Okay, this recent flurry of activity has caught my attention and I felt the need to comment. I think we need to take a step back here and try to wrap our heads around what we're really trying to tease out when we create these rankings.
First, it goes without saying that the vast majority of us are not familiar with >75% of the programs that exist. Therefore, many of the programs that end up on these "tiered" lists are just randomly thrown on for no good rhyme or reason. In addition, I think it's fair to say that most of the people on this forum only like paying attention to the cream of the crop, making minor rearrangements, and then balking at changes that are contrary to their (inherently subjective and under informed) beliefs. It is an ultimately silly and futile endeavor, but I get it: it's fun, and we all like the mini-dramas that ensue. Here is my short-list of
standout programs based on what I'd like to think is a more thorough, honest, and current analysis of programs. Please feel free to disagree:
1) TRAINING
I think the first problem that needs to be addressed is training vs. reputation. The two should go hand-in-hand, but I'm sure many of you, as with me, have had experiences to the contrary. Based on rotating at 5 different programs through medical school and residency, I think there are huge disparities even amongst the so-called "elites." When I envision what I think perfect training should be, I think of great didactics, great patient and case diversity, being busy (but not too busy), a balance between autonomy and faculty mentorship, and having great co-residents. Yes, being at a big time cancer center helps - oncology training is multidisciplinary these days and there is a real benefit to training at a known cancer center. Here are my thoughts with comments in some cases:
1) Harvard – Busier rotations admixed with lighter rotations. Exposure to multiple hospitals and multiple attendings translates to a richer training experience.
2) MDACC - Working with the movers and shakers in every subsite. Very benign training environment overall; heavily focused on resident learning.
3) JHU – Great training environment for anything onc in general; very academically oriented. Workload can be demanding at times but did not strike me as being onerous-more of a good busy. Mix of younger (ambitious) and older, established attendings with a balanced patient population.
4) MSKCC – Residents can be VERY busy, to the point of being exhausted, although it is hit and miss depending on the rotation. Phenomenal training otherwise.
5) Michigan – Unbelievable mentorship and strong didactic training in all subjects. However, residents are extremely busy on a regular basis. Scut may be an issue.
6) Penn – Strong overall, just busy past the point of resident benefit. Things are reportedly improving now.
7) Stanford – Somewhat similar in flavor to Michigan, resident scut has been a problem in the past.
8) Wash U St. Louis
9) Wisconsin - strong faculty and great academic training.
10) Mayo
Notable 'top 10' omissions:
11) UCSF – No offense to our esteemed moderator. No one can deny that UCSF has a tremendous reputation in the field, but strictly with respect to resident training, they are, frankly, not a top 10 program for reasons discussed ad nauseam in prior posts. This is sadly true even in 2012 - won't get into specifics.
12) Yale – If there's any way to describe this program it's "laid-back," in almost every respect. It's awesome, in many ways, but a little too hands-off to the detriment of overall training.
13) UChicago – It's a love it or hate it system. On balance, having spoken to many residents across various programs, the training is more stressful than it is beneficial.
2) PRESTIGE
Second, aggregate prestige as qualified by current faculty and residents. This list needs to be included for the following reason: it's what people perceive/believe to be true, for whatever reason, and in many cases, in spite of information to suggest otherwise. This way of thinking is erroneous on a few levels, but I think it is more reflective of resident 'desirability' during the dreaded job hunt and is therefore an undeniably important metric to consider.
1) Harvard
2) MSKCC
3) UCSF
4) MDACC
5) Stanford
6) Penn
7) Hopkins
8) Michigan
9) Wash U St. Louis
10) Yale
11) Duke
12) UChicago
13) UWisconsin
14) Vanderbilt
15) Beaumont
Surprises this year: I see UCSD, Moffitt, and Emory as rising stars. I've heard a lot of chatter about these programs…
Of note, program location was NOT taken into account. Anyone who's honest will admit that happiness comes from within, not from without
. I presume everyone who ranks programs in radiation oncology is wise enough to understand that
where you live does not determine your happiness as much as
how you live...
And there it is!