Programs to look at

[cubsfan]

So as a budding 4th year planning to apply into PM&R, I am starting to research programs to apply to...my question is besides the big name obvious programs (RIC, Kessler, NYU, Spaulding, Baylor, UW, UMich, Philly programs, Stanford)...I was curious what other programs are great all around but kinda fly under the radar (maybe like a Charlotte, OSU, or Mt. Sinai?)

Thanks!

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[Atlantic]

I would say that last year I "over-interviewed" but in the process found some awesome programs in unexpected places. The two that really stood out to me where Charlotte Institute of Rehab and the University of Alabama. Even program directors at big schools mentioned the quality of these programs. And honestly, I almost cancelled these interviews...but I'm glad I didn't because they were at the top of my rank list in the spring.

 

[axm397]

So as a budding 4th year planning to apply into PM&R, I am starting to research programs to apply to...my question is besides the big name obvious programs (RIC, Kessler, NYU, Spaulding, Baylor, UW, UMich, Philly programs, Stanford)...I was curious what other programs are great all around but kinda fly under the radar (maybe like a Charlotte, OSU, or Mt. Sinai?)

Thanks!

I also liked JFK in NJ (small but quality)

 

[paz5559]

I also liked JFK in NJ (small but quality)

Stanford should not be on your top tier list. NYU USED to have a great reputation in PM&R, but those days are long gone. While Temple and Jeff are great programs, it would be tough to argue Penn belonging in anyone's top tier list.

I echo Charlotte and JFK, and want to make sure you also consider MCV on the east coast, Utah and in the west, and Indiana in the midwest, all of which are well respected second tier, or perhaps even sleeper first tier programs.

San Antonio and Colorado don't get a whole lot of ink on this board, but they, along with OSU, in my mind are very close to the equals of the old guard (and in the case of OSU, Earnie Johenson IS the old guard himself). IMHO they are clearly members of the elite group of programs.

UAB is a second tier program, and clearly well respected, but it would be a reach to put it in the top tier. Mt. Sinai is a good inpatient program, and Columbia/Cornell is a terrific option as well if you have to be in the City. That being said, none of the NY programs measure up to either of their Jersey competitors.

 

[rehab_sports_dr]

Some excellent smaller programs include Pittsburgh, Virginia, Indiana (IUPUI), JFK, and UC-Davis. For each of those programs, though, they tend not to be as comprehensive as some of the bigger programs, so you may want to inquire more about particular areas of interest (e.g., Pittsburgh is especially strong in TBI, Indiana in musculoskeletal/EMG, Davis in Pediatrics), etc.

I can only speak of Mount Sinai as an outsider, but I have been impressed with the newly recruited faculty, and they appear to have emerged as the strongest overall program in NYC.

I also concur with Colorado as an upper tier program. Charlotte also seems to have a good buzz about it.

 

[stumpjumper94]

I think overall, the quality of the programs across the board have improved significantly over the years. I think there are programs that clearly have progressed more so than others but for the most part, 1st tier, 2nd tier, etc is simply based on heresay than objective measures. When someone ranks a program as 2nd tier, you may interview there and consider it the best program for what you're looking for. So when people like Paz puts a program down in the 2nd tier, just know that these are his opinions. Personally, I think that a program like UAB is not a far stretch from the top tier if its not a top tier program already along with many others that are not normally considered as such. I just have a thing about putting a program down if you haven't personally trained there yourself and are just basing it on heresay. iI know this doesn't help your question, but just know that the gap between many programs is closing quickly as you will find on the interview tour.

 

[paz5559]

I think overall, the quality of the programs across the board have improved significantly over the years. I think there are programs that clearly have progressed more so than others but for the most part, 1st tier, 2nd tier, etc is simply based on heresay than objective measures. When someone ranks a program as 2nd tier, you may interview there and consider it the best program for what you're looking for. So when people like Paz puts a program down in the 2nd tier, just know that these are his opinions. Personally, I think that a program like UAB is not a far stretch from the top tier if its not a top tier program already along with many others that are not normally considered as such. I just have a thing about putting a program down if you haven't personally trained there yourself and are just basing it on heresay. iI know this doesn't help your question, but just know that the gap between many programs is closing quickly as you will find on the interview tour.

Please forgive me if I offeneded with my opinions. Let me suggest that you may be misinterpreting what I had intended my terms to mean

1) Top tier: 10 programs everyone puts in the "top 5"

2) Sleepers: programs people don't immediately consider top 10, but when you ask them, they respond that those are also great places

3) Second tier: Programs that are well respected, have their strengths, but that no one would put in their top 10. Still well worth considering, but probably not going to get credited as much as the top tier when it comes to fellowship interviewing

4) Average

5) Should not apply

I realy meant no offence, and please recognize that, unless there is evidence to back up what I or anyone on this board says, everything on here is opinion. I make no claim to my posts being anything but exactly that, and would certainly hope no one gives my posts anymore weight than they would to the musings of any random lunatic

 

[Finally M3]

I second Paz's props to OSU (Ernie Johnson's fiefdom). May also add Mayo to the top tier.

Wasn't there a thread like this last year? Maybe we can resurrect & sticky it, because it seems like this is a question that most newly-minted M4s ask around this time (and I've been telling rotating med students about where to apply as well).

 

[JabsterL]

1) Top tier: 10 programs everyone puts in the "top 5"

2) Sleepers: programs people don't immediately consider top 10, but when you ask them, they respond that those are also great places

3) Second tier: Programs that are well respected, have their strengths, but that no one would put in their top 10. Still well worth considering, but probably not going to get credited as much as the top tier when it comes to fellowship interviewing

4) Average

5) Should not apply

Where does emory and cinci stand in this tier system? Which programs are considered top tier then, preferentially in order from 1-10? From what all the residents, fellows, and PM&R docs say, it seems RIC and spaulding are up at the top, followed by umich, uwash, baylor, mayo, etc. What school is kessler associated with, and where exactly is it located because this isn't a big place known for anything besides rehab is it?

 

[rehab_sports_dr]

> What school is kessler associated with, and where exactly is it located because this isn't a big place known for anything besides rehab is it?

Kessler is a group of stand alone rehab facilities. The 3 residents train at are Kessler West (the main one, in West Orange, with a special focus on SCI, and soon to also focus on TBI), Kessler East in East Orange (a TBI center), and Kessler North in Saddle Brook (special focus on stroke and amputee).

Kessler is the common name for the UMDNJ-New Jersey Medical School residency, which actually has many training sites in addition to Kessler, including the VA, University Hospital, Children's Specialized Hospital, and the Atlantic Health System. Dr. Delisa, the chair, prefers people refer to it as the New Jersey Medical School program to acknowledge the contributions of the other training sites.

Kessler is universally acknowledged as one of the top tier programs, very much in a class with RIC, Mayo, UWAsh as one of the candidates for the mythical title of "best program in the country"

Kessler should not be confused with the JFK training program, which is a smaller program affiliated with UMDNJ-Robert Wood Johnson (the other medical school in NJ, located in the central part of the state, as opposed to NJMS, which is located in the northern part of the state). JFK is an excellent, but smaller program, than the Kessler program.

 

[paz5559]

Where does emory and cinci stand in this tier system? Which programs are considered top tier then, preferentially in order from 1-10? From what all the residents, fellows, and PM&R docs say, it seems RIC and spaulding are up at the top, followed by umich, uwash, baylor, mayo, etc. What school is kessler associated with, and where exactly is it located because this isn't a big place known for anything besides rehab is it?

Programs most frequntly mentioned as being in most people's top 5, in no particular order, are

RIC/Northwestern
UW
Mayo
Kessler/UMDNJ
Baylor
Spaulding/Harvard
Michigan


Those usually agreed to as also belonging when brought up, although not typically the first to be mentioned:

Jefferson
Temple
OSU
Colorado
UT-San Antonio

For what it's worth, below please find the 2006 US News top rehab list (Ranked only by reputation, each hospital was recommended by at least 3 percent of responding board-certified physicians surveyed in their specialty by U.S. News in 2004, 2005, and 2006) - (I do not pretend to assert that best hospital equates with best residency, so please take this only for what it is worth):

1 Rehabilitation Institute of Chicago 62.4
2 Kessler Institute for Rehabilitation, West Orange, N.J. 32.5
3 University of Washington Medical Center, Seattle 30.4
4 Mayo Clinic, Rochester, Minn. 22.1
5 TIRR (The Institute for Rehabilitation and Research), Houston 21.6
6 Craig Hospital, Englewood, Colo. 16.3
7 Spaulding Rehabilitation Hospital, Boston 15.2
8 Rusk Institute, NYU Medical Center, New York 14.8
9 Ohio State University Hospital, Columbus 13.3
10 National Rehabilitation Hospital, Washington, D.C. 9.2
11 University of Michigan Hospitals and Health System, Ann Arbor 9.0
12 Shepherd Center, Atlanta 8.2
13 Moss Rehab, Elkins Park, Pa. 7.5
14 Thomas Jefferson University Hospital, Philadelphia 6.9
15 Magee Rehabilitation Hospital, Philadelphia 6.7
16 Rancho Los Amigos National Rehabilitation Center, Downey, Calif. 6.5
17 Johns Hopkins Hospital, Baltimore 6.0
18 Mount Sinai Medical Center, New York 5.1
19 Stanford Hospital and Clinics, Stanford, Calif. 4.7
20 Baylor Institute for Rehabilitation, Dallas 4.6
21 Montefiore Medical Center, New York 4.5
22 Cleveland Clinic 4.2
23 New York-Presbyterian Univ. Hosp. of Columbia and Cornell 4.1
24 Hospital of the University of Pennsylvania, Philadelphia 3.0

 

[rehab_sports_dr]

As always, I think Paz's comments are pretty on the money.

I concur that one should have caution when equating the US News Hospital rankings with the quality of the residencies, for a few reasons:

1. Unlike many of their other hospital rankings, the US News rankings for rehab programs are based solely on reputation, and not objective quality measures. There is definitely a lag between changes in the quality of hospitals and how that affects their reputation. For example, many speak of Pittsburgh, Charlotte and UVa as up and coming programs, but they do not yet have the alumni bases to boost up the reputation rankings. Similarly, Rusk's reputation remains strong despite concerns that it may not be as elite as it had been in the past.

2. Residency programs usually train at many sites, and the US news rankings only reflect the rehab hospitals. For example, the UMDNJ-NJMS program is equated with the Kessler Institute, but residents typically spend 1/2 their time at other training sites. This is true of many other programs

3. Since so many programs train at multiple sites, the rankings don't reflect the quality of programs that train at multiple sites. IMO, the program most hurt by this is Thomas Jefferson, which looks like the #14 hospital, but the residency actually has affiliation with the #13,14, and 15 hospitals, and IMO should be a clear top 10 program.

4. It doesn't reflect stand alone children's rehabilitation facilities or other specialized training facilities. For example, UMDNJ-NJMS does their pediatric training at the Children's Specialized Hospital, the largest pediatric rehab facility in the US. The excellence of this training facility is not reflected in the rankings. I am sure other residency programs also have some excellent training sites that are not stand alone adult rehab facilities that are not reflected in the rankings (e.g., UC-Davis and their Shriner's hospital, or the VA hospitals of varying quality).

For all of these reasons, I would take the rankings with a very large grain of salt.

Programs most frequntly mentioned as being in most people's top 5, in no particular order, are

RIC/Northwestern
UW
Mayo
Kessler/UMDNJ
Baylor
Spaulding/Harvard
Michigan


Those usually agreed to as also belonging when brought up, although not typically the first to be mentioned:

Jefferson
Temple
OSU
Colorado
UT-San Antonio

For what it's worth, below please find the 2006 US News top rehab list (Ranked only by reputation, each hospital was recommended by at least 3 percent of responding board-certified physicians surveyed in their specialty by U.S. News in 2004, 2005, and 2006) - (I do not pretend to assert that best hospital equates with best residency, so please take this only for what it is worth):

1 Rehabilitation Institute of Chicago 62.4
2 Kessler Institute for Rehabilitation, West Orange, N.J. 32.5
3 University of Washington Medical Center, Seattle 30.4
4 Mayo Clinic, Rochester, Minn. 22.1
5 TIRR (The Institute for Rehabilitation and Research), Houston 21.6
6 Craig Hospital, Englewood, Colo. 16.3
7 Spaulding Rehabilitation Hospital, Boston 15.2
8 Rusk Institute, NYU Medical Center, New York 14.8
9 Ohio State University Hospital, Columbus 13.3
10 National Rehabilitation Hospital, Washington, D.C. 9.2
11 University of Michigan Hospitals and Health System, Ann Arbor 9.0
12 Shepherd Center, Atlanta 8.2
13 Moss Rehab, Elkins Park, Pa. 7.5
14 Thomas Jefferson University Hospital, Philadelphia 6.9
15 Magee Rehabilitation Hospital, Philadelphia 6.7
16 Rancho Los Amigos National Rehabilitation Center, Downey, Calif. 6.5
17 Johns Hopkins Hospital, Baltimore 6.0
18 Mount Sinai Medical Center, New York 5.1
19 Stanford Hospital and Clinics, Stanford, Calif. 4.7
20 Baylor Institute for Rehabilitation, Dallas 4.6
21 Montefiore Medical Center, New York 4.5
22 Cleveland Clinic 4.2
23 New York-Presbyterian Univ. Hosp. of Columbia and Cornell 4.1
24 Hospital of the University of Pennsylvania, Philadelphia 3.0

 

[DistantMets]

Programs most frequntly mentioned as being in most people's top 5, in no particular order, are

RIC/Northwestern
UW
Mayo
Kessler/UMDNJ
Baylor
Spaulding/Harvard
Michigan


Those usually agreed to as also belonging when brought up, although not typically the first to be mentioned:

Jefferson
Temple
OSU
Colorado
UT-San Antonio

For what it's worth, below please find the 2006 US News top rehab list (Ranked only by reputation, each hospital was recommended by at least 3 percent of responding board-certified physicians surveyed in their specialty by U.S. News in 2004, 2005, and 2006) - (I do not pretend to assert that best hospital equates with best residency, so please take this only for what it is worth):

1 Rehabilitation Institute of Chicago 62.4
2 Kessler Institute for Rehabilitation, West Orange, N.J. 32.5
3 University of Washington Medical Center, Seattle 30.4
4 Mayo Clinic, Rochester, Minn. 22.1
5 TIRR (The Institute for Rehabilitation and Research), Houston 21.6
6 Craig Hospital, Englewood, Colo. 16.3
7 Spaulding Rehabilitation Hospital, Boston 15.2
8 Rusk Institute, NYU Medical Center, New York 14.8
9 Ohio State University Hospital, Columbus 13.3
10 National Rehabilitation Hospital, Washington, D.C. 9.2
11 University of Michigan Hospitals and Health System, Ann Arbor 9.0
12 Shepherd Center, Atlanta 8.2
13 Moss Rehab, Elkins Park, Pa. 7.5
14 Thomas Jefferson University Hospital, Philadelphia 6.9
15 Magee Rehabilitation Hospital, Philadelphia 6.7
16 Rancho Los Amigos National Rehabilitation Center, Downey, Calif. 6.5
17 Johns Hopkins Hospital, Baltimore 6.0
18 Mount Sinai Medical Center, New York 5.1
19 Stanford Hospital and Clinics, Stanford, Calif. 4.7
20 Baylor Institute for Rehabilitation, Dallas 4.6
21 Montefiore Medical Center, New York 4.5
22 Cleveland Clinic 4.2
23 New York-Presbyterian Univ. Hosp. of Columbia and Cornell 4.1
24 Hospital of the University of Pennsylvania, Philadelphia 3.0

I would just like to add Virginia Commonwealth (MCV, MCV/VCU, etc) to the list of often overlooked top 10 quality programs. I heard nothing but good things about this program from residents at other top teir programs while out-rotating and interviewing. It has every fellowship you could want, it's very well-rounded, and the faculty and staff are some of the nicest people I met on the trail. Drs. Cifu and McKinley go to bat for and listen to their residents are are willing to make changes. I interviewed at the Harvard's, RIC's, Kessler's of the world and I left VCU just as excited. Reasons they're not mentioned more: Location is big...Richmond isn't Boston, NY, or Chicago, and it's "The South" which turns off some people. Likewise, Medical College of Virginia, Virginia Commonwealth University and the VCU Med Center aren't immediately name recognized. So, they tend to draw from the Mid-Atlantic, South and Midwest. It's only been around 20 years or so, and they needed to pick a name...VCU (formerly some combination of MCV, VCU, or MCV/VCU??) I'm really happy I ended up there and it certainly wasn't on my short list when I started the whole residency search.

http://www.pmr.vcu.edu/residents/index.html

 

[njdevil]

I would agree with several comments on this thread.

I am a pgy-4 at Jefferson in Philadelphia. I would agree that all three city programs are not created equal. Temple and Jefferson and far more established that our ivy league sister UPenn; which has some nice things to offer, but is far more unstable.

I only interviewed on the east coast, but I can not say enough about MCV and UVA. Both VA programs impressed me and were ranked very high on my list.

hope this helps.

 

[CasaElGato]

I also really liked Emory University in Georgia and it is one of the only places I interviewed in the South besides Baylor-uth (and ranked it higher than Baylor). Shepherd Center is amazing. The program is in a bit of a flux right now with the chair or PD stepping down I think can't remember. Great place if you like procedures. Overall a nice smaller program in an exciting (though inland) town. One of their newly finished 4th years is going to a great primary care sports fellowship in 'bama. Nicer environment than many of the hotshot names I think.

The only thing about this program is that they do not do much at Grady Memorial which is the county hospital for the Fulton-DeKalb Hospital Authority which one might see as a plus or minus as other programs have more exposure to the "county" population, like UW with Harborview (sweet views) or UMDNJ with University Hospital Newark (lock your car, it might be there when you get back...) which though not a county hospital, serves a county-like population. It's a bit unusual since most Emory & Morehouse residency programs use Grady extensively.

Also keep in mind that while a program might be more prestigious, it may not be more competitive to get. Colorado and UW are really tough to get because they are in geographically desirable areas and are the only programs in their state. Colorado typically goes no further than a dozen down their list for 4 slots, and UW no more than 15ish for their 8 slots. Non-city midwest programs might not be as attractive to some by geography alone (just using that as an example), anecdotally hearing that a prestigious program in that part of the country routinely goes to 25 or 30 to fill their handful of spots.

Most importantly, I think, you should try to pick a place where you think you would be happy for 3-4 years. See if the residents are happy, see how the administration and the chiefs treat them. There were hotshot places where I felt the residents weren't always treated well. There were also some places where the residents were very tight (MSK oriented UC-Davis and UVA come to mind). Certain programs are limited by the myopia of their administration.

To further expound on this: If you have SAD, you might want to shy away from Seattle, e.g. If you have a spouse who works in i-banking then you might not want to be in [fill in the blank].

 

[Gauss]

I know the Western programs fairly well
Warning! Biased opinion below:
I'm hesitant to recommend UW right now since Larry Robinson stepped down and numerous attendings migrated to Utah. This of course has increased the value of Utah, but remember it still is in Salt LAke and if you are single and not LDS you may not find the night life to your liking. (Of course Mayo is somewhat similar for singles)
Ucolorado is becoming solid, some flux as the hospitals are moving all around and it's only been like 4 or 5 years since Akathota stepped in to ramp up that program. THey do have the Peds Fellowship there.
Stanford and UCI are highly overrated.
UCDavis is an excellent program, and I hear good things about Loma Linda. UCLA is an upcomer and will only get better with the new attendings. Commutes are atrocius in LA though.
/end opinion

 

[CasaElGato]

Ucolorado is becoming solid, some flux as the hospitals are moving all around and it's only been like 4 or 5 years since Akathota stepped in to ramp up that program. THey do have the Peds Fellowship there.

This multiple hospitals all over greater Denver turned me off somewhat to Colorado but I was very impressed on interview day there. Akathota really sells his program without turning into a used car salesman.

Stanford and UCI are highly overrated.
UCDavis is an excellent program, and I hear good things about Loma Linda. UCLA is an upcomer and will only get better with the new attendings. Commutes are atrocius in LA though.
/end opinion

Irvine's department is located in a dark basement that was difficult to find on interview day. When I mentioned an interest in research one of my interviewers told me I should consider other programs, namely a program up the 405/San Diego Freeway. UCI Medical Center is also surrounded by scandal.

UC-Davis remains one of my very favorite programs, the people there were so personable and genuine. The one thing is their schizophrenic scheduling of rotations which I thought was strange. You do half days of different rotations all throughout the year instead of a more traditional 3 month block of something like at Colorado or a 2 month block of something like at UMDNJ.

UCLA is a VA based residency, something to keep in mind. Also should "appreciate" chocolate colored air.

 

[rehab_sports_dr]

> I'm hesitant to recommend UW right now since Larry Robinson stepped down and numerous attendings migrated to Utah.

Which attendings left for Utah?

I would expect UW to remain a super-elite program. Robinson will still be at UW, albeit in a more administrative position. There are too many great people (Teresa Massagli, Stan Herrng, Leighton Chan, Mark Harrast, Stu Weinstein, Greg Carter, George Kraft), such an incredibly strong tradition, and a supportive administration (especially with Robinson in the administration)- I can't imagine them as anything but a superb program.

 

[Hemisphere]

In making decision where to apply it also helps knowing what you want to do and to think about a geographic region where you will be happiest.

for me it was the east coast.

someone said the the nj progs are better than the ny progs, but this is such a sweeping generalizatoin how could it be true... true kessler has a good reputation on the east coast, but if you go outside the field of rehab out midwest or west who even heard the name?? and look at all the administrative nonsense going on at UMDNJ. JFK is a model systems in TBI. Then again, there is also renkowned TBI expert at colum/cornell as well, not to mention rotations at hosp for spec surgery and memorial sloan kettering having that name and exp. can't hurt to be hired by a university or neurosurg practice less familiar with rehab specific rankings. The advantage of the ny progs over jersey is that the jersey residents spend a lot of time at free-standing rehab and interact less with other specialities, less readily available support for consults and emergencies, and to learn from other fields than the hospital-attached large university rehabs at nyu, colum/cornell, and mt.sinai.

well, all prog bashing aside agree with casa el gato... go where you think you might be happiest and the program that best matches what you are intersted in.

 

[rehab_sports_dr]

> someone said the the nj progs are better than the ny progs, but this is such a sweeping generalizatoin how could it be true... true kessler has a good reputation on the east coast, but if you go outside the field of rehab out midwest or west who even heard the name??

The reputation of Kessler is very strong nationally. Now that I am in fellowship in the Midwest, people definitely are familiar with Kessler. For the rare physician I've encountered not familiar with the program, I'll mention that I trained at the hospital where Christopher Reeve went, or where Dudley Moore went, or the hospital showcased in Murderball.

I personally think that reputation is overrated when looking at programs, but to the extent that reputation matters, the reputation of Kessler is (deservedly) excellent.

> and look at all the administrative nonsense going on at UMDNJ.

The administrative stuff at UMNDJ has had no impact on the training except that they no longer have drug sponsored lunches. If anything, now that Dr. Garstang is the program director, the program is as strong as it has ever been.

> The advantage of the ny progs over jersey is that the jersey residents spend a lot of time at free-standing rehab and interact less with other specialities, less readily available support for consults and emergencies, and to learn from other fields than the hospital-attached large university rehabs at nyu, colum/cornell, and mt.sinai.

Hmmmm... When I was a resident at Kessler, it seemed like I benefited quite a bit from doing 20+ pre-part physicals with the orthopods, rounding with the neurosurgons and trauma surgeons on my TBI consult service, talking to the neurosurgons and neurologists during consult months at Overlook, walking downstairs several times a week to talk to one of two double boarded urologists/physiatrists in the world (Dr. Linsenmeyer) during my SCI months, etc.

I don't want to downgrade what may be a fine experience at the NYC program. But I think it is inappropriate to criticize Kessler when you are obviously not familiar with the system.

Moreover, becuse of Kessler's worldwide reputation, the quality of the guest speakers who come through to speak to us is outstanding. Virtually every physiatrist known nationally for the quality of their teaching at other institutions (Press, Herring, Massagli, Robinson, Smith, Yablon,Dumitru, Haig, Zafonte, Macheo, etc.) has been to Kessler at some point to speak to the residents.

Mind you- these experiences are not unique to Kessler- residents at many other programs have similarly fine experiences. But the poorly-veiled criticisms targeted at Kessler are not warranted, and frankly, are a bit petty.

I agree with the overall comment, though, that fit is more important than the perception of "best." There are so many quality programs available that every medical student should do a real assessment of location, intensity of program, particular skills they want to acquire, how "progressive" a program they want to train at (as much as that term irritates me), how much elective time they want, etc. One medical student I recently advised had a top 10 of programs I had never considered when I was a medical student, and they were all great programs. So there are plenty of great programs out there.

 

[Hemisphere]

hey sports doc...

If people on this thread are going to say that the nj programs are hands down better than the ny programs, then I don't think it is petty to constructively criticize the nj programs in response.

I did rotate at kessler in medical school and am familiar with it to a certain extent, so assuming that I am "obviously not familiar with it" was petty on your part.

But since we are being petty, let me just say the following disadvantages of kessler, not in an attempt to downgrade it, but to say why it might not be a fit for some people

-I found during the interview process the chairman to be offputting, i am sure many will agree, it is important to have pro-resident faculty rather than malignancy
-What you described as rounds with the trauma team, i experienced as we saw the patients ourselves and had authority to write our own orders independently which on a few occasions were taken with big grains of salt/and or not followed, eg they would continue using haldol for tbi patients when we rec'd other drugs. not sure how long ago you trained there, but we never rounded "with" the trauma team although we did see their patients in a consultative role.
-pre part physicals you speak of were done by physiatrists, not orthopods, that said the teaching was still pretty good.
-the rotations are scattered all around
-newark, nj is not the safest area to be in
-no elective time in which to pursue your own interests further
-in-bred culture... it seems they recruit heavily from their own medical
school, you can't argue that the % of UMDNJ grad residents is probably
higher than the % of UMDNJ grad applicants

> someone said the the nj progs are better than the ny progs, but this is such a sweeping generalizatoin how could it be true... true kessler has a good reputation on the east coast, but if you go outside the field of rehab out midwest or west who even heard the name??

The reputation of Kessler is very strong nationally. Now that I am in fellowship in the Midwest, people definitely are familiar with Kessler. For the rare physician I've encountered not familiar with the program, I'll mention that I trained at the hospital where Christopher Reeve went, or where Dudley Moore went, or the hospital showcased in Murderball.

I personally think that reputation is overrated when looking at programs, but to the extent that reputation matters, the reputation of Kessler is (deservedly) excellent.

> and look at all the administrative nonsense going on at UMDNJ.

The administrative stuff at UMNDJ has had no impact on the training except that they no longer have drug sponsored lunches. If anything, now that Dr. Garstang is the program director, the program is as strong as it has ever been.

> The advantage of the ny progs over jersey is that the jersey residents spend a lot of time at free-standing rehab and interact less with other specialities, less readily available support for consults and emergencies, and to learn from other fields than the hospital-attached large university rehabs at nyu, colum/cornell, and mt.sinai.

Hmmmm... When I was a resident at Kessler, it seemed like I benefited quite a bit from doing 20+ pre-part physicals with the orthopods, rounding with the neurosurgons and trauma surgeons on my TBI consult service, talking to the neurosurgons and neurologists during consult months at Overlook, walking downstairs several times a week to talk to one of two double boarded urologists/physiatrists in the world (Dr. Linsenmeyer) during my SCI months, etc.

I don't want to downgrade what may be a fine experience at the NYC program. But I think it is inappropriate to criticize Kessler when you are obviously not familiar with the system.

Moreover, becuse of Kessler's worldwide reputation, the quality of the guest speakers who come through to speak to us is outstanding. Virtually every physiatrist known nationally for the quality of their teaching at other institutions (Press, Herring, Massagli, Robinson, Smith, Yablon,Dumitru, Haig, Zafonte, Macheo, etc.) has been to Kessler at some point to speak to the residents.

Mind you- these experiences are not unique to Kessler- residents at many other programs have similarly fine experiences. But the poorly-veiled criticisms targeted at Kessler are not warranted, and frankly, are a bit petty.

I agree with the overall comment, though, that fit is more important than the perception of "best." There are so many quality programs available that every medical student should do a real assessment of location, intensity of program, particular skills they want to acquire, how "progressive" a program they want to train at (as much as that term irritates me), how much elective time they want, etc. One medical student I recently advised had a top 10 of programs I had never considered when I was a medical student, and they were all great programs. So there are plenty of great programs out there.

 

[rehab_sports_dr]

> If people on this thread are going to say that the nj programs are hands down better than the ny programs, then I don't think it is petty to constructively criticize the nj programs in response.

I have never been one of those people. I think in general it is unprofessional to knock a competitor's program. I can speak in the first person about Kessler and the great experience I had there as a resident (I graduated one month ago). I can also speak of the experiences my friends had at places JFK, Mt Sinai (of which I have heard many great things), Cornell/Columbia, NYU, and in general people seem to be happy with their experiences there.

> I did rotate at kessler in medical school and am familiar with it to a certain extent, so assuming that I am "obviously not familiar with it" was petty on your part.

I pointed out that what you said was factually incorrect, and obviously intended to take Kessler down a notch. That's petty.

First off, it's silly to comment that hospitals based out of stand alone facilities are flawed. Many of the best programs in the country- RIC, Kessler, Spaulding, Baylor, are based largely out of stand alone facilities.

Second, in the specific example of Kessler, they are NOT exclusively based out of Kessler. I spent 10 months out of 36 at Kessler, which is not atypical. Many of my rotations were hospital based rotations at some tremendous hospitals- University Hospital is the leading trauma hospital in NJ, Overlook is the neuro center of excellence for Atlantic Health Care system, etc. This is not fundamentally different than the city programs.

So in a general and specific manner, your comments were incorrect. And petty.

>-I found during the interview process the chairman to be offputting, i am sure many will agree, it is important to have pro-resident faculty rather than malignancy

I will agree that Delisa can be abrasive in his initial interactions. I also will note that he is incredibly dedicated to providing a great educational experience for his residents. He had an open door for me throughout residency, advocated for me to be put into positions of national leadership as a resident, aggresively went to bat for me when I applied for fellowships, and was a source of great support to me. He is also regarded as one the true leaders in the field of rehab. It's not an accident that the AAP names one of their annual lectures in his honor. Delisa is a tremendous human being and has created one of the most pro-resident programs in the country. Calling him malignant is an inappropriate besmirching of a very good man.

>-What you described as rounds with the trauma team

I guess the individuals reading this discussion will have to judge the experience of one medical student's rotation or a resident who spent 3 years there. I felt like my consults were appreciated by attendings in other specialties.

-pre part physicals you speak of were done by physiatrists, not orthopods, that said the teaching was still pretty good.

Some pre-parts were only with physiatrists, some were with multi-disciplanary teams. What is in induspitable is that we had great sports medicine exposure. I cannot remember all the pre-parts I did, but they included Whippany Park HS, Hanover Park HS, Delaware Valley HS, West Orange HS, Passaic HS, Bloomfield College, Jersey City College, St. Peter's college, Drew University, Farleigh Dickinson U, etc. It was an incredible pre-part expereince, all part of a great sports medicine experience.

-the rotations are scattered all around

True. Fair criticism. It is worth noting, though, that this is true of all the programs in the NYC area, most of which have rotations in multiple boroughs, and sometimes in NJ or Westchester.

-newark, nj is not the safest area to be in

Fair point. Of course, Newark is also one of many training sites. The places where I lived in NJ are considered some of hte most desirable areas in the country, and were actually more central to the residency.

-no elective time in which to pursue your own interests further

Fair criticism

-in-bred culture... it seems they recruit heavily from their own medical
school, you can't argue that the % of UMDNJ grad residents is probably
higher than the % of UMDNJ grad applicants

This is a misrepresentation. UMDNJ does an incredible job of marketing the field of physiatry to the medical students (part of Delisa's grand vision for promoting PM+R). This is why there is a high number of UMNDJ residents at many programs throughout the country. That said, once we do a good job of selling the field of PM+R to the medical students, it is not surprising that many want to stay at a program that is located in their home state and is considered on the short list for the best program in the country.

This is true of many of the great programs. Medical students at Ohio St like to stay there for residency. Same thing with Northwestern, Washington, Baylor, Michigan, etc.

Bottom line, I thought your criticisms of Kessler were made to try and create a negative impression of what is a terrific program, and the arguments made to do so were based on many factually incorrect comments.

Again, I don't want to create the impression that Kessler is the best program that ever existed and should be the first choice for everyone. There have been some specific incidents when I have recommended to medical students that other programs would be a better fit. Now that I am training at another well regarded program, I can appreciate that there are multiple ways to create a great learning environment. That said, Kessler was a great learning environment and doesn't need to apologize.

I would hope that your future comments are made in a spirit of greater collegiality, less defensiveness, and greater accuracy.

 

[jsaul]

> If people on this thread are going to say that the nj programs are hands down better than the ny programs, then I don't think it is petty to constructively criticize the nj programs in response.

I have never been one of those people. I think in general it is unprofessional to knock a competitor's program. I can speak in the first person about Kessler and the great experience I had there as a resident (I graduated one month ago). I can also speak of the experiences my friends had at places JFK, Mt Sinai (of which I have heard many great things), Cornell/Columbia, NYU, and in general people seem to be happy with their experiences there.

> I did rotate at kessler in medical school and am familiar with it to a certain extent, so assuming that I am "obviously not familiar with it" was petty on your part.

I pointed out that what you said was factually incorrect, and obviously intended to take Kessler down a notch. That's petty.

First off, it's silly to comment that hospitals based out of stand alone facilities are flawed. Many of the best programs in the country- RIC, Kessler, Spaulding, Baylor, are based largely out of stand alone facilities.

Second, in the specific example of Kessler, they are NOT exclusively based out of Kessler. I spent 10 months out of 36 at Kessler, which is not atypical. Many of my rotations were hospital based rotations at some tremendous hospitals- University Hospital is the leading trauma hospital in NJ, Overlook is the neuro center of excellence for Atlantic Health Care system, etc. This is not fundamentally different than the city programs.

So in a general and specific manner, your comments were incorrect. And petty.

>-I found during the interview process the chairman to be offputting, i am sure many will agree, it is important to have pro-resident faculty rather than malignancy

I will agree that Delisa can be abrasive in his initial interactions. I also will note that he is incredibly dedicated to providing a great educational experience for his residents. He had an open door for me throughout residency, advocated for me to be put into positions of national leadership as a resident, aggresively went to bat for me when I applied for fellowships, and was a source of great support to me. He is also regarded as one the true leaders in the field of rehab. It's not an accident that the AAP names one of their annual lectures in his honor. Delisa is a tremendous human being and has created one of the most pro-resident programs in the country. Calling him malignant is an inappropriate besmirching of a very good man.

>-What you described as rounds with the trauma team

I guess the individuals reading this discussion will have to judge the experience of one medical student's rotation or a resident who spent 3 years there. I felt like my consults were appreciated by attendings in other specialties.

-pre part physicals you speak of were done by physiatrists, not orthopods, that said the teaching was still pretty good.

Some pre-parts were only with physiatrists, some were with multi-disciplanary teams. What is in induspitable is that we had great sports medicine exposure. I cannot remember all the pre-parts I did, but they included Whippany Park HS, Hanover Park HS, Delaware Valley HS, West Orange HS, Passaic HS, Bloomfield College, Jersey City College, St. Peter's college, Drew University, Farleigh Dickinson U, etc. It was an incredible pre-part expereince, all part of a great sports medicine experience.

-the rotations are scattered all around

True. Fair criticism. It is worth noting, though, that this is true of all the programs in the NYC area, most of which have rotations in multiple boroughs, and sometimes in NJ or Westchester.

-newark, nj is not the safest area to be in

Fair point. Of course, Newark is also one of many training sites. The places where I lived in NJ are considered some of hte most desirable areas in the country, and were actually more central to the residency.

-no elective time in which to pursue your own interests further

Fair criticism

-in-bred culture... it seems they recruit heavily from their own medical
school, you can't argue that the % of UMDNJ grad residents is probably
higher than the % of UMDNJ grad applicants

This is a misrepresentation. UMDNJ does an incredible job of marketing the field of physiatry to the medical students (part of Delisa's grand vision for promoting PM+R). This is why there is a high number of UMNDJ residents at many programs throughout the country. That said, once we do a good job of selling the field of PM+R to the medical students, it is not surprising that many want to stay at a program that is located in their home state and is considered on the short list for the best program in the country.

This is true of many of the great programs. Medical students at Ohio St like to stay there for residency. Same thing with Northwestern, Washington, Baylor, Michigan, etc.

Bottom line, I thought your criticisms of Kessler were made to try and create a negative impression of what is a terrific program, and the arguments made to do so were based on many factually incorrect comments.

Again, I don't want to create the impression that Kessler is the best program that ever existed and should be the first choice for everyone. There have been some specific incidents when I have recommended to medical students that other programs would be a better fit. Now that I am training at another well regarded program, I can appreciate that there are multiple ways to create a great learning environment. That said, Kessler was a great learning environment and doesn't need to apologize.

I would hope that your future comments are made in a spirit of greater collegiality, less defensiveness, and greater accuracy.

you ever think about going back and working for your old program?
You do a good job of selling it

 

[ihaveaquestion]

this is an entertaining thread

 

[Finally M3]

Pistols at ten paces, gentlemen?

 

[Nerdoscience]

Can we stop quoting the entire previous post in the responses? It's making it hard to scroll through this heated argument that, in my opinion, could have been composed of short comments expressing the points that were pertinent, and taken to private messaging for the rest.

 

[paz5559]

Can we stop quoting the entire previous post in the responses? It's making it hard to scroll through this heated argument that, in my opinion, could have been composed of short comments expressing the points that were pertinent, and taken to private messaging for the rest.

we could, but then what would be the point of writing half-page long rants and diatribes?

 

[drusso]

In order to conserve band-width on SDN, from now on all germane rants and diatribes may only be posted in Haiku format...

Late night transfers come
Piles and piles of notes
Give me a Touhy or death

 

[eddo]

Hey Ms4's

I'm an intern now already matched to PM&R. Wasn't even in your shoes looking at PM&R at this time a year ago. I was IM-bound thinking about cards or Pulm/Crit Care. Finished my ERAS for IM. I'm a DO, so I thought I'd take a shot at PM&R for curiosity and see how much I could use my MSK training....mind you this was right around September, October. I was out in the Bay area (San Fran Bay area) for 2 rotations at Stanford...so cards was one and PM&R the other!

The short and quick is that despite how amazing my experience was at the CCU , I totally fell in love with PM&R thanks to the big S. Suffice it to say...I WAS SOLD! I knew nothing about the programs, the reputations, the competitiveness, NADA! Since I was applying, I had to learn really quick about what I wanted to do in this great, amazing field to determine where I would eventually apply and where I would match (if any place).

So everyone reading this NOW (Summer 06) is way ahead of where I was. I won't overkill the strategies aforementioned or go into the nitty gritty of any programs (except where I matched and rotated). Instead, I'll give you some of my views as both a newbie to the field (first impressions) and then as an exhausted, but happily matched candidate. I will say why I didn't rank a program highly, but in no way is this meant to lower my opinion of any of the programs. East to West...(applied to mid-Atlantic, Chicago area, Texas, California for those that are skimming for programs)

SIZE: Small < 4, Mid <9, Large >9 spots per year

EAST COAST(3)
Temple: Mid-size. Great overall inpt and outpt at multiple facilities throughout Philly with great residents and gungho PD and attendings. Strong balance in every way. Up there on my list - not my top because not a big fan of Pennsylvania and outskirts of Philly(outside of downtown, Center City which ROCKS!) Roadways throughout the Philly area drive me crazy. I spent 4 months in Philly for med school and I hated the traffic (Route 1, 76 interstate - PM me if curious)

UPitt: Mid-size. Most impressive academic program with cutting edge research in a great college town. Veteran PD looking to bring Pitt to the forefront of PM&R. DON'T OVERLOOK THIS PROGRAM. Why not on the top...it's in Pennsylvania (I know it's a bad reason...but it's MINE )

Sinai Baltimore: Small. Community hospital formerly associated with Hopkins. Training done at single site. Didn't remember too much emphasis on research opportunities. Residents attitudes about PM&R (don't deal with medicine issues) not my cup of tea.


Midwest(3)
UW-Madison: Small. Pillar of strength for outpt/MSK. Great case discussions and lectures. Most dedicated attendings and PD of all the programs. You will feel like a big family here. Research opportunities. Consider seriously for Peds and MSK. Amazing University facilities and outpt clinics.

RIC-Northwestern: Large. Impressive in every way deserving their authority in the field. My experience interviewing and talking with the attendings, PD, and residents left me with the utmost respect of the program. A traditional inpatient powerhouse with plenty of outpatient/MSK opportunities. The academic resources and research opportunities are abound! You are encouraged to do research here - a plus in my book! RIC is a standalone rehab hospital that is breathtakingly innovative and advance.

Schwab-University of Chicago: Schwab Rehab is a large community hospital a good distance from its U of C affiliate. Spend most, if not all, of your rehab time there. Forget how much time you spend at U of C university hospital. A lot of the attendings are graduates from RIC. I could be wrong, but I got the sense that there is a stronger clinical emphasis, less research compared to RIC.

Texas(4)
Baylor-UT Houston: Large. Balanced in/outpt. Largest medical center in the world! Anything you want is right there. All the residents have the greatest personalities. The PD is so responsive and progressive here. Research, academic resources, specialties - you've got it! Lectures are comprehensive. My only thing is that because this is such a large medical center - everyone is so spread out. The residents tell you this too - sometimes you feel like you are disconnected from the rest of your program. Other than this little thing, Baylor-Houston was right up there, again deserving of its reputation.

Baylor-Dallas: Small. Program has a good balance of just about everything. Sorry I can't remember more. Nothing really stuck out. It was in the middle of my pack. It left me with a good feeling.

UT-Southwestern: Mid-size. Balanced program. Didn't see too many residents on interview. The program coordinator (not PD) is amazing. The program provides a generous stipend on top of giving you most all of the PM&R texts throughout your residency. Interact with Baylor-Dallas residents on ocassion. A top-notch program.

UT-San Antonio: Small. Integrated 4 year program (includes internship). Leaving this interview, I felt that this program had THE most-well rounded academic/clinical, inpt/oupt curriculum of ALL the programs out there. In my opinion, the BEST curriculum of all the programs I visited. In my top 3!!!! YOu get University Hospital, VA Hospital, and community hospital experience. In addition, the program teaches you the business side of the practice throughout your training so you'll know how to make $$$ by billing properly - we could all use that!

CALIFORNIA
Stanford: Medium. My first love and my match! Balanced inpt/outpt. NIDDR SCI and TBI model systems at affiliated community hospital-SCVMC. They also have a Rehab Trauma Center at SCVMC where you may work with Neuro, Neurosurg to manage acute trauma patients! MSK/outpt experience occurs jointly with the Ortho department at the University Hospital. PD's are awesome! Residents from top-notch medical schools and one transferred from UCLA ortho. Why I chose it: MY Friends, beautiful weather, awesome residents, passionate attendings, university resources, research opportunity are all there! Only downside, I can't afford Palo Alto! I enjoyed every minute of my experience there. The patient volume at SCVMC is high because it is a county and regional SCI/TBI center. Pts have been flown in from Colorado for advanced care. I like that the program has you still deal with medicine-related issues on top of their PM&R issues. I did manage a vented patient in the rehab facility; the patient did not have to be shipped out to a Med-Surg floor just because of the vent! Only 4 weeks there, but saw some more exotic [neuro] cases - West Nile encephalopathy, Guillian-Barre atypical variant, LeForte III facial fracture.

 

[ihaveaquestion]

^^ excellent post and very informative. thank you.

 

[fozzy40]

I agree. Great post EDDO! What is your particular field of interest in PM&R? What is the going rate out there (Palo Alto) for apartments or houses?

 

[eddo]

I'm glad my tidbits help you all. In terms of the price in Palo Alto for houses, ummm....unaffordable for me. Even if you happen to have a cool half million, you won't be finding a house anywhere within biking/walking distance of Stanford! Apartments are more reasonable....compared to other big cities: in the neighborhood of $1000 around the area (i.e. I doubt this is the case for the complexes across the street. If I am wrong, it will be a pleasant surprise!)

 

[fozzy40]

Is there a good mix of exposure if I were to do a PM&R rotation at Stanford? I've really only been exposed to outpt. I have 2 inpt rotations set up, however.

 

[eddo]

Seems that you have a good number of PM&R rotations under your belt. Suffice it to say that it would be beneficial for you to rotate wherever you're interested in going for residency. However, realize that you need to draw from all disciplines in PM&R so try to keep your clinical years well-rounded. Be cautious NOT TO BASE YOUR IMPRESSIONS OF THE FIELD ON ANY ONE PROGRAM. Even amongst the better known programs, your experience can vary dramatically. I've heard students decide to go into/turn away from PM&R based on one experience - sometimes just in a private office. THAT'S A BIG MISTAKE! If you are a newbie, try to rotate at a residency program site where they offer a broad experience - perhaps a week in TBI, a week in SCI, one in nonsurgical ortho, one in outpt setting....etc. I never rotated in a private doc's office to tell you whether they provide a sufficient breadth of experience to represent the wide spectrum of the field.

I would compare it to medicine - where there are generalists as well as specialists. You can't extrapolate your experience from outpt sports medicine to TBI just as you can't base your decision on whether you like nephrology based on your cardiology rotation.