Where does this program rank with the other ivy league schools? I almost never hear about this program but looking at their fellowship placements, they seem to be doing quite well. Anyone recently interview there or has any other info?

yeah i know ppl in the program and i did a sub-i there.. overall, it's a solid program with ppl getting into GI, cards etc w/o too much difficulty. the residents are upbeat, smart, and friendly. the PDs are great.

a word of caution however re: the units at Brown that i only found out during my sub-i rotation as no-one seems to talk about it...the program is all about fostering autonomy in the residents to the point that residents are often left w/o any guidance (especially true in the units overnight) and, worse, feel that they are unable to turn to someone in the middle of the night should questions/problems arise. it seems that Brown forget that they are RESIDENTS TRAINING! the fellows go home at night in the units (as is true in most places), and the resident has the duty of monitoring the unit pts and going down to the ED (which is far far away) for consults. the resident alone decides who to accept and who not to. i did my sub-I at RIH ICU, and one particularly bad post-call day, the attending berated/yelled at the resident for accepting non-ICU players, not managing a problem appropriately in the unit though the resident had done the best that she could in the situation (reading, asking the nurses and ultimately just using her best judgement, as she obviously had no-one higher up to verify with whom to verify her plans) etc etc. later that resident admitted that she and many of her friends took xanax and the like just to get thru the units.. also, any form of didactics is sorely lacking at least from my 3-week stint there....

i'm not asking to be coddled and to be treated like a med student, but i think that as a resident who's still learning, it's nice have someone to bounce ideas off of and learn from...the balance between autonomy and supervision is just not present.

also, brown has residents do 3 units the second yr, (2 the first yr, 3 the 2nd year, and 2 the last yr) they get away with it by calling the RICU month a 'ward' month because it's q4 overnight. from what i hear it's the bane of the residents' existence since the resident is alone in the unit (no intern) AND has the responsibility to deal with ed consults. residents have been trying to get rid of it by getting the PAs to cover it, but it looks like it aint going to happen...

so, overall, i think if you can survive the tough-love approach at Brown, you will come out stronger and better. my friends are happy with their choices, and one hopes to stay on for gi... i went to brown undergrad, and love providence, but ultimately ended up ranking it lower on my rank list, and am happy where i am. no program is obviously perfect, but for someone like myself who didnt want so many unit months (without the learning that usually comes with it), and who prefers to have more backup should i need it, brown was not the best choice for me. just my 2-cents

brin

this program sounds like the ideal program
i'd love to be calling all the shots right from the start

yeah i know ppl in the program and i did a sub-i there.. overall, it's a solid program with ppl getting into GI, cards etc w/o too much difficulty. the residents are upbeat, smart, and friendly. the PDs are great.

a word of caution however re: the units at Brown that i only found out during my sub-i rotation as no-one seems to talk about it...the program is all about fostering autonomy in the residents to the point that residents are often left w/o any guidance (especially true in the units overnight) and, worse, feel that they are unable to turn to someone in the middle of the night should questions/problems arise. it seems that Brown forget that they are RESIDENTS TRAINING! the fellows go home at night in the units (as is true in most places), and the resident has the duty of monitoring the unit pts and going down to the ED (which is far far away) for consults. the resident alone decides who to accept and who not to. i did my sub-I at RIH ICU, and one particularly bad post-call day, the attending berated/yelled at the resident for accepting non-ICU players, not managing a problem appropriately in the unit though the resident had done the best that she could in the situation (reading, asking the nurses and ultimately just using her best judgement, as she obviously had no-one higher up to verify with whom to verify her plans) etc etc. later that resident admitted that she and many of her friends took xanax and the like just to get thru the units.. also, any form of didactics is sorely lacking at least from my 3-week stint there....



brin


I read in scutwork.com that Brown is starting to become borderline malignant and the amt of teaching is going down due to enormous amount of admissions into RIH, and this was written by a resident at Brown? is this really true?

I'm a second year med student at Brown, so take my opinions with a grain of salt. I do know a lot of 3rd/4th years and a few residents, plus a number of the attendings. So far, I've never seen or heard anything bad about the program. The general concensus is that the teaching is good, facilities are nice, the atmosphere is not malignant, and that residents get a broad exposure to diverse pathology and come out as excellent clinicians. Fellowship placements are very good, although obviously not at the level of the super-elite places like B&W or Hopkins.

Like any program, I'm sure there are some downsides, and some people who aren't happy, but I haven't run into any of that yet.

How does Brown IM residency compare to places like Cornell, or BU? Is it comparable in quality of its teaching, research, and academia?
Also, saw there '07 and '06 fellowship match list, they seem to take more of their own than place people into top programs, and I really don't know if Brown's own fellowship programs are ranked well or not.

I read in scutwork.com that Brown is starting to become borderline malignant and the amt of teaching is going down due to enormous amount of admissions into RIH, and this was written by a resident at Brown? is this really true?

I read that review as well. I'm a resident at Brown and I think that deeming it malignant is a bit harsh. As with any program, there are pluses and minuses. There are certainly an enormous amount of admissions that come through the RIH ED, especially since they expanded it 3 years ago without increasing the number of residents or services. It's the curse of our cachement area, which runs from pretty much south of Boston to north of New Haven, west to Hartford and east to the cape. There are days (especially in the winter months) that the teams walk in capped or are capped before 12 noon, necessitating backup to be called in to admit "over the caps." However, there are also days where the teams don't cap at all and the overnight admissions are few. The quantity of people that get admitted also depends upon the quality of the medical admitting resident, who can try (and may often fail) to fight BS admissions with the backup of an attending.

The number (and indeed quality) of admissions is something we talk about at pretty much every housestaff meeting. The hospital is responding, albeit a bit slower than we'd all like, by hiring more hospitalists to help shoulder some of the burden.

Then there's the Miriam Hospital, which is the high-acuity community hospital--census numbers can go up there too, which is frightening at times given just how sick those patients are. But patients may be made "non-teaching" at the Miriam, whereas they cannot at RIH.

I've found the teaching to be on the whole quite good--conferences are great and usually given by experts in their fields and grand rounds are always interesting. Morning report is fun, and you learn from your colleagues. Bedside teaching occurs on most wards services, but again, on a busy day teaching may be sacrificed in the interest of getting work done. In response to residents wanting more teaching, they actually booted the "multiple attending" system at the Miriam and streamlined it to be more like traditional teaching services with one attending who rounds every day with the team. Not sure how it's working out, but from what I understand it changed to augment the teaching experience at TMH.

As for the units, we're definitely unit heavy, probably because pulmonary/CC is huge here and we have lots of units in the hospital. But in response to residents feeding back that we had too many units, now 2nd and 3rd year residents will only have 2 units (or 1 in 3rd year I think, CCU and/or RICU/MICU), which is more in adherence with ACGME anyway (5-6 total over 3 yrs.).

I've definitely been frustrated at times with patient volume and with how difficult patients can be (social and economic barriers), but am always challenged to think of a place I'd be happier at. My colleagues are some of my best friends, and we definitely do our fair share of socializing. We work hard, but we have time to play. Elective months are awesome. Our faculty are supportive and the program directors are fantastic. People match into the fellowships they want and seem to be more than competent doctors when they leave the program. Feel free to PM with any questions--

Hope this helps!

DS