Best IM programs, in terms of real learning

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GassiusClay

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Hey to all,

Everybody talks about programs that are ranked high in newspapers, magazines, etc.

What about programs that are conducive to good resident health? So better hours, less scutting, and better call schedules are important, not secondary goals. This means more time to read up on stuff than just chug out paperwork for admin to get more billing. One particular thing that I think most people like is night float. Any good programs in the Midwest have this?

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Mayo definitely
Scripps in San Diego
? Brigham
 
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"Best IM programs, in terms of real learning"

Depends on what you want to learn. Residencies at a large academic, county, or big city general hospitals will offer different experiences than that of residencies at community, suburban/regional, or clinic (smaller enrollment) hospitals. Warzone versus country club; research powerhouse or clinical care? Where do you want to fellow and/or attend after residency? Then there's you to consider, and how would you fit into their residency program?
 
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Any good programs in the Midwest have this?

If you are limiting the question specifically to the Midwest then Mayo cannot be beat in this regard. The PD's particular area of research is Quality of Education & Resident Satisfaction and is well published on the topic. There are numerous teaching labs (cadavers, mannequins, simulated patients, real patients:rolleyes:, etc). The physical exam workshops utilize patients with real pathologic findings. The call schedule on wards averages out to Q6. Lunch provided daily, on-call meal stipend, and one of the highest salaries on the interview trail.

Mayo definitely has its quirks though, and is not for everyone...
 
Any good programs in the Midwest have this?

On top of BlackNDecker's reccomendation of Mayo, I think it is also worth considering Wash U., UTSW and Michigan, especially if you are interested in research or academic medicine. Subspecialty fellowship matches from these programs also compare very favorably. Also noteworthy is Alabama and Iowa.

Most programs nowadays have a nightfloat system to comply with ACGME requirements while keeping hospitals to capacity.

I think you have to be careful what you are asking for. There are many circumstances where you suffer through inferior ancillary services (and hence more scut) with the tradeoff of having increased autonomy and incredible patient diversity. Many municipal hospitals (like Bellevue(NYU), Parkland(UTSW), etc.) and training programs located in inner city locations (like JHU) provide an amazing level of autonomy. Although you may not see it now, but it's a real rush being the doctor in charge and having first crack at procedures. The same can be said for programs affiliated with VA medical centers. Although ancillary services usually have much to be desired, the vets are a special breed of patients (tough as nails, tolerant of being poked around by trainees, multiple illnesses and very appreciative) whose disease profiles are becoming the bread and butter of community medical practice (diabetes, coronary artery disease, obesity/metabolic disorder, mental illness, COPD, GI bleed, HIV, etc.).

Housestaff happiness seem to change from year to year, and many residencies are continuously tweaking their training programs to comply with ACGME requirements while balancing learning experiences with quality of life. The best thing to do is apply broadly and talk directly with the residents (also go out of your way to find working residents and not just those who show up to volunteer for interview days. you want to avoid cheerleaders but talk with the average schmo to get the pulse of the place). Just remember, the most vocal people tend to be either complainers or cheerleaders. Try hard to get a fair and balanced opinion.

Good luck!
 
I already did my intern year at a BIG academic place for IM. I liked parts of it, but also some was a little bit too much for me such as the ICU. Maybe it was being a fresh intern. Plus, no night float.

I basically want a program with good hours. I realize that more time away from the hospital gives me a chance to not to have my brain drained and allows for some reflection/reading. I don't know how some of you do it after repeatedly long days.

I am open to community university affiliates. I heard evanston hospital (not supposedly northwestern anymore) is really good. However, I really did like my time on GI so then comes the problem of picking a decent med residency that could get me into GI or at least has favorable match rates.
 
I already did my intern year at a BIG academic place for IM. I liked parts of it, but also some was a little bit too much for me such as the ICU. Maybe it was being a fresh intern. Plus, no night float.

I basically want a program with good hours. I realize that more time away from the hospital gives me a chance to not to have my brain drained and allows for some reflection/reading. I don't know how some of you do it after repeatedly long days.

I am open to community university affiliates. I heard evanston hospital (not supposedly northwestern anymore) is really good. However, I really did like my time on GI so then comes the problem of picking a decent med residency that could get me into GI or at least has favorable match rates.
Ah, there's the rub. First, are you signed up for a transitional year (in which case it is pretty late in the game to be looking for a 2nd year position) or are you a categorical resident? I hope it is the latter. If so, program directors and chiefs do NOT take kindly to people wanting to transfer out once the academic year is about to begin (they will have to fill a capable warm body in a pinch). Depending upon whether they want to be sticklers about it, they may not allow you to be eligible to start another program if you violate your contract.

Also, if you want to apply for fellowship, the application process starts in only a few months. It is precious little time to garner resources, especially if you plan on switching programs. GI, as you already know, is a competitive fellowship and usually fairly hard work. If you are not prepared to perform in a demanding residency, I don't know whether you'll want to be in a demanding fellowship.

If you plan on switching (which is administratively a nightmare at this point), be prepared to delay fellowship applications for a year and take an additional year after residency to do research. You may also want to seriously rethink your subspecialty goals for something less demanding and without a lot of call (for example, there are very few ID emergencies that require you to come in at night).

Overall, I think you should try to hang in there. You might find that you will enjoy your residency much more after internship is under your belt. The R2 and R3 years tend to be a lot more fun (less scut and more thinking). Also, being at a big academic place has its advantages when applying for fellowships. Chin up!:hardy:
 
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I'm a transitional year intern. I only had 1 month of surgery which I would be willing to make up. I know it's late in the year so I will honor my first chosen specialty which you can guess from my screenname. I don't plan to mess up the program at this point. I wish I didn't ever feel the way I do now. I wish I just purely hated IM and would be glad that I would never see it again after intern year like some of those lazy folks. However, the first year left me with a different feeling. I don't know if it's a naive part of me or just actually liking what I've been doing. Medicine did not go well as a student, but now, I finally make decisions rather than just write up some 6 page H&P.

So I'm left with only one option at this point. I'll start my specialty and judge for myself. I can only wish that everything turns out right. Alternatively, I will be looking for a PGY-2 or some midway PGY-1 position sometime during the coming year. I guess for some life just isn't simple.

If anybody out there left a specialty late in the game and came back to IM, please contact me. I appreciate any ideas or perspectives that could help me analyze myself over the coming months. Words from IM graduates who switched would be even better.
 
I heard University of Tijuana is great for learning. Where else would you be able to take care of a prostitute and a donkey at the same time? Of course, you need at least a 120 on step 1, so it's fairly competitive.
 
I heard University of Tijuana is great for learning. Where else would you be able to take care of a prostitute and a donkey at the same time? Of course, you need at least a 120 on step 1, so it's fairly competitive.

:laugh::laugh::laugh::laugh::laugh:
 
i think you might like northwestern. i didn't apply there. but check out this thread from a couple of years ago.
 
Hey to all,

Everybody talks about programs that are ranked high in newspapers, magazines, etc.

What about programs that are conducive to good resident health? So better hours, less scutting, and better call schedules are important, not secondary goals. This means more time to read up on stuff than just chug out paperwork for admin to get more billing. One particular thing that I think most people like is night float. Any good programs in the Midwest have this?

Texas A&M Scott and White - no overnight call ever (except an ICU month at the VA [if I remember correctly, "something" is overnight at the vah]). Nice number of in-house fellowships in everyone's favorites, GI and Cards.
 
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