I’m wondering if anybody has any comments about this program. Thank you.

I’m wondering if anybody has any comments about this program. Thank you.

Reviews are available on Scutwork.com and "Interview trail impressions."

don't forget house of god....

Thanks, guys, I actually had looked at the scutwork page before and only found 1 recent review by a resident, which was glowing. I was looking for some verification from other current housestaff . . . .

I will take a look at the interview trail anecdotes from last year as well, thanks.

There didn't seem much interest in this thread, but, the BID Internal Medicine program does elicit a variety of views.

Most of us have an "idea" of what BID offers for the resident and/or fellow. But, some seem to "love her or leave her" when compared to other academic hospitals. (Here at Hopkins, we refer to BID as "she or her", not intended as an insult either).

Any current gut-level commentary concerning "The "Deaconess"?

bump... I'm wondering about BID as well.

bump... I'm wondering about BID as well.

You bumped it up from two days ago....:D

You bumped it up from two days ago....:D

I'm really curious about BID... that's why :laugh:

bump... I'm wondering about BID as well.

<---- (Didn't interview there)

Here's the gossip . . . generally considered "elite" (arguable), excellent fellowship placement, the most "cush" of any elite program (which doesn't mean that it is "easy"), very difficult to get into for these reasons

<---- (Did interview there)

The nicest people on the interview trail and happiest residents. The place runs like a well-oiled machine. Gave the impression it was cushy. Some of the faculty affirmed that it was cushy, and there are no procedures (you join the procedure team for two weeks after internship to get ABIM certification in procedures). For this reason, I did not rank BID, and I have no idea if I would have matched. I ranked MGH because I perceived it to be more severe and I felt MGH would be me more. I did not match there.

Thanks... appreciate the responses :)

I am not sure where people get this idea of no procedures. You'd think the enormous population of ICU patients never needed central lines. There is an ICU on their east campus, two ICUs on their west campus plus outliers in other ICUs, a busy CCU and rotations at the VA ICU and CCU... There are PLENTY of opportunities for for procedures. One might argue there is too much critical care.

The whole ABIM requirement for procedures has changed and each program must define whether they are required and what the number is to be "competent". As fellow now at another program, I am seeing many people are finishing residency without comfort in subclavians and IJ's or are dependent on an ultrasound machine. I think BIDMC handled training in this well, and those that were interested got very comfortable.

<---- (Did interview there)

The nicest people on the interview trail and happiest residents. The place runs like a well-oiled machine. Gave the impression it was cushy. Some of the faculty affirmed that it was cushy, and there are no procedures (you join the procedure team for two weeks after internship to get ABIM certification in procedures). For this reason, I did not rank BID, and I have no idea if I would have matched. I ranked MGH because I perceived it to be more severe and I felt MGH would be me more. I did not match there.

As fellow now at another program, I am seeing many people are finishing residency without comfort in subclavians and IJ's or are dependent on an ultrasound machine.

Unfortunately, or perhaps fortunately . . . U/S is now standard of care when placing IJs.

Unfortunately, or perhaps fortunately . . . U/S is now standard of care when placing IJs.

This is a subject for a whole different thread, but if you are learning to place a line, you should decide where you are going to stick, then use the US to confirm and guide you the rest of the way.

I personally think it is bordering on malpractice trying to put in an IJ without US. As you said, unfortunately, you can still find places that don't have an US machine. You can also have a hundred US machines around, but if its an emergency and you need to throw in a RIJ for a temporary wire in a crashing patient, as long as you're comfortable with both techniques, you can get the line in before someone finds that machine, starts it up and places the probe a sterile sleeve/glove!

<---- (Did interview there)

there are no procedures (you join the procedure team for two weeks after internship to get ABIM certification in procedures). For this reason, I did not rank BID, and I have no idea if I would have matched. I ranked MGH because I perceived it to be more severe and I felt MGH would be me more. I did not match there.

My S.O. is at BI for internal medicine, and did two CVLs and one IJ on his first day in the ICU as an intern. He's not the only resident doing procedures either!!

I'm a resident there and would be happy to address any specific questions/concerns. As for procedures, we're very focused on both resident education and patient safety/quality issues, and for both reasons residents are required to have supervision in most instances while doing procedures. I think this adds to rather than takes away from the experience, and there are certainly plenty of procedures to be done around here, almost all of which residents end up as primary operators on. It's true we have a procedure service (staffed by 2nd and 3rd year medicine residents) who are available for procedures on the general medicine wards. This is a nice rotation because you get an intensive block of practice with the skills. Primary team on the wards can also do procedures themselves if they have the time/inclination. In the ICU all of the procedures are done by the primary team.

I agree that the nicest and happiest folks end up here. :-) I've also been astounded by the clinical competence of my colleagues.

Finally, we do have a reputation for being cushy. I actually think it's more the case that we were just cushy before other programs were, and in recent years many programs have moved away from regular 100 hour work weeks, but even today we have a comparatively nicer schedule vs many programs. The weeks where we push 80 hours are limited to the ICUs (and there we often get a bit of sleep including) and the oncology rotations during intern year (generally 1-2 months). Wards are more like 65h, especially later in the year. Not a bad deal.

Cush is a bad thing when it comes to medicine residency. You want to be able to do central lines by yourself with or without ultrasound, and you can't use an u/s for subclavians, which u need during codes (ppl messing around with et tube) or for pts in c-collars, also more comfortable for the patient than an IJ (assuming not intubated). Within reason resident-run high-autonomy programs provide much better training. Never understood why 'cush' is desirable, if u want cush don't go into IM.

Cush is a bad thing when it comes to medicine residency. You want to be able to do central lines by yourself with or without ultrasound, and you can't use an u/s for subclavians, which u need during codes (ppl messing around with et tube) or for pts in c-collars, also more comfortable for the patient than an IJ (assuming not intubated). Within reason resident-run high-autonomy programs provide much better training. Never understood why 'cush' is desirable, if u want cush don't go into IM.

This is a diversion from the OP...but...

I think "cush" is a vague term and means many different things to many different people.

Regarding procedures, specifically - I agree that you should be able to perform them in a competent fashion - but, realistically, procedures are not intergral to an IM career. Residency - yes...Hospitalist career - maybe...Rural hospital - sure...General IM - probably not. And I will certainly never use those procedure skills in my endocrinology career. I loved being able to perform procedures on patients who needed help (ie: bedside thora for progressively worsening effusion/dyspnea, LP to r/o meningitis, etc) -- but other than for these acute situations, the reality is that hospitals are shuttling nonurgent/diagnostic procedures to interventionalist services (ie: IR). I think the ACGME/RRC adjustments reflect this (for better or worse) by removing the requirement for these procedures (just need the "opportunity for exposure"). As for subclavians - couldn't you just throw a femoral? heheh :-)

Sorry for the tangent...back to regularly scheduled programming

Cush is a bad thing when it comes to medicine residency. You want to be able to do central lines by yourself with or without ultrasound, and you can't use an u/s for subclavians, which u need during codes (ppl messing around with et tube) or for pts in c-collars, also more comfortable for the patient than an IJ (assuming not intubated). Within reason resident-run high-autonomy programs provide much better training. Never understood why 'cush' is desirable, if u want cush don't go into IM.

Would be so hard to actually type out "you"?

It's not like this is some sort of phone text session with your OMG BFF(!!! <3).

You (notice how easily it types) might have had a reasonably legitimate point, but you merely looked like a ****ing douchetard.

This is a diversion from the OP...but...

I think "cush" is a vague term and means many different things to many different people.

Regarding procedures, specifically - I agree that you should be able to perform them in a competent fashion - but, realistically, procedures are not intergral to an IM career. Residency - yes...Hospitalist career - maybe...Rural hospital - sure...General IM - probably not. And I will certainly never use those procedure skills in my endocrinology career. I loved being able to perform procedures on patients who needed help (ie: bedside thora for progressively worsening effusion/dyspnea, LP to r/o meningitis, etc) -- but other than for these acute situations, the reality is that hospitals are shuttling nonurgent/diagnostic procedures to interventionalist services (ie: IR). I think the ACGME/RRC adjustments reflect this (for better or worse) by removing the requirement for these procedures (just need the "opportunity for exposure"). As for subclavians - couldn't you just throw a femoral? heheh :-)

Sorry for the tangent...back to regularly scheduled programming

I addressed "cush" here (http://forums.studentdoctor.net/showthread.php?t=575364), it's my definition, and I don't have much respect for it. With that said when people say BID is "cushy" it is relative to the rest of the Ivy's, which doesn't mean people sit around doing nothing, coming in at 9AM and leaving at 2PM.

As for procedures, I have to generally agree with you about post-residency training. However, when it comes to IM residency itself, one should know how to do all of these procedures and I think a training program does a disservice to it's resident's if people graduate not feeling comfortable putting in lines, doing thora/paracentesis, spinals, and joint injections.

And fem's suck because you have to take them out in two days now, which means if you really need central venous access another procedure for the patient.

And fem's suck because you have to take them out in two days now, which means if you really need central venous access another procedure for the patient.

Totally OT but I think I can count on 1 hand the number of femoral CVCs I've put in where that 2 day thing would have been an issue.

In my experience, "somebody drop a fem line!" = "we should probably just call this now."

Totally OT but I think I can count on 1 hand the number of femoral CVCs I've put in where that 2 day thing would have been an issue.

In my experience, "somebody drop a fem line!" = "we should probably just call this now."

I agree

What's interesting about ACLS, now that we are WAY off topic, is that they teach us about osseous access, which would probably be the easiest and fastest way to get in fluids and meds and I don't know why in the "code situation" we don't use it first line - vvvvrrrrrrip and it's in, wallah! And I've yet to see one used on the floor.