West vs. East

[Saluki]

I have gotten interviews at several excellent programs in the East, Midwest, and South, but I haven't had nearly as good of luck with the West Coast.

I was wondering if I wanted to do fellowship at UW or UCSF, would I be better off going to a more prestigious program out East or matching at a good but not as competitive place in the West or Mountain West.

I would also be interested in how coming from one of the UW rural tracks would affect things in terms of fellowship opportunities compared to the main track or a well regarded program in another part of the country.

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[splik]

looking at the fellowship matches from east coast programs I would say there are always a handful in individuals who match at top places on the West coast or even get attending gigs at stanford, UCLA, UCSF etc. Also fellowships arent that competitive compared with residencies so you would have a much better shot.

The UW-Alaska track is basically being in seattle but doing your elective time in Alaska so I imagine you would have exactly the same chances of bagging a good fellowship etc as if you were in the Seattle track all things being equal. I am not so sure how true that would be for the Idaho track (though it is meant for people who are interested in rural practice).

At the end of the day I would go to the place where you think you will be happiest because you are most likely to perform the best there and have the opportunities (e.g. publications/presentations/teaching/leadership/awards etc) that will help you secure the best fellowship or job after residency. I would eventually like to end up in california but for various reasons will only be ranking east coast programs (+UW). I do not think I would have much difficulty if I landed one of my top 5 choices.

 

[notdeadyet]

I was wondering if I wanted to do fellowship at UW or UCSF, would I be better off going to a more prestigious program out East or matching at a good but not as competitive place in the West or Mountain.

I'd opt for proximity, personally.

For something like a UCSF fellowship, doing a UCSF residency is the biggest factor. After that, another local top residency is probably next best. The powers that be at ucsf know the powers that be at UCLA, Stanford, UCSD, etc, better and interact more than they do with the folks at Columbia, MGH, etc. I probably wouldn't extend that to somewhere farther out of state though.

That said, choose the best place for you for residency overall. Picking the best fit for the next four years will probably be a lot more satisfying and fruitful than reading tea leaves for residency. And people who are happy in residency will perform better in residency, which is ultimately the most important thing no matter where you train.

 

[atsai3]

I have gotten interviews at several excellent programs in the East, Midwest, and South, but I haven't had nearly as good of luck with the West Coast.

I was wondering if I wanted to do fellowship at UW or UCSF, would I be better off going to a more prestigious program out East or matching at a good but not as competitive place in the West or Mountain West.

I would also be interested in how coming from one of the UW rural tracks would affect things in terms of fellowship opportunities compared to the main track or a well regarded program in another part of the country.

The UW rural tracks do not have same prestige attached to them compared to the UW-Main Campus track, simply because they are not located on the main campus (and, in a tragic and self-fulfilling prophecy, because they do not have the same prestige, they do not attract residents of the same caliber). However, the clinical training and supervision you get from the faculty will be equivalent. Whether this will translate into equivalent fellowship opportunities is an open question. The purpose of the rural tracks is to train rural clinicians who want to practice in the WWAMI states, and your mentorship and support will be geared towards exactly that-- so you should have no problem matching to a UW fellowship if you went through one of their rural tracks.

UCSF would be harder, simply because their fellowships are in higher demand among Bay Area residents, California residents, and West Coast residents. Proximity helps. No secret that most of the UCSF fellowship slots are taken by UCSF grads.

I agree with notdeadyet and splik-- go to the residency that is the best fit.

 

[TexasPhysician]

Fellowships are generally not as competitive as the residencies associated with them, so I would go where you are happiest now. I've seen poor residents from poor programs match at excellent fellowships.

 

[cleareyedguy]

Fellowships are generally not as competitive as the residencies associated with them, so I would go where you are happiest now. I've seen poor residents from poor programs match at excellent fellowships.

In my experience, solid residents from top-notch east coast programs are rarely rejected anywhere for fellowships. There aren't all that many on the west coast because people tend to get settled down and not want to move, but I'd agree: go where you most want to go.

 

[nitemagi]

I would say that proximity is most important for where you want to end up practicing.