So is it all just hearsay?
Is this it? Should I assume that all academic institutions are going to be more or less the same in terms of training?
DrMasochist,
As you've seen, this is a controversial topic. For physicians, and radiologists in particular I think, our intelligence is a big part of our identity, which makes us defensive at the implication that someone or some other program is "smarter" or "better." Posts like this are always going to degenerate into arguments because we feel like we need to defend our sense of self against the idea that someone else "beats" us.
Here's a list I created using the annual Aunt Minnie awards for best training program.
http://forums.studentdoctor.net/showthread.php?t=973851
This list isn't perfect, but at least it averages out the subjective opinions of a lot of different radiologists, rather than any one department.
Regional bias is very strong and very important. If you want a long-term career in Texas, than a place like UT-SA or UTSW will serve you better than a higher ranked institution. Many of the "best programs" lists out there are affected by regional bias as well - for example, someone in this thread implied that basically all the academic California programs were top tier. The idea that California has cornered the market on excellent radiology training is silly, though there is some truth that many of these may be more competitive to match into than "better" programs in the Midwest or South, simply because people want to be in CA.
As for what you get at a highly ranked institution:
If you think you might want to do some research or teaching, the opportunities are better at centers where the research money is available, there are lots of mentors to show you how, and the institution values these activities. If, like most radiology residents, you know you want a private practice career, these are less important, but there's still value in training with highly specialized teachers. If you go to a community program, you'll be taught how to manage bread and butter radiology by very skilled general radiologists. If you go to a more academic center, you get to inherit the expertise of radiologists who've dedicated their attention to specific areas of radiology. Because you'll train with experts from all specialties, you'll come out with more specialized knowledge than the generalists can give you. You'll also see more zebras, which *I* think is important in radiology because often you'll be the one to catch that diagnosis in the community, saving the patient a lot of aggravation and time.
Finally, you'll be taught by academic radiologists, who (while not always true) generally like to teach and will give you more time, attention and didactic training.
The reputation of a school is a bit like the emperor's new clothes: we're the best because everybody says so. What this does accomplish is attracting the best residents to the program. As someone else mentioned, these residents would be great at any program, but putting them all in one place - I think - helps them all challenge and teach each other to be even better. When I interviewed, I noticed that I felt more comfortable with residents who were 'at my level,' that is, I felt intimidated in some places, not challenged in others, and "just right" at some. The better reputation schools also generally draw the best faculty, who will be training you.
One last thing to think about that may or may not be important to you: after med school nobody sees your transcript again. The only marker you carry forward that you rocked as a med student is the name of the place where you trained. Again, it's a bit like the emperor's new clothes, but if people are going to be making assumptions about the quality of your training, this may as well work for you instead of against you.
I'm of the opinion that within any tier of reputation you can find diversity of location and geography, so you should find the location you like the best within the highest tier that you are competitive for. I don't think there's a lot of value in quibbling over whether the program is ranked 7th or 12th - this probably doesn't make a difference in your training.
Good luck in your decisions! You're not choosing between right and wrong programs - it's a "multiple correct answers" test.
