Penn

[polkadotcap]

Any thoughts on the program from those that have done aways/interviewed last year/are current residents?

Thanks in advance!

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[CremeSickle]

I have worked with many attendings now from Penn. and talked to some residents from there.

Penn is, bar none, the best residency in PA/NJ/DE area.

If you want the best thats where you have to go. Ive been told it is unbelievably competitive as well.

 

[lushmd]

...Ive been told it is unbelievably competitive as well.

How so? To match, or once you're there (or both)?

 

[coprolalia]

I have worked with many attendings now from Penn. and talked to some residents from there.

Penn is, bar none, the best residency in PA/NJ/DE area.

If you want the best thats where you have to go. Ive been told it is unbelievably competitive as well.

Easy there. Your opinion is one of an outsider. Let's just say that I've also "worked with" many attendings who trained at Penn and met several of their faculty. They are good, but no better necessarily than others that have trained elsewhere. I will tell you, for example, that the Geutsche (pronounced like "gucci") spinal that is taught there is definitely not what you'll be doing in private practice or anywhere else, unless you like to chase blood pressures for the first half-hour of the c-section. This is all part of the "Pennwee" phenomenon (i.e., you'll hear them say "at Penn we did this..." or "at Penn we did that..."). Also, the hours are pretty malignant as are some of the faculty. So, if you want to go there, just know you're going to work.

So, overall, they are Penn. They are pretty self-impressed. And, they are respectable anesthesiologists. No doubt about it. But, based on my experience (which, in my humble opinion, I've seen a large sample of firsthand), they are not necessarily leagues beyond other area programs, as you suggest.

-copro

 

[urge]

the Geutsche (pronounced like "gucci") spinal...

-copro

What's that?

 

[CremeSickle]

I can only say what Ive seen, you may very well be right on.

I was surprised to see one of them do a thoracic epidural from a midline approach, he was slick. I may be judging the individuals as opposed to the program tho, who knows.

"Pennwee" BWHAHAHAHHAHAHHAH, you pegged that one for sure!

Lushmd: its competitive to get a residency there. I have heard its cut throat when you are there but i dont really know. People get attacted to residency positions at ivy league schools.

 

[coprolalia]

What's that?

Everyone gets 15mg of hyperbaric bupivicaine (i.e., 2mL), plus whatever other narcs you might put in which is usually 20-25 mcg of fentanyl and 0.2 mg of Duramorph plus 100mcg of epi. So, you're basically injecting about 3mL of solution into the cistern. It doesn't matter if they're 5'10" or 4'11". Purportedly, according to Geutsche it's "not a good block" unless the patient's "hands are tingling". And, it's a mantra that many fresh-outta-residency Pennwee's regurgitate like gospel. Silliness. Just plain silly.

Academia is academia, no matter where you go.

-copro

 

[deleted126335]

.

 

[coprolalia]

Brett spells his name "Gutsche". Remember that Penn is a teaching hospital where we had OB residents learning to operate. It took alot longer than an experienced private practice OB to do a Csection. Brett is one of the most loved and respected docs in the building.

Hey, I know the guy. I think he's great. I've heard him speak several times. I'm a big fan. No argument there. Very cool, very laid back, very down to earth.

BUT...

I am a resident at another program, and I've never been taught this technique. We also have obstetric cases that chug along at an "academic pace" as well. Sometimes you do get down to the wire with the timing of your reasonable spinal, and you start notifying the surgeon that it's time to wrap it up instead of handing the needle driver to the third year ed student. What you don't do is expose your patient to a potentially dangerous technique just to mollify an inexperienced of the surgeon. Who is really learning anything from that? And, what you're really saying by "defending" the Geutsche (or Gutche, or Gutsche, or Gucci's... sue me for not spelling it right) technique is that it's okay to teach residents to overcompensate for bad surgical technique, and that there are no other options if your spinal wears off therefore you better, in essence, overdose the patient the first time around. (Yeah, private practice guys like to have their patients in the PACU for an extra hour before they get any return of motor or sensory function before sending their patients to the floor.)

So, I think it is fair to use this example to underscore the fact that academia is academia, and that even "the best" programs aren't necessarily fully preparing their forthcoming grads for the real world. How do I know this? I've seen it firsthand.

It's not so much a slight against Penn or Gutsche himself, as it is a general indictment about how residents - even at purportedly the best of the best programs - are taught to simply "do as your told" instead of how to think.

Penn has always been one of the most competitive residencies to obtain. Still is.

I'm sure it is as much as I'm sure you think it is.

Your handle "coprolalia" is well chosen.

Hey, I chose it, didn't I? Read what I say and like it, or not. I don't really give a ****. I'm still gonna say it.

-copro

 

[nutmegs]

in talking to people at other area hospitals, they are all very happy with the penn grads they hire but they definitely have a reputation for knowing the "penn way"- ie, not exposed to much diversity in technique. as with anything, depends on what you're looking for. nobody will argue with the quality of training but there is a lot more to picking a residency program.

 

[coprolalia]

nobody will argue with the quality of training but there is a lot more to picking a residency program.

Agreed. And, pedigree helps a lot. But, being at another "PA/NJ/DE" area program (and having the ability to occassionally moonlight and work with a large variety of other grads from area programs), I can tell you firsthand that most of the Pennwee's I've worked with have an air about them. That's all I'm going to say. Not always the most laid back of the group.

You see, attendings don't often work with or know the capabilities/practices of the other attendings in their practice. So, when you tell them what "so-and-so" did during another case, they will either look at you quizzically, roll their eyes, and/or chuckle when they hear what their colleagues did. It's great for me because, as a resident, I get to see a variety of different techniques not often taught at my home program. I also get to see how to be truly efficient and do what's "slickest" for a case.

Based on this experience and what I've seen (especially with the newer attendings), I can definitively tell you there are things, for whatever reason, that are not routinely taught in residency... to our detriment. I'm not excluding my program either. We get taught some silly stuff that only gets done in the academic centers, often perhaps with good intentions (e.g. the "academic pace" of some cases as alluded to by dr doze). Point is, some of these practices probably aren't going to help you in the real world. That's the real shame. And, even the puportedly "best" programs are not immune to this phenomenon.

To all residents just remember that you are going to be a consultant. You can probably get by in this field just being an extremely good technician. But, everytime you do a technique or learn something knew, never for get to ask yourself "why" you're doing it that way. Ask your attendings that too. You'll learn when you get to the real world that there are a lot of different ways to climb a tree, and unless you're really clever or get the opportunity to get more experience (like I have) working with different attendings out there, some of whom took years to "unlearn" what they were taught in residency, you may take a lot of time figuring this out. Because, once you're in the real world you'll be on your own. And, no one is going to teach you different and possible slicker ways to do things unless you figure them out on your own. Hell, a lot of the attendings in academia probably couldn't do a case on their own anymore at this point.

So, I personally don't care where you train. This is the way it is. Again, I've seen it firsthand. Quick, efficient, and safe anesthesiologists are the true studs of our profession. And, no, not all of them came from the "best of the best" programs. Keep that in mind as you choose a program and go through your training.

-copro

 

[japhy]

interviewed at penn a week or so ago, not expecting too much, but i gotta say i was BLOWN away by both the PD and residency director. they definitely want to be in that elite group of programs, they are interested in training excellent anesthesiologists, but also creating the next generation of leaders in medicine. residents were uniformly happy, i didn't think they worked any more than any other place i've seen AND they get paid if they stay later than 5:30.

plus, the pd did mention that they have been known to have a "penn way" so he has been working very hard to draw attendings from other programs to give the place a little more diversity.

anyway, penn will definitely be very high on my list

 

[polkadotcap]

thanks for the info, japhy. good to hear. how were the actual interviews? anyone to watch out for?

 

[japhy]

no.. all the interviews were fantastic. meet with the residency director and PD, plus one of the chiefs, and then 2 faculty. no stress at all... as they say, just want to get to know ya