UCSF vs Columbia

[Mental Gymnast]

---

Members don't see this ad.

Hey guys,

I'm considering cardiology or endocrine for fellowship, and have no real geographic restrictions. Having a lot of trouble choosing between Columbia and UCSF. Both have excellent and rigorous clinical training, diverse underserved patient populations, wealth of research opportunities in everything you can imagine, comparable fellowship match lists, etc. In terms of standard of living, both are in the two most expensive cities in the US. So I am really having a lot of trouble finding differences between these two. With the exception of three hospital vs two hospital system, and the east coast vs west coast debate (which I could care less for), I cannot seem to find real advantages that make either program stand out. Any insight?

Thanks! 🙂

PS Don't wanna hear none from you Gold&Black 😎

 

[ResidentMD]

Hey guys,

I'm considering cardiology or endocrine for fellowship, and have no real geographic restrictions. Having a lot of trouble choosing between Columbia and UCSF. Both have excellent and rigorous clinical training, diverse underserved patient populations, wealth of research opportunities in everything you can imagine, comparable fellowship match lists, etc. In terms of standard of living, both are in the two most expensive cities in the US. So I am really having a lot of trouble finding differences between these two. With the exception of three hospital vs two hospital system, and the east coast vs west coast debate (which I could care less for), I cannot seem to find real advantages that make either program stand out. Any insight?

Thanks! 🙂

PS Don't wanna hear none from you Gold&Black 😎

An honest question - have you lived on the West Coast? You need to have lived on the west coast to make that comment.

I'm biased - I think UCSF is one of the top 3 programs that are head and shoulders above the next tier. Plus, you would not have to deal with the scut and nurse issues of NYC - your focus would be on education (and research). There is a huge stronghold of bench research at UCSF (I think they get the maximum NIH funding if I remember correctly). But then, as I said, I'm biased.

 

[EaglesPA]

If you really don't care with regards to East Coast verus West Coast, then where did you go for med school? If East Coast, choose UCSF so you can experience the WestCoast. If West Coast, choose Columbia to experience the East Coast. If neither, choose UCSF.

 

[jdh71]

This is a NICE conundrum to find oneself in . . . 😎

UCSF is elite. I think you go there you punch your own meal card from here on out.

And San Francisco is a MUCH cooler town to live in IMHO (West Coast bias revealed 😳)

Unless your gut SCREAMS Columbia over UCSF. I have to say UCSF all the way.

 

[houstoncfh]

Those views of the Golden Gate Bridge were pretty sweet. And UCSF gets the most VA exposure of all the top programs. 🙂

 

[Mental Gymnast]

This is a NICE conundrum to find oneself in . . . 😎

UCSF is elite. I think you go there you punch your own meal card from here on out.

And San Francisco is a MUCH cooler town to live in IMHO (West Coast bias revealed 😳)

Unless your gut SCREAMS Columbia over UCSF. I have to say UCSF all the way.

Thanks for the replies guys! To answer your questions ResidentMD and EaglesPA, I go to school on the East Coast but have lived in San Francisco for two months while doing clerkships there. So I am familiar with the lifestyle and culture differences on both coasts. As for the "scut," I did not think it was as huge of a difference. Although, the unionized nursing in NYC makes your life more difficult, at least Columbia has an entirely electronic EMR. On the other hand, the UCSF system still involves some hand-written components which eat into your day. Also, from speaking to the residents at SFGH, they seem to spend a large part of their day doing scut and working on patient placement for this immensely underserved population. This all eats out of your "education" time too. As for it being a benchtop research powerhouse, I wonder how overrated that is for IM residents who do clinical work 80-90% of their training, especially for non MD/PhD or non short tracked residents. (I remember the Hopkins PD saying research was overrated and that all his residents could match to any fellowship without research if they wanted to). So anyhow, jdh and others I know everyone keeps saying UCSF is elite or head and shoulders above columbia or duke/penn, but i just cant seem to definitively say why.

 

[rdzak]

I go to one of these schools and a fellow who attended the opposite one for residency broke it down for me in a somewhat helpful fashion.

He considered these the 6 "best" medicine programs. You will note there is a somewhat coastal bias here.

"in this together" programs
Brigham
UCSF
Penn

one man army/you can handle this alone programs
MGH
Hopkins
Columbia

The amount of work you are doing at these programs is relatively comparable it is just the atmosphere that you will thrive in best that should determine which you choose. Do you want a little more hand holding or do you want to jump in there and do it all on your own (though there is obviously a safety net)

Hope that helps.

 

[indiamacbean]

I am a senior resident at UCSF. I bet the clinical training is probably comparable. At these really good programs, a lot of it is going to be what you put into the training that determines how you come out at the end. I would decide whether you want to live in NYC or San Francisco and then just choose. This is splitting hairs and it is more important to be happy IMHO.

 

[ResidentMD]

Thanks for the replies guys! To answer your questions ResidentMD and EaglesPA, I go to school on the East Coast but have lived in San Francisco for two months while doing clerkships there. So I am familiar with the lifestyle and culture differences on both coasts. As for the "scut," I did not think it was as huge of a difference. Although, the unionized nursing in NYC makes your life more difficult, at least Columbia has an entirely electronic EMR. On the other hand, the UCSF system still involves some hand-written components which eat into your day. Also, from speaking to the residents at SFGH, they seem to spend a large part of their day doing scut and working on patient placement for this immensely underserved population. This all eats out of your "education" time too. As for it being a benchtop research powerhouse, I wonder how overrated that is for IM residents who do clinical work 80-90% of their training, especially for non MD/PhD or non short tracked residents. (I remember the Hopkins PD saying research was overrated and that all his residents could match to any fellowship without research if they wanted to). So anyhow, jdh and others I know everyone keeps saying UCSF is elite or head and shoulders above columbia or duke/penn, but i just cant seem to definitively say why.

Just regarding the research part - I think research being overrated is a non-issue. I was talking more from the point of, if you are interested in research, and want to do something meaningful (not that you cannot do that in Columbia). The Hopkins PD's comment was in the context of research helping you to get a fellowship - but that becomes a moot point with programs like Hopkins and UCSF (and Columbia) - as JDH put it, you basically punch your own ticket from those places.

But if you are really looking for something meaningful to do in residency (when you have time off)- i.e.research for the sake of "research", not for the sake of a fellowship - then it would be nice to have the system in place to do that (and the time, and the approachable faculty).

So my comment regarding research was made in that context, and you need to evaluate the two programs in that context as well, if these issues matter to you. You may be going to a top-notch place, but if the faculty are so uptight that they would not give you the opportunities because "residents are anyway so busy and they cant finish anything so why give them anything significant", then that may taint your experience there.

I liked EaglesPA's suggestion too.

 

[futureres]

I hope you REALLY 😍 NYC to consider ranking Columbia over UCSF. We can debate all day about what defines the "elite" group of residencies, but what matters is how fellowship directors feel, and UCSF is perceived to be among the elite of the elite. Jdh is absolutely right.

NY programs are notorious for scut and poor nursing staff/services. Perhaps if you knew you wanted to be in NYC for fellowship Columbia would have the edge...not sure. With the negatives about UCSF you have listed, it seems that you are leaning towards Columbia (perhaps you're more comfortable on the East Coast?). But if I had the option of UCSF at all...clear West Coast bias (SoCal!)...UCSF>>Columbia based on many factors, including "prestige", resident satisfaction, support, city, etc., etc., etc...

 

[Scaredshizzles]

I hope you REALLY 😍 NYC to consider ranking Columbia over UCSF. We can debate all day about what defines the "elite" group of residencies, but what matters is how fellowship directors feel, and UCSF is perceived to be among the elite of the elite. Jdh is absolutely right.

NY programs are notorious for scut and poor nursing staff/services. Perhaps if you knew you wanted to be in NYC for fellowship Columbia would have the edge...not sure. With the negatives about UCSF you have listed, it seems that you are leaning towards Columbia (perhaps you're more comfortable on the East Coast?). But if I had the option of UCSF at all...clear West Coast bias (SoCal!)...UCSF>>Columbia based on many factors, including "prestige", resident satisfaction, support, city, etc., etc., etc...

If you want to go to Hopkins or MGH or BWH for cards, I think your odds are actually somewhat better out of Columbia than UCSF. Just a connections thing. While UCSF has a beast of an im program, I feel some of their fellowship programs are not quite on par with the elite. Which is why I usually think of UCSF as the fourth of the big 4 and not much better than a Penn or Columbia or Duke.

 

[ResidentMD]

If you want to go to Hopkins or MGH or BWH for cards, I think your odds are actually somewhat better out of Columbia than UCSF. Just a connections thing. While UCSF has a beast of an im program, I feel some of their fellowship programs are not quite on par with the elite. Which is why I usually think of UCSF as the fourth of the big 4 and not much better than a Penn or Columbia or Duke.

Please put up UCSF's match list.

 

[Scaredshizzles]

Please put up UCSF's match list.

I didn't mean match list, I meant in house fellowships at UCSF. In house is always your best. I don't think UCSF cards is as well esteemed as Columbia or even UPenn, and obviously it isn't Hopkins, MGH, or BWH. Feel the same way about heme-onc. UCSF GI I think is pretty well reputed.

 

[ResidentMD]

I didn't mean match list, I meant in house fellowships at UCSF. In house is always your best. I don't think UCSF cards is as well esteemed as Columbia or even UPenn, and obviously it isn't Hopkins, MGH, or BWH. Feel the same way about heme-onc. UCSF GI I think is pretty well reputed.

You have got to be kidding me.

And when you reach fellowship, its not necessarily about the BEST place you can go to. Many people have families, one or two kids, their research mentors set up in place. When your home institution is arguably one of the best in the country (yes, it may not be rank 1 or 2 or 3, but definitely in the top 5 or 10), then other things take precedence.

And the way you are living your life starts mattering more and more...if someone is getting whatever they want in a city like San Francisco and an institution like UCSF (career-wise, research-wise), why would they leave SFO and go to Baltimore?

 

[VCMM414]

I didn't mean match list, I meant in house fellowships at UCSF. In house is always your best. I don't think UCSF cards is as well esteemed as Columbia or even UPenn, and obviously it isn't Hopkins, MGH, or BWH. Feel the same way about heme-onc. UCSF GI I think is pretty well reputed.

You are right about the general consensus on UCSF's heme/onc and GI divisions. However, cardiology at UCSF is extremely robust and very much on par with the top east coast programs (MGH, Brigham, Hopkins, Duke). The CVRI as well as the Gladstone Institute at UCSF are major basic-science players in cardiovascular research -- as well as biomedical research in general.

 

[Scaredshizzles]

You are right about the general consensus on UCSF's heme/onc and GI divisions. However, cardiology at UCSF is extremely robust and very much on par with the top east coast programs (MGH, Brigham, Hopkins, Duke). The CVRI as well as the Gladstone Institute at UCSF are major basic-science players in cardiovascular research -- as well as biomedical research in general.

Cards fellowships, and rightfully so, are 2/3 years clinical, one year research. While UCSF's basic science funding is incredible across the board, I think UCSF's cards is probably at best riding the reputation of the im training. Lets put it this way, if a former president who is in California needed a coronary catharsis, I'm guessing UCSF would be about the third option for where he would be sent. If in New York, they would go to Columbia Presbyterian, no question about it. If in Massachusetts, probably Mass General, maybe Brigham.

 

[Frugal Traveler]

If you go to San Francisco, you have to watch out for this guy:

http://en.wikipedia.org/wiki/World_Famous_Bushman

 

[gold&black2005]

Mental Gymnast, don't hate!

Anyway though, on the serious, I'd say the following:

-First, you're choosing between two great programs that, for either endo or cards, will put you at fantastic places. (Particularly for endocrine - you'll be able to write your ticket from either.) As such, while UCSF may be a tad bit higher in terms of prestige/quality than Columbia, you truly are splitting hairs here.

Note: I will give you that UCSF does inspire a little bit more of the "eye-widening/sparkles" effect in terms of impressing people at dinner parties, but unless you solely socialize with physicians, not many people will have even heard of UCSF. (Sorry, gang, but unless you're in medicine or from California/the West in general, the average educated layperson doesn't really know what UCSF is or how incredible of an institution it really, really is in medicine.)

-Given that program quality and fellowship placement, then, is essentially a wash, let's look at workload.

Columbia's ancillary services do leave something to be desired - as we can all attest, the fearful question about whether nurses/staff do lab draws/IVs asked on almost EVERY tour was inevitably from a Columbia/Cornell/NYU/Sinai student.

UCSF's system, however, isn't without its faults. Friends of mine at UCSF say the quality of ancillary services is varying across the three hospitals. Throw in the fact that the SF system is not yet completely paperless (and even if it's transitioning soon, that is a process that I know from experience can be painful), and the two again probably draw even on workload.

-So...quality of life. Judging by your posts and where you applied, you seem to have more of a Northeast/Mid-Atlantic bias than a West Coast one. If that's true, then I'd urge you strongly to consider what you'd be leaving behind in the East were you go to SF.

East Coast and West Coast lifestyles are both great in their own way - so you can't go wrong there. But where is your support network? Do you have a particular vision for where you want to be in 5 years - and is that BWH/MGH for Cards/Endo or Stanford for Cards? The connections you make and the circles in which you travel over the next 3-6 years will do as much (if not more) to determine where you end up for fellowship as your performance in residency will - and if that's the East, then Columbia emerges as the better choice.

On a final note - it does seem like you're trying to justify ranking Columbia over UCSF from the tone of this post/thread. It's a hard decision and one that I wish I could make (wasn't lucky/baller enough 😉), but if your gut/heart is telling you Columbia...then go Columbia.

😎

 

[indiamacbean]

"Which is why I usually think of UCSF as the fourth of the big 4 and not much better than a Penn or Columbia or Duke."
"I don't think UCSF cards is as well esteemed as Columbia or even UPenn, and obviously it isn't Hopkins, MGH, or BWH."

hey scaredschizzles. I am interested in how you have such great information about UCSF? aren't you still a medical student? why don't you get back at us after you've been a doctor for at least one day. Or perhaps even better, after you've actually gone on some fellowship interviews or gone through the fellowship match.

 

[IMtoHO]

If you want to go to Hopkins or MGH or BWH for cards, I think your odds are actually somewhat better out of Columbia than UCSF. Just a connections thing. While UCSF has a beast of an im program, I feel some of their fellowship programs are not quite on par with the elite. Which is why I usually think of UCSF as the fourth of the big 4 and not much better than a Penn or Columbia or Duke.

This forum seems to be all about prestige! NO ONE will commit career suicide by picking Columbia over UCSF. If you interviewed at both, then you are one hell of a badass who would do equally well in residency.

 

[jdh71]

So anyhow, jdh and others I know everyone keeps saying UCSF is elite or head and shoulders above columbia or duke/penn, but i just cant seem to definitively say why.

Well . . . realistically speaking . . . it's not. It's the prestige baby. And at the end of the day, sometimes that counts more than anything else . . . not saying it's right, just the way the world works.

 

[jdh71]

This forum seems to be all about prestige! NO ONE will commit career suicide by picking Columbia over UCSF. If you interviewed at both, then you are one hell of a badass who would do equally well in residency.

No one is saying that. Merely that: all things being equal, go UCSF. I didn't make the rules, but I have to play by them . . .

 

[ResidentMD]

This forum seems to be all about prestige! NO ONE will commit career suicide by picking Columbia over UCSF. If you interviewed at both, then you are one hell of a badass who would do equally well in residency.

I find it even more hilarious that half the people here are arguing over the prestige of UCSF, and half of them are arguing about the prestige of Columbia.

 

[Scaredshizzles]

"Which is why I usually think of UCSF as the fourth of the big 4 and not much better than a Penn or Columbia or Duke."
"I don't think UCSF cards is as well esteemed as Columbia or even UPenn, and obviously it isn't Hopkins, MGH, or BWH."

hey scaredschizzles. I am interested in how you have such great information about UCSF? aren't you still a medical student? why don't you get back at us after you've been a doctor for at least one day. Or perhaps even better, after you've actually gone on some fellowship interviews or gone through the fellowship match.

I imagine intern year will be spent learning how to practice medicine and procedures, not sure if it will give me much more perspective on this. And I won't be applying to cards most likely, so I will never gain insight from that. And I certainly talk a lot about prestige here, but I do it more from an objective stand point, not because I'm really obsessed at getting myself to the most prestigious place. I know being at the right fit is very important too. As far as my comments on UCSF, I admittedly do it with an East coast bias. I just don't think UCSF has the name recognition that Hopkins or MGH has. And it is true, a lot of this has to do with non-medical people's name recognition. But the thing about that is that non-medical people's name recognition lasts longer than that in the medical community. Lets say the University of Minnesota becomes the world leader in stem-cell related treatment of organ failure 50 years from now. UMn may supplant UCSF in the medical community, but Hopkins and MGH have more staying power because of the way regular non-medical people view those places.

 

[ResidentMD]

I imagine intern year will be spent learning how to practice medicine and procedures, not sure if it will give me much more perspective on this. And I won't be applying to cards most likely, so I will never gain insight from that. And I certainly talk a lot about prestige here, but I do it more from an objective stand point, not because I'm really obsessed at getting myself to the most prestigious place. I know being at the right fit is very important too. As far as my comments on UCSF, I admittedly do it with an East coast bias. I just don't think UCSF has the name recognition that Hopkins or MGH has. And it is true, a lot of this has to do with non-medical people's name recognition. But the thing about that is that non-medical people's name recognition lasts longer than that in the medical community.

Lets say the University of Minnesota becomes the world leader in stem-cell related treatment of organ failure 50 years from now. UMn may supplant UCSF in the medical community, but Hopkins and MGH have more staying power because of the way regular non-medical people view those places.

You clearly have no idea what is happening at UCSF.

Firstly, ask any academician in medicine about UCSF - seriously, anyone who is serious about any kind of research, or clinical practice guidelines....seriously. Yes, if you go into private practice, then its not going to matter.

And when you are the one who is going into fellowship, who in the world cares about what the non-medical people think?

Do you think the NIH gives the maximum research dollars to UCSF because its reputation is going to be overtaken by the University of Minnesota in 50 years? I mean seriously, do you even know what happens at UCSF? Do you even know why people go to that university (as med students, residents, fellows or faculty)?

Your last sentence is utterly ridiculous to anyone who has any idea of what happens at UCSF.

Btw, FYI, many of the Current series (CMDT, CSDT, the works) comes out of UCSF - and guess what, a resident will often find their way to being an author on one of those chapters (not that it matters as much, but those are definitely some brownie points in academia). But just FYI.

Caveat: By all means, if you want to enter private practice, the non-medical thing becomes even minorly important (I remember reading on SDN sometime back, ask someone on the streets of St Louis if they would rather be treated at Barnes Jewish or the Mayo Clinic - many would choose Mayo - that was another phenomenal comment on how to choose a residency program). But if you at all want to be in academia, UCSF and Columbia are on par, and many purist academics and researchers will rate UCSF over Columbia for Internal Medicine and its subspecialties.

But coming back to the OP's point - I stick to G&B's and EaglesPA's advice - its really a non-issue...decide it by the level of comfort and where you want to spend at least the next 3, if not the next 6-8 years.

 

[Scaredshizzles]

Of course a ton comes out of UCSF...It wouldn't be in the big 4 if that weren't the case. A ton comes out of Harvard and Hopkins too though, and probably a little more. This has been discussed before, the only reason Harvard isn't by far #1 in NIH funding is because MGH, BWH, and Harvard split it all up, whereas UCSF is one entity.

 

[Speculatrix]

Not to steal thread here but I'm having a similar issue. Brigham vs UCSF?! This is really for my #3 though. No clue for specialty, but cardiology vs heme/onc for me.

My list-
#1/2 (tie???) MGH/JHH --> Any insights here? I did a second look to Baltimore and it didn't seem too bad of a city to live in. Mt Vernon area seems kind of cute, though I'm not sure how many residents live there. Speaking to the interns and chiefs, the culture seems similar.
#3/4 BWH vs UCSF?? (hence previous question)

Then BIDMC (?? >) Penn vs Stanford (which I haven't heard much talk of here)/Columbia vs Cornell. I really liked BI, but someone remarked that it had more of a 'community' feel to me, which in retrospect rang true a bit. They were really nice people, but I'm not sure if I'm shooting myself in the foot by ranking it higher than potentially Columbia or Stanford.

I'm willing to work hard wherever I go so, so grueling schedules are kind of irrelevant. Looking at a more clinician/educator track in future.

 

[indiamacbean]

speculatrix-
You can't go wrong here. But having been in that spot, it's not like that makes it any easier. I think you should think about where you see yourself ending up. If you have a specific interest in going to Harvard for fellowship training (particularly cards) it will be easier to get there from BWH than UCSF. granted with an MD/PhD and UCSF behind you, no doors will be closed but all else being equal it will probably be easier. At UC many many people had a hard time choosing between BWH and UCSF so you are not alone there.
Also, realize that if you like the vibe of JHH/MGH you may prefer an east coast training program. You could go three years here and never put on a tie. From talking with a resident who has been at both BWH and UCSF it seems like there may be a bit more autonomy at UC but I think that it's splitting hairs to talk about which is better clinical training.

I think you should be thinking more about factors outside the training program such as family, friends, outside activities, etc. when trying to choose between all these great programs. residency lasts a long time and the shiny name will only get you so far if you aren't in a situation that makes you happy outside of work.

 

[Frugal Traveler]

Not to steal thread here but I'm having a similar issue. Brigham vs UCSF?! This is really for my #3 though. No clue for specialty, but cardiology vs heme/onc for me.

My list-
#1/2 (tie???) MGH/JHH --> Any insights here? I did a second look to Baltimore and it didn't seem too bad of a city to live in. Mt Vernon area seems kind of cute, though I'm not sure how many residents live there. Speaking to the interns and chiefs, the culture seems similar.
#3/4 BWH vs UCSF?? (hence previous question)

Then BIDMC (?? >) Penn vs Stanford (which I haven't heard much talk of here)/Columbia vs Cornell. I really liked BI, but someone remarked that it had more of a 'community' feel to me, which in retrospect rang true a bit. They were really nice people, but I'm not sure if I'm shooting myself in the foot by ranking it higher than potentially Columbia or Stanford.

I'm willing to work hard wherever I go so, so grueling schedules are kind of irrelevant. Looking at a more clinician/educator track in future.

For # 1, if you like Boston, I would go with Harvard. MGH has the most resources of any of the programs it seems. Baltimore is better than it was a few years ago, but it still sucks compared to Boston. I would say the major disadvantage of the Hopkins program is that you have the same attending on the Osler service... who is one year out of fellowship (I like seeing different styles... and a few gray hairs here and there are invaluable in obtaining clinical wisdom 😉). A great pro at Hopkins that is found nowhere else is their Oslerian tradition of listening to the patient like no other (they bring patients to conferences, grand rounds, the whole shebang). You learn to be a true physician and not just another provider. The firm system can be a pro or con based on how much you like close-knit groups. The Bigelow service also has a unique service structure, which encourages autonomy/decision making and substantial team management skills at the PGY-1 level. The great thing about MGH is that even in this recession: If you have an idea, they can pull money out of thin air it seems. A possible con is that MGH does not have the under-served population like Hopkins (East Baltimore has many poor people in need).

For # 2/3, tough choice since BWH and UCSF are similar in structure and culture. UCSF has a medical education AOD in addition to a molecular medicine track for MD/Ph.Ds. BWH has Katz and the legendary medical educator Marshall Wolf. I thought UCSF probably offered a substantial advantage over BWH in regards to patient population/diversity despite BWH being # 2 in Boston for under-served population. BWH has innovative services like the intensive teaching service... Katz is dedicated to resident education over service-structure dictating program structure. Research again is going to be a toss-up here, but Harvard may have some advantage with the cross-talk between the three institutions and very unique aspects like the Broad institute, the Framingham cohort, and the list goes on. Here I would concentrate on the espirit-de-corps at the programs, where you want to live, and your gut reaction.

The other issue at all of these programs is that for utilization of your Ph.D... could you identify any mentors at this stage who you would find inspirational and a must-work with?

You cannot go wrong with any of these programs.

 

[lemonade02]

I wanted to chime in and support scaredshizzles.. He's got a point that can't be ignored. Yes, if you want to get into a super duper fellowship, UCSF is in a tier above Columbia. Yes, if you are planning to to be come an academic hot shot and chairman of medicine somewhere good, I think most people recognize having the UCSF reputation in medicine will open more doors than Columbia. BUt ask yourself one simple question, if you are going into private practice, which program do you think the lay person will respect more? I would bet that it is Columbia. To be honest, I didn't even know what UCSF was until I started applying to medical school but I knew what Columbia was since 5th grade.

Its just a point that I wanted to make. I think its a point that will fall on deaf ears because honestly the people that are successful enough to have those options really don't think about private practice, they are in it for the glory of academics. As a private practice doctor, you really don't care what your colleague thinks of you, just the patient who is going to put money in your pocket. Having said that, if I had the option, I would choose Hopkins/Mayo/Cleveland Clinic above all for that type of name recognition!

"Brigham and WOmen's hospital? WHat's that??? Hmm..that doesn't sound any different than Local Presbyterian hospital!" People are dumb....hahahaaha

 

[Frugal Traveler]

^^^

This thread officially gets "best of..." status, which is a pejorative term for excellence in ridiculousness.

I'm going to go change my ROL right now so I go to a place that people recognize. 🙄

 

[gold&black2005]

lolllllllllllllllllll. I guess if I end up matching at MGH, by this logic (which, admittedly, I contributed to), my grandparents will pleased that I'm matching at a hospital with its own soap opera.

^^^

This thread officially gets "best of..." status, which is a pejorative term for excellence in ridiculousness.

I'm going to go change my ROL right now so I go to a place that people recognize. 🙄

 

[Frugal Traveler]

lolllllllllllllllllll. I guess if I end up matching at MGH, by this logic (which, admittedly, I contributed to), my grandparents will pleased that I'm matching at a hospital with its own soap opera.

Make sure to give them peri-match beta-blockers to reduce mortality. Matching at such a famous place could cause a MI, aspiration (gullet spasms from excitement), or incontinence (fecal, urinary).

 

[Mental Gymnast]

Thanks for all the feedback guys! I think that both programs have a lot of history, reputation, and prestige. They will both likely continue to be "top tier" powerhouses in the near future (unless the UC system continues to suffer more budget cuts). Although there are differences in opinion, the one thing we all tended to agree on is that it really is splitting hairs at this point. So thanks jdh, residentMD, scaredschizzles, G&B, indiamacbean, FT, and all. 👍

 

[pedronavaja2005]

I wanted to chime in and support scaredshizzles.. He's got a point that can't be ignored. Yes, if you want to get into a super duper fellowship, UCSF is in a tier above Columbia. Yes, if you are planning to to be come an academic hot shot and chairman of medicine somewhere good, I think most people recognize having the UCSF reputation in medicine will open more doors than Columbia. BUt ask yourself one simple question, if you are going into private practice, which program do you think the lay person will respect more? I would bet that it is Columbia. To be honest, I didn't even know what UCSF was until I started applying to medical school but I knew what Columbia was since 5th grade.

Its just a point that I wanted to make. I think its a point that will fall on deaf ears because honestly the people that are successful enough to have those options really don't think about private practice, they are in it for the glory of academics. As a private practice doctor, you really don't care what your colleague thinks of you, just the patient who is going to put money in your pocket. Having said that, if I had the option, I would choose Hopkins/Mayo/Cleveland Clinic above all for that type of name recognition!

"Brigham and WOmen's hospital? WHat's that??? Hmm..that doesn't sound any different than Local Presbyterian hospital!" People are dumb....hahahaaha

Actually, more people go into private practice (especially fellows in cards, gi) including those who come from those highly ranked residency programs because private practice is where the money is and the jobs are more readily available.
Don't be silly to think there is much relevance on how a lay person perceives the reputation of your med school or residency as it will most likely not have an effect on your practice whatsoever. The issue of national and international reputation and how patients perceive your training institution is overrated and doesn't really matter for most.
The perception of your colleagues in the medical community is definitely important and relevant to your practice.
Columbia vs. UCSF....I'm an east coast person soon going to the west. I know about Columbia, been there many times, have heard the stories from a handful of friends and colleagues that have trained there...happiness is always in question but their opinion of the clinical experience is always positive. NY is a great place to be for someone with minimal attachments. Washington Heights might not be the most attractive place to some peeps...although, I personally don't have a problem with it.
If these are your choices, don't get too bogged down on the name game...the name will most than likely not make a huge difference...your performance will. Many of the guys like to make these comparisons that are groundless and at best entertaining. Go with where you felt the best...that never fails. I saw the latest fellowship match at Columbia and it was outstanding. I can only imagine the one for UCSF to be as strong

 

[lemonade02]

actually i think patients do care about where their doc has trained...some really do look at that in deciding who their physician is going to be..but that is besides the point of the original post...another point could be that if you train at better places, you may have better private practice job opportunities..but obviously everybody medical person knows columbia and ucsf are redonkulous institutions

 

[gutonc]

actually i think patients do care about where their doc has trained...some really do look at that in deciding who their physician is going to be..

But they only care where you went to med school, and have likely never even heard of residency training.

Also, since most people are idiots, they will probably base their judgment of your med school on whether or not the football team at the undergrad campus has ever played in the Rose Bowl.

 

[dragonfly99]

gutonc is right about the laypeople, I'm afraid. I do get asked where I went to med school...less often where I did residency...and most don't know what a fellowship is. If you asked an average guy whether Yale or UCSF is a more prestigious med school, 95% will probably say Yale. Also, Cleveland Clinic and the Mayo are also super famous among the general public...I think the med students graduating from the new Cleveland Clinic med school will do well posting their diplomas on their office walls in the future, if those have the Cleveland Clinic seal on there.

I do think that Columbia versus UCSF is splitting hairs. I doubt I could have gotten into either program, and I've subsequently done pretty well for myself. You likely won't have a problem getting into a decent fellowship from either of those places, unless you piss people off in your residency. I do think that if you want to end up on the west coast, then going to UCSF might be more helpful...also they may have the edge in terms of bench research. If you want to end up back in the northeast and you aren't as much into basic science research, then Columbia might be better...just for the connections.

 

[souljah1]

If you are interested in:
- landing on the west coast for fellowship and beyond
- landing at Harvard
- working at an amazing county hospital hell bent on improving health policy
- being an hour away from the Sonoma/Napa valley
- being a few hours away from Yosemite
- being 10 minutes away from the Pacific Ocean
- training in general medicine at the place that invented hospitalist medicine (Wachter)
- having essentially no private attendings or private attending admissions

then go to UCSF. They have a love fest with the Harvard programs and exchange people like arranged marriages. They have no problem coming to the east coast when they want to, for the most part.


If you are interested in:
- living in NYC
- battling for top fellowship spots in NYC with Cornell, Sinai, and NYU

then go to Columbia

They are too totally different places socially, structurally and politically.

In reality, who gives a **** what patients think of your diplomas on the wall? Laypeople think that House and Grays Anatomy are realistic..It is about the quality of the training and the OPPORTUNITIES granted to residents, i.e. research, international work, exposure to prominent individuals in the field, etc. Which program did you click with and where do you think you'll be able to flourish?

 

[lemonade02]

lol again this forum is biased towards academicians..but you better believe a DO, who did IM residency in Guatemala, who then somehow does cardiology fellowship at JHU-Bayview...when he gets a baller private practice job, you better believe his group is going to take out an ad in the local paper "please welcome our new HOpkins trained cardiologist!"

 

[Speculatrix]

speculatrix-
You can't go wrong here. But having been in that spot, it's not like that makes it any easier. I think you should think about where you see yourself ending up. If you have a specific interest in going to Harvard for fellowship training (particularly cards) it will be easier to get there from BWH than UCSF. granted with an MD/PhD and UCSF behind you, no doors will be closed but all else being equal it will probably be easier. At UC many many people had a hard time choosing between BWH and UCSF so you are not alone there.
Also, realize that if you like the vibe of JHH/MGH you may prefer an east coast training program. You could go three years here and never put on a tie. From talking with a resident who has been at both BWH and UCSF it seems like there may be a bit more autonomy at UC but I think that it's splitting hairs to talk about which is better clinical training.

I think you should be thinking more about factors outside the training program such as family, friends, outside activities, etc. when trying to choose between all these great programs. residency lasts a long time and the shiny name will only get you so far if you aren't in a situation that makes you happy outside of work.

It's a really tough spot. I'm leaning towards east coast fellowships... but how does Harvard do for UCSF's fellowships??? I might want to head to the west coast after residency... sigh.

 

[Speculatrix]

For # 1, if you like Boston, I would go with Harvard. MGH has the most resources of any of the programs it seems. Baltimore is better than it was a few years ago, but it still sucks compared to Boston. I would say the major disadvantage of the Hopkins program is that you have the same attending on the Osler service... who is one year out of fellowship (I like seeing different styles... and a few gray hairs here and there are invaluable in obtaining clinical wisdom 😉). A great pro at Hopkins that is found nowhere else is their Oslerian tradition of listening to the patient like no other (they bring patients to conferences, grand rounds, the whole shebang). You learn to be a true physician and not just another provider. The firm system can be a pro or con based on how much you like close-knit groups. The Bigelow service also has a unique service structure, which encourages autonomy/decision making and substantial team management skills at the PGY-1 level. The great thing about MGH is that even in this recession: If you have an idea, they can pull money out of thin air it seems. A possible con is that MGH does not have the under-served population like Hopkins (East Baltimore has many poor people in need).

For # 2/3, tough choice since BWH and UCSF are similar in structure and culture. UCSF has a medical education AOD in addition to a molecular medicine track for MD/Ph.Ds. BWH has Katz and the legendary medical educator Marshall Wolf. I thought UCSF probably offered a substantial advantage over BWH in regards to patient population/diversity despite BWH being # 2 in Boston for under-served population. BWH has innovative services like the intensive teaching service... Katz is dedicated to resident education over service-structure dictating program structure. Research again is going to be a toss-up here, but Harvard may have some advantage with the cross-talk between the three institutions and very unique aspects like the Broad institute, the Framingham cohort, and the list goes on. Here I would concentrate on the espirit-de-corps at the programs, where you want to live, and your gut reaction.

The other issue at all of these programs is that for utilization of your Ph.D... could you identify any mentors at this stage who you would find inspirational and a must-work with?

You cannot go wrong with any of these programs.

Thank you for the single best piece of most helpful feedback I've received on this site. Wow. Amazing.

You're totally on with your MGH vs JHH for me, to the point where I might even rank JHH slightly lower for that reason. I wasn't too much of a fan of the firms, because I have no idea who I'd be with. Plus, yeah, fresh attendings on Osler... umm, I think I do prefer them to be old and more seasoned. I thought that the high # of "private patients" at Cornell was actually a pro for this reason.

I really liked the resident educator focus at BWH (and to some extent elsewhere - I'm lookin' at you, BIDMC!), but felt like I could gain QUITE a lot from serving the indigent population of San Francisco. You're right, this is the tougher of my decisions.

 

[Speculatrix]

"Brigham and WOmen's hospital? WHat's that??? Hmm..that doesn't sound any different than Local Presbyterian hospital!" People are dumb....hahahaaha

"Eww, how come you didn't learn about men too?!?!"