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We have a new PD, and with him came new schedules. We have two elective general surgery services, an acute care surgery service, a trauma service, and a critical care service. There are also other specialty services that PGY2-4 rotate on intermittently. The day starts at 6AM at signout; it occurs in the same conference room for everyone; you pre-round on your patients after that. You usually run the list as a resident team before first case between 7-7:30 and round independently with attendings between cases or after clinic. The trauma and critical care services have more formal rounds with attendings. The day ends at evening signout at 5PM for everyone. We have a night float system, so the night team takes over from 5PM-6AM. An intern, second year and fourth year make up the call team Sunday-Thursday nights. Residents from the other services are pulled to take call on the weekends, so if you're not on night float, you'll likely be taking call on the weekend, but you usually get one weekend free of call a month.
The faculty in general are great. They are made up of academic and non-academic surgeons, and you get to see the different methods of both groups. We have two conferences days a week, M&M on Wednesday and grand rounds on Friday. We are assigned a chapter out of a text book by our PD every week (this year we are using Sabiston, but I hear we will be switching texts every year), and have a "basic science conference" after grand rounds every Friday, which is basically just a pimp session with the PD on the chapter assigned for that week. Then, after M&M the following Wednesday, we have the "Evidence Based Medicine" conference, which is basically a quiz with ABSITE-like questions written by the PD on the chapter from the previous week.
The didactic sessions are very much ABSITE-oriented. This program has had trouble with low ABSITE scores in the past and there is a conscious effort to improve the scores, however, I have a somewhat philosophical objection to trying to teach the test. With the ABSITE a few weeks away, we shall see how well it works.
The camaraderie is improving. There was a problem in the past with several residents who were difficult to work with, but that is getting better. In general everyone gets along, but we're not all best friends. The older/married residents tend to do their own thing more than the younger/single residents.
The residents and attendings get along. Our attendings are some of the least malignant people I could imagine being surgeons. Our new PD is probably the most malignant attending, but he's definitely an outlier.
The hospital is a nice facility. There are often issues with administration, who aren't known for their common sense, but in general it's a nice hospital to work in. Despite what others may say, the food is actually pretty good for cafeteria food...I've had A LOT worse.
I definitely have a life outside of work. Not so much on night float, but even then I get the weekends off. I usually work 60-70 hours a week; that's per week, not average. I have not worked greater than 80 hours in one week this academic year.
The main thing that stands out are the attendings and the opportunity to operate early. I think the early operative experience is actually better now that we have the Acute Care Surgery service.
The biggest drawback I've noticed lately is that our PD gives the impression that he plays favorites. One of the main problems we had with our old program director was some people got away with a lot of things they shouldn't have, and I was hopeful that the new PD would change that, but unfortunately the same people are still doing the same things. Some things have gotten better, other things haven't.
I definitely think I'll be prepared once I finish. A lot of interesting pathology and operative exposure.
I would definitely consider this program if I had to re-apply. However, this isn't the same program it was when I arrived; some good, some bad.
Most graduates end up going into private practice, however, we've had quite a few do fellowships recently. A majority of those seeking fellowships have done vascular.
I typically arrive at the hospital around 5:30am. We finish rounds before 7am, and "run the list" with the chief of the service. Daily goals are set for the day, and usually left for the intern to complete while the more senior residents on the team go to the OR. Scutwork is minimal, but social issues, disposition, discharges, etc, cannot be avoided. I usually leave the hospital around 6pm after checking out to the on-call intern. The 80hr work week is strictly enforced and is rarely a problem.
The hospital overall is a great place to work. The staff are friendly, and the enviornment is clean. Half of the hospital is brand-new. We have learning conference on Wednesday mornings and M and M on Friday mornings. Teaching in the OR is variable depending on the attending, but overall is pretty good. I am not affraid to ask questions. The conferences are good, but we need to focuse more on a basic text such as Sabiston or Schwartz. This will probably occur with the addition of our new program director.
Camaraderie among fellow residents is great. We all get along for the most part, and are willing to help each other when needed. I can ask my cheifs for help at any time. Attending-resident relationships are also great. We work with some of the nicest attendings possible. The percentage of foreign medical graduates is small. There are about 4 out of 30. A life outside of work is very possible. Most of my co-residents have children and families. They seem to be happy, and have enough time. With that being said, surgery still demands more hours than most other programs. If you are really worried about how much free time you will have, then you should probably pick another speciality.
The most outstanding points of this program include: great work environment, and early operative experience. The drawbacks include several months spent on the trauma service (different PGY years) where you are not allowed to take vacation. I would certainly choose this program again, and I feel that I will be well prepared once finished. Graduates of this program can do almost anything including rural general surgery or very competitive fellowships. I highly recommend this program.
I usually begin my day between 5:30 and 6:00 with rounds. Morning report is at 6:45 on weekdays. We go to the OR or to educational conference. 2 afternoons a week in clinic. Afternoon rounds are brief and I usually leve by 5:00 pm. Weekends I start with morning report at 7:00 then do rounds and usually leqve by 10:00.
Faculty are typically very approachable and willing to acept discussion. There are some who are very good about teaching and others who tend to do their own thing unless you ask questions. OR experience is very good for year level. Weekly conferences follow a standard basic science text. The educational environment here is changing and will continue to improve.
Atmosphere here is great. I enjoy the people I work with (residents, faculty, nurses and other staff). No scut. Ancillary services are great. Program is not malignant at all. It's a nice environment to work in and I am happy to be here. I have a life outside of work that is very busy with a lot going on - so there is time to do other things. Roanoke is a great city. I enjoy the people and find plenty to do. The hospital is very nice and growing. Carilion is investing a lot in its facility and in our education.
Great environment here. It's a growing and developing program with good people. I would definitely choose this program again if I had to reapply. Fellowships are easily obtainable. It's a great place for my famliy. Cost of living is low. I highly recommend it.
The 80hr per week schedule has affected almost all programs significantly. Over here Faculty and staff take it very seriously to have all of us comply. It has worked very well without the need for night-float team. We start rounding around 6AM, sometimes 5:30 depending on how busy the service is. We're usually done at 5. Call schedule for the most part is pretty benign, some months even being q5. On call you cover both general surgery and trauma along with an intern and a chief. We go home no later than at 1pm post-call.Of important note, the chief residents take most of their call at home. If the in-house team (intern, mid-level and PGY-4) is overwhelmed they come in, but this hasn't happened yet to my knowledge.
Roanoke Memorial has been renovated (still undergoing at some parts) and it is truly an inspiring place to work. Particularly the ICUs are very well planned. There are 6 new ORs with state of the art tech, such as Hermes, a voice activated computer for laparoscopic procedures.
Most teaching occurs in the OR. Rounds are>80% the residents team on their own. I have only witnessed 2 cases where the chief scrubs with the junior for a case, all the rest is the attending with a resident. Almost all attendings are really interested in making each case a learning experience.
Conferences are taken very seriously. Assistance is mandatory unless you're in a case or trauma. The computer system is awesome with projectors, powerpoint and podiums that make it a nice experience when you're the presenter. M&M is fantastic in that it is very useful without being aggressive. Most residents seem to enjoy this conference.
Camaraderie among residents is pretty high. Of course every year is different, however I honestly foresee pleasant years to come. There is one AFG and one FMG categoricals. I do have a life outside the hospital and everyone seems to have nice things to do from gardening to training for a private pilot certificate.
This is a program that stands out, in my opinion, because of an excellent caseload well correlated with very useful m&ms, which gives you a round perspective of surgical practice. Even though the clinic is not nearly as fun as the OR, in this program it is run exclusively run by the residents, which makes it a lot more interesting. The only drawback I see is not having a famous name behind the program, which could potentially increase the difficulty of getting a competitive fellowship. I would choose this program again is I had to reapply. I didn't give my program 5 stars only because of the missing fame that would make it a surgical heaven.
Hours per week is, on average, 80. Typical day involves rounds on ICU, stepdown & floor patients starting @ about 6 AM. Caseload is varied and extensive. This program helps you feel comfortable in any setting be that ICU, ER, or floor.
Teaching conferences are more than 3 times per week. Upper year residents typically teach in a format that is modified and supplemented by the attendings who are present. Everything is powerpoint/keynote based. Faculty are very willing to teach. The didactic sessions are useful and not intrusive.
I do have a life outside of work. The physical environment is incredible. CT scanners are practically built into the trauma bays. The ancillary staff here is excellent! There are two foreign graduates in categorical positions.
We will be well prepared we finish this program. Residents do obtain fellowships if they desire. Graduates are split about 50/50 between fellowship and starting practice upon finishing.
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Last Update: 09-Dec- 2013 at 17:40:48