Things to ask or look out for:Jumping in. I submitted early this week. One invite so far. I'm most interested in multi-disciplinary programs. A question I open up to others, is questions to ask on interviews. Or things to look out for as a red flag at programs.
Wow. Those were amazingly insightful questions. Thanks a tonThings to ask or look out for:
- What is the role of the fellow on the service after the first few weeks? You should be running rounds, and the first person the team members go to with questions and concerns. If you're instead an observer or treated the same as a resident, then you're not getting a good experience.
- Will you be the sole fellow on service at a given time? If you're on Neuro, and the Neuro-CC fellow is on at the same time, your education is diminished.
- How much time do you get to spend alone (no attending) in the unit? There is a large amount of growth when you are primarily responsible for the care of your patients, and the attending is not physically present to bail you out.
- How much time is spent in each unit? Nine months of just Neuro and SICU are excessive, and you aren't going to be expressed to enough pathology. Be sure to go somewhere with exposure to most all adult ICU types.
- Are the units closed? If other services can override the plan you discussed on rounds, then you're not getting a good experience.
- What is the composition of teams in each unit (all NPs, mostly interns, PGY 3 and 4s, etc)? Teams composed primarily of off-service interns and junior residents are no fun, as you are going to have to actually do everything. You're not going to be able to tell the FM intern to go start an art line while you have a family meeting.
- Are you expected to supervise or train non-physicians with unit procedures? This should not be your job, but in some places, it is, as the attendings are giving up on their actual responsibilities.
- Similarly, who gets dibs on procedures? If you really want to do something, or to train a med student or intern, will you get to do that 100% of the time, or are you expected to let the NP/PA do them when they ask?
- Is there built in non-clinical time to study or work on academic projects?
- Are rotations in echo, nutrition, ID, etc available and encouraged?
- What does the call schedule look like/how much time is spent in house at night? No overnights/weekends decreases education, as does Q4 24+ hour call.
Those are a few off the top of my head.
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To clarify, it does immensely matter if you are adequately trained. I think you’re trying to say it’s not sufficient to be adequately trained, you must also be able to prove that competence.@psychbender 's post above should be appreciated by applicants.
I am not an anesthesiologist -- although 50% of my clinical group at one hospital is made up of triple-boarded anesthesia/CCM/cardiac anesthesia.
That said, I would also refer current anesthesiology applicants to the thread by @chocomorsel called "discrimination against...".
If you want to work in a MICU or multi-disciplinary ICU run by a traditional pulm-CCM director after fellowship, I would make sure to ask at interviews how much MICU experience there will be...or, in what ways is the fellowship multi-disciplinary? How does this fellowship show the pulmCCM doc who will hire me after fellowship that I am adequately trained to handle not just SICU but MICU patients?
It doesn't matter if you are adequately trained...it only matters if the director who is going to hire you FEELS that you are adequately trained.
Oh yes, you are correct. Thank you for clarifying. I didn't communicate that thought very well.To clarify, it does immensely matter if you are adequately trained. I think you’re trying to say it’s not sufficient to be adequately trained, you must also be able to prove that competence.