columbia for IM?

[sank]

Hi,

I just finished my last interview this week for
internal medicine at Columbia in NYC and contrary
to everything I heard on the interview trail, I
loved it there. The residents definitely are
worked but they get an excellent education and have a great sense of camaraderie. My question...what do those of you who have been there think (I'm a categorical applicant). Did i just speak to an unusually happy group of residents, or is the program really not as malignant as I've heard?

Also, a separate question, do you think it would
be useful to let them know that they'll be my
top choice? Obviously a school like Columbia
knows that many people will rank them high, so
does it really serve a purpose to ram it down
their throats?

Thanks,
sank

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[Voxel]

Full Ramming Speed man! Aye. Aye. Captain.

Seriously, you should make it a point for them to know that you really really want to go there. I cannot say if you will tell them that this will be your #1 choice. That's a decision you will have to make.

 

[task]

I interviewed at Columbia and while I did not rank them (wanted warmer climes) I thought it would be a great place to train. For Medicine programs, if you are interested in a place, I would definitely let the program director as well as the people you interviewed with know in writing that you plan on ranking them highest on your list (first, or whatever you eventually plan on doing). Also, I would consider doing a second look if you can, and line this up with the PD's full knowledge and try to see him when you're there, even just to say hi -- you would get the chance to meet a different mix of residents and faculty than on your interview day, things are usually a lot less formal so you can really see how things are done on a daily basis, and it lets the program know you are VERY interested in them -- enough to make the effort to spend another day with them, with some expense if you're from out of town.

While there, I would try to hook up with a post-call team and spend some time with the interns on that team to see what kind of pain they have post-call, as you figure the pain titer is highest on that day. This is a good time of year becuase the interns are a little more than halfway done and they're proficiency with getting things done and decision making at this level will be good for you to see. Focus on ease of disposition and obstacles to getting things done for your patients (labs, cultures, imaging) and getting them healthy/back to their baseline and out of the hospital. I think this will give you a true sense of how life there for three years will be.

 

[sank]

Thanks for your responses...I am writing letters to Columbia indicating that they will be at the top of my rank list. I was reluctant because the program director said something to our interview group about how thank you lettters are nice, but not required and that he thinks that things like thank you letters and second looks as means to let a program know how interested an applicant is in them "corrupt" the process of residency selection. In any case, I guess it couldn't hurt to let them know that I loved their program.

Thanks...

 

[dcl12]

As someone who has been at the medical center for a while, let me say that the program director does not include any post-interview letters in your file, so if you feel like writing as a courtesy, go ahead and do so. BUt don't expect it to help, either.

As for the atmosphere of the place, it probably would not be the best place for someone who wants to find a cushy prelim year for, say, derm. The weakest part of the program are the ancillary services--in speaking to graduates of the medical school who are now in programs elsewhere, the general consensus I received was that ancillary services are better pretty much anywhere else. BUt having said that, what all the residents become very good at are doing procedural things--the graduates of P&S who go elsewhere for residency like to boast that the students at many other medical schools that they teach tend to be "fragile" and "squeamish"as they describe them.

The 2-attending system on ward teams, while no longer unique to COlumbia, is something that provides a lot of teaching, more so than some other comparable programs. Spanish language skills are very important given the local populations; while there is an interpretor corp here, they are all volunteers, and their availability become scarce overnight--and no, the hospital does not choose to subscribe to the AT&T translator service, a point on which I personally strongly disagree with the administration.

Quality of life is improved by the Bell commission, a New York state commission that limits work week to a max of 80 hrs/wk averaged over 2 weeks with no more than 24 hrs continuously on duty and at least one day off every 7 days (current legislation in Congress that is being considered is based on this commission). Columbia follows these commission guidelines by having a night float system that allows on-call interns to go home usually by midnight/1 am.

Housing in the local area is far cheaper than downtown, and safety is not a concern if one lives near the medical center. Also, to acheive some parity with our sister hospital at Cornell, there is an additional $3000 a year housing allowance given on top of the base salary.

As for morale, I would say the happiest residents are those with the most gung-ho, cowboy mentalities. Again, because of the weak ancillary systems, the program is not for those who will be easily frustrated because, for example, the blood tech didn't get to your patients, yet, or transport has not arrived to bring your patient from the unit.

In summary, the program is ideally suited for those with an academic bent yet at the same time have no fear of getting down and dirty in the trenches and who have a command of Spanish.