Surgical oncology fellowship question

[surfsurg]

I am applying for surgical oncology this year and have a few questions about programs.
Which programs are considered the best in terms of combination of surgery volume, autonomy and excellent reputation/recognition in the community. I have heard many say the top programs are sloan kettering and MDACC. but is this just because they have the "reputation/recognition" aspect? Do they allow fellows autonomy especially in the OR?

Also wanted to know what people think is the most important aspect of matching?

Is it LOR from well recognized faculty in surgical oncology? Or is research and publications more important?

Please feel free to send a PM me (i understand that surg onc is a small community and some may feel some information is too sensitive for the public forum).

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[surg]

Every program is different, but since I don't have experience with all of them as they stand now, I will refrain from commenting as to the quality of each program. This is particularly true as each program will be responding to the need to become ACGME compliant in different ways over the next year or so, and thus the programs may not at all resemble the programs I am familiar with in terms of their structure.

MDACC and MSKCC have traditionally been the "top" brand names in fellowship. They are the 2 biggest programs and have the most extensive alumni networks, particularly in academics. It is analogous to choosing Harvard for undergrad. They get some of the top students because of who they are, the excellent training there improves them, and the great product they put out reinforces their reputation. Other programs have excellent training as well, but they are smaller, and with smaller networks, it is harder for them to "break through" into the same mental category as the 2 programs you brought up in terms of prestige and recognition.

As to your second question, it is a little cliche to say it, but I'm going to anyway. There is no ONE aspect of your application that will ensure matching. While some programs are heavily research focused, others are more clinically focused and would not be at all perturbed by a low publication count. That being said, as a group, surg onc fellowships are heavily academic leaning and some evidence of research/academic interest is almost de rigeur these days even at the more clinically oriented programs. The number of publications is always looked at as a plus factor and a sign of the ability to follow through, but all of us have had experience with failed projects that don't get published, so someone evidence of good research effort with a solid explanation of what happened can suffice. A great letter from a recognizable person is also a huge plus. As you say, surg onc is a small community. If someone I know personally or someone who I know has high standards says you are the best resident ever, I'm going to take that seriously. The person doesn't have to be world famous, and some of the best letters come from the alumni writing back to their home program on behalf of someone.

Good luck in the match.