Top 20 Orthopedic Programs

I agree you want to come out of residency well trained technically. That said, I dont think you need to do 100 DHS cases during a 5 year period to become skilled. The advantage of the big name programs is the wide variety of cases one encounters. I'm no expert, but I doubt many community programs see a ton of brachial plexus operations etc, etc.

re previous post.

while there many people have listed the same programs. clearly others have suggested some about which there is no consensus. it is misleading to suggest any program can be top 20.

I agree that it's impossible to make a top 20 list for everyone, but I wanted to give a shout out to NYU-HJD....definitely top 20 if you want either academics or private practice. I think it sometimes gets overlooked because it's in the same city as HSS, but this place is an extremely strong program and was the most balanced place that I interviewed at. It's very pro-resident, they have a great chairman(Zuckerman), great didactics, operative experience is awesome, tons of research opportunities if you want them, outstanding group of guys that are probably closer than most small programs, and of course you're in a sweet neighborhood in NYC.

You are probably right about brachial plexus surgeries at community programs, there are probably only a handful a year here. However, unless you are going into hand, in which case, you will be doing a hand fellowship, it isn't really necessary to see many, or any for that matter.

Once again, I would stress that top 20 is dependent on what you want in a career. If you want to go into academics, you will most likely want to go to a big time research place with the names and contacts to get yoru career started off. If you know you interested in being a sub-specialist, you may want to go to a place with some big names in that particular specialty. If you want to do a fellowship, but still practice a fair ammount of general orthopaedics, or be a generalist, you will likely want to go somewhere that will get you the best operative experience possible. For me, it was a no-brainer. I knew I wanted to be a generalist and I am happy to be training at a place that has allowed me to be primary surgeon, or first assist on almost 100 TKAs at the midway point of my PGY3 year.

the SEC is king (followed now by the ACC). Texas had their year, but if a team can go undefeated throughout the regular season and the SEC championship game, they shouldn't even have to play for the national championship - just give it to them, because their conference schedule is the most punishing by far. Look at USC, Texas etc. - 2 MAYBE 3 tough teams all year, blow out the cream puffs and walk in healthy to the bowl games.

damn, dude, you make me proud to be a texan.

cheers.
firegirl

I'm currently an intern at U of M. I ranked this program in my top 3 and am very excited that I matched here. I don't think I could be happier at another program. I also don't think there is anything "keeping it from glory." If anyone has any specific questions or concerns, please feel free to email me (Apurva Shah - [url=mailto][email protected][/url]).

After interviewing or speaking with people who interviewed at these places, the top I saw/heard about were:

Very Top Tier
HSS, WashU, Rush, Duke, UCLA, Mayo, Iowa

Top Tier
Pitt, Harvard, Campbell Clinic, Cleveland Clinic, Case Western, UCSF

Other Top Places
U Washington, Michigan, Hopkins, Vandy, UC-Davis, Loyola, Northwestern, UT-SW, Florida

Hope this helps. Each program has its strengths and if you really want to be sure you are going to the best place for you (and be a good applicant) do some research. If you know you don't want to do trauma, and are trying to decide between sports, joints, or spine somewhere like Rush or HSS would be your top choice. If you like Peds, pick somewhere with its own Peds hospital and a large peds department to get a broad spectrum of approaches and multiple perspectives on indications and treatments. If you know you want to do research go somewhere that offers a 6th year (Case, Cleveland Clinic) and has big researchers. If you don't know what you like you can narrow it down by city, area of the country, research, time with community docs, etc.

It is interesting to hear people talk about choosing residencies based on what they think they want to do (sports, spine, etc) Every resident in my program that is doing a fellowship in something came in thinking they wanted to do something else. I came in thinking I would do spine (cant remember why i thought that now). That lasted until about halfway through my second year. I discovered I really liked trauma and now am going to a great trauma fellowship in 2007.
My point is that choosing a residency based on the fact that they may have a strength in the area you THINK you want to go into could be considered short sighted. I think you would be better off to find a place that gives a good broad exposure. You might be surprised at what you end up doing. Also, dont underestimate the effect of the faculty you work with in a certain area turning you on/off to it. You may think you wanna do hand but if all the hand attendings at your residency are jerks you probably will have a bad taste in your mouth about the field. A lot of people ask me how I can do trauma b/c, I will admit it, there are plenty of traumatologists around with "personality issues". However all the ones I have personally worked with have been super cool, down to earth people, including my fellowship directors so that was never an issue with me

Bottom line is to keep your options open so early in your career

I agree with bonedoc. I've wanted to do sports medicine since college, and that had absolutely no bearing on the program that I picked for residency. And any one who knows CWRU's program knows that sports is in no way, shape, or form our strong suit. I picked CWRU because, of the 12 places that I interviewed, it was in my eyes the best "total package." And for me that meant getting a broad exposure to EVERY single aspect of Orthopaedics and being comfortable handling most general Orthopaedic issues. I also wanted to go to a place where the residents got the crap kicked out of them on trauma call. Why? Because just about all Orthopods need to do trauma, and I wanted a "mini-fellowship" during residency so that I will be able to handle most general trauma things that will come across my door step or at the very least do the appropriate damage control and not screw the traumatologist that I'm gonna send it out to. So that's my take on it. Pick a place that's gonna train you to be a good Orthopaedic Surgeon. Not just a good trauma, spine, sports, upper extremity, joints, peds, hand, tumor or foot/ankle guy. Sorry about the shameless plug for CWRU
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Bone_Jock

While I understand the points being made here, I doubt you would get a poor training anywhere you go in orthopaedics. I asked the same question at every interview with a chief resident-would you feel comfortable going out into the real world and dealing with any general orthopaedic (including non-pelvis trauma) problem that came into your office or ED-and they all surprisingly said yes. Therefore I came to the conclusion that there is little chance a program will be accredited if you do not get an overall good, broad training, and if this is the case why not go somewhere that has some big names in the area you are interested in.

I got to disagree with the last poster. One of my attendings told me about a former fellow at our program. He came from a different program which is known for a lack of operating experience for the residents and hardly any trauma. This fellow consistantly had to call in other people to help on Trauma call because he didn't know how to handle the cases that came in.

I would agree with this. We have an attending at my program who is good at his particular specialty, but only b/c he did a fellowship and got great training that year. He admits he did his fellowship b/c he felt unprepared surgically and wanted get good at one small area so that he could focus on that and not do stuff he is not comfortable with. Dont get me wrong, he is very good in his little niche, but not so good with everything else.

After talking to attendings and friendly PD's at my home institution and on my aways during my 4th yr, i think these are the consensus top tier programs:

HSS, UCLA, Mayo, Iowa, UCSF, Harvard, Case Western

I agree with the previous post that most of us agree on about 75% of the programs, and those are probably the true top tier. In talking to attendings though, they seemed biased towards programs where they knew the faculty on a personal basis...interestingly, I didn't find much of a bias regarding where they trained.