university programs with strong clinical training

[ResidentMD]

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Hey,

As the application process gets near, I thought we could make a list of the places we know where residents get strong clinical training (without being abused - as discussed previously, if you are entering IM, you need to be prepared to work hard).

I have heard at some places fellows have more autonomy, so residents don't get to learn as much hands on.

Have heard Mayo and CCF are pretty good - both were top community places but are now attached the universities/med schools. UTSW also takes pride in its hands on intensive training for residents.

Would really appreciate inputs on academic programs with good fellowship matches and yet a strong focus on clinical training.

 

[TommyGunn04]

Duke definitely belongs on this list. Our program boasts a very good balance between resident autonomy and master clinician teaching that yields skilled internists who are also highly sought-after in the fellowship match process. I suspect this is why over just the last two years Duke has matched an incredible 6 residents into cardiology fellowship spots at the Cleveland Clinic!

Since UTSW was mentioned, your post will likely spark debate about the balance between more "hardcore" schedules and the effect thereof on the quality of training, as compared to more cushy programs that still produce good residents. Everyone learns differently, and there's no single correct way to train residents, but looking back I can say that I'm very happy I chose Duke, and that I'd do it again in a heartbeat. I also think it was a very humane, manageable, and incredibly amazing 3 years, and hardly the "malignant" place people sometimes think it is. I also know that places that seemed more cushy on the interview trail ended up being quite different in reality, based on many discussions that I've had with medical school colleagues who matched at other institutions, so it's really difficult to make comparisons based on hearsay.

There are many good programs though, so it ends up that individual style, ultimate career plans, geography, and other considerations come into play as much as anything else in the process of choosing a program. Nonetheless, places like MGH, Brigham, Penn, Michigan, UCSF, Stanford, Vandy, Wash U, Hopkins, etc. always end up on lists like this, in addition to ones you've mentioned. And then everyone argues about which ones are too difficult, or "malignant." 🙂

I hate the "M word." I think it's so ambiguous that it's not very descriptively useful. Coupled with its loaded nature, being seen as a rather negative label, I'd caution against throwing it around willy nilly the way some people do on this board. Instead, the substantive issues and perspectives should be debated honestly and fairly, rather than being charicatured by rumor and name-calling. Not that this has been done yet in this short thread, but it usually comes shortly after someone asks a question like yours, so I thought I'd try to head it off at the pass 🙂

 

[ResidentMD]

Duke definitely belongs on this list. Our program boasts a very good balance between resident autonomy and master clinician teaching that yields skilled internists who are also highly sought-after in the fellowship match process. I suspect this is why over just the last two years Duke has matched an incredible 6 residents into cardiology fellowship spots at the Cleveland Clinic!

Since UTSW was mentioned, your post will likely spark debate about the balance between more "hardcore" schedules and the effect thereof on the quality of training, as compared to more cushy programs that still produce good residents. Everyone learns differently, and there's no single correct way to train residents, but looking back I can say that I'm very happy I chose Duke, and that I'd do it again in a heartbeat. I also think it was a very humane, manageable, and incredibly amazing 3 years, and hardly the "malignant" place people sometimes think it is. I also know that places that seemed more cushy on the interview trail ended up being quite different in reality, based on many discussions that I've had with medical school colleagues who matched at other institutions, so it's really difficult to make comparisons based on hearsay.

There are many good programs though, so it ends up that individual style, ultimate career plans, geography, and other considerations come into play as much as anything else in the process of choosing a program. Nonetheless, places like MGH, Brigham, Penn, Michigan, UCSF, Stanford, Vandy, Wash U, Hopkins, etc. always end up on lists like this, in addition to ones you've mentioned. And then everyone argues about which ones are too difficult, or "malignant." 🙂

I hate the "M word." I think it's so ambiguous that it's not very descriptively useful. Coupled with its loaded nature, being seen as a rather negative label, I'd caution against throwing it around willy nilly the way some people do on this board. Instead, the substantive issues and perspectives should be debated honestly and fairly, rather than being charicatured by rumor and name-calling. Not that this has been done yet in this short thread, but it usually comes shortly after someone asks a question like yours, so I thought I'd try to head it off at the pass 🙂

I agree with you - I too think malignant is probably not a very clear term - a reason why I clarified in my first part that when you enter IM ,expect to work hard.

Lets keep malignant out of the thread. Rather like the post above, it would be good to get inputs on how confident you feel/felt during/after training handling any case thrown at you, and could live a decent life as well as well as being treated as a respectable human being.

Also the programs mentioned above are phenomenal, and have earned that respect. It would be good to get inputs on some of the lower-upper tier to mid-tier programs as well, as I guess not many people are aware of things happening there. There was an earlier post which mentioned about UAB, Colorado, Utah, Iowa, Creighton to name a few.

I hope this thread turns into something useful for everyone!

P.S. Scutwork is too old..a lot can happen in a program over 2-3 years - most of the reviews there are too old.

 

[EPADHA]

Hey,

As the application process gets near, I thought we could make a list of the places we know where residents get strong clinical training (without being abused - as discussed previously, if you are entering IM, you need to be prepared to work hard).

I have heard at some places fellows have more autonomy, so residents don't get to learn as much hands on.

Have heard Mayo and CCF are pretty good - both were top community places but are now attached the universities/med schools. UTSW also takes pride in its hands on intensive training for residents.

Would really appreciate inputs on academic programs with good fellowship matches and yet a strong focus on clinical training.

I think the best gauge would be the rankings of departments of medicine that US news comes out. The rankings are controversial, but they are among the best gauge we have.
What fellowship are you interested in? Say if its ID then the number of strong programs you shd consider would go up as there are several strong programs out there, but they dont have a 100 percent track record of placing people in say cards.
I would certainly say that in terms of strong clinical training the 'famous' programs would be- MGH, Hopkins, BWH, UCSF, Duke, Wash U, Michigan, U Chicago, Penn, Columbia, UTSW, Stanford, UAB, UCLA and U Washington. Now the disclaimer is that these programs may not actually be as strong as they are perceived to be in terms of actual hands-on training. I am also not sure about the strength of didactics at few of these programs as well. But in corridors of academic medicine, their clincial training is considered to the best.
Mayo and CCF are somewhat iffy in terms of actual autonomy that the residents have. A few of my friends who are at the Mayo say that because of emphasis on safety, good outcomes and the Mayo culture the attendings make most of the shots. Even fellows many times take a backseat. Not sure though.
I think CCF is also like Mayo.
I hope this helps.

 

[ResidentMD]

I think the best gauge would be the rankings of departments of medicine that US news comes out. The rankings are controversial, but they are among the best gauge we have.
What fellowship are you interested in? Say if its ID then the number of strong programs you shd consider would go up as there are several strong programs out there, but they dont have a 100 percent track record of placing people in say cards.
I would certainly say that in terms of strong clinical training the 'famous' programs would be- MGH, Hopkins, BWH, UCSF, Duke, Wash U, Michigan, U Chicago, Penn, Columbia, UTSW, Stanford, UAB, UCLA and U Washington. Now the disclaimer is that these programs may not actually be as strong as they are perceived to be in terms of actual hands-on training. I am also not sure about the strength of didactics at few of these programs as well. But in corridors of academic medicine, their clincial training is considered to the best.
Mayo and CCF are somewhat iffy in terms of actual autonomy that the residents have. A few of my friends who are at the Mayo say that because of emphasis on safety, good outcomes and the Mayo culture the attendings make most of the shots. Even fellows many times take a backseat. Not sure though.
I think CCF is also like Mayo.
I hope this helps.

Ive heard the issue about attendings making the calls at CCF and Mayo as well. Never thought Stanford was clinically as strong..thought it was more academics oriented. Regarding the rankings, yes, I agree it gives a baseline. But I did think having a sort of personal opinion would help (like the person who commented on Duke above and your comments on Mayo and CCF) as it can help to dispel myths. Of course, one can clarify these themselves at interviews, but it would give a few things to keep an eye out for.

Also things become a bit of the blur in the rankings as you go past the top 15-20..so would really like opinions at the lesser known academic programs as well. Thanks!

 

[Whats_up_doc]

Ive heard the issue about attendings making the calls at CCF and Mayo as well. Never thought Stanford was clinically as strong..thought it was more academics oriented. Regarding the rankings, yes, I agree it gives a baseline. But I did think having a sort of personal opinion would help (like the person who commented on Duke above and your comments on Mayo and CCF) as it can help to dispel myths. Of course, one can clarify these themselves at interviews, but it would give a few things to keep an eye out for.

Also things become a bit of the blur in the rankings as you go past the top 15-20..so would really like opinions at the lesser known academic programs as well. Thanks!

If you could shed some light about Emory it would be awesome! Thanks!

 

[theunderdog]

If you could shed some light about Emory it would be awesome! Thanks!

You guys are missing Tulane and NYU.

Both of those programs are amazing in IM.

 

[ResidentMD]

You guys are missing Tulane and NYU.

Both of those programs are amazing in IM.

Tulane is def a strong program - and I admire how they resurrected themselves after Katrina. I read some of the posts on SDN on this how they managed themselves during the interview season. However, they have an ABIM pass rate of <90 - was just wondering if it had any relevance to the teaching?

NYU is of course good - Ive heard Bellevue is an awesome place to train...heard a bit about a considerable amount of scut there which can occupy a fair bit of clinical training time..probably someone can comment on this.

Regarding Emory - I heard Grady had some issues. I hope they are sorted out. Emory is an awesome place.

Thanks for the inputs everyone; this thread is turning out to be what I hoped it would.

 

[Whats_up_doc]

Tulane is def a strong program - and I admire how they resurrected themselves after Katrina. I read some of the posts on SDN on this how they managed themselves during the interview season. However, they have an ABIM pass rate of <90 - was just wondering if it had any relevance to the teaching?

NYU is of course good - Ive heard Bellevue is an awesome place to train...heard a bit about a considerable amount of scut there which can occupy a fair bit of clinical training time..probably someone can comment on this.

Regarding Emory - I heard Grady had some issues. I hope they are sorted out. Emory is an awesome place.

Thanks for the inputs everyone; this thread is turning out to be what I hoped it would.

Can you elaborate? Thanks in advance for your response.

 

[ResidentMD]

Can you elaborate? Thanks in advance for your response.

I dont remember exactly. But I had read on some SDN post that there were issues with Grady wanting to split off from Emory, or some financial trouble. This was a long time back though. Hence, I wanted the current status. (bit like Baylor and Methodist, or Wayne State and DMC?)

 

[Whats_up_doc]

I dont remember exactly. But I had read on some SDN post that there were issues with Grady wanting to split off from Emory, or some financial trouble. This was a long time back though. Hence, I wanted the current status. (bit like Baylor and Methodist, or Wayne State and DMC?)

I am considering Emory for my Internal Medicine Residency. Can you elaborate in the "awesome" aspect? Thanks again!

 

[ResidentMD]

I am considering Emory for my Internal Medicine Residency. Can you elaborate in the "awesome" aspect? Thanks again!

I apologize - this was just how I felt. I liked the program (on paper) because i liked the kind of patient population that comes to Grady. I also liked their curriculum and the size of the program. I like their research in a particular sub-specialty I am interested in. I also have family in Atlanta. So I should've been more specific in saying why I thought it was awesome 🙂

 

[dreamfox]

I think Cornell is the best program, of course, I'm somewhat biased.

 

[souljah1]

I think Cornell is the best program, of course, I'm somewhat biased.

Rumor has it that Cornell is in some deep doo doo with ACGME and that there's been some changes in program direction. True?

 

[ResidentMD]

Rumor has it that Cornell is in some deep doo doo with ACGME and that there's been some changes in program direction. True?

Haha 😀..we are now getting into the fun stuff..yes the IM program at Cornell is on probation as per the ACGME website..I believe the review was somewhere in early Aug...have not heard any updates since then. Can anyone who knows about it clarify? I'm sure it will do whatever it needs to to get out of it..like MGH, JHU have done in the past. Will love to hear more about the "changes in program direction" though...

 

[dreamfox]

resident at cornell here.

we had a re-review three weeks ago and waiting to hear. i'm going to assume we are going to be taken off probation sometime soon. again, a lot of other places have had to deal with this as well - mgh, hopkins, univ of washington, etc.

the problem with the "probation" in the first place is that we were notified in late april from a review that took place last august. there were major changes last year to the program (for the better) and 99% of the issues that were the cause of the probation in the first place had already been resolved by the time we were notified.

i think the mentality at cornell had been fairly old school, but a lot has changed recently. and not too brag, but new york presbyterian hospital (where the cornell medicine program is, not columbia) was ranked the #6 hospital in the US a few weeks ago by usnews, and from my experience, its an absolutely amazing place to train. you will see every aspect of medicine you could possibly dream of and you will be working with some of the most prominent names in the country.

there are a lot of places when you interview that pride themselves on "diverse patient population". from my experience, that means one thing - poor people. it's sad, but true. well, at cornell we see everything - from the richest of the rich to the poorest of the poor. if anyone has any specific questions, feel free to msg me.

 

[pedronavaja2005]

resident at cornell here.

we had a re-review three weeks ago and waiting to hear. i'm going to assume we are going to be taken off probation sometime soon. again, a lot of other places have had to deal with this as well - mgh, hopkins, univ of washington, etc.

the problem with the "probation" in the first place is that we were notified in late april from a review that took place last august. there were major changes last year to the program (for the better) and 99% of the issues that were the cause of the probation in the first place had already been resolved by the time we were notified.

i think the mentality at cornell had been fairly old school, but a lot has changed recently. and not too brag, but new york presbyterian hospital (where the cornell medicine program is, not columbia) was ranked the #6 hospital in the US a few weeks ago by usnews, and from my experience, its an absolutely amazing place to train. you will see every aspect of medicine you could possibly dream of and you will be working with some of the most prominent names in the country.

there are a lot of places when you interview that pride themselves on "diverse patient population". from my experience, that means one thing - poor people. it's sad, but true. well, at cornell we see everything - from the richest of the rich to the poorest of the poor. if anyone has any specific questions, feel free to msg me.

Just curious, how do you distinguish Columbia and Cornell in those US new rankings? It appears to me that they lump both programs in all the categories and do not make a specific distinction between the two. However, their residency programs are separate and independent of each other and their is minimal exchange if any at all

 

[dreamfox]

for those of you that are curious - cornell was taken off probation today. again, they were placed on probation for a few months because of old issues as described below. hope to see you all at interviews!

resident at cornell here.

we had a re-review three weeks ago and waiting to hear. i'm going to assume we are going to be taken off probation sometime soon. again, a lot of other places have had to deal with this as well - mgh, hopkins, univ of washington, etc.

the problem with the "probation" in the first place is that we were notified in late april from a review that took place last august. there were major changes last year to the program (for the better) and 99% of the issues that were the cause of the probation in the first place had already been resolved by the time we were notified.

i think the mentality at cornell had been fairly old school, but a lot has changed recently. and not too brag, but new york presbyterian hospital (where the cornell medicine program is, not columbia) was ranked the #6 hospital in the US a few weeks ago by usnews, and from my experience, its an absolutely amazing place to train. you will see every aspect of medicine you could possibly dream of and you will be working with some of the most prominent names in the country.

there are a lot of places when you interview that pride themselves on "diverse patient population". from my experience, that means one thing - poor people. it's sad, but true. well, at cornell we see everything - from the richest of the rich to the poorest of the poor. if anyone has any specific questions, feel free to msg me.

 

[dreamfox]

hard to deliniate between columbia and cornell. i am obviously biased. you will go where you want to go if you go to either for residency. i do know one thing, though. i live in a much cooler area of nyc than those at columbia and we have the best housing out of any program in the city.

Just curious, how do you distinguish Columbia and Cornell in those US new rankings? It appears to me that they lump both programs in all the categories and do not make a specific distinction between the two. However, their residency programs are separate and independent of each other and their is minimal exchange if any at all

 

[CanIMakeIt]

hard to deliniate between columbia and cornell. i am obviously biased. you will go where you want to go if you go to either for residency. i do know one thing, though. i live in a much cooler area of nyc than those at columbia and we have the best housing out of any program in the city.

Is the housing situation true for Fellows as well? I have heard that the subsidized rates and flats are booked for residents and not so much for the fellows.
Thanks.

 

[dragonfly99]

In the South, I would say that Duke, Emory, UAB, UT Southwestern and Vanderbilt all have good reputations. Duke probably has the highest reputation, though also somewhat of a reputation for being old school and at times malignant or at least high pressure, which some may be experiences as "malignancy". Duke is well known for clinical research and cardiology, and probably Emory may have somewhat of an edge, particularly in areas like cardiology and public health. Duke + Emory also tend to get more notice from those in the East,so you may want to consider that if you are thinking of fellowship out there.

 

[JoyfulMD]

Is the housing situation true for Fellows as well? I have heard that the subsidized rates and flats are booked for residents and not so much for the fellows.
Thanks.

Yes, fellows (and hospital employees) are eligible, but residents get first priority. Fellows pay more. Beware, there is a huge bottleneck in June/July, so expect to live in temporary accommodation for a week or two while the prior occupant is moving out and the apartment is being cleaned.

 

[dreamfox]

Yes, fellows (and hospital employees) are eligible, but residents get first priority. Fellows pay more. Beware, there is a huge bottleneck in June/July, so expect to live in temporary accommodation for a week or two while the prior occupant is moving out and the apartment is being cleaned.

I got my apartment on June 1st (two weeks before orientation began).

 

[Non-TradTulsa]

I'm interviewing in a lot of places, but I'm definitely leaning toward staying at The University of Oklahoma, Tulsa for IM. Tulsa is a pretty unique partnership program in that it's a university program but the teaching hospital is a community-based Catholic hospital, St. John Medical Center. The program is growing and has a very solid faculty. The big drawback to the program has been the lack of fellowships combined with a lower profile - but fellowships will be added in Cards, IM, GI, nephro, and geriatrics by 2012. Each class is usually about half US, half FMG - with a few DO's from OSU-COM, which is always ranked as one of the top osteopathic schools. Tulsa is a terrific Southern city with one of the lowest costs of living in the country - many of the residents buy houses rather than rent. Not a place you want to go if you want to do research - nearly all of OU's research is at the Health Sciences Center in Oklahoma City. Top drawer name, no - solid, yes.