2015 Critical Care IM

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DrTerex

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I just had my ERAS token registered. For those applying for Critical care IM only when do you ask for LORs? is it now or July? when usually the interviews? and Just wondering when do you need to use NRMP.
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Any hospitalist applying for critical care? it is bad to apply after 3 yrs of hospitalist work?
 
You should get your LORs uploaded by now
 
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DrTerex said:
Any hospitalist applying for critical care? it is bad to apply after 3 yrs of hospitalist work?
Click to expand...
Why would it be bad? You know more IM than many fresh grads. You think like an independent attending, not a supervised resident. You are (hopefully) board-certified. You probably know better what you want and are more motivated to learn than the average second year-resident.

You will still need a good resume, good LORs, and to be an attractive candidate otherwise. Plus you will have to convince the interviewers that you are motivated and can go back to working as a supervised trainee.
 
Hi, I am an infectious diseases fellow applying for a critical care position. Does anyone know if all programs accept a 1 year spot or one has to individually call the programs and ask about it.
 
Tried to apply to CC IM only today but still cannot apply yet... I thought July 15 is the day we could apply to programs. Any thoughts? Need to call ERAS
 
FFP said:
Why would it be bad? You know more IM than many fresh grads. You think like an independent attending, not a supervised resident. You are (hopefully) board-certified. You probably know better what you want and are more motivated to learn than the average second year-resident.

You will still need a good resume, good LORs, and to be an attractive candidate otherwise. Plus you will have to convince the interviewers that you are motivated and can go back to working as a supervised trainee.
Click to expand...
--Thanks FFP...I have 2 programs that do not participate to ERAS..Likely I need to call them..iS there any reason why they do not participate to ERAS?
 
I don't know. I am anesthesia, and we don't use ERAS for any fellowship AFAIK.
 
CC program at UCSF was closed already..one reason why the program does not participate in ERAS..
 
Anyone applying only for CC internal medicine?
 
i know its too early, but just to keep conversation going---
how many programs you see have downloaded your applications? none on my list.
 
dhp said:
i know its too early, but just to keep conversation going---
how many programs you see have downloaded your applications? none on my list.
Click to expand...
just 2 out of 15 programs that I applied..How many programs did you applied?
 
i applied to 5. just to be sure, if a program downloads the only way to know is that its blue in color?
before i remember it would show the date and time of download which would be different then the date and time it was available to eras.
 
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how about other CC fellow applicants? Bring on your thoughts about this coming application season..
There are only 25 CC programs participating..when do they usually send IV invitations?
 
dhp said:
i applied to 5. just to be sure, if a program downloads the only way to know is that its blue in color?
before i remember it would show the date and time of download which would be different then the date and time it was available to eras.
Click to expand...
Thank you dhp are you hospitalist like me or 3rd year resident?..
 
Nothing yet..no additional programs downloaded my application docs
 
i am not even sure what the color changes mean. the old system was better, just showed the time when the file was downloaded. now it says not yet retrieved, then there is last accessed and it looks basically the same date and time stamp for all the programs i applied to, and then there is an occasional tab which turns blue. and there is no explanation given anywhere by ERAS what all this means. If someone saw an explanation pl post.
 
awesome, do u mind to share which place?
 
and number 2. how is everybody else doing with invites coming in?
 
do you mind sharing from where? this forum is meant to share useful information!
by saying you have 2 interviews and giving nothing more means nothing much to the rest of us here!
 
Feeding the beast.
My first offer was Mayo, followed by Wash U. Midwest seems to be going early, anyone hearing from the coasts?
 
thanks! that was helpful..
havent heard from any of the program i applied to.
 
your not alone dhp:(.. i was told that its still early
 
What do people think about Mayo? I am scheduled for an interview there later this month
 
EMIM2011 said:
What do people think about Mayo? I am scheduled for an interview there later this month
Click to expand...

I was very torn about Mayo.
Certainly the academics are impeachable; you will be book-smarter than most.

The downside is the culture and the locale.
Patients there have a certain level of expectation and the hospital caters to it. So people get moved from the floors to the ICU for observation for things that a resident would just handle on the floor at most other hospitals. And they do it to be cautious at Mayo and that's admirable, but it adds to your workload without adding much to your education. The locale also means less fresh criticality. The vast majority of people who come to Mayo have traveled a great distance, so they are stable. They have some kind of zebra, but they aren't just falling apart sick right in front of you. And that's what you need in CC. If you're doing pulm, then yes, its a mecca. But for straight CC, you want to be in a big city with lots of fresh sepsis and respiratory failure showing up at the ED. You don't want some other hospitals 3 month ICU dweller who they can't figure out how to get off a vent because no treatments are working.
They do get a lot of post-op sickies though because people come to Mayo for their last-ditch surgical intervention, then crump after the procedure. But then you don't get much autonomy in those cases because the surgeon is swarming all over them.
 
Thanks, Dr Bob. Did you "only" interview there, or do you have some first-hand experience as well (just asking, because it sounds like you know quite a bit about their program)
 
Have not heard from a single program so far, not sure if that is good or bad ...... what abt you guys ?
 
Rejection from Mayo.
Email from Baylor saying they received my application but were still reviewing applications - not sure what the significance of this is , if any ?!
Haven't heard from any other programs - anyone with interviews from programs on the east coast or anywhere else ?
 
I applied to 8 programs, no interviews, no rejections, only 2 emails saying that they received my application (geisinger and baylor). Has CCM become competitive ?
 
Same here, Baylor and Geisinger notified me that the application is being reviewed. I guess CC programs don't have the manpower to make quick decisions on interviews ?
 
Question I haven't found the answer to. Every program says application through ERAS but there's no match specified on any website. If these programs don't participate through NRMP, then how do you get a spot?

Sorry if that seems like a dumb question. I wish you all a ton of luck. So far no luck for me with interviews. No review emails, either.
 
Airplane Doc - IM CCM is outside of the match, meaning that after the interview programs either offer you a position or don't. I have heard deadlines anywhere from 2-30 days to accept a contract. I had heard great things about Mercy St. Louis (peripherally affiliated with SLU). They gave me 30 days after an acceptance letter to make a decision. Mercy, however, is also outside of ERAS and began accepting applications in February and interviewing in June.

I noticed a few comments about UCSF and wanted to weigh in as I had personally contacted the PD earlier this summer regarding what is offered at their institution. It sounds as though they have funding only for one-year fellowships, not two. Therefore, UCSF will only accept candidates who have already completed another sub-specialty fellowship.

I'm wondering if anyone has any personal experience with Mercy St. Louis they would be willing to share. I've spoken with people who trained there previously (>10 years ago), as well as other faculty who completed fellowship at some of the other "top CCM" institutions (Pitt, Mayo, etc). Obviously everyone raves about Pitt being intense, but arguably providing the best overall training in the country for IM-CCM. I am not interesting in comments that strictly arise from hearsay or rumor, but rather if anyone has a recent experience with Mercy's program (ie you personally or someone you know well who trained there). Feel free to send me a PM if you're not comfortable posting it for everyone to see.

To round out the question about coasts - Stanford was the first to send a "We're reviewing your application" email, but has yet to offer up an interview. Wake Forest also has a very approachable PD who answered many of my questions prior to submitting on ERAS.

Cheers!
 
67CamaroSS said:
Airplane Doc - IM CCM is outside of the match, meaning that after the interview programs either offer you a position or don't. I have heard deadlines anywhere from 2-30 days to accept a contract. I had heard great things about Mercy St. Louis (peripherally affiliated with SLU). They gave me 30 days after an acceptance letter to make a decision. Mercy, however, is also outside of ERAS and began accepting applications in February and interviewing in June.

I noticed a few comments about UCSF and wanted to weigh in as I had personally contacted the PD earlier this summer regarding what is offered at their institution. It sounds as though they have funding only for one-year fellowships, not two. Therefore, UCSF will only accept candidates who have already completed another sub-specialty fellowship.

I'm wondering if anyone has any personal experience with Mercy St. Louis they would be willing to share. I've spoken with people who trained there previously (>10 years ago), as well as other faculty who completed fellowship at some of the other "top CCM" institutions (Pitt, Mayo, etc). Obviously everyone raves about Pitt being intense, but arguably providing the best overall training in the country for IM-CCM. I am not interesting in comments that strictly arise from hearsay or rumor, but rather if anyone has a recent experience with Mercy's program (ie you personally or someone you know well who trained there). Feel free to send me a PM if you're not comfortable posting it for everyone to see.

To round out the question about coasts - Stanford was the first to send a "We're reviewing your application" email, but has yet to offer up an interview. Wake Forest also has a very approachable PD who answered many of my questions prior to submitting on ERAS.

Cheers!
Click to expand...


So if IM-CCM is outside of the match, when are most of the offers distributed by? I'm an EM guy considering CCM. I'll likely be applying to both anesthesia-cc and IM-cc. Presumably, I would know if I had an offer prior to the required anesthesia-cc (san francisco) match, right?

Thanks.
 
hearsay is the most common form of information though
 
Interview from U Pitt
Rejections - Mayo, U Washington, Henry Ford
How abt the lurkers ? Any interviews ?
Anyone heard from Baylor ? Stanford ? UMD ? Miami ?
 
Anyone know how the U Pitt interviews are ? Lots of pimping ? Technical stuff ?
 
Interviews: UPMC, Mayo (yesterday), OHSU, Sinai, Mercy-SLU.

Rejections:

Still Waiting: Stanford.

Best of luck everyone.
 
Doctor Bob said:
I was very torn about Mayo.
Certainly the academics are impeachable; you will be book-smarter than most.

The downside is the culture and the locale.
Patients there have a certain level of expectation and the hospital caters to it. So people get moved from the floors to the ICU for observation for things that a resident would just handle on the floor at most other hospitals. And they do it to be cautious at Mayo and that's admirable, but it adds to your workload without adding much to your education. The locale also means less fresh criticality. The vast majority of people who come to Mayo have traveled a great distance, so they are stable. They have some kind of zebra, but they aren't just falling apart sick right in front of you. And that's what you need in CC. If you're doing pulm, then yes, its a mecca. But for straight CC, you want to be in a big city with lots of fresh sepsis and respiratory failure showing up at the ED. You don't want some other hospitals 3 month ICU dweller who they can't figure out how to get off a vent because no treatments are working.
They do get a lot of post-op sickies though because people come to Mayo for their last-ditch surgical intervention, then crump after the procedure. But then you don't get much autonomy in those cases because the surgeon is swarming all over them.
Click to expand...

I'm going to generally agree with the above but then caveat with saying 1) one of my current partners and an attending in fellowship trained at Mayo CC and both are really fantastic docs and 2) a decent amount of what you see mentioned above at Mayo about patients that aren't actually super sick but just "too sick" for "the floor" will be a real phenomenon at almost any community shop. You spend probably 10-20% of your time working as a "super-hospitalist". Like everything in medicine it's nuanced. But sometimes trying to figure out the pieces that need to occur between off pressors, IV meds, intubation to eventually discharge can be its own challenge.

I guess my point is I don't think Mayo would be the end of the world. Most of us will not be working in big academic medical centers with medicine teams that can handle "step-down" patients without blinking. Most of you will need to accept that the "real world" (ugh. I used to HATE it when that term got tossed at me) is more like Mayo than it's not.
 
My real reason for wandering in here though . . .

As a group in this site looking to do just critical care I am wondering how the folks in here would feel about a job that was a week on/week off but 50% nights. Basically your "week on" would alternate between days and nights.

???

Honest answers will be helpful here. Be brutal if you like.
 
jdh71 said:
one of my current partners and an attending in fellowship trained at Mayo CC and both are really fantastic docs ... I guess my point is I don't think Mayo would be the end of the world.
Click to expand...

Oh yea... lest anyone get the wrong impression from me... Mayo would be great training. It's just not predominantly the method by which I learn best. So it was not the best choice for me. But that's an n of 1, and nobody would ever accuse Mayo of giving anything less than great training.
 
(just an intern here)

i'm assuming this means "1 week nights, 1 week off, 1 week days, then fourth week off".

I kinda expect to be working a decent number of nights no matter where i go, but i'm not sure i'd be down with 50% of my career (25% of my life) being nights. Don't a lot of community hospitals just have NPs on nights with the intensivists alternating home call?

50% nights would play into job selection just like city/location, facilities, benefits, etc. did, IMO. If i had the option between a prestitigious academic ICU gig (which required 50% nights) and a lucrative community ICU slot that provided NPs, then I'd probably choose the community gig only if family life necessitated it.
 
timbuktu said:
(just an intern here)

i'm assuming this means "1 week nights, 1 week off, 1 week days, then fourth week off".

I kinda expect to be working a decent number of nights no matter where i go, but i'm not sure i'd be down with 50% of my career (25% of my life) being nights. Don't a lot of community hospitals just have NPs on nights with the intensivists alternating home call?

50% nights would play into job selection just like city/location, facilities, benefits, etc. did, IMO. If i had the option between a prestitigious academic ICU gig (which required 50% nights) and a lucrative community ICU slot that provided NPs, then I'd probably choose the community gig only if family life necessitated it.
Click to expand...

You are assuming the schedule correctly.

Most major shops are moving the intensivists back in house 24/7 and that will be the tend going forward. If you've got a low acuity, few admit per day kind of shop you might get away with the NP or Hospitalist admitting. You might be somewhere where that is the ONLY way to keep you from going nuts working too much and it is what it is. But in house night shifts will be part of most intensivist jobs.

What about a job where for every two weeks of days you work a week of nights? A 1/3 nights kind of a gig?
 
jdh - I think it would depend a lot on the size of the unit, how busy nights really are, what kind of support staff is available, etcetera, etcetera. Given the right numbers and compensation, it would likely be a fair consideration for someone early in his/her career. If it is solely a couple intensivists on that schedule, however, it might get rough down the road. I could see myself working nights every fourth week, or even something that is split, as in Month 1: 1 week of nights, 1 week off, 1 week of nights, 1 week off; Month 2: 1 week of days, 1 week off, 1 week of days, 1 week off... You get the idea. As an aside, I've noticed your posts around the CC threads and appreciate your comments, notably the ones about not going into the specialty with sole aspirations of being a line monkey. It appears you have a solid presence in the SDN forums and may be able to shed some light on my question posed below...

I look around at other forums and see "rank-lists" of the most well-respected programs in various sub-specialties. When I ask my buddies going into Cards where the "top programs" are around the US, they all spout off the same 4-6 in any given order (ie Duke, Texas Heart, Brigham, etc). Even P/CCM has a pretty decent list of reputations out there (Penn, Colorado, etc). I've scoured hundreds of posts, some much more useful than others, but have yet to see a recent list for CCM. There are posts from 2006-2008, which are rendered (at least in my mind) utterly useless 6-8 years later after faculty turnover, PD changes, and a multitude of other factors. Obviously, with only 30-50 programs in the country, narrowing to 3 or 4 shouldn't be that tough. Again, as above, I don't care what happened 30 years ago at these places; I don't even care how they looked, smelled, or trained fellows 5-10 years ago. I would like to hear as of now, September 2014, what people believe to be the "meccas" of critical care for training (which I believe to be somewhat different from the meccas of patient care). This can be through IM/EM/Gas, but please specify which route you're referring to. I understand all the intricate details about how one program is better than another for each individual candidate, because I am one, so spare the personal reasons for picking one or another. I can assure you this is not an attempt to make my rank list, but rather an attempt to provoke discussion and better understand how these places stack up in the eyes of individuals from vastly different backgrounds and experiences than my own. After months of looking into the topic, talking to faculty around the country who have trained at various CCM programs, and listening to fellows talk up/talk down, their current programs, I often hear the same four or five: Pitt, Stanford, Mayo, Sinai, for starters. Thoughts?
 
67CamaroSS said:
jdh - I think it would depend a lot on the size of the unit, how busy nights really are, what kind of support staff is available, etcetera, etcetera. Given the right numbers and compensation, it would likely be a fair consideration for someone early in his/her career. If it is solely a couple intensivists on that schedule, however, it might get rough down the road. I could see myself working nights every fourth week, or even something that is split, as in Month 1: 1 week of nights, 1 week off, 1 week of nights, 1 week off; Month 2: 1 week of days, 1 week off, 1 week of days, 1 week off... You get the idea. As an aside, I've noticed your posts around the CC threads and appreciate your comments, notably the ones about not going into the specialty with sole aspirations of being a line monkey. It appears you have a solid presence in the SDN forums and may be able to shed some light on my question posed below...

I look around at other forums and see "rank-lists" of the most well-respected programs in various sub-specialties. When I ask my buddies going into Cards where the "top programs" are around the US, they all spout off the same 4-6 in any given order (ie Duke, Texas Heart, Brigham, etc). Even P/CCM has a pretty decent list of reputations out there (Penn, Colorado, etc). I've scoured hundreds of posts, some much more useful than others, but have yet to see a recent list for CCM. There are posts from 2006-2008, which are rendered (at least in my mind) utterly useless 6-8 years later after faculty turnover, PD changes, and a multitude of other factors. Obviously, with only 30-50 programs in the country, narrowing to 3 or 4 shouldn't be that tough. Again, as above, I don't care what happened 30 years ago at these places; I don't even care how they looked, smelled, or trained fellows 5-10 years ago. I would like to hear as of now, September 2014, what people believe to be the "meccas" of critical care for training (which I believe to be somewhat different from the meccas of patient care). This can be through IM/EM/Gas, but please specify which route you're referring to. I understand all the intricate details about how one program is better than another for each individual candidate, because I am one, so spare the personal reasons for picking one or another. I can assure you this is not an attempt to make my rank list, but rather an attempt to provoke discussion and better understand how these places stack up in the eyes of individuals from vastly different backgrounds and experiences than my own. After months of looking into the topic, talking to faculty around the country who have trained at various CCM programs, and listening to fellows talk up/talk down, their current programs, I often hear the same four or five: Pitt, Stanford, Mayo, Sinai, for starters. Thoughts?
Click to expand...

I don't know Sinai by reputation. Pitt is Pitt (though I think you end up taking care of too much post transplant and I get the arguments but I think it's pretty unnecessary). I've always been kind of impressed with what I've heard about the Stanford program. But I honestly don't have a lot of insight into the straight IM CC programs to be honest. I think the gas programs at UCSF and OHSU sound fantastic. And Maryland's surgical shock/trauma fellowship is super cool.
 
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