In no particular order

UPenn, UCLA, UCSF, Harvard, Columbia, Mayo, Wash U, HSS (definately dont think its the #1 residency program), U of W and Brown.

My top 10:

1. Wherever I match
2-9: Wherever I can find colleagues who have outgrown this conversation.

My top 10]

word.

Agree with MD007.

I cannot comment on some of those programs because I didn't interview/rotate there, but I've heard good things about all of them.

Of my interviews, WashU was probably best overall. Obviously Mayo and Harvard are stellar. UW was good.

I think Campbell Clinic and Duke should be included.

My top 10]

*thumbsup*

also applicable: 2-9: wherever people realize the "Best" program is the one that is "best" for them, their learning style, their personality and their geographic preferences. the shifty enigma of reputation comes and goes.

Totally depends on what you want. Some are the best for research, some for operating a lot and some have a lot of good people to hang out with. Highly doubt that anywhere is the best for all of those things.

In regards to Penn:

Just lost big shoulder chair to other major center

Spine is in the shadow of other major center in Philadelphia

Not sure if they cover any prof sports teams

No spine trauma

Seems like it rides the ivy league name, not sure what the hype is about.

Dude,

I can personally tell you why Penn is a great program, as I am an intern there now. First and foremost, the focus is on teaching you to be an orthopod, which, I can only assume by the fact that you post on this site that you want to be.

It may be too late for you, as the date for certifying rank lists is over, but for next year's crop, I would recommend remembering that staff comes and goes for reasons that are beyond your control. When choosing a residency program, the important part is a program's philosophy. Penn's philosophy is teaching residents. This is evident in the following way. Where other programs take a lot of fellows (which tends to dilute the operative experience) Penn does not. Penn has a complete contingent of Subspecialists, including Spine, Joints, Hand, Trauma, Sports, Foot and ankle, Shoulder and elbow, Tumor, AND neuro orthopaedics. It is, therefore an extremely well rounded program.

Things like covering sports teams, big names, and fellows may seem like selling points, but the reality of things is that when there are big names, more often than not, fellows are doing the operating, not you, and you are not going to do an ACL on Donovan McNabb, the attending is, and when there are a lot of fellows around, YOUR operative experience is going to be diluted.

I would therefore caution those who go into this next year to focus on programs that have a philosophy to teach you to be a great orthopod, and not to fall for some of the flash that is out there, and choose a program that will teach you as opposed to a program that will scut you and not care about your education. I invite any MS 3 now to rotate with us, and rotate at any other "top" place, I think that they will find that we compare favorably.

Fatman

well I think most ortho programs want to teach...

Penn is a good program. I do think it rides the Ivy league name...and this is the reason it is sometimes mentioned along with some of the academic powerhouses. But in orthopedics, Penn is a good clinical program but is not an academic powerhouse, except the peds department at CHOP.

I completely agree with Fatman. I know UPenn quite well, and I would rank UPenn to be one of the top 5 programs in the nation. Definitely, stands along side of Harvard, HSS, columbia, Hopkins.

I interviewed at all of them, and unfortunately, many of them have great attendings who won't let you operate. "This guy is world-famous, but won't let you operate." "This guy invented orthopaedic surgery, but won't let you operate." "This guy is the god of sports medicine, but won't let you operate." I won't mention names here. UPenn is one of the few academic powerhouse that stray away from that. I thought columbia and Hopkins were similar in that regards.

I honestly don't care about fellowship since everybody does well in them, but UPenn does produce a lot of leaders in orthopaedic field and that says a lot about the program. The residents were polished when I interviewed there, and they were UNIVERSALLY very very happy with the program.

With all due respect, I disagree with orthogater1. I would humbly suggest checking out his previous post on orthogater1's rank list to see what he considers the top program in the nation. Maybe other than UVA, I've never even heard of most of them. Seems like another one of those bitter-revenge post to me.

So far, I've defended two programs: columbia and UPenn... Everyone should realize that the more people try to trash the program, the more it adds to their greatness.

It wasn't a flame, or at least it wasnt meant to be. I just didnt see what the big appeal was about their program. Versus going after my rank list, which is extremely adult.

I rotated and interviewed at Penn. It is a good program but like all programs it has its deficiencies. They definitely put on a good show on the interview - moreso than the rotation. Nonetheless, it is a solid, solid place to train, and I would recommend it to anyone.

"Academic powerhouses" publish in large quantities. Places such as Iowa, Mayo, HSS, Wash U publish extensively and in a variety of subspecialties. The faculty at Penn don't publish much in the MAJOR ortho journals...the faculty at CHOP do, but not much else.

Let's not throw that word around so much without knowing what it means.

My 2 cents

1st off, when someone tries to knock a program by saying that "the dont cover any pro sport team", like orthogater1 said, its hard to believe that that person knows what a solid program is made of. Last I heard Mayo was not taking care of any prosport team in Rochester, Mn.....dont hear people complaining.

Pen probably does gain some benefit from its Ivy League name but so do other Ivy programs. Harvard ortho (which is a great program) would not be as competitive if it was not Harvard ...but that is irrelevant.

I think that some might underestimate the importance of good training. I think its the most important aspect of a good residency program...dont want to leave feelining incompetent. Penn excels at this and from an academic stand point, they have RESIDENTS that match associate professors from a publication standpoint. That is uncommon at a lot of "powerhouses".

The program also has an exceptionally collegial athmosphere that you would not find at many places. The residents are very fun and at the same time talented.....it is not uncommon to find residents who ranked Penn over the other "very top programs".

Spine is a weakness at Penn

Trauma is a weakness at HSS

Sports is a weakness at Mayo

Harvard is a somewhat disorganized

etc

My point is all great program have their flaws.. cant think of a program that doesn't. They can all get you great fellowships where you can specialize.

Thanks Banging_bones. Nice way to sum it all up. Strong work.

loving_ortho

I concur.

Here is all I am saying, regardless of anything else, when considering a residency program there are a number of things which anyone should consider, and some which are going to be specific to the individual.

Things that anyone should consider:

1. What will my life be like in each PGY year? This is particularly important if you are married

2. Will I learn what I need to without a lot of needless scut. Some scut, believe it or not is actually useful, as it teaches you to care enough about patients to do things which can be painful.

3. Will I learn what I need to to be able to answer 95% of patient's questions (and examiners questions when it comes to the boards)

4. Will I be able to be a competent surgeon that will go on to a fellowship in the area of my choice, or be able to come straight out of practice and be a general orthopod.

5. Does the program have a teaching style that is conducive to my learning type? (Ours does preceptorship which accomplishes 2 things, assures operative time, and gives one on one training with attendings).

There might be some things I left out, but I think those are the main ones.

Individual things are is geography important, spouse/ significant other preferences, academic v clinical etc.

I think only then can you determine YOUR top programs, and that is really all that matters.

His adiposity

Fatman

i am glad that you all came to a conclusion on this discussion ... the fatman summed it up ... i think you all get caught up in the ranking of programs ... who is the best ... the best is different for every person ... and is different on the east coast than on the west coast ... academics and community ... so, fatman and all thanks for summing it up ...

i am going to refer to a couple of things i posted ... read them if you want ....

My Rank List

My residency is better than yours ....

thanks all

Just wanted to chime in...

It's really easy when looking at programs to get sucked in to the big academic names that get thrown around on this website and the circuit. Think more about what you want to end up doing. If you want to do a lot of research and be a chairman someday, then yeah...check out the big names (i.e. HSS, Harvard, Hopkins, etc.) You'll have the name, research opportunities, and connections to flourish academically. You may give up some things though...like lifestyle, more personalized teaching, one-on-one OR time.

These are generalizations, of course. There are obviously big places that are well-rounded (Case Western comes to mind.) Just be wary of thinking you'll only get good training at the big academic places. You'll be a great orthopod no matter where you go given you stay disciplined and motivated.

To mention a few specific places. I rotated at Penn as a student. I agree that it does get a lot of attention because it's Ivy League, but it's a great bunch of guys and the staff is dedicated to teaching.

I've spent significant time at Hopkins. It DEFINITELY get undeserved attention/credit just because of the name. Ortho is the red-headed step child of the hospital and gets crapped on. There's tons of NIH money at Hopkins, but NONE of it goes to ortho. Also, it's an extremely tense and unpleasant atmosphere. The residents get abused, mostly as juniors and on call; and it gets to them after a while. They're losing their only foot and ankle surgeon, and the hand rotation is next to worthless with very little volume. Peds and the rotations at other hospitals are the highlights.

Find a program that fits your personality and career goals.

This topic comes up every other year. Someone will sing UPenn's praises and invariably someone will make some negative comment. I've posted about this topic sometime ago. I rotated at UPenn as a med student and at Jefferson. I've said it many times before and I'll say it again: Upenn is NOT the best program even in Philly. Jefferson is hands down the better ORTHOPEDIC program. The volume of surgery at Jeff is staggering. And don't be fooled, it's not just joints and spine. all specialties are covered.

I enjoyed my time at Penn and do believe it's a good program. But I agree with the poster who stated that it's reputation is somewhat based on its Ivy league name. This is absolutely true. Similar with Hopkins as Sawbonz stated. But fatman is correct in saying that Penn has a good program and the residents were very happy when I rotated there as well. But sorry fatman, Jeff takes the cake in my book.

Staff - Thanks for your effort to publicly reflect on these topics.

In my opinion, one line you said in particular really drives this topic home, at least for me:

"Being a great researcher does not correlate with being a good educator."

Your blog helped me make my rank list on February 20th. I'm sure there are others, and hopefully that gives you some encouragement to continue.

Thanks