2008-09 Pediatric Interview Impressions Thread

Okay, since J2B requested it:

Please don't ignore the "official" interview feedback area, but here's a chance to perhaps expand on things, and present a little more fully the impressions of each place.


Arkansas

Overall impression: I really liked this program

Residents: Very heavy from the Southeast, and they do tend to retain quite a few of their own students (which in my opinion is a positive thing). This was my second interview, took place in mid November, so still pretty early in the season too, but the residents here have stood out as being the most outgoing, and the most frequent askers of "do you have any other questions". Having only interviewed at my home program prior, I was pretty unprepared. I think there were 6 or 7 residents at the dinner the night before and then another 5 or 6 that came to Lunch the next day. Biggest thing: The residents were happy.

Hospital Big, expanding, and you can tell it's a children's hospital (not just an adult hospital painted in bright colors). It is not a "new" facility, at least compared to some of the other places I'm looking. Again, they are adding more beds.
PICU was awesome. This was the first "rat farm" NICU I'd seen (all the NICU's at my home program have been built within the last 8 years and so they're built in the "villous" semi-private room format).

There are only a couple months that are not at Arkansas Children's, instead at the University Hospital. I'll have to check my notes, but I'm pretty sure it was only a NICU rotation. We did not tour the University site.

Continuity clinic is not attached to the hospital (a couple blocks away). BRAND NEW. I did not tour the location, but the pictures looked awesome. Looked like a set up you'd find in an affluent private clinic.

Call rooms and resident lounge were nice. There hasn't been a lot of variation in call rooms from place to place (what do you really need?) but these were among the best.

Interview Day Early day. They'll put you up in the Hilton, and the shuttle to ACH leaves at 7am. Program coordinator will meet you at ACH, the Department Chair will meet with the group. Go to Morning Report. Three interviews are 30 minutes each, one with the PD, one with the Chief Res, and one with a faculty member. All were laid back. Faculty spent most of the time with me "selling me". PD seemed very grandfatherly, and liked to talk, I pretty much listened. Chief's interview was about trying to get to know me. Returned to hotel at 3pm.

Curriculum
LOTS of ER time. Outpatient months are split between clinic and ED.
Benign call schedule - 3-4 overnight calls a month while on wards, due to night float system. Interns do a month of NF.
Didactics schedule varies on time of year: Early on, noon conferences are M-F as "intern lecture" series. After August, goes to W-F. PD claims it's a 2 year repeating sequence of lectures, but residents didn't seem to notice that. In May/June, it becomes a board review sequence.

7 months of electives, 5 in the third year. There are some requirements that have to be fulfilled with elective time.

There are fellows, but did not seem to be a fellow driven program. The "biggest" complaint I heard was that fellows are a little eager in the first couple months, but after those, there's little animosity. Fellows are NOT an extra layer between you and the attending.

Unique intra-program moonlighting opportunity - after completing PICU as a PL2, you can go out on transport services, doing initial stabilization and helicopter flights. I can't remember if it was $50 or $75/hour in 12 or 24 hour shifts. But b/c it's intra-program, you do have to keep below work hours, so it does limit your months you can do it.

There are lots of non-academic services to make sure that residents aren't dealing with poor learning cases.

Benefits
Don't have salary benefits in front of me, but it wasn't any sort of outlier in terms of amount. Free parking, On-call meal allowance, plus $ for keeping up on your paperwork (which surprised me). Standard library stuff including UpToDate. $400/year educational fund. Program will pay for costs to go to conferences.

Research
Not a huge deal was made about it, but there were some that did it. I don't have much in my notes about it.

Location
LR surprised me. It is one of my smaller locations, which was a concern. But overall, seemed nice. Housing costs are extremely reasonable whether renting or buying. I've looked at some of the apartment sites and it's pretty cheap (at least in my opinion). Seemed like there was enough to do socially. The residents mentioned that they hang out pretty frequently, especially the single ones - pretty common to do happy hours, and they usually go play bar trivia on Monday nights vs the Ortho residents.

Concerns
Board pass rate is only at the national average (maybe lower), including one year in the last three which was particularly poor. I think the noon conference board review series is a new entity. One of the PL3's did mention that she and several of her classmates are studying as a group on their own accord.

One resident did claim it was a "work" program, which I take to mean that the expectation is you're going to learn through patient load rather than didactics and teaching...but she was the only to label it that way. None of the other residents said anything that was similar...but on the other hand didn't push it the other direction.

Little Rock. It's not that I dislike the town, but I'm just not "sure" about it. Might go back for a second look. I'm a single guy, so my concerns are different than what might matter for someone who is married, or has kids.

Other considerations

For those with Step 1 or 2 scores >90 OR AOA membership, or a certain class rank, there is the Chairman's Scholars fund, which gives you $1500 in both the 2nd and 3rd years which can be used for any number of educational uses including saving it to pay for board review or boards cost.

There must be something in the water because there were a LOT of pregnant residents, for those who are concerned about that.

Program Coordinator was excellent and everyone loves her. Most said they would donate part of their own salary to keep her.

 

REMINDER: Please don't ignore the "official" interview feedback area.

Oklahoma

Overall impression: Not my favorite, not by a long shot. Depending on how the rest of my interviews go, this may not make my rank list.

Residents: I did not find the residents particularly engaging, though of course, it could easily be mutual. The residents, with the exception of one of the Chiefs (who in another life could be my best friend), were rather short with their answers. Unlike the residents at the other places I've interviewed, the OU residents answered the question, then offered no more information. Much different than the other places I've been. Again, this was just me and maybe if I had met a different subset, I'd have thought differently.


Hospital: Brand new...like opened in summer 2008 new...and yet (in a theme that would repeat itself throughout the day for me), it wasn't that great. There were a lot of things they had that should have been AMAZING that just missed the mark.

In terms of the hospital, it really appeared to me to be an adult hospital painted in bright colors. Maybe I've been spoiled by the children's hospital at my home program, but I seriously thought at one point "well if this whole 'kids' thing doesn't work out, you can at least utilize this for the adult side of things with no changes". Maybe it was so new, they were waiting on artwork or something, but if I was a kid, I don't think this hospital would have made me more comfortable. Felt extremely institutional.

The outpatient clinic building is in the process of being finished and should open pretty early in the Class of 2009's intern year, if not right before we all start as PL-1s. It will match the new hospital, and shortly after completion, a huge atrium (which the Chairman correctly described as the feature that will make it a "landmark" building) will be constructed.

PICU was very nice, and actually had the sort of feel I would have liked to seen throughout the other wards floors.

Essentially, with everything being new (call rooms, NICU, etc), they were nice, but not outstanding in my opinion

Interview Day
Dinner with residents night before was at Cheesecake Factory...which bothered me - a lot. If you're trying to show off your city, take me someplace local, not someplace I can go any time I wish.

Actual interview day starts about 8am, short (8min) drive from the hotel (Sheraton, downtown OKC). Hotel was fairly easy to get too, but I had my GPS with me. Meet with Chief, go to Morning report, meet with the Department Chairman, then tour, interview with PD and then separately with Assistant PD. I did not have a faculty interview. Lunch was supposed to be in the OUHSC "club" restaurant, but there were some issues with that, so we ended up going to this place in Bricktown (which was excellent).

I loved the assistant PD - she is very dedicated to teaching and devotes a lot of time to going over learning styles with the interns, and teaching styles with the upper level residents. This sort of educational theory stuff is right up my alley, and she and I really connected - probably the best connection I've made with a faculty member during an interview so far.

PD was fairly bland. Nothing exciting. I had to ask a lot more questions of her then I've had to with any other program director so far. She was much like the residents the night before: answer my question then offer nothing else.

Compared to my other interviews...did not get a lot of facetime in with the residents. I don't want to say that they were hiding them, because I know what the connotations are, but it just didn't feel quite like they gave as much access as the other programs I've been too. Only got to talk to the handful at dinner, then the 3 others at lunch. Again, just another example of the whole vibe I felt that was just "off". Not bad mind you, just not quite what I was hoping for.

Curriculum: Don't have a lot in my notes about didactics. (From their website - noon conference MWF, follows a board prep lecture sequence).

They do have night float, but it makes up one week of your ward months. I'm not a fan of that. If you want to minimize the disturbance to my sleep schedule, give me a month (or at least 2 weeks) of Nights.

Interns get a month in the PICU, and you'll be on call with an intensivist when you're on call. But as an upper level, you take call by yourself. I want to do Critical Care and that doesn't sound like a good idea to me.

Otherwise pretty standard. Only 5 elective months over the course of the three years.

Benefits
I don't recall anything particularly unique. Salary is pretty standard, and the usual on-call meals and parking and stuff.

Research
The Chairman made a big deal about all the big time names (at least he claimed they were important), but it seemed like for all that these people were doing, the residents really weren't taking advantage. Hard to tell if that meant it was because they were too busy, or they just weren't attracting people who wanted to get involved. Similar situation with child advocacy, as they have a Nationally known faculty member in the field of advocacy (this one did have some substantial credentials) and didn't seem like the residents were making the most of the connections she undoubtedly has.

Location
OKC is an up and coming city for sure. It's about 1.2 million, and I think there's definitely a lot of things to do there. I've always heard great things about the Bricktown area, and I think it could be a lot of fun. Real Estate prices aren't horrible, and the widespread interstates mean you can live a lot of different places and still get into work pretty quickly.

Concerns
Obviously for me, my interactions with the residents wasn't where I wanted it to be.

I also felt that the program didn't do a very good job selling itself. There was a lot of information on the website that wasn't mentioned to me at all during the interview day. This begs the question why not? If you can't tell me the good things, why should I believe I've heard all the bad things?

Other considerations
Not a whole lot. I'm sure that other people will be drawn to this program for a number of reasons, but I'm a big believer in gut feel, and this is not the place for me. I do find it unfortunate though because I know I would gotten a lot out of the connection I made with the Assistant PD. I almost feel like I owe her an apology for not coming to the program to work with her.

 

REMINDER: Please don't ignore the "official" interview feedback area.

Utah

Overall impression: This place is great! Well-established, basically tweaking things to become better.

Residents: Very laid back. I wasn't able to go to the dinner since they only have dinners 2x a week and I was traveling. Really wish I could have though. My tour guide was from my current city and it was nice to have someone who understood where I was and answer my questions based on our shared experiences. But based on the residents I did meet, there weren't any concerns


Hospital:
Opened in 1991 I believe they said, currently expanding Peds ER and PICU. Attached to University Hospital via skywalks. Literally on the side of a mountain, great view of the valley, TRAX light rail stop nearby for easy transit throughout the city.

Felt like a children's hospital, but not quite as grand as Arkansas or UT-Southwestern.

PICU was a busy place, cluttered. Looked like the way a Movie set designer would imagine hospital wards to convey all the activity that was going on.

Call rooms were okay. Resident lounge was nice, well stocked with food (cookies here were delicious!).

Interview Day: They put you up in the University Guest House which was part of the Olympic Village in 2002. Short walk over to the hospital. Did not go to AM report, PD gave powerpoint presentation to group and answered a lot of questions, interview with faculty, PD and chief one-on-one. Did not meet Chair. Lunch was with tour guide sort of one on one. We skipped noon conference, but that's where we picked up our food (potato bar).

After tour, that was pretty much it. I knew one of the med/peds residents somewhat tenuously but I paged him and asked a few more questions about living in SLC, and that's where I met a few more residents.

Curriculum:
Lots of didactics. Have an AM and noon conference everyday. Noon conference is a 2 year repeating lecture series off of the Peds PREP curriculum.

Hospital has a huge catchment area. The m/p resident I know said that you really don't sleep while you're on call. They have gone to a night float system for upper levels, but interns are still q4. This is a fairly new change and people seem to like it, and it results in greater continuity of care for the patients as between intern, sup and night float resident, there's always someone who knows the patient. They do cap interns at 9 patients.

Most unique thing was the two half days of continuity clinic. As an intern you do both every week, but as an upper level, you can elect to use the second half day for either research or advocacy. I thought this was very cool, and allows for a lot of flexibility.

Benefits
Ski resorts are less than an hour away. Some residents ski/board as many as 40 days a season, especially if they go post-call. There's an elective month available in which you can be the on-mountain doctor at one of the resorts! Residents get discounted passes.

Free parking, free TRAX passes. Noon conference always has food, the hospital cafeteria is open to 2am, resident lounge is nicely stocked.

Resident rafting trip starts off each year to welcome the new intern class. Have your standard resident retreat stuff for each class...

Research
Significant, the extra half day a week really allows a lot of involvement. Program pays for travel to conferences

Location
SLC is a clean, beautiful city. Only 43% Mormon. Residents said (and my IM friends said their residents said the same thing) that there are so many non-LDS people affiliated with the hospital that it's kind of like it's own sub-culture. SLC is very progressive, and seems to be doing a lot to shed it's reputation, as it realizes the need to attract outside companies and stuff to continue growing its economy.

Concerns
Mormons...43% is still significant.

Nightlife. There are some goofy liquor laws, and the cabbie on the way to the airport told me the cops are very strict about public intox...they'll test you if they think you might have been in a bar, not just if you're making a scene. I'm not a huge "club" person, but I do like to go out on occassion, and I just wonder how restrictive is it really?

 

Didn't ask specifically...if it was mentioned, I think they said they start check out at 1630, but I can't guarantee that was at Utah...these are starting to run together a little bit.

As for the weekend, I definitely did not hear anything like that. The med/peds resident I knew talked about how awesome Sunday skiing was (which I did not think about as an unintended consequence of living around a bunch of Mormons), if that means anything to you.

 

REMINDER: Please don't ignore the "official" interview feedback area.

University of Arizona - Tucson

I did my away rotation here, so my notes from the interview are really kind of lacking. I apologize for their sparseness

Overall impression: This program is making it's way to the launch pad, and will take off in 2010. Lots of potential here.

Residents: Couldn't go to dinner, but I did an away rotation here, so it wasn't that important.

The residents are nice, and they definitely get along with each other very well. On my interview day everyone was talking about the holiday party that one of the residents was throwing that night and it sounded fun. I think the residents definitely fit in with the program too. UofA is VERY laid back and VERY collegial with attendings. Even med students call attendings by their first name.

Hospital: Current: not great. Diamond Children's Hospital is going to be opened in stages over the course of Spring 2010, so right in the middle of the PL-1 year for us going through the process.

This massive change does make it hard to evaluate in my opinion. As it's difficult to really "see" myself there.

Interview Day: Meet with PD as a group, 2 faculty interviews. Lunch with residents, meet with director of Continuity clinic program as a group, tour, end of the day.

PD is AWESOME - younger, very dynamic. Only been PD for about a year (old PD is still involved some), the opportunities that the new hospital presents is certainly not lost on him. The residents love this guy, and some told stories about how, even before he was PD, they went to him to get changes made in the program. He definitely has the residents interests at heart.

Curriculum:
AM report x3, Grand Rounds on Tuesdays.
Wednesdays are "Teaching Day". From 10am to 1pm, 3 one hour lectures cover a variety of important topics. Sometimes it's a resident run patient management conferences, sometimes it's a faculty presentation on the latest developments in their field, sometimes it's core curriculum. Lunch is provided, and attendance is pretty much mandatory. It is HIGHLY protected time. The Chiefs actually take your pager away from you. One of my interviewers actually talked about how she did an LP the week before because there were no residents. That is one of the keys too, the attendings have been extremely important in taking on the extra work it presents.

I can promise from experience that the faculty are all great teachers and bedside rounds and brief presentations we got in during downtime were awesome. One of my attendings went over (using calculus!) why changing PEEP is so much more important than PIP for oxygenating vent patients. That's just one example from a month's worth.

The M3 Clerkship has won the "Best Clerkship" award 6 out of the last 8 years or something ridiculous. At least at my school, in my experience, the clerkships that do the best job educating students also do the best job educating residents.

Benefits - pretty standard.

Research
Steele Children's Research Center is a pretty huge deal. Most places I've been do not have a dedicated pediatric research center. This has allowed them to do some interesting things, and will help them expand faculty. The Tucson Children's Respiratory Study is essentially the Framingham study for Asthma, and is a result of having the Steele Center.

That said, I didn't get the feeling that most residents took advantage.

Location
Tucson is very pretty. There are mountains all around (Mount Lemmon actually is tall enough to get enough snow for skiing in the winter), and it's just an interesting set of views. It does get hot...it's the desert. But being at a slightly higher altitude means it's usually 10-15 degrees cooler than Phoenix on any given day. When I was there for my interview it was about 75 in the afternoon, but crisp in the morning, in the 40's.

I was struck by the way Tucson still thinks of itself as this sleepy little college town, despite the fact that it has about a million people. I got a lot of comments while on my away like "oh, if you want that, you'll need to go to Phoenix". I guess that's what happens when you live less than 2 hours from the 5th largest city in the US (13th largest Metro).

There's a ton of outdoorsy things to do, especially hiking if you're into that. Good hiking spots was definitely one of the main topics of conversation when I was there for my away.

Concerns
Lots going on here, but there are going to be snags as things roll out. That can definitely be a turn off, especially when the other programs I really like are more established.

I'm not sure that I fit in great with the peds residents. Of course one of my best friends is down there for residency in another field, and I have the people I've met through him that I know, so my social life is not a concern, but I do think it's important to have good connections with my close colleagues and not always being the guy who is off with the ortho/ER/Anesthesia residents.

Other considerations
For those that are interested, a significant number of residents have kids and I believe they've had 2 births in the last 6 months. Going along with the laid back feel of the place, it's very family friendly.

 

REMINDER: Please don't ignore the "official" interview feedback area.

UT-Southwestern/Children's Medical Center Dallas


Overall impression: Excellent. May not have some the unique features that other locations have, but I really found no truly weak areas. Currently part of the logjam at the top of my rank list.

Residents: Wow! All the residents I met were extremely outgoing and EXCITED about their program. Really, if I had to go based purely on how the residents talked about their program, this program would be the winner.

Dinner the night before was at a resident's house and honestly, the other applicants and I could not get a word in edgewise to ask our questions. It was four PL-3's and you could tell they were all really great friends and it really felt like they wanted to tell us everything they could. In addition to these four, there were a bunch of residents at lunch and definitely no feeling like the residents were being hidden from applicants

Most of their residents are from TX, which might be a consideration for some.

Hospital:
Gorgeous. HUGE. Sits to the Northwest of Downtown Dallas. Building another tower, but the plan is not to increase the burden on residents (they've been expanding the number of residents, while decreasing the total number of patients on teaching services). I really liked the hospital.

PICU was pretty amazing, huge rooms (first place I've been where they can covert PICU rooms to OR's if patient is too unstable to make to surgery). CVICU is on 11th floor, PICU on 12th (or is it 9th and 10th?) either way there are awesome views of Dallas on all sides.

Interview Day:
Meet in Lobby, met by coordinator. Went to AM report, Intern Recruitment Attending gives a 1/2 hour presentation about opportunity and his feelings on the program (very nice gentleman). Chief Resident gives a long presentation that answers a lot of questions. PD and 2 faculty interviews follow. Lunch with residents at UT-SW faculty club (really great desserts), tour, then a little bit more with Chief (essentially going through the http://www.childrens.com/PediatricResidentsCD/index.htm website). Then final closing remarks from the PD.

PD is nice, though perhaps a little socially awkward (in a good sort of way), but the residents warned us about that the night before. Definitely one of those people that you can see the gears turning while you're talking to them. She ended up talking to us a bunch about the IOM reccomendations about duty hours that just came out and it was one of those things where you could tell she was making the jumps in thinking that it was hard to keep track of where she was headed. Again, it was a little odd, but in an endearing sort of way. The residents all said that she really cares about her residents.


Curriculum:
Plenty of didactics. AM report is a little a different than everywhere else I've been. Might have been b/c it was Friday. Case is presented and very little time is spent on coming up with Differential and then appropriate lab tests and more on the "ask an expert" questions the residents come up with. The questions ranged from common diagnostic dilemmas associated with the pathophys to tips on educating parents on prevention. Just was a little different, but I think was a great way to get faculty involved. I've sometimes felt at my own school, too much time is wasted on getting individuals to say "well we need a chest x-ray for our patient with suspected pneumonia".

For interns there's AM report every day, most days there are separate conferences for Interns and upper levels. One morning a week, interns have a conference with the Department Chair giving him a chance to get involved.

Have a monthly journal club/critically appraised topic. There's a resident run boards review program which runs through the Zitelli Atlas of Pediatric physical diagnosis and board prep questions.

No official cap system. Floors are between 18-22 beds and there are usuallly 3 or 4 interns on each team, so the de facto cap is between 6 and 8 patients. Also doesn't sound like there's an admit cap, as you only admit to your floor until it's full, and it'd be rare to have a patient census less than 8 or 12.

NICU is BUSY, may carry upwards of 12 babies. It's attached to Parkland which has over 16,000 births a year (>45 a day), and is the busiest L&D hospital in the country, and 2nd in the world.

7 electives over three years, including 1 in the first year. 4 of the 7 have to be ambulatory. Sounds like there is a lot of personalization to the elective months so if you want certain experiences they work to get them for you.

Benefits - normal stuff. AM and Noon conferences are catered every day. Do provide relocation $$$ up to $1000.

Unlike a lot of places they do not pay for travel to conferences or for research presentations.

Research
There if you want it. For their size I guess I was a little surprised that it wasn't a bigger point of emphasis. Like most places, some residents really get into it and others don't. Definitely not as widespread as at Utah.


Location
Dallas is a big city, there's definitely not going to be a lack of things to do.
Children's is located just NW of downtown and Dallas is HUGE, but there seemed to be a lot of affordable housing close by. If you want to live farther out, you can, but you will have to deal with traffic, even at resident hours, compared to other locations.


Concerns

It is Texas...I've never pictured myself living there, but I do realize that because of it's size, a lot of the concerns I have about other places don't exist here. I also didn't really intend to apply here, but did so at the encouragement of my Department Chair. Glad I did though.

 

REMINDER: Please don't ignore the "official" interview feedback area.

Kansas

Overall impression: Small, and as my first experience with a non-freestanding childrens' hospital, the difference was definitely noticed. With Children's Mercy literally 2.5 miles away as the crow flies, I really have to worry about their exposure...despite the assurances from everyone there.

Residents: Okay, not great. The chief (they don't have PL-4's in their chief positions as far as I could tell) was really great at not hearing all of my question, then answering based off of what she thought I was asking. It got really frustrating to keep having all my questions partially or tangentially answered. Everyone did seem pretty nice.


Hospital: Again, non-freestanding. The Peds building is small, and kind of old. They are getting close to breaking ground on a new building (that's going to be built around the first floor of the current one) that will greatly enhance their outpatient clinic/continuity clinic experience.

KU Med itself is kind of a bipolar hospital...at least how I see it. Very much a place that builds new when it can but doesn't follow up with renovations in the older parts.

The Peds floor was literally just that, a single floor, with about 28 beds.
PICU was nothing special. Currently at 6 beds, with average daily census about 4. If needed peds patients will be placed in some of the other ICU settings (CVICU, SICU, NSICU, MICU - which I'm sure those nurses love). There are plans to double PICU size.

Interview Day
Starts at 7:45, starts with tour, then 4 25 minute interviews, 1 with the PD, one with an Asst PD, then 2 faculty. Get a presentation on benefits then lunch with residents, that's the day.

I LOVED the PD, we had a really awesome conversation and she definitely has a well thought out plan of where she believes the program can go. Very conscientious about who she's selecting in each intern class and the types of personalities that she believes will succeed there. Didn't flinch one bit when I asked about their low board pass rate (32% for the last 3 years). Explained that they had 2 years where they let the residents have too much freedom in arranging their board prep. The classes that sandwhich those two years were at the national average, and with 2008 results coming, there should be a significant rise in the pass rate.

Asst PD and the faculty were nice as well, and I really thought that it would be nice to work with them.

Curriculum: I didn't keep good track, so I'll have to look at the materials they gave me.

Benefits
Standard, though the salary they offer is about 6k less than Children's Mercy for living in the same city.

Research
Very possible, they do have a required "scholarly project" month which could include research or advocacy or quality improvement. If you wish to do research they'll put that month in the intern year so that you can get started on things.
Location
I'm a Kansas City native, and that was my main reason for interviewing here. I will say that KC has improved a lot since I left for college in 2001. The Country Club Plaza is always awesome (worth a look at the wikipedia article http://en.wikipedia.org/wiki/Country_Club_Plaza) but the new Power & Light District downtown is brand new and surrounds the recently opened Sprint Center. Likewise, the development around the Kansas Speedway has created yet another center for nightlife and things to do. Throw in things like the Nelson-Atkins Museum of Art, the Negro Leagues Baseball Museum, the KC Jazz Museum and the College Basketball Experience and Hall of Fame and there's a lot of things to do in KC. Cost of living is relatively cheap and I think it makes for a pretty great place to live. That said, if you don't want to live in a city of 2 million people, then those things aren't going to matter.

Concerns

Board pass rate was adequately explained and I feel confident that they're taking the right steps to get it fixed.

The amount and acuity of cases. Several comments were made by residents and faculty alike about how important it is to have time to read and study daily. The fact that it came up multiple times makes me think that it's one of those code words for "we're not that busy, but here's how we're spinning that into a positive". I mean, I'm all for having time to read and stuff, but that's something I think needs to be a personal decision. And I think that most of the big places I've been have been keenly aware of having that balance between work and free time.

Other considerations

I felt I owed it to myself to see a program that wasn't a freestanding children's hospital just to make sure that's what I wanted and I came away feeling comfortable with that decision. The main reason I'd come to this program is because it's in KC and my family is there (which might also be the main reason I WON'T be going there ) but I think Children's Mercy has a lot more to offer and I'd be better trained.

I also wish that I could get one of these PD's that I really loved to be at the programs I really want to be a part of!

 

Yeah, I got that pretty much everywhere...even the programs I least expected it at. The best though was at one of those programs where I didn't expect it...and their Peds Intensivist was a grad of their residency program, went to Rainbow Babies, came back and was on my interview itinerary! Kind of made it impossible to doubt.

Basically I think it's really important to keep in mind the overall competitive level of most peds fellowships...few completely fill, and even fewer have enough US med school grads apply to come anywhere close to filling all the available spots. Add in all the extra variables that come from being older (ie it's only logical more fellows are married than residents, and more will have kids), and I'm certain the limited candidate pool becomes even more limited for the programs.