Advice from an MGH resident

[anesthesia1]

I am a resident at MGH. The most recent reviews up on scutwork are not that accurate. If you look at all the reviews posted you will see some glowing ones and some horrific ones. I do find it a little interesting that such glowing reviews are coming out around interview time. Truth be told there is truth in all of them. You will work your butt off here and Boston is a harsh place if you are not from here. It is very expensive, very cold and in general a hard place to get around. I am reasonably happy but the environment here can be harsh. MGH certainly has an air of arrogance and you will notice it when you interview. I will be honest MGH attracts a certain type and they tend to be hardcore, nerdy, research types (not sure if I fit into that lol). I came here for the name not my happiness. Not sure if that was a mistake or not but it has been a long two years. Yes, you will be highly trained coming from here but at what price? This is a sink or swim place and you will not be pampered. As a resident here you are drug tested because in years past we have had some residents who got addicted. Our chairman Dr. Zapol rubs many people the wrong way and I feel like we do not get many people we would want because of him. He is certainly not of the caliber of our previous chair Dr. Kitz (who is oftern regarded as the best of all time-he produced more chairman than anyone else). If you interview with Zapol he will either be somewhat normal or he will ask you about korean divers and their physiological response to deep water diving blah blah blah. Just a few thoughts on things. Remember, go where you fit in personality wise, you can't go wrong when you do that.

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[Tenesma]

anesthesia1

1) there is ONLY one horrific review that is factually relatively inaccurate making me doubt that a real MGHer wrote it

2) Boston is expensive (so is New York, Chicago, LA, San Francisco...)

3) Boston does get very cold in winter (so does any other city north of Baltimore)

4) NOT difficult to get around - the T is very convenient and safe, and you really don't need a car if you live in the city... or worst case scenario you get a cab... altogether cheaper than owning a car, renting a spot and paying insurance and gas

5) i agree that residents are pretty hardcore here... a few are nerdy and even fewer are researcher-types... every year only 1 person out of 26-29 does research.... and almost 80% of graduates end up (including after fellowship) going into private practice and making bank

6) All medical professionals who handle narcotics regularly should be drug-tested... at some anesthesia programs it actually has been mandatory for 5+ years

7) people not coming because of Zapol??? that is crap... your exposure to Zapol during residency is limited to 1) lobster bakes at his house 2) dinner with him after the annual cemetery tour (optional) 3) chatting with him and his wife at the yearly cocktail party 4) chatting with him at the yearly formal spring fling dance.... what effect could that possibly have on learning anesthesia here??? his interviews are famous for weird discussions because he wants to see if you can handle a normal conversation that doesn't revolve around your scores in med school

8) you have been a resident at MGH for 3 months now? at most.... and you knew Dr. Kitz? considering Zapol has been the chair since 1991....

Anesthesia1 = If you really are an MGH resident (and I have my ways of finding out) then I don't understand what point you are trying to make... If you aren't an MGH resident then shame on you for trying to make non-sensical propaganda to perpetuate a false myth about the MGH.

PS: there is no arrogance that i can detect there... just because we don't bash other programs out of insecurity (like some other programs i won't mention) doesn't mean we are arrogant... just confident...

 

[militarymd]

What do you think of dick pino?

 

[Tenesma]

dick's a good guy... fun to work with, and smart.

 

[Hockeyguy]

dude "Dick Pino" is a tight name

 

[VolatileAgent]

hmmmm. interesting to see this kinda post so early. usually these come out right before people finalize and submit their rank order list.

 

[aredoubleyou]

Its an especially competitve year, i suppose

 

[bigdan]

ooops...

You just got caught up, anesthesia1. Any rebuttal? Make it good, 'cause Tenesma's word is gold 'round these parts.

Just like Justin, sucka.

dc

 

[militarymd]

So , does tenesma know anesthesia1?

My the way say hi to dick for me. Tell him the navy anesthesia critical care guy from NMCP is in private practice and doing great.

 

[Tenesma]

will do....

 

[bullard]

will do....

Tenesma, what's the regional training like at MGH? I can't seem to find any info on the webpage or scutwork about dedicated "block doc" months or # of blocks done per year...

 

[Tenesma]

when i was a resident (not so long ago) we had the following block exposure

2-3 months on ambulatory with another 2-3 months as CA-3s (if you chose to do so)... during that rotation you get your fill of interscalenes, infra-claviculars, femoral, pop. fossa, ankles... your 2nd or 3rd month on ambulatory you are considered a "senior" and you do most of the blocks (and the extra elective months are gravy)... as a senior or elective you can count on between 4-7 blocks per day...

during the rest of your rotation you will primarily do blocks on the dedicated ortho months (another 2 months)...

there are some attendings who primarily do ALL their blocks under ultrasound - which is neat because it is a different technique alltogether..

by the end of residency i did about 100 interscalenes, 80 infraclaviculars, 20 axillaries, 50 pop. fossa blocks... and a handful of the rarer blocks

be careful though, because a lot of residencies will include in their numbers epidurals, spinals and Bier blocks - which i think is bogus...

i still think that if your goal in life is to be a regional anesthesiologist it is well worth doing a fellowship at HSS, Iowa or Virginia Mason or some other strong program ...

 

[bullard]

Thanks for the reply. Don't want to be a regional anesthesiologist -- I just want to be competent (during one of my anesthesia rotations I saw an anesthesiologist from a very reputable Midwest program have to call his colleague to do an interscalene b/c he just didn't have the experience. Not impressive). But are you saying that one should do a fellowship in order to be able to do all those blocks with confidence in private practice? I thought regional fellowship was just for people who want to be academicians or had shoddy regional training during residency.

when i was a resident (not so long ago) we had the following block exposure

2-3 months on ambulatory with another 2-3 months as CA-3s (if you chose to do so)... during that rotation you get your fill of interscalenes, infra-claviculars, femoral, pop. fossa, ankles... your 2nd or 3rd month on ambulatory you are considered a "senior" and you do most of the blocks (and the extra elective months are gravy)... as a senior or elective you can count on between 4-7 blocks per day...

during the rest of your rotation you will primarily do blocks on the dedicated ortho months (another 2 months)...

there are some attendings who primarily do ALL their blocks under ultrasound - which is neat because it is a different technique alltogether..

by the end of residency i did about 100 interscalenes, 80 infraclaviculars, 20 axillaries, 50 pop. fossa blocks... and a handful of the rarer blocks

be careful though, because a lot of residencies will include in their numbers epidurals, spinals and Bier blocks - which i think is bogus...

i still think that if your goal in life is to be a regional anesthesiologist it is well worth doing a fellowship at HSS, Iowa or Virginia Mason or some other strong program ...

 

[Tenesma]

no, i don't think you need a fellowship to do these in private practice... i feel perfectly comfortable incorporating them in my practice...

however regional anesthesia is a whole new beast in private practice
1) some surgeons aren't comfortable with the idea (based on their training)
2) some insurances don't reimburse the block if you did it for post-op pain and used a G.A. for the case...
3) it takes between 15-45 minutes for the block to kick in - so some big regional practices actually have an extra anesthesiologist to put in all the blocks while a CRNA babysits the sedation case...

the advantage of a fellowship is that it opens up doors for you if doing regional is really your thing... if you do a fellowship at HSS for example you can go anywhere and become director of ambulatory surgery and run the show the way you want to with tons of blocks....