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Feel free to add your reviews of rotation sites and military bases to this thread. I'll periodically cut and paste to keep things somewhat organized for easier reading.
rotatores said:I guess I'll start:
Naval Medical Center Portsmouth for general surgery:
Consists of two teams: Gold and Blue with about 8 attendings, a chief resident, a junior resident, 3 interns, and between 2-5 med students per team.
The typical day consisted of working from 0430-1830 mon-fri...and from 0530-1100 one weekend day. Call is usually about q5 for 3rd yrs and q6 for 4th yrs.
Surgery was two days a week, tue's were academic days in the morning and clinic in the afternoon with clinic the remaining 3 days. Students usually scrubbed in on about 2-3 cases a surgery day.
Students were of course expected to see their patients in the am...write the notes...present pt at rounds...and the same for afternoon rounds.
If I had to give the rotation a grade I would give it a B-...
Positives: Plenty of OR time, Great patient exposure, practice presenting patients, learning how to not get called on during rounds
Negatives: I was often known only as..."hey you", I only got one compliment the entire rotation, academic days were of no value to the med students, med students did about twice as much work as the transitional interns rotating through.
warriordoc said:Has anyone rotated at BAMC or TAMC in OB/GYN? I will be doing 4th year rotations at both sites and am hoping to do my residency at one of the two spots. Any comments on either location?
Thanks!
darth vegeto said:How about a clinical rotation at BAMC on General surgery. Experiences and tips. And, Is it really hard to enter into a surgery residency at BAMC?
Capt_Mac said:You are in luck... I am a PGY2, almost 3 at BAMC right now. Yes, I am on leave, and am watching my 4 year old for my wife.
Granted, my response is biased because I am here right now and doing it:
Pluses:
1) This is THE BEST surgical training program in the DOD. We are a Level I trauma center and are well trained and equiped to go out to combat situations and be able to adapt our training to the unique circumstances that we will face. We see lots of oncology, bread and butter stuff, lots of endoscopy, laparoscopy and of course trauma. You will be doing trauma from day one of internship all the way through graduation. This is unique to our instituition. You will be adept and comfortable taking care of SICK patients. You will also be able to rotate up in the Burn Unit where you will get this same experience.
2) Progressive program. Our program director has a lot of good ideas and is dedicated to our program. As a part of this, we take the 80 hour thing seriously at our program. For example, my chief did not take a day off one week, the program director gave him a mandatory day off, and I got to do his two thyroid cases that day...Most importantly, he values resident input and emphasises that this is "our program". Another example: Our Cardiothoracic rotation used to be a painful series of months were the PGY4 "was allowed to retract the heart" for 3 hours. We weren't getting anything out of it. Last year one of the PGY4's on his own accord arranged for us to rotate with a senior CT surgeon at TexSan (he was one of Cooley's understudies) and now this is one of the best rotations of all residency.
3) BAMC and San Antonio - good hospital, and will only be getting better. We are going to benefit greatly with the BRAC, more cases, more money. San Antonio has good cost of living and is actually a really nice city for singles and those (like myself with families).
Neutral
1) We (as well as Madigan and Walter Reed) are now obligatory 6 year programs with a research year in between the PGY2 and PGY3 year. Unless you go to Tripler (not a bad place) or Eisenhower (avoid like the plague) or Beaumont (great if you like sand... lots of sand) you will be doing a 6 year program. You can research at either the University here in town or at the Institute of Surgical Research right next door. They have a ton of funding and support, lots of exciting projects that have direct impact on the care that the troops are getting right now.
Bad
1) We are currently finishing our programs with about 1000 - 1100 cases. This will be getting better under the current program director.
2) Deployments are effecting the staff situation, this is not BAMC specific and will be a problem at all DOD facilities. This effects the continuity of training with the faculty.
3) If you don't want to do a research year.
Every program has negatives and positives. You need to search out the program that fits your personal philosophy on how you like to learn and the environment that you want to work in.
On competitiveness:
We had about 20 some odd 4th years come through last year. With the 80 hour deal, surgical specialties have become more enticing especially at programs that take the 80 hours seriously. (Ours) The best thing for you to do is to come over, do a rotation with us, work your tail off and see if this is the place for you. I would bet that right now we are fairly competetive. It is generally us, reed and madigan are the top 3 choices. Each one has it's strengths and weaknesses.
JWSimmons said:Does anyone know how many residents each army program takes in General Surgery? I believe Tripler takes 4.
JWSimmons said:Does anyone know how many residents each army program takes in General Surgery? I believe Tripler takes 4.
JWSimmons said:Does anyone know how many residents each army program takes in General Surgery? I believe Tripler takes 4.
kedhegard said:I'm finishing a month of dermatology at WRAMC tomorrow, thought I'd write about my experience.
All the residents have been very accomodating, and several of them offered to get me started on research projects pretty much as soon as I got here. The attendings all pretty much encouraged me from day one, and were great to work with.
Typical day:
7:45 AM (tough I know)- Slide show, mini-lecture
8:30 - Clinic, usually see about 5 patients each morning, following those that need procedures
12:00 - Lunch
1:00 - More clinic or go to procedure side and do Mohs surgery/laser clinic 3 days a week
4:00 - Home
About two days a week, there is lecture all morning +/- catered lunch.
The only bad thing about this rotation is that you are split pretty evenly between WRAMC and NNMC at Bethesda, and have to do a lot of driving between the two, since the Army and Navy programs have been integrated here. Well, that and I had to wear polyester pants every day.
You really learn a lot on the rotation, and if they like you, they definitely let you know. The support staff is literally the best I've ever seen, everyone gets along. Really a dream job if you ask me. There is one attending that is pretty hardcore, but he's actually leaving soon, so no problem there.
I'm doing a gen surg rotation at Wilford Hall MC w the AF in February. Any suggestions, words of wisdom, or knowledge on that rotation? Furthermore, I would eventually like to do a Gen surg residency either there or at Keessler. Any idea as to the difficulty in securing one of these residencies? Any further words of wisdom, other than rotate at both before match?
Cheers.
mitchconnie said:I would be careful about starting either of those surgical programs. Both WHMC and Keesler are scheduled to be eliminated in the BRAC. I know WHMC has a relationship with UT so they may be more stable long-term, but Keesler has no civilian program nearby to take the residents once they close. Even at WHMC, you have to assume that residency slots will be eliminated once they merge with the BAMC program. I know of no likely scenerio which would leave the Keesler program viable in 6 or seven years when you are a chief resident.
You DO NOT want to be looking for a PGY 4 or 5 surgery spot after your program closes or you get downsized. The PGY 4 and 5 years are the KEY time in your operative training, and the foundation for the rest of your career. You will not have a quality experience if you are forced to learn a new system, and prove yourself to a new set of attendings in this critical time (and that's assuming you get a decent spot...very difficult as a PGY4 or 5).
The residency directors will surely promise you that you'll be "taken care of" if the program closes, but beware. When programs and hospitals fold, NO ONE cares much about the residents left out in the cold. Selling those programs to students will be VERY difficult, and program directors may have to shade the truth significantly to get solid candidates to fill their services. The program director who you interview with will probably not even be there anymore in 5 years when you are a PGY 3 scrambling to find enough cases in a hospital which is in the process of closing. The worst case scenerio would be to end up as a GMO after doing three years of surgical residency, then trying to apply for PGY 4 spots after doing primary care for two years--impossible.
I would look into Wright-Pat and Travis. Both are pathetic downsized military "hospitals" (clinics), but the programs have completely moved to stable, busy civilian institutions at Wright State and UC Davis (not sure about Travis details, but I know WPAFB well).
That said, if you feel like you are a marginal candidate, WHMC might be a good opportunity to get into a "name" program. I expect the competition will be less given the BRAC. The "Wilford Hall" name still means a lot to some Air Force people, and even many civilians, who are unaware of the extent of the downsizing and impending closure.
Feel free to PM me with any specific questions.
threepeas said:just had a briefing this summer. WHMC is not being eliminated just physically moved to provide a more efficient, cohesive delivery of military medicine. same goes for walter read army medical center that is being moved to bethesda naval.
Capt_Mac said:Hmmmmm, I have heard alot about the BRAC thing being in SAT and this is the first peep about a "move". Where are they moving to? What is the source?
My impression is that they are moving all of their inpatient services to BAMC. However, I do know for a fact that they are not planning on sending their surgical residents. There is NO talk, not in the news, around the hospital, among people with parakeets on their shoulders that know, that Willy is being revamped and rebuilt, like Walter Reed is.
haujun said:Does anyone know the quality of IM at BAMC ?... Is it advantageous to complete the IM there if you want to have a fellowship there?!
JWSimmons said:Does anyone know how many residents each army program takes in General Surgery? I believe Tripler takes 4.
Capt_Mac said:1) We (as well as Madigan and Walter Reed) are now obligatory 6 year programs with a research year in between the PGY2 and PGY3 year. Unless you go to Tripler (not a bad place) or Eisenhower (avoid like the plague) or Beaumont (great if you like sand... lots of sand) you will be doing a 6 year program. You can research at either the University here in town or at the Institute of Surgical Research right next door. They have a ton of funding and support, lots of exciting projects that have direct impact on the care that the troops are getting right now.
RugbyFool said:wish i'd known about this forum a long time ago....
could anyone comment on any of the ortho programs at the Army hospitals?
Capt_Mac said:Disclaimer: I am not an ortho resident. (I did sleep at a Holiday Inn.)
I am a general surgery resident and work a lot with them.
Right now ortho is a hot area in the Army. At least 3/4 of military casualties have orthopedic injuries and there is a lot of those going around right now. The departments at BAMC and WRAMC are very well funded right now and operate like it was nobody's business. If you have specific questions call the program directors yourself. At least here at BAMC, they are all very nice guys and would be more than happy to answer your questions. Granted, when I was starting med school, I didn't know what the "right" questions were. Maybe you do.