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Cush Internal Medicine Programs

Discussion in 'Internal Medicine and IM Subspecialties' started by sanktank7, 12.08.12.

  1. sanktank7

    sanktank7

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    MS3 here interested in allergy/immunology or rheumatology ultimately and currently planning away electives. I was curious if those who have been on interviews lately can comment on some more chill internal medicine program if such a thing exists. I dont mean low hours necessarily (although thats a plus), just programs that tend to really look out for residents, good house-staff, minimal call, less procedurally demanding (dont think its critical given my subspecialty aspirations), minimal scut.

    I suppose the answer to this is community-university affiliated programs; however, I also want good access to research and decent reputation since allergy is pretty competitive.

    I often see Northwestern, OHSU, Beth Israel listed as some of the programs that fit this bill. Any others? A list of medicine programs that are strong in the allergy/rheum departments would be helpful too. Any advice?
  2. ihatescience

    ihatescience

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    Scripps (Green), Cedars-Sinai are strong community programs, the former of which has an in-house A/I fellowship.
  3. MeatTornado

    MeatTornado

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    you don't necessarily have to settle for a community program, there are plenty of university programs that are "chill" ....i'd say NS-LIJ probably fits that description. look for places with 3+1, 4+1, or 6+1 and in a suburban area (usually have better ancillary services)
  4. bombas238

    bombas238

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    Houston Methodist meets a lot of the criteria you mentioned. They have a rep for being a super cush program that they are trying to shake off, but the benefits are through the roof and it is a very fancy pants private hospital in the middle of the Houston healthcare megaplex. They also offer a lot fellowships that are largely taken up by their own graduates.
  5. sanktank7

    sanktank7

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    I really like the 4+1 type programs - thanks for pointing that out. Ive never seen that before. I noticed that Tulane has that model in their medicine residency. Anyone know of other upper tier (top 25 in reputation, yes I understand its very subjective) that have this type of program?
  6. gutonc

    gutonc No Meat, No Treat Administrator SDN Senior Moderator

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    1. Tulane is not Top 25.

    2. Lots of programs have this setup (or some X+Y schedule)...and more will be adopting it. It's a nightmare to schedule but pretty nice for the residents.
  7. jarmen

    jarmen

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    mayo. based on what i remember from the interview mayo is the most cush program ever. they are 4wks inpt 4wks outpt the whole intern yr. and for those 6 months on inpt ur capped at 6 pts. no call. u never even come close to breaking work hour restrictions. basically u just write case reports every day and try to make it to minneapolis for human contact. and they a top 25 program with world renowned docs and sharp residents. if ur looking for a good cush program thats what i would go with.
  8. coffeebeanjenn

    coffeebeanjenn

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    University of Chicago will be going to a 4+2 schedule next year.
  9. Interviewtime

    Interviewtime

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    Bump...
    Last edited: 12.21.12
  10. Gpan

    Gpan

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    UMC Las Vegas:D
  11. surge55

    surge55

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    just curiuos, can someone explain the 4+1 or whatever thing? what do the numbers pertain to? residents to faculty ratio?
  12. gutonc

    gutonc No Meat, No Treat Administrator SDN Senior Moderator

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    Inpatient:Outpatient weeks. Instead of having clinic mixed into your Wards/ICU/ER/Consult months, you do 3,4,6,whatever straight weeks of inpatient/ER without any clinic to ruin your flow. That's followed by 1 or 2 weeks of nothing but outpatient medicine. The mix of that outpatient experience varies by program.

    The program where I was a resident went to a 3+1 program last year. During the inpatient months you have no clinic whatsoever, with the possible exception of sub-specialty clinic if you're on consults (which is up to the discretion of the subspecialty service). During your clinic week, you have your continuity clinic for 4 half days (which may not mean 4 separate half days) and other clinics to make up the rest of the week such as HIV clinic, Women's Health clinic or if you have expressed a specific interest in a subspecialty, a subspecialty clinic with a mentor.
  13. OneStrongBro

    OneStrongBro Senior Member

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    Have a cousin that is a current IM resident at Indiana University Ball Memorial.

    It is as cush as it gets because it is a community program. However, the residents there have matched into Cardiology, Heme/Onc, Allergy, Nephrology, and Critical Care because of the Indiana University School of Medicine connection.

    Apparently the residents are very happy because of the lighter load of a community practice program, plus they get a $8500 signing bonus.

    How many programs give you a check for $8500 on the first day of internship? :laugh:
  14. Gpan

    Gpan

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    WTH, they give glorified medical student $8500 for just signing the residency contract? DAMN I should have gone there haaha
  15. Radonkulous

    Radonkulous

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    .
    Last edited: 12.20.12
  16. inspirationmd

    inspirationmd

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    http://iuhealth.org/ball-memorial/f...ency/internal-medicine-salaries-requirements/

    Had to look for myself. In addition to the $8500 check on Day 1 they get a $5,000 business account (annually!) that they can use to pay housing, get books, etx. Meals are also free all 3 years. That's crazy. Not the best location but for that amount of cash and a solid look at IU with all its fellowships...not bad at all at least from a benefits standpoint.
  17. CanIMakeIt

    CanIMakeIt Fellow

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    Looks like a sweet deal!
  18. hamsterdam

    hamsterdam Game done changed.

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    ---
    Last edited: 12.20.12
  19. sunset823

    sunset823

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    My home program gives a $10,000 signing bonus for anyone who matches in a primary care specialty. In a program similar in location to Ball Memorial, small city in a neighboring state. While it was a good place to be a med student, I have no intention of staying here for residency (looking at other parts of the country of similarly small size though, I dislike huge cities), but it is a pretty sweet deal. The salary is pretty ridic for the (very low) cost of living in the area.
  20. Interviewtime

    Interviewtime

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    bump
  21. Instatewaiter

    Instatewaiter But...There's a troponin

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    utsw
  22. gutonc

    gutonc No Meat, No Treat Administrator SDN Senior Moderator

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    Just spit coffee on my laptop.
  23. Interviewtime

    Interviewtime

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    I assume you are being sarcastic...:thumbup:
  24. notbobtrustme

    notbobtrustme Crux Terminatus

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    friends don't let friends go to UTSW.
  25. LumberJack

    LumberJack

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    Why exactly are you guys so keen to find the easiest, least-challenging training program possible?
  26. LumberJack

    LumberJack

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    Nevermind. Not even sure why I asked since it has nothing to do with me. Carry on.
  27. Instatewaiter

    Instatewaiter But...There's a troponin

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    Figured we should spice this conversation up a bit. If people are going to accuse others on SDN of giving terrible advice, I figure we should start doling out terrible advice once in a while.
  28. gutonc

    gutonc No Meat, No Treat Administrator SDN Senior Moderator

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    I've actually changed my entire approach to only dole out complete bull**** advice on SDN now.
  29. TheLesPaul

    TheLesPaul

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    :thumbdown:
  30. TheLesPaul

    TheLesPaul

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    :thumbdown:
  31. obiwan

    obiwan Junior Member

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    I hear Hopkins is pretty chill.
  32. DIce3

    DIce3

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    I am confused here. A doctor has to go from being a medical student to a solid starting internist in 36 months. If you are not willing to focus nonstop on that pursuit for a short three years, please drop out now. This is sad sad talk.
  33. LumberJack

    LumberJack

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    This.

    But as I realized earlier, other people's training preferences don't directly affect me, so knock yourselves out if you want to put in someone else's orders and take call q week.
  34. Instatewaiter

    Instatewaiter But...There's a troponin

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    It is. The beatings are only QOD and now with a nerf bat instead of the metal ones the used to use.
  35. gutonc

    gutonc No Meat, No Treat Administrator SDN Senior Moderator

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    So suck it Southwestern.
  36. Raryn

    Raryn Infernal Internist

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    I've reported you to JCAHO for the crime of using a forbidden abbreviation. May God have mercy on your soul.
  37. obiwan

    obiwan Junior Member

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    just wondering are you guys 4+1?
  38. LoudBark

    LoudBark

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    Some of us like to sleep and have a life outside of the hospital.

    They used to call them "residents" because they used to reside in little rooms in the hospital.
    This is not your grandfathers (or fathers) residency.

    A lot of us like the chill lifestyle, but didn't have the grades, AOA, USMLE of 250 to match into derm or radiology. It is not a crime against humanity to want to take some time to have a beer, go on a date with a member of the sexual preference of your choosing, go to the gym for a couple of hours, or sleep 9 hours a few days.........so if I am less of a doctor than your grandfather (or father):scared: was for it......so be it.
  39. DIce3

    DIce3

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    First, we are on the same team and I am not here to argue.

    There is a much larger picture here.

    I graduated from medical school in 1995 and went to a large university program where more than half of my class went into traditional internal medicine as a solo doc or part of a small group.

    Where are we now? 17 years later. The current generation looks nothing like mine. Total complacency with a hospital employed job, signing off exactly what an army of MBAs says, regardless of what is in your patients' best interest. Lack of interest in rounding on one's own patients in the hospital because the shift-work life style is better. Allowing a mid level to do the sub specialty consult or admit the patient and placing a squiggle under the PA's name. Running to the hospital in a pair of jeans and saying three sentences to the patient with a nonexistent exam. I could type pages of examples of unacceptable practices that I see nonstop.

    In Western Europe in the 500s, men lived in squalor beneath great architectural wonders with little understanding of what stood before. Failure to demand a level of competency, continuous pursuit to optimize, and vigilant attention to details results in the unthinkable. The future of American medicine is on a slippery slope with the "cush lifestyle."
  40. sluggs

    sluggs

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    Gotta say that Dice is correct. I am a much more recent graduate, but as an older non-traditional, I knew and was inspired by old-school docs. Some of my classmates are just as dilligent and hardworking, but I perceive widespread lack of dedication now.
    Medicine is a calling and a profession. It is not just a job. Treat your patients the way you would want your mom or dad treated.
    Long hours and hard work do breed dedication in those who are already committed to the program!
  41. LumberJack

    LumberJack

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    There is always time for beer--I don't care where you work.

    I guess we should specify what we mean by "cush." If you mean "everyone is nice, residents hang out together frequently, and the PD is really supportive," then that sounds great to me, too. If you mean taking call infrequently, getting to leave early, not pre-rounding on your patients, doing less ICU time, and having a lower intern patient census, then I think that program is doing a disservice to its residents.

    I recently watched someone break down the typical medicine residency under the new work hour restrictions into total hours worked. The figure the presenter came up with was just over 7000 hours. Anyone familiar with the literature on expertise (especially deliberate practice) or who has read anything written by Malcolm Gladwell can tell you that you have to do 10,000 hours to be good at anything. That's impossible now, be it at Hopkins, UTSW, or Timbuktu State. I personally think expertise is a little more nuanced than time worked and would suggest that the quantity, quality, and diversity of meaningful patient encounters has more to do with becoming skilled doctor. The two concepts are related, though. For my part, I prefer to squeeze all I can out of the limited training time I will have. It's just three years, and after that you can drink beer until your liver writes its congressman. And let's not confuse the training our fathers/grandfathers experienced with what we had before 2011. I don't want the House of God experience, but I do want to spend enough time on the wards and see enough patients to become a good internist.

    I originally tried to withhold judgment because the idea of med studs pursuing "cush" training didn't seem to affect me, but then I realized I might work with some of you corncobs one day.
  42. ukdoc74

    ukdoc74 Junior Member

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    I am at a top twenty IM program and we are very busy. My interests are in Heme/Onc so why would I wants to do 2 extra months of Cardiology and ICU service? Big university programs take advantage of residents and interns because of cheap labor. Doing a tough IM residency for someone interested in outpatient medicine or an outpatient subspecialty is like a derm or rads resident doing a surgery internship.

    One should not judge. We all know the right answer ie work your tail off with 5 months in the ICU as an IM resident even when one is interested in Rheumatology, Heme/Onc, or Endocrinology. But the fact is we all have different interests so as long as you stay true to yourself that is what matters.
  43. Instatewaiter

    Instatewaiter But...There's a troponin

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    There is rumor that we are going to a 4+1 setup. I don't know for sure.

    I'm pretty sure I just vomited rainbows and unicorns.
  44. Pinworm

    Pinworm

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  45. path or no path

    path or no path

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    Interesting discussion.

    As I am trying to decide between several fairly cush community programs and hard core county program. I realize that initially you'd be better prepared coming out of high volume program, but I am wondering if it makes a difference in the long run?

  46. disorder

    disorder isrdero

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    so. our current perception of "malignant" = better training?

    i definitely don't mind working, i just want to be doing the RIGHT work to learn. i don't want to be stuck doing other peoples' jobs.
  47. todo

    todo

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    youre actually really helpful on the site and take time to answer people, sometimes youre sitting on a stick for whatever reason, probably b/c you read so much nonsense moderating this sight
  48. obiwan

    obiwan Junior Member

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  49. Instatewaiter

    Instatewaiter But...There's a troponin

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  50. sanktank7

    sanktank7

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    Thanks guys, theres some pretty good advice in here. Just wanted to bump to see if others might want to chime in.

    Could we please back off the whole "work ethic in residency" BS please? Yes, there are programs that are more rigorous than others, but guess what, not everyone aspires to them or is able to get in. Its kind of elitist to think that people without GI/Cards/HO aspirations or those who dont put in 100hrs a week at an academic powerhouse are less of physicians...Also if you believe so much in "work ethic" why not make the effort to scroll to the top of the thread and read what its actually about...

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