I am inclined to rank Iowa U higher than U Washington because the crime rate in St. Louis, my interview day impression in WU that residents weren’t very happy and the reputation that they are overworked. Am I making a mistake to rank this way?
Current WashU resident. When choosing a program, I limited myself to the Midwest, and found myself weighing these two programs at the end of the interview season. When it came down to it, I picked WashU because the facilities were great, it was a place I knew I would be "pushed", and I couldn't see myself really enjoying Iowa City (I'm not against smaller towns, but a small college town that isn't where I went to school??? yuck). For the record, I own a house just outside St. Louis proper. The only crime perpetrated against me or my spouse was theft of license plate tags once, which cost us $3 and a quick trip to the DMV. The medical campus and immediately surrounding neighborhood is safe; I'm not aware of any residents being victims of crime, much less violent ones.
To clarify, when I say "pushed", I mean that the expertise of the faculty and trainees help motivate you to be better. Think Jack Nicholson--"you make me want to be a better [pathologist]" sort of thing. Yes, it is on the high end of the spectrum for grossing, but let me be clear--you are never grossing biopsies, and there is appropriate PA staffing to keep you from getting crap cases like ostomy closures, appendices, gallbladders, traumatic amputations, etc. While there are upsides to the program's structure of essentially separate AP and CP programs (like you will see all AP specialties before it's time to apply for fellowships at the start of PGY-3 year, no weekend call outside of autopsy for the first 2 years, and you will never be pulled from CP to AP), it does make for a busy first 2 years, which may explain why residents aren't the most bright eyed and bushy tailed at interview functions.
It is fair to say that perhaps over the past decade the program was a bit complacent and ignored a lot of trends both in residency and surgical pathology fellowship training. We have new leadership for the residency program and also a new department chair starting in May. The AP/CP program will integrate (CP rotation each PGY year) either this coming academic year (2019-20), or the year after, which will break up the intensity of the first 2 years. Fellow grossing days are numbered (beyond establishing competence). We have been working with PAs to assign time values to different specimen types, to make sure the residents don't get overworked in the gross room (piloting a 3 hour cap on a trial basis soon).
I felt the need to speak up, because there is a lot of misinformation about our program out there. This definitely was a "gross till midnight" place in the past (probably >5 years ago), but if someone is doing that now, they're either a night owl or frankly doing it wrong. You get amazing hands-on training here, on both AP and CP services, which will serve you well whether you plan on staying in a large academic center, or heading out into the community. Plus, all else being equal, it can't hurt your job prospects to graduate from a program where it is known that you work hard!
