(05-15-2020, 04:47 PM)Guest Wrote: (05-15-2020, 04:30 PM)Guest Wrote: pretty sure the above poster has never set foot at either UW or Mayo, being clinically heavy does not equate with just being inundated with trauma at all time. UW is notoriously busy beyond even just the Harborview experience and Mayo routinely has 11 first start ORs, which is a number only Barrow can match. 2000 is more in line with the number of cases their graduating residents have.
This x 1000. I rotated at both Mayo and BNI + a program with a busy level 1 trauma center. Mayo was just as busy as BNI (some days they had 14 first starts). The residents did complex cases with autonomy, not 3,000 trauma cranis. Both Mayo and Barrow are ultra wealthy, resource-rich hospitals that only cover 1 site so the residents operate starting intern year because they don't need that many bodies on the floor and overnight (BNI is a little more frontloaded). All the labs and imaging are done immediately so no one wastes time tracking down random BS. They have transport and OR teams that get everything set up for you so your only job is to operate and do research. If you do an enfolded during one of the elective years they get at Mayo (or operate during the 18 months BNI gives you) you will easily hit 2,000 cases at graduation at both places.
Wow, 11 and 14 first starts a day is a lot as is the 11, but when you consider these programs have 4 residents per year, its not that much different from my top tier program (and others) which has 7-8 first starts a day but only 3 residents per year program.
(05-15-2020, 10:44 PM)Guest Wrote: I am a PGY5 from east coast who was going to transfer to UCSD for personal reasons.
I just found out that they are undergoing investigation by ACGME for many violations...
sounds like ucsd has an OPENING
(05-16-2020, 03:09 PM)Guest Wrote: (05-15-2020, 04:47 PM)Guest Wrote: (05-15-2020, 04:30 PM)Guest Wrote: pretty sure the above poster has never set foot at either UW or Mayo, being clinically heavy does not equate with just being inundated with trauma at all time. UW is notoriously busy beyond even just the Harborview experience and Mayo routinely has 11 first start ORs, which is a number only Barrow can match. 2000 is more in line with the number of cases their graduating residents have.
This x 1000. I rotated at both Mayo and BNI + a program with a busy level 1 trauma center. Mayo was just as busy as BNI (some days they had 14 first starts). The residents did complex cases with autonomy, not 3,000 trauma cranis. Both Mayo and Barrow are ultra wealthy, resource-rich hospitals that only cover 1 site so the residents operate starting intern year because they don't need that many bodies on the floor and overnight (BNI is a little more frontloaded). All the labs and imaging are done immediately so no one wastes time tracking down random BS. They have transport and OR teams that get everything set up for you so your only job is to operate and do research. If you do an enfolded during one of the elective years they get at Mayo (or operate during the 18 months BNI gives you) you will easily hit 2,000 cases at graduation at both places.
Wow, 11 and 14 first starts a day is a lot as is the 11, but when you consider these programs have 4 residents per year, its not that much different from my top tier program (and others) which has 7-8 first starts a day but only 3 residents per year program.
Good point. In the case of Mayo though they can have up to 8 residents gone because of the 2 research/elective years. At BNI 4-6 might be gone at any given time (as is likely the case at a lot of programs with protected years).
(05-16-2020, 04:09 PM)Guest Wrote: (05-16-2020, 03:09 PM)Guest Wrote: (05-15-2020, 04:47 PM)Guest Wrote: (05-15-2020, 04:30 PM)Guest Wrote: pretty sure the above poster has never set foot at either UW or Mayo, being clinically heavy does not equate with just being inundated with trauma at all time. UW is notoriously busy beyond even just the Harborview experience and Mayo routinely has 11 first start ORs, which is a number only Barrow can match. 2000 is more in line with the number of cases their graduating residents have.
This x 1000. I rotated at both Mayo and BNI + a program with a busy level 1 trauma center. Mayo was just as busy as BNI (some days they had 14 first starts). The residents did complex cases with autonomy, not 3,000 trauma cranis. Both Mayo and Barrow are ultra wealthy, resource-rich hospitals that only cover 1 site so the residents operate starting intern year because they don't need that many bodies on the floor and overnight (BNI is a little more frontloaded). All the labs and imaging are done immediately so no one wastes time tracking down random BS. They have transport and OR teams that get everything set up for you so your only job is to operate and do research. If you do an enfolded during one of the elective years they get at Mayo (or operate during the 18 months BNI gives you) you will easily hit 2,000 cases at graduation at both places.
Wow, 11 and 14 first starts a day is a lot as is the 11, but when you consider these programs have 4 residents per year, its not that much different from my top tier program (and others) which has 7-8 first starts a day but only 3 residents per year program.
Good point. In the case of Mayo though they can have up to 8 residents gone because of the 2 research/elective years. At BNI 4-6 might be gone at any given time (as is likely the case at a lot of programs with protected years).
Which is the case at places like MGH, Columbia, and JHU, which this form habitually hates on
(05-16-2020, 04:26 PM)Guest Wrote: Wow, 11 and 14 first starts a day is a lot as is the 11, but when you consider these programs have 4 residents per year, its not that much different from my top tier program (and others) which has 7-8 first starts a day but only 3 residents per year program.
Good point. In the case of Mayo though they can have up to 8 residents gone because of the 2 research/elective years. At BNI 4-6 might be gone at any given time (as is likely the case at a lot of programs with protected years).
Which is the case at places like MGH, Columbia, and JHU, which this form habitually hates on
Yeah. I personally like those programs (I have a few good friends at them and I rotated at one of the places you mentioned as a med student). I think people's main qualm with those places isn't necessarily the total number of cases/resident, it's how hands on the attendings are. If those programs would let PGY-4s and up do the critical portions of the case, get out of their comfort zone, struggle a little bit with the attending in the room, that would make for a great operative experience. At least when I rotated (and even now from my friends my year), the attendings are really fast to jump in even with PGY-6s+ and would honestly be happy to do the whole case. I'm not saying you can't be well trained, you can work to get your reps in at any place, it just makes it harder at those programs.
(05-15-2020, 05:16 PM)Guest Wrote: How bad is the trauma at UW? It sounds like something that might be exciting and educational for like one year and then end up ruining your life afterwards.
Bump
(05-15-2020, 10:32 PM)Guest Wrote: Can anyone talk more about Pitt?
bump
(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.
+1 As a resident I couldn't agree more with everything you said
U the real MVP 
looked more into UCSD, they are in hot waters...persistent theme
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