When you say DO a lot what do you mean? I guess I'd rather have the opportunity to see more ILD's and alpha1's at the end of the line and get comfortable with their management rather than do my 300th IJ or Bronch. Did you feel that the interventional/clinical skills were deficient at these places because they farmed out what should be fellow procedures to other services or that the numbers just weren't where you wanted them to be? Also JDH I kind of want to try the physician scientist deal only because its really the last time in the development of my career that I get the opportunity, maybe the ratio will change I just don't want to look back with regret.
What I meant was that the 2nd group of programs I mentioned are a lot more research-focused, and the procedural training is not as good, and it's not like their particularly stand-out when compared to the first group in terms of the diversity/complexity of cases they see (except OSU, Yale for transplant - they're firing back up).
Indiana and UCLA for example see tons of everything and their physician-scientist track is very, and I mean very well laid out. Indiana has a Master's program that is very well integrated into their 36 month fellowship, the mentors are amazing, and their clinical rigor IMO is hard to beat.
UCLA's clinical stuff is top-notch, and for fellows who want to take the physician scientist track they're very open about advertising that they'll support you 100%. In fact, they guarantee you a slot as junior faculty after you graduate and will 'keep' you until funding hits if you show commitment and promise. I haven't been to any other place that's so supportive.
Mayo and CCF - you'll see a lot more complex ILD/end-of-the-road/crazy stuff than most other places, and can go be an 'ILD expert' elsewhere when you graduate from these programs, and be great with procedures as well. Both do provide the option of some career development as a physician-scientist, but it's somewhat less well structured.
I haven't interviewed at UPMC/UMich/UPenn/UCSF but of the places I've interviewed at, the Yale program seems to offer the most options in formal education as a researcher and the flexibility and support to mould your research trajectory as you like, but you'll have to forget about the possibility of being able to do EBUS on your own when you graduate. They also don't tube their own patients (to me, that's very important. It's my patient, I'm at the bedside, and I should be comfortable tubing them). Most of the big name north east programs just about meet the ACGME requirements for regular bronchs, and that's about all they're doing for procedures other than thoras. In fact, I know from speaking with my attendings/seniors that at regional conferences/skills labs, UMass/UConn/Rochester fellows are miles ahead with procedural skills.
I know that I would love to match at my #1, but I know for a fact that I'd be perfectly happy and content matching into any of my # 2 through 8 as well. There's a LOT of absolutely awesome programs out there. I started out the season really looking for that physician-scientist track and star-struck about interviewing at some places. After talking with faculty, getting a better sense of what the reality of it is like, I decided I'd been a little naive, and would not compromise my clinical training at the cost of my research training. I personally hate, and have no interest or skills with politics and one-upmanship. I will absolutely do research in the future, there are some burning questions/theories I'd like to test out, but probably in a little while.
One important thing - the confounder, that grain of salt. Every interviewee's experience/day is slightly different. After that, it's a personal choice as to what you want most at the expense of, or in addition to what. I remember you had some awesome calls...all the best!
It won't be snowing, nor will it be 'getting away' from the summer heat that time of year! ******s! Oh well, once in a while I guess you should actually attend the sessions at at least one conference you're paid for to go to...
