Top 10 General Surgery Residencies Rankings

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Getting back to your original topic - I think it's very difficult to rank the "Top 10" programs, as this will vary depending on what you're looking for. My idea of a Top 10 program is one in which you graduate in 5+ years and everybody knows you've received amazing training. You tell them where you trained and they raise their eyebrows and instantly respect you a little more. It's a combination of clinical exposure, autonomy, research, and a general reputation in the surgery community that you survived 5 years of boot camp and nothing will faze you. With that in mind, and in no particular order:

1) Hopkins
2) MGH
3) UT-Southwestern/Parkland
4) UCSF
5) Baylor (Houston)
6) Wash U.
7) Louisville
8) Duke
9) UAB
10) Michigan

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I told myself that I would not get involved in this debate, since the best program is obviously the one that best meets your needs and interests, but being as I am I just can't resist. Let me start with my exceptions from the previous list, which are:

3) UT-Southwestern/Parkland: I don't know enough about this place to really comment one way or the other.

4) UCSF: Is this really a good place? Or do people just like SF that much? I think this is a well thought of program, but is it really all that? My med school advisors don't seem to think so, but that could just be regional bias. I have also been told that the financial status of the hospital affects day to day life.

5) Baylor (Houston): I think this goes in the category of regional powerhouse with some nationwide recognition.

7) Louisville: I know everyone says that people can operate their butts off when they come out of here, but research is pretty much nil. I don't think this is much of an academic environment. I have been told by residents in my program who went med school there that while there is a ton of bread and butter, there is a paucity of complicated cases. I think this place also goes in the regional powerhouse.

9) UAB: A program on the rise. By all accounts, a phenomenal center with big operating and research. I think the location hinders many of the highest quality applicants from looking at it.

Now that I finished bashing programs that I would not mind going to, let me present my thoughts on "top" programs. I prefer to group by grade, since, in my mind, Picking between some of these places is a matter of personal preference, and the gap between the "elite" programs and the next best set is really not all that much either, at least as far as I have seen on the interview trail so far.

A: Hopkins, MGH, Brigham, UCLA, Michigan, Wash U, Duke

A-: Penn, Vandy, Cornell, UCSF, UAB, Baylor, UTSW, Columbia, Cincinnati, U of W (Seattle)

B+: Northwestern, U Chicago, Louisville, U VA, UNC, Emory

Of course, only a partial list. Just the places I considered applying to and actually have some (albeit superficial) knowledge of. Hopefully someone will continue this thread and have some other interesting things to say about my choices.
 
I totally agree that there are a few different aspects that build into a program's rep on the interview trail- word of mouth, location, history, to name a few.

Kind of funny how there's a program "personality" that is right for all of us. I personally liked UAB and Louisville much more than Duke and UNC. Also thought UVa was quite a nice place. There's a lot of hype over the Raleigh-Durham-Chapel Hill area which I think makes those places more popular with applicants. I used to live in Chapel Hill; it is a pretty place, but unless you are an 18-year-old college boy (I beleive the undergrad pop. > 70% female) or married with an interest in the area's strong public school system, I don't think it is the most interesting place to live. Though the traffic in not comparable to NYC, parking can be a real PITA. UNC's chairman is cool, and you could probably get great training at either Duke or UNC. So I'm not knocking them or anything; the "personalities" of both of those places were not for me- just was not crazy about either of them.

Haven't yet been, but also been hearing over and over great things about UTSW.

B'ham and Louisville- don't know much about those cities, though both appeared to have enough going on that would be fun to check out on free time. Can't say it'd be like living in NYC or Miami, but looked okay. Charlottesville is very, very interesting; not a huge city, but a very unique part of the country.

BTW, womansurg; I actually have heard about Iowa Methodist on the trail- all good things. :)
 
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Originally posted by smithani
7) Louisville: I know everyone says that people can operate their butts off when they come out of here, but research is pretty much nil. I don't think this is much of an academic environment. I have been told by residents in my program who went med school there that while there is a ton of bread and butter, there is a paucity of complicated cases. I think this place also goes in the regional powerhouse.

I would disagree with this word of mouth from personal experience. My operative numbers will indeed be obscene, but this is actually the "braniest" kind of program I interviwed at other then Washington University & has a pretty stong academic bent to it (5 of 8 graduating chiefs are planning academic careers). 1-2 residents per year go into the lab by choice & have been exceptionally productive. This is really the tertiary referall center for the state (as well as southern Indiana and northern Tennessee) and I have several multiples of the national average in literally each index case category for the super specialty cases.

I agree with the regional powerhouse categorization, mostly due to the less prodigious research bases of the University (as a whole) as compared to some with multi-billion $$$ NIH funding. However, Dr. Hiram Polk, Dr. David Richardson, and Dr. Frank Miller are known internationally in surgical education circles & there dozens of alumni who are department chairs and in other academic positions of power
 
Originally posted by Foxxy Cleopatra
B'ham and Louisville- don't know much about those cities, though both appeared to have enough going on that would be fun to check out on free time.

As a native of Birmingham & current resident of Louisville, I can say I love these two cities. They are very much similar & if you like one, you'll like the other. Both are very pretty, easy to live in, & great for raising families. IMHO I think that the training program is better here ;) , but UAB has had a much improved quality of life reputation since Dr. Kirby Bland took over which has lead to a resurgence in popularity among interviewees
 
I would think the Mayo Clinic would rank in the top 20. Some people have claimed that the Gen Surg residency is not so great because of the limited responsibility/independence residents get in the OR. I heard this isn't true anymore- it is actually quite the opposite. Residents now get a ton of experience and responsibility. Anyone with first hand knowledge willing to comment? I'm interviewing there in a few weeks.
 
Originally posted by superstar
I would think the Mayo Clinic would rank in the top 20. Some people have claimed that the Gen Surg residency is not so great because of the limited responsibility/independence residents get in the OR. I heard this isn't true anymore- it is actually quite the opposite. Residents now get a ton of experience and responsibility. Anyone with first hand knowledge willing to comment? I'm interviewing there in a few weeks.

Hi there,
I spent some time at Mayo Clinic, Rochester in General Surgery and it profoundly affected the way that I practice today. I found that the chiefs have plenty of independence and the academics are off the scale. The residents are a close-knit family-oriented bunch that are great folks. The only weakness of Mayo is lack of trauma experience but Detroit is there to fill that hole. The attending physicians are off the scale and I love the Mayo method of training. Mayo Clinic sees and handles things that you are just not going to find elsewhere in the country. The nursing staff is well-trained and plentiful. There is almost no scut to be found anywhere. The total emphasis is on training excellent surgeons. I found Rochester, MN the worst part of the whole deal. Housing is overpriced and I have to be wary of any locale where there are too many underground walkways.

The best General Surgery program is going to be the one that you can match into and grow with. Some of the community programs are very strong and offer excellent opportunities both from the standpoint of academics and from the standpoint of research. Inova Fairfax Hospital (outside DC) is going to be one of those outstanding community programs. This program is wealthy (read they bought some of the best attendings) and located very close to NIH, the premier research center in the country. This brand new community program offers cushy digs, plenty of money for travel and books and some very dedicated teaching faculty. The biggest drawback to this program is that housing in the DC area is very expensive and the traffic is murder even at 0400h.

I have found the University of Virginia to be the best of all worlds. There is excellent research, good town to live in, excellent colleagues and great attendings who take a personal interest in your development as a surgeon. There is a good mix of autonomy here and the support in the hospital is great. We have a plan in place to meet the 80-hour work requirements and provide a quality educational experience for the residency. We are even starting to pick up on the penetrating trauma as the "bullet and knife club" of DC has set up shop in the I-64 corridor.

When I first arrived at Va, I thought the academics would be far below Mayo but I have been blown away. These folks teach and heavy emphasis is placed on academics and research. There are opportunities to write book chapters and the "Recall Series" is a total UVa project. The hospital is very modern and totally computerized. We have the most wonderful panoramic views of the mountains with almost any kind of sporting experiences that you might want to do. Our department chair invited us fly-fishing during my first month of residency. The nursing staff is well-trained and the scut work is a minimum.

Our residency director is off the scale and really makes sure that the resident experiences here are top notch. The attendings have been trained at a variety of places from Harvard to Duke to Michigan to Penn. I have far more than 90 cases and I am only 6 months into my first year with my VA experience yet to come. There are loads of operative experiences even at the intern level. This place has been heaven for me.

It is of great comfort to have the rank of #1 program but if you match at Duke, Birmingham or Mass General and you are miserable for whatever reason, the rank of your program is secondary. A good match at a strong community program is way better than a bad match at a university program. I knew that a surgery intership was going to be extreme and it is better than I thought it would be and more work that I have ever experienced in my life but I have grown and learned so much.

Spend some good quality time with the residents (they will be totally honest with you) in the Mayo program and do some real running around town so you can get the total feel of Rochester. When that 15 below zero wind hits you in the face, you cry and your tears freeze. I just found that Minnesota was not the climate for me for five + years.

My experience at Mayo was great and I would not have changed it for anything but I am totally happy to be here at University of Virginia. Have fun with the interview.

njbmd:cool:
 
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My top 10 (for what its worth)
1.) MGH
2.) Hopkins
3.) UTSW
4.) UCSF
5.) Vandy
6.) UPenn
7.) Columbia
8.) NYU
9.) Baylor
10.) Northwestern

Top Community Programs:
1.) CMC
2.) Baylor - Dallas

Please feel free to critique: I am currently applying (academic programs more, thus the sub-category for good community prog.) and this is the consensus from what i have heard/read (I would be interested in knowing if people think I am way off! haha)
 
1) 8 year bump - nice

2) That is a bizarre list - MGH but no Brigham? UTSW is obviously strong and known for the Parkland experience but it doesn't mesh with the rest of the list in terms of research/prestige. No Michigan or other midwest programs? Bottom line all of these are subjective.

Did anyone else notice the shout out to Wichita on the first page?!? YES!!!! We're famous!!!!

Sometimes I question my decision to train here, since it usually gets left out of the "Top 10 powerhouse university" lists.....I'm guessing it's #12 or 13....but after reading this 8 year-old thread, I finally feel validated.

Here's my list:

1. Hopkins
2. Wichita
3. MGH
4. Penn (you know how they get when you leave them out)
5. Burger King near my hospital


I know what you're thinking: Does Burger King really deserve to be in the top 5 instead of places like Wash U? Well, let me remind you that BK double cheeseburgers are only a dollar right now......


On a side note, in support of Robo Liver's comments from 8 years ago, the surgeon with the best hands I've ever seen is a Louisville graduate.
 
One rank list does not suffice. There needs to be three rank lists:


1. Academic Programs Training Academic Surgeons
--Pick your fellowship, find a great lab, feed the ego monster. Does it really matter if you are well rounded and proficient operative general surgeon when you are done if you are going to be a subspecialist anyway?
1. Brigham
2. Hopkins
3. MGH
4. UCSF
x. U. Washington
x. WashU
x. Stanford
x. UCLA
x. Columbia
x. Penn
x. Baylor--Houston

2. Academic Program Training Academic/Practical General Surgeons
--Get your fellowship somewhere, maybe spend a little less time at night imagining your name of the binding of a book. Your mom may not have heard of the school, but if I had to pick a doctor to be trapped on a desert island with, they would be from this group.
1. UTSW
2. Vanderbuilt
2. Utah
x. Wisconsin
x. Davis
x. USC
x. OHSU

3. Community Program Training Practical General Surgeons

--Fellowship prospects hard to judge, seems more dependent on who knows who than program reputation/training. Many don't want fellowship anyway. Operative training varies, but at good places it is better than the academic centers, even if the patients are perhaps less complicated, better insured and having more decisions made by the boss.
1. Mayo, MN (Could argue to put above, hard to place)
2. Virginia Mason
3. Baylor-Houston
4. Good Sam-Phoenix
5. Swedish-Seattle
6. St. Josephs--Denver
 
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I theoretically tentatively agree with your (1), (2), and (3) distinction of "types" of programs, but again the lists themselves are subjective. I interviewed at half the programs on your (1) and (2) lists - it is silly to say that (for ex) Vanderbilt is somehow less academic or offers you better training than say Baylor Houston or that Wisconsin is any less academic than Washington.

I agree. I certain don't, nor do I know how anyone could have the experience to try and rank all of the programs in the country, or really know how "academic" or the quality of their operative experiences are. If someone really wanted to do it they would need some type objective measures, and still would probably need to break it up regionally to have it mean anything, even if you were using outcome measures--they don't mean anything among different institutions patient populations. Just an idea, not trying to offend anyone at any particular program, nor claim that my 3-minute ranking project is anything other than a flight of my own imagination.
 
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my list was thrown together in minutes and (obviously) doesn't reflect any real thought (aka no offense to anyone/program), i just wanted to see if more knowledgeable people wanted to comment on an interesting thread (which they have, thank you). thanks for the intelligent discussion/insight
 
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i can add some programs that really impressed me from interviews:

Yale -- VERY impressive research program for residents and strong clinical experience, based on interview. seemed very rigorous. i did not get the impression this program emphasized academics to the detriment of clinical experience AT ALL.

Emory -- my impression was very similar to yale. outstanding program in terms of clinical experience AND great research opportunities. this was one of the very best programs i saw on the trail, but i didn't want to live in atlanta so i ranked it lower.

Cornell -- i thought the clinical experience was strong relative to other nyc programs: good overall with adequate trauma at jamaica queens and great clinical opportunities to work "as a fellow" (their words ... i.e., you take on similar responsibility on your own team as an R4/R5 sans PGY6+ 'real fellow') at memorial sloan kettering. research opportunities looked strong, also.

specifically in terms of outcomes research--something i'm interested in--i would include these programs:

a) michigan -- very strong with the person heading it having worked previously at dartmouth
b) university of washington -- their researchers have a very strong research core and they collaborate with the brigham
c) brigham -- i hear one guy there is famous
d) dartmouth -- didn't make it to my interview here, but their reputation is they are exceptional
e) +/- mt. sinai -- i hear they've taken on many of the clincial outcomes researchers who were at columbia

*i use letters so no one misconstrues this for a rank list.

out of 15 programs where i interviewed, i would only rate 1-3, as being places where i wasn't VERY confident about the training. i tried to interview at a wide spectrum of places (from places like the brigham to places ... not like the brigham) because i was concerned about matching--thankfully, this turned out NOT to be a problem, but i was doing the match as an independent applicant so i was paranoid.

of the 1-3 places where i had some concerns, they were also places with weak reputations. all of the 'academically strong' places looked to be 'clinically strong,' too. of course, interviews are not always the best way to form a realistic judgment of a place ...
 
i can add some programs that really impressed me from interviews:

Yale -- VERY impressive research program for residents and strong clinical experience, based on interview. seemed very rigorous. i did not get the impression this program emphasized academics to the detriment of clinical experience AT ALL.

Emory -- my impression was very similar to yale. outstanding program in terms of clinical experience AND great research opportunities. this was one of the very best programs i saw on the trail, but i didn't want to live in atlanta so i ranked it lower.

Cornell -- i thought the clinical experience was strong relative to other nyc programs: good overall with adequate trauma at jamaica queens and great clinical opportunities to work "as a fellow" (their words ... i.e., you take on similar responsibility on your own team as an R4/R5 sans PGY6+ 'real fellow') at memorial sloan kettering. research opportunities looked strong, also.

specifically in terms of outcomes research--something i'm interested in--i would include these programs:

a) michigan -- very strong with the person heading it having worked previously at dartmouth
b) university of washington -- their researchers have a very strong research core and they collaborate with the brigham
c) brigham -- i hear one guy there is famous
d) dartmouth -- didn't make it to my interview here, but their reputation is they are exceptional
e) +/- mt. sinai -- i hear they've taken on many of the clincial outcomes researchers who were at columbia

*i use letters so no one misconstrues this for a rank list.

out of 15 programs where i interviewed, i would only rate 1-3, as being places where i wasn't VERY confident about the training. i tried to interview at a wide spectrum of places (from places like the brigham to places ... not like the brigham) because i was concerned about matching--thankfully, this turned out NOT to be a problem, but i was doing the match as an independent applicant so i was paranoid.

of the 1-3 places where i had some concerns, they were also places with weak reputations. all of the 'academically strong' places looked to be 'clinically strong,' too. of course, interviews are not always the best way to form a realistic judgment of a place ...

I am going to take this opportunity to disagree with you on Cornell again, mainly because my impression is that no one there will even argue with you too much that NYU gives the stronger CLINICAL experience (by stronger, I mean you run the service and really act as the attending... they might argue you get exposed to and learn from better surgeons, but the level of operating for the resident is less) but probably no one will argue that the ACADEMIC/RESEARCH experience is probably stronger at Cornell over NYU. Columbia even touted that a Lap Chole is a PGY1-2 case, end of story, whereas on my 2nd look to Cornell, I PHYSICALLY saw a PGY5 resident essentially 1st assisting the attending on a Lap Chole...

This again just demonstrates how all of these lists are subjective and there really can't be an objective meassure of this. To Flank Pains lists, I'd argue adding my new program, UMDNJ-NJMS to the Academic Programs Training Academic/Practicing GS's... also would argue add to NYU to that list (or list A)... I mean, we have argued on this forum that Surg Onc is probably the 2nd or 3rd most competitive fellowship (definately behind Ped Surg, +/- with Plastics), so for NYU to send 6 residents to MSK over the past like 7-8 years, arguably one of the top 2 most competitive fellowships within Surg Onc [along with MD Anderson], you have to consider it a top place for sending fellows... I don't think any of those other on the list can boost those type of numbers... and UMDNJ-NJMS, well, it isn't as flashy of a name, or in as flashy of a city, but they both place well for fellowship (multiple into Surg Onc, including FMG's, 2 into plastics just this year, and then top places for the 'easier' to match fellowships like CT at MGH/UCLA, Vascular at WashU, Transplant at Columbia), and train the **** outa their residents, but again, that is a very subjective meassure (but good enough to recruit me and for me to recommend anyone else applying to take a look at it).
 
duly-noted, dojo. i believe your experience was an outlier. we'll have to agree to disagree.

here's some resident reviews of cornell: http://www.scutwork.com/cgi-bin/links/review.cgi?ID=403&d=1

i also heard great reviews of the program from PDs at other new york programs.

maybe someone else could weigh in on the program if they care enough to do so.
 
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Everyone thinks their residency is top 10 or 20. Pretty soon we will have 100 programs in the top 20 with 81 tied for 20. Just relax about the rankings, they are for children who didn't win enough spelling bees. Have a Corona or Cuervo today.
 
I am going to take this opportunity to disagree with you on Cornell again, mainly because my impression is that no one there will even argue with you too much that NYU gives the stronger CLINICAL experience (by stronger, I mean you run the service and really act as the attending... they might argue you get exposed to and learn from better surgeons, but the level of operating for the resident is less) but probably no one will argue that the ACADEMIC/RESEARCH experience is probably stronger at Cornell over NYU. Columbia even touted that a Lap Chole is a PGY1-2 case, end of story, whereas on my 2nd look to Cornell, I PHYSICALLY saw a PGY5 resident essentially 1st assisting the attending on a Lap Chole...

This again just demonstrates how all of these lists are subjective and there really can't be an objective meassure of this. To Flank Pains lists, I'd argue adding my new program, UMDNJ-NJMS to the Academic Programs Training Academic/Practicing GS's... also would argue add to NYU to that list (or list A)... I mean, we have argued on this forum that Surg Onc is probably the 2nd or 3rd most competitive fellowship (definately behind Ped Surg, +/- with Plastics), so for NYU to send 6 residents to MSK over the past like 7-8 years, arguably one of the top 2 most competitive fellowships within Surg Onc [along with MD Anderson], you have to consider it a top place for sending fellows... I don't think any of those other on the list can boost those type of numbers... and UMDNJ-NJMS, well, it isn't as flashy of a name, or in as flashy of a city, but they both place well for fellowship (multiple into Surg Onc, including FMG's, 2 into plastics just this year, and then top places for the 'easier' to match fellowships like CT at MGH/UCLA, Vascular at WashU, Transplant at Columbia), and train the **** outa their residents, but again, that is a very subjective meassure (but good enough to recruit me and for me to recommend anyone else applying to take a look at it).


I tend to agree with the opinion regarding Cornell. As a 4th year student I did a rotation at MSKCC and the resident on the service did absolutely NOTHING in the OR the entire month. Sure, he scrubbed, but I don't think the attending or fellow even let him hold a retractor. I got to put the Foley in before every case, and that was more than the resident got to do.

I also did a second look at Cornell (2-3 yrs ago). Same scenario as you mentioned. The 5th year was trying to do a lap chole. The attending didn't let her struggle very long before taking the case away from her.
 
duly-noted, dojo. i believe your experience was an outlier. we'll have to agree to disagree.

here's some resident reviews of cornell: http://www.scutwork.com/cgi-bin/links/review.cgi?ID=403&d=1

i also heard great reviews of the program from PDs at other new york programs.

maybe someone else could weigh in on the program if they care enough to do so.

yeah, i know it keeps coming off like I sound like a dick and keep bashing your program to be (so I appologize, but I also will continue to share my impression and my experience), and from my experience there on the night before dinner, interview, and 2nd look, almost all the residents did love their time there / wouldn't trade it for the world (and spent like 2 hours talking with one resident who was a grad from my school, loved our chairman, and had a hard time not wanting to stay, but after 2 years at Cornell she has no second thoughts or issues... did she drink the coolaid, putting on a good show, or was it legit... i think it was legit). And you are going to have your programs stellar reputation / your obvious hard work and intelligence propelling you to pretty much any fellowship you desire, while I will be clawing my way to where I want to be... we all make our own decisions for our own reason:cool:.
 
we all make our own decisions for our own reason:cool:.

A-****in'-men to that, brother.

1. Academic Programs Training Academic Surgeons
--Pick your fellowship, find a great lab, feed the ego monster. Does it really matter if you are well rounded and proficient operative general surgeon when you are done if you are going to be a subspecialist anyway?
1. Brigham
2. Hopkins
3. MGH
4. UCSF
x. U. Washington
x. WashU
x. Stanford
x. UCLA
x. Columbia
x. Penn
x. Baylor--Houston
Can I selfishly admit it gave me a little thrill of pride to be joining an X-ranked program? Oh, the bragging rights to the family-- "you do know we're ranked X in the country, right?" The trash-talking: "that's what I'd expect from someone training at a shop of your pathetic caliber; we in the X tier have more lofty expectations."

Not as much fun being X-ranked as being X-rated, unfortunately.
 
The idea that you can rank surgery programs 1-10 is just silly. Flank pain's post above came the closest to reality. The best you can do is to group them into categories like he has done and group "peer" programs together, except all of them with "x" ranks. I like the categories he has made. How they rank numerically beyond that is up to the individual evaluating them. If you can't stand Boston, then the Partners hospitals probably aren't going to be at the top of your list, for example. Then the question of on what basis you're making a ranking comes into question. Prestige? Operative experience? Fellowship placement? Research? The rank changes for each parameter. If you're looking for a better operative experience with few fellows and care less about pedigree, then your list shuffles. If you're dead-set on being a division chief by 45 then you're going to aim toward the more traditionally highly regarded programs. If you want to be an awesome community general surgeon who can do 72 cases a day then you're probably going to look outside the "traditional" top 5 academic programs. And all that being said, there are plenty of PDs and division chiefs who didn't train at those programs too, so there's no real ultimate truth.

It's still fun to talk about programs though...
 
The idea that you can rank surgery programs 1-10 is just silly. Flank pain's post above came the closest to reality. The best you can do is to group them into categories like he has done and group "peer" programs together, except all of them with "x" ranks. I like the categories he has made. How they rank numerically beyond that is up to the individual evaluating them. If you can't stand Boston, then the Partners hospitals probably aren't going to be at the top of your list, for example. Then the question of on what basis you're making a ranking comes into question. Prestige? Operative experience? Fellowship placement? Research? The rank changes for each parameter. If you're looking for a better operative experience with few fellows and care less about pedigree, then your list shuffles. If you're dead-set on being a division chief by 45 then you're going to aim toward the more traditionally highly regarded programs. If you want to be an awesome community general surgeon who can do 72 cases a day then you're probably going to look outside the "traditional" top 5 academic programs. And all that being said, there are plenty of PDs and division chiefs who didn't train at those programs too, so there's no real ultimate truth.

It's still fun to talk about programs though...

This doesnt really make any sense. You always CAN rank programs. It just depends on what you are ranking them on. Of course its true that words like "best" are filled with ambiguity, and lead to confusing conclusions. I mean, in baseball we have a Most Valuable Player award and even though "value" seems like a much clearer term, we still have guys like Justin Morneau winning it, or Bonds NOT winning it, which is basically just laughable by ANY definition of value.

So the problem isnt really with trying to come up with a ranking. The problem is twofold: what are some reasonable, USEFUL, practical criteria that we can use to rank programs (difficult) and what are the best ways of collecting the necessary data to give any sort of legitimate ranking (very difficult)?

Dont confuse the difficult with the impossible. Lets say we decide that by "best" we mean "gives an average resident the best chance of becoming a department chair in the future?" This would be very DIFFICULT to find out (because of conflating factors) but is not in theory impossible to calculate. We would then have an OBJECTIVE ranking of the "best" programs. People might not like it, people would INSTANTLY start nit-picking every little detail if they were at a lower ranked program, but that has nothing to do with the inherent invalidity of the ranking....thats just human nature.

Now, if by "best" you mean "the best for me personally," then sure, its not very practical to come up with a ranking, because there are as many rankings as there are applicants. But I dont really think thats what people are asking, at least not to that extreme. I think most people would be happy with a small handful of rankings, such as "What academic program will lead the average applicant to the highest annual median salary?" or "What community program will lead the average applicant to the highest probability of #1 fellowship position match?" and probably 5 or 6 others. All of these CAN, in theory, be calculated, if we just had enough data, in an objective fashion.

The problem is essentially one of too little data, and too little agreement on what is meant by "best." It is not true that it is "just silly" to rank programs 1-10. It might be "just tasteless" to be so explicit about what you are really asking, or "just tricky" to go about collecting data that the programs involved have very little incentive to provide.
 
Was thinking about the rankings in general and comparing it to the NFL draft. Lots of players went out of high school into top ranked programs and many of those players were selected in the first round of the NFL draft, the players from Oklahoma were a good example. However, there were also guys from Rutgers, South Florida, TCU, Idaho, and Clemson. Everyone knows that going to a great program doesn't assure success. However, I guess the question is whether only a limited number of people in a great program will succeed? Should one consider internal competition when choosing a program? Is it better to be a top recruit at a good program, then somebody lucky to land a spot at a great program?:confused:
 
This doesnt really make any sense. You always CAN rank programs. It just depends on what you are ranking them on. Of course its true that words like "best" are filled with ambiguity, and lead to confusing conclusions.
This thread and discussions like these are always about creating an all-encompassing, BEST surgery programs list. That's what I'm saying is unfeasible. Which is "better," MGH or the Brigham? Brigham or Hopkins? At this point you're splitting hairs. It depends on whom you ask. You and I are arguing different things, I think.

Dont confuse the difficult with the impossible. Lets say we decide that by "best" we mean "gives an average resident the best chance of becoming a department chair in the future?" This would be very DIFFICULT to find out (because of conflating factors) but is not in theory impossible to calculate. We would then have an OBJECTIVE ranking of the "best" programs. People might not like it, people would INSTANTLY start nit-picking every little detail if they were at a lower ranked program, but that has nothing to do with the inherent invalidity of the ranking....thats just human nature.
This is an extension of what I was attempting to convey. Perhaps you have done it better. There are many "best" lists. Best to become PD or chair. Best to become a simply awesome surgeon. Best for great fellowship placement. But more to the point, I'm also saying it's just too hard to compile a list that even a handful of people would agree on. An "objective ranking" (i.e. what percentage of a program's graduates become a chair over the last 50 years) is next to impossible as well because it wouldn't take into account the individual goals of each program's residents. What is much easier is to say is, this group of programs, while not generally considered to be "top" programs, has pretty sick fellowship placement. But putting that group into a numerical listing from best to worst is not possible, IMHO. That's something that USNWR has been doing for a while for colleges and medical schools, and I think most around these parts think that list, while "objective" as you claim you'd like to rank surgery programs, is just hot air created to sell magazines.

The problem is essentially one of too little data, and too little agreement on what is meant by "best."
Agreed.
 
i agree ranking 1-10 is pretty dumb for the reasons recent posters have stated.

i do think its worthwhile to list programs you think are great, so future applicants have an idea what is out there. for example, i did med school in the south, and i heard many northeast programs were no good (just some uninformed, blatant north-south discrimination). since i hadn't seen yale listed as a great program, i listed it here. i think future applicants should know it's great and give it a shot if it meets other criteria they're looking for (career goals, geographic desires, etc.).

applicants will be searching SDN for "top general surgery residencies," and if they come across an informative thread listing great programs (perhaps categorized by region, academic/community, etc.) that's great. if anything, it would reduce the number of repetitive threads which are met by "do a search" replies.
 
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i agree ranking 1-10 is pretty dumb for the reasons recent posters have stated.

i do think its worthwhile to list programs you think are great, so future applicants have an idea what is out there. for example, i did med school in the south, and i heard many northeast programs were no good (just some uninformed, blatant north-south discrimination). since i hadn't seen yale listed as a great program, i listed it here. i think future applicants should know it's great and give it a shot if it meets other criteria they're looking for (career goals, geographic desires, etc.).

applicants will be searching SDN for "top general surgery residencies," and if they come across an informative thread listing great programs (perhaps categorized by region, academic/community, etc.) that's great. if anything, it would reduce the number of repetitive threads which are met by "do a search" replies.

But we love to rank crap. Everything has to be quantitated. If you can't take hundreds of factors and smash them into a single number that applies to every person, we don't want it!
 
I disagree that it is stupid to rank programs; however, I would personally rank programs in a more tier-like ranking as was done earlier. The name matters whether we want it to or not. For people pursuing competitive academic positions and fellowships, evaluating a rank order is imperitave. That being said, I would remove Baylor-Houston from the list of tops for the time being. They are undergoing a lot of rearrangements with Methodist and are not a very stable program at the moment. Additionally, I feel that Vanderbilt is very deserving of a top 10 spot.
 
I disagree that it is stupid to rank programs; however, I would personally rank programs in a more tier-like ranking as was done earlier. The name matters whether we want it to or not. For people pursuing competitive academic positions and fellowships, evaluating a rank order is imperitave. That being said, I would remove Baylor-Houston from the list of tops for the time being. They are undergoing a lot of rearrangements with Methodist and are not a very stable program at the moment. Additionally, I feel that Vanderbilt is very deserving of a top 10 spot.

I agree that program rankings are helpful for applicants and a tier-based ranking is probably the best approach. Several times, my PD told me to "look up the rankings" and then apply to some programs that were in the top tier, middle tier, and a few back-ups in the lower tier. For months, I kept wondering where this magical, well-hidden rank list was for general surgery programs.

I disagree with your reasoning concerning instability at Baylor based on its affiliation with Methodist. A large quantity of the resident's surgical experience comes from time spent at the short-staffed, high volume county hospital rather than the big-name private hospital where patients want the big-named attending doing their operation rather than the PGY3 who is still in training. The resident's private hospital experience is mainly at St Luke's which happens to be ranked much higher in US News & World for cardiology and cardiothoracic surgery, interestingly enough. Furthermore, Methodist now has its own surgical residency program. If it is truly the powerhouse you seem to imply, then why isn't its program receiving accolades? (and yes, I recognize that this thread was started before Methodist had its own program)

I would agree that the school as a whole has been through quite a bit of turmoil (BCM hospital fail, Rice-BCM merger fail, BCM-Baylor merger fail [thank goodness], Traber fail). Only time will tell how this ultimately affects the department. However, my understanding is that the PD is still large and in charge and I think his continued presence holds a stronger [positive] impact on the future of the surgery department.

As for Vandy, I admit that I know very little about the school except that it has a gorgeous undergrad campus. I hope to be enlightened regarding its strengths.
 
I see that people have left out DUKE and UNC as well as BIDMC out of all the rankings. Opinions? Reasons for leaving them out?

I would argue that Duke graduates are stronger surgeons and perhaps equally strong academics/researchers as, let's say, Stanford.

Thanks.
 
I see that people have left out DUKE and UNC as well as BIDMC out of all the rankings. Opinions? Reasons for leaving them out?

I would argue that Duke graduates are stronger surgeons and perhaps equally strong academics/researchers as, let's say, Stanford.

Thanks.
Based on what? Some of Duke's grads in recent years finished with fewer than 800 cases. I got the distinct impression while I was there that they don't get to operate as much and do as much in the OR as most places I have been. I think UNC has a much better clinical educational experience, and their grads go to the same fellowships that Duke's go to.
 
Based on what? Some of Duke's grads in recent years finished with fewer than 800 cases.

Perhaps. But, their pants are by far the whitest. You cannot argue with their superiority when it comes to white pants-ness.

Anyway, while we are talking about programs being left out, where the hell is KU-Wichita? We like to consider ourselves as the "Harvard of Southeastern Kansas."

We must be number eleven......
 
Anyway, while we are talking about programs being left out, where the hell is KU-Wichita? We like to consider ourselves as the "Harvard of Southeastern Kansas."

We must be number eleven......

favorite post in this thread so far. :D


I'm curious about some of the NYC programs. If we were to compare NYU, Sinai, Columbia, Cornell, can anyone offer their opinion of the strengths/weaknesses relative to eachother (or perhaps even some of the other NY/Long Island programs?). I'm curious if my gut feelings from interviews correspond to the group-think.
 
can anyone comment on the other programs besides these 4 in the NY area? i.e. Montefiore, SLR, Downstate, Maimonides, NSLIJ, NYMC, NJMS, ... Thanks.
 
can anyone comment on the other programs besides these 4 in the NY area? i.e. Montefiore, SLR, Downstate, Maimonides, NSLIJ, NYMC, NJMS, ... Thanks.

All 7 of those are considered top 5.
 
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Perhaps. But, their pants are by far the whitest. You cannot argue with their superiority when it comes to white pants-ness.

Anyway, while we are talking about programs being left out, where the hell is KU-Wichita? We like to consider ourselves as the "Harvard of Southeastern Kansas."

We must be number eleven......
Duke interns don't have to wear the white pants anymore. They still wear a short(er) coat (longer than a med student coat) and they get the pants but few wear them. Apparently some of the guys like to wear them but the girls for obvious reasons never do.
 
favorite post in this thread so far. :D


I'm curious about some of the NYC programs. If we were to compare NYU, Sinai, Columbia, Cornell, can anyone offer their opinion of the strengths/weaknesses relative to eachother (or perhaps even some of the other NY/Long Island programs?). I'm curious if my gut feelings from interviews correspond to the group-think.
I would order them Cornell, Columbia, NYU, Sinai, all others... Honestly I don't think they offer anything special. You don't really go to these programs for the training; you go to live in NYC. If training is your top priority, then go elsewhere. If must live in NYC for some crazy reason then that's the order I'd put them in. I know nothing about the others except I heard from a former resident that Montefiore is terrible. Stay away.
 
I agree that program rankings are helpful for applicants and a tier-based ranking is probably the best approach. Several times, my PD told me to "look up the rankings" and then apply to some programs that were in the top tier, middle tier, and a few back-ups in the lower tier. For months, I kept wondering where this magical, well-hidden rank list was for general surgery programs.

I disagree with your reasoning concerning instability at Baylor based on its affiliation with Methodist. A large quantity of the resident's surgical experience comes from time spent at the short-staffed, high volume county hospital rather than the big-name private hospital where patients want the big-named attending doing their operation rather than the PGY3 who is still in training. The resident's private hospital experience is mainly at St Luke's which happens to be ranked much higher in US News & World for cardiology and cardiothoracic surgery, interestingly enough. Furthermore, Methodist now has its own surgical residency program. If it is truly the powerhouse you seem to imply, then why isn't its program receiving accolades? (and yes, I recognize that this thread was started before Methodist had its own program)

I would agree that the school as a whole has been through quite a bit of turmoil (BCM hospital fail, Rice-BCM merger fail, BCM-Baylor merger fail [thank goodness], Traber fail). Only time will tell how this ultimately affects the department. However, my understanding is that the PD is still large and in charge and I think his continued presence holds a stronger [positive] impact on the future of the surgery department.

As for Vandy, I admit that I know very little about the school except that it has a gorgeous undergrad campus. I hope to be enlightened regarding its strengths.

Does anybody know where BCM does their general surgery training (ie bread and butter)? Is it St. Luke's or Ben Taub or neither?
 
Does anybody know where BCM does their general surgery training (ie bread and butter)? Is it St. Luke's or Ben Taub or neither?
Ben Taub. That's where they get the appys, gallbladders, and breast cases for example. At St. Luke's it sounds like they hold hook a lot.
 
Does anybody know where BCM does their general surgery training (ie bread and butter)? Is it St. Luke's or Ben Taub or neither?

Here they talk about rotating at both places.

For something interesting, read the picture captions, especially the one on the home page: "Chief resident *assisting* Dr. Brunicardi during surgery", "Attending X walking PGY-4 through laparoscopic procedure". Not sure if that means anything.
 
Wow, those operative numbers are low. Granted they were from 05-06, but still. They must be bad about logging. And their listed number for endoscopy was lower than the requirement. Odd.
 
Wow, those operative numbers are low. Granted they were from 05-06, but still. They must be bad about logging. And their listed number for endoscopy was lower than the requirement. Odd.

I wouldn't assume that low OR numbers are the result of "bad logging." It's probably the result of low numbers. Baylor has long been known for this, and we even had a discussion about the Brunicardi picture a couple years back....can't remember the thread.

When I was starting out, I remember talking to a PGY-3 at Baylor who was stoked because he had just done his first lap appy. Something to think about.
 
can anyone comment on the other programs besides these 4 in the NY area? i.e. Montefiore, SLR, Downstate, Maimonides, NSLIJ, NYMC, NJMS, ... Thanks.


I interviewed at Einstein (Monte), Downstate, NYU, Sinai, Cornell, Columbia, and go to NJMS (no secret out there). you gotta think what you are looking for. I wanted the big part of my training (my chief year) to be at a public hospital, so Sinai, Cornell, and Columbia suffered in the rankings... if you look at above posts by me, Cornell probably has the most prestigue of the 4 manhatten ones, but might be the worst autonomy, followed by Sinai. NYU had the most autonomy, perhaps too much. Einstein seemed to have a nice mix, but their PD/Chair was a major turn off, had no personality, a real bore on the interview. Downstate, while fitting the bill of public hospital, and one of the premier trauma experiences probably anywhere, seemed too much in disarray for me... it was my last ranked program... they rotate at 5 hospitals and were having trouble with numbers so cut from 8 to 5 residents.... Why I choice NJMS, besides being a student there and thus being most comfortable and familiar with it, was the balance between public (university hospital, almost all charity care patients, just lost its big surg onc attending so did take a big hit, but great trauma, critical care, complex general surgery (chairman gets large ventral hernias that no one else will touch)) and private (Hackensack, which is no slouch of a hospital when it comes to known attendings, and we operate like crazy), plus a VA experience. There are things that suck at this program (not much peds, cardiac isnt great but we did send ppl to MGH and UCLA 2 years ago, too much trauma, surg onc now took a big hit), im gonna know how to operate and will have good fellowship placement.
 
I wouldn't assume that low OR numbers are the result of "bad logging." It's probably the result of low numbers. Baylor has long been known for this, and we even had a discussion about the Brunicardi picture a couple years back....can't remember the thread.

When I was starting out, I remember talking to a PGY-3 at Baylor who was stoked because he had just done his first lap appy. Something to think about.

I scrubbed my first lap appy Sept 2nd of this year (PGY1) and essentially did the whole thing for themby the end of september (and have 8 logged already)... that is definately something to shake your head at...
 
grammar_nazi.jpg
 
I find the posts about Baylor residents not operating very strange. True the operative number posted online is low, but as has been alluded to in different posts, it all depends on how much of the case you actually do. I can assure you that the residents at Baylor operate. When I rotated, lap appys and lap choles were routinely performed by Interns and 2nd years from skin to skin with either a 4 or 5 as first assistant (of course some junior residents were more aggressive than others). If I recall correctly, approximately 10 +/- a few scheduled cases are done per week per service (there are 4) at Ben Taub, with additional Trauma/Acute care surgery cases throughout the night, every night. Thus the comment about the 3rd year doing his/her first lap appy is very strange. Perhaps this was a resident just out of research? A discussion of more detailed operative experience is best left to Baylor residents.
 
Guilty as charged. "Definately" is one of the worst though.
 
I find the posts about Baylor residents not operating very strange. True the operative number posted online is low, but as has been alluded to in different posts, it all depends on how much of the case you actually do. I can assure you that the residents at Baylor operate. When I rotated, lap appys and lap choles were routinely performed by Interns and 2nd years from skin to skin with either a 4 or 5 as first assistant (of course some junior residents were more aggressive than others). If I recall correctly, approximately 10 +/- a few scheduled cases are done per week per service (there are 4) at Ben Taub, with additional Trauma/Acute care surgery cases throughout the night, every night. Thus the comment about the 3rd year doing his/her first lap appy is very strange. Perhaps this was a resident just out of research? A discussion of more detailed operative experience is best left to Baylor residents.

Any time the awesomeness of a big famous program is questioned on SDN, people spring up out of nowhere to defend its honor. The same thing has happened for Penn, Duke, Mayo, and Hopkins in the past....I've found that some people can get their prestigious panties in a bunch pretty fast.

These fanboys don't feel the need to contribute to SDN at any other time, but become very distraught when their beloved program is brought into question. They always end the post by mentioning that nobody can talk about it except residents from the program, as if it is blasphemous for an outsider to mention the program's holy name.

Anyway, it's possible that we're way off about Baylor, and the autonomy and operative numbers are great....but in my experience, where there's smoke, there's fire, and these reputations don't develop spontaneously.
 
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