:smokin: I'm currently chief resident at Columbia and will tell you that it is not a "2nd Tier" program. Contrary to what you have heard, it is one of the best, if not the best program in NYC. The program has no weaknesses and is well-balanced in every regard. We have the best Shoulder Service Around, we also have every branch of Orthopaedics covered-- we have: Peds (The only Babies Hospital in Manhattan), Spine, Hand, Sports, Foot/Ankle, Joints, Tumor and Trauma with Roy Sanders in Tampa (all NYC residents have to go to other hospitals for their trauma because trauma in NYC is down overall). The caseload and mixture of cases is competetive. Our out-pt experience is exceptional. We recently went to a night float system, so we may comply with resident work-hour limitation laws. Now most residents are on-call on average q4 to q14 ( I wish I had that when I was a junior resident). We take 6 residents a year (unlike 8-12 residents taken at "other" top NYC programs), so every resident gets personalized attention, is known by the chairman and DOES NOT get lost in the system. Dr. Bigliani is our chairman and one of the world's best known names in orthopaedic surgery. He has improved the program such that we can now compete with any program in the country. Year after year, we send residents to the best fellowships in the country. Just this year, we are sending one to LA Children's for Peds, one to HSS for Sports, one to Pittsburgh for Sports and one to Harvard for Joints. So I would be careful on how you categorize programs before you see them for yourself. If you are fortunate enough to come interview here, you will see what I mean. I am very fortunate to have been a resident here at Columbia-Presbyterian Medical Center.