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Hopefully, this post will be well received by future plastic surgery applicants. It is purely intended to be one individual's opinion of various programs and in no way a condemnation of any program. IMHO, every program graduates competent residents it just depends on what you want from a training program. During the application process I enjoyed reading varying accounts of PRS programs and thought I would give back. Here are some brief pros and cons of several places:
1. NYU
Pros: strong 3 years of plastic surgery, well known faculty, Bellevue is a machine with incredible autonomy, solid head and neck recon with good exposure to free fibs and the like, pretty strong in all areas (McCarthy thinks genital reconstruction is weak, but if that is your only weakness!), very strong volume which also means kiss 80hrs goodbye because these guys really work, no double scrubbing
Cons: 3 years of gensurg nad during this time the operative experience is fairly weak, Bellvue is very tough and the residents do everything from start IVs, push patients, draw blood etc.., it is a top down militaristic program which might turn some people off, Tisch is a little more hands off but the residents still get a decent operative experience but nothing like Bellevue, many of their well-known faculty could be close to retirement within the next 6 years or sooner(McCarthy, Cutting, Ashton and maybe some others) but I am just guessing because of current age.
2. Pitt
Pros: amazing operative experience especially in reconstruction of every variety, some of the best autonomy available on every rotation, all of the head and neck cancer flaps recon is done by plastics, amazing in the OR teaching, Losee truly cares about the training of his residents, Rubin is the new chair and really nice guy, 18 months of gensurg (1.5 +4.5), research is amazing, great faculty, work hard but the residents are treated with respect, no double scrubbing
Cons: almost no cosmetic (depends on your goals), these guys pile up the hours especially on the recon service which may not be a con to some, didactics is average, 7 years with that extra year in basic science research with no exception, at the interview they will tell you that they have no interest in training private practice PRS guys, with the loss of Andy Lee probably no more hand transplants
3. Harvard
Pros: great residents who treat medical students well and really get along, good case volume, good case variety, one of the largest programs in the country, 80hr work week is def. possible, solid didactics and curriculum, 2+4 so you get strong PRS exposure, well known faculty members
Cons: one of the least hands on residency programs I personally interacted with, but I was only at MGH so it could be different at the other hospitals , frequent double scrubbing, attending's were very hands on, other friends have made similar comments to me about Harvard when comparing that program to others.
4. Northwestern
Pros: excellent clinical surgical experience, great residents, great faculty, happiest residents on the trail by far, 80hr work week very likely, there are no fellows and so the residents do every case, very strong case load, operative autonomy is amazing (only place I have seen a PGY-2 do a palate alone), really strong cosmetic, really strong craniofacial, breast and micro is also strong, PA's help with the floor work leaving the residents to pretty much just operate, 1.5+4.5 so strong PRS exposure, new childrens hospital opening, everything is pretty localized which limits a lot of driving all over the city, moonlighting during research year allows residents to save a considerable amount of money
Cons: PRS does only about 50-60% of head and neck recon, craniofacial trauma was a weakeness but 6-8 months of cook county has been added which should fix that problem, recent faulty departure (Bauer, Few), Mustoe stepped down but is still pretty young (late 50s I believe) and still operates with the residents but nonetheless it must be considered, while hand surgery is pretty good for elective stuff there are not many replants, not as many "famous" faculty members as other institutions, 1 year of research required which might be a downside for some
These are the programs that I either only interviewed at and/or heard about from others on the trail:
5. UW
Pros: great 3 years of plastic surgery, strong craniofacial, strong hand, residents very happy, good operative experience, strong volume, several household names in plastic surgery
Cons: supposedly weaker operative experience in general surgery in the first 3 years, gen surg years are tough, there are a lot of fellows but the case load is strong, weak cosmetic training
6. Upenn
Pros: great 3 years of plastic surgery, great craniofacial and breast recon, well known faculty, appeared to be leaning towards a 1+5 in the future which would make this place amazing
Cons: hand not as strong as other areas, 3 years of gen surg is supposedly miserable with prs residents being given the least desired rotations, although when on the entire trail I only met a couple of residents who did not absolutely hate gensurg and think it was overkill so this is not just isolated to this program, Whitaker is likely to leave soon
7. UTSW
Pros: Amazing training (very close to a 1+5, maybe 12 months of GS because Rohrich thinks GS is a waste and gives his residents bad habits. I agree with Rohrich). Whenever someone says the only thing that matters to them is getting the best surgical training I always say, "Go to UTSW." The courses that are available each year that other programs have to pay for in order to attend are amazing. The operative experience is phenomenal throughout every rotation and especially at parkland. The program is filled with heavy hitters. You are able to publish in PRS reflexively and when it is time to get a job you have Rohrich backing you. There is even a photography course to make sure you know how to utilize the camera appropriately and take pictures for your boards. Former residents were remarking that oral boards were a piece of cake after going through the didactic sessions led by Rohrich, Barton, Kenkel, and Janis. Tons of cosmo, recon, hand. The best organized interview day on the trail. While I did not end up at UTSW, nor did I rank it #1, I have no problem saying this is the best plastic surgery training program by the numbers.
Cons: There is little head and neck recon., but that is almost every program except for NYU or Pitt. The program is on hand replant call 24hrs a day/365 days a year, which can be tough. The time at Parkland is tough and the residents work insane hours here...that place is no joke and is similar to Bellevue in NY. Militaristic program and the personality of that program is very tough. The entire interview day the faculty emphasized that they had changed and were no longer malignant but the residents were undercutting this message behind the scenes. The interns and PGY-2's thought the program wasn't malignant but the residents who had been in the program for several years did not hide it. Many of them stated that it was not a "happy place" but thought the training was top-notch, and some used the term malignant. A good friend of mine did a fellowship at UTSW recently and I talked with him about the place. He told me that unequivocally the residents were treated with an iron hand and some had openly second guessed their decision to come to UTSW. He told me that he would not have gone through it and unless you wanted to be a chairman then it was not worth it and even then. Rotators were split, some thinking that the program was mildly malignant and others feeling that the reputation was over blown. UTSW is painfully aware of their reputation and I believe tone it down for rotators and applicants, and doing something for 4 weeks is different than doing it for 6 years. Ask the residents that have been in the program for several years, not just the interns and pgy-2's, and see what they say. Be careful about doing this on the interview day because I got the feeling that applicants who seemed overly concerned about "resident treatment" did not appear to be heavily favored by staff or residents.
8. Stanford
Pros: Location. Tried to stay away from mentioning this but I felt this was one of the biggest strengths of Stanford. The people are awesome (residents and faculty) and so is the lifestyle. Gordon Lee is an great microsurgeon and teacher who is well thought of.
Cons: Low operative volume is the main negative critique. Someone who rotated through Stanford, and was an amazing applicant, revealed to me that he would not even rank the program because of his opinion of the operative experience.
9. University of Chicago (requested by PM)
Pros: the faculty and residents were extraordinarily nice with the applicants and each other. They really emphasize fit which is underscored by the presentation they have each applicant prepare and present. Really solid reconstruction experience, described as the "soul" of the program by the chair. The craniofacial experience appears to be solid as well with Dr. Reid and Dr. Bauer leading the charge. Cannot really comment on autonomy because while I asked I got the plain response of, "Its pretty good."
Cons: several cosmetic surgeons have been added but previously cosmo was low, rumored to have an average volume by some rotators. Nothing about the program personally floored me, but it seemed to be a decent program on most accounts. The first 3 years appeared to be mostly general surgery which was a turn off.
10. UW Madison (Requested by PM)
Pros: Bentz is an amazing chairman and fosters a nurturing environment for the residents. Bentz likes to focus on the "fit" of the applicants and on interview day said, "You can pretty much teach a monkey to to operate," but it was the intangibles that were difficult predict on one interview day. The operative experience is "solid" but the volume is not crazy by any means, a friend of my mine who rotated there said she would judge the resident operative experience as "most likely good enough"; while there Bentz indicated he was decreasing the amount of residents to two in order to achieve a better balance. The academics are average and I did not get the feel it was first priority or that the majority of the residents were dedicated to academic careers. With that being said, there were some exceptions and Bentz appeared to go out of his way to lend supports to residents inclined to pursue the research path. Great faculty, great residents, and everyone was really happy. It appeared to be a family program. Teaching is supposed to be very good in and out of the OR.
Cons: Research not overwhelming and it appeared to more of a clinical program. Average volume, maybe a little on low side but not Stanford low (this is from a fellow rotator who visited both of these places). Low prestige factor, not many famous plastic surgeons (if that is important to you, it was not to me but thought I would mention it). I got the impression that the first three years was mostly gensurg.
11 MCV
Pros: Dr. Posez is quite nice and the residents appeared to be extraordinarily happy. Residents appeared happy with OR experience.
Cons: Quite a small program with little emphasis on research(could be a positive). Not a high volume place with a lot of the "bells and whistles" that you would find at a more prestigous program.
12. Georgetown
Pros: Reportedly a very good operating experience. Work hard/play hard atmosphere. Get to work with some big names such as Spear, Nahabedian(sp?), and Posnick. Decent recon. Spear is a strong advocate of integrated PRS and GS time is limited. Mostly positive comments by rotators. There were some fellows at my home program who were recent G-Town grads and they had great things to say about their training.
Cons: Weaker in craniofacial and hand. The program is very breast heavy, which depending on your goals could be a positive or negative. A resident who graduated from G-TOWN said Spear was supposedly retiring in the next 3 years, but who knows if that means retiring all together or just stepping down as chair. Some rotators felt the atmosphere was best suited for a former athlete because it had a jock or frat house feel. The hours are supposedly tough according to some rotators and residents. Although reportedly a great teacher, Dr. Spear can be difficult but he only really works with chief residents. If if he left in three years then the new incoming residents would not work with him much.
Got tired of writing, but feel free to PM me with any questions about specific programs and if I can give any help I will. I hope to encourage other applicants to give their feedback on programs to start a running dialogue.
Sorry for any typos
1. NYU
Pros: strong 3 years of plastic surgery, well known faculty, Bellevue is a machine with incredible autonomy, solid head and neck recon with good exposure to free fibs and the like, pretty strong in all areas (McCarthy thinks genital reconstruction is weak, but if that is your only weakness!), very strong volume which also means kiss 80hrs goodbye because these guys really work, no double scrubbing
Cons: 3 years of gensurg nad during this time the operative experience is fairly weak, Bellvue is very tough and the residents do everything from start IVs, push patients, draw blood etc.., it is a top down militaristic program which might turn some people off, Tisch is a little more hands off but the residents still get a decent operative experience but nothing like Bellevue, many of their well-known faculty could be close to retirement within the next 6 years or sooner(McCarthy, Cutting, Ashton and maybe some others) but I am just guessing because of current age.
2. Pitt
Pros: amazing operative experience especially in reconstruction of every variety, some of the best autonomy available on every rotation, all of the head and neck cancer flaps recon is done by plastics, amazing in the OR teaching, Losee truly cares about the training of his residents, Rubin is the new chair and really nice guy, 18 months of gensurg (1.5 +4.5), research is amazing, great faculty, work hard but the residents are treated with respect, no double scrubbing
Cons: almost no cosmetic (depends on your goals), these guys pile up the hours especially on the recon service which may not be a con to some, didactics is average, 7 years with that extra year in basic science research with no exception, at the interview they will tell you that they have no interest in training private practice PRS guys, with the loss of Andy Lee probably no more hand transplants
3. Harvard
Pros: great residents who treat medical students well and really get along, good case volume, good case variety, one of the largest programs in the country, 80hr work week is def. possible, solid didactics and curriculum, 2+4 so you get strong PRS exposure, well known faculty members
Cons: one of the least hands on residency programs I personally interacted with, but I was only at MGH so it could be different at the other hospitals , frequent double scrubbing, attending's were very hands on, other friends have made similar comments to me about Harvard when comparing that program to others.
4. Northwestern
Pros: excellent clinical surgical experience, great residents, great faculty, happiest residents on the trail by far, 80hr work week very likely, there are no fellows and so the residents do every case, very strong case load, operative autonomy is amazing (only place I have seen a PGY-2 do a palate alone), really strong cosmetic, really strong craniofacial, breast and micro is also strong, PA's help with the floor work leaving the residents to pretty much just operate, 1.5+4.5 so strong PRS exposure, new childrens hospital opening, everything is pretty localized which limits a lot of driving all over the city, moonlighting during research year allows residents to save a considerable amount of money
Cons: PRS does only about 50-60% of head and neck recon, craniofacial trauma was a weakeness but 6-8 months of cook county has been added which should fix that problem, recent faulty departure (Bauer, Few), Mustoe stepped down but is still pretty young (late 50s I believe) and still operates with the residents but nonetheless it must be considered, while hand surgery is pretty good for elective stuff there are not many replants, not as many "famous" faculty members as other institutions, 1 year of research required which might be a downside for some
These are the programs that I either only interviewed at and/or heard about from others on the trail:
5. UW
Pros: great 3 years of plastic surgery, strong craniofacial, strong hand, residents very happy, good operative experience, strong volume, several household names in plastic surgery
Cons: supposedly weaker operative experience in general surgery in the first 3 years, gen surg years are tough, there are a lot of fellows but the case load is strong, weak cosmetic training
6. Upenn
Pros: great 3 years of plastic surgery, great craniofacial and breast recon, well known faculty, appeared to be leaning towards a 1+5 in the future which would make this place amazing
Cons: hand not as strong as other areas, 3 years of gen surg is supposedly miserable with prs residents being given the least desired rotations, although when on the entire trail I only met a couple of residents who did not absolutely hate gensurg and think it was overkill so this is not just isolated to this program, Whitaker is likely to leave soon
7. UTSW
Pros: Amazing training (very close to a 1+5, maybe 12 months of GS because Rohrich thinks GS is a waste and gives his residents bad habits. I agree with Rohrich). Whenever someone says the only thing that matters to them is getting the best surgical training I always say, "Go to UTSW." The courses that are available each year that other programs have to pay for in order to attend are amazing. The operative experience is phenomenal throughout every rotation and especially at parkland. The program is filled with heavy hitters. You are able to publish in PRS reflexively and when it is time to get a job you have Rohrich backing you. There is even a photography course to make sure you know how to utilize the camera appropriately and take pictures for your boards. Former residents were remarking that oral boards were a piece of cake after going through the didactic sessions led by Rohrich, Barton, Kenkel, and Janis. Tons of cosmo, recon, hand. The best organized interview day on the trail. While I did not end up at UTSW, nor did I rank it #1, I have no problem saying this is the best plastic surgery training program by the numbers.
Cons: There is little head and neck recon., but that is almost every program except for NYU or Pitt. The program is on hand replant call 24hrs a day/365 days a year, which can be tough. The time at Parkland is tough and the residents work insane hours here...that place is no joke and is similar to Bellevue in NY. Militaristic program and the personality of that program is very tough. The entire interview day the faculty emphasized that they had changed and were no longer malignant but the residents were undercutting this message behind the scenes. The interns and PGY-2's thought the program wasn't malignant but the residents who had been in the program for several years did not hide it. Many of them stated that it was not a "happy place" but thought the training was top-notch, and some used the term malignant. A good friend of mine did a fellowship at UTSW recently and I talked with him about the place. He told me that unequivocally the residents were treated with an iron hand and some had openly second guessed their decision to come to UTSW. He told me that he would not have gone through it and unless you wanted to be a chairman then it was not worth it and even then. Rotators were split, some thinking that the program was mildly malignant and others feeling that the reputation was over blown. UTSW is painfully aware of their reputation and I believe tone it down for rotators and applicants, and doing something for 4 weeks is different than doing it for 6 years. Ask the residents that have been in the program for several years, not just the interns and pgy-2's, and see what they say. Be careful about doing this on the interview day because I got the feeling that applicants who seemed overly concerned about "resident treatment" did not appear to be heavily favored by staff or residents.
8. Stanford
Pros: Location. Tried to stay away from mentioning this but I felt this was one of the biggest strengths of Stanford. The people are awesome (residents and faculty) and so is the lifestyle. Gordon Lee is an great microsurgeon and teacher who is well thought of.
Cons: Low operative volume is the main negative critique. Someone who rotated through Stanford, and was an amazing applicant, revealed to me that he would not even rank the program because of his opinion of the operative experience.
9. University of Chicago (requested by PM)
Pros: the faculty and residents were extraordinarily nice with the applicants and each other. They really emphasize fit which is underscored by the presentation they have each applicant prepare and present. Really solid reconstruction experience, described as the "soul" of the program by the chair. The craniofacial experience appears to be solid as well with Dr. Reid and Dr. Bauer leading the charge. Cannot really comment on autonomy because while I asked I got the plain response of, "Its pretty good."
Cons: several cosmetic surgeons have been added but previously cosmo was low, rumored to have an average volume by some rotators. Nothing about the program personally floored me, but it seemed to be a decent program on most accounts. The first 3 years appeared to be mostly general surgery which was a turn off.
10. UW Madison (Requested by PM)
Pros: Bentz is an amazing chairman and fosters a nurturing environment for the residents. Bentz likes to focus on the "fit" of the applicants and on interview day said, "You can pretty much teach a monkey to to operate," but it was the intangibles that were difficult predict on one interview day. The operative experience is "solid" but the volume is not crazy by any means, a friend of my mine who rotated there said she would judge the resident operative experience as "most likely good enough"; while there Bentz indicated he was decreasing the amount of residents to two in order to achieve a better balance. The academics are average and I did not get the feel it was first priority or that the majority of the residents were dedicated to academic careers. With that being said, there were some exceptions and Bentz appeared to go out of his way to lend supports to residents inclined to pursue the research path. Great faculty, great residents, and everyone was really happy. It appeared to be a family program. Teaching is supposed to be very good in and out of the OR.
Cons: Research not overwhelming and it appeared to more of a clinical program. Average volume, maybe a little on low side but not Stanford low (this is from a fellow rotator who visited both of these places). Low prestige factor, not many famous plastic surgeons (if that is important to you, it was not to me but thought I would mention it). I got the impression that the first three years was mostly gensurg.
11 MCV
Pros: Dr. Posez is quite nice and the residents appeared to be extraordinarily happy. Residents appeared happy with OR experience.
Cons: Quite a small program with little emphasis on research(could be a positive). Not a high volume place with a lot of the "bells and whistles" that you would find at a more prestigous program.
12. Georgetown
Pros: Reportedly a very good operating experience. Work hard/play hard atmosphere. Get to work with some big names such as Spear, Nahabedian(sp?), and Posnick. Decent recon. Spear is a strong advocate of integrated PRS and GS time is limited. Mostly positive comments by rotators. There were some fellows at my home program who were recent G-Town grads and they had great things to say about their training.
Cons: Weaker in craniofacial and hand. The program is very breast heavy, which depending on your goals could be a positive or negative. A resident who graduated from G-TOWN said Spear was supposedly retiring in the next 3 years, but who knows if that means retiring all together or just stepping down as chair. Some rotators felt the atmosphere was best suited for a former athlete because it had a jock or frat house feel. The hours are supposedly tough according to some rotators and residents. Although reportedly a great teacher, Dr. Spear can be difficult but he only really works with chief residents. If if he left in three years then the new incoming residents would not work with him much.
Got tired of writing, but feel free to PM me with any questions about specific programs and if I can give any help I will. I hope to encourage other applicants to give their feedback on programs to start a running dialogue.
Sorry for any typos
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