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Fellow Overall Rating: 19-Mar- 2003 Teaching: Atmosphere: Research: Schedule Brigham & Women's Hospital is a rather extraordinary place. You would think that being surrounded by Harvard faculty, many of whom are world thought leaders in their fields would become an uncomfortable, intimidating experience. Little could be further from the truth. In a program that pioneered the study of sleep deprivation among housestaff, the BWH medicine program is not only humane, it makes learning easy. We are particularly fortunate to have Joel Katz as an unrelenting advocate for the housestaff, who refuses to allow service committments dominate our educational agenda. Days are busy, and there are many, often complicated transfer patients to see. The addition of the Faulkner community hospital to the program has balanced us away from becoming overexposed to tertiary care, and allows for a break away from the main hospital with shorter days and lower criticality. That being said, our lives are well taken care of, though ICU time is a tough exception that is not unique to the BWH. Our on call is protected: nightfloats come on at 10pm, and you're left only to cover your own patients and accept admits till 1am. At 1am, you sign out your pager to the nightfloat, and go to sleep. This guarantees at least 5 hours of uninterrupted sleep on call nights! Teaching I couldn't want for more interested, informed and talented teaching faculty who continuously go the extra mile for our education. There are more conferences every day than you could count on 10 hands, but most of our education stems from morning report, and lunchtime conferences (free lunch *every* day provided by the dept education fund, not pharma! [we all put on 10lbs in our first year!]) All residents get 6months to spend in research (at Harvard, in the US or abroad) in their final year, and many are very productive during this time. The computer system (all computer entry, access from home incl), support staff, IV services, phlebotomy, nursing - all are great. Atmosphere The camaraderie among the housestaff is probably the single thing that makes doing a residency here as painless as residency can be. Residents are not only good friends to each other, but also the source of significant learning. We do all get time to have a life outside work, more than I know my colleagues at other local hospitals enjoy. Conclusion The program does provide a very thorough exposure to general internal medicine. Our status as a national cancer center does make the onc experience a little heavy, though admittedly I learned much of my general medicine taking care of those patients. The program is a little large (we cover BWH, Faulkner and jointly the VA at West Roxbury) but I would not let that influence a decision to apply. The program is extremely competitive, consistently in the top 5 most desired programs in the country according to the NRMP, and accepts only very few [0-2, often exceptional] foreign grads per yr. Any interested applicants should check out the website and email Joel Katz, our program director for more info.

PGY2 Overall Rating: 22-Oct- 2000 Teaching: Atmosphere: Research: Schedule Long days are typical, but at least two hours of didactic teaching per day Teaching Superb harvard faculty are easy to get along with, are superb teachers, and interested mentors Atmosphere The residents are very supportive of each other Conclusion This is a great place to be, I'm glad I came here.

PGY2 Overall Rating: 07-Aug- 2000 Teaching: Atmosphere: Research: Schedule The intern will preround on the ward services by 8am. An average census for each intern is 6-8 patients. Therefore, his/her day will usually start at 6:30-7am. Work-rounds goes from 8-9am. During this time, the second year resident leads the team, learns what has happened to the patients overnight and allows the interns to formulate a plan for the day. 9-10am is resident report during which time 2 cases are presented for diagnosis/discussion etc. Resident report is held 5 days a week and is intended for the residents while the interns are doing their work (orders/phone calls etc). If the interns have time they are certainly welcome at this conference. Next comes attending rounds (10am-12pm) - here we briefly update the attending about the patients then the attending will teach on a topic of his/her choice. 12:00 to 1:30pm is lunch and noon conference. All general medicine topics are covered over the year. The afternoon is spent finishing work. Call is every 4th (every 3rd in units). Non-call days, one finishes work between 3pm and 6pm. Post-call days usually end also between 3pm and 6pm. Each ward team consists of 1 junior or senior resident and 2 interns. There may or may not be a medical student, depending on the service. When on call, each intern can expect 5-7 admissions. Residents are great at helping, especially when multiple admissions arrive at once. The nurses are excellent but can, at times, flog one with pages. Teaching Many of the faculty members are world-experts in their respective fields. Most are down-to-earth and very approachable. In fact, it's not unusual to hear a resident call a faculty member by his/her last name. Some faculty are too superspecialized - ex. doing thyroid only which may make them lose sight of the whole person. Teaching in the form of didactic sessions and conferences is excellent. There is a skew towards cardiology and oncology issues (these 2 fields are the strongest of our hospital) so many lectures focus on these topics. Then again, cardiac and oncologic diseases are amongst the most common causes of mortality now-a-days. Our chief residents are actively involved in teaching and have all been stellar. Atmosphere The housestaff is one of the Brigham's strongest assets. Residents are all extremely supportive of one another and get along very well. Attendings are open to suggestions from residents regarding patient care, format for attending rounds etc. The work environment is probably average. Patient rooms are arranged around nursing stations. The biggest problem is that there is not enough sitting room. There is definitely time for some life outside of residency. Conclusion The Brigham is a phenomenal place to do your residency. The program is humane - residents are not overworked allowing sufficient time to learn! We have a night float that takes over cross-cover from 10pm and admissions from 1am, allowing several hours of uninterrupted sleep. The housestaff is all of a high caliber and very social with one another. Some may feel the care at our hospital is too tertiary - some patients receiving bone marrow transplants, internal defibrillators etc. but you do get sufficient primary care through your continuity clinic and will feel well prepared to handle any career chosen. I would choose to come here again in a heartbeat. Prospective applicants should contact our program director Joel Katz if they have any questions.