Rochester vs. Brown

check your PM

6 yrs vs. 5 yrs will most certainly be a big deal when everyone is graduating residency and you have 1 more year left.

do a 5 year program. Trust me on this. Life is too short.

do 5 years - 6 is for suckers or research people.

6 is for suckers period. I think people who want to do academics and research are much better served doing a 2 year (instead of 1 year) fellowship. Residencies that are 6 years serve the purposes of the faculty at that program. It boosts their own research program. What sense does it make for you to spend a year doing research in, say, hand surgery, as a PGY2 or PGY3 when you end up going into joints or spine surgery? It makes no sense. That year of research should be done when you're a more "seasoned" surgeon (as a fellow) and when you know what field you want to specialize in. What is interesting about all 6 year residencies is that they make residents do their research year early on (either as a 2 or 3). It would make sense to do this research year at the end when the resident actually has an idea what kind of career he or she wants to have. But that would be too logical, and would not serve the interests of the faculty at these programs.

6 year residencies are for suckers and people who WANT to be research people, but are misguided in their efforts.

As for Brown, I interviewed there several years ago. They have a "super" chief who is a pgy6 who pretty much runs the trauma service and functions as an attending...not a bad setup for the faculty who don't have to take primary trauma call. So not only do they have a resident available for research, but they have a "superchief" who is a board-eligible orthopaedic surgeon (they take their boards after pgy5 year), running the trauma service for them. You tell me who benefits most from this arrangement.

Brown is an outstanding program with many strengths, but I ranked it last because of the 6 year thing.

Just for some balance...

I interviewed at Brown, and have spoken witha number of Brown grads... the 6 year program at Brown is NOT the equivalent of other 6 year programs. It is designed to be 6 months of a trauma fellowship and 6 months of research during your 6th year. And as per the chairman, if you are able to complete significant research earlier in your residency, you can then take those additional 6 months during your 6th year to set up a mini-fellowship... a number of residents have done this, and have completed 6-month rotations with some of the best surgeons in the US (thanks to Dr. Ehrlich).

As to who benefits? Debatable. Certainly the program benefits from the research and the existence of 2 house traumatologists at all times. However, if you think that the research doesn't help graduates, you are mistaken. Their projects are typically completed LATE in residency, unlike most programs, allowing you to do research in the field you are pursuing. Moreover, any hospital that hires you gets someone with 6-months of attending-level trauma experience at a major trauma center under their belts. While the 6th year might be a little long for some, and probably unecessary for those going into private practice, you need only look at the fellowship pedigrees and staff positions obtained by young Brown grads to appreciate the impact of the 6th year on an academic career... I think it speaks for itself.

personally, i think this program is overall one of the three best I interviewed at (of note, Rochester would have also appeared on this short list). I was extremely impressed by the combination of academic strength with a down-to-earth attitude. Regardless, take all of these opinions with a grain of salt, but take the time to consider the program from multiple angles.

DrH

Kevin Black at Penn State showed last year that an extra year of research during residency did not positively influence residents to enter a career in academics. While residents who did this year of research had more publications DURING residency than those without an extra year, there was no difference in number of publications AFTER residency between the 2 groups.

See CORR 449, pg 89, 2006

Point well-taken... Take note that that is a different issue, however. These are the issues with applying that study to decide whether or not the 6th year positively effects attainment of an academic position:
1) The study asked a different question: it looked at whether the research year shows correlation with the eventual practice of academics. It evaluates correlation with career, not success in attaining academic careers if desired. Moreover, correlation cannot assess cause-effect. You would need a much more extensive, prospective study to study causal effects. Or, you could simply ask chairman whether a research year or higher publication volume would positively affect there choice of prospective attendings (I am sure the answer would sway to the affirmative.)
2) It isn't generalizable: residents were from only 2 programs, with an inordinate number staying in Pennsylvania, and >90% going into private practice (higher then national average).
3) Participation in a research year does not imply interest in pursuing academics, as many of us who have finished the application process know. Most applicants are willing to do a 6th year just to get into a program, begging the question: "How many of the research residents were actually seeking academic careers?"

Regardless, as I pointed out, the sixth year at Brown is distinctly different than almost any other. Most 6-yrs do a research year in their 2nd or 3rd year. If you looked specifically at Brown, results would differ. My memory may be flawed, but I believe that during the interview day Dr. Ehrlich cited a number greater than or equal to 50% for graduates entering academics over the past ten classes... MUCH higher than national averages. i am sure he would be willing to give more precise numbers if you care to ask.