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Anyone familiar with Exempla St. Joseph hospital program in Denver?

Discussion in 'Internal Medicine and IM Subspecialties' started by petehm, 02.11.05.

  1. petehm

    petehm New Member

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    Just looking for more info on this program. I hear that their residents get pretty good fellowships even though its a community program affilliated with the Univ of Colorado. Thanks!
  2. gagolden

    gagolden Call me the DOgg

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    its been a year since this posted. anybody have any info this year?

    I cant find a review of anykind anywhere on this program. Fellowship placement? % of IMG/FGM? anything and everything else?
  3. Mumpu

    Mumpu Burninator, MD

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    It's a community program. A lot of non-IM interns due to the large number of prelims, R2s and R3s are a mixed bag... no one terrible that I saw and some very strong FMGs but also DOs here and there (again, not a bad thing per se). Pretty good teaching, including an amazing cardiologist, and decent selection of cases (plus specialty rotations at University of Colorado). Very family-like sense among the residents.

    Bads: ICU is Q3 and you may get two months a year... including back-to-back. Residents don't do any procedures other than paracenteses (surgery called for every single line during my four weeks of ICU) -- not forbidden as far as I could tell, just not interested and no supervision available to teach. Private attendings suck bad. No support at night (sure you can call them, but will they ever call back?). Non-evidence based bizarre wild-ass medicine by the privates that leads to you getting reamed during rounds with your teaching attendings. Total lack of autonomy and decision-making -- every non-emergent test has to be approved by the private attending... Huge dumping service for indigenous patients in a hospital that's not set up to provide good care for the indigents leads to constant clusterf*.

    Good program if you want to be a private attending at Kaiser when you grow up, but I wouldn't count on any fellowships.

    The program is not affiliated with U of Colorado -- the U simply lets a few St Joe's residents do specialty rotations there.
  4. gagolden

    gagolden Call me the DOgg

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    Thanks for the info about the program. The lack of procedurals kinda scares me. Anybody have any other opinions, I would love to hear em.
  5. Mumpu

    Mumpu Burninator, MD

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    I honestly can't say if the procedures are lacking or if the residents are just not motivated to do them (or lack the proper supervision and training to feel comfortable doing them... more likely the latter since GME demands a certain number of procedures to get licensed).
  6. babyjbobby

    babyjbobby

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    Any new info on this program? Specifically regarding the prelim positions? Also a rough estimate of potential snowboarding days? :)
  7. noodler

    noodler

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    Days on the mountain..... Few and far between. This is not a cushy prelim program with lots of time off. You will work hard here and learn how to take care of patients. If you want time off this is not the program for you. My wife (non-resident) hates this program.
  8. gutonc

    gutonc No Meat, No Treat Administrator SDN Senior Moderator

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    If your wife is not a resident (and neither are you), why should her opinion of the program matter?
  9. BolderNewfy

    BolderNewfy

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    you only get two electives in your intern year. you get two 5 day vacations during those months. the rest of the year is wards, ICU or night float (think 12 hour(minimum) days, 6 days a week, call q 4. its not gentle by any means. (you also get the last 5 days of residency off as well, in order to move. they call that "intern week"...
    prelims get either one or TWO months of night float.
    you get four days off per month on wards. period. doesnt matter if the month was longer than 4 weeks. there are literally no weekends or two days off in a row, except for the two elective months and night float months.
    the kaiser hospitalists are great teachers, and physicians.they are the blessing of the program
    the program director is a nearly 80 year old retired military doc, and his style definitely reflects that
    you wont ski, believe me. you will be exhausted on your one day off and sleep.
  10. mtnman12

    mtnman12

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    Different perspective from the above poster. While there are only two elective months (weakness), and vacation is taken during these months, there is also a month of EM where you have the option to only work 16 shifts (!!) and take a third week of vacation. The EM month is cushy (basically act as a med student but can freely order tests and meds, lots of suturing), and you can work the schedule to get lots of days off. Also some seniors will give you a 5th day off on a ward month (but not always). And more importantly than the amount of days off-almost all of the seniors are awesome people and will work hard to help you out. Most admitted patients for me, wrote progress notes, and are easily available so you never feel alone. I also usually would get the attending's phone number and they want to be texted/called with any question. It definitely makes life much better.

    At the beginning of the year I was averaging 75 hours weekly on wards, but as my efficiency increased I brought that number down to ~65. Also my average patient load on the wards was 6-7, which is definitely easier than many other programs I interviewed with. And the one or two months of nights are set up so you get two days off in a row every 4 days, and are 12-13 hour true shifts otherwise. Nights are very busy (and often intense/overwhelming), but if you want to become very confident in many aspects in internal medicine, it's definitely a way to do it. Being busy isn't always bad if you're learning a little too.

    People ski, I saw my family, but much of it depends on what you want for your intern year. If you love internal medicine and from that become an efficient worker, you will hopefully love this place and the comforts of a community based program, the very strong nursing and support staff, and the really cool co-interns and residents. Especially coming from a hospital that doesn't have all of those things. Denver is also amazing. There are definitely people who get overwhelmed though including myself at times. If you don't want to be busy on internal med wards or get frustrated with internal med and would prefer a more cush program, I would agree there are better options.
    Last edited: 01.06.14
  11. brax

    brax

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    Could you PM me? Was hoping I could ask you a couple of questions...
  12. Crayola227

    Crayola227 Slacker

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    This poster's info claims that they are, in fact, a resident. Noodler is mentioning their wife, who I take it is not in fact a resident. This is based on putting together the poster's info on the sidebar and the parentheses and assigning what seems to be the categories to each that make the response make sense, because you are right, your interpretation does not make sense. I think that noodler is mentioning their wife's opinion in the context of replying to a question about days off and time for snowboarding in this program, and this makes sense that as the wife of a resident she may have some basis for an opinion on the matter. The fact that noodler mentions that the wife is not a resident is giving us perspective on how to interpret her opinion. My interpretation is that nookler is mentioning this to say that as a non-resident the wife feels her spouse is working too hard, and that this is the opinion of an outsider and not someone who is within the program as well. While adding the weight of the wife's opinion to noodler's own, noodler is attempting to help attenuate our response to her opinion by giving us this information.

    I'm only responding because it seemed to me that your comment was dismissive of noodler's basis for having an opinion on the program. I'm assuming this was a misunderstanding. Unless I'm the one misunderstanding noodler, or I'm misunderstanding you.

    In any case, I interviewed there, and my impression from the residents reflected all of the above comments.

    Even mtman12 writing in to say how awesome the program is doesn't really contradict what boldernewfy had to say. They tweaked it a little and put a spin on how they feel about the workload.

    Seriously, I'll paste here everything that I was led to believe about the program or observed myself and with editing (sorry plagiarism)

    It's a community program
    Large number of prelims
    also DOs here and there
    Pretty good teaching - am report was good. Had a bit of a "put you on the spot scared to be wrong" feel but not really malignant, not like the place I went to where people screamed
    I observed the EKG teaching personally. They brag about the residents graduating and reading EKGs better than fellows at the end of their first year. I'm inclined to believe this given the attention to it and the famous cardiologist dude who teaches there,

    Specialty rotations at University of Colorado but not formerly affiliated, not gonna do research there
    Very family-like sense among the residents - I agree. One of the more fun to lunch with groups I've met on the trail (and I've been a lot of places, mostly community programs)

    The chief resident personally admitted to me that opportunities for procedures are hard to come by, that the night shift is very "independent" and about 100 calls per night (it's a twelve hour shift, but for the sake of math, 10 hrs = 10 calls/hr = about 1 call/5 min. Let me say it again ONE CALL EVERY FIVE MINUTES APPROXIMATELY, not every call is going to be a 5 min problem.... this isn't a rare thing tho, lots of other places report the same to me)

    Quoted from above:
    the program director is a nearly 80 year old retired military doc, and his style definitely reflects that
    Yes, definitely the impression I got.

    "ICU is Q3 and you may get two months a year... including back-to-back." I think this is true.

    "Private attendings suck bad. No support at night (sure you can call them, but will they ever call back?). Non-evidence based bizarre wild-ass medicine by the privates that leads to you getting reamed during rounds with your teaching attendings. Total lack of autonomy and decision-making -- every non-emergent test has to be approved by the private attending... Huge dumping service for indigenous patients in a hospital that's not set up to provide good care for the indigents leads to constant clusterf*."
    The questions you have to ask at every community program. I can only speak to the fact that this part about having cases dumped on you by the private service and the resident team being the indigneous patient team was essentially confirmed for me by the chief resident on the tour. They don't believe in taking the patient that's been on service for 13 weeks waiting for a residential facility placement off your list to a private hospitalist.

    "Good program if you want to be a private attending at Kaiser when you grow up, but I wouldn't count on any fellowships."
    They make good claims about their fellowship placements. I dunno. I was pretty impressed with what they have to say about the quality of the case presentations and stuff they do at national meetings, quality improvement projects A lot of support for academic stuff like this.

    "you only get two electives in your intern year. you get two 5 day vacations during those months. the rest of the year is wards, ICU or night float (think 12 hour(minimum) days, 6 days a week, call q 4. its not gentle by any means. (you also get the last 5 days of residency off as well, in order to move. they call that "intern week"... prelims get either one or TWO months of night float. you get four days off per month on wards. period. doesnt matter if the month was longer than 4 weeks. there are literally no weekends or two days off in a row, except for the two elective months and night float months."
    Yup. I was told this too at orientiation, numbers about schedules don't lie.

    "the kaiser hospitalists are great teachers, and physicians.they are the blessing of the program"
    Yup. I was told this too by many residents at lunch.

    "month of EM where you have the option to only work 16 shifts (!!) and take a third week of vacation. The EM month is cushy (basically act as a med student but can freely order tests and meds, lots of suturing), and you can work the schedule to get lots of days off. Also some seniors will give you a 5th day off on a ward month (but not always)."
    Yup. I was told this too. A plus, but any bone is good to a starving dog, if you see the schedule above.

    "And more importantly than the amount of days off-"
    Wait? more importantly? There's something that isn't a day off that something substitutes for one in a satisfactory manner?

    almost all of the seniors are awesome people and will work hard to help you out. Most admitted patients for me, wrote progress notes, and are easily available so you never feel alone. I also usually would get the attending's phone number and they want to be texted/called with any question. It definitely makes life much better."
    Yup. I was told this too. I definitely believe they are collegial with each other and with the attendings as far as the attendings are young & there is texting going on (more than one resident said this, one even showed me some of the texting conversations on their phone at a glance.) Don't know if that means they call you back at night. Although, I was told they really really really encourage this behavior. Did they used to not supervise well enough, the attendings almost had their patients die and they are ultimately liable so now they want you to call whenever you want so you don't accidentally kill their patient? Do they like to micromanage you? Do they just tell you that you can get a hold of attendings at night to make you feel better or is it true? Or are they just nice approachable helpful? Hard to say. I was told nice things.

    "At the beginning of the year I was averaging 75 hours weekly on wards, but as my efficiency increased I brought that number down to ~65. Also my average patient load on the wards was 6-7, which is definitely easier than many other programs I interviewed with. And the one or two months of nights are set up so you get two days off in a row every 4 days, and are 12-13 hour true shifts otherwise. Nights are very busy (and often intense/overwhelming)," You admit it!! Although I was told by a higher up there ARE no caps to a team, which doesn't even make sense with GME regs... Maybe I misunderstood. In any case, they were adamant that you admit every single day and get new admits overnight and are very very busy but not capped. I dunno what to make of that.

    but if you want to become very confident in many aspects in internal medicine, it's definitely a way to do it. Being busy isn't always bad if you're learning a little too.
    Yes, being overworked and left alone with patients at night, exactly.

    People ski, I saw my family, but much of it depends on what you want for your intern year. If you love internal medicine and from that become an efficient worker, you will hopefully love this place and the comforts of a community based program, the very strong nursing and support staff, and the really cool co-interns and residents. Especially coming from a hospital that doesn't have all of those things. Denver is also amazing. There are definitely people who get overwhelmed though including myself at times. If you don't want to be busy on internal med wards or get frustrated with internal med and would prefer a more cush program, I would agree there are better options.
    Denver is awesome. Residents seemed busy but surprisingly very very happy given what I would think would be a hard situation. Nice newer hospital, they feed you well, parking, nice call rooms, amazing resident lounge where they all hang out. Amazing ancillary staff I hear, efficiency, and it sounds like good social work support.
    I'm just weighing in here to confirm or deny these resident claims, and as you can see, I tend to agree with both of them. Seems like a solid program where you will work hard. How they go about it, well, it's up to each of us to decide...


    Hope this was helpful.
  13. lsr2115

    lsr2115

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    How does St. Joe's prelim year compare to the University of Colorado's prelim year? They seem really similar in number of hours worked, vacation time, patient load, call schedule, etc.
  14. baculum1

    baculum1

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    Any current Prelims wanna comment on their current experience or recent experience with the prelim?

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