Baylor CM vs Univ. of Washington for GS

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Eduardo Glz

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Okay. It's too late by now to ask, but since I had a lot of input on this from different sources (interns, residents, attendings @ my school) I decided to post it here to see what your input/experience has been.

My main bias for choosing btw. these two has been location, but not taking that into count, what do you think ???
 
If you're a 4th year, for god's sake, it's already too late. Have a beer, (or two from what it sounds like in your case), calm down, give this nonsense a rest and stop doing this!!!

If you're a 3rd year, it's too early, you have no letters as of yet, and it's too early. Remember that sometimes the only way to know a program is to do an AI there.

If you're anything else... don't worry about it.
 
I heard Ben Taub lost its Level 1 trauma accreditation and all of the traumas are going next door now. That is less than ideal...
 
SocialistMD...what's your source?

I believe it's UTMB in Galveston who lost their accreditation as a Level I trauma center. Ben Taub remains not only a Level I trauma center, but one of the few GOLDMINES remaining for surgical training (due to resident autonomy and volume of operative trauma).
 
Scrubbed In said:
SocialistMD...what's your source?

I believe it's UTMB in Galveston who lost their accreditation as a Level I trauma center. Ben Taub remains not only a Level I trauma center, but one of the few GOLDMINES remaining for surgical training (due to resident autonomy and volume of operative trauma).
Click to expand...

While I can't comment on the trauma accreditation, I don't know if I'd call Baylor "one of the few goldmines" when it comes to operative experience, as you've insinuated. I've heard plenty of stories about PGY-3s ecstatic about doing their first lap appy.

Maybe you meant specifically operative trauma, which may be true. Still, "GOLDMINES" in caps is overstating it a little.....
 
SLUser11 said:
I've heard plenty of stories about PGY-3s ecstatic about doing their first lap appy.
Click to expand...

No you haven't. Baylor has been a Top 5 GS residency for decades.

Scrubbed In has it right: UTMB lost its Level 1 - Ben Taub is still Level 1, and kicking ass.
 
Danbo1957 said:
No you haven't. Baylor has been a Top 5 GS residency for decades.

Scrubbed In has it right: UTMB lost its Level 1 - Ben Taub is still Level 1, and kicking ass.
Click to expand...

Yes I have. Baylor may have a strong reputation, but it's not the Alpha and Omega of surgical training....and they don't hide the fact that they subscribe to "graduated responsibility" in the OR.

Here's some unbiased objective data. 845 cases for a graduating chief surgical resident is average at best. They appear to be below average in Vascular, Endoscopy, laparoscopy, and, ironically, thoracic. They are definitely above average in operative trauma, with 45 cases.


This data is a couple years old, but as you mentioned, they've been kick@ss for decades....

I'm not sure what part of this thread got both of your panties in such a bunch. We all think Baylor is a nice place to train if you love whipples and getting yelled at.....Socialist was not stating a fact, just relaying what he'd heard. ScrubbedIn can correct him without the "get your facts straight" approach.


I have no doubt that Baylor is an excellent place to train.....it's just not the "goldmine" of operative experience that's been described. Also, I am the first one to say that the operative experience is probably less important than the quality of the surgical curriculum.
 
SLUser11 said:
Yes I have. They appear to be below average in Vascular, Endoscopy, laparoscopy, and, ironically, thoracic. They are definitely above average in operative trauma, with 45 cases.

I have no doubt that Baylor is an excellent place to train.....it's just not the "goldmine" of operative experience that's been described. Also, I am the first one to say that the operative experience is probably less important than the quality of the surgical curriculum.
Click to expand...

the other numbers that stand out there are the 563 critical care cases- I am sure we will all have treated that many people in the SICU over our 5 yrs, who would really have the time to log this??
 
SLU123,

I've worked with dozens of Baylor and UT-H GS residents over the last 25 years. 1825 cases done by chiefs are a long-ago number - those at UCLA or Hopkins rarely make 1000 now. Curriculum, and number of cases performed at the major residency programs has changed due to the 2003 reforms and other factors, including related surgical medical advances... You should know this.

ESU_MD,

That resident is assisting Brunicardi, the Chairman of Surgery.

Hatin' is sooooo pathetic.
 
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Scrubbed In said:
SocialistMD...what's your source?

I believe it's UTMB in Galveston who lost their accreditation as a Level I trauma center. Ben Taub remains not only a Level I trauma center, but one of the few GOLDMINES remaining for surgical training (due to resident autonomy and volume of operative trauma).
Click to expand...

A resident at UT-Houston told me they are getting everything from Ben Taub because Taub can't consistently maintain a neurosurgeon in house, thus leading to the loss of Level 1 accreditation. This conversation was Wednesday, though, so my information may be dated...
 
One of the Vascular fellows that I worked with a few years ago had done his GenSurg training at Baylor. He was a total badass in the OR and was fantastically smart. He did make their training sound difficult, but he seemed pretty happy with his end result.
 
Danbo1957 said:
SLU123,

I've worked with dozens of Baylor and UT-H GS residents over the last 25 years. 1825 cases done by chiefs are a long-ago number - those at UCLA or Hopkins rarely make 1000 now. Curriculum, and number of cases performed at the major residency programs has changed due to the 2003 reforms and other factors, including related surgical medical advances... You should know this.

ESU_MD,

That resident is assisting Brunicardi, the Chairman of Surgery.

Hatin' is sooooo pathetic.
Click to expand...

You're entitled to your opinion about their training....and honestly, I can't say for sure because I've never experienced it. Then again, you've never experienced any surgical training, so I'm not sure how you're qualified to comment because you've seen DOZENS of residents second-hand.

Honestly, after reading your comment on caseloads and the ACGME rules, you are either a troll being ignorant on purpose to get a rise out of us, or you have absolutely no idea what you're talking about. I think they are equally likely.

Once again, nobody is hating on Houston education. Baylor is probably a fine place to train (if you like whipples and getting yelled at). Also, I have a very good friend in residency at UT-Houston and he is getting an excellent, albeit hardcore, surgical education.....I just find your over-reactions pretty humorous, so I'm going to keep arguing here for my own amusement....
 
Danbo1957 said:
That resident is assisting Brunicardi, the Chairman of Surgery.

Hatin' is sooooo pathetic.
Click to expand...

Thats right he's assisting him. The chief resident following the following the stitch, holding hook and cutting sutures. If he's lucking, opening and closing.

a big red flag to me about the culture of a program. even the most hard core guys will stand on the other side of the table when recruiting season is on and the candidates are around

Where I come from, the chief of surgery assisted ME- when i was chief resident- (at least he would make pretend he was assisting me) But fundamentally, I was supposed to be doing the cases, not just rotely assisting someone else.
 
Got... to... stop... coming... in... here...
 
SocialistMD said:
A resident at UT-Houston told me they are getting everything from Ben Taub because Taub can't consistently maintain a neurosurgeon in house, thus leading to the loss of Level 1 accreditation. This conversation was Wednesday, though, so my information may be dated...
Click to expand...

I can tell you first hand that there is no talk whatsoever of level 1 accreditation being lost at Ben Taub. They have no trouble maintaining a neurosurgeon in house.
UTMB does not have level 1 accreditation due to hurricane Ike damage. As a result, volume has increased substantially at both BT and Memorial Hermann. Memorial does have a helipad, unlike BT, so perhaps that's what the UTH guy was referring to?
 
latinfridley said:
UTMB does not have level 1 accreditation due to hurricane Ike damage. As a result, volume has increased substantially at both BT and Memorial Hermann. Memorial does have a helipad, unlike BT, so perhaps that's what the UTH guy was referring to?
Click to expand...

No, he said Ben Taub, and I am pretty sure he knows the difference between the hospital next door and one 40 miles away. Again, I have no personal, first hand knowledge of the situation, but the guy who told me had no real reason to lie about it and, no offense or disrespect to a Baylor student, residents tend to be in the know more about stuff like this than students, especially when it is their work volume that is increasing. I've tried emailing friends I have at Baylor/Taub to find out the scoop, but as of yet I haven't heard from them. If I get any first hand knowledge (i.e. residents or faculty at Ben Taub), I'll post it.

Edit: As an aside, I both admire and find it a bit pathologic the way all former and current BCM students come to the defense of Ben Taub. I know of its reputation. I know how important it is to trauma. That is why I was absolutely shocked when I heard what I heard. However, just because Ken Mattox is there doesn't mean everything is under control. I know he would never let it happen, but the most recent word I have from the battle lines is that they are having coverage trouble and it may cost them, however temporarily, their level 1 trauma status. I'm not trying to pick a fight with any former-BCMers and I'm not trying to criticize the school or the hospital. I'm just trying to find out what is going on, because it would be a huge blow to the program if it happens.
 
Last edited:
SocialistMD said:
No, he said Ben Taub, and I am pretty sure he knows the difference between the hospital next door and one 40 miles away. Again, I have no personal, first hand knowledge of the situation, but the guy who told me had no real reason to lie about it and, no offense or disrespect to a Baylor student, residents tend to be in the know more about stuff like this than students, especially when it is their work volume that is increasing. I've tried emailing friends I have at Baylor/Taub to find out the scoop, but as of yet I haven't heard from them. If I get any first hand knowledge (i.e. residents or faculty at Ben Taub), I'll post it.

Edit: As an aside, I both admire and find it a bit pathologic the way all former and current BCM students come to the defense of Ben Taub. I know of its reputation. I know how important it is to trauma. That is why I was absolutely shocked when I heard what I heard. However, just because Ken Mattox is there doesn't mean everything is under control. I know he would never let it happen, but the most recent word I have from the battle lines is that they are having coverage trouble and it may cost them, however temporarily, their level 1 trauma status. I'm not trying to pick a fight with any former-BCMers and I'm not trying to criticize the school or the hospital. I'm just trying to find out what is going on, because it would be a huge blow to the program if it happens.
Click to expand...

K. Any good info you have is appreciated. I will do the same seeing as how I will be a surgical resident at BCM this fall.
 
latinfridley said:
...seeing as how I will be a surgical resident at BCM this fall.
Click to expand...

Then you should be able to actually find information quicker than I can from a source more reliable than my UT resident source or the two former BCM students and the current BCM student (you) who have already chimed in.
 
SLUser11 said:
Yes I have. Baylor may have a strong reputation, but it's not the Alpha and Omega of surgical training....and they don't hide the fact that they subscribe to "graduated responsibility" in the OR.

Here's some unbiased objective data. 845 cases for a graduating chief surgical resident is average at best. They appear to be below average in Vascular, Endoscopy, laparoscopy, and, ironically, thoracic. They are definitely above average in operative trauma, with 45 cases.


This data is a couple years old, but as you mentioned, they've been kick@ss for decades....

I'm not sure what part of this thread got both of your panties in such a bunch. We all think Baylor is a nice place to train if you love whipples and getting yelled at.....Socialist was not stating a fact, just relaying what he'd heard. ScrubbedIn can correct him without the "get your facts straight" approach.


I have no doubt that Baylor is an excellent place to train.....it's just not the "goldmine" of operative experience that's been described. Also, I am the first one to say that the operative experience is probably less important than the quality of the surgical curriculum.
Click to expand...

SLUser,

Can you elaborate on why you think "operative experience is probably less important than the quality of the surgical curriculum"?
 
Ben Taub has had only one neurosurgeon for quite some time. I had thought they were hiring another, but maybe not. In any event, the residents are as autonomous there as you can get under current Medicare regs. Starting with PGY-4, the resident is primary surgeon from start to finish, with the attending in the room but often not scrubbed for the seniors and almost never scrubbed for chief cases. So I'm not sure why it's suddenly a problem that there's only one attending neurosurgeon.
 
surge0n said:
SLUser,

Can you elaborate on why you think "operative experience is probably less important than the quality of the surgical curriculum"?
Click to expand...

You can teach a monkey to operate, and you only have to do so many Lap Choles to become proficient. Obviously there are some advantages to a program with high volume, but if there isn't a strong, standardized curriculum, then you will not be challenged intellectually, and you will develop into a simple technician, rather than a strong clinician.

There is a lot more to being an excellent general surgeon, the last renaissance man in the hospital, than being able to operate well.
 
Samoa said:
Ben Taub has had only one neurosurgeon for quite some time. I had thought they were hiring another, but maybe not. In any event, the residents are as autonomous there as you can get under current Medicare regs. Starting with PGY-4, the resident is primary surgeon from start to finish, with the attending in the room but often not scrubbed for the seniors and almost never scrubbed for chief cases. So I'm not sure why it's suddenly a problem that there's only one attending neurosurgeon.
Click to expand...

They are actually hiring another neurosurgeon to help cover ben taub and the VA. Should be starting this fall.
 
latinfridley said:
. They have no trouble maintaining a neurosurgeon in house.
Click to expand...

I have worked at Level I's that did not have neurosurg INHOUSE, but they all had them on call. Neurosurg call at a level I, is by default essentially inhouse since they get involved in a significant amount of trauma, but I'm not sure this is required to be physically inhouse.

that being said, I think one neurosurgeon could easily cover Ben Taub, since the neurosurg residents have free reign there, at least for the common trauma things.

Trauma neurosurg isnt exactly that hard, compared to the other stuff those guys do. I imagine its rather a nuisance- ICP monitors are routinely put in by mid-levels at a lot of places, and the only way you can screw-up a trauma crani is to make the incision on the wrong side- not to mention the head-injury critical care: alot of notifications by ICU nursing to the residents, but is essentially cookbook. 99% of the calls never make it to attending ears.
easily within the range of the residents
I doubt the staff has to "come-in" much.
 
ESU_MD said:
I have worked at Level I's that did not have neurosurg INHOUSE, but they all had them on call. Neurosurg call at a level I, is by default essentially inhouse since they get involved in a significant amount of trauma, but I'm not sure this is required to be physically inhouse.

that being said, I think one neurosurgeon could easily cover Ben Taub, since the neurosurg residents have free reign there, at least for the common trauma things.

Trauma neurosurg isnt exactly that hard, compared to the other stuff those guys do. I imagine its rather a nuisance- ICP monitors are routinely put in by mid-levels at a lot of places, and the only way you can screw-up a trauma crani is to make the incision on the wrong side- not to mention the head-injury critical care: alot of notifications by ICU nursing to the residents, but is essentially cookbook. 99% of the calls never make it to attending ears.
easily within the range of the residents
I doubt the staff has to "come-in" much.
Click to expand...

It is true the residents pretty much run the show there, but the nsurg attending does come in quite often.
 
Does not having neurosurgery coverage mean you get to keep all the penetrating stuff and transfer out the head bleeds? That doesn't sound like a bad deal to me.
 
You can find all the official requirements for level one trauma verification here:

http://www.facs.org/trauma/vrc1.html

for those interested in the neurosurg requirement, scroll down to the chapter 8 topics.

To see all the current verified level one trauma centers, go here:

http://www.facs.org/trauma/verified.html

See that * next to Ben Taub, means that it is 'in progress' (but I have no idea what that really means!)
 
jc7721 said:
You can find all the official requirements for level one trauma verification here:

http://www.facs.org/trauma/vrc1.html

for those interested in the neurosurg requirement, scroll down to the chapter 8 topics.

To see all the current verified level one trauma centers, go here:

http://www.facs.org/trauma/verified.html

See that * next to Ben Taub, means that it is 'in progress' (but I have no idea what that really means!)
Click to expand...

The ACS list is simply a list of trauma centers that have completed the paperwork and submitted it to ACS. ACS only verifies that the requirements set aside have been met. There is no measure of quality, etc.

Being "in progress" means that they have submitted the paperwork (you'll notice none of the Level 1 trauma centers in Pennsylvania are ACS verified, even HUP, nor is Baltimore Shock Trauma, Ryder or UT Memphis listed) but that it has not been completed by ACS.
 
Winged Scapula said:
The ACS list is simply a list of trauma centers that have completed the paperwork and submitted it to ACS. ACS only verifies that the requirements set aside have been met. There is no measure of quality, etc.

Being "in progress" means that they have submitted the paperwork (you'll notice none of the Level 1 trauma centers in Pennsylvania are ACS verified, even HUP, nor is Baltimore Shock Trauma, Ryder or UT Memphis listed) but that it has not been completed by ACS.
Click to expand...

Good to know, and I agree that these lists say nothing about quality.

I'm not so sure, however, about the list simply representing programs that have completed and submitted the paperwork. At the top of the ACS page it states:

"Verified Trauma Centers

....The ACS does not designate trauma centers; instead, it verifies the presence of the resources listed in Resources for Optimal Care of the Injured Patient. This is a voluntary process and only those trauma centers that have successfully completed a verification visit are listed below."

Can you be a level 1 without ACS verification?
 
jc7721 said:
Can you be a level 1 without ACS verification?
Click to expand...

Good question.
Especially considering there isn't a single hospital on that list from New York STATE.
 
jc7721 said:
"Verified Trauma Centers

....The ACS does not designate trauma centers; instead, it verifies the presence of the resources listed in Resources for Optimal Care of the Injured Patient. This is a voluntary process and only those trauma centers that have successfully completed a verification visit are listed below."

Can you be a level 1 without ACS verification?
Click to expand...

Absolutely, that was the point of my post above.

My residency hospital (a Level 1 trauma center), indeed all the Level 1 trauma centers in Pennsylvania are not listed (probably because Pennsylvania has its own trauma verification/credentialing system.)

Some of the biggest and best known Level 1 trauma centers in the US are not on the ACS list - Baltimore Shock Trauma, Ryder in Miami, UT Memphis, etc. And that was a cursory 5 second look by me, there are plenty of others missing.

Thus, my point was that the ACS list isn't really useful. It shows you completed the paperwork and ACS came out and saw that you were telling the truth. Whoop-de-do.
 
So I finally got information from a reliable source (one of the trauma surgeons at Ben Taub who was just involved with their site review), and they passed their site review. They were told to work on the neurosurgery issue, but they are maintaining their level 1 status.
 
Winged Scapula said:
Absolutely, that was the point of my post above.

My residency hospital (a Level 1 trauma center), indeed all the Level 1 trauma centers in Pennsylvania are not listed (probably because Pennsylvania has its own trauma verification/credentialing system.)

Some of the biggest and best known Level 1 trauma centers in the US are not on the ACS list - Baltimore Shock Trauma, Ryder in Miami, UT Memphis, etc. And that was a cursory 5 second look by me, there are plenty of others missing.

Thus, my point was that the ACS list isn't really useful. It shows you completed the paperwork and ACS came out and saw that you were telling the truth. Whoop-de-do.
Click to expand...

thanks
 
SocialistMD said:
So I finally got information from a reliable source (one of the trauma surgeons at Ben Taub who was just involved with their site review), and they passed their site review. They were told to work on the neurosurgery issue, but they are maintaining their level 1 status.
Click to expand...

Thanks for the verification. From what I was told the neurosurgery issue will be solved with a new hire starting this fall.
 
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