UCSF VS Johns Hopkins, NEED HELP

[fuzzy_wuzzy]

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Hi all...

For quite some time, UCSF has been my #1 choice. They have Dr. Miller, huge research funds, 25 attendings certified in critical care w/ closed ICUs, Chairs everywhere etc. Plus I just love San Francisco. It is the best city in the USA and completely feels like home to me. Some negatives is that they seemed a little stuck up, residents said they "work hard" and weren't as laid back as I had hoped. Worse of all, the 3rd year schedule is all proscribed aka no electives! Who cares though... it is San Fran and it is UCSF.

I had good experiences at other "top programs" but the only other place that could really match UCSF in terms of prestige was Hopkins (I didn't interview at the General). I went to Hopkins about a month later and to my surprise, everybody's attitude was much better than at UCSF. The residents seemed very happy and a transfer from Stanford said that he worked harder at Stanford. Residents said call wasn't so bad since they had didactics on that day (were not assigned OR rooms). Finally, Dr. Mittman seemed to really care for the residents and be responsive to their needs. Were Dr. Miller (UCSF) basically said that 3rd year schedule was too important a decision to be left for the residents, Dr. Mittman (I guess the residents call him Scott) said we are all big boys and girls ergo 12 out of the 13 sessions fourth year are electives.

Furthermore, I see a lot of good things being said on SDN and scutwork about Hopkins by Hopkins residents and even staff. All I see about UCSF is a bad review on scutwork by a UCSF medstudent. Will any from UCSF comment on the rumors that you are a malignant program? I have heard much of this on the interview trail: med students at UCSF being told by UCSF residents not to go there, and residents from other places whose friends are at UCSF and tell them that they are not happy.

So you see my dilemma. I know, I'll just live in San Francisco and commute to Hopkins in Baltimore.
Any comments, ideas or points of view on this would be greatly appreciated.

 

[MD Dreams]

Why don't you do your training at Hopkins, and land a job at San Francisco after your training is done. Then, you'll have the best of both worlds.

Personally, I would go where I felt welcomed.

All the best.

 

[VentdependenT]

Honestly you can't go wrong by going to either of those programs. Just don't go to those places if you aren't an intensely motivated resident or you're gonna break.

You are going to get worked at both of those training programs. Hopefully you will be able to recall the vibe of how well the residents got along with eachother. Remember that these folks are your impetus for motivating and certainly for commiserating.

 

[xjohns1]

Hi all...

For quite some time, UCSF has been my #1 choice. They have Dr. Miller, huge research funds, 25 attendings certified in critical care w/ closed ICUs, Chairs everywhere etc. Plus I just love San Francisco. It is the best city in the USA and completely feels like home to me. Some negatives is that they seemed a little stuck up, residents said they "work hard" and weren't as laid back as I had hoped. Worse of all, the 3rd year schedule is all proscribed aka no electives! Who cares though... it is San Fran and it is UCSF.

I had good experiences at other "top programs" but the only other place that could really match UCSF in terms of prestige was Hopkins (I didn't interview at the General). I went to Hopkins about a month later and to my surprise, everybody's attitude was much better than at UCSF. The residents seemed very happy and a transfer from Stanford said that he worked harder at Stanford. Residents said call wasn't so bad since they had didactics on that day (were not assigned OR rooms). Finally, Dr. Mittman seemed to really care for the residents and be responsive to their needs. Were Dr. Miller (UCSF) basically said that 3rd year schedule was too important a decision to be left for the residents, Dr. Mittman (I guess the residents call him Scott) said we are all big boys and girls ergo 12 out of the 13 sessions fourth year are electives.

Furthermore, I see a lot of good things being said on SDN and scutwork about Hopkins by Hopkins residents and even staff. All I see about UCSF is a bad review on scutwork by a UCSF medstudent. Will any from UCSF comment on the rumors that you are a malignant program? I have heard much of this on the interview trail: med students at UCSF being told by UCSF residents not to go there, and residents from other places whose friends are at UCSF and tell them that they are not happy.

So you see my dilemma. I know, I'll just live in San Francisco and commute to Hopkins in Baltimore.
Any comments, ideas or points of view on this would be greatly appreciated.

i'll be a ca-1 at ucsf in july, so obviously i can't give a first-hand account yet. but, i think your assessment (happiness level, hard-working program, a little "stuck up") of the place is a common one. i'm not sure myself if it's entirely untrue. i do think it's a very hard working program. and clearly if there's no way you'd be happy without electives it's not for you. i did not apply to jhu mainly because i knew there was no way possible i could stand to live in baltimore. remember, any extra free time you have if you'd be working less at jhu will be spent in baltimore. some people like baltimore just fine--i'm not among them. i'd rather suffer a bit more pain at work and have san francisco to come home to. i think the residents at ucsf were definitely a serious bunch, but i hope to make friends outside of work, though i agree the attitude of your coresidents is something to consider. i don't know about ucsf residents telling ucsf students not to go there. all ucsf students are required to rotate through the dept and historically a solid percentage of the incoming class comes from ucsf. it's hard to believe that the dept would be able to cover up the infamous malignancy of the program with all those students rotating through (unless ucsf students are gluttons for punishment and don't mind the malignancy they do see). you're right to notice the considerable emphasis on critical care in the dept, though jhu is one of the very few anesthesia depts that can come close to matching ucsf in the critical care arena. anyway, my overall impression is that ucsf is clearly not a warm and fuzzy place. but i'm not sure it's malignant. combine the unsurpassed training (board pass rates in the >95%ile range), amazing critical care, visionary departmental leadership that is charting the future course of the entire field, more NIH dollars than any dept in the country, and the city itself and it was enough for me to rank #1. best of luck--you're in an enviable position and you really can't go wrong with either program.

 

[ecCA1]

A helpful tip: if you wind up in San Francisco, realize that nobody will call it "San Fran" other than a transplant.

 

[notdeadyet]

A helpful tip: if you wind up in San Francisco, realize that nobody will call it "San Fran" other than a transplant.

True of "Frisco", but not "San Fran"...

 

[2Deep]

I'm 5 months from finishing my residency at UCSF and I can tell you firsthand that this is not an "uptight" program. I am on a first name basis with 95% of attendings. The working environment is rich and full of oppotunities to learn the most advanced anesthetic techniques. The department leadership is second to none and will continue that way for the forseeable future. If you graduate here in good-standing you will get practically any job or fellowship you want. As for the social aspects, SF and the Bay Area are incredible. Restaurants, nightclubs, architecture, art, music, etc are overwhelming. Not to mention beaches, mountains, bay, Napa, Tahoe, etc. Residents and attendings ski, snowboard, golf, sail, and surf on a routine basis. We have an annual department golf tournament which is a blast. In the last 3 years here I have worked hard, played hard, and become an outstanding anesthesiologist. I have rarely felt I have not had enough free time to do anything and everything I wanted extracurricularly. The last 2 weeks it's been 70-75 F and spectacular in the city and at the beach. Tahoe has 10 feet of powder. I doubt Baltimore has had the same experience. If you want to be in Cali, this is the best palce to train hands down. Half our class is doing fellowships, mostly pedi, pain, and critical care. The other half is going into private practice, all in California. Everyone has a sweet job lined up. Any questions PM me.

 

[toughlife]

I'm 5 months from finishing my residency at UCSF and I can tell you firsthand that this is not an "uptight" program. I am on a first name basis with 95% of attendings. The working environment is rich and full of oppotunities to learn the most advanced anesthetic techniques. The department leadership is second to none and will continue that way for the forseeable future. If you graduate here in good-standing you will get practically any job or fellowship you want. As for the social aspects, SF and the Bay Area are incredible. Restaurants, nightclubs, architecture, art, music, etc are overwhelming. Not to mention beaches, mountains, bay, Napa, Tahoe, etc. Residents and attendings ski, snowboard, golf, sail, and surf on a routine basis. We have an annual department golf tournament which is a blast. In the last 3 years here I have worked hard, played hard, and become an outstanding anesthesiologist. I have rarely felt I have not had enough free time to do anything and everything I wanted extracurricularly. The last 2 weeks it's been 70-75 F and spectacular in the city and at the beach. Tahoe has 10 feet of powder. I doubt Baltimore has had the same experience. If you want to be in Cali, this is the best palce to train hands down. Half our class is doing fellowships, mostly pedi, pain, and critical care. The other half is going into private practice, all in California. Everyone has a sweet job lined up. Any questions PM me.

Sounds like a dream program!

 

[GasEmDee]

Were Dr. Miller (UCSF) basically said that 3rd year schedule was too important a decision to be left for the residents,

Interesting, so he still says this. I thought this was an incredibly huge turn off, esp. since i came from an educational system where the philosphy was to take motivated people and then provide them with the resources necessary to be successful. It was just a bit too condescending for my taste.

I was really big on UCSF, given the prestige and opportunity for research, but in the end I could not overcome to cold feel of the program. However, if you love SF, that counts for a lot!!

 

[hermanodequeso]

hey there,

i'm a ca-2 at ucsf and went to hopkins for medical school. i too struggled to decide between the two....many variables, including a couples match led me to ucsf.

as for ucsf, i totally agree with 2deep. the attendings as a whole are an accessible, knowledgable, friendly group. the case variety is excellent with an abundance of neuro, transplant, trauma, etc in the sickest of the sick. i've found my classmates and colleauges to be cooperative and funloving, not overly serious or grim. i spend a lot of time with my classmates and attendings skiing at tahoe, surfing the pacific, climbing in yosemite, enjoying the city. as for the department scaring away medical students, i think it's worth pointing out that the anesthesia rotation has been voted the best clinical rotation by medical students for the past few years. the icu is not closed. in fact, they are wide open which can lead the icu residents feeling a bit superfluous, in my opinion. the lone elective month is a little bit of a bummer, but certainly not a deal-breaker for me.

i also loved hopkins. i moved there expecting to hate baltimore, but rather enjoyed it. the faculty are outstanding and the department is very supportive. the icu is closed and the attendings are amazing. if you're serious about critical care, i would lean toward hopkins. the residents at hopkins were similar to those i've encountered at ucsf. overall happy, fun with the occasional stick-in-the-mud. many of my friends stayed at hopkins and are enjoying it....

in both prgrams you'll work hard, but it's not that bad. ucsf is an absolute breeze compared to internship. most weekends completely off and night-call a week at a time feels much less disruptive to life. both programs are big which can lead to feeling anonymous as you start. it's overwhelming to join a department with over 100 faculty and 75 residents. over time, however, you'll figure things out and soon everyone will know your name and you'll figure out your place.

in the end, i think you're in a win-win situation between the two. in terms of nuts & bolts issues, they are extremely similar programs. in terms of the intangibles, i think everyone needs to answer that for themselves. who did you "click" with? are you from the east or the west? do you want to end up in the east or the west? each program has a broad reach for jobs after residency, though clearly they are stronger in their respective halves of the country.

best of luck to all of you going through the match this year. you're almost there.

🙂

 

[fuzzy_wuzzy]

You guys are right, these programs are so close together, i cant go wrong either way. Since last i posted, i've changed my mind countless times. I THINK I’M GOING CRAZY!!!. I think I’m gonna end up doing what the first post suggested which is go to Hopkins then work in san Francisco/ ucsf. what's having me lean towards hopkins is their many electives. i wrote the chief resident to make sure I had a clear picture:

"The CA-3 schedule is almost entirely elective. There are three required rotations - WACU (2 week block focused rotation), OBPM (2 week ob nights), and airway neuro (2 week difficult airway rotation). You are allowed 2 months of away rotations and the reminder of the year is spent within the Hopkins system but is relatively self designed with a focus of your choosing."

to me i like flexibility at Hopkins and the one elective at ucsf is conscricting; to me it is their only drawback. there are several reasons i put such high weight on being able to pick my own ca3 schedule. for example, if you enjoy critical care, you could do that for most of your ca3 year and then decide you are strong enough in it that you don't need a fellowship. or conversely, you might be looking forward to going into peds but decide you hate it after you are able to experience it more w/ a ca3 schedule of your design. then you could avoid a needless fellowship. on top of that, we are all big boys and girls and should be able to decide on our own what to take based on our weaknesses and our goals.

so what are your guy's opinions on electives? i am overstating their importance or are you all with me?

 

[Little Donny]

Here's my take on this as I'm weighing a similar decision. Electives are important if you think private practice is in your future. For example, if you are joining a general practice that wants someone strong in peds for the occasional case, you could configure your third year to include a lot of peds. If you are planning academics, chances are you're going to need a fellowship anyway and I'd expect your exposure should be sufficient to make that decision.

As for the original question, what stood out for me about Hopkins was the teaching -- the pre/post call small groups are very well set up and the attendings/fellows leading the discussions are there just to teach. Downside for me was Baltimore, but it depends what you're looking for, and it certainly wasn't as bad as the rep.

UCSF is clearly in an amazing city and a great program. They work hard and I've been trying to get a handle on how much (seems 6am-6pm). Only real concern for me is that it's across the country.

Either way, you'll end up a great anesthesiologist. Funny how it's easier for me to give advice than to make my own decision, eh? Best of luck.

 

[fuzzy_wuzzy]

I've heard that concerning UCSF and i dont know what it means either. i've agree that it seems to be about 6:30-6pm but you get like 3 weekends off. That doesn't seem "hard" that seems average, nothing to realy complain about. So maybe hard means that they have to do a lot of scutwork and bs cases &/or that they get no respect. from reading some postings from UCSF residents it doesn't seem that either of these is the case. also, i cant imagine getting bread & butter cases for too long at an institution like this. anybody know when you do your first whipples and cardiacs?
so this is what i'm starting to think: when a UCSFer tells you "we work hard" he means "there's a lot of work to get done so you better be smart and a team player" when somebody outside UCSF says "they work hard" they mean "we are jelous of them because they are on the wrong coast but still getting all the prestige and the money"
what does everybody think?

 

[2Deep]

What "we work hard" from a UCSF person means just that, you will work hard while at work. You will have most weekends off. If you are in the general OR call pool, you will work on call shifts. This means you will come in anywhere from 12 pm to 6pm and work to various hours of the evening depending on the amount of cases going. The residents coming in at 6 pm stay overnight. The others are usually leaving between 9-11pm. It's not that bad. If you're working regular days you will get here about 6:30 - 6:45 ish and do cases, many of which are huge. Major spine, Major crani, major abdominal, major thoracic, livers, plus lots simpler cases on complex patients. Adult cardiac volume is definitely not Texas Heart, but the patients are sick as sh&*. Pedi heart room is busy (and you get the see them as adults coming for their redo). You will learn how to take care of the most complex patients. We run 24-28 OR's a day in the main OR at UCSF, plus SFGH runs 10, UCSF/Mt Zion (cancer center) runs 10, Ambulatory runs 4-6, and the VA runs 5-7. This doesn't include peripheral sites like neuroangio, MRI, Cath lab, and GI lab. We are very busy, but we have a big residency and HUGE presence in the medical center in terms of influence. A prominent vascular surgeon recently got the boot for excessively mouthing off and having a history of a bad attitude towards anesthesiology. Many anesthesia anesthesia departments do not have that kind of clout. The biggest drawback is little elective time.