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Preliminary Year:1 month vacation (2x2 weeks)2 months electives1 month night float (2x2 weeks)2 months ICU6 months floorTypical floor day is from 7:30-4:30, and I mean I start work at 7:30 and I am out the door by 4:30.
Most faculty are very willing to teach. No "malignant" attendings. Teaching happens before rounds with new admissions, during rounds always, and sometimes after rounds. Faculty are readily available.
Didactics were ok at best, but the program is constantly making changes for the better.
Residents go out together frequently, which is facilitated by the relatively early typical work days.
Work environment is probably better than average for NYC in terms of scut. I carried average of 6 patients. I had lots of down time during the day to study for Step 3 or take naps.
Categoricals are mostly FMG and IMG. Preliminaries are mixed.
Main positive is the program director. He is a true advocate for the residents in that he frequently applies resident suggestions to the program, and strives to continuously improve the quality of training.
Main drawback is that the patient volume is high as this is the third busiest hospital in the nation. However, there are at least 100 residents, with 3 interns per team, so the work gets distributed quite well.
For preliminary residents, this program is great. No clinic means you have even more free time. Again, I was able to take day time naps and study for Step 3.
For categoricals, you will be able to manage any patient you encounter for the rest of your lives. Research is not spoon-fed, but due to the abundance of pathology the opportunities are endless.
If you want a super-cush intern year, then go outside of New York. If you want practical experience and the opportunity to take advantage of NYC, then consider this program.
It looks like the few very positve reviews on this program here on scutwork.com are made by the former program director that got shocked by the truth told by several residents that started giving reviews just after this website began. During the PGY-1 there was 0-1 elective and you will feel like a slave. On starts at 8 AM at the general wards but 7:30 if you are in MICU or CCU. One month per year is a night rotation, working 6 nights per week. In MICU or CCU work is 12 hours (plus 2 in paper work) but 8 hours (plus 1-2)at the floors. Patient progress notes are written 6 days per week so you had to come either Sunday or Saturday for a morning round when working on the general floors as PGY-1 or PGY-2. Only the PGY-3 has most weekends off. Outpatient clinics are 2 afternoons per week but there are also full month rotations at the outpatient clinics. One month is in the medical ER. Nursing is of very variable quality and they are not involved in any decision making. The inter-class relationship is poor and often rather tense. A lot of scutwork lands on the PGY-1 but some improvements in auxiliary services were made though.
Generally the internists on the general floors did not have much experience and were not skilled in teaching. Therefore the experience there depended on their personality. Around 2 of 10 attendings had some valuable input, and 2-3 of 10 were a nightmare to work with, due to obsessive way of thinking or some sort of oddness. Among the attendings in the subspecialties there were several very good ones that had a genuine interest in teaching and showed nice attitude towards all residents. One could enjoy these rotations during PGY-2 and especially PGY-3. During PGY-1 I missed all conferences (and morning reports) except the grand rounds on Fridays, so teaching was very limited that year. Best round was MICU since the attendings there did some teaching. Overall the faculty lacks in clinical maturity or personal maturity and the pecking order makes the PGY-1 experience almost unbearable.
Conferences on Friday mornings were mostly fairly good but too seldom the Wed noon conferences were of high quality, although most of the time useful. Biweekly a short quiz was held during noon time and that was useful although stressful.
Camaraderie was quite good and one of the big plusses. One gets to meet people from all over the world which makes this experience unique. There were downsides also since some of the PGY-2 or PGY-3 residents come from cultures where those who are below them in order are treated like senseless animals. This sort of pecking order and disrespect to the beginners is a big blemish on this program, and unfortunately many of the attendings either turn a blind eye to it or take part in it. There were nice exceptions but unfortunately this was a common experience during the PGY-1.
Percentage of foreign medical graduates is 99-100%
The Bell laws are obeyed to there were around 60-70 working hours weekly during the PGY-1, slightly less in PGY-2 and around 50 during PGY-3 so there was some life outside of work.
What stands out in this program is the massive hands on experience and opportunities for the more complicated procedures and invasive treatment, such as intubations and central vein caths. The burden of disease is immense in this area so the residents see a lot of pathology that is either common but at serious stages (DM, ESRD, HIV etc.) or very uncommon diseases or unusual presentations. The work is disciplined but teaching quality on general wards is generally low. Lack of Fellowship programs lowers the standard of high quality academic training, but there were still some excellent specialists that were no less knowledgable than the attendings that I got to know at Bellvue Hospital. The program director at the time I was in training there (around year 2000) was horrible in human relations and very self centered. I believe the current administrators are much better. The office staff had also some very scoffed individuals that should be working where no human interaction is needed. At the time the administrative method was to instill fear of beeing rejected into the residents, but many of them had no other options than to stay in this misguided program. In the end one can learn a lot of clinical practice in this program and make good use of it if one keeps reading the textbooks along with it. Most residents 95-100% do well at the ABIM boards but are ignored by the Fellowships. Therefore only 2-5 out of 40 get into Fellowship at first try and maybe double that in later tries. All of them should do well in any clinical practice since most of them will be a "piece of cake" compared to Lincoln. However some of the residents might have to recover from the stress and subsequent lows in spirit after it. I only advice strong characters, that are confident and can deal with a harsh atmosphere, to consider participation in this program. It has some great advantages but the downsides make it a choice that a person would only make from a point of disadvantage or special interest in the medical care of the poorest and most disease burdened populations in the USA.
Typical day starts 7:30 that is when night pgy2 signs out to day pgy2. Interns Pre-rounds on his/her patients earlier than that. The night float interns presents to the Attending. The interns are not allowed to listen in on pgy2 sign out. There is no such thing as signing out on breakfast. That is an outright lie. It is very tense because followups need to be done prior to the Attendings' round. Once the rounds begin, the interns are responsible for all the scut work. The day supposed to end at 4:30pm but it never does. Intern has to make sure all the labs are drawan because nurses or phlbotomists don't do it.
There are only 2 attending that I am aware of that are nice but the rest are very rude and unprofessional. The Atmosphere is typical for an Indian residency program. The Indian Attending give hard time to non-Indian residents. No one has time to attend the morning report. There are hardly any interns in noon conference's as well. There is no teaching done by most of the attending. If you ask a question, then you are accused of showing your weaknesses.
The group is a union of different nationalities. The interns usually stick together. They are all busy in their own teams thus they have hardly any time to help each other. There is no help by the pgy2's at all. They treat the interns like a hired help. If you are lucky enough to be in one of the good attendings' team then you'll get to learn. The night team stays in ER thus when you see them in AM, they are pretty exhausted. There are some attending that don't care and come late for AM rounds. Especially some of the Indian one's. I won't name them. But, I would recommend try to get yourself in the non-Indian attendings' team.
I would keep this as a last resort. Once you are in, start looking for pgy2 position somewhere else. The PD is nice, and non-Indian Attending/hospitalists are nice. If they make a mistake or misdiagnose then the intern becomes the victim for not doing proper job. If you want to learn and apply for fellowships then stay away from this program. The reviews you read following mine are done by the one's who were hired after residency or their spouses were hired. GOOD LUCK to the one's who end up here.
Remember, you need to get into a residency program so don't ignore it, just keep is as your last choice.
Typical day starts at 7.30 when the floor residents meet with the night float residents and sign out to each other. The sign-out usually takes 30 minutes (while eating breakfast) and then the medical team briefly prerounds on the patients. The team consists of a PGY-2 and two PGY-1s; there are also medical students and rotators from other specialities; the team is suppervised by the attending physician. After the night intern presents the new admissions to the day team, the team rounds on all the patients with the attending physician. The team uses a portable computer and checks all the info about the patient on the computer - labs, x-rays, CT scans, EKGs etc on the computer and changes or adds new orders - very simple and straingt forward; no need to write written orders or search for xray films. The attending physician will teach all residents as they round on the patients and emphasize important points in the management. Often times the team will check the most uptodate info (about the particular problem) on the computer - we have uptodate and we love it. The rounds usually finish by 11.00 AM or depending on the situation. After the rounds the residents go to the noon conference to listen to a lecture and take or gather in a resident's lounge for a brief lunch. In the afternoon the residents continue to follow up on labs and other studies of the patients, they prepare discharge summaries, change orders if necessary, make phonecalls, perform procedures etc; and if they are on call they admit new patients. PGY 1 is usually responsible for the H&Ps, Progress Notes and Discharge summaries; PGY 2 is responsible for Orders and Careplans and generally oversees and distributes the work The attending physician provides supervision, teaching and writes attending's notes. The team wraps up at 4.30 PM and signs out to the team on call. The elective rotations - there are usually 2 residens and some med students rotating on an elective; say during Renal elective the residents come to work at 8.00 Am and meet with the nephrologist; the nephrologist then usually gives the residents a brief lecture. These lectures are quiet intensive especially at the beginning of the rotation. Then the nephrology teams checks in the computer if there are any consults that need to be done. The consults are distributed amongst the residents and the nephrologist. On everage a resident will see 1-3 consults per day and will discuss the case in detail with the attending. The resident will also go to the nephrology clinic 2-3x per week and will learn how to manage patients with CKD (we are very proud to be the inventors of the SHAPE UP format for CKD patients). At the end of the renal rotation every resident is very confortable with ABGs, Electrolytes, ESRD, CKD, Anemia, ARF.MICU and CCU rotations - are busy but very useful; we have very dedicated attending physicians who teach the residents a lot - by the end of the residency everyone is comfortable with Ventilators, Sepsis, Shock, MIs, Stroke, PCP pneumonia etc. This residency is very much into critical care - which everyone who wants to be a hospitalist appreciates a lot.Hours per week - on everage on medical floor rotation a resident works 6 days per week; 8 hours per day; and is on call every 4th day; on a call day a resident works 12 hours. On an elective a resident works 5 days per week; 8 hours per day and has usually 1-2 weekend calls in MICU; the MICU call is 12 hours. Workload - a medical team on everage carries 12-20 patients and the team usually consists of 4 physicians (attending + 3 residents), oncall and postcall days are bussier then precall days. A well-organized resident will be able to finish the work by 4.30 and manage to go to the gym or visit the Village in the evening.Scut-work - there is 24/7 phlebotomy at Lincoln which does all the routine bloodwork; residenst will do only occasional labs which are needed Stat (like potasium level) or labs which need expertise like blood cultures; all other labs are ordered through the computer and phlebotomy will come and do them (you can oreder labs say for the morning or for midnight etc).Procedures - I may have placed 40-50 central lines and did multiple Paracentesis, LPs, intubations etc. This is definitelly a place where you can do many procedures and become very comfortable with them.
Faculty - motst of the attendings here are very good teachers; some of them are excellent teachers; also senior residents will quide the inters through many problems. There is a lot of bedside teaching - say about vents, interpreation of labs, xrays, CTs etc. Certain things are explained ad absurdum - I heard about the management of ARDS or ABGs probably 25x during my residency.
Teaching - formally we have noon conferences on Tuesdays, Wednesdays, Thursdays - they cover all the basic stuff from Internal Medicine. On top of than when you are on an elective you will have many minilectures from that particular speciallity almost every day. Every Friday we have a Grand Round - usually a very well known speaker comes from outside Lincoln and give us a big lecture in the Main Auditorium; the speakers are usually nationally renowned.
Debates - usually 6x per year; they are something not to miss; they are real fun - the most controversial topics are discussed (gay marriages, physician assisted suicide etc), Journal Clubs - monthly - usually done by residents who finished reasearch rotation and who prepared an appraisal of a clinical trial, Autopsy Reports - monthly - macropathology and histopatology presented by pathologist, M&M reports and morning reports - interesting cases (usually 2) admitted overnight or interesting m/m cases (usually) are discussed briefly amongst the housestaff between 8.00-9.00 AM.
Research - we have a research rotation and a research course provided by Cornell University; all residents learn the basics of biostatistics and work on some research projects and publications during the residency; many of our attendings and facutly are very dedicated to research and our research coordinator is very dedicated to help everyone with research.
Fellowships - it is not true that you cannot get into a fellowship from Lincoln; last year 9 out of 26 graduates went into fellowships including Hem/Onc; Pulmonary/Critical Care; Renal; ID; Geriatrics. We have a felloship in Hem/Onc here at Lincoln.
I have very good friends here at Lincoln, now that we are 3rd years we really appreciate our friendship and we help each other looking for jobs after the residency. Also I think there is an incresing sense of comaraderie and a lot of peer support; most of the seniour residents try to help the interns as much as they can and there are many interns who appreciate this guidence. The attendings are friendly and approchable; the program director and the faculty are exceptionally approchable and helpful; they have very good sense of humor.
Physical environment - residents have a lounge with computers, a TV set, refrigerator, microwave where they hang out. On-call rooms with beds are provided for the on-call teams. Locker rooms are provided; cafeteria is on the 1st floor; big and quite library is on the 2nd floor.
IMG - most of our residents are foreign medical graduates from different parts of the word; this makes this place very special and provides us with an oportunity to learn about each other a little more.
Life outside of work; Yes, there is life outside residency - times have changed; the myth about residency being a period of time with no life outside work is simply not true; obviosly some rotation are busier than other; but most of the time you go home at 4.30 or 5 pm and you do what you want; in the PGY1 your life is busier on the weekends but in the PGY2 and PGY3 level you have 2-3 weekends/per month for yourself or your family. You can fly back home to PortoRico and enjoy warm weather or go skiing in the Catskills.
What stands out? - if you go for an interview and say you come from Lincoln everyone will know you have had excellent training and will be able to handle any situation.
What are the drawbacks - this place is busy but if you are organized and focused you will have no problem.
Prepared once finished - many hospitals that like to hire Lincoln graduates - they know they are well prepared and used to any clinical scenario.
Would I reapply - yes.
Positives - you will love Renal, Endo, MICU, GI, ID here - teaching on these rotations is great. Negatives - Primary care clinics are busy and it will help if you speak Spanish because our patients speak Spanish a lot.
9 out of the 26 graduating residents went to fellowships in July 2006; they went into Critical Care, Hem/Onc, ID, Renal, Geriatrics. The rest of the graduates became hospitalist or do traditional medicine.
All inquiries about Lincoln Medicine Residency are welcome.
On a regular floor day we start at 7.30 am and work until 4.30 pm, on on-call days we leave at 9.00 pm( no 24 hour shifts).The time of coming and leaving is closely monitored with a time clock were you sign in and out by using your fingerprint. If there is a problem with leaving late someone (usually PD) will try to figure out if there is anything wrong(bell commission violation). Yes it is true that Lincoln is a busy hospital but once you get comfortable with computer system you should be able to leave on time.I am a 3rd year now and I am not on the floors anymore. I have mostly electives which I find extremely useful .In renal attendings are excellent, there is a lot of teaching and fun, ID is the same, geriatrics is very good as well. Everybody is approachable and easy to work with. Also we have Medical admiting resident rotation which we recently changed to one week on one off.
Teaching in Lincoln is really good; there is a lot of bed side teaching, morning reports, noon conferences and grand rounds. Some of the attendings are exceptional and I enjoy working with them. We have computer access to anything, we have uptodate, and library where they can get any article you need. Plus the cases that you see are so diverse that with each case you will learn something.
We have research rotation were you are encouraged to prepare a manuscript, letters to the editor, or case reports; many of our residents have publications.
The camaraderie among residents is large. I made close friends and I hope that i'll have them as my friends forever. We help eachothe and we gossip :)
With attendings I don't have any problem ,all of them are extremly kind; PD (Dr Dimitrov) is the nicest PD ever, he is one of us, you can joke with him, ask for advises, you can ask for changes in the schedule and if he can help he will for sure.
Outside life... we are in NY! We go out dancing, playing pool, shopping. During my internship I've seen most of the Broadway shows, we go to movies, concerts in Central park. Every year we have Christmas party, Graduation party,picnics.But all this depends on you if you prefer to sleep that is totally up to you.
This program is unique, it is busy and is hard work sometimes but hey this is how you learn to be a good doctor. The diversity of the patients, diseases that I've never seen, procedures, computer system, and fun everything is in Lincoln. You will be prepared for everything and anything when you graduate.
We treat poor people; you'll see sadness and lack of opportunity often but you are there to help. This is the most enriching experience of my life.
Negatives: lack of fellowships; but you have so much support to get into one if you want.
I never felt that I want to leave or that I made the wrong choice , I am happy here and that's why I'm here, I am here by choice.
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