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Aim to be to work by 7 but typically make it by 7:15. Morning report at 7:30 to 8:00. Preround on patients until 9 then do sit-down rounds with teaching, attending-dependent. Many times the interns write notes while the senior/attending round on the patients. The remainder of the short-call days we admit patients. Theoretically the limit is 3 per team per day but it is always exceeded. On long-call days, same for rounds, then go home after notes are done and return at 4:00 when call starts. Usually out of the hospital the next day by 1:00 PM. When on electives, will have a weekend of night float each month.
Most good, one or two bad. Typical amalgam for community hospital.
There is a fair amount of camaraderie among peers as most of us live in resident housing. Weekly volleyball in the summer and frequent get togethers. The attending-resident relationship is dependent on personalities. Our salary is good and they provide us with housing that is practically free without any additional living expenses except for gas (for cars).
I have a life. Ample free time. Somewhat of a good ole boy system but previous perceptions were likely skewed by the stressors of internship. There are 5 nursing administrators to every 1 bedside nurse, which strains the bedside nursing staff. It is probably a Midwest thing, but strong personalities in female physicians are not embraced. However, there is room for several.
Unfortunately recent change in health care plan means that the quoted salary is actually less than what the actual salary is because the deductible is so extraordinarily high and will only cover for one annual visit with bare minimum if you are totally healthy. It is not the type of insurance one would expect as a physician (resident or otherwise) and has been largely unpopular. I'm glad I kept my otoscope - it saves money for us to avoid going to the doctor.
What makes the program stand out is the housing. Every other program will show the very best teachers, boast the friendliest staff and the residents will claim they are the happiest. Anyplace you visit will tell you the same things. However, I know of no other program that offers practically free housing to the residents and their families. Can afford to put away for a down payment for a future/permanent home, can make decent payments on student loans, can feed my family, and can get to know the families of my colleagues at the same time. Free everything (including central air - a novelty to us)!
I still maintain that the housing is the most attractive option. My children have built-in playmates and there is automatic camaraderie with your peers because you live in a community. Its fun, relaxed and the best commute I've ever had. That and its practically free. People don't realize the advantage this offers for those with children and a stay-at-home parent.
Good teaching. Bad health care but this may change. Overall I've been impressed with the attending physicians. In academia, there is a miconception that is dispersed that non-teaching institions are filled will hillbillies. This has not been the case. The majority of medical decisions are based on the most up-to-date evidence. The physicians know their stuff. The attendings/hospitalists have fewer patients giving more room for teaching. After a less than pleasant intern year (which will be made immensely better with the new work-hours restrictions), I've enjoyed my 2nd year. I love walking to work. I enjoy most of my fellow residents and respect the majority of the attendings. The program director is excellent and very involved with our education. Overall, I do not regret my decision to come here at all and I believe I would have regretted not coming here had I ranked anywhere else #1.
The typical day depends on the rotation, but on General Medicine (5 months as PGY1, 4 as PGY2, and 3 as PGY3) I expected to work between 65 and 75 hours per week on average and arrived around 7 AM, finished by 6-6:30 PM on non-call days and 12-1 PM on post-call days. The workload was reasonable for interns compared to what I've heard from colleagues at other programs, and for senior residents it was even more reasonable. On ICU and Cardiology rotations (done once per year), the hours per week are variable depending on the census. One year I worked close to 80 hours per week in the ICU and another year probably more like 65, just based on the number of patients and the season (winter and early spring is generally busier). Cardiology differs from day to day and the overnight call on ICU and Cardiology also varies similarly. For example, I had a couple Cardiology call nights where I had one evening admission and slept through the night with minimal pages, but on another night I had several sick patients to deal with and 4 admissions. ICU is similar to that, feast or famine but either way very manageable. On General Medicine, I usually expected to have a full night of work but did often find time to sleep for a few hours.
Teaching sessions can take place during morning report, during attending rounds at 9 AM, subspecialty rounds, bedside, and on-the-fly. I think the the faculty at Gundersen is fantastic. Because there are no "pure hospitalists" and pretty much every Medicine attending does some teaching service, most of the attending physicians are very interested in teaching and make a lot of efforts. There are the occasional exceptions, but on the whole this program has exceptional teachers in general, not just "for a community program." I had friends at larger, university-based programs who complained to me that their attendings never had time to teach them because the whole team was always swamped, and this is not usually the case at Gundersen (there are the occasional crazy days as you would find anywhere). In addition, the didactic sessions I listed above as well as our weekly Board Review session are extremely helpful.
First of all let me say that I think anyone about to start their residency needs to have realistic expectations about intern year. No matter where you go, it will be hard and you will spend a lot less time at home than you might like. However, I think the situation is much better at Gundersen that at most places. The reason for that is the support we receive from colleagues, attendings, administrative staff, and the program director. The people at Gundersen are terrific and made the hard days easier. The camaraderie is great and I think attendings are extremely accessible and easy to work with with very few exceptions. Regarding the physical environment, I think that the call rooms left something to be desired but we had a wonderful resident lounge and computer work area that we all spent a lot of time in, and this made up for it.
FMG precentage is probably about 20-30% depending on the particular year, but I have to say that my FMG colleagues are some of the smartest people I have worked with and the fact that they didn't train in the US was hardly even an issue.
As to whether I had a life outside of work...during intern year it was very busy, especially during General Medicine rotations. However, this program has a perk that most others don't--senior residents do not take overnight call on Medicine months. We stayed until 9-10 PM to finish supervising evening admissions and then went home. The downside is you have to stay the whole next day when the interns go home, but this is really not a big deal and I was usually home post-call by 5 PM. This is a terrific thing to look forward to while you're working hard as an intern. It means that as a senior resident, you only take overnight call for 2 months out of the year. I don't know of any other programs (out of the 12 I applied to) that do that, and it really allowed me to have a life outside of work, especially as a senior resident. I had a baby during residency and was able to spend good time with him, as my administrative staff was flexible in helping me arrange my schedule so I could have that time.
I have very few complaints about this program, which I think stands out as the best of both worlds--great teaching that is at least equivalent to a university setting and less workload than a larger program. The only negative is that my research experience might have been a little soft, but I know for a fact that the research aspects of the program are receiving more focus now, especially as Gundersen just started a Hem/Onc fellowship program.
I am now just starting private practice doing traditional internal medicine, and I feel extremely prepared for my career ahead. Of my group of recently graduated residents, half are doing general medicine and half went on the specialties/fellowships, including Hem/Onc, Cardiology, and Palliative Care, and I think the vast majority of them would agree with most of my statements above. This program was my first choice, I would definitely choose it again, and I highly recommend it to those who want personalized learning and a reasonable workload with positive surroundings. I welcome any inquiries from prospective applicants.
Hours can differ depending on the rotation. During your general medicine rotations, you will probably work 80 hours a week (but you have fewer of these as your progress through each year). During electives, it can be 40 hours (sometimes a little less, sometimes a little more depending on the elective/subspeciality). There is ample support staff to do all IV placement, blood draws, social work, etc... There is a lot of paperwork, but that is just how medicine is, no matter where you are (and there is more when you get to the real world, so you might as well get used to it!)
The faculty is overall great! They all WANT to teach and that is why they work on the resident teaching teams - they have variable teaching styles, so you are bound to find someone who clicks with you. Teaching takes place pretty much daily - during morning report (where you will find even some of the subspecialist attend on a regular basis), during rounds, when staffing just about every patient. Most of the conferences are in the morning or at noon - and there is free lunch every noon at the conference.
The camaraderie among the residents is awesome! If someone is sick, their child or parent is sick - people will support you, work your shift, etc... even if it is a call shift or an overnight shift. There is a great resident work area and lounge that was built about 2 years ago. And there was time for life outside of work. My husband and I started our family during this program and got a ton of support from everyone. We lived outside of resident housing and made some good friends both in and outside of the program.
I think the two things that I always thought stood out about this program were: 1) the faculty are actually there to help you become a better physician - they love to teach and see you succeed. And 2) the residents who support each other through thick and thin - every program is going to be a lot of work, that is how you learn, but having people around who are supportive (residents and staff) is one of the most important things and GL definitely has that. Of course, GL isn't perfect, there were many transitions during my residency - adding a nightfloat system, changing call schedules that sometimes made things more difficult, but the program directors were always interested in our feedback and including us in making changes. After starting my first "real" job, I now realize that GL was a very special place! I have definitely felt good about my training now that I am out in the "real world". In fact, I think some of my new colleagues have been suprised how little I have needed to ask their advise and feel very comfortable letting me care for their patients in there absence. I would chose this program again in a heart beat! I think about a third of the residents do fellowship (and everyone who has wanted a fellowship from my class got one) and about 2/3 go into primary care/hospitalist. I would be more than happy to answer any specific questions anyone may have about GL.
Hours per week: Variable but on a busy rotation 60-90 hrs/wk (that includes call time).Workload: Overall comfortable. No complaints.Scutwork: Not bad. Too much paperwork (I feel bad for the poor disk drives always getting hammered). No other significant scut usually.
Faculty: Most are outstanding. Very few complaints with faculty.
Teaching: Very good with multiple teaching opportunities in a single day - am report, noon conference, medicine conference, and many other conferences.
The residents are a great group. Excellent working relationships amongst residents.
The residents DO have a non-work life.
If I were to do it all over again, I would come back here.
I feel prepared to practice.
Gundersen is a great organization. You can tell the people of Gundersen care about caring for patients. To me, that's what it's all about. There is a life outside of residency. Overall, the people at Gundersen are very good to work with.
My typical day varies greatly depending on the rotaion. On Gmed I keep busy with an average patient load of 4-6. I average 3-4 admits per call night (q4). We have short call 2 out of 4 days and I typically admit one patient every other short call. This is definitely busy enough where I'm learning good medicine but not so busy that I can't read and take the time to give my patients the best possible care. While I can't speak to other programs, I feel that our "quality of life" is second to none.I did derm as an elective which was o.k. but I'm glad it won't be my life.
Again, I feel that our teaching, both on wards and in conferences is second to none. Our program is designed to prepare residents for boards (97% 3 year pass rate, average???), and clinical excellence. Being a somewhat smaller program, we have very interactive conferences with high rates of attendance. Our attendings all are well informed that we are expected to be free for conferences, including Gmed, ICU and cards months. I think one of the most important questions you can ask on the interview trail is, what are your conferences and what are the attendance rates? Documentation should be available. If residents are overworked or conferences are poorly run you will see the correlation.
Camaraderie- excellent. There's a certain type of personality that comes to a program like this, both as a resident or a staff. People are here to teach, learn and enjoy life while they're doing it. People are not here because they're egomaniacs, have something to prove, or want to boss people around.
Work environment- excellent. My patient population is respectful, appreciative and compliant (everything's relative). A drawback to our program (if you call it that) is that we don't see large populations of HIV, IV drug abuse, or "inner city" social problems. The nurses, social workers and other ancillary staff are great, taking care of all the little things. I don't draw labs (do any residents really do that?), or waste time doing scut work. I'm here to work with patients and learn medicine.
My life- "This must be heaven". Seriously, I'm busy but then again I'm an intern. I have a wife and 2 kids, and I'm able to spend alot of time doing husband and dad things like bike rides, sledding, hikes, Chuck E Cheese... I also do things with other residents and friends, like waterskiing, fishing, hunting, dinners...In fact a bunch of us are going downhill skiing tonite (free and 7 minutes from resident housing).
I feel that 99% of programs will prepare you well to practice medicine or secure a quality fellowship. Our program will provide these things (Look at the % of foreign grads doing GI and Cards fellowships- Seriously, it's on FREIDA).
The way our program stands out is in the way of resident and staff interactions (I have called several staff, including subspecialists in the middle of the night and have never been berated), quality of life (home call for Gmed and subspecialties!!!), accessibility to outdoor activities, quality of life (I know, but it's really important).
Drawbacks- minimal bench research opportunities. There is plenty of clinical research but if your dream is to be an academic guru this place is not for you. Minimal African American population, hence not much sicle cell anemia, we do have a fairly large Hmong population.
As far as being prepared for practice when I'm done- I have no concerns. In fact it's likely that I'll practice in a similar setting, so I will be better prepared than if I were to train in a big university based program spending inordinate amounts of time with burns, bone marrow transplants, inner city populations and other "academic" pursuits.
If I were to reapply I would definitely repeat this as my #1 choice. When I interviewed, I strongly considered some of the university based programs. I am incredibly happy that I ranked GLMC #1 rather than any number of other programs simply because I know that I couldn't be this happy anywhere else.
I welcome any inquiries. P.S. we have a great web page at Gundluth.org.
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Last Update: 20-May- 2013 at 05:01:47