reputation vs happiness

[donesoon]

Now that I've done a few interviews, I'm finding a rough dichotomy: there are big name programs with a huge reputation, lots of zebras but a correspondingly huge workload, and then there are programs with less reputation, whose residents seem a lot happier, with a lesser workload and perhaps lesser pathology.

I'm interested in academics and am receiving strong encouragement towards the big name programs. However, I'm finding myself drawn to the places where the residents genuinely seem more happy with their lives, but may not be "top-10".

Am I shooting myself in the academic foot by not going to a big name program? Anyone else having the same dilemma, or think they've found the best of both worlds?

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[Acherona]

I can't imagine as an MD/PhD that you'd have any doors closed to you by going to a good but not top 10 program.

And the big names are the big names because of research, not because they have better pathology. I mean I fail to see how the amount of NIH funding would affect the type of neuro patients that happen to present at a particular hospital, assuming it is a large tertiary center.

 

[typhoonegator]

I agree with the above. However, I encourage you to keep looking. There are some excellent programs at big-name places where the residents are truly happy. It is possible to find both.

 

[buckley]

I agree, it's possible to find both. And since u say you are interested in academics, keep in mind that some places are better in one area (i.e. stroke, nm, epilepsy) and not so much i the other. So factor your possible future interests in mind!

 

[soulofmpatel]

My theory is that big name programs have less of a motivation to keep their residents happy because they'll always attract suckers each year who just go ga ga for the big name. I say screw those places and go to where you'll be happy.

 

[memento]

My theory is that big name programs have less of a motivation to keep their residents happy because they'll always attract suckers each year who just go ga ga for the big name. I say screw those places and go to where you'll be happy.

I second that! Go to a place where you can spend 3 years in a hospital and the surrounding city. Its not a sprint, but a marathon. To me, I think its even easier for those who want to go into private practice. The name is less of a factor than in academia.

 

[Neurologee]

I think you already know the answer to your own question, based on the fact that you have enough insight to make the observation...
I agree with the encouragement of the others -- don't make any decisions until you have gone to all of your interviews ... you may find the exact right school

Or, if you share my experience, you may still agonize a bit ... I think it is in the nature of an MD/PhD to avoid huge life choices -- you like to have tons of options coexisting all the time, hence pursuing both degrees ... I also strugged with choosing Name vs Location vs Lifestyle. And you also know that no one on this forum can tell you what is most important in your life and priorities...

I would say to go on a second look, though. I went on one -- that was all I needed to sort out my top two choices. And it was very helpful. The second look was very tempting - the school really showed itself and the town well... but ultimately, I also was able to get more of a feel for the lifestyle and resident happiness.

Not sure if this applies to you, either, but especially interesting to me was whether or not the significant others were happy -- I have a spouse, and my First Priority was to have a good sound relationship during and beyond residency. In the end, I basically came up with a list of programs where I thought I could be happy, and then let my spouse rank them based on job prospects, available recreation, etc -- bottom line is that the significant other spends a lot of time on his/her own during your residency, and no matter how great the program, anyone will be miserable in a stressed relationship. I am sure many, many people would object to this advice, BUT -- the decision to let my spouse have major input - and veto power - in the residency ranking process was undoubtedly one of wisest decisions I have ever made. If you do not have a significant other, that is one less concern

Anyhow, bottom line: if you get some vague feeling in the pit of your stomach about a place you really thought you would like, then either go on a second look and investigate further ... or listen to yourself. You never go wrong when you go with your gut.

 

[Strokeguy]

I think you already know the answer to your own question, based on the fact that you have enough insight to make the observation...
I agree with the encouragement of the others -- don't make any decisions until you have gone to all of your interviews ... you may find the exact right school

Or, if you share my experience, you may still agonize a bit ... I think it is in the nature of an MD/PhD to avoid huge life choices -- you like to have tons of options coexisting all the time, hence pursuing both degrees ... I also strugged with choosing Name vs Location vs Lifestyle. And you also know that no one on this forum can tell you what is most important in your life and priorities...

I would say to go on a second look, though. I went on one -- that was all I needed to sort out my top two choices. And it was very helpful. The second look was very tempting - the school really showed itself and the town well... but ultimately, I also was able to get more of a feel for the lifestyle and resident happiness.

Not sure if this applies to you, either, but especially interesting to me was whether or not the significant others were happy -- I have a spouse, and my First Priority was to have a good sound relationship during and beyond residency. In the end, I basically came up with a list of programs where I thought I could be happy, and then let my spouse rank them based on job prospects, available recreation, etc -- bottom line is that the significant other spends a lot of time on his/her own during your residency, and no matter how great the program, anyone will be miserable in a stressed relationship. I am sure many, many people would object to this advice, BUT -- the decision to let my spouse have major input - and veto power - in the residency ranking process was undoubtedly one of wisest decisions I have ever made. If you do not have a significant other, that is one less concern

Anyhow, bottom line: if you get some vague feeling in the pit of your stomach about a place you really thought you would like, then either go on a second look and investigate further ... or listen to yourself. You never go wrong when you go with your gut.

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I was in a similar situation. But the above reply is probably the best advice/suggestion.