USC vs. Johns Hopkins Anesthesia Residency

[AnesthesiaBro]

I posted this on Reddit but thought I would make an account here to get a take from some of you old crusties who might really tell it like it is:

"I am torn between USC and Johns Hopkins University. Obviously, JHU has a superior name and education, etc. It is a better program in pretty much every way. It is the objectively best program I have received an interview at. USC on the other hand seems like a strong program but not on this level. I believe clinically I would get everything I need here and they have a nice fellowship match. I am from LA and want to practice there or somewhere else in CA. Am I crazy to pick USC over JHU? Should I just do 3 years at JHU and come back? I would prefer to be close to home and am leaning USC but I want to get other's perspectives."

In general, this a thread that runs through the other parts of my rank list. For whatever reason, I am from LA but all my best programs are on the east coast. Does it really make a difference going to a top program vs. a good program? I don't want to be president of the ASA lol. I just want to be a great clinician and be good enough to get hired to a good PP group or maybe stay on at my home program.

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[GaseousClay]

If you want better clinical training JHU all the way if you want to live in California and possibly get a job there after then USC. Clinically there is no comparison.

 

[Peterluger]

Didnt usc get shut down a bunch of times by the acgme? Lol

 

[vector2]

I posted this on Reddit but thought I would make an account here to get a take from some of you old crusties who might really tell it like it is:

"I am torn between USC and Johns Hopkins University. Obviously, JHU has a superior name and education, etc. It is a better program in pretty much every way. It is the objectively best program I have received an interview at. USC on the other hand seems like a strong program but not on this level. I believe clinically I would get everything I need here and they have a nice fellowship match. I am from LA and want to practice there or somewhere else in CA. Am I crazy to pick USC over JHU? Should I just do 3 years at JHU and come back? I would prefer to be close to home and am leaning USC but I want to get other's perspectives."

In general, this a thread that runs through the other parts of my rank list. For whatever reason, I am from LA but all my best programs are on the east coast. Does it really make a difference going to a top program vs. a good program? I don't want to be president of the ASA lol. I just want to be a great clinician and be good enough to get hired to a good PP group or maybe stay on at my home program.

JHU then fellowship in CA.

 

[repititionition]

You'll find no shortage of fellows at LA programs from hopkins. It's a safe path back. USC has a few clinical strengths but in sum there's no comparison.

 

[repititionition]

JHU then fellowship in CA.

you beat me to it.

 

[Angus Avagadro]

My only complaint about JHU is the neighborhood. Its bad.

 

[DrOwnage]

My only complaint about JHU is the neighborhood. Its bad.

The clinical experience is so good you might get a chance to place an art line and central line on yourself

 

[Velefunt]

The clinical experience is so good you might get a chance to place an art line and central line on yourself

My advice is go for the groin lines.

 

[Kevin Durant]

My only complaint about JHU is the neighborhood. Its bad.

What kind of people live in the neighborhood?

 

[Katheudontas parateroumen]

Rank lists are always so tough to decide. But having gone through it recently, I still feel like go with where you believe you’d feel happiest. In the end, the programs we all do will prepare us. Yeah JH has name but USC isn’t some unknown place either. I’m not saying go to USC, I’m just saying be honest with yourself. If living near your family would make you happier and therefore a better resident, then by all means. If you think being at JH would make you happy, then do that. Residency can be a dark place sometimes. Just being honest. Might be an unpopular opinion but your well-being means the most.

 

[Test Boy]

My only complaint about JHU is the neighborhood. Its bad.

Isn’t USC in a ghetto area too?

 

[Angus Avagadro]

Isn’t USC in a ghetto area too?

I've never been on USC campus so I can't say if the area is distressed

 

[Peterluger]

The area around USC has had multiple USC students/staff murdered actually pretty recently

 

[Arch Guillotti]

What kind of people live in the neighborhood?

Who knows. I heard the same thing when I interviewed there years ago.

 

[sevo00]

What kind of people live in the neighborhood?

have you seen The Wire on HBO?

 

[UscGhost]

Usc offers great clinical experience..great autonomy and great case variety.

Autonomy is huge! You can have the best attending in the world...but if they hold your hand and make all of the decisions for you then you will have difficulties in the real world.

I picked USC over several other major programs in California for that reason alone. That being said..I know nothing about JHU other than the name

 

[Ronin786]

Usc offers great clinical experience..great autonomy and great case variety.

Autonomy is huge! You can have the best attending in the world...but if they hold your hand and make all of the decisions for you then you will have difficulties in the real world.

I picked USC over several other major programs in California for that reason alone. That being said..I know nothing about JHU other than the name

Autonomy is usually code for lazy ass attendings.

 

[Test Boy]

Also, if you don’t wanna deal with a vast majority of Spanish speaking only patients, then probably don’t pick USC.

 

[coffeebythelake]

Autonomy is usually code for lazy ass attendings.

This

 

[Peterluger]

Usc offers great clinical experience..great autonomy and great case variety.

Autonomy is huge! You can have the best attending in the world...but if they hold your hand and make all of the decisions for you then you will have difficulties in the real world.

I picked USC over several other major programs in California for that reason alone. That being said..I know nothing about JHU other than the name

Johnhopkin better. Usc dangerous street.

 

[bdy604]

Yooo, previous grad from USC. Will try to answer many of the questions here as succinctly as I can.

1) --The training -- I don't know anything about JHU, so unfortunately I can't really compare them. I will say, pretty much all of my co-residents had interviews at places like hopkins, northwestern, yale, cornell, etc.. We aint stumble in to USC or something. We pretty much all chose it for location. Behind UCLA, I wouldn't choose any other program if you want to live in LA during residency. USC is definitely sufficient if you want to be a competent anesthesiologist. I certainly had my gripes with certain aspects of the training (as I'm learning all residents at all programs do). If you have specific questions you can message me and I'll answer completely honest. I'm sure JHU will lead you back to a nice spot wherever you want in california. But I doubt it would significantly impact your job outlook in california, but probably would in the rest of the country as the name is obviously more prestigious.

2) --The neighborhood -- it's not in a nice area of town, but it's not some slum where you gotta watch your back in fear. I've seen way, way worse. The neighborhood is actually part of what makes it good training in working with low income populations and that's also where much of our trauma comes from.

3) --Where should you go --As everyone said, just pick where you think you'll be happiest and it will all work out. I chose it because I wanted to be able to go to the beach any weekend I wanted and actually enjoy some of our 20s! If JHU and Baltimore sounds like fun, go for it!

 

[mmag]

Just make sure you are applying to the right JHU anesthesiology training program.

DNP: Nurse Anesthesia - Johns Hopkins School of Nursing

OVERVIEW Voted top 10 Best Healthcare Jobs Become a nurse anesthetist through the top-ranked DNP program at Johns Hopkins. Students learn to administer anesthesia to a diverse population of patients across the lifespan and in a wide array of clinical settings. Graduates are prepared to translate...

nursing.jhu.edu

 

[UscGhost]

Autonomy is usually code for lazy ass attendings.

I preferred to run my own cases so that worked for me most of the time

 

[Peterluger]

I preferred to run my own cases so that worked for me most of the time

The problem is, residents don’t know what they don’t know....

 

[deleted171991]

The problem is, residents don’t know what they don’t know....

True words.

Most of my good habits were picked up from (sometimes tough) experienced attendings. Otherwise, the main way people change their bad habits is through near-misses and major mistakes (as attendings), not what I'd wish on a patient.

Heck, I would HATE to be a patient in a place with loose supervision. I'm surprised nobody has sued them into oblivion yet. This is one of those moments when I disagree with caps on non-economic malpractice damage limits.

 

[GassYous]

True words.

Most of my good habits were picked up from (sometimes tough) experienced attendings. Otherwise, the main way people change their bad habits is through near-misses and major mistakes (as attendings), not what I'd wish on a patient.

Heck, I would HATE to be a patient in a place with loose supervision. I'm surprised nobody has sued them into oblivion yet. This is one of those moments when I disagree with caps on non-economic malpractice damage limits.

I think that near misses as an attending is how everyone learns, no matter how supervision you have. I feel like I got great training with many involved attendings and high level cases but there were just some things that I had to experience for myself, by myself to really learn what the right thing to do is.

 

[deleted171991]

I think that near misses as an attending is how everyone learns, no matter how supervision you have. I feel like I got great training with many involved attendings and high level cases but there were just some things that I had to experience for myself, by myself to really learn what the right thing to do is.

Sure, I don't disagree with that. But that should be just the frosting on the cake, not the cake itself.

 

[Katheudontas parateroumen]

It is really difficult to figure out whether a place gives you enough autonomy. I am sure everywhere has places that has attendings do everything/spoon feed and then other attendings who don’t show up/horrible and attendings who are just right. I think in general, you earn the respect of autonomy. One way to figure out is usually call shifts. Like are you allowed to run things during the night like case, the board, etc. covering codes yourself. Stuff like that I think varies from program and is highly educational.

 

[deleted171991]

It is really difficult to figure out whether a place gives you enough autonomy. I am sure everywhere has places that has attendings do everything/spoon feed and then other attendings who don’t show up/horrible and attendings who are just right. I think in general, you earn the respect of autonomy. One way to figure out is usually call shifts. Like are you allowed to run things during the night like case, the board, etc. covering codes yourself. Stuff like that I think varies from program and is highly educational.

Every place will give you enough autonomy, as long as the attending is not 1:1. Most attendings will want to keep their patients safe, and, beyond that, to get out of the OR as soon as they can.

The only question is whether a place gives TOO MUCH autonomy (i.e. not enough supervision). We are working on people, and seconds do matter (so does resident stupidity). Every time when we give too much autonomy (e.g. no in-house attending for the code resident), patients can and will get harmed, sooner or later.

Anesthesiology is unlike most other specialties, where one can easily fix a trainee mistake later. Do you see many "autonomous" EM residents?

Let's not mention the fact that true "autonomy" is illegal.

 

[Lidolover]

Investigate what type of personalities fit better in the USC program. I know JH is aggressive in training and very laid back, passive ppl would not do as well

 

[Taco Time]

Autonomy is usually code for lazy ass attendings.

+1, coming from a current CA1 with plenty of "autonomy"

 

[FiO2@21]

For me the key concept when interviewing for residency is the presence of appropriate, graduated autonomy. When I was interviewing for residency I always made sure to ask exactly how they handled that.

I have a co-resident who we inherited from another program that had cartoonishly malignant levels of “autonomy” that was clearly different from the good kind.

 

[GassYous]

+1, coming from a current CA1 with plenty of "autonomy"

You will learn to appreciate it later. Use the time to read and ask questions when the attending is in the room with you. A lot of anesthesia is learning how to develop your style and how you want to do it.

 

[Hork Bajir]

There are obviously right and wrong ways to approach resident autonomy.

An example of the right way: when I’m working with a CA2 or 3 whom I trust to have a good head on their shoulders, i’ll tell them “go ahead and induce, I’ll be nearby in the lounge if you need me…” when in actuality, I will be standing right outside the door to the operating room, peeking in through the window and spying on them (though they don’t know that). Afterwards, I’ll come into the room and we can post game how the induction went - if I have any useful feedback or suggestions based on what I saw, i’ll confess that I was spying on them and offer constructive feedback. I find that especially for residents who have never started a case without an attending present, this experience tends to be a bit terrifying, and makes it very clear to them what “real” autonomy feels like... Of course if I see anything dangerous happening, I’m in the room intervening immediately.

An example of the wrong way: push propofol, bounce from the room the second the tube goes in, don’t show your face again until extubation.

Obviously doing autonomy the right way is infinitely more work for the attending. There is a real art to making residents feel as though they have autonomy while also teaching and ensuring optimal patient care. Autonomy done the wrong way is even worse than micromanagement.

 

[Hork Bajir]

Side note for the residents: at many places autonomy will not necessarily be offered to you, but it is there for the taking (assuming a good institutional culture). If I walk into the room and you hand me the drugs, I will push them. On the other hand if I walk into the room and you have the IV tubing taped at the head of the bed, and ask me “is it OK if I get started?”, then I’m happy to stand back and let you do your thing

 

[FiO2@21]

The only times attendings regularly push drugs in our program is in the peds or heart room.

 

[Sriddymopboi]

There are obviously right and wrong ways to approach resident autonomy.

An example of the right way: when I’m working with a CA2 or 3 whom I trust to have a good head on their shoulders, i’ll tell them “go ahead and induce, I’ll be nearby in the lounge if you need me…” when in actuality, I will be standing right outside the door to the operating room, peeking in through the window and spying on them (though they don’t know that). Afterwards, I’ll come into the room and we can post game how the induction went - if I have any useful feedback or suggestions based on what I saw, i’ll confess that I was spying on them and offer constructive feedback. I find that especially for residents who have never started a case without an attending present, this experience tends to be a bit terrifying, and makes it very clear to them what “real” autonomy feels like... Of course if I see anything dangerous happening, I’m in the room intervening immediately.

An example of the wrong way: push propofol, bounce from the room the second the tube goes in, don’t show your face again until extubation.

Obviously doing autonomy the right way is infinitely more work for the attending. There is a real art to making residents feel as though they have autonomy while also teaching and ensuring optimal patient care. Autonomy done the wrong way is even worse than micromanagement.

Are you by any chance familiar with UCSD? They stress resident autonomy but am wondering where on the spectrum they are with respect to the right kind vs the wrong kind of autonomy

 

[Hork Bajir]

Are you by any chance familiar with UCSD? They stress resident autonomy but am wondering where on the spectrum they are with respect to the right kind vs the wrong kind of autonomy

Sorry, can’t say I know anything about the program. Try reaching out to current residents, I’d bet they’re willing to give you an unfiltered honest take

 

[acer80808]

<deleted by mod>

as someone who is currently a resident at USC this is not my experience at all. There are so many half-truths, distortions and flat out lies that’s it’s sad someone would post so negatively about their own residency.

I really enjoyed my time as a resident at USC. I feel like I got great clinical training and am ready for whatever I will face as an attending. All the residents in my year (and the senior residents who graduated above me) got the fellowships and jobs they wanted in the locations they wanted. It’s sad the above poster had such a negative perception, but it doesn’t match my experience and I would absolutely come back here if I had the choice

 

[TalesFromLACounty]

as someone who is currently a resident at USC this is not my experience at all. There are so many half-truths, distortions and flat out lies that’s it’s sad someone would post so negatively about their own residency.

I really enjoyed my time as a resident at USC. I feel like I got great clinical training and am ready for whatever I will face as an attending. All the residents in my year (and the senior residents who graduated above me) got the fellowships and jobs they wanted in the locations they wanted. It’s sad the above poster had such a negative perception, but it doesn’t match my experience and I would absolutely come back here if I had the choice

I'm glad you enjoyed your time here. There is certainly the case volume and variety to gain the experience you need. And if you are proactive getting a fellowship isn't difficult. But don't accuse me of lying if you don't know the facts. People should be informed when making this decision, especially now with the whole process being virtual.

That being said, outide of a few personal opinions in my post, there are no 'half-truths, distortions and flat out lies' as you put it. It's good you haven't seen these things yourself but I can assure you they are there. Everything I mentioned was either witnessed personally, from a trusted colleague, directly mentioned in resident and/or attending surveys, mentioned in multiple ongoing or previous investigations, or right out there in the open. I'll happily answer any other questions via DM.

 

[Midazzz]

I too am a former USC grad but I had a much different experience than TalesfromLACounty. While I can't say USC is a perfect program by any means, I certainly had a positive and rewarding experience and found the faculty exceptional, well-qualified and respectful to everyone including residents. While experiences can vary person to person, It's clear that Tales seems to be disgruntled and is reaching to paint the program in a negative light.

Now to my two cents:

If you're looking for excellent clinical training, this is the place for you. Being a Level 1 trauma center exposes you early to placing lines and trauma resuscitation while Keck gives you exposure to tertiary level care and transplants. The dual exposure you get is truly unparalleled. I always thought it important to learn both types of hospital systems and to provide anesthesia to two totally different patient populations that carry with them very different co-morbidities. Variety is the spice of life and LAC+USC definitely provides that.

Personally, I’ve found the PD and APD to be extremely supportive and caring people. There are monthly resident meetings where residents are encouraged to bring up issues at hand. They've been nothing but approachable and proactive about resident concerns through all my years.

While USC emphasizes clinical training, it still very much supports research and scholarly activities as well. I have presented at numerous conferences during my years there and gotten published in a peer reviewed journal. If you are interested in research, do not be discouraged from going to USC. The county is a gold mine for research. You just have to put in some leg work.

Lastly, I have to address location. I too, was torn between an east coast program and USC. I'm so glad I ended up picking the latter. Having family close by was very important and made holidays a lot easier. Knowing I didn't have to hop on a plane for 6-7 hours or have to scrape ice off my windshield in the dead of winter was also a huge plus. Los Angeles is one of the greatest cities in the world, if not the best!

All in all, my time at USC was positively transformative and a time that I reflect on very fondly. I would easily pick USC again.

 

[MommyDoctor]

<deleted by mod>

Hi!
Also a former USC Anesthesia Residency grad. Wow, I feel like this is a bad Yelp review from a disgruntled customer . But, all joking aside, I had a great experience at USC, you’ll get great training and as with everything USC-the connections it creates for you, especially within the SoCal area, are invaluable. We are well known as being clinically sound, hard working anesthesiologists so it’s relatively easy to get a job after graduation, whether it be private practice, academics, or fellowship. Wherever you train, you’ll be spending a lot of time at work, so it’s important to be around people and an environment you enjoy.
I know of several individuals who couples matched/had families (some while in residency)/were of different backgrounds so definitely wasn’t my experience while I was there. The comments on the APD and PD are not only hurtful, but are factually untrue. They dedicate a large majority of their lives to the well-being of their residents. Throughout my training at USC, I found that they were supportive and receptive to feedback and evolved the residency for the better. Lastly, when you look at the field of anesthesia on a national level, females only make up about 25% so I’d say that number reflects an overall trend of applicants to the specialty.
In short, residency is an incredible time in your life where you will make life long friends and build unique memories. You really can’t choose “wrong” wherever you go, so just go with your gut!

 

[TalesFromLACounty]

Hi!
Also a former USC Anesthesia Residency grad. Wow, I feel like this is a bad Yelp review from a disgruntled customer . But, all joking aside, I had a great experience at USC, you’ll get great training and as with everything USC-the connections it creates for you, especially within the SoCal area, are invaluable. We are well known as being clinically sound, hard working anesthesiologists so it’s relatively easy to get a job after graduation, whether it be private practice, academics, or fellowship. Wherever you train, you’ll be spending a lot of time at work, so it’s important to be around people and an environment you enjoy.
I know of several individuals who couples matched/had families (some while in residency)/were of different backgrounds so definitely wasn’t my experience while I was there. The comments on the APD and PD are not only hurtful, but are factually untrue. They dedicate a large majority of their lives to the well-being of their residents. Throughout my training at USC, I found that they were supportive and receptive to feedback and evolved the residency for the better. Lastly, when you look at the field of anesthesia on a national level, females only make up about 25% so I’d say that number reflects an overall trend of applicants to the specialty.
In short, residency is an incredible time in your life where you will make life long friends and build unique memories. You really can’t choose “wrong” wherever you go, so just go with your gut!

I'm glad your experience at USC differed from mine. However my comments are, unfortunately, very much true. The field of anesthesia has increased from around 25% to over 37% female for all anesthesiologits (the data you quoted is close to a decade old) and the residency application is well over 40%. I have personally heard the PD/APD disparage women who may become pregnant during interviews. I have also personally heard the APD tell a candidate that 'this isn't that kind of residency' when asked about research. Keep that in mind before stating something is 'factually untrue'. I will agree that they are receptive to feedback...to a fault. How many well qualified attendings have been banned from resident teaching for minor disagreements? And the 'large majority of their lives' comment is just odd. Anyhow, you certainly can get the training you need to succeed here, there are just some serious issues that need to be addressed that won't be brought up interview day.

 

[Arch Guillotti]

Wow, I feel like this is a bad Yelp review from a disgruntled customer

Good analogy and everyone should take what they read on the internet with a grain of salt. I know nothing about this program myself.

 

[GassYous]

All I have to say is that the last time I saw one of these threads it was with several current residents. A lot of what they said had merit and there were multiple posters agreeing, including a former resident who was a longtime poster here. The poster that replied in support of the program was likely one of the suckup chiefs who no one liked. There were big problems with the program at the time, likely growing pains. But the review here seems more like a personal attack on the leadership of the residency due to some persecution complex. I have no affiliation with either program. I do like accrac though.

 

[Gaseous2.0]

I'm glad your experience at USC differed from mine. However my comments are, unfortunately, very much true. The field of anesthesia has increased from around 25% to over 37% female for all anesthesiologits (the data you quoted is close to a decade old) and the residency application is well over 40%. I have personally heard the PD/APD disparage women who may become pregnant during interviews. I have also personally heard the APD tell a candidate that 'this isn't that kind of residency' when asked about research. Keep that in mind before stating something is 'factually untrue'. I will agree that they are receptive to feedback...to a fault. How many well qualified attendings have been banned from resident teaching for minor disagreements? And the 'large majority of their lives' comment is just odd. Anyhow, you certainly can get the training you need to succeed here, there are just some serious issues that need to be addressed that won't be brought up interview day.

Agreed with Mommydoctor that this sounds like a personal vendetta. As a recent graduate of the program, none of this sounds true to my experience. Kind of like claiming election fraud and just keep repeating it enough times hoping somebody will believe you because you say it is true 😂🤣. Allow me to first point out some pesky facts that don't line up with this anti-female propaganda. I've attached a link to prove that female anesthesia residents are 33%.... not "well over 40" as claimed. It really is tough when hard data doesn't line up with the claims and I suspect looking into the other claims would show them equally inaccurate. There are no well qualified attending banned.... in fact, there were none banned. There were two that had investigations into their behavior and during the investigation were not allowed to work with residents... but that is standard practice at institutions as a mechanism to protect the accused from more accusations. All of those that left (3 to my knowledge) left VOLUNTARILY. And they all had a history of poor behavior with residents.

Table B3. Number of Active Residents, by Type of Medical School, GME Specialty, and Sex

Number of Active Residents, by Type of Medical School, GME Specialty, and Sex

www.aamc.org

My experience at USC was over all positive. The program was very supportive of resident education. The cases were amazing and I became a VERY competent anesthesiologist. It was not my first choice of programs, but I'm very thankful that I had the opportunity to train there. I have many friends that I still am in contact with both inside the program and within other specialties.

To the original poster, I echo the majority that it is a personal choice. That said, USC has a very strong reputation in the Southern California region. Our graduates are in charge of many groups in the area and USC grads are happily accepted due to their clinical competence. JHU likely has a stronger national reputation, but in the SoCal area, it would not give you an edge in job opportunities over USC. As to fellowships, I know of several graduates from USC who have landed top notch fellowships around the country, although I'm sure JHU does well in that regard as well. It really is a matter of where you think you will be happy. Both will likely train you exceptionally well so you can't go wrong with either. Best of luck in your decision!!

 

[MinimalEBL]

I am a recent USC graduate and I had a very good experience at USC. I'll reiterate the previous reviews in this thread and years past that LA County hospital has the bread and butter cases along with major traumas. Keck hospital has higher acuity cases such as liver transplant but no traumas and fewer bread and butter cases. Residents spend most of their time as a CA1 at LA County and then as a CA3 at Keck. Residents are always prioritized to do good cases at both facilities.

The PD and APD are resident advocates and receptive to feedback. If there were issues with attendings, surgeons, staff, etc, they would address it. I felt comfortable approaching them with any concerns. They always responded supportively and accommodated effectively. Under their leadership during my time, the program significantly changed for the better.

Research is definitely not as strong as JHU. However, there are resources readily available but publishing papers will take motivation. Still, USC regularly sends a comparable amount of residents to ASA/WARC/CSA conferences for presentations. If you strongly desire to do research in your career, JHU will likely provide you with a better start.

My goal was to work in private practice in Southern California, and USC provided me with all the necessary tools and connections to be successful. I would strongly consider it if you have a desire to live in California. But even if you wanted to live elsewhere, you'll graduate with strong and diverse clinical training to transition into any type of practice.

 

[GassYous]

Why are you guys deleting posts?