After falling in love with the field this year, I would definitely encourage you to consider transplant. It's a unique field with amazing operations, interesting medicine, and opportunities to really have meaningful patient interaction.
Transplant is competitive at the top places. I saw applicants from great institutions with transplant research at my interviews. Traditionally, it's not competitive.
I don't think you need research but it helps, along with a demonstrated interest in the field.
The best programs from my perspective as an applicant this year and from the thoughts of my transplant mentors are
(I didn't interview at all of these places, and Wash U didn't hold interviews this past year.)
UCSF- Balanced L/K/P, great reputation- didn't get an interview there
Columbia- Balanced L/K/HB, great HB and living liver donor experience, good autonomy and dedicated faculty
Wisconsin- Balanced L/K/P. Faculty seemed incredibly devoted to the fellowship. Fellows perform the operation. Great tradition.
UCLA- Liver heavy L/K/HB. Unique for having the sickest patients (50% of recipients come from their Liver ICU), and the most management of the pre-transplant Liver patients. Includes an ICU/donor rotation where you run the Liver ICU (24 beds?). Great HB experience. Perennial concern re: kidney exposure, but numbers are very high (>300/year). Good autonomy.
Toronto- Balanced and very high living liver donor numbers. Only heard great things but going to Canada wasn't feasible for me.
Wash U- Didn't interview this year, but supposedly a great L/HB component. Only HPB certification I saw. (A lot of programs give HB certification)
Penn- L/K. Most academic-centric place I interviewed- all the faculty do reseearch.
Baylor (Dallas)
Northwestern- Traditionally among the best, but the stories I kept hearing were about how malignant the program was ... Chicago wasn't a good place for me or family, so I didn't learn more. Hopefully, someone can shed more light on this one.
A lot of my co-applicants were impressed by UAB.
I wonder what folks thought about Mt. Siani?
I'm sure there are others. All the programs have their unique features and selling points.
I'll give a long answer later and my impressions, but a few things, and I'll admit my bias cause I matched my #1 choice USC. In the LA market, it seems the tide has very much turned from UCLA to USC. I obviously liked them more, but most everyone else I talked to did as well. They rival the level of sick patients (quoted 60% of transplanted patients were icu prior to transplant), did 130 livers last year compared to UCLA's 170, and they have a living donor program. I can get into more of why I fell in love with the program if anyone is interested. That being said, UCLA is still a powerhouse and probably a top 5 program, especially if you are liver centric person.
To address your comment regarding Toronto, USC is also HPB certified and do roughly 300 hpb cases, pretty well split between hepatic, biliary, and pancreatic. WashU, which didn't interview because they did an accelerated 4+2 pilot program for this year, also has HPB certification. Emory does as well, but I cancelled my interview, and Georgetown, Kansas, Lahey clinic are all listed as HPB but I didn't interview at those.
UCLA didn't fill either. They matched 1 of 3 spots (ucla is the only 3 person a year program. A few like Columbia, Mt. Sinai, Northwestern, Georgetown, Miami do 2 each year, few like UCSF, USC, Hopkins, Upenn, Wisconsin alternate between 2 then 1). That was the only surprise, but they only interviewed 10 people. But they are, imo, better than many programs out there that did fill
UCSF only interviewed like 3 people because they had an internal candidate. I also heard it's a rough program that the fellows are busy, but it's a powerhouse in every sense of the term.
Northwestern does have a horrible reputation of being very hard on their fellows, and they even admit that they are very demanding and require excellence from them and would not be serving them well by sugar coating it. I heard they are more service and less operative as well. They are also probably the most academic center in the country (I'd argue with you regarding UPenn, and I'd place Hopkins as right up there as well, if for no other reason than Dorry Segev). I wanted to like it much more than I ended up doing. I loved Chicago too.
The knock on UPenn as well is concerns about surgical autonomy/attendings double Scrubbing. But I was super impressed with their program as well.
Mt. Sinai was an intriguing place, and my impression was everyone had mixed feelings. Definitely have donor autonomy, going out on them solo. Great HB experience with Myron Schwartz, just got intestinal approval. But I couldn't gauge it that well. And I think they play second fiddle to Columbia.
I agree everyone loved UAB, but I couldn't do Alabama.
Another great program you didn't mention is Hopkins. A little bit of staff turnover, but great group of surgeons good volume, hb surgery and may be hpb approved now that they set up that the transplant fellows spend a month or two with the surg onc attendings doing panc cases.
I'll have more thoughts later
