have a reputation for being really "top heavy." That being said there are a lot of different learning styles, so that can suit some people really well.

You may have heard that most 4th years plan on academics, but most don't...

Take everything with a grain of salt, go with your gut and hope for the best. Chances are you will do great anywhere.

 

[OtoHNS]

The ENT RRC has fairly stringent requirements for residency programs to maintain accreditation, so you are very likely to get excellent training wherever you end up.

I personally trained in a program that sounds more like your #2. We were small and close-knit, and the long hours rotations at our main university hospital were balanced by some easier VA and community rotations (which were still beneficial in their own way). We did not have any "big name" faculty.

I had excellent training and felt fully competent to do general ENT upon graduating.

Out of the cohort of residents I knew well (+ or - 3 years), there are 3 who did fellowships (2 peds, 1 laryngology) and are now faculty at prestigious university centers. Another is completing a H+N fellowship and will join an academic department next year. There have also been graduates who matched in facial plastics (several), rhinology, and otology.

You definitely don't have to go to a big name program to have an academic career. My advice would be to go somewhere where you like the people you work with and your wife is happy (i.e. program #2)

 

[neutropeniaboy]

Nothing to add to this. Great advice from the three above.

 

[vjorl]

Sounds hokey, but go with what your gut says. Always. You know the answer already inside. Whenever you go against your intuition, it is never a good thing. Good luck!

 

[nacholibre]

Thanks everyone for the advice. I think the answers given here are very representative of why I am going into this field!

 

[Daodejing]

Once the time comes in March, can we get something compiled for the 2014 match data, like what urology did this year (https://excel.officeapps.live.com/x/16.0.2430.3014/_layouts/mobile/mXL.aspx?Fi=SDDF8A77E20D97622!262&H=emul&C=1__SN2-SKY-WAC-WSHI&ui=en-US&rs=en-US&wdo=2&su=1006738676876146210&cy=canary&ak=t=0&s=0&v=!AHX_4avaRQr5MZM&aid=98b8d4b3-a090-499b-af02-3cc4ca5fee27&m=en-us&ad=en-US&sc=host=&wdMobileHost=2)?

ENT and uro seem pretty similar in competitiveness, and a tool like this would be resourceful for next year's batch.

edit: easier to read version -> https://docs.google.com/spreadsheet...N5aXAxdzJXQ3l0bjZFamhDTmc&usp=drive_web#gid=2