University of Washington - thoughts 2006-2007?

I'm a current intern at UW, so here goes:

In general, I absolutely love it here and I have not regretted my decision for a minute. My friends in the intern class seem very happy as well (but of course there could be others out there who feel differently). The pt population is diverse, the teaching is excellent, and there is plenty of autonomy, but you also have backup when you need it. I have been blown away by the senior residents - they are all extremely smart and competent at taking care of very sick, complex patients. I think that’s a great indicator of how strong the clinical training is. Most importantly, though, the people are just great to work with. The attendings are down-to-earth and approachable and the resident teams have a lot of fun together. It’s a very collegial environment.

Given the recent probation, I was worried about the workload, but it's been manageable. There is no problem staying under 80 hours/week, and I don't feel overworked. Occasionally on tough rotations we go over 30 hours on a shift, but there is a huge effort to get us out on time. On all but one rotation, I've had senior residents, fellows, and attendings pitch in to help out when we're running late. I think most of the changes they made to accommodate the 30 hours had to do with adding floats, adding mid-level and hospitalist coverage, staggering call start/stop times, rounding on the post-call team's patients first, etc.

BTW, on non-call blocks (at least 4 out of 13 during the R1 year, more if you do the primary care track) we average 35-50 hours with a good number of weekends off, so that provides a nice break.

Teaching still seems to be a priority despite the work hours changes. Attending rounds were moved earlier in the day on most services, so the post-call team can be there. Noon conferences are pretty well-attended by interns, though we do get paged out quite a bit. AM report is harder as that's prime work time - I go maybe 30-50% of the time. The senior residents are almost always at AM report. I also want to point out that even if you aren't able to get to noon conference/AM report, you still learn a great deal just from rounding on any given day. The Medicine and ICU attendings LOVE to teach and they will make time for it, even on what seems like a boring patient. On the other hand, attendings on Cards and Heme-Onc are hit-or-miss with regard to teaching and helping with the workload.

There are plenty of research opportunities and willing mentors here. One attending sat down to help me with career planning in my 2nd week of residency, and I walked away with a nice long list of people with active projects. But you're right - the focus during intern year is definitely on clinical experience and there are no elective blocks. People spend elective blocks in the R2-R3 years doing research - I'm not sure how many months total you could fit in. Personally, my goal in IM residency is to get excellent clinical training, rather than to do a ton of research (I'll have time in fellowship for that!), so I may not be the best one to ask.

Obviously, the program isn't perfect. It's really big, so you don’t have a close-knit feel within the entire program and the program director doesn’t know each individual resident that well. Because the program’s so big, it's hard to know whether you'll get your schedule requests (I got all of mine, but I know some people who have no vacation until March or various things like that). That said, the administration has been really nice and supportive. They are very responsive to questions/concerns and they really do change things that bother us. However, since we're at a state-run institution there are limits to how much they can do (e.g., no free parking no matter how much we beg). Other annoying things: the computer systems are confusing and inefficient, and there's no computerized order entry yet. The hospitals are all spread out around Seattle, which makes for a painful commute at certain times of the day.

As for the interview day, I agree that it wasn't the greatest last year. Supposedly they have made a bunch of changes, so hopefully it's better.

So there you have it. Hope this helps - I'll be looking forward to seeing some of you at the interview dinners!

-BBB

Hey BBB--
Do you know any information regarding the two primary care tracts at UW? Any friends from your intern class that are either day Seattle PC or Seattle-Boise PC and impressions regarding the program? I'm particularly interested in how to rank all three of these programs... do they each have their own NRMP number and therefore constitute three separtate programs to rank?? How would you judge the difference between these tracts at UW?

JAPrufrock said:

Hey BBB--
Do you know any information regarding the two primary care tracts at UW? Any friends from your intern class that are either day Seattle PC or Seattle-Boise PC and impressions regarding the program? I'm particularly interested in how to rank all three of these programs... do they each have their own NRMP number and therefore constitute three separtate programs to rank?? How would you judge the difference between these tracts at UW?

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Unfortunately, I don't know too much about the primary care tracks, but I will do my best...One thing I do know is that all 3 tracks have their own NRMP number, so you can theoretically rank UW 3 times if you want. A lot of the UW med students do this so they have a greater chance of matching here. The only reason I didn't apply to the PC tracks was because I don't enjoy clinic and those tracks have several more months of clinic time. On the traditional track we spend those months doing inpatient electives and research, which I prefer.

I do have friends in both the Seattle and Boise tracks and they all seem pretty happy. The Boise track in particular is really popular - during the year those residents spend in Boise they have a ton of autonomy and get great experience. If you don't mind moving away for a year it's a great option.

One thing that is different about PC here compared to some programs is that our PC and traditional track residents are very well-integrated. You would never know what track someone was in unless you asked them. The residents are equally strong between all three tracks (in fact, some of my best upper levels have been from the PC tracks), and have equal ability to get fellowships if so desired.

Hope that helps! Let me know if you have other questions.

-BBB

Adcadet said:

BBB - thank you for the info. I'm flying out to Seattle soon, maybe I'll see you there.

Can you give more info on the computer systems? Are they the same at each hospital, or totally different? Is parking and driving a huge deal - long drives for most people, expensive parking, etc? Is the administration friendly? How is the cardiology experience(s)? Is two months in the ICU too much, too little, or about enough in your opinion, and are the two months in different hospitals?

Thanks!
Adcadet

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OK, here you go:

The computer systems are the same at Harborview and UWMC (of course it's CPRS at the VA). The problem is that there are 3 programs, and each has a slightly different set of info. You can't get everything by just looking at one of them. So, prerounding is a huge pain until you figure out a system. Once you get the hang of it, though, you can be pretty efficient. They are in the process of migrating everything to one of the sytems, but who knows how long that will take.

As for the driving, it isn't terrible (but I guess that's a matter of perspective). I think commutes average 15-30 minutes but with wide variation based on where you live, traffic, etc. For example, I live a bit further out and I'm 20-40 minutes from the VA depending on traffic. UWMC is 15-20 minutes, and Harborview is somewhere in between. It's mostly a problem on clinic blocks, because your hours are 8-5ish and you usually have clinics at two different hospitals on the same day.

Parking is about $4/day at Harborview and UWMC and free at the VA. You have a card that you swipe in and they deduct it from your paycheck. Some people take the bus or bike to save money, but I prefer to pay $4 and save some time on my commute.

The administration has been great. I have absolutely no complaints - friendly, supportive, responsive to our concerns. Honestly, that was one of my bigger concerns before I came here, but I've been pleasantly surprised.

As for cardiology, I don't know if I can really speak to the overall experience, since a lot of it comes in the R2-R3 years. As an R1 you do a month of cards at UWMC, which has good variety - AFib, MI, r/o MI, endocarditis, new CHF, etc. You get some really sick patients on balloon pumps and multiple pressors and whatnot. It's a tough rotation but I felt like I'd learned a lot by the end. As an R3 you go back to the UWMC on another service of more advanced CHF and transplant patients, as well as helping out on the interns' service at night. I know a couple of the R3's got frustrated with the amount of scut the fellows gave them on that rotation, but I don't know if that is universal. During the R2-R3 years you also cover cards/CCU stuff at the VA and Harborview, but I don't know much about those rotations yet.

I think we have a great amount of ICU exposure during intern year. (Of course, I plan on going into critical care so you'll never hear me say I wish there was less ICU time.) The two ICU months during intern year are at different hospitals - Harborview and UW - so they are very different experiences. Also, on several other intern rotations you follow patients into the ICU. This happens on VA medicine wards, Cards, Neuro, and maybe Heme-Onc. I think between all of this we have more ICU exposure than many programs, but I see that as a positive thing. I think it's a major reason why the senior residents are so comfortable managing very sick patients.

-BBB

BBB,

Do you have any insights into the cardiology match from UW? It seems from the match list that there are very few people going into the field for such a large program. Do people not match, or are just few people from UW interested in cards? Thanks!!!

Q

QuakerMD said:

BBB,

Do you have any insights into the cardiology match from UW? It seems from the match list that there are very few people going into the field for such a large program. Do people not match, or are just few people from UW interested in cards? Thanks!!!

Q

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Do you mind if I ask where you found their fellowship match list? I'd be much obliged for that information.

bolopan, the fellowship stats can be located here: http://depts.washington.edu/medweb/educational/residency/career.html.

QuakerMD said:

BBB,

Do you have any insights into the cardiology match from UW? It seems from the match list that there are very few people going into the field for such a large program. Do people not match, or are just few people from UW interested in cards? Thanks!!!

Q

Click to expand...

Well, I don't know too much about cards matching in particular. I know some people who have matched in cards but I don't know them very well - it's possible they all did research or were otherwise outstanding. FWIW, I have not heard of anybody having a problem with it. According to the link above, about 30 people have gone into cards over 6 years, which is about 10% per year. I don't have a good sense as to whether that's low for cards or not. The list was pretty heavy on UW, with the occassional Cleveland Clinic, Duke, Stanford, Michigan, UCSF, etc.

There are a couple of reasons we might have fewer people going into cards than at some programs. First off, we have a strong primary care track and emphasis on rural medicine, which attracts some people who don't want to specialize. The med school has agreements with Montana, Wyoming, Idaho, and Alaska, so people from those states come out here for training before going back to practice rural primary care. I don't know for certain that we have more people going into PC here than at other places, but I suspect that's the case (I seem to run into a lot of them anyway!). The other thing is that we have an unusually high number of people who want to do ID, Pulm CC, and Heme-Onc compared to other programs.

I think the bottom line is that it's certainly possible to get a cardiology fellowship from this program, but whether or not it's easy for everyone who wants it is another question. If you come here for an interview, I'd try to pick some of the senior residents' brains about that.

-BBB