Tiers 2023

[Guest]

Those hoops are only difficult if you’re born in the wrong zip code.

[Focus]

How you became good at hoop jumping unfortunately is less important than being good. There's a compounding effect with each set of hoops.

[Guest]

Being good and jumping through hoops are two separate things. Unfortunately it doesn’t matter. Starting on third base and acting like you hit a home run never hurt anyone.

[Guest]

The wildest part about this side of things is that a whole group of people is getting an education on what privilege is. It's receiving special access to something for no particular reason. Do you have that feeling of frustration watching someone less qualified (papers, boards, skill, etc) get a residency spot, fellowship, or job just because of a name on their resume? Now you can start to empathize with people who never got in the door at all.

[Guest]

It’s not the group that matters though. Med students that bitch about who can get into Harvard can’t do anything about it. Those that can do something about privilege are the same ones that benefit from it, so they’ll typically do whatever cognitive gymnastics they need to do to keep things the way they are.

After all, it’s not about equity to some. Life is a zero-sum game to them, and any advantage they give up can easily lead to “losing.”

[Guest]

Lol. Pathetic Harvard still can't beat the giga-Chad UCSF Neurosurgery.

[Guest]

And when people who can do something about privilege try to change the system they get roasted for being "woke". The system is changing, albeit very slowly. Some things will not change during your career - example: UCSF's network in academic neurosurgery makes it much easier for their graduates to find jobs. Others, like program reputation, will change. Hard for anyone to feel bad for a group of people whining about not getting their dream job and having to divert to a less reputable place to train as a neurosurgeon.

Your career is not a zero-sum game. I went to a "mid-tier" program and would place my operative abilities on par or above any one of the dozen fellows who came to that "mid-tier" program from "elite" programs. The only real opportunities are those which you make for yourself. Your ability to create research and career advancement is yours.

Going to one of the top-tier places will speed up the timeline to success. But ultimately, you need to trade on your own name. Cream rises to the top. Life isn't a zero-sum game if you're a badass.

[Focus]

Part of the issue is the difference between perceived nepotism/ favoritism and actual nepotism/ favoritism. There is a natural human tendency to overestimate your merit relative to peers. We probably overvalue ourselves by 10 to 25% more than those around us would place our value at. Part of that is hubris and part of it is not knowing the full story on every other person in the peer group. So you may, for example, be in a competition for some position with a person you value as equal to yourself. But in reality, those around you value that person higher than yourself. When that person rightfully gets the position you are going to feel as if there was some unfair advantage that they had over you where in reality you just aren't as good as you think you are. Yes, people do get advantages that fall outside of pure merit but as someone who has been on both sides of the pedigree fence I can tell you that my experience is that merit is still king in most situations. Focus on competing with yourself. A. Self-improvement focused attitude will carry you a lot farther than resenting and competing with others.

[nsgy243]

As a current resident at UVA, couldn’t be happier with how much they care about residents, are vested in our education, our research, pay for conferences equipment and support, our autonomy in the OR, all the world leaders we have on faculty, work hours, living in Charlottesville, etc. I’m posting anonymously so I could just have easily trashed the program if I wanted to. RE Dr Jane leaving, he was PD for 9 years and his tenure ends at 10. Advancement from PD to chairman of another program is a classic move for those in academic neurosurgery, and Dr Shaffrey our chairman isn’t leaving anytime soon, so Jane took a job opportunity at Carillion in Virginia close to Charlottesville, his home. Jane’s father has left an unbelievable impact on the field of neurosurgery, he started JNS which is still based here in Charlottesville. Jane Jr. has an amazing pituitary/peds practice here that brings in wheelbarrows of cash for the hospital (mostly pituitary cash lol). If you think it was an easy decision for him to leave the program where he is loved and has spent his life training and as an attending at, you’re wrong. However, we are incredibly happy with our internal selection of next PD, and the residents were given a big say in this.  We are sad that Jane is leaving but we’re bringing in about 5 fantastic attendings that I would be really excited to work  with if I was a new junior resident.  For the real people that received an interview at UVa, reach out and speak to the residents, we are genuinely excited. Personally love it here and I don’t have any alterior motives for posting here on neurosurgery hub unlike some of the previous commenters.

[Guest]

The self-improvement mindset angle only goes so far and doesn’t address systemic issues like bias. That’s the downside to that type of thinking.

Assuming everything is controlled at the individual level keeps underserved populations down by pointing to a few improbable stars and asking others “Why couldn’t you do that too?” There’s a migrant farm worker that became a neurosurgeon? That must mean they all can do it, and those that didn’t must not have pursued improving their station because of some individual defect. That’s what your argument says.

The individualism angle is an example of the previously-named mental gymnastics that the privileged go through to justify privilege as a construct…and feel good about it.