UTMB anesthesia

[Deanmonster]

Does anyone know anything about UTMB anesthesia? From what I've heard it used to be the best in Texas. How was it affected by Ike... what's the future hold for UTMB? I'm debating whether I should apply/interview there.

Thanks,
Dean

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[coprolalia]

I'm sure there are many great aspects of this program, as much as I'm sure that the area will recover from Ike (if it hasn't already) including the continued need for high quality physicians.

But, one of the greatest aspects of this program is their program director, Dr. Lynn Knox. Why? Well, I'll tell you.

Dr. Knox is a former CRNA. So, I would advocate for selecting this program, among other things, to have the opportunity to train under someone who can provide you firsthand knowledge of what it means to be a physician anesthesiologist. She knows, probably better than anyone out there fighting the current battles against mid-levels, just how relevant and critical the distinction between our training is. And, she at the very least deserves serious kudos for making the decision to walk away from a lucrative career as a nurse anesthetist to purse eight additional years of training, in lieu of taking the easy - and political - route of fighting for parity of practice without the requisite stuff to back it up.

I hope that you will consider this program not only for this reason, but in large part because of it. Don't believe me? Take a visit and speak to her yourself.



-copro

Sources:

http://www.asahq.org/Newsletters/2002/1_02/swissman.htm

http://www.cms.hhs.gov/eRulemaking/downloads/CMS-1512-PN email Comments 796-845.pdf (page 2)

http://news.nurse.com/apps/pbcs.dll/article?AID=2001106040319&template=printart

http://watchdog.net/contrib/77555/s_lynn_knox

http://anesthesia.utmb.edu/residentapplicants/welcome_director.html

 

[UTKB]

I can attest for UTMB as well. Dr. Knox is great, as are all the other faculty. All very approachable and down to earth. Regularly are there parties and the residents are friends and hang out away from work. If research is your thing, UTMB is your place. Also the hospital has a great EMR.

After Ike, the program cut its class size from 14 to 10. I believe six of the ten in the class of 2013 are UTMB alumni. I don't know when they plan to increase their class size again, and this may be an issue as the surgical volume picks back up. They also changed the way they do the clinical base year. Prior to Ike, the CB year was split so that they did six months of anesthesia and six months of "other stuff" during the PGY-1 year, and same for PGY-2 year, and all years thereafter were exclusively anesthesia. Some people liked this, as they were able to get into the OR a lot as interns...but that's a trade off for having to go back to doing medicine, ER, etc. as a PGY-2 after you have done anesthesia. Now, from what I was told on the interview last year, the CB year will be a transitional year in Houston at St. Joseph, with one or two months spent in Galveston. The drive from downtown Houston to Galveston takes about an hour . But, St. Joseph used to have a well respected transitional year several years ago.

All in all, I think the biggest detractor from UTMB is its location in Galveston (even before the hurricane), and I'd say that's the only reason why some alumni of the medical school don't choose to stay.

 

[TX515]

It's a great program, just a bit smaller now.

 

[jsckvc]

Can any of you past or present residents add anything else, I am very interested in this program.

 

[Ignatius J]

Can any of you past or present residents add anything else, I am very interested in this program.

I matched there this year.

They do an intern year at St. Joseph's in Houston, which is a very nice hospital and is supposed to be absolutely incredible per the CA-1s (first class to do it there if I am not mistaken). That is a big sell.

They do prisoners' care in the Texas state system, so there will always be great pathology.

The faculty/resident relationship is supposed to be very close knit and well-working. I thought it was second to none on the interview trail.

Perhaps the best part is that the residents are very active in the hospital's resident board. This year, they have all 4 leadership positions.

Also, if research is your deal, they are top 15 in the nation in grants.

 

[anbuitachi]

Any updates on this program? Is it back to fully functional after that storm many years ago? Is it still the best in Texas or up there? Are they back to 14 residents?

 

[anaesthetic]

.

 

[anbuitachi]

Not the best in Texas, IMO, but not the worst by far. They are back up to 14 residents (10 go to St. Joseph's in Houston for intern year, and 4 stay back at UTMB). St. Joseph's is supposedly a very relaxed intern year, while the 4 residents who stay at UTMB have a more rigorous intern year, but they get very early exposure to anesthesia. I think they get around 4 months of O.R. time during intern year somehow.

The residents are a very relaxed group of people, and they seem to get along very well with the faculty who are also very relaxed. I think the program is still recovering somewhat, but they are on the up-and-up and are opening up a brand new hospital relatively soon. I emphasized the "relaxed" because I did not fit in very well there. I am hesitant to use the word "lazy" because I only had one day of exposure to their residents, but a couple of the residents came in and talked to us and a recurring theme was that they had trouble motivating other residents to help out with pre-ops and things of that nature. Their numbers and board pass rates were decent, so maybe that feeling is injustified--but that's what I felt.

Applicants from UTMB whom I met on the interview trail were pretty cool people for the most part, and they seemed to like their home program and echoed the same "relaxed" environment that I felt. The location in Galveston was universally disliked though. UTMB's interview day was probably the worst organized one out of all the programs I've been to. My interviewers came straight from the O.R. between cases and hadn't read anything about me, and I don't think they knew Twas interview day, which is fine but may be a reason why I didn't feel very comfortable there. Interviews went fine though, and everyone was very friendly overall.

Any moonlighting or overtime? And Galveston is such a small place/island.. Where Do they get a diverse case base?

 

[HollywdAnesth]

Any moonlighting or overtime? And Galveston is such a small place/island.. Where Do they get a diverse case base?

They have in house moonlighting. You can work rooms that run late for $50/hr.

 

[Ignatius J]

Not the best in Texas, IMO, but not the worst by far. They are back up to 14 residents (10 go to St. Joseph's in Houston for intern year, and 4 stay back at UTMB). St. Joseph's is supposedly a very relaxed intern year, while the 4 residents who stay at UTMB have a more rigorous intern year, but they get very early exposure to anesthesia. I think they get around 4 months of O.R. time during intern year somehow.

The residents are a very relaxed group of people, and they seem to get along very well with the faculty who are also very relaxed. I think the program is still recovering somewhat, but they are on the up-and-up and are opening up a brand new hospital relatively soon. I emphasized the "relaxed" because I did not fit in very well there. I am hesitant to use the word "lazy" because I only had one day of exposure to their residents, but a couple of the residents came in and talked to us and a recurring theme was that they had trouble motivating other residents to help out with pre-ops and things of that nature. Their numbers and board pass rates were decent, so maybe that feeling is injustified--but that's what I felt.

Applicants from UTMB whom I met on the interview trail were pretty cool people for the most part, and they seemed to like their home program and echoed the same "relaxed" environment that I felt. The location in Galveston was universally disliked though. UTMB's interview day was probably the worst organized one out of all the programs I've been to. My interviewers came straight from the O.R. between cases and hadn't read anything about me, and I don't think they knew Twas interview day, which is fine but may be a reason why I didn't feel very comfortable there. Interviews went fine though, and everyone was very friendly overall.

Just a few things for clarification. Each class is 18 people. 14 are taken as interns and then 4 slots are left open for being transferring out of various specialties, transferring programs, etc.

It is a very relaxed environment. The department is close knit and has a great cast of characters.

As far as the pre-op situation, that is a situation that you will find pretty much anywhere that you go to and continues to be an ongoing thing in private practice. Like all programs you will see and like any other work environment, there are All-Star residents who are willing to help out to no end and others that seem to disappear once their work is done for the day. It happens.

The good thing is that residents are very self-governed, meaning the 4 Chief Residents (voted on my faculty and residents equally) have a good amount of pull to squash things like people welching on helping others.

All in all, it's a close knit, laid back program. Galveston may not be for everyone, but I enjoyed the hell out of it for four years and couldn't imagine going anywhere else.

 

[Ignatius J]

Any moonlighting or overtime? And Galveston is such a small place/island.. Where Do they get a diverse case base?

$50/hr after 4:30. Assigned mandatory late rooms about twice/month and can volunteer for as much as you want.

For the second question, case base comes from several things:

1.) Provide the majority of the healthcare in the state of Texas prison system (TDC). Weird pathology and sick patients.
2.) Satellite surgery center in League City for ambulatory stuff CA-3 year.
3.) Lots of indigents from the valley in OB (OB is pretty much non-stop there).
4.) A couple months at Methodist in Houston doing hearts (can choose to go back if you want for elective) and a month at Driscoll in Corpus doing peds.
5.) Shriner burn hospital for children has a wide referral base and we do some time there as well.

 

[Guy Caballero]

Any moonlighting or overtime? And Galveston is such a small place/island.. Where Do they get a diverse case base?

I was familiar with the program pre-Ike. It was really an awesome program with great tradition and reputation and a strong presence within the UTMB system. Ike hit them hard, there is no doubt. However, the program retained many of their faculty and the island rebuilt. They are a tertiary referral center, so they do not typically rely just on the island population for their patients. Also of note, they have several unique things that most other programs do not have. While they do not have a VA hospital, they have something even better. The prison hospital. Sounds weird, but it provides some of the best learning opportunities in a "captive" group of patients. The hospital is right there on the UTMB campus and is quite large. In addition, The Shriner's Burn Hospital is right there on campus as well. This hospital is outstanding and gives a very unique learning experience in dealing with burn patients both acutely and then the long term complications that go along with severe burns.
In addition, I have met the program's leadership a few times and I have a great deal of respect for them. I think it is a well run program that took a huge hit and has been resilient in its efforts to provide excellent training for their residents. Many have avoided the program because of fear of another Ike situation, but I would encourage all to give it a look.

This is an outsider's opinion. I have zero affiliation with the program, but admit that I have some knowledge of the program's history over the years. I agree with the poster above who said, it is not the best program, but it is far from being the worst program. In my opinion, it is a solid program with a rich history that will provide a solid education. The location has its positives and negatives. I think the positives are more than the negatives.

 

[anbuitachi]

$50/hr after 4:30. Assigned mandatory late rooms about twice/month and can volunteer for as much as you want.

For the second question, case base comes from several things:

1.) Provide the majority of the healthcare in the state of Texas prison system (TDC). Weird pathology and sick patients.
2.) Satellite surgery center in League City for ambulatory stuff CA-3 year.
3.) Lots of indigents from the valley in OB (OB is pretty much non-stop there).
4.) A couple months at Methodist in Houston doing hearts (can choose to go back if you want for elective) and a month at Driscoll in Corpus doing peds.
5.) Shriner burn hospital for children has a wide referral base and we do some time there as well.

Do you know where I can find a list of their most recent fellowship placements?

 

[Ignatius J]

Do you know where I can find a list of their most recent fellowship placements?

Not sure about a list but getting fellowships for prospective graduates hasn't been a problem.