My opinion on the best academic West coast programs:

1)U Wash: Probably one of the most well-rounded academic training programs I've seen. Every area in orthopaedics is represented with at least two faculty (in most areas there are far more than two). You have the best trauma experience in the country, one of the world leaders in foot and ankle in Hansen, one of the best hand surgeons in Hanel and one of the premier shoulder surgeons in Matsen (also chairman) not to mention all of the trauma attendings who are on all national boards and publish a ton. On top of that, the type of cases some residents do the most of by the time they're done are joints. Downside of UW is they don't have any big name faculty in Sports or Joints (except Matsen if you consider shoulder part of sports). Ultimately UW is a very stable program with the longest and most recognized tradition in Orthopaedics in the west. It presents a great balance of academic training and hands-on operating. There's nothing these guys haven't seen by the time they're done. And they take pride in doing things the right way rather than just doing what they feel like doing.

2)UCSF: Best program in California. Residents operate a lot. Well recognized faculty in spine (Serena Hu), joints (Michael Ries and Kevin Bozic) and Sports (Marc Safran). Just hired Foot and Ankle attending (he's the only one - trained at UW) - currently no foot and ankle rotation. One attending in tumor and one attending in Peds. Residents go to Shriners in Sacramento for peds rotation in their 4th year (No children's hospital in SF). Program has been without an active chairman for about 4-5 years now but on interview day they said they would hopefully have one by Aug. SF is a great city, though expensive (REALLY expensive). Residents get along well with eachother and with attendings.

3) UC Davis: Very well balanced training in a very livable city with a great group of residents. Busy trauma service. Residents get a lot of good hands on operative experience. Downside for me was that they don't get their first sports experience until 4th year. They will be getting a new chairman this fall. Some would argue that this is the best program in California - I just don't think they have as many attendings that are as well-recognized - this helps when getting fellowships.

3) UCLA: Not sure whether to put Stanford above UCLA or not. UCLA has well-recognized attendings and is a popular program because of the location and the 'gentleman's program' feel. Not very rigorous schedules (relatively speaking) and most of them get pretty good fellowships. Trouble with the place is that there is very little autonomy for the residents and they really don't operate much. This has been a rumor everyone hears about UCLA and I usually don't listen too much to rumors about programs but from people who go there and who have rotated there I've heard uniformly that it's true - they just don't operate much. And they're not comfortable with a lot of bread and butter trauma. You may think trauma's not a big deal ("I'm not going to be a trauma guy", right?) but everyone takes trauma call at somepoint after residency and not being comforable with it is a bit of a problem when your a@# is on the line and you're the only guy in the OR. Overall, I've heard the residents are happy here.

4) Stanford: In a year or two Stanford will probably jump UCLA. New Chair (Maloney) is fantastic according to everyone I've talked to around the country. He's got a bit of work to do to get the program where he wants it but he's definitely talented enough to do it. Plus it appears that Stanford has the financial commitment to the department to make it great (unlike UCSF). Very cush program in Palo Alto - quaint place but not big city like some want. Better weather than SF, though.

5) UC Irvine - good up and coming program. Sweet location. A fairly small program with great residents. A little different curriculum - you could be on a different service every other day instead of spending 2-3 months on one service at a time.

6) UCSD - Dude, it's in freaking San Diego! Perfect weather all the time. If you like the research year this may be for you (mandatory 6 years). I just wish that they would move the research year back a couple years in your training instead of throwing you in the lab after your intership before you know anything about Ortho. Some well-known attendings and a great chairman and program director! And you can't beat the location.

7) USC - a lot of trauma but not a lot of supervision/teaching. Nice that it's in SoCal. Didn't apply here so I can't speak too much on the program.

OHSU - don't hear much about this place but they do have a new chairman who I've heard will be good and Portland is a nice town. Most would not consider this to be one of the stronger west coast academic programs.

Hey, I don't know what amc is smokin', but I want some of it.

I interviewed at Washington and most of the big California programs - UCLA, UCSF, Stanford, UCD, and UCI (didn't get in to any of them - not that I'm bitter).

1. UCLA

There's a reason UCLA is consistently ranked in the top ten nationally.

First, a great program must be strong in all subspecialties. UCLA has world famous attendings in subspecialties that aren't even represented at many institutions (i.e. Cracchiolo - Foot and Ankle, Eckardt - Tumor). Whereas most of the big time sports guys are not at academic centers, Finerman at UCLA (the longtime chairman) is one of few exceptions (NISMAT at Lenox Hill is another). And don't forget the other giants in their field - Oppenheim in pedi-ortho, Jones in Hand and Microsurgery (are you kidding me?!) Not to mention the many other faculty members who are already major players nationally.

To his credit, amc did bring up the issue of financial backing for the ortho dept. when he was discussing Stanford. So how did he miss the fact that Finerman just orchestrated one of the biggest coups of all time. UCLA is joining with Orthopedic Hospital (a private ortho hosp. in LA) and in doing so adds $100 million to the ortho dept!!! That's a boat load of endowed professorships, research positions, PA's, books, computers, jelly beans...a lot of whatever the hell you want.

And you can't be an academic center without an emphasis on research. Not only has some of the most important work consistently come out of UCLA, but they are one of the few programs around the country that have a full-year of research during residency (for 2 of the 6 residents every year). Oh, and by the way, they have a new 75,000 square foot research lab. 75,000 square feet. Who dedicates that much real estate to research in the heart of LA?

Of course, predictably, amc repeated the mantra that says UCLA is top heavy. It's the same song you hear about HSS, MGH, and Mayo. No trauma. Too many fellows. Don't get to operate enough. The fact is you don't need to do 1000 hips to be good at hips, and how many distal radius fractures do you need to reduce before you're competent. It's not only about numbers. That's part of it, but these top places are special because they're major referral centers. They see stuff that doesn't get taken care of at other places. Many of the posters on this site are quick to ignore this fact and thus like to say that the training at hospital x is the best because from the time you're an intern, you're doing a billion tibias by yourself. How great.

Oh, and one other thing. It's southern California, ladies and gents.

2. UW

This is place is just as amazing as UCLA. Let's talk about all the giants they have here: Matsen - sports/shoulders and the chairman, Hansen - the Mark Myerson of the pacific northwest (for all you east coasters), Hanel, Chapman, Conrad...the list goes on. And if you want to talk about trauma...fugedabowdit. There's shock and harborview, and then a bunch of substitute teachers. Let's not forget the research. One of the most prolific and well respected labs in the country makes this place an academic powerhouse.

And then there's Seattle. Only probably the coolest place to live right now in the whole country. So it's no wonder UW is also consistently placed in the top 10 nationally.

I'd like to wax on more about U Dub, but I think I'm starting to cramp up and I'm pretty sure I've worn out my welcome here. So let's just leave it at that.

3. UCSF
4. UCD
5. UCSD
6. Stanford

Right on, Hoosier. I rotated at UCLA and found it to be a solid academic program. The rumors about never operating are somewhat exaggerated. The residents are solid--both in the OR and on the OITE. Hoosier also alluded to all the great changes taking place with the construction of the new orthopaedic hospital. It is definitley an excellent program that is only going to get better.

My vote goes to UCSF as No. 1. Well balanced, hands on, and great fellowships for graduating seniors.

Ranking these programs depends on the factors that are important to you.
If you go only by reputation:
1) UW - no doubt here
2) UCSF
3) UCLA
4) UC Davis
5) UCSD
6) OHSU
7) USC
UC Irvine
9) St. Marys, Harbor

I have spent time at 4 of these programs and interviewed at some others.
Here are the one I know the best:

UW-
+ well-known faculty, teaching, conferences, and walk your way into any fellowhship afterwards
- you don't operate for jack as an R2 b/c you spend most of your time during this year at Harborview where you are literally up all night in the ER seeing 20 to 30 consults per night. yes, 20 to 30 consults. you tee everything up, send it down to the OR, and the chief and fellow operate while you throw on the next splint/traction pin
overall: a great reputation and the staff are awesome. in my mind a fabulous place to do a fellowship, but a tough residency with little early operative time

UCSF
+ same as UW and SF is a great city
- lots of animosity with the faculty. expensive city to live in and nearly impossible if considering kids
overall: not as busy as UW and earlier operative experience

OHSU
+the earliest and most operative experience of the west coast academic programs (you literally get to operate as a intern); portland is a great livable city
-not nearly the reputation of the other programs
overall: improving program with best operative experience since only one fellow (spine). consider this place if you want to operate early, don't if you want to be chairman - the reasearch isn't strong enough for that yet

Stanford
+good name, good weather, pretty good operative experience
-expensive. some malignant staff. weak on academics
overall: above-average social name, average program