The TOP programs

the topic of what programs are best is hottly debated around here. Basically people on here cannot seem to "agree to disagree". The short of it is, the answer to your question is "it depends". I dont think even the most pretentious name droppers use NIH funding, but that does give you an idea as to how research focused the place is. Not all programs fall under a stereotype. If someone is adamant by saying something like "you definatly dont want to go to a big academic center" or "why would you want to go to a program where you work with mostly private guys that are not well known?" then they are just expressiing their own biases (and maybe insecurities
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) Best advice: think hard at what kind of environment you wanna spend 5 (or 6) years in and what you hope to accomplish when you are done, then ask around for places that match those criteria and dont let other people poo-poo you preferences (like my chairman tried to do) Good Luck

Yeah, I also come from a program that the chair tries to give everyone a certain angle (academic) on where you should be. He is very well known in all the right national circles, but I believe this gives him a different viewpoint than I have. After interview season, I found that the top seven places on my rank order list included only one program on his Big Time programs, and that three of my top five programs (one's I could really see myself spending five years) were on the bottom 1/2 of his list.
Its different strokes for different folks, and you've gotta sit down and really look at where you see yourself in ten years. If you are looking academic, then examine the HSS/HJD, Mayo, Harvard, Iowa, Wash U, Duke's, but if you want to be a top notch clinician then look at the CMC, Campbell, Kalamazoo, Michigan, Ohio State, Georgia's of the world.
I just didn't want to go somewhere that fellows were taking all the cases that I may need to see to take care of Mr. Higginolopalis or Mrs. Jones in my private practice.
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OSB has the right idea. The TOP program is the one YOU rank No. 1. Although USNews (and maybe your chair) has a rank list, the decision is personal.

jesus christ - if i have to hear the: :teaching at MGH stinks to high heavens and residents don't get proficient" one more time i'll throw up.

i did (did as in: blade, not retractors) 300 cases as a PGY-2 last year. all teaching conferences (4-7 /week depending on rotation) are attending directed. there's CORE conference every wednesday 8-12, which is protected time, so no residents in OR or clinic during that time. no saturday conferences. journal club 1x/month, directed by dr heckman, chief editor of journal of bone and join surgery. dr herndon, the program director and president elect of the academy of orthopedic surgeons, has in his 5 years here changed some many things for the better that i don't even know where to start. during his tenure, our OITE scores have gone up from an abysmal 25% to >80% as a program. private surgeons uninterested or unwilling to teach have lost their resident coverage, the program switched from 6 to 5 years, we have started night-floats for all hospitals, comply with the 80hour work-week and 24h call limitation, etc etc.

harvard combined used to have a deservedly bad rep, but that has changed dramatically since dr herndon came on as program director. if you don't want to look at or rank this program, then do it for the right reasons: boston is a big and very expensive city to life in; you work hard; on top of your clinical responsibilities there are academic requirements that other places might not have; big residency program with 10/year spread out over 3 major teaching hospitals making it a little less cozy than smaller places, etc.

but please don't base a decision that will affect the rest of your career on something that somebody heard from somebody else who spent a month there 10 years ago.

if you want to hear more, send me an e-mail, the address can be found on the residency web-page, name's andreas (PGY-3):

PS and no, this is no desperate attempt to make myself feel good about my program - i already do.

I do not mean to offend those who express these opinions, but the decision is not to be EITHER an excellent academic OR an excellent clinician. While I very much agree with BoneDoc's wise statement that people should agree to disagree on what programs are the best fit for them, other posts seem to interpret that to mean that one has to choose to be an academic or a good clinician. It is simply not the case. Surgeons from academic programs are not necessarily inferior clinicians.

It is true that the feel of programs can be very different between academic and more community-based programs. It is true that there are many aspects of academic teaching and expectations that many might not be willing to put up with (for example, doing serious research, knowing who published what paper and when, knowing the history of orthopaedic treatments and disease.) One should not choose an academic program if these aspects of education seem superfluous and annoying. However, should one choose to go for an academic program, with all these extras added in, one is not thereby choosing to be a less excellent clinician or surgeon.

Most academic programs have long histories of turning out excellent physicians and surgeons. Who is especially exceptional has a LOT more to do with his or her brain and hands than it does with training hospital. I am not certain, but I would imagine that the majority of the attendings at these private community hospital programs come from fairly academic places.

Even if it is true that you may have a few fewer primary total hips or femoral nails and few more hemipelvectomies or revision total hips, it is quite arguable that doing hemipelvectomies and revision total hips makes you a better total hip surgeon or general orthopaedic trauma surgeon in the end. However, the difference will be in how you think about things in the OR and clinic. This may or may not matter to you. It may or may not make any difference in the quality of care you give your patients.

Choose what program fits your personality and your career goals, but please try not to insist that everyone else will be inferior to you in your chosen emphasis. Ultimately, as surgeons in private or academic practice, it is almost impossible to tell who is better than whom.

We have all chosen a field that tends to attract highly competitive medical students. During your matching season, you are feeling the height of this competition. Once you are past the match, hopefully, most of you will forsake these petty comparisons and simply choose to be happy and take good care of your patients.

Great post OP1...

Subject: The TOP programs..The End !!