brigham and womens

[dennis]

Dear Friends, I know that this is a tertiary hospital. i was wondering if you know if the residents do any procedures at all. Eg

How many CVCs , Swans, Artlines , taps would a reisent typically do.
Do the fellows do all the management and procedures.

Thanks a lot.
May

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[Henle]

if you don't get any answers I would recommend contacting a resident on call in the unit. they might give you a quick and accurate answer rather than faculty.
very good question of yours - especially if you want to become hospitalist or subspecialize you will realize that some programs offer shockingly few procedures in IM. IM graduates often are only glorified secretaries who cannot even place difficult peripheral venous lines. another tip: once you are in a program in IM consider doing an elective in anesthesiology.
good luck

 

[AJM]

Even though it's a tertiary hospital, the IM residents at BWH do a good number of procedures.

They do all their own CVC's, taps, LPs, etc. I don't have exact numbers, but by the time residents reach their 3rd year, they feel comfortable supervising/doing any of the main procedures that come their way. With the exeption of the oncology service, the fellows play a pretty secondary role, and are not the ones making the primary management decisions. This is most evident in the MICU, where up until a month ago, there were no critical care fellows in the Brigham MICU, and it is the medicine senior and intern who run the unit. There is a fellow now, but the fellow plays more of a supportive role, and is there solely for backup and teaching (and they are not in-house at night). The IM senior is still expected to be in charge of the MICU. There are also other critical care units where there still are no fellows, such as at the Faulkner MICU, which is an affiliated community hospital the residents rotate at. The Brigham is building a second MICU right now, so there will be even more critical care experience for the residents starting next year, and therefore more procedures.

 

[irlandesa]

Based on my observations working at Faulkner with the BWH residents; I fully agree with AJM. The senior residents are essentially in complete control of the FICU, do all their own procedures, and they are fantastic at teaching the interns how to place A-lines, central lines, Swans. Faulkner is a little on the slower side, so I mostly got to watch with the exception of learning how to place an A-line and ABG's (which are a breeze after you do a couple), but I'm sure that procedural opportunities abound at BWH as AJM said.