Best clinical / Hands on Residencies?

[Guest]

Okay med students talking shit. We'll see how your tune about "shit tier Hopkins and Stanford" changes when you don't match or end up in some backwater place in the rust belt

[Guest]

(04-07-2022, 11:04 AM)No Lies Wrote:

(04-06-2022, 08:05 PM)Guest Wrote:

(04-05-2022, 12:19 AM)No Lies Wrote: Most of the residencies in the Midwest. None of you from the coasts can even hold my Midwest surgical jockstrap. I’ll be in the doctor’s lounge dictating my op notes before you’ve figured out why your nav is off.

And you'll have a very satisfying life of chronic subdurals and single level ACDFs. I bet your mom is so proud!

Yeah being in the Midwest protects you against aneurysms. Lol, I learned to split the fissure by doing it.  I did my first bypass probably before you even got to close a wound.

I don't doubt you did, but here's a little secret- when you're applying for jobs in a couple years no one will give a shit. And you'll end up getting that PP job in Fargo and spend the rest of your days bragging about the cases you did as a PGY-2. 

You know what they will care about? The recommendations coming from big names on the "coasts", the publications, the innovation. And they'll ignore you as you scream "but i clipped an ACoM as a PGY-3!!!" into the void.

Don't worry though, you'll convince yourself you didn't like academics anyways in a couple years so you'll still be happy.

[Guest]

(04-07-2022, 02:47 PM)Guest Wrote:

(04-07-2022, 11:04 AM)No Lies Wrote:

(04-06-2022, 08:05 PM)Guest Wrote:

(04-05-2022, 12:19 AM)No Lies Wrote: Most of the residencies in the Midwest. None of you from the coasts can even hold my Midwest surgical jockstrap. I’ll be in the doctor’s lounge dictating my op notes before you’ve figured out why your nav is off.

And you'll have a very satisfying life of chronic subdurals and single level ACDFs. I bet your mom is so proud!

Yeah being in the Midwest protects you against aneurysms. Lol, I learned to split the fissure by doing it.  I did my first bypass probably before you even got to close a wound.

I don't doubt you did, but here's a little secret- when you're applying for jobs in a couple years no one will give a shit. And you'll end up getting that PP job in Fargo and spend the rest of your days bragging about the cases you did as a PGY-2. 

You know what they will care about? The recommendations coming from big names on the "coasts", the publications, the innovation. And they'll ignore you as you scream "but i clipped an ACoM as a PGY-3!!!" into the void.

Don't worry though, you'll convince yourself you didn't like academics anyways in a couple years so you'll still be happy.

Without question a lot of the programs in the coasts have bigger names who can get you academic jobs. But that reflects the nepotism of neurosurgery and not the skill of the person getting the job. You’ll just be another clinically inept academic neurosurgeon who relies on fellows to do your cases, residents to manage your floor patients, and med students to write your papers. But you’ll get to proclaim yourself an expert neurosurgeon even though once you’re in the OR you are a greater hazard than the high school student shadowing you. Also, innovative? What is innovative about doing bypass at Stanford for Moyamoya or doing open laminectomy at Hopkins? You simply decide yourself into thinking that you move the field forward. Just be happy with what you get and recognize that the people who publish aren’t necessarily the best surgeons and there is ultimately a conflict between being a big academic who publishes a lot and a slick surgeon who thrives in private practice. Both are ultimately acceptable outcomes and whether you are a “success” in having achieved that is determined by whether you’re happy at the end of the day.

[Guest]

Barrow, Pitt, Mayo, UCSF, Carolinas, Tenessee, USC, Miami, UWash, and a few more- this isnt meant to be a comprehensive list it just depends on what your priorities are from a location, research, and mentorship standpoint

[Guest]

Emory

[Guest]

A lot of this is common sense:
-big county/safety net hospital with a VA in a city/town without many other options, program has few fellows, and state laws letting attendings run multiple rooms = lots of hands on
-private hospital with 10 other hospitals in town, attendings by law must be present whole time and lots of fellows = not as much hands on

[Guest]

Here's some data I pulled in order of top ten biggest US metro areas followed by NSG residency programs and a rough estimate from quick google search of other hospitals in the area

1 New York-Newark-Jersey City, NY-NJ-PA MSA 19,768,458 NYU, Columbia, Cornell, Mt Sinai and 62 acute care hospitals
2 Los Angeles-Long Beach-Anaheim, CA MSA 12,997,353 Cedars, UCLA, USC and 80 acute care hospitals
3 Chicago-Naperville-Elgin, IL-IN-WI MSA 9,509,934 Northwestern, Rush, U Chicago, UIC and 40 hospitals (acute care not specified)
4 Dallas-Fort Worth-Arlington, TX MSA 7,759,615 UTSW and 82 acute care hospitals
5 Houston-The Woodlands-Sugar Land, TX MSA 7,206,841 Baylor, Methodist, UTH and >125 hospitals (acute care not specified)
6 Washington-Arlington-Alexandria, DC-VA-MD-WV MSA 6,356,434 GW, Georgetown, and 62 hospitals(acute care not specified)
7 Philadelphia-Camden-Wilmington, PA-NJ-DE-MD MSA 6,228,601 Temple, Jeff, Penn, PCOM, and >30 acute care hospitals
8 Atlanta-Sandy Springs-Alpharetta, GA MSA 6,144,050 6,089,815 Emory and 22 hospitals (acute care not specified)
9 Miami-Fort Lauderdale-West Palm Beach, FL MSA 6,091,747 Miami 46 hospitals (acute care not specified)
10 Phoenix-Mesa-Chandler, AZ MSA 4,946,145 Barrow, Mayo and 50 Hospitals (acute care not specified)

[Guest]

This is accurate for programs that get most of their volume from acute issues (traumas, strokes, SAHs). It’s less accurate for “elective” pathologies where patients have more time to choose their surgeon (tumors, skull base, functional, pain procedures). In general, programs will tell you what their volume is. That’s the best way to know

[Guest]

(04-07-2022, 02:15 PM)Guest Wrote: Okay med students talking shit. We'll see how your tune about "shit tier Hopkins and Stanford" changes when you don't match or end up in some backwater place in the rust belt

why the hate on the rust belt?

[Guest]

(04-07-2022, 07:02 PM)Guest Wrote: A lot of this is common sense:
-big county/safety net hospital with a VA in a city/town without many other options, program has few fellows, and state laws letting attendings run multiple rooms = lots of hands on
-private hospital with 10 other hospitals in town, attendings by law must be present whole time and lots of fellows = not as much hands on

It's CMS that won't pay for more than 2 concurrent cases, not a state law