CASE
WESTERN/Metrohealth
I was
skeptical: this is Cleveland.
Interviewed
with 7 others. I was the only one that needed a visa. 3 current surgery
residents were interviewing for anesthesia. There were 3 Caribbean students, US
citizens. I was the only foreigner.
There
were only 4 candidates at dinner, with around 6-8 residents. Candid residents.
Very friendly. Talked openly.
·
PROS:
o
H1
B possible
o
Residents
are happy, very confident, camaraderie+, they hang out downtown a lot. Mix of
married and single residents.
o
TRAUMA
experience so intense. Level 1 trauma. Important Burns center in Cleveland.
TRAUMA ANESTHESIA!! NICU level 3 (highest level). High risk OB.
o
County
hospital, so mix of LES and HES patients.
o
Newly
renovated ORs (2004), new anesthesia machines. Apollo drager. >20 ORs
o
28
attendings~21 residents.
o
CWRU
students rotate, also students from other schools.
o
GYM
in the hospital, 45$/month. Access to Veale recreation center, also access to
all of CASE resources: Lib/Labs etc
o
Insurance
with no extra charge for vision/dental plans
o
FINANCIALLY
STABLE, and expanding.
o
Great
Sim lab: Dummies. Plus might get a new USG training module.
o
Great
didactics: 4/ week. Lectures staggered based on year. CA1 have separate basic
lectures. CA2 and 3 have advanced lectures.
o
No
fellows, so lots of autonomy, CCF fellows come to metrohealth and are
overwhelmed by trauma. Not so for residents here. However no sink or swim
attitude. ‘Residents work as fellows’
o
Fellowship
placements are high: including Johns Hopkins, UPMC, Uni of Iowa.
o
All
surgical specialties are equally representated. Lots of regional done here
o
CA1
49,000 CA2 50,000 CA3 53,000.
o
No
SRNA training here
21 attendings ~7 residents/class
o
In
house moonlighting allowed on the Lifeflight plan
o
Outside
moonlighting is also permitted
o
Lots
of really sick patients, and so lots of confidence
o
CA3:
6m elective time. Can do research, but they are not very interested in research
electives. They don’t care about not doing research but if you do research then
they support you fully. One faculty is into research. Research is clinical
oriented, not basic science! GREAT
o
CA1
1500$/year for books/tablet. CA2 and 3 2000$/year
o
Meal
cards 90$/month.
o
Vacation
time can be scheduled in one day increments, no need to take 2 or 4 weeks
‘blocks’ off
o
If
presenting at a conference: Days off NOT taken from vacation, financial support
for travel and hotel.
o
Board
Exam: paid based on ITE results. 30 percentile get 50% off, 40 percentile get
75%off, 50 percentile get 100% cost waived
o
Board
pass rate is much higher than national avg.
o
Anesth
run ICU rotation in CA2 at VA hospital
o
Supportive,
stable leadership. Residents run the residency. Feedback is taken and worked
upon.
o
They
mix up cases throughout training, so for eg: Even though on neuro cases, might
be OB call. So constantly ‘in touch’ with clinical cases.
·
CONS
o
Bottom
heavy program: CA1 intense work. Get in at 5:30am, get out at 6:30pm. Call can
be upto 8/month. 24 hour calls.
o
CA1
get 7-8 calls/month, CA2 5-7/month, CA3 3-5/month
o
Cleveland
o
No
prelim year linked here.
o
CA1
gets out at 6pm, CA2 at 5pm, CA3 at 4pm
INTERVIEWS
Dr T:
Went over my entire app with me. Asked about how I figured out the electives on
my own, scheduled them etc. He seemed to like that I had planned everything
out. Said I was better than the other international applicants. ‘You are self
driven and self motivated and that will get you far’. I showed him the
magazine. Asked how I would deal with the pressures of residency.
Dr B:
Asked me why I picked anesthesia, asked what I like to read. How often I
exercise. Talked about the Hunger games and The Game of Thrones. Books are
always better than the movies. What am I looking for in a residency program.
Talked about my experience at Case Medical Center ER.
Dr K:
‘Do you have any questions for me’. I asked what kind of prelim they prefer.
She said anything, IM is more appropriate. Try to get 2m ICU, 1m ER. Strong
Renal, Cardio, Radio, Pulmonology ICU rotations. Asked me about a challenge I
had to overcome, What accomplishment I am most proud of. Showed her the
Magazine. Asked me to email her later when I have questions.
Dr S,
Chairman: Spoke to all of us. He is Indian. Told us that they love the
residents, but work is hard. I believe him.
This
program is awesome because of the strong focus on trauma and how it will turn
me into a rock star anesthesiologist that can deal with ANYTHING.
DETROIT:
Henry Ford Hospital, Anes, 12 categorical spots (but only 8 for MD, rest DO)
Cons:
·
Detroit
·
No
structured didactics: ‘learn by yourself/read by yourself’
o
‘scheduled
lectures often cancelled’
o
CA1
separate lectures: trying to start but not really happening yet
o
SIM
lab: CA1 only thrice a year. CA2/3 : one to two times a year.
o
I
really would prefer dedicated didactics.
o
Learning
on the job is the norm here. With so many of their residents already having
post grad training in Anesthesia, I wonder how I would cope.
·
Only
4m electives in CA3
·
Bottom
heavy program, like Metrohealth
·
Community
program
·
Peds
is low: They have designated peds rotation months at Childrens hospital. Call during that time is Peds call. The rest of the time, won’t be dealing with
pediatric patients at all. No call, no
general peds cases at Henry Ford.
·
CA1
only neuro and OB (apart from Gen)
·
CA3
only 4m electives
·
I
got a nicer, more laidback vibe from Metrohealth. Metrohealth felt like a more American/white
program compared to Detroit.
·
Lots
of IMGs at Detroit. All Indians here have previous post grad training in home
country.
·
Sladen
library: ‘terrible place’ 17th floor, only 9 to 5 timings. BUT
everything available remotely with a username and password.
·
Call
rooms: basic, bunk beds. Anes resident hangout areas are small, cramped.
·
SIM
Center exposure: ‘In CA-1 maybe 3 times/year’
·
3
weeks vacation/year, they like you to take it in 1 week blocks. ‘Sometimes you
can get 2 weeks at a time.’ Sick days are taken out of this 3 week vacation.
·
35
attendings~36 residents
·
ITE
yearly. Mock oral boards in CA1,2,3. Individually, I will only get a chance to
practice about once/year.
·
Pros:
·
H1B
possible
·
Transplants,
start by beginning of CA2, Livers+, Intra op MRI.
·
Residents
seem happy, lots of clinical experience. Residents say it is a welcoming
program.
·
High
risk OB, Level 1 trauma
·
No
problem meeting numbers. They do more ASA3 cases than avg: This means the
residents are constantly dealing with sicker, higher acuity patients. ASA 1 is
lower.
·
More
regional anesthesia: also implies sicker patients that can’t handle GA.
·
No
24 hour call
·
Intern
year includes interesting things: Int Med, Nephro, ENT, Cardio, Pulm, EM,
Critical care, Pain med, Transfusion med, Preop clinic, Anesthesia in final
month
·
Good
orientation, lots of autonomy
·
Fellowship
in Cardiothoracic anesth, Pain medicine.
·
Moonlighting
possible after cardiac month in CA 2
·
EPIC
·
LOTS
of ICU experience. Lots of rooms, patient pathology is incredible. Lots of
experience.
·
Resident
housing. ~800$/month. Directly behind henry ford hospital. Basement of hospital
almost connected to the housing facility. BUT it only accommodates aout 20% of
physicians. Usually in short supply. Might need to make transition arrangements
for June, July.
·
PGY1
48G, PGY2 49G, PGY3 52G, PGY4 54G
·
Professional
devp fund for step 3, iPad, Books, journals, abstract fees. Professional society
dues. $300 for PGY 1,2. $1250 for PGY3,4.
·
Iphones
for hospital communication: email/text/calls
·
Grads
are comfortable going into pvt practice/fellowships. Some ate Henry Ford
Hospital faculty.
·
High
pass rate for ABA.
·
Good
eval process: electronic evals, intra day debriefing. Feedback is given early
so time to improve during the same rotation.
·
No
SRNAs
·
Many
opportunities to teach.
·
No
major changes expected, apart from better CA1 didactics for the Basic exam
·
Non
clinical responsibilities: presentations at grand rounds, presenting a
paper/poster. Need not be published. No one pushes for publication.
·
Sim
lab exists
·
Diverse
residents, lots of Indians, I will feel ‘at home’
INTERVIEWS:
‘Behavioral’
Dr
GA: Challenging patient, How did you organize elective rotations, medical
education. Situation where you had to speak up. ‘I have a good understsanding
of your work ethic’
Dr
WA: speed vs accuracy and why. Deficit in medical training. Working smart and
working hard.
Dr
AS: Chief resident. Talked about Indian jokes, Dealing with conflict in the
workplace. Getting along. Why anesthesia. Said he likes me.
Dr
DG: Talked about the comparison between Henry Ford and Hopkins. Mistakes made
at the workplace. Talked about what I want from a residency program. I
expressed a strong interest in Henry Ford. Said I would fit in well, that he
likes me.
CURRENT RANKING:
1. Metrohealth Anes, Cleveland. H1B possible, requires prelim
2. Henry Ford Anes, Detroit, H1B possible, categorical
3. New York Methodist Anes Brooklyn, out of match, H1b only if already sponsored, req prelim
4. Metrowest TY, Framingham, only J/ Griffin Hosp, Derby Int Med, H1B possible
5. UIC MGH Surgery, Chicago, only J
6. St Agnes, Baltimore Int Med, H1B possible
7. Uni at Buffalo Sisters of Charity, Buffalo Int Med, J1 only
8.Bronx-Lebanon, NYC, Surgery H1B possible
