Programs in this cycle

[Guest]

I will 3rd the UCSD thing. I was a sub-i during at time they had a chief resident who thought he was better than the Chairman (probably true), but let him to speak bad behind his back, skip out on his cases, etc. Seemed a program with lack of discipline and accountability.

[Guest]

(05-08-2020, 12:23 PM)Guest Wrote: Given that residency interviews might be virtual this year, if graduating M4's could write some more of their experiences with different places (positive and negative) I think all of the people applying this cycle would greatly appreciate that!

I was looking for a balanced program. With this in mind:
 
Pleasant Surprises:
 
- USC: Very balanced program with tough lifestyle, though not in a malignant way. Residents felt proud of their work ethic. On the other hand, people I met on the trail that sub-I'd there said it wasn't as bad as advertised, so perhaps the strong impression on interview day is a scare tactic to avoid weak-willed applicants.
- Rush: Clinically strong with heavily operative focus and fantastic resident culture. Spine-heavy reputation but heard sub-I report that cranial was great as well, with chiefs handling complex cases solo. Downside is academics, with some clinical research but basic science is nonexistent.
- Emory: Felt similar to USC, with better hours at the cost of slightly less unified resident group. Hard working program with excellent academic connections. Atlanta cost-of-living seemed great for a big city.
 
 
Disappointments:
 
- UVA: Resident culture didn't seem particularly unified at interview.
- Hopkins: Resident didn't seem particularly unified at interview. Volume felt low for a four resident cohort.
- Cleveland Clinic: Lots of fellows seems to result in less autonomy and lower case volume.

[Guest]

I Can anyone speak to duke, penn, Stanford, BWH
Some of the more academic leaning programs?

[Guest]

does anyone have any thoughts on programs like MUSC, Univ of Tennessee, or others somewhat southeastern located

[Guest]

(05-12-2020, 08:18 AM)Guest Wrote: I Can anyone speak to duke, penn, Stanford, BWH
Some of the more academic leaning programs?

I can try. I rotated at a few academic programs.

Penn - Pros: Amazing PD (hard to find someone more pro-resident than Schuster), incredible research in every subspecialty, including peds at CHOP, really great group of residents who were fun to work with, New Zealand experience where you get paid quite a bit and have a lot of autonomy, 18 months of protected time where you can do research/go abroad. 
Cons: Very weak vascular (Jeff dominates Philly and vascular at Penn is run by radiology), not great autonomy, at least for me - I watched a PGY-6 literally do nothing during an MVD, some of the spine attendings give more but if you rotate at any clinical powerhouse, it simply isn't comparable.

Columbia - Pros: Phenomenal group of faculty in every subspecialty (JB/Sisti in tumor, Connolly/Solomon (stepping down but still operating) in vascular, etc., really liked the residents, amazing research via neuroscience labs at Columbia, also in the neurosurgery labs, contrary to what I heard before going, great culture without the strict hierarchy that I expected.
Cons: Volume - some days we'd have like 2-3 first start ORs (just to compare, BNI has 11+ every day), autonomy 

MGH: Pros: Also amazing faculty, especially if you're interested in neuro-onc. Arguably the best research infrastructure in the country (can work at HMS/MIT, Farber, etc.). Faculty are down to earth and treat the residents well. 2 years of research. Great group of residents. At interview day said that 1 resident enfolded endovascular.
Cons: In house call through PGY-6 year (they have both a junior and senior resident on in house every night), PGY-5 research year not protected due to call, heavy call burden during junior residency interferes w/ OR time, volume/autonomy, independent North service eliminated

tl;dr some amazing academic places out there with really great people who are fun to work with. At almost every one of these places though (with the notable exception of UCSF), prepare to give up a lot of OR time and stand behind people twiddling your thumbs until far into residency. On the flip side, you can have a university setting with amazing collaborators and internal funding opportunities.

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(05-12-2020, 07:16 PM)Guest Wrote:

(05-12-2020, 08:18 AM)Guest Wrote: I Can anyone speak to duke, penn, Stanford, BWH
Some of the more academic leaning programs?

I can try. I rotated at a few academic programs.

Penn - Pros: Amazing PD (hard to find someone more pro-resident than Schuster), incredible research in every subspecialty, including peds at CHOP, really great group of residents who were fun to work with, New Zealand experience where you get paid quite a bit and have a lot of autonomy, 18 months of protected time where you can do research/go abroad. 
Cons: Very weak vascular (Jeff dominates Philly and vascular at Penn is run by radiology), not great autonomy, at least for me - I watched a PGY-6 literally do nothing during an MVD, some of the spine attendings give more but if you rotate at any clinical powerhouse, it simply isn't comparable.

Columbia - Pros: Phenomenal group of faculty in every subspecialty (JB/Sisti in tumor, Connolly/Solomon (stepping down but still operating) in vascular, etc., really liked the residents, amazing research via neuroscience labs at Columbia, also in the neurosurgery labs, contrary to what I heard before going, great culture without the strict hierarchy that I expected.
Cons: Volume - some days we'd have like 2-3 first start ORs (just to compare, BNI has 11+ every day), autonomy 

MGH: Pros: Also amazing faculty, especially if you're interested in neuro-onc. Arguably the best research infrastructure in the country (can work at HMS/MIT, Farber, etc.). Faculty are down to earth and treat the residents well. 2 years of research. Great group of residents. At interview day said that 1 resident enfolded endovascular.
Cons: In house call through PGY-6 year (they have both a junior and senior resident on in house every night), PGY-5 research year not protected due to call, heavy call burden during junior residency interferes w/ OR time, volume/autonomy, independent North service eliminated

tl;dr some amazing academic places out there with really great people who are fun to work with. At almost every one of these places though (with the notable exception of UCSF), prepare to give up a lot of OR time and stand behind people twiddling your thumbs until far into residency. On the flip side, you can have a university setting with amazing collaborators and internal funding opportunities.

edit: Sorry I think it's the PGY-4 (first) research year that isn't fully protected.

[Guest]

How do big Northeast academic programs compare (BWH/MGH/NYU/Columbia/Cornell?)

[Guest]

Probably the most honest writeup on the bigger east coast academic powerhouses, thank you for that.

[Guest]

(05-12-2020, 07:16 PM)Guest Wrote: tl;dr some amazing academic places out there with really great people who are fun to work with. At almost every one of these places though (with the notable exception of UCSF), prepare to give up a lot of OR time and stand behind people twiddling your thumbs until far into residency. On the flip side, you can have a university setting with amazing collaborators and internal funding opportunities.

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Good wrietup, but these things aren't remotely equivalent. You are there to learn to OPERATE. Even if you want to be 50-50 research at some point in the future, the other 50% is spent OPERATING. Completely agree that you will be fighting for OR space at most big-name programs in the NE.

[Guest]

(05-13-2020, 12:49 AM)Guest Wrote:

(05-12-2020, 07:16 PM)Guest Wrote: tl;dr some amazing academic places out there with really great people who are fun to work with. At almost every one of these places though (with the notable exception of UCSF), prepare to give up a lot of OR time and stand behind people twiddling your thumbs until far into residency. On the flip side, you can have a university setting with amazing collaborators and internal funding opportunities.

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Good wrietup, but these things aren't remotely equivalent. You are there to learn to OPERATE. Even if you want to be 50-50 research at some point in the future, the other 50% is spent OPERATING. Completely agree that you will be fighting for OR space at most big-name programs in the NE.

Yeah I completely agree with you. I ranked clinically busy and more balanced programs at the top of my list for that exact reason. No amount of research can make up for poor autonomy (at least for me). It also makes residency a lot more fun when you can actually operate and do things. I just wanted to give whatever info I had on those programs for people who wanted it and provide the silver lining. Some people have different priorities and value name/location above all else.

[guest101]

(05-13-2020, 01:10 AM)Guest Wrote:

(05-13-2020, 12:49 AM)Guest Wrote:

(05-12-2020, 07:16 PM)Guest Wrote: Amazing residency programs throughout the country exist no doubt. But (and not to disparage any programs in particular), it does need mentioning that there is a drastic difference in the operative experience/autonomy/skills that a resident attains at clinical-heavy programs (i.e. BNI, Pitt, USC, UW, Miami, Mayo, etc.) in comparison to research-driven powerhouses (MGH, BWH, Cornell, Columbia, etc.). While you meet the minimums in each category regardless of where you train, confidence in operative skills upon graduation and ability to use fellowship to fine-tune/become proficient in complex/niche procedures definitely comes with the former. That being said, the time to be able to pursue academic pursuits definitely decreases in clinically-heavy programs just by nature of the demands of patient turnover, documentation, consults, etc. This Catch 22 exists across the country albeit with few exceptions (BNI/Mayo being the two where you can get trained well clinically and still have enough time to pursue basic science and/or clinical opportunities - yes at BNI these are definitely limited but its worth pointing this out regardless). A large part of making your rank list, selecting sub-internships, etc. is taking a minute to be introspective and envision the career you see for yourself. Excellent neurosurgeons have come out of clinical and academic programs and where you do residency is not a hindrance to becoming a great surgeon but having strong clinical training allows you to use the first few years out of residency to determine the niche in which you'd like to specialize/build your practice rather than worrying about getting enough cases in fellowship to feel comfortable operating. Another important point worth mentioning is how different neurosurgery residency training is today vs the late 20th century when malpractice claims were fewer, fewer medical conglomerates existed within the same cities, etc. programs that were historically great then were so because of limited competition from other centers within the same city (giving more operative experience to residents). Additionally (and this is probably the most important to consider), be sure to determine the culture of the program that fits best with the way you see yourself. 7 years is a LONG time for any sort of training. Being happy with who you are surrounded by will far supercede program name, clinical volume, academic reputation, etc. Finally, realize that the Match is RANDOM. people do not frequently match at their #1,#2,#3, etc. When residents tell you about their program and why they love it, understand that for many of them they ended up at a program that they had not initially envisioned they were going to be at. They adapted, made the most of the situation, and saw positives in where they were assigned to work. Life is the same way, and is always what we make of it. The important thing to remember is to take what is being said on interviews with a grain of salt. When residents tell you that they picked this program because of "x, y, and z.." know that they may not have actually "picked" anything to begin with. They ranked programs where they wanted to be, and were assigned to one in the end. Trust the process, trust yourself, and most importantly, be kind to all along the way. 

tl;dr some amazing academic places out there with really great people who are fun to work with. At almost every one of these places though (with the notable exception of UCSF), prepare to give up a lot of OR time and stand behind people twiddling your thumbs until far into residency. On the flip side, you can have a university setting with amazing collaborators and internal funding opportunities.

---

Good wrietup, but these things aren't remotely equivalent. You are there to learn to OPERATE. Even if you want to be 50-50 research at some point in the future, the other 50% is spent OPERATING. Completely agree that you will be fighting for OR space at most big-name programs in the NE.

Yeah I completely agree with you. I ranked clinically busy and more balanced programs at the top of my list for that exact reason. No amount of research can make up for poor autonomy (at least for me). It also makes residency a lot more fun when you can actually operate and do things. I just wanted to give whatever info I had on those programs for people who wanted it and provide the silver lining. Some people have different priorities and value name/location above all else.

---

Amazing residency programs throughout the country exist no doubt. But (and not to disparage any programs in particular), it does need mentioning that there is a drastic difference in the operative experience/autonomy/skills that a resident attains at clinical-heavy programs (i.e. BNI, Pitt, USC, UW, Miami, Mayo, etc.) in comparison to research-driven powerhouses (MGH, BWH, Cornell, Columbia, etc.). While you meet the minimums in each category regardless of where you train, confidence in operative skills upon graduation and ability to use fellowship to fine-tune/become proficient in complex/niche procedures definitely comes with the former. That being said, the time to be able to pursue academic pursuits definitely decreases in clinically-heavy programs just by nature of the demands of patient turnover, documentation, consults, etc. This Catch 22 exists across the country albeit with few exceptions (BNI/Mayo being the two where you can get trained well clinically and still have enough time to pursue basic science and/or clinical opportunities - yes at BNI these are definitely limited but its worth pointing this out regardless). A large part of making your rank list, selecting sub-internships, etc. is taking a minute to be introspective and envision the career you see for yourself. Excellent neurosurgeons have come out of clinical and academic programs and where you do residency is not a hindrance to becoming a great surgeon but having strong clinical training allows you to use the first few years out of residency to determine the niche in which you'd like to specialize/build your practice rather than worrying about getting enough cases in fellowship to feel comfortable operating. Another important point worth mentioning is how different neurosurgery residency training is today vs the late 20th century when malpractice claims were fewer, fewer medical conglomerates existed within the same cities, etc. programs that were historically great then were so because of limited competition from other centers within the same city (giving more operative experience to residents). Additionally (and this is probably the most important to consider), be sure to determine the culture of the program that fits best with the way you see yourself. 7 years is a LONG time for any sort of training. Being happy with who you are surrounded by will far supercede program name, clinical volume, academic reputation, etc. Finally, realize that the Match is RANDOM. people do not frequently match at their #1,#2,#3, etc. When residents tell you about their program and why they love it, understand that for many of them they ended up at a program that they had not initially envisioned they were going to be at. They adapted, made the most of the situation, and saw positives in where they were assigned to work. Life is the same way, and is always what we make of it. The important thing to remember is to take what is being said on interviews with a grain of salt. When residents tell you that they picked this program because of "x, y, and z.." know that they may not have actually "picked" anything to begin with. They ranked programs where they wanted to be, and were assigned to one in the end. Trust the process, trust yourself, and most importantly, be kind to all along the way.