Rotation Reviews of Four NY/NJ Programs (JFK, NYMC, NYU, Mount Sinai)

[nonotphysicist]

Congratulations and hello to all of my future colleagues! We did it! I’m a long time free-loader of the excellent advice on this board and am ashamed that it has taken my entire medical school career to get involved in our community.

I’ve been meaning to make this post for a few months and now that the match dust has settled I find myself with the time to sit down and do it. I applied exclusively within the northeast and was dismayed to find a lack of current coverage of the programs in the tri state area. Really all I managed to scrounge was that programs in NYC were malignant grinders that produced bitter, broken physiatrists who would go on to hate their lives and bring misery to their patients and loved ones. I went on to rotate at four programs in the area and interviewed at the three who participated in the match this year, so for the benefit of our small board and future applicants I humbly submit my very subjective, but detailed experiences of Mount Sinai, NYU Rusk, JFK and NYMC Metropolitan Hospital. I interviewed at many other programs this season and could comment on those experiences, but here I want to focus on these four because I feel that I can better crystallize their resident experience having spent a full month at each on various services. I hope that these reviews will be valuable to future applicants considering this region as a place to train. I am going to break these reviews into separate posts so that they might be more easily found by people who are searching systematically for program information.

I preface these reviews by saying that I loved all of my rehab rotations and felt that each showcased different facets of the field. Any corrections/clarifications are heartily solicited and will be amended as quickly as possible.

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[nonotphysicist]

Mount Sinai

Number of spots: I think 8 advanced
Sites: MSMC – E 102nd between 5th and Madison, Elmhurst Hospital in Queens, Bronx VA
Fellowships: SCI, interventional spine and sports medicine, pain through anesthesia

I spent all of my time at MSMC on the Upper East Side. The hospital is situated right by the park in a very fancy-pants part of the city, and as a result most residents lived in cheaper areas/boroughs, although a few made use of the subsidized housing across the street which while cheaper than the going rate on the Upper East Side, is still outrageously expensive for a resident to afford. Parking is a pain anywhere in Manhattan so I think basically everyone made heavy use of the shuttle between the different sites when necessary and one resident mentioned being able to leave one’s car at Elmhurst Hospital. Residents take call in house and enjoy a post call day. One resident is designated to follow only patients of the day’s post call resident. Residents typically carried about 10 patients.

The two inpatient floors consist of SCI/general rehab and a TBI floor which I did not spend time on. Sign out from the on call resident was between 730 and 8, and the day typically ended between 4 and 5. Attending rounds were 1:1. The TBI unit is formerly a NIH TBI model system. The SCI unit is also formerly a model system which is now Form II and continues to collect data on follow up patients. I found the attendings to be very thorough and involved in patient care and education (bedside sharp debridement, insufflations, ASIA exams on everyone). My chief concern about any program in the area was that all of the juicy pathology would be glommed up by Kessler, but in reality there are way more people getting shot/stabbed/whatevered in NYC than Kessler has beds. Mount Sinai was the only program I rotated at where I saw vented SCI patients, and I saw many other excellent, complex cases there. The inpatient facilities are not shiny or new which is something I found in common with all of the programs within NYC; I think this is because acquiring new space is very expensive in Manhattan and renovations would be a logistic nightmare given there would be no place to house current patients. That being said the equipment was sophisticated and up to date. When I came back for my interview the program had recently acquired ReWalk devices which were breathtaking to observe in action.

I also spent time at the faculty outpatient practice around the corner, where patients are followed for sports medicine, SCI, TBI, disability and interventional pain management (C arm). There is also a clinic for individuals affected by the WTC attacks. Here residents worked with faculty on a 1:1 basis and I was pleased to see attendings encouraging residents to perform procedures privately and volunteering them in front of patients. I found that patients were more likely (not the majority by a long shot) to insist on an attending at Mount Sinai than at any other institution, and my impression was that this is likely due to the more affluent patient population the hospital serves (compared to Metropolitan for example, which is on the same street a few blocks away). I’m sure residents experience other populations at the Bronx VA and Elmhurst, but this was my experience at the main hospital.

The residents were a mix of MDs and DOs and were all sociable and seemed to have great chemistry with each other, socializing in and out of the hospital. They did not hesitate to volunteer that when you’re on inpatient you work more than you might at other places but did not seem upset by this. They seemed genuinely excited to have medical students and sought teaching opportunities. I can say the same of the attendings. The PD Dr. Herrera is funny and sarcastic; he won’t hesitate to give you a hard time if you seem too serious. I didn’t have a lot of interaction with the chair Dr. Ragnarsson but he’s very big in the field and was friendly in passing.

Random things: PGY-3s have an anatomy course where they do their own dissections. There’s this floor called “11 West” (imagine saying it with a super waspy accent) which resembles a hotel (silverware, embroidered robes, wood paneling, mood lighting) where all the fancy people stay. Food is great in the area and being close to the park is awesome. No inpatient peds experience.

 

[nonotphysicist]

Metropolitan Hospital

Number of spots: 3
Not in the match this year
Sites: Metropolitan Hospital 1st ave between 97th and 99th, Lincoln Medical Center Bronx, Jamaica Hospital Center Queens (TBI), Bronx VA (SCI), Blythedale Children’s Hospital Westchester.
No Fellowships
Traiga su espanol

Metropolitan Hospital is part of the city’s HHC program and serves East Harlem (Spanish Harlem). I only spent time there during my rotation. The residents were a mix of DOs and FMGs and lived mostly in other boroughs. This is not a fancy hospital, which may or may not be important to you. There’s no proper cafeteria and instead a “café” of sorts that serves different things every day that you can take back to your floor to eat. The day began at 8 and finished in the mid afternoon with no set in stone time to leave. Call was on weekends only, with sign out to medicine during the week. As a public hospital the vast majority of patients are uninsured or on Medicare/Medicaid, which is in stark contrast with Mount Sinai even though they are a stone’s throw from each other. The only time this was problematic was in patient disposition. For the month I was on service, as many as 50% of the inpatient population was on ALC and of no educational value to the residents. The rehab floor appeared recently refurbished and was the nicest area of the hospital from what I saw. Residents carried around 10 patients for the month I was there counting ALC. TBI patients were on this floor (not locked) and created a few humorous/stressful moments.

I found the outpatient experience to be excellent at Metropolitan. The clinics are on the same floor in a different area so residents doing inpatient are free to come over when their floor work is finished. On multiple occasions Dr. Islam the PD set me up in my own room to see patients and write exams/plans to present to him. I never saw any patients with misgivings about residents doing injections and attendings expected them to do them. Wheelchair and brace clinics were interesting; attendings and vendors both taught much on what goes into getting equipment properly selected and approved for patients. Inservice lectures were both informative and interactive, including wheelchair races in the hallways. EMGs are also performed in the same area and residents did at least a few every day. The rehab department does all of the EMGs in the hospital and sometimes patients would be brought down in their beds for testing.

A few residents confessed that before the arrival of the new chair, Dr. Lopez things were disorganized and not very good, but that the program seemed completely different and improved under his direction. Perhaps this is responsible for some negative things I had heard about the program online or at other places. I had one strange interaction with a resident that gave some color to the priorities residents with different backgrounds can have: he was perplexed that I was bothering to go on interviews for my prelim year when I could “easily scramble into surgery and not have to worry about it”. Overall the residents were cheerful but did not seem closely knit.

 

[nonotphysicist]

NYU Rusk

Number of spots: 12 or 13 advanced
Sites: Hospital for Joint Diseases - Lower East Side, Bellevue - Lower East Side, Manhattan VA – Lower East Side, Center for Musculoskeletal Care – Lower East Side, Brooklyn VA
Fellowships: TBI?

The residents are a mix of MDs and DOs and live in Manhattan, the other boroughs and New Jersey. Call is in house when you’re on inpatient and is stacked against juniors (where isn’t it?). Sign out is at 730 and the day ends between 4 and 5. When I rotated a few residents said that they felt like they worked harder than their colleagues at other programs. Most everyone was nice and clearly passionate about rehab; there were some cranky individuals. With so many residents it appeared that they split into smaller social groups but got along very well within those groups. Overall the residents seemed MUCH happier with the state of affairs post Sandy than before. Something to the effect of “it’s great/much better here now” was said by multiple residents. DOs might be interested in an OMT group that some residents run. Dr. Moroz (PD) indicated that he’d like to see a sports fellowship established in the coming years.

I rotated at NYU when they were still using the Rusk building. The Rusk Institute was the first dedicated rehabilitation hospital ever built and you could tell. While it was convenient to be physically attached to a giant hospital like Tisch, it was a dump and I wasn’t upset to hear that they tore it down. When I came back for interviews I learned that those beds were moved to HJD and that there was an overall reduction in beds after the move. The Manhattan VA and Bellevue were severely damaged in Hurricaine Sandy and while Bellevue has reopened, the Manhattan VA remains closed and I believe will reopen in the spring or early summer. Residents indicated that the program was reorganized after the hurricaine with more outpatient experience due to the lighter inpatient load. Residents at HJD carry as many as 15 patients but don’t write notes every day in an effort to get them to spend more time in the gym, although they seemed to have just as much work and didn’t go to the gym more often than anywhere else. I know that the TBI service was awarded a NIH TBI Model System grant but am unaware in which hospital this service resides.

Residents at Bellevue work in the TBI and general rehab units and encounter the same ALC problem I saw at Metropolitan but to a lesser degree. They also do consults for the entire hospital and work in the outpatient clinics which I found to be excellent, with opportunities for procedures dependent on which attending was there. Senior residents go to the Manhattan VA mainly for P&O and outpatient. Multiple junior residents mentioned looking forward to having a personal office with their name on the door there. The staff in the P&O lab were excited to see a student and let me see/play with all of the equipment. The CMC is located in an old telecommunications building that NYU bought and converted into outpatient offices for all of its services. It takes up 2 or 3 floors and was the nicest facility I saw during the interview season (maybe except for the Center for Human Performance at SUNY Upstate which looked like a cyborg factory from the outside). All administrative and faculty offices are here as well as conference rooms for lectures. Everything was very new and nice and refreshing compared to the old Rusk building.

 

[nonotphysicist]

JFK

Number of spots: 4 advanced
Sites: JFK Johnson Rehabilitation Institute – Edison NJ, Robert Wood Johnson University Hospital - New Brunswick NJ, St. Peters Medical Center – New Brunswick NJ, Children’s Specialized Hospital, Mountainside NJ
Fellowships: Pain, TBI

I rotated only at JFK JRI on the TBI, consult and general rehab services. The residents live in the area which is suburban and very nice. Call is from home and frontloaded. The day begins at 8 and usually ends between 4 and 5, but can end very late if you are waiting on an admission. PGY2s indicated that juniors get the last admission of the day, which means they can’t leave until the patient shows up from wherever they came. Meals are free in the cafeteria which was very extensive and above par. Residents were a mix of more MDs than DOs; some were very friendly and outgoing and others kept more to themselves. While much of the system was electronic there were still paper charts and notes, but I imagine that will be done away with this summer along with every other hospital still in the Stone Age.

The TBI unit was very recently refurbished and was the best I saw. I think they either just finished their TBI Model System grant or still have it, at any rate it was an excellent experience. They take care of patients at very low functional levels (Rancho 1 and 2) and there are a lot of opportunities for cutting edge research. All residents go through a trach management workshop before they start on the TBI service. The general floors also have cardiac rehab patients. I saw very little by way of SCI, and residents rotate through Kessler for this experience. SCI aside the scope of pathology was excellent. Residents were very happy about their EMG training but their preceptor did not take students so I didn’t get to see for myself. I got to see a lot of spasticity management in the outpatient clinics and spent an afternoon with an attending that does acupuncture. The inpatient and outpatient gyms are spacious and beautiful. The hospital in general is good looking.

Consults are with Dr. Cuccurullo (Program Director and author). She places a huge emphasis on education and resident support. She goes through every consult in detail with the resident/student and explains the formulation of the plan of care. Residents were very complimentary of her support and outgoing seniors said that she evaluated their contracts and helped them negotiate for better terms. I found the didactics to be excellent at JFK, residents will go through Dr. Cuccurullo’s review book once per year. If I remember correctly she indicated that nobody has failed the boards during her tenure as PD. Residents all said something to the effect of once you finish PGY2 you are very happy, but I found even the PGY2s to be pretty happy.

 

[Eilat87]

Dude. You're the best.

 

[Baritonebass]

Update on Rusk: based on next years schedules
PGY2: 10 month inpatient(4 rusk, 4 bellevue, a lil Peds and cards) 2 months outpatient clinic
PGy3: 2 month Inpatient(could be Rusk chief, or Bellevue senior minimal call), Manhattan VA(above description accurate), Sports and integrative medicine, EMG
PGY4: Brooklyn VA, EMG, 1-2 months inpatient, electives, EMG,
Rusk is easier than Pre-sandy
But Bellevue is harder(resident ran service now)
less MSK inpatient(AKA ortho scut), more msk outpatient(learning)
PAtient population Mirrors the further of inpatient rehab, stoke, TBI, medically complex
See you new guys at bellevue in July
Resident class currently 14 per yr... Will decrease in the future

 

[Prof Moriarty]

Nice reviews.