Top Derm Programs as ranked by Derm Times

[dermquest]

The nation's best dermatology programs, ranked by Dermatology Times as Clinical Centers of Excellence for 2009, include (in alphabetical order): Harvard, Mayo Clinic, Mt. Sinai, NYU, UCSF, University of Michigan, UT Houston, and Wake Forest. Any thoughts?

http://dermatologytimes.modernmedic...3?searchString=clinical centers of excellence

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[Dermguy]

The nation's best dermatology programs, ranked by Dermatology Times as Clinical Centers of Excellence for 2009, include (in alphabetical order): Harvard, Mayo Clinic, Mt. Sinai, NYU, UCSF, University of Michigan, UT Houston, and Wake Forest. Any thoughts?

http://dermatologytimes.modernmedicine.com/dermatologytimes/Dermatology/Clinical-Centers-of-Excellence-Dermatology/ArticleStandard/Article/detail/592583?searchString=clinical%20centers%20of%20excellence

Those are all awesome programs, of course. The only one that makes me wonder a tiny bit is Wake Forest. It is not a huge program, but they do a lot for the size of their department. There are a few others that probably belong right up there as well. Additionally, just like the rankings for medical schools there are things that are impressive and good for rankings but that don't really reflect the training. For example at least a few of those "top programs" there is ZERO cosmetics training. How can you be a top derm program when a huge chunk of what is dermatology is not a part of your curriculum at all? You can be an awesome place to train, but I think the very top programs include everything. Also, a number of those places see only vanilla skin. Can you be at a top residency program and be trained to handle one type of skin color? All I'm saying is this: those may be the top derm programs, but I'm not sure those are the top places to train.

I'm eager to hear what everybody else has to say on the topic.

 

[N-Surge]

No University of Alabama or Colorado? My impression from others is that they are pretty good too.

 

[Dermguy]

No University of Alabama or Colorado? My impression from others is that they are pretty good too.

Right. Those are two good examples of great places to train that may not have the faculty size to look great in the rankings. There are several more examples as well. Top-ranked programs are all good places to train, but in my opinion they may not necessarily be the best of the best places to train. Again, I think a lot of this is analogous to medical school rankings. Those U.S. News rankings, for example, take into account NIH research dollars. Does the total number of research dollars at an institution really affect the quality of the medical education? I argue no. My school has some big time faculty that never interact with students and some others that are the WORST lecturers of 1st and 2nd year. Their research dollars may benefit the institution, but they hurt my education if they did anything for it.

 

[N-Surge]

Totally agree.

 

[deltamed]

I would subtract wake forest and mount siani from that list and add northwestern and possibly yale/stanford.

Colorado and Alabama? Certainly excellent programs but no where NEAR the top ones listed there. The ones on that list should be those that almost everyone agrees on and there are 10-20 that I could think of before alabama, colorado, wake forest and mount siani.

 

[Dermguy]

I would subtract wake forest and mount siani from that list and add northwestern and possibly yale/stanford.

Colorado and Alabama? Certainly excellent programs but no where NEAR the top ones listed there. The ones on that list should be those that almost everyone agrees on and there are 10-20 that I could think of before alabama, colorado, wake forest and mount siani.

I guess these sorts of ranking arguments can go back and forth and it's all just opinion in the end. As far as Colorado goes though they have immunoderm, mohs, and path fellowships along with a big faculty. There's some diversity in the skin types you see and they have a lot of impressive specialty clinics. UAB is similar with a strong faculty and lots of variety and opportunities.

Northwestern is particularly strong in peds, and they have a peds fellowship along with mohs and path, but I don't think anything else stands out there. It's pretty much a private practice feeling there, isn't it? I think it's a great place, but I don't know how you could justify saying that it's better than WF, Sinai, Colorado, and Alabama. What do you see as special about the training there?

Stanford has some pluses and minuses. You see different types of skin and patients with the VA and at Santa Clara, but there's only 3 months of derm path and none in the first year. The research there is impressive, but I don't think that it has much effect on the residents' training. I don't think they have any fellowship opportunities, right? That's a good thing and a bad thing in my mind. Again, I don't see how you could say that there's superior training there over a Colorado or an Alabama.

In my mind all four of those are similar. I'd love to learn what sets Stanford and NW in your mind from Colorado, Alabama, Sinai, and Wake. Why are those on the list the ones that "almost everybody should agree on?" Is it not important to see different skin types and get exposed to all areas of Derm? That's a huge part of training missing at several of those top places. The research dollars that play a heavy role in rankings like this don't mean much for residency training.

 

[N-Surge]

I would subtract wake forest and mount siani from that list and add northwestern and possibly yale/stanford.

Colorado and Alabama? Certainly excellent programs but no where NEAR the top ones listed there.

For clinical training? We are talking about clinical training. Colorado would most definitely be near the top. UAB, I am not sure. I have just heard it is a very strong program. Then again, this is all very subjective because it depends on what one is looking for.

I thought we had moved on to talk about "great places to train", no?

 

[Long Dong]

I'd like to add that on the dermboard they had a fab four that was always mentioned in the same sentence as the top derm programs. They were, in no particular order, Harvard, UCSF, NYU, and UPenn. So I would like to add to the list UPenn, since it hasn't been mentioned in this thread yet.

I would also like to give honorable mention to Jefferson, since I've always read good things about jefferson on the dermboard.

(disclaimer never been to UPenn or Jefferson, just wanted to add them for conversation)

 

[N-Surge]

I'd like to add that on the dermboard they had a fab four that was always mentioned in the same sentence as the top derm programs. They were, in no particular order, Harvard, UCSF, NYU, and UPenn. So I would like to add to the list UPenn, since it hasn't been mentioned in this thread yet.

I would also like to give honorable mention to Jefferson, since I've always read good things about jefferson on the dermboard.

(disclaimer never been to UPenn or Jefferson, just wanted to add them for conversation)

I am a bad person for not having mentioned UPenn in my previous post as well... Terrible...

 

[werd]

it's all a matter of perspective i guess... i interviewed at u.mich and wake, both were in the middle of my rank list. haven't been to the other ones.

 

[asmallchild]

I'd like to add that on the dermboard they had a fab four that was always mentioned in the same sentence as the top derm programs. They were, in no particular order, Harvard, UCSF, NYU, and UPenn. So I would like to add to the list UPenn, since it hasn't been mentioned in this thread yet.

I would also like to give honorable mention to Jefferson, since I've always read good things about jefferson on the dermboard.

(disclaimer never been to UPenn or Jefferson, just wanted to add them for conversation)

Having interviewed at Penn, I would definitely agree that it's a top notch program. The only thing that kept me from ranking it higher was location (I more of a Texas gal ) A fairly large and diverse program with lots of unique opportunities.

I was kind of surprised to not get an interview from Jefferson after having received one from Penn but it's another program that I've heard very good things about as well.

I'm not too familiar with other programs in the Pennsylvania area however.

 

[dgruntledmizzou]

I'd like to add that on the dermboard they had a fab four that was always mentioned in the same sentence as the top derm programs. They were, in no particular order, Harvard, UCSF, NYU, and UPenn. So I would like to add to the list UPenn, since it hasn't been mentioned in this thread yet.

I would also like to give honorable mention to Jefferson, since I've always read good things about jefferson on the dermboard.

(disclaimer never been to UPenn or Jefferson, just wanted to add them for conversation)

I interviewed at both. Nice programs

 

[number1mejdc]

does anyone know anything about lsu new orleans derm program. i was not even aware that they had one.

 

[dermRus]

I tend to agree with Dermguy on this one. Rankings are based on research dollars but your clinical education is based on the individual faculty that are going to teach you. There are a lot of great clinical educators but they really don't get as much love as the research faculty (for ranking or for promotions) and so their contributions get hidden.

These conversations never come to a solid conclusion and we're usually left with naming the top research programs as the best programs...they are top programs for sure but your clinical education (which is no small feat by any means) is based on a lot of factors not accounted for in the research rankings...like the clinical educators, the individual resident, and patient population. Small example...some places give you resident continuity clinics and some don't...I think it's important to see your own patients and make your treatment judgments and see them back in follow up to see how that worked.

I'm saying this coming with a heavy research background and I love the research side of derm. But don't think that research atomatically means the best clinical training. Nothing makes me cringe more than to hear somebody say that a particular program sucks, especially when they have never trained there...how do you know?...you were never there...you don't know who the individual educators are.

I went to a top flight graduate program and I remember all the BRILLIANT people that I would meet from all over at the conferences. Don't let labels get in the way of your education.

 

[werd]

there are a lot of strong derm programs, and what programs are "best" is very individualized. these rankings are often based on a number of factors, many of which an individual applicant may or may not care about at all. person A doesn't care about research, person B doesn't care about number of faculty, etc. by the time you get to residency, many ppl have particular goals and priorities, and external rankings of programs become less meaningful.

 

[PMPLPPR]

I tend to agree with Dermguy on this one. Rankings are based on research dollars but your clinical education is based on the individual faculty that are going to teach you. There are a lot of great clinical educators but they really don't get as much love as the research faculty (for ranking or for promotions) and so their contributions get hidden.

These conversations never come to a solid conclusion and we're usually left with naming the top research programs as the best programs...they are top programs for sure but your clinical education (which is no small feat by any means) is based on a lot of factors not accounted for in the research rankings...like the clinical educators, the individual resident, and patient population. Small example...some places give you resident continuity clinics and some don't...I think it's important to see your own patients and make your treatment judgments and see them back in follow up to see how that worked.

I'm saying this coming with a heavy research background and I love the research side of derm. But don't think that research atomatically means the best clinical training. Nothing makes me cringe more than to hear somebody say that a particular program sucks, especially when they have never trained there...how do you know?...you were never there...you don't know who the individual educators are.

Here here! Aside from continuity clinics, when going on interviews, ask about how much direct experience you get in surgery,gen derm clinics, etc. Your clinical education is much more important that dollars the dept brings in for research. Are the patients yours or are you merely shadowing/presenting a subjective and objective. Are you getting to do a lot of Mohs or there to blot and cut sutures for the fellows?

 

[doctalaughs]

Here here! Aside from continuity clinics, when going on interviews, ask about how much direct experience you get in surgery,gen derm clinics, etc. Your clinical education is much more important that dollars the dept brings in for research. Are the patients yours or are you merely shadowing/presenting a subjective and objective. Are you getting to do a lot of Mohs or there to blot and cut sutures for the fellows?

I would add a few things that can help determine the quality of clinical training:
1. What's the quality of grand rounds and how often are they held?
2. Do the residents have any say in which attendings they work with or are they "stuck" with learning derm from a few faculty that may or may not be good (ie if an attending doesn't teach do they still get residents)
3. Are most didactics run by faculty or residents?
4. Does the program "emphasize" boards prep and memorizing minutiae?
5. What's the consult service like- what kinds of cases do you see and how often? Are the residents comfortable with complex cases and systemic therapies?
6. What specialty clinics are available?

 

[reno911]

2. Do the residents have any say in which attendings they work with

I'd like to see the program where the residents can "choose" their attendings in any meaningful way, so I think this question isn't a particularly useful one.

The others are fine.

 

[doctalaughs]

I'd like to see the program where the residents can "choose" their attendings in any meaningful way, so I think this question isn't a particularly useful one.

The others are fine.

Untrue. There are definitely programs where there are enough faculty so that if an attending consistently gets bad evaluations from residents (ie does not teach or abuses residents) he/she will no longer get residents assigned in subsequent years. Of course this is unlikely to happen to chairs or very senior attendings though it can.

I've noticed there are departments where residents have very little power and that is one thing to get a sense of during interviews. A system that promotes and rewards good teaching is key. Otherwise you may have to "extract" the truly useful clinical knowledge that is invaluable (if the faculty you are working with even have it).

 

[squam76]

I would subtract wake forest and mount siani from that list and add northwestern and possibly yale/stanford.

Colorado and Alabama? Certainly excellent programs but no where NEAR the top ones listed there. The ones on that list should be those that almost everyone agrees on and there are 10-20 that I could think of before alabama, colorado, wake forest and mount siani.

"Best programs" totally depends on what you are looking for in a program! Why is UCSF on these "best" lists, but not Stanford? Maybe because in general, UCSF is a top 10 Med School.........Stanford is not. In addition, UCSF has a much larger, more senior faculty, and fantastic dermpath and surgery (both of which are weak at Stanford.) BUT, Stanford is much more "friendly". The reputation of Stanford being the "coddled" residency is true, but is that bad? You are going to learn dermatology anywhere if you match. While the faculty at Stanford can't hold a candle to UCSF (except for the basic researchers..... which has nothing to do with becoming a good clinical dermatologist), there is a warm and fuzzy feeling at Stanford that UCSF doesn't have. So what are you looking for? UCSF and Stanford are totally different............which is "better" depends on what you want. UCSF is much more academic, with a much stronger clinical faculty.... but Stanford may be a more enjoyable place to train.

 

[reno911]

Untrue. There are definitely programs where there are enough faculty so that if an attending consistently gets bad evaluations from residents (ie does not teach or abuses residents) he/she will no longer get residents assigned in subsequent years. Of course this is unlikely to happen to chairs or very senior attendings though it can.

I've noticed there are departments where residents have very little power and that is one thing to get a sense of during interviews. A system that promotes and rewards good teaching is key. Otherwise you may have to "extract" the truly useful clinical knowledge that is invaluable (if the faculty you are working with even have it).

First of all, the phenomenon that you are talking about is so rare that it is not useful to use it as a criterion for rating a program. An attending would really have to be extremely bad for such an action to be taken. And there would have to be repeated complaints over years.

Secondly, what you are talking about is not really residents choosing attendings in a meaningful way. If I'm coming in to a program, then that choice is already made for me. I'm not choosing anything. Perhaps after years of complaints, things may change (and that is unfortunately rare), but I'll be gone by then. Once again, the chance of this even happening is minute.

Unfortunately, there is no such thing in academia as a system that promotes and rewards good teaching. I'm not saying that some programs don't try, it's just that they're not effective. There are no substantial rewards (monetary or otherwise) available that are really going to motivate someone to go from being a mediocre teacher to a good one. The best that programs can do is make sure their good teachers are retained and don't leave for other reasons.

Most of the good teaching that residents get generally comes from attendings who really enjoy teaching and feel responsible for making sure that their residents end up well-trained. Such attendings, in general, will teach well regardless of any "rewards" you may be envisioning.

 

[Nellyakgo]

What's a "resident continuity clinic"? Sorry if it's a stupid question. I did google it, but didn't get the point.


Btw, re. one of the very first posts - this is tangential but: interesting that vanilla has come to be used in the general lexicon for a color it isn't. Real vanilla is dark brown.

 

[Iwy Em Hotep]

What's a "resident continuity clinic"? Sorry if it's a stupid question. I did google it, but didn't get the point.

Your clinic, with a rotating attending depending on the day. It's a chance to make your own decisions and see your own patients over again.

 

[Nellyakgo]

Thank you.
As opposed to what?

 

[turkish]

As opposed to clinics wherein the patients "belong" to the attendings and are scheduled under their names. Residents are randomly and haphazardly inserted into clinic, doing biopsies and prescribing treatment for patients whom they may or may not ever see again. Much valuable knowledge is lost this way, but it is the most efficient method for programs to see patients and make money. You learn a lot of dermatology through follow-up, through seeing which treatments work for which morphologies, how quickly they work, and what the side-effects look like up close.