I pulled a lot out of useful information from these reviews when I was figuring out where I wanted to apply, so I figure I ought to add my observations to the mix. That being said, I think this thread goes a little overboard with the amount of information that’s requested. That is useful in aggregate, but that’s why this site has traditionally kept a google doc where applicants can input their data and others can analyze it. As much as I’d love to brag to you internet strangers, I don’t feel that rehashing my application or telling you where I ranked on my match list adds anything to this other than an opportunity for me to satisfy my own ego, so I’m omitting those parts. And I’m listing programs alphabetically, because no one reading this has any clue who I am or what I’m like, and there were a lot of personal factors in how I made my match list. Everyone is looking for something different in this process, and matching anywhere is a huge accomplishment. Don’t get caught up with things like how highly regarded it is. Whether or not I, or anyone for that matter, liked a program should be irrelevant. The reasons I didn't like a place might be the exact reason that you would love it. You're the only person who knows what will be a good fit for yourself. Just use our experiences to help you make an informed decision.
Spend some time giving some serious thought to where you want to go in your career, and then consider what kind of program you need to be in to end up there. There are some programs you should only go to if you think that someday you might want to be a department chair. There are others where you should only go if it really matters to you that you can leave residency functioning at the level of a trauma fellow. And when you get an opportunity to listen to the pitch at one of these trauma-heavy places or one of these uber-academic places, you should think really carefully about how much that pitch aligns with who you are and where you want to go. If you don’t have a compelling need to do one of those two things, you could probably find a program where you’d have more personal time during residency and there’s absolutely nothing wrong with wanting that. You’ll have tradeoffs at all of these places, and you can’t weigh those tradeoffs until you’ve really inspected your own priorities. Once you’ve done that, find the programs that align with those priorities and then look for a group of people you’ll fit with. This is 5 years of your life. Find a place you’ll be happy at work in a city where you can be happy away from it and don't let anyone else's opinions influence you too much.
I’ve tried to compile as much objective information as I can here. And rather than concluding with what I viewed as the strengths and the weaknesses, I’ve tried to describe what kind of applicant would be a good fit for each place. If that description fits you, then that program might be a good place to apply.
Allegheny General
Camaraderie was a big aspect of their sales pitch – they really emphasized how well everyone got along and how much time they spent together outside of the hospital. They did seem close, but they didn’t seem terribly enthusiastic about their program. Rotators said that the operative experience for the residents was robust and they got a lot of trauma. Weekday call is covered by night float as a PGY2. Fellows on trauma, hand and sports. Sounded like they had good PA support. There is support for research and apparently some residents have been fairly productive, but they stressed that it’s not forced on anyone. Fellowship placement of recent graduates is fine, and the specifics can be found on their website. The facilities were nice. The ortho home base was really big. Stay predominantly at AGH so commuting isn’t too bad, but they have to go to Akron for pediatrics. AGH is currently building a pediatrics floor which will improve the pediatrics experience in Pittsburgh, but the residents will still have to go to Akron. They tried to sell that as a positive by saying they all love the experience there. I still wouldn’t want to get shipped to Akron for several months. Also have to cover high school football games every Friday night. They get paid $150 per game, but I’d much rather have my Friday nights. Pittsburgh is a cool town that’s being revitalized by the tech industry. Most of the residents live in Lawrenceville, which used to be where all the steel workers lived. If you like a Midwest feel and just want to be among a group of really close friends who operate a ton then this would be a good place for you.
Augusta
There is one guy from Wisconsin, one guy from California, and the entire rest of the residency is Southern. In fact, almost everyone is from Georgia itself. This could be off-putting if you’re not okay with some good old boy culture, but they were also some of the nicest people I met during the process. Southern hospitality is no joke, and they made me feel very welcome here. They were incredibly down to earth and inviting. They all felt that it was a good place to live, a good group, they got a good operative experience, they could count on their coresidents to look out for them and they had a solid home life. In the first few lines of the morning presentation people described the program as a bunch of real laid back people who don’t take themselves too seriously. All of my interviews reflected that mentality. Residents never have to leave Augusta for rotations – there is a children’s hospital and a VA onsite and a private group in town who they all work with in addition to the main hospital. The facilities were rather bleh, but I didn’t really care that much. In terms of attendings there are 1 sports, 1 joints, 3 peds, 1 hand, 1 trauma, 1 shoulder, 1 spine, 1 foot and ankle (podiatrist), and 3 at the VA. There’s no oncology rotation. All of the attendings seemed like they’d be tremendous to work with, but I did have some concerns about learning each subspecialty from such a limited number of people. The trauma attending runs two rooms, with a PGY2 covering one and a PGY5 covering the other. Fellowship matches were surprisingly good. Weekday call is covered by a PGY2 night float which handles trauma, hand, spine, peds and the floor. Cost of living is so low in Augusta that residents are able to afford not just homes but large homes. The surrounding area is beautiful, too. This has understandably attracted a lot of married residents with kids, which seemed to make up the majority of the program. Lifestyle was very solid. Everyone shows up at 6:30 for the morning report from the night float resident, with the exception of the trauma intern who comes in earlier to round. Rounding is done between cases. If you’re alright with Georgia culture, a small city, and working in a small department this would be an amazing place to spend 5 years, especially if you have a family.
Baylor University Medical Center (Dallas)
The first question everyone I was with had about this place was how you could be named Baylor but not have any association with Baylor. The story was that way back in the day, the main Baylor hospital was in Dallas. Around World War II, the hospital moved to Houston, which is where the Baylor College of Medicine is now located. Some physicians didn’t make the move from Dallas to Houston, though, and that group continued using Baylor in its name. At the present time the hospital is named Baylor University Medical Center (BUMC). It has traditionally been a private practice group, and they are affiliated with the Baylor Scott and White health system. The orthopedic department at BUMC just started this orthopedic residency. Currently there are only PGY1s and PGY2s. The upshot of this is that the interns are already getting tons of OR reps because they aren’t truly needed yet. BUMC traditionally ran solely with PAs, and it was repeatedly emphasized during the interview day that the department could function without the residents. This means there’s very little scut and it allows them to spend their time in the OR. It also means that the emergency room is used to functioning without an in-house orthopedist, so at least at this point the call schedule is only in-house until 11 pm. The flipside is that there is no track record of fellowship placement for the program, there are no older residents to serve as role models or mentors, and if you make a dumb mistake as an intern it will get caught by an attending rather than a senior resident. However, all residents and attendings insisted that while there is additional attention and the residents hear things “from the horse’s mouth” rather than having them filtered down to them, that this comes along with understanding and patience. Because it’s primarily a private hospital, attendings participate on an opt-in basis, and residents have had a lot of input as to who they work with. The same is true for rotation schedules –the residents have a lot of say. Really nice group of guys – 3 of the 6 were former college football players. Several had kids. All very laid back, definitely a Texas-heavy group. BUMC is a level 1 trauma center, and there are 3 trauma surgeons and no trauma fellow. This means that currently the interns get to be first assist a lot. This will likely change over time as the program matures to a full cohort of residents, though. One PGY2 said he had already done 600 cases and one PGY1 said he had done 200. All rotations were in Dallas. It’s unclear whether or not they’ll rotate through Scottish Rite, but that’s a possibility. There is a new Cowboys training facility being built north of the city that they’ll work at as well. Dallas is a pretty big city, and it sprawls forever because there’s so much space in Texas. There’s a considerable amount of uncertainty here given the short track record, but if you are alright with that, it would be a phenomenal place to work and it would provide some of the best early operative experience imaginable.
Carolinas
Very interesting combination of private (OrthoCarolinas) and academic (Carolinas Medical Center). The line between CMC and OrthoCarolinas seemed to get blurry at times, but it’s estimated that about 50% of the residents’ time is spent in CMC and 50% is spent in OrthoCarolinas. The residents never leave Charlotte and the clinical sites are clustered within a mile of each other - there is CMC, the attached children’s hospital, an attached cancer hospital, and the Mercy hospital. Charlotte is an interesting city. It’s a big banking center, which has ended up making it into a transplant city. It doesn’t feel as southern as some of the other places I visited. It's very spread out. The downtown area is small, not much in the way of a big-city skyline, and it turns into suburbs very fast. There are a fair amount of fellows, however every rotation but peds is set up as a mentorship model. This means that each resident has a specific attending they’re working with for weeks at a time. There’s no crossover in attending assignment between fellows and residents, so in theory they should stay out of each other’s way. The mentorship model is also designed to get attendings familiar with what the residents are capable of on a day-to-day basis in order to maximize their ability to assume responsibility in the OR. Tough to say whether or not the model is better than the typical team-based model, but rotators seemed impressed by the way it worked. The residents were happy, easy-going, and nice. What stood out most was how proud they were of their program, at one point emphasizing that “it really is as good as we make it sound.” Very cohesive-feeling group. Several were married with kids. Fairly diverse group, and I don’t think anyone had a connection to Charlotte. Fellowship placement was very impressive for recent graduates, it’s got a strong reputation nationally, and there are some big name attendings, especially in foot and ankle. During the month of August the interns spend every afternoon working on simlabs, didactics, cadaver labs, etc. in order to get up to speed. Didactics sounded very strong too, and they leverage OrthoCarolinas to provide a strong education in the business side of medicine. CMC is the 6th busiest trauma center in the country and the trauma experience was described as a “high level experience without being trauma heavy.” There are 4 trauma attendings, 3 trauma fellows and 3 NP’s on the service. The NP’s hold the consult pager during the day but residents are responsible for all of the morning rounding. I got the impression that things get pretty rough on trauma, but when working at OrthoCarolinas, lifestyle sounded great. Weekday call is covered by night float, and residents take their turn either in the second half of PGY2 or the first half of PGY3. The night float resident fields peds, hand, spine and trauma consults. There is very little spine call because neurosurgery takes the vast majority of it but lots of hand call because plastics doesn’t take any. Research resources were immense, as CMC and OrthoCarolinas both have fully staffed research arms. One resident per year does a research year between PGY1 and PGY2 and it’s determined after the match. Multiple residents emphasized that one of the things they liked most about the program was that it allowed them to spend time with their family. The perks here were absurd. Lead aprons, lead glasses, loupes, a personal locker in what looked like a country club, and boatloads of free food. If you think you are inclined towards a career in private practice, I don’t know if you’re going to find a better exposure to it in residency than this, and it’s balanced by a strong academic center with a good trauma experience. These residents are taken care of incredibly well, and they seem very happy. You’ve gotta like the mentorship model, though.
Fresno
Newer program that has only sent a few classes into fellowship so far. They’ve done well, though, already matching at UCLA, UW, Methodist, Rush and Orlando. Some of the nicest, most easy-going attendings I encountered during this process. It seemed like a friendly place where the culture is super relaxed and everyone was looks out for each other. Sequoia National Park is literally next to Fresno, and Yosemite is an hour and a half away. One residents said he gets out to Yosemite for day trips roughly once a month. Fresno seems to get a bad rap, but I drove through the northern part of town and could easily have settled down there. There were several residents with kids. Everyone had gone through my application in a fair amount of detail and prepared questions before I showed up, which I really appreciated because that was not always the case. Major draws to the place were the affordability, the fact that it was in California, the outdoors, the operative volume and the lifestyle. Another applicant who had rotated there said there couldn’t have been less pretense, everyone was down to earth, and the attendings treated all of the residents with great respect. The chairman was pretty energetic and excited about what they’re building. Said that they had this massive volume and felt like it was going to waste not having trainees around to learn from it. The program director was a younger guy who seemed very close with the residents. There were a fair amount of residents with California ties, but not an overwhelming majority. Definitely not pitched as a heavy academic program, but there are research rotations in PGY2 and PGY3 to allow you to get some things done. Some rotations are in Visalia, which is a 40 minute drive away, and it sounded like there’s an option to sleep there. There’s also oncology in San Francisco at UCSF as well. Call was a little bit funky. Ortho consults go first into “Gorilla Call.” This is an intern call pool which covers plastics, burn, ortho trauma and general surgery trauma in addition to handling pages for the general surgery trauma list. Every intern does a month on Gorilla Call, covering 10 days of days and 10 days of nights. Gorilla Call weekends are covered by the interns on other services, with a max of 4 shifts per month. It sounds like you’re literally wrestling a silverback the entire night. They were not shy about the fact that these calls can be brutal. However, it means that EM interns and gen surg interns also end up holding ortho’s bomb for portions of the year because those services rotate their interns through Gorilla Call as well. Another benefit of Gorilla Call is that even as a PGY2, someone has staffed the consult before you. There is no night float system, and residents don’t work on post call days. Trauma sounded pretty intense. They’re the sole provider of level 1 trauma care between San Francisco and Los Angeles, and the program just added a fourth resident per class. I got the feeling that they needed that fourth resident in order to address the massive volume. It’ll also be big for the call schedule. One huge perk is their onsite hospital gym, which was really nice. I was really pleasantly surprised by this place. If you’re an outdoorsy type who cares a lot about being a part of a positive culture and is looking for a quality operative experience, you’d love it here. It’s not especially academic, though, and you’d better be ready to work.
New Mexico
These were hands down the happiest residents I have been around. The faculty here is clearly concerned with their well-being and makes a significant effort to take good care of them. It shows. The social was by far the best attended of any I’ve been to. It was at a resident’s house and we hung out around a campfire. It seemed like a good portion of the residents’ wives had shown up as well, and when I talked to the wives they all emphasized how happy their husbands were. The residents came from all over the place, and were a pretty outdoorsy bunch. The attendings seem comfortable trusting the residents to get the job done, and provided them with considerable autonomy. They showed us a tremendous amount of respect, too. The program director knew who I was when I showed up at the social, as did one of the chiefs. The next day, the program director gave a brief introduction and one of his main points was that their goal is to prepare residents to be great orthopedic surgeons but also to make sure they have a good work-life balance, I would love working for him. The city itself is at 5,000 feet of elevation and rimmed by foothills. It gets 300 days of sunshine, and even during the winter people are out golfing. It was 50 degrees during the day when I was there, although it did get down into the 20s at night. I was told that during the summer it’s uncommon to top 100 degrees. It looked like you leave civilization pretty quickly when you get out of town. The residents couldn’t stop talking about the skiing around here – there are 8 ski resorts within a 4 hour drive, ranging from a respectable place to get a few runs in within 15 minutes of town to some places that supply them a lot of trauma a little bit further out. There’s also a lot of hiking, stuff to do in the desert, and the Rio Grande River Canyon. Outdoors was cited by just about all of them as a main reason they had chosen to come here. There is a large meth-head population in Albuquerque, which sounds like a major source of their trauma. There is a PGY5, PGY4, PGY3 and two interns on trauma as well as a fellow. Additionally, there are 2 fellows on sports and 1 on hand. But sports has 7 attendings so there’s enough to go around there. They clearly got all of the reps they needed, it sounds like attendings will let the residents fly once they’ve demonstrated that they’re capable. There is a weekly session where device companies bring out their stuff, put on a lab, and pay for drinks for the whole department that turns into a big social hour. That was cited as one of the main reasons they’re such a close group. Research has not traditionally been a strong point but there is ample support staff around to help the residents with their projects. In order to incentivize it, every publication residents put out earns them $1,000. Lifestyle was repeatedly touted as a big perk of the place. The day starts at 6:30 for everyone, including interns, and by the time you’re a senior most weekends are off. Everyone was able to talk at length about the hobbies they were involved in, with skiing and golfing being the most popular. They told us that “we work our asses off while we’re here, we’re extremely efficient, and then we get enough time at home.” I find it hard to imagine there are happier residents anywhere in the country.
North Carolina
The big calling cards of this program are the strong camaraderie and the mentorship model. It was a fun, warm atmosphere, they were extremely close and everyone maintained active lives outside the hospital, which was encouraged by their attendings. The mentorship model begins in PGY2. This means that each resident is paired up with one attending, and sees patients with that attending in clinic as well as operating with them. They are paired up for 10 weeks at a time. Seniors will help the juniors out with stuff because everyone gathers around the same home base in the ortho library, but every resident is doing their own thing. The downside of this is that senior residents are filling out their own discharge papers for all the patients on their attending’s service, and one resident said that they might not get the same operative volume as senior residents that you would on a team-based system. The upside is that as a PGY2, you’re first assisting on everything that attending does and they work with you so frequently that they become intimately familiar with your capabilities, which allows for growth in what you’re trusted with during each case. I didn’t have any experience with a mentorship model, but I viewed it as a major positive for any program that had one. In terms of program philosophy, the program director showed a powerpoint where he said the priorities of the orthopedics department are “1: education, 2: education, 3: education.” Everything they do is built around maximizing resident learning, and he does not view residents as employees, he views them as students. Chapel Hill is a college town with a lot of really fun looking restaurants, bars and breweries. Housing is pretty affordable, too. Each attending has an academic day once per week, and the night before, the PGY2 working with that attending takes overnight call and then has their post-call day off. They said that there’s a considerable amount of variability in the amount of volume you get. Wake is a separate in-house call pool. Currently there are no fellows but they are adding a sports fellow because there are more attendings than there are residents on the sports service right now. There are daily attending-run didactics. There are also some formal education sessions for the interns called kindergarten, and the PGY2s have a 2 week rotation where they focus entirely on teaching the musculoskeletal block of the MS2 curriculum. Fellowship placement was solid. Residents were open about the fact that if you want to pump out a bunch of papers, this isn’t the place to go because they don’t get much logistic support. The majority just do their one required project and call it good there. Their trauma experience comes at Wake in Raleigh which is a 25 minute drive without traffic early in the morning. Coming back from there if you hit rush hour it can be twice that. If the mentorship model jibes with your style and you don’t have a burning desire to be in a big city, then this would be an awesome place. Just be aware of the commute to and from Raleigh for trauma.
OHSU
The vibe was very down-to-earth and easy-going. Essentially aligned with a typical Northwest culture. One resident said "Residency is hard. We don't make it any harder than it has to be." They get a solid operative experience starting in second year, all rotations are centrally located on one campus (main hospital, peds hospital, cancer hospital, VA and Shriners are all connected by skybridges at the top of the hill), their night float covers everything (trauma, spine, hand, peds), amazing views of the city from all of the hospitals, solid lifestyle, and the attendings are all nice. Majority of residents are single. They are a happy group, they get along well, and they have enough time to keep some hobbies. Fellow interference is non-existent. The chairman is incredibly involved in the residency program – shows up for fracture rounds at 6 AM every day including weekends. Very philosophical guy. There is currently a hospital being built at the bottom of the hill where the tram starts. When it’s finished, they will add rotations there, which would necessitate a separate home call pool. Didactics are all resident-run and research resources are pretty scant, so it’s not exactly an academic powerhouse. The location can’t be beat – the Northwest is a beautiful area. Portland is a weird town for sure, but the surrounding area is unbelievably beautiful, there’s tons of opportunities to get outdoors, and there are boatloads of amazing breweries. Housing costs are beginning to become an issue, as Portland is catching the overflow of the tech industry from Seattle and San Francisco. It seemed it was not a gigantic issue for the residents right now, but Portland has some of the fastest rising rent in the country. This would be a great place to spend 5 years learning how to operate and exploring the Pacific Northwest, but if you have ambitions for an academic career it might not be the best fit.
Rothman
The Rothman Institute is a machine, and the residents are integral cogs in that machine. Rothman has over 20 separate locations, there are 87 surgeons listed on their website, and they run a very tight ship. The efficiency is unbelievable. Because it’s essentially a private practice with an academic arm that’s affiliated with Thomas Jefferson University, there is not much trauma. This is also hampered by the fact that Jefferson competes with Penn, Drexel and Temple for trauma patients. Jefferson does have a trauma attending, though, and the residents universally described him as a fantastic teacher during the interview day. In terms of locations, the residency program is centralized around the center city campus, but they also get out to Bryn Mawr for a more community feel, DuPont in Delaware for Peds, Shriners, and some of the Rothman satellites. This unfortunately means the residents do a fair amount of commuting. Most residents live within walking distance of the hospital in Center City and then commute out to other sites as necessary. The residents are a very nice group. The fellowship match list is just stupid, at least in part because there are world famous attendings in multiple fields, especially joints and spine. Lifestyle here is solid. The lack of a robust trauma service means it never gets too crazy, and the incredible efficiency of the operating rooms away from Jefferson means things get done very quickly. There are a ton of fellows in just about everything except trauma, but rotators insisted that there’s so much volume that they really don’t get in the way of the residents. They do a fair amount of business education for the residents since Rothman is a private practice group. People either love Philly or hate it. Research is pushed on the residents, but there is also ample support staff to make it happen. This residency is an interesting opportunity. The residents are not the center of the show here. You’re a cog in a wheel for 5 years, life is great the whole time, and when you leave you can go wherever you want. Trauma is lacking and you’ve gotta be alright with big-city living.
St. Mary’s
San Francisco is obviously an awesome city, and I get the appeal of the place. Logistically, though, I just don’t get how you make this one work. Roughly half of the residency is in Oakland, and roughly half of it is in San Francisco so right off the bat you’re doomed to commute across the bridge half the time. But even when you’re on the right side of the bridge, there’s still a considerable amount of commuting involved because they get farmed out to a bunch of different places. They work at St. Mary’s, Kaiser, Highland, CHO, and Shriner’s in Sacramento. Add to that the fact that San Francisco has horrible traffic and these residents are spending a lot of their time sitting in their cars. Another issue was the fact that the rent in San Francisco is astronomical. That makes life difficult for the tech workers making 6 figures. On a resident’s salary, it’s a whole different ballgame. They get a $3,500 per year housing stipend, but their salaries are pretty low. If you add the stipend to the salary, they’re making the same as residents in the two Dallas programs I interviewed at. That’s crazy. In terms of the actual program, I didn’t learn as much about it as I did other places because they didn’t do a presentation in the morning. I just showed up 15 minutes before my interview was scheduled to start and then left afterwards. Pretty California heavy group. A lot of California kids refer to it as a hidden gem because they like San Francisco so much. Definitely slanted towards single residents. They field primary call at five hospitals, all of them are separate call pools, and they only have 15 residents, so do the math. Everything is home call, and the residents estimated they come in on about 40% of nights. Majority of the trauma work comes in Oakland at Highland, which is a level 2 trauma center. No fellows. Tons of operative autonomy, if the residents show confidence they are allowed to fly. All didactics are resident run. Fellowship placement is absurd for a community program like this. They have put someone into every elite sports fellowship you can think of. It’s online, seriously, look it up, it’s unreal. I think this program is summed up by the fact that so many of the residents in the program are from California. This is a good place to go if you absolutely love San Francisco.
Stanford
About as academic as one would assume. Interview was pretty intense and impersonal. The residents, however, were very engaging, eager to answer any questions I had, and proud of their program. It’s Silicone Valley so there are lots of young rich smart people out driving around in Teslas and it’s a beautiful city. There are palm trees everywhere, you’re within a short drive of the beach and good hiking, and a 5 hour drive away from good skiing. The tradeoff, obviously, is that it’s so expensive. Housing was described to me as “doable, but you have to dig around to find things.” One resident said "it's tough to make ends meet.” Anyone with a family would struggle to make it work here, and there are only 3 residents in the program with kids (7 residents per year). There is a $500 per month housing subsidy provided by the university, as well as a $3000 moving allowance. The chairman will be the AAOS president in 2017-2018. Sounds like he is not involved much with the day-to-day affairs of residents, but when it comes time to apply for fellowships he is able to pull some serious weight. He also has pulled some serious weight in recruiting big-name attendings to come to Stanford, for instance the former program director from Carolinas who is just starting there. The program director was spoken of very highly. He is very responsive to resident input. This is how they got a night float system. In years past that had been a big concern because residents were formerly taking “home call” and then working post-call days. Total game changer for them to move to the night float system. There are a lot of fellows, and it seemed like that might create an issue for the operative experience for the residents, particularly on joints, spine and trauma. The Valley was repeatedly stressed as the main place where they get operative reps. One resident said that “Stanford is where we learn how to do operations, and the Valley is where we do them.” It was unclear how much residents get to do on each service at Stanford Hospital as well as how much the fellows impact the resident experience, and that was my main concern. Fellowship placement was mind-blowing. Every single person was going somewhere insane. The hospital they’re in is really nice, and they’re building a brand new one. There will be 70 ORs when they’re done, and they told the chairman he could have all 21 at the original hospital but he turned them down so he could have the ones in the new building. Plenty of research opportunities available, and most residents get a lot done. If you are single, wouldn’t mind bunking up with some roommates, and think that a career in academics is in the cards for you, then this would be right up your alley.
Utah
This is what every academic program should strive to be. The didactics are perfect, I can’t imagine anyone managing to teach residents better. The residents were stupid smart, and could rattle off answers to pimp questions like nobody’s business. The attendings were passionate about education. Salt Lake City is the coolest city in the world. There’s world class skiing within a half hour of the city, it’s absolutely beautiful, the culture is laid back, and the city is spacious. Unfortunately there are separate call pools for trauma, peds, and the VA, and anytime a spine trauma comes in the senior resident on spine is required to staff it instead of the night float. Additionally, there are a ton of fellows, and this pretty significantly impacted the resident operative experience. While Utah doesn’t sound like a big name, the program’s reputation is very elite, and the fellowship matches aligned with that reputation. All of the rotations are clustered on one hill so the residents never have to leave that area. If you want to be at a place where you’ll learn orthopedic literature inside out, crush the OITEs, get whatever fellowship you want, and leave open the possibility of being a bigtime academic surgeon then you won’t find anything better than this. Bonus points if you’re big into outdoor activities. If you want to learn by doing, you’ll be able to find places that will give you more opportunities to get your hands dirty.
UTSW
If all you care about is trauma, then you won’t find anything much better than this. Felt like a real work hard-play hard type of group. Almost had a frat-like feel to it. They definitely prided themselves on how hard they work. There was a board in the resident call room where all of the PGY2s tally the number of consults they’ve seen in the year, and they were all pushing 500 by interview season. Brand new chairman just took over and has a pretty grand vision for the department. They hired 6 new faculty in the last year, and the chairman put up a slide showing that he wanted to add 7 more faculty in the next year. There’s also a merger underway with another health system, and additional facilities are being built. Trauma seemed to not just be their strongest suit, but also their identity. There are 5 trauma attendings and I got the definite vibe that all of them are very busy. All of the trauma happens at Parkland. There’s so much trauma coming in that they have two separate trauma services. There is a PGY2 and a PGY4 on each of these services, and the operative experience is generally centered around the PGY4 teaching the PGY2 how to do the case. I heard this described as “trickle-down” education. The senior residents take a lot of pride in the junior residents, especially the PGY4s with the PGY2s since they essentially teach them everything. The PGY2s play a big role in the weekly Wednesday conferences and I was told that it was not uncommon on Tuesdays for the PGY2s to operate late into the day, take care of rounding afterwards, and then pull an all-nighter before Wednesday morning conference so they could pull together their case presentations. Research is available, but the residents work so much that they don’t have time for it. The requirement for resident research publications has also been increased from 1 to 2. When the PGY2 on our tour talked about this he wasn’t sure how they were going to accomplish that because they “already work the maximum hours in a day” and they don’t have any protected research time. All rotations are in Dallas: New Parkland, Old Parkland, Scottish Rite, (a very highly regarded orthopedics-only pediatric hospital), VA, Children’s, and two UTSW hospitals (Clements and Zale). They just built new Parkland Hospital and it lives up to the reputation of Texans liking big stuff. There’s an option to go to Norwich, England during PGY5 year which is dependent on OITE scores and research publication. During the social I was sitting with several other applicants who hadn’t rotated and the residents never made an effort to talk to any of us. We were told that a big part of their applicant selection process is essentially proving that you can handle their workload, so non-rotators need to come back for a second look to have a chance. I elected not to do this. If trauma is what matters to you, you’re going to be hard-pressed to find a place where you’ll get more of it than here. And you’ll become a part of a brotherhood in the process. You won’t do much else for 5 years, though.
Yale
I had concerns coming into this one that it would be an elitist, pretentious, Ivy League environment and that couldn’t have been more inaccurate. Very easy-going, friendly, warm, collegial, and inviting. The residents were cracking jokes amongst themselves throughout the entire introduction talk, the attendings I interviewed with were all very interested in getting to know me as a person, and the overall vibe was fantastic. Applicants who had done subinternships there insisted that I was getting the right read on the place, that there was no hint of Ivy League pretentiousness, and that the residents were a great group who had a solid relationship with the attendings. Described repeatedly as a “resident-run program”, meaning that residents make a lot of the decisions about the program. This included setting their own call schedule, deciding which speakers to invite to give guest grand rounds, and which changes would be made over time. This is generally viewed as a positive aspect of the program because you have a lot of autonomy, but it does also carry some extra administrative responsibilities as a senior resident. Yale has only had 2 chairmen in their approximately 50 year history, and the second one just stepped down although he has stuck around and continued practicing. Residents were a very diverse group. Self-described as a little nerdy, which was fairly accurate, however they were all personable, outgoing and energetic. They universally seemed happy and were very open about all aspects of the program. For call, interns have night float and run the floor. PGY3’s have q4 24 hour shifts where they take consults overnight, then have their post-call day off. Sounded like all of the single residents lived in a couple apartment complexes that were within walking distance of the hospital while the married residents either rented or owned homes about a 10-15 minute commute out of the city in more suburban areas. There was a gigantic lineup of food trucks directly outside the hospital that blew my mind. Residents insisted they usually had time to grab food at the food trucks between cases. It must have been a quarter mile of food trucks parked end to end. It was unbelievable. Anything you could think of, there was a food truck there cooking it up. I cannot emphasize enough how amazing that lineup was. It influenced my rank list more than it should have. They get a ton of trauma because New Haven is at the intersection of all the main highways between New York and Boston, and this dropped a lot of MVC’s on their doorstep. Apparently there’s so much volume that roughly 30% of cases go uncovered. There is one trauma fellow. They have a second hospital, St. Raphael’s, which I was told was within 5 minutes of the main hospital. All of the elective cases are transitioning over there. Everyone emphasized operative experience as a strength of the program. In the words of one of the chief residents, “I don’t know how many repetitions you need to be good at basic orthopedic procedures, but whatever that number is, I know that I’ve hit it.” Applicants who had rotated here agreed that the operative experience was solid, with good early opportunities and graduated responsibility. The seniors typically run their services entirely independently, too. There is a feeling-out process where the attendings ensure that the senior has everything under control, but once they trust them, it becomes a “call me if you need me” relationship and they’re allowed to run the show. They only addressed fellowship placement by showing the highlights, but they had been pretty successful. Ample opportunities to conduct research thanks to 10 week research rotations in third, fourth, and fifth year. Additionally, the residents at Yale get paid absurdly well for living in New Haven. They have to have the best cost of living:salary ratio in the country. If working in a blue collar program with a white collar name sounds appealing to you, you’ll get that along with a tremendous lifestyle thanks to the research rotations and the salary. And seriously – those food trucks are amazing.
but there’s clearly enough volume to go around. Research opportunities are plentiful and they said they have the more NIH $ than any other ortho hospital on interview day. Absolutely no areas of specialty weakness.
