Does anyone know much about the residency program at U Cincinnati? How is the rapport there, the residents, what is the PD like, the lifestyle, etc.? Is it a female or POC friendly program?

I am a junior neurosurgical attending practicing for three plus years now.  I have been hospital employed health system. The pay is good, but the bending over to the health system, and inability to pick my staff is frustrating.  It seems to me that generation before us, which sold their practices to the health systems, had the bargaining power and could stand up to hospital administrations to advocate for themselves.   In our current systems I feel we are losing that.  
 
This issue is the current private jobs out there seem to be from bigger groups and a pyramid scheme which you can never really become an equal.  Going solo has a high barrier for entry and big EMR systems are making this a more difficult option.  

What are other people experiencing out there?  Is independent practice gone?  Are some people happy working in the employed systems and if so, what are some of the things that help.  One of my bigger frustrations is being on call for many hospitals that I don’t go to, and getting called for clearly non-surgical stuff by a growing number of NP/PA’s that don’t’ know how to manage non-operative spine.  If the radiologist says anything on the report they don’t understand, they call and write down any narrative they want in the chart.  Then the CMO’s try to encourage remote management without ever seeing the patient.  Private ortho spine attendings refuse to take call ED call, take block time at the health system, and when their post ops hit the ED, they reflexively call the on-call for their post ops and if push comes to shove we have to take their post-op complications.
Who’s having a better time out there?  What's our options ?

Have been trying to track this but curious if anyone has a list/insight - what programs do a night float system, or have lighter call burdens? Not the most important thing, but does matter and sometimes hard to figure out from interviews.

been getting a lot of "you have great letters"...if you went to a home program than had 10-15 rotators/sub-I, do they all have great letter of recs? is there multiple people from the same institution that get the " top 1%" on the letter of recs. curious if any residents/faculty can comment on that.

I'm in a situation where I have a good relationship with both my home PD and chair, and it's a program I would be happy to train at, I'll most likely be ranking it #2. However, there's another program that I'm going to rank #1 that I would absolutely want to go to. How do I put in my best chance to get my #1 rank (i.e. ask my home chair to call the chair at my #1) without losing my position on the rank list at my home program in case I don't get my #1? Does telling my home PD or chair that another program is my #1 cause me to drop down on their rank list?

As you finish December interviews, if you've done at least 15 (maybe even 10-12 for really strong applicants) and have some that you're not interested in, strongly consider cancelling. There are folks out there who will gladly fill that spot. The data show that between 10 and 15 is the 'magic' number for neurosurgery, so doing much more than that if you're really unlikely to go to that program is a waste of your time and potentially hurts someone else. When I applied to med school, I was accepted at 6 of my top choices within the first few months, what more could I ask for? I cancelled the rest of my interviews or withdrew my application anywhere else. I'd like to think that someone else got a look who deserved it as much or more than I did. It is hard to match in neurosurgery, no question, but program directors aren't interested in interviewing someone who is not genuinely interested in them, especially when there is a long line of folks who really want the spot. Good luck!

PS. On a personal note, I've gotten 8 invites, feeling good but of course would love to get up to 10. Thanks to anyone who cancels interviews in the Northeast or West Coast!

Wanted to ask for anyone who did a sub-I there. Had heard some things a few years ago about residents being very cutthroat with each other and fighting every day over who gets to scrub in the OR. Don't know if things have changed for the better since then, especially since they have a new PD.

What are programs that are used to having or taking in IMGs? Or ones that have a high number of IMGs do research fellowships and eventually match somewhere?

How good is this Chicago review course? Any good/bad reviews of those who actually attended it? Are 7 days of your time worth it? Is it interactive or just listening to those lectures?

What happens on these? Do you get to scrub cases? Take call? How does this work?