Location Advice

[SuzySunshine]

Hi all, as I think you know my husband has started the residency application process and we are getting ready to decide which schools to send the application to.

If any of you live in the following cities now, have lived, know people that live there, or have any experience with them I'd love to hear the pros and cons! I know there aren't many neurosurgery spouses here, but if you know anything about the programs that would be great too!

Cities:
St. Louis, MO (WashU)
Seattle, WA (U of WA)
Ann Arbor, MI (U of MI)
Pittsburgh, PA (U of Pitt)
Rochester, MN (Mayo)
Houston, TX (Baylor)
Cleveland, OH (Cleveland Clinic)
Boston, MA (Harvard programs?)
New York, NY (Columbia/Cornell programs)
Phoenix, AZ (Barrow)
Chicago, IL (Northwestern)
San Francisco, CA (UCSF)
Baltimore, MD (John Hopkins)
Raleigh/Durham, NC (Duke/UNC)

Can you tell we're casting a wide net?

Thanks!

[mommax3]

I know nothing about any of the programs at these places, but I feel like I have enough experience with them to give an opinion just based on liveability:

I love Chicago -- we just spent a week there and enjoyed every minute of it. Obviously, inexpensive housing will be a challenge, but maybe coming from California, you wouldn't have too much sticker shock. If you are a city person and don't mind cold weather, Chicago is great. There is always something going on. If I didn't have three kids, I would buy a condo downtown and move there myself!

St. Louis is also nice --- not on the same level of city as Chicago, but nice just the same. It is smack in the middle of the country so it is not too hard to fly to one coast or the other. The weather can be miserable (humid) in the summers, (not all the time, though) but the winters are certainly more moderate than Chicago and other northern cities, although you would still get to experience all four seasons.

I have heard recently that Ann Arbor is one of the most expensive places to live in the nation, especially considering that you are not talking big city living by a long stretch. My sister lived there when she went to grad school and apartments were pretty expensive. It tends to be a very liberal community as well, which may be a plus or a minus for you. COLD.

Houston ---- lots of traffic nightmares, air pollution issues from the refineries, and humid as can be. They are also vulnerable to hurricanes. On the plus side, except for summer, the weather is very enjoyable, and housing is cheap, comparitively. Houston also has that whole Texas thing going on --- a lot of people find the state addictive!

Sally

[fluffhead]

Re: Location Advice

Wow that's a long list...
My wife interviewed at wash U - she loved the program, but I HATED St. Louis, and vetoed it. I found it extremely segregated, gray, and small-minded. (but that's just me...)
I hear wonderful things about ann arbor - they didn't get us an interview date until she was 9 months pregnant...so we didn't go.
Columbia/Cornell: Cornell gives very subsidized housing on the upper east side, which is an amazing deal, but it can be pretty small. For many of the specialties they offer home call because the housing is right across the street, but that doesn't mean he won't be called in every night on call. Columbia is another story, you may not want to live in the immediate area, but some New Jersey towns are within easy commuting distance, though expensive. My wife interviewed at both - Columbia can be pretty malignant in some specialties - see if the residents are happy.
I've heard bad things about Hopkins. Baltimore can be very cool - depends on the neighborhood. Though summers can be brutal.
People here can tell you about Boston and Rochester.

Cities:
St. Louis, MO (WashU)
Seattle, WA (U of WA)
Ann Arbor, MI (U of MI)
Pittsburgh, PA (U of Pitt)
Rochester, MN (Mayo)
Houston, TX (Baylor)
Cleveland, OH (Cleveland Clinic)
Boston, MA (Harvard programs?)
New York, NY (Columbia/Cornell programs)
Phoenix, AZ (Barrow)
Chicago, IL (Northwestern)
San Francisco, CA (UCSF)
Baltimore, MD (John Hopkins)
Raleigh/Durham, NC (Duke/UNC)

[migirl]

Ann Arbor, MI

Ann Arbor, MI

My husband is a PGY-2 resident in urology at the University of Michigan, and we currently live in Ann Arbor. We both attended the U-M for undergrad and grew up in the area, so coming here was like coming home for us. While I have to agree with Sally's observations (a tad on the pricey side for living expenses and pretty liberal), we absolutely love it here. It's a not-too-big-city, so (IMO) it's a bit more manageable than some bigger cities. Since it is a college town, there are always lots of cultural things to do; if you're a fan of "outdoor" type activities, there are tons of parks and gardens, etc. Regarding the cold: maybe because I grew up here, it's never really bothered me (I sort of think that the claims of cold have been generally overstated ). However, to make up for what might be perceived as a brutal winter, we have the most beautiful springs, summers, and falls! 8) We're about 30 minutes from Detroit (which, contrary to popular belief, has some nice things to do ) and about 3-1/2 hours from Chicago. I think it's a wonderful midwestern community to live in and I would be happy to live here forever (unfortunately, my husband with a potential fellowship, has other ideas…).

As far as the hospital goes, my husband absolutely loves it; it was far and away his top choice for residency. The surgery department at the U-M seems to be not as "malignant" as some programs can be, and in general the residents are treated very well. As I understand it, the U-M is one of the few hospitals where the residents are unionized; that bargaining power has gotten them some very good benefits. The general surgery intern year was not as bad as we thought it was going to be, it is definitely manageable.

If you have questions specifically about U-M's neuro program, my husband has a couple of friends who are neuro residents; if you're interested I can try to put you in touch with them, or you can PM me any questions and I can ask him to find out the answers for you.


Chicago, IL

While I've never lived in Chicago, we live close enough that we try to go there for the occasional weekend. When we made up our rank list, Chicago (Northwestern, in fact) came in a very close second. We love it there; it is such a fun place to be! It is a great city with somewhat of a midwestern feel, so it doesn't feel too big and imposing. Chicago can also be very cold and wintry, but IMO the other seasons more than make up for it.

The Northwestern hospital is actually in downtown Chicago (just a few blocks from all of the shops on Michigan Ave!), so it's a great location but if you want to live nearby you're going to pay big $$$. I'm trying to remember … I think my husband mentioned something about the residents there getting subsidized housing. I can't remember exactly, so don't quote me on that. It's a beautiful hospital though (since my husband is a total geek , he actually made us walk through part of the hospital while we were walking by on our way to breakfast), it actually looks like a hotel when you first walk in.

I hope this is helpful, it can be hard trying to choose a new place to live!

Well, I think that is great that you are casting a wide net. It opens up more opportunities for you. A few things I would suggest:
1. Go on as many interview trips with your husband as you can.
2. Make lists of things you like and don't like about your current location and other places you have liked living. Use these criteria when looking at other places.
3. What do you think the next 5 or so years will bring in your lives? Do you want to have children? Pursue your career? Think about cities and locations that would be good for these things (good schools, close to family, concentration of industry you are interested in, etc).
4. We used the website bestplaces.net to get an idea about a city (it is high level information so it doesn't tell a whole story).
5. When your husband does interview at these places, there should be time available to talk to the residents and get a sense of the community.

Here are my thoughts on some of the locations (for the most part I know nothing about the programs):
St. Louis, MO (WashU) -- All I recall of St. Louis from childhood visits is the summer humidity. My cousin's friend went to med school there and did her IM residency there. It was *ridiculously* competitive and cut-throat (more so in the med school than the residency). Don't know about other specialties though.

Seattle, WA (U of WA) -- We love Seattle! A really fun city with lots to do if the rain won't leave you totally depressed. Housing costs are *high*. When we were there for IM interviews a few years ago, a house within reasonable distance of the U would be about $300K (1000 sf bungalow). Because of the traffic, you wouldn't want to live that far away. The hospitals are really spread out and necessitate having a car and putting up with the Seattle traffic. So, if you live close to one hospital that means you have a good 20-25m drive to the others (assuming it's not the peak of traffic). I think I remember that correctly --it was a few years ago.

Ann Arbor, MI (U of MI) -- We have a friend doing ER residency there and he LOVES the program. His wife and daughter love the neighborhood they are in and have met many friends there. When we talked to him a few weeks ago, he did mention the cold three separate times. Biggest problem was that their toddler daughter got a little stir crazy being inside all the time. If you grew up in this or don't mind weather much, it's not a big deal. If you're a foodie, Zingerman's deli would be a big plus!

Cleveland, OH (Cleveland Clinic) -- Haven't been here. Wasn't particularly interested in going here and just about had a fit when I found out that Eric applied here for derm. But maybe it's not so bad....a friend of mine said it's much nicer now that the river doesn't catch fire. But really, I have heard that Cleveland has undergone some major changes and has a much nicer urban center. Maybe worth looking at, esp if the location is good for you in terms of family. I'll bet housing prices are lower.

Boston, MA (Harvard programs?) -- Boston rocks! I love Boston! It is just so dang expensive! After having a child, we realized it would just be out of our price range.

San Francisco (UCSF) -- Eric looked at both IM and derm here. Great programs but definitely leaning more to the malignant side. Not awful though and don't know how that corresponds to other programs.

Raleigh/Durham, NC (Duke/UNC) -- We were just in Raleigh/Durham last February and l *loved* it there! A friend is doing ob/gyn at UNC and he loves the program and after adjusting to a new place, his wife really likes the location. Housing is very expensive in Chapel Hill but you can find really nice newer homes in the Durham area. I thought this would be a really cool place to live. And the Outer Banks aren't far away making for an easy getaway.

[Rapunzel]

Houston, TX (Baylor)

I grew up in Texas so I second Sally's "Texas thing" it has going for it. Pros of Houston:
-You have the choice of living in one of the largest metropolitan areas on earth OR you can live just outside of the city borders (which are huge land-area-wise) in virtual farmland. Houston straddles several geographic areas and what portion of the city or 'burbs you live in will vary in landscape from plains to pine forest to swamp.
-The cost of living is CHEAP - especially for such an enormous metropolitan area. If you go southwest of the city (to Friendswood for example) you can find newly built, 4 bedroom houses for less than $150K.
-The weather is pleasant during the fall, winter, and spring.
-You are very close to the shore of the Gulf Coast (don't swim in Galveston, though, go to Padre Island southwest of there) and you can use Houston as a base to visit San Antonio, Austin, Mexico, etc. quite easily (and New Orleans if you really want to go to Louisiana).
-Texans are TEXANS - most are very proud of their identity. However, Houston is the least "Texan" of the Texas cities perhaps due to its status as a financial capital and thus mecca for outsiders.
-The Houston "Medical City" is one of (if not THE) largest conglomeration of hospitals in the world - and Baylor is VERY proud of its programs.
Cons of living in Houston:
-The weather during the summer months is miserable. It is the most humid place (next to Galveston) that I have ever visited.
-The bugs are ENORMOUS. Let me say that again: The bugs are ENORMOUS.
-Horrible traffic.

Boston, MA (Harvard programs?)
I currently live in Boston (the West Roxbury neighborhood to be exact) and my husband is in a Harvard residency program (Brigham and Women's). Pros of Boston:
-It has a distinctive culture and history with many, many interesting and informative landmarks.
-The weather during the summer and fall is GORGEOUS!
-Boston is a "home base" for visiting Maine, New Hampshire, Vermont, Rhode Island, Montreal, Europe, etc, etc.
-I don't know much about the neurosurgery residencies at the Harvard programs but my husband is VERY happy in the rads program at the Brig.
-The architecture is beautiful in and of itself.
-Close to many cool beaches and whale watching (which we have yet to do ).
-The public transportation system is extensive enough to warrant only having one car - or none at all for the truly brave.
Cons of Boston:
-Tourist traps (and there are LOTS).
-TONS of beauracracy - Boston was the birthplace of beauracracy.
-SKY HIGH cost of living. You will pay through the nose to live near your spouse's program. For example, a studio apartment in the Back Bay near MGH will run you $500,000 to
buy and you'll have to pay extra to buy a parking space. We live about a 15 minute drive from B&W in an OK neighborhood and we pay $1800/month for 1900 sq ft and that's cheap - this place could easily go for $2400/month after we're done renovating it.
-As mentioned above, parking is at a premuim and residents and fellows pay for parking in the hospital garages ($15-$30 per DAY).
-The New England "culture" is not as polite and friendly as most other parts of the nation - I've heard this blamed by locals on everything from the fact that the winters are so darned cold to Boston being the most "European" city in the US. Be prepared for rudeness unlike anything you've ever witnessed before among those over the age of 6.
-The winters are miserable.
-Horrible traffic - and the taxi drivers will kill you - seriously.

-Horrible traffic - and the taxi drivers will kill you - seriously.

I forgot about that. But true -- and if the taxi drivers spare you, the regular Boston drivers have a good shot at seriously harming you (whether you are in the car with them, walking, or driving near). Driving in Boston is crazy. A big plus of the extensive subway system!

[SuzySunshine]

Wow, everybody - thanks for the comments, keep them coming!

I do plan to go on as many interviews as possible but because there will be so many it will probably only be a handful. My husband and I are both from Kansas so we've dealt with both extremes of the weather!

Thanks again for all the advice.

[houseelf]

Hi, my advice won't be too helpful because I'm not truly familiar enough to speak about any of these locations.

For whatever it is worth, however, surgical lore has it that Duke and Wash. U. are particularly malignant programs. Is this mere gossip? I honestly don't know. To be honest, our program ain't exactly for pansies. But I've heard this comment from multiple individuals so you might want to check it out.

Kelly

[SuzySunshine]

Excuse the stupidity, but in terms of a program, what does malignant mean?

Malignant means mean, bad, stay away! It means that the programs tend to seriously overwork residents, have NO regard for their personal lives or needs, work them at the expense of their education, horrible call schedule, etc. You can also have a malignant rotation -- a rotation through the medical ICU in a county hospital during winter would probably qualify. (Not that I'm speaking from experience or anything on that one ).

Kelly, I have heard the same re: Duke surgery. If I am remembering correctly....I think I heard that from the PBS special (The Making of a Doctor??) that aired a few years ago. The producers followed several Harvard (?? maybe? or another Boston program?) medical students through school and their residencies. One of the married students went to Duke for surgerical residency and morphed into a serious a**hole, if I remember right. He was divorced a few years into it. The rumor is that Duke surgery brags that no resident who is married going in comes out married. Thus, it is a malignant program.

[SuzySunshine]

Yikes, well since I've been told neurosurgery already has the highest divorce rate we don't want to look at Duke, now do we? :P

[PrincessFiona]

Wow!

Thomas applied for fellowship to a wide number of programs as well. It was expensive, but it did allow us to see more and make comparisons.

My experience with the cities that you listed is limited, but I do have some info. I know about the Rochester program from a surgeon here that operated on our son. He was faculty there (general surgery) for 2 years and left because he said that it was extremely 'malignant'. His problem for the most part was the personalities of the faculty members and politics of the programs.

Having lived in TX for several years, I'd say that Houston is a pretty nice city..though I second what Sally said about pollution...I was also there in August one year....and 115F in the shade....yipes 8) But...Texas just has something about it

I lived in Chicago for years and I would say that it is extremely expensive to live there...like what Rapunzel said for Boston....Traffic is terrible too.

What I would suggest though when choosing a residency is looking at a few factors:

1. Will your husband be at one hospital or will he be driving across the city to several each day?

2. What is the cost of living in the area that you would be and how would it potentially compare with salary that he will be earning?

3. Are there professional/educational opportunities for you if that is what you desire.

4. If you have children, how are the schools in the area?

To do some of these comparisons, check out these sites:

http://www.homefair.com
http://www.cityrating.com
http://www.costofliving.org

Aslo...check out some of our Residency Reviews. we have two from MA:

http://www.medicalspouse.com/iMSN/modul ... ntent&id=6

http://www.medicalspouse.com/iMSN/modul ... ntent&id=4

and one from Ann Arbor:

http://www.medicalspouse.com/iMSN/modul ... ntent&id=7

This would also be a good opportunity to scream at everyone here to post an anonymous review of their spouse's residency program. The information about the program and the surrounding community can really be invaluable to people at this stage of the game! It doesn't cost you anything and it only takes a couple of minutes!

Lastly, check out this page:

http://www.sfmatch.org/public_dir/r-ns/default.htm


This will take you to the dept. websites for the various neurosurgery programs...

kris

[Phoebe]

Cheri- Good luck on your residency search. I can't add much to the mix, especially about any surgery programs, except to say that I echo comments people have made about Ann Arbor. Michigan is a great state to live in and has wonderful vacationing spots north and west of Ann Arbor. I grew up an hour north of Ann Arbor.

I just spent the last three years in Cleveland, but with no association with the Cleveland Clinic. Someone said the city is a lot better than it was years ago when the river caught fire. I have to say that is true. I didn't know much about it before moving there myself. The city is basically separated by the west and the east side divided by downtown. The Clinic is on the eastern side, but minutes from downtown and close to both western and eastern suburbs. Housing and cost of living was affordable on a resident's salary and many were are able to purchase three bedroom homes.

As far as entertainment, the city has lots of cultural activities including symphony, a large theatre district downtown and a decent waterfront. The park system is also very good for hiking, biking and fitness. They are also working on plans to revitalize the downtown. This being said, I have to say that while we were in Cleveland, we enjoyed our experience, but wouldn't want to make it a permanent home. There are some very nice areas and some very scary parts of Cleveland. The crime rate is twice the national average. The suburbs are generally safer, more diverse and have better school systems.

I would be happy to answer any questions about Cleveland if you like.

Jennifer

[Auspicious]

Re: Location Advice

Boston, MA (Harvard programs?)
New York, NY (Columbia/Cornell programs)
Chicago, IL (Northwestern)

Boston: My boyfriend was born and unhappily raised in the northern suburbs of Boston and we still visit his family there, and at this point the entire state of Massachusetts fascinates me. My experiences there match up with everything Jennifer/Rapunzel said (New England is BEAUTIFUL), with the exception that I've found about 2/3 of the people to be Crazy-with-a-capital-C and a little scary and the rest to be terrific, salt-of-the-earth, well-grounded people. The area also seems to have both a noticeable puritanical streak AND a noticeable liberal streak and a number of other weird little contradictions like that. It's an interesting place but we've agreed never to move there.

New York: There's no way to tell someone else whether they'd like NYC without knowing them VERY well. It's like trying to tell people whether they'd like sushi--either it's your thing or it's not. I definitely would suggest visiting for as long as possible before deciding to move here.
I believe the lifestyle here is very distinct from other places, including other major American cities. Just the sheer size of it, the extreme density, the vast public transportation system, the diversity . . . it's just very different from anywhere else I've been, including London and Chicago.
I think it's a terrific place to spend one's early twenties--it's very high-energy, so much is going on 24/7 and you learn so much so fast, it's a crash course in all kinds of things good and bad . . . eventually you either adjust to that level of energy and you go on to have this great, productive life, or it all starts to wear on you and you need to leave to get on with the rest of your life (but look back on your time in the city fondly and proudly). I am in the latter camp.
Life is very public here. You have an itty-bitty apartment here and then you live most of your life out on the street. You don't have dinner parties, you meet your friends at restaurant. You don't open the door and let your dog out in the yard, you walk him down to the community dog-run and chat with the other dog owners. There's lots of sidewalk cafes, lots of people on the street almost all the time, and lots of interaction with people you have nothing in common with except that you both landed in NYC.
As I've said before, I wouldn't want to start a family here unless I had a financial situation that was well above average, so if you're planning to start a family before residency is over, I'd definitley look into all the implications of that choice.
Since you're only in your mid-20s and since you're already the type of person to make the move from Kansas to Stanford, though, New York might be perfect for you. Let me know if you want to know more--obviously I can go on and on about this topic.

Chicago: I was raised in the outer suburbs of Chicago and my boyfriend has agreed that this is where we should eventually settle (of course we could change our minds). I would be thrilled it if he did his residency at Northwestern. I think Chicago is a very under-rated city. Mostly, though, I love the midwest--the reserved but good-hearted people, the open landscape, the more reasonable pace of life, and the relative sanity of the culture. Also, my family is there.

So, obviously I'm biased on all sides here, and I'm trying to be open about it so that you can take that into account. Sorry I don't know anything about any of the programs, but we're way behind you in this process. Good luck, and I'm looking forward to hearing how all this goes!