Truths or Just Rumors about California Programs?

There have been a lot of opinions voiced here on Southern California programs, and before I add my $0.02 I should stress that you should evaluate the merits of a program based on your own experience. It is entirely possible that a program that one person finds intolerable would be a great fit for you. When in doubt, rotating at a program, interviewing or even just talking with the residents by email will give you a much more accurate picture of a program than any of the posts on this web site.

That having been said, as a native Californian I don't think I'm a traitor for saying that California isn't all that. The weather may be nice, but where ever you end up for residency the forecast for every day of the next 5 years of you life is going to be 70 degrees with a 100% chance of fluorescent lighting. And California does not have a monopoly on outdoor activities. The orthopeadic programs in Southern California are nothing special. I agree with the statement made in the previous post--you can get better training at many Midwest and East coast programs than even the "best" programs in California (UCD, USC).

I've rotated at UCI so I am very familiar with the program and the facilities. I think UCI has one of the best programs in So Cal--very well rounded, and great operative experience with just the perfect amount of supervision. The faculty are great, and the residency is very low key. You do rotate through other hospitals like Mission, Long Beach VA, and Children?s Hospital OC--but all the residents seem to agree that being at those locations is better than being at UCIMC. At UCIMC the facilities are undergoing major improvement--UCI is currently building an entirely new hospital, which is projected to be completed by 2009, but probably won't be done until 2010 or 2011. In considering UCI you should know that you may have all the negatives of huge construction (**poor parking conditions**) and never see any of the benefits. Currently the facilities are in an ok condition, but the main OR is small.

What I'm going to say now is a family guy's take on So Cal, so this may not apply to most of those single people reading this post. I am married, and will have two children by the time I start residency. Those of us with families of our own have different concerns than single residents. Here's my take on Southern California:

1. California has just about the worst public school system in the country. Even in the very nice areas of Southern Orange County the public schools are languishing under the prohibitive California state budget.

2. Congested Southern California freeways will probably guarantee that at least 1.5 hours of your free time each day will be wasted listening to insipid radio programs instead of spending time reading or at home with your family.

3. Unless your parents or spouse are independently wealthy, you're not going to be able to buy a home on a resident's salary. Housing in the SD, OC and LA areas will be around $800K for a 3-4 bedroom home, and $500-600K for a condo in a safe area. Housing may not be too bad for the single resident who only needs one bedroom or can share rent with a roommate, but for people with families housing is prohibitively expensive.

I'm willing to take a little bit of snow in the winter, or heat in the summer to have a nice, affordable place to raise my family with good public schools. But that's my opinion.

Well, there are a lot of biased opinions on here, and mine will be no different. None of us have worked at all of the Cali programs, so comparing them all is trivial. What we can all do and mostly have done is discuss the plusses and minuses of each place we worked, not just heard through this website. I'll give you my opinion as unbiased as possible on each of the places I rotated at.

The other issue I'll address first because few discuss it, is why we argue about what's the best Cali program to go to? I'll start with a quote from a recent conversation with a west coast chairman, "I don't understand what all the fuss is about the west coast programs. There are numerous better programs in the Midwest and east coast that get far less attention." I mentioned this because I've received the impression, and I'm guessing several others have too, that certain Cali programs are great, UCD for example. While I do agree, it's important to keep in perspective the reasons why we choose a residency. Anyone that wants to get a top-notch training should not come to Cali. While the programs here are good, there are clearly others that are superior. Even the best, perhaps UCD, doesn't compare to the best programs in the Midwest and east coast. Now with that said, having been born and raised in Cali, I'd do just about anything to get back. The bottom line, weather is priceless. There is no amount of money I wouldn't pay for a home in Cali in order to have year round comfortable weather. To be able to play golf in January, cycle in February, and ski in March, it's worth millions over a lifetime. I would gladly pay an extra few hundred thousand dollars for no freezing cold winters and no hot and humid summers. (Many Californians are sick of people crowding us and raising house prices, so they send out negative vibs about the area. I think my opinions are representative for how most of us really feel though).

UCD - I rotated here on the trauma service and unlike everyone else I don't think they are all that trauma heavy. They only rotate on the trauma service 1 or 2 months as interns, 6 months as 2's, 3 months as 3's, and 3 months as chiefs. Compared to USC where they do 21 months of trauma, UCD's 13 months doesn't seem heavy to me. Granted, the trauma service is busy, their morning triage is run by trauma attendings, and you'll work hardest on the trauma service, but at least from what I saw all the juniors left after 24 hours on call and only took call every 4-5 nights. More importantly the only ortho resident that takes call is the trauma junior, i.e. - do I need to do the math for you, you have no call for almost 3 years of your residency, that's as priceless as the Cali weather. The guys and gals here are great, and seem very happy. They have a well-rounded experience, and almost all of the attendings are cool. Like everywhere, there are negatives though. My best example is one day when I ended up being the sixth, yes 6th, assistant on a case. The entire team was scrubbed in, the attending, fellow, chief, 2 juniors, the intern, and myself. Needless to say I could barely see and this gave me a bad taste, but fortunately that isn't common, and in the end I will still likely rank them number 1. Furthermore, having grown up in a town of 150 K, living in Sacramento isn't as bad as many it make out. There are dozens of superb restaurants, several nightclubs, a load of cool bars, and tons of outdoor activities to do. Furthermore, you're only 90 minutes from SF and 90 minutes from the Tahoe, so there is always something fun to do during your brief moments of spare time. It's probably a better place for applicants with families rather than singles/couples, but either way you can be happy as long as you're not longing to be in middle of a huge city.

San Francisco Orthopedic Residency Program (St. Mary's)- Small tight-knit program. Deemed cushy because all five years are home call, and while at St. Mary's you rarely need to go in. On the other hand, because it's small, when you're at Kaiser Oakland or Highland Hospital in Oakland you can be there all night by yourself, and because you're home call doesn't count toward the eighty-hour week, you can end up working a pretty grueling schedule while at these hospitals. Also, one of your two 3-month peds rotations is at Shriners in Sac, so you'll be away from home for a while in your 5th year. With that said, they are all still very happy and they all believe they have it easy. They end up doing ~1500 cases in 5 years; from what I've seen and heard this is very respectable with the 80 hour work week and the reputation of a cushy program. They get great hands-on, personal training, and I guarantee they are never more the 2nd or 3rd assist on any case, usually primary or 1st assist. The residents are all extremely fun loving, easy going guys and gals, and they are all very happy there, it was almost everyone's 1st choice. ~15 rotate, 5 of which get interviews. Another 5 random applicants get interviews, and then they take 3 of the 10 interviewed. They only went to 5 on their rank list last year. The negatives: They are a tiny program with minimal didactics, and minuscule research (don't go here if you care about this). They have a new chairman for the first time in 30 years with a few other potentially significant changes, and St. Mary's is less than dedicated to education, both of which gave me an uneasy feeling of instability. Obviously I'm geographically biased, but if it wasn't for the instability I would rank them No. 1. Taking the instability into account, I'll likely rank them #3 or 4.

so there is lots of info out there about the california programs...some old and some new.... here is my take on some programs...i rotated at UCLA, USC and UCI... - hopefully some others will post to fill in info on other programs...

UCI - one of the best all around programs...the residents operate early and are not double scrubbed...they have attending supervision but by the time you are a chief, you are comfortable running a service and operating on anything...there is a great lifestyle..the residents are very happy and a cool group to work with...plus it is in southern california and the weather couldn't be better! plus -there are no fellows to take cases away from you!!

the only down side is that there aren't "services" - you don't do 6 months of joints or six months of hand...instead, everyday you can be doing anything...some say this is a plus b/c it mimics real life but as a resident it makes reading a bit of a challenge...

USC - good program if you can deal with a county system...the residents are much more supervised in the past and come out of USC with a great operative experience...trauma heavy and fellows are some of the downsides...they have a big class every year and most of the residents are happy....

UCLA - great name but operative experience is not great...you do get most of your experience at the VA or in fellowship...as a medical student, i was scrubbed in behind the 3rd year who was watching the chief fix an ankle- ugh!!...great location, the resdients are happy and they get great fellowship positions... fellows take some of the cases as well and i am not sure the chairman knew all of the residents name...


remember...when you are picking a program you have to decide what is best for you...for some people it is name..for some it is location and some it is operative experience...if you have made it this far..most likely you will succeed no matter where you will go, so just make sure you are happy with your choice b/c you will be there for 5 or 6 years...no one can tell you where to go or what is a better choice...just be excited and get ready to work hard, learn a lot and have fun!!

Bump for the other thread

Here's just another way to look at programs, since residency is hopefully not your entire life (remember, you got to do research too)

USC: disgusting 1923 hospital until they get the new hospital sometime later this decade. Free food. Lots of other residents to hit on, like a city on its own- full of Spanish speaking patients with broken everything. Tienes dolor doesn't cut it here.

UCLA: cool location stuck in the middle of freeways packed with suicide boxes. Get to walk around your neighborhood passing boutiques where a pair of slacks cost $1200. Come out desperately in need of a fellowship.

UCSD: great place to get laid and surf, especially during your research year.

UCD: what's the point of being in Cali if you come to Sacramento. You'll have a better time in a nice city outside cali than in sac. high trauma, almost like USC. For those who seek the "Ortho prestige"

Stanford: can't complain. Full of more bells and rings than I've seen among most programs.

St Mary's: live it up guys, they do it all here. Contrary to its name, strict religioning churchgoers need not apply.

Loma Linda: see above

Harbor: "mini-USC"

Drew: lets not even get into this.

There are many things to consider when looking for a program: didactics, reputation, operative experience, lifestyle, coverage of all subspecialties, size of program, fellowship placement, research opportunities, happiness of the residents, personality of the residents, location (including cost of living, proximity to family, weather, etc..). Unfortunately, there is no such thing as a perfect program. That is great if you find a program that is perfect in every area for you, but it probably won't happen. I know this was something that I struggled with when I was interviewing at the various California programs this past year. When ranking the programs, I had to determine what was most important to ME. The best program in California is the best program for YOU. I was impressed with many of the California programs and would have been happy to match at most of them. I ended up ranking UCLA first. It is an awesome program in a fabulous location that had what I was looking for. I would have been okay in a program where the operative experience was a little top heavy because of all the other great things that UCLA has to offer. This is how I felt. You may not feel the same way, and that is okay. I would have been thrilled to match at UCLA, but I unfortuntately did not. I know it is a competitive program that does not go far down its rank list. If you have questions about specific Cali programs, feel free to PM me.

Here's what I know about these places from rotating/interviewing last year...

1) UCI- great underrated program in Orange County-sweet location. They get a ton of rotators (I think 30+ last year) for 4 spots, so this is probably not the highest yield place to rotate. Residents all seemed pretty cool and happy. They get to operate pretty early here, but they seem to work a little harder here than at a lot of other places. Also, the faculty is pretty small and not much specialty coverage. One negative to this place is that residents spend a lot of time in Mission Viejo, which is a long drive. They may be adding a 5th resident spot this year.

2) UC Davis- some say best program in California, I don't know. Supposedly really trauma heavy, and I've heard not nearly compliant with 80 hr week. Sacramento is not the greatest place to live.

3) USC- This is a huge program- 10 per year. Very trauma heavy with in-house call all 5 years!! This is the only program I recall seeing that had in-house call every year. Get to operate a lot, but not much attending supervision/instruction, and you pay the price with a pretty painful lifestyle for 5 years. But, you will be in LA, and will be a great trauma surgeon when you're done.

4) UCLA- Awesome program in great location. UCLA Medical center is brand new- opening new center next year, and there is a brand new orthopaedic hospital almost finished, opening in 2007. You will probably not see the OR much at all as an intern, but will operate quite a bit as a PGY2 (maybe not as much as at other places) and you are always in OR as 3, 4, 5. The rumors about "not operating" are very exaggerated, in my opinion. Chiefs seemed well trained to me, and all were going on to great fellowships. 2 people volunteer or are encouraged to do a 6th year for research after the PGY2 year. Almost all residents here seemed super happy.

If I had to rank the Cali programs you mentioned, it would go like this: UCLA, UCI, UC Davis, USC.

Ok, I have to bump this again. I am from Washington and am trying to choose two California away rotations during the beginning of my 4th year. Right now I am looking at:

UC Davis
UC Irvine
USC
UCLA

I was going to try UCSF, but their dates don't coincide with my rotation schedule and they say they refuse to make date accommadations on their website. I was also going to try UCSD, but their website says they refuse to accept any visiting students before September, which doesn't work for me.

Has anyone rotated at these schools? Is anyone a resident in any of these programs? Is anyone here from one of these schools? Any information about these programs would be helpful. I need to pick two of these programs for rotations.

Not sure if this will help, but here is my take:
1. UCLA and UCSD. Both are great programs. You will probably operate more at UCSD, but will be well prepared at the end with either. Both have research years (@ UCLA you have a 33% chance). Residents seem super happy at both. The good thing about UCLA is that the researcch year is after your PGY-2, therefore you can moonlight in ortho. In addition, the reidents at UCLA seem to be super happy.
2. Stanford....Great program, operate early and often. Well prepared when they graduate and get awesome fellowships. Lack of didactics is a blessing (concern to some). Happy residents, but expensive area to live.
3. UCSF....Also good, with outstanding reputation. Residents seem to be worked to death. Great city...Residents like to associated hospitals more than their home base.
4. USC....The "working man/woman's" program. The residents their have in house trauma call most years (yes, even as chiefs). If you train here you will be an awesome trauma surgeon without a fellowship.
5. St. Mary's... Very under-rated community program. Great program with supportive faculty. Research is weak, but most do not care. They crush the OITE. Great didactics and the residents probably work the least hours of any cali program. Their rotations at St. Mary's are slow and some take vaction time during these. Very happy residents.

looking through the old posts on this thread it is clear that there is a lot of old/incorrect info - and of course, these are only a few peoples' opinions...

however, having rotated at UCDavis and having interviewed at most other cali programs i have a few points to contribute.

basically:
Davis - awesome trauma and autonomy, ok sports (although with Heiden's blessing you could probably go wherever you want for fellowship), GREAT group of guys, but sacramento pretty much blows (despite it being close to tahoe, etc)
UCSD - i was impressed! residents are happy and ALL love the research year - even those not that interested going in - they operate a boatload and get great fellowships (which i am sure having more publications doesn't hurt). come on - it's san diego after all! and they DO NOT have conference on saturdays anymore.
UCLA - be careful here. there is a bunch of controversy; do they or don't they operate... my experience there was that residents said to me,"this is a program where you need to be comfortable sitting the bench for the first year or 2, then when you get the shot to do it, you do it right" - i guess sitting the bench was just never my style. great lifestyle though if you can handle LA traffic.

that's all I feel I know enough about to really say something. good luck.

Similar question for me - I'm trying to figure out if I should do a sub-I at UCLA or UCSF. I really like both programs for obviously different reasons, but I was wondering if anyone had insight enough to compare the two. I'd say my preference is to be in San Francisco as a city, but I hear the UCSF reputation isn't as good as UCLA. Is this true? How is the fellowship match from each program? How about residency life - good or bad?

Thanks in advance for all your advice.

Thought I would bump this thread up a bit to see if anyone would be willing to talk some more about the cali programs now that the whole ROL process is finished. I'm a third year from the east coast thinking about a cali away elective, especially at either UCSD or Stanford. Any impressions from those of you who spent time there/are a resident there/interviewed there would be appreciated. thanks

UCSF: SF is an expensive place to live, but recently UCSF residents received a large raise. $500 / month for housing allowance while at UC. it still hasn't gone into effect at the VA and at SFGH, but probably will soon. with the extra cash, money shouldn't be a deciding factor. also, it is not a malignant program. the residents are a happy bunch of guys/gals. great group of people.

SF is almost as (if not as) expensive as Manhattan, even surrounding 'burbs are somewhat astronomical. LA can be pricey too, especially in the more desirable areas (i.e. near the beach, west LA). Cheaper rents can be found in the less fashionable neighborhoods of LA, but still $$$ if you compare to rents in the South or Midwest. That said, California is beautiful with many perks, and can be quite addictive. Davis has the reputation of being the best. USC is a huge program (50 residents) that is considered a "working man's/woman's" program - you operate early/a lot, spend a good portion of time on trauma (in house call all 5 years), get minimal didactics, but graduate capable to handle nearly anything. The word is that 'SC grads are as good as fellowship trained in trauma. UCLA: operate late, super academic. Loma Linda: not the most hip of places to live, but you'd be in Cali.

now that several have interviewed at the cali programs are the rumors below true or not?

also what programs in cali have affordable housing nearby for residents? i really don't want to live in a cardboard box in san fran

good luck to all on the interview trail

they're only telling you that eta cuz they want it to themselves!
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cali is great and i'd give a spleen or something else expendable to go back!!!

What about Loma Linda program [please no more comments that the city is full of LA smog and is to hot to live in like I hear from everyone else in Cali]

now that stanford has just named Maloney (from Wash U) as their new chairman, would have anyone have ranked/interviewed any differently?

bimodalortho, aren't you a third year med student in miami? how is it that you were able to rotate at all these places and go on interviews?

my two cents on cali ortho programs is that there isn't a perfect program. each program has tradeoffs, ie, ucd has great training/attendings but get worked hard and have to live in sac. ucla is in a great location, but has a suboptimal operative experience. there isn't really a consensus on what is the best program... if you really want to match in cali, you just have to decide what's most impt to you - location, reputation, training, or resident happiness.

I can understand where you're coming from. there are just so many rumors about the cali programs. Here are my insights


1. UCD
Happy residents, nice attendings, hugely trauma heavy with crappy lifestyle. sacramento isn't for everyone, especially if you're considering the other cali programs.

2. UCSF
Same disclaimer as UCSD (didn't rotate). Great OR experience, great academic faculty who are well known and rapidly diminishing malignancy (many of the older guys, including the chairman, are leaving and the new faculty are supposedly much nicer). You do get worked pretty hard though and the ancillary staff is probably the worst among the major cali programs. The residents are happiest when at affiliated hospitals, not at UCSF med center (probably because they operate more with nicer attendings at other hospitals).
San Fran is a great city too.

3. UCI
Lots of OR, nice attendings, nice lifestyle, not trauma heavy. Not the brainiest program and with lesser known attendings. Orange county can be great or boring. this program is a lot like stanford but with a lesser national name (perhaps undeservedly so)

4. Stanford:
I rotated here as well. The residents were quite happy from plentiful OR time, not being trauma heavy, benign staff, and generally easy lifestyle. However, these aren't the sharpest guys in the world. In fact, i was pretty underwhelmed at the lack of brainy-ness from the residents and woeful lack of academic talent in the faculty (only 2 attendings are well-known)
Tons of clinic, average ancillary staff for california, Palo Alto is either great or boring (depending on your preference) and of course no chairman for three years.
Then again, the residents are happy both inside and outside the hospital.

5. UCLA:
From my experience (as a rotator), the rumors about ucla are all TRUE. The residents really don't operate that much.
I saw fellows fighting over cases, leaving the poor R4 holding retractors. The really poor R2 got to write orders. fun.
some of the residents admitted that only half the chiefs could be competent in general ortho private practice. I believe it since I didn't think the chiefs were particularly talented (largely from inexperience) in simple trauma cases. They're all smart guys but i personally would be pretty annoyed and unhappy working hard but not getting the benefits of operative time. While the residents were indeed happy, they were mostly happy only when they left the hospital.


6. UCSD
I didn't rotate here. All I know is from residents at my home institution and from when I interviewed there. The research year comes after your internship and this SUCKS. Even the chairman admits this is the one thing he would change if he could. The faculty say they don't ask the resident's opinion on the research year scheduling because they know the answer already.
I also thought they exaggerated their OR experience and resident camraderie. They seem like a disparate group with often conflicting personalities - with each other and the facult. Considering how small they are, that could be a disaster.
On the other hand, it's probably not as malignant as people say and like UCLA, the residents are very happy when they leave the hospital (it's San Diego after all).

Oh, they have SATURDAY conferences. terrible.