(05-13-2020, 04:15 PM)guest101 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.
+1 As a resident I couldn't agree more with everything you said
Is Mayo better than UCSF?
(05-13-2020, 05:03 PM)Guest Wrote: Is Mayo better than UCSF?
Depends on what you want. They're completely different programs. UCSF has significantly better basic science, large university setting, West coast location in a desirable city. Downsides are a tough culture, strict hierarchy/lots of yelling, really bad lifestyle. Mayo is the exact opposite - major hospital center but no affiliated university, Midwest location (downside for some), and some of the nicest attendings in neurosurgery where the residents do zero scut work and have an amazing lifestyle even as juniors.
(05-13-2020, 05:12 PM)Guest Wrote: (05-13-2020, 05:03 PM)Guest Wrote: Is Mayo better than UCSF?
Depends on what you want. They're completely different programs. UCSF has significantly better basic science, large university setting, West coast location in a desirable city. Downsides are a tough culture, strict hierarchy/lots of yelling, really bad lifestyle. Mayo is the exact opposite - major hospital center but no affiliated university, Midwest location (downside for some), and some of the nicest attendings in neurosurgery where the residents do zero scut work and have an amazing lifestyle even as juniors.
+extremely high cost of living (UCSF)
(05-13-2020, 05:12 PM)Guest Wrote: (05-13-2020, 05:03 PM)Guest Wrote: Is Mayo better than UCSF?
Depends on what you want. They're completely different programs. UCSF has significantly better basic science, large university setting, West coast location in a desirable city. Downsides are a tough culture, strict hierarchy/lots of yelling, really bad lifestyle. Mayo is the exact opposite - major hospital center but no affiliated university, Midwest location (downside for some), and some of the nicest attendings in neurosurgery where the residents do zero scut work and have an amazing lifestyle even as juniors.
is the hierarchy/culture at UCSF that bad?
(05-13-2020, 06:06 PM)Guest Wrote: (05-13-2020, 05:12 PM)Guest Wrote: (05-13-2020, 05:03 PM)Guest Wrote: Is Mayo better than UCSF?
Depends on what you want. They're completely different programs. UCSF has significantly better basic science, large university setting, West coast location in a desirable city. Downsides are a tough culture, strict hierarchy/lots of yelling, really bad lifestyle. Mayo is the exact opposite - major hospital center but no affiliated university, Midwest location (downside for some), and some of the nicest attendings in neurosurgery where the residents do zero scut work and have an amazing lifestyle even as juniors.
is the hierarchy/culture at UCSF that bad?
The hierarchy/culture of neurosurgery is that bad in general. Neurosurgeons have always looked at their training as Navy Seal-esque. If you want to train at good programs you have to be able to work in that system and accept it. UCSF, USC, Miami, UVA, UWash, and many more, all great programs that are very hierarchical and getting yelled at is commonplace. Just be thankful you're not in the era where you have to duck from screwdrivers being thrown at you. I'm not endorsing this behavior in any way, but as someone who's been in this system for a couple years it's unavoidable and tolerable.
That being said there are softer programs, places like the BNI and Michigan, where almost no one behaves that way and residents are pampered. If that's what you value then rank those types of programs higher.
(05-13-2020, 06:24 PM)Guest Wrote: (05-13-2020, 06:06 PM)Guest Wrote: (05-13-2020, 05:12 PM)Guest Wrote: (05-13-2020, 05:03 PM)Guest Wrote: Is Mayo better than UCSF?
Depends on what you want. They're completely different programs. UCSF has significantly better basic science, large university setting, West coast location in a desirable city. Downsides are a tough culture, strict hierarchy/lots of yelling, really bad lifestyle. Mayo is the exact opposite - major hospital center but no affiliated university, Midwest location (downside for some), and some of the nicest attendings in neurosurgery where the residents do zero scut work and have an amazing lifestyle even as juniors.
is the hierarchy/culture at UCSF that bad?
The hierarchy/culture of neurosurgery is that bad in general. Neurosurgeons have always looked at their training as Navy Seal-esque. If you want to train at good programs you have to be able to work in that system and accept it. UCSF, USC, Miami, UVA, UWash, and many more, all great programs that are very hierarchical and getting yelled at is commonplace. Just be thankful you're not in the era where you have to duck from screwdrivers being thrown at you. I'm not endorsing this behavior in any way, but as someone who's been in this system for a couple years it's unavoidable and tolerable.
That being said there are softer programs, places like the BNI and Michigan, where almost no one behaves that way and residents are pampered. If that's what you value then rank those types of programs higher.
Please remember that by "pampered" this person still means working 16+ hour days for a month straight at a time
(05-13-2020, 06:24 PM)Guest Wrote: (05-13-2020, 06:06 PM)Guest Wrote: (05-13-2020, 05:12 PM)Guest Wrote: (05-13-2020, 05:03 PM)Guest Wrote: Is Mayo better than UCSF?
Depends on what you want. They're completely different programs. UCSF has significantly better basic science, large university setting, West coast location in a desirable city. Downsides are a tough culture, strict hierarchy/lots of yelling, really bad lifestyle. Mayo is the exact opposite - major hospital center but no affiliated university, Midwest location (downside for some), and some of the nicest attendings in neurosurgery where the residents do zero scut work and have an amazing lifestyle even as juniors.
is the hierarchy/culture at UCSF that bad?
The hierarchy/culture of neurosurgery is that bad in general. Neurosurgeons have always looked at their training as Navy Seal-esque. If you want to train at good programs you have to be able to work in that system and accept it. UCSF, USC, Miami, UVA, UWash, and many more, all great programs that are very hierarchical and getting yelled at is commonplace. Just be thankful you're not in the era where you have to duck from screwdrivers being thrown at you. I'm not endorsing this behavior in any way, but as someone who's been in this system for a couple years it's unavoidable and tolerable.
That being said there are softer programs, places like the BNI and Michigan, where almost no one behaves that way and residents are pampered. If that's what you value then rank those types of programs higher.
Rotated at 2 of the above, matched at 1 of the nicer ones. Once again, this poster is right on the money. EVERY single program in the country has some pluses and some minuses. Those of you applying should rank based on things that are important to YOU personally.
neurosurgeryhub
Unregistered
(05-13-2020, 05:02 PM)Guest Wrote: (05-13-2020, 04:15 PM)guest101 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.
Cannot overstate the importance of reading this post over and over again @all medical students applying for neurosurgery
(05-14-2020, 12:03 AM)neurosurgeryhub Wrote: (05-13-2020, 05:02 PM)Guest Wrote: (05-13-2020, 04:15 PM)guest101 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.
Cannot overstate the importance of reading this post over and over again @all medical students applying for neurosurgery
+1 super important
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