Teaching:  | Atmosphere: | Research:  |
Schedule
Typical Day varies depending on your patient load.
On general medicine months (4 months) come in between 7-7:30 go home when work is done. This depends completely on how many admissions you got, how long your patients stay in the hospital, etc. May patient list has varied from 3 patients at minimum to 15 at maximum (including consulting patients - eg. medicine consults for diabetes etc. from the psych unit) which mean could go home anywhere from 4 to 9 pm on a given day. Call for admitting is q 4 nights on gen med months. SOD as they call it are the busiest months, but you learn a lot too. You always go home by 1:30 when you are post-call no exceptions.
Electives are variable depends on the attending when they like to do rounds. Mostly it is less busy than SOD medicine months. On one elective I came in at 10 am but round until 6 pm or so. On cardiology usually came at 7:30 leave around 5:30.
Curriculum
Electives 7 months (tailor to your career goals)
SOD medicine 4 months
ER 1 month
ICU month optional but may be required if you go into anesthesia, etc.
Teaching
Faculty are good here. On SOD medicine, there are 2 services SODA and SODB. One service you get considerable autonomy for caring for your patients and call up senior resident if you have questions. On the other service it is more tightly controlled about letting you write your own orders without clearing them. Either way it's good to experience both modes of operation.
Most electives are balanced between patient care, teaching, and maintaining some free time for you life. Faculty have done fellowships at reknowned programs, eg brown, columbia, penn state hershey, etc. etc. and are all evaluated by residents and things will get changed if they are not performing up to par, but they do. The daily lectures from the attending during ID rotation on antibiotics were practical and informative. The didactics on electives are usually practical and patient-care based rather than theoretical like you might find at an academic center. Also the relative lack of fellowship programs at this community hospital work in the TY's favor since you will work directly with attendings no under wing of a fellow.
Atmosphere
Camraderie is good. Residents are all friendly with each other here, except when I am on SOD I tend not to like my senior resident at times but that's inevitable. We hang out outside of work when there is time either at local bars or potluck type dinner or something or department holiday party for example. Really depends on the class if you make your own bonds. Usually don't have much life on SOD medicine months, but electives are good.
Conclusion
+'s. Strong training in patient management skills. Confidence in clinical decision making through daily didactics, autonomy, and having seen a variety of cases. Attendings encourage you to take ownership of your patients with them as more of a supervisor in the background. Continuity Clinic for TY's - good primary care experience, you are the primary doc for these patients for the year you are here under attending supervision. Didactics on outpatient topics weekly in case-based format prior to start of clinic day. Even if your goal is not to manage patients eg. radiology, Step 3 exam still has a lot of outpatient based exam questions. Daily didactics.
(+) morning report is at noon not in the morning!
(+)'s : money. cost of living is good compared to salary. food money lasts whole year probably, caf isn't top notch, but is decent and inexpensive + 20% employee discount for food. 500$ book money for whatever books you want to buy. PDA money.
(+)'s good ancillary staff: do what you order, page you if your patients are declining in a timely manner, sometimes page you too much for tylenol orders at nighttime but as long as it's ordered prn in the daytime shouldn't be too bad ;)
(+) TY's treated no differently than categoricals.
white coat says dept of internal medicine so noone even knows unless you tell them. (Could be a negative b/c they also expect the same amount of work out of you.)
(+) categoricals with 100% board pass rate last 8 years in a row.
(-)'s calls on elective months can be frequent if others are on vacation and are internal medicine calls which may detract from studying the topic on the elective you are on. call usually q5-6 on elective months as "house intern" responsibilities include admitting overflow patients (admitting intern on SOD caps at 5 per night and senior resident + house intern do the rest), responding to codes/emergencies, evaluating patients who fell down in the hospital, and cross covering any issues for patients of the 3 other SOD gen med interns who are at home for the night.
(-')s not the "cushiest" of TY's around, but balanced by the strong educational component, doing whatever people ask eg some have asked me to put in a foley or read an x-ray if an NG-tube is ok to use. In either case though if you can't get in the foley there is also surgical PA on call, if you can't read the x-ray you just say you're not a radiologist and wait until morning before feeding him. So you are never on-call alone, always senior resident on call too.
(-)'s senior residents sometimes leave the program, for categorical senior residents it can be a make it or break it type of environment which have led some to leave to family practice or other programs. Although seniors only do 2 months or so on SOD service.
Overall would reapply here again.
Please direct inquiries to program manager who will give you an email address of an appropriate resident to anwer your questions.
