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Brown Affiliated Residency Program based at Rhode Island Hospital

Discussion in 'Anesthesiology' started by MedEdGasDoc, Aug 16, 2017.

  1. MedEdGasDoc

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    I want to introduce a (hopefully) soon-to-be approved ACGME Anesthesia residency program based at Rhode Island Hospital and affiliated with the Warren Alpert Medical School of Brown University. During out recent site visit, we received permission to start the "advertisement" process and are planning to interview during this upcoming match cycle. Our program will be based out of Rhode Island Hospital, a busy level 1 trauma center. Case complexity and diversity are a highlight of our department. Residents will also spend time at our community hospital affiliates. Obstetrics is not currently performed at our primary sites, thus that training will be obtained at a Boston teaching hospital. Though we have not formally had our own training program, our faculty have been training anesthesia residents from Boston area hospitals for several decades - many of them subsequently joining our staff after training. I am happy to answer your questions about our program and will update you about the progress of our approval in the coming weeks.
     
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  3. nimbus

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    Good luck on your enterprise but is there really a need for another anesthesia program in the northeast? Are the existing programs not producing enough graduates to meet the projected needs? The ONLY reason to start another program is if there is a projected shortage of anesthesiologists.
     
    #2 nimbus, Aug 16, 2017
    Last edited: Aug 16, 2017
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  4. repititionition

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    Genuine questions: what would you say the programs strengths will be, and why should an applicant take a chance on your program in its first year?
     
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  5. Bru

    Bru
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    About time! I grew up in the south coast area and always wondered why Brown never had an anesthesia residency when I was looking for programs.

    Having said that, having to go to Boston for OB would give me pause.
     
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  6. Hoya11

    Hoya11 Senior Member
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    I rotated through RIH (years ago) as a resident at one of the boston programs. I did enjoy many aspects of my time there but saw lots of areas for improvement. I would think you would be talking about a class of 4-6 residents. Commuting to Boston for OB (a very important part of residency) is brutal. Commuting to providence from Boston was horrendous. Very early mornings every day for a month. Few early days because even when relieved early (which did happen occasionally) you have the 1.5hr drive ahead of you. And no one wants to stay in a random apartment when there home base is in the other city. To me I viewed it as slightly better than being incarcerated.

    That said, I do think you would probably fill with decent residents should you attain ACGME accreditation. Good bunch of docs overall and good cases. Not just some easy community hospital. The Brown name and the good location (near a cool city and in the heart of new england) will also help.

    As time goes on, I would work on a relationship with a closer community hospital and have the new Brown residents go there for OB. Those docs wont turn down the free labor
     
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  7. Temeraire

    Temeraire ASA Member
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    Why can't you get OB experience at Women & Infants Hospital next door to RIH? Were they actually bought out by the Brigham?
     
  8. MedEdGasDoc

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    Extremely valid and fair question - something I expect I'll be asked frequently. I certainly understand the trepidation in taking a chance on an infant program, but I also think there's a huge amount of benefit via de novo development. In full disclosure, I am one of the staff that rotated here as a resident and decided to join based on my experience. First, we currently do not and do not plan on relying on residents to fully staff our operating rooms (i.e. there are many months currently when we do not have any residents rotating with us). This lack of reliance on residents will allow prioritization of resident education - you will not need to be simply a warm body in a room. Along the same lines, you will not need to "compete" for cases. Our pediatric program is a prime example - large volume, high acuity, good variety (save for pedi hearts). Second, we are not beholden to the "traditions" of a program that has been around for decades. The residency admin has an intense interest in educational program development and we will work hard to continually tweak our curriculum and rotations based on real-time feedback. Third, we have a great core of young staff who have varied clinical/research interests and really love to teach. While I can't promise of a hiccup-free program initiation, I can assure you that the program will be resident-centric and responsive.

    To address the concerns regarding OB. We realize it's a potential drawback and are working hard to address it. The short answer is that the OB anesthesia experience will eventually be home-based but it will be a bit before that happens. Rhode Island Hospital is currently seeking the ability to add obstetrics services (you can read more via a google search for "Lifespan" and "obstetrics"). For now, we will need to have our residents complete their OB training in Boston (3 months). Understanding the commuting inconvenience, housing will be provided. To answer "why not W&I's?" - the short answer is politics in addition to our focus on resident educational experience.
     
  9. FFP

    FFP Grunt, cog, body, pompous ass
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    You say you're staff (meaning faculty?) there. Who's your employer, who pays your salary? Is it Brown University, the hospital, or a private group? Because that tells more to the future candidate than all the BS promises.
     
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  10. MedEdGasDoc

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    My employer (who pays my salary) is Lifespan Physician Group, a multi-specialty group that is physician-led and physician-governed and provides care at the Lifespan affiliated hospitals. The anesthesia group was formally private practice (Providence Anesthesia Associates) and joined the hospital group within the last decade. My colleagues and I have academic appointments at the Warren Alpert Medical School of Brown University. Have a lovely day..
     
  11. skypilot

    skypilot 2K Member
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    Lifespan includes the Miriam Hospital in Providence which is a large community hospital, Newport Hospital which is a small community hospital with a low volume of Obstetrics, Rhode Island Hospital which has one of the busiest Level 1 trauma centers on the East Coast, and Hasbro Children's Hospital in Providence. Ironically, as was mentioned above, it does not include Women and Infants Hospital, even though it is located on the same campus as Rhode Island Hospital and Hasbro, and is connected by a tunnel to the other hospitals!
     
  12. omn

    omn
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    Hmm, ... "ironic" ... some of us here went to business school.
    Smart business plan? Strategic? Sounds interesting, put me on your short list? Private message me at your convenience, I am an older graduate with business experience with alot to contribute to a new programs. (and quantitative background, not strategy, but that of course is strategy consulting)
     
  13. anbuitachi

    anbuitachi ASA Member
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    It can save the hospital a lot of money to have an anesthesiology residency. We'd have to hire many more attendings/CRNAs if we didn't have 100 anes residents
     
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  14. FFP

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    Bingo! And that's the motivation behind this newfound academic interest. Brown University, my behind. This is a PP group looking for cheap workforce. For great anesthesiology education, please look elsewhere.
     
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  15. MedEdGasDoc

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    Interesting you have so much insight into the program without any knowledge. I'm fairly certain I was clear that we are not a private practice group. Further, the number of spots that we requested will not fulfill any workforce needs that you reference. We WILL be a location for great anesthesiology education.
     
    #14 MedEdGasDoc, Aug 18, 2017
    Last edited: Aug 18, 2017
  16. FFP

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    The country is full of anesthesia providers but we need more anesthesiology residencies, especially in the crappy Northeastern market, right? Sure, it's all about "great anesthesiology education".
     
    #15 FFP, Aug 18, 2017
    Last edited: Aug 18, 2017
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  17. skypilot

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    I am sure there is some truth to this. But Brown has every residency but Anesthesia, plus a medical school. Maybe a better question is why wasn't this program established 20 years ago? And as I said before Rhode Island Hospital has one of the busiest Trauma Centers on the east coast, Renal Transplant, Neurosurgery, a Children's hospital etc. It probably won't be a bad environment to learn Anesthesia.
     
  18. anbuitachi

    anbuitachi ASA Member
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    How many residents are you accepting? Are you paying for the taxi rides to boston for OB? Why opening residency now of all times? Will attendings be covering residents 1:1 all 3 years of residency and during nights/weekend call?
     
  19. Arch Guillotti

    Arch Guillotti Senior Member
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    Does this happen anywhere?
     
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  20. IlDestriero

    IlDestriero Ether Man
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    Navy.


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  21. IlDestriero

    IlDestriero Ether Man
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    Good luck with the new program. You'll need it.
    Texas Tech El Paso tried to revive their residency program a few years ago and it ended disastrously with the group being taken over by an AMC. It might be worth reaching out to them to try to avoid some of the problems that they had. They seemed to be in good shape, new leadership, poached some experienced faculty, research plans, etc., etc. I'm not sure what happened there.


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  22. anes121508

    anes121508 ASA Member
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    Pm me I think we might know each other
     
  23. anes121508

    anes121508 ASA Member
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    Hey guys been on the site for a while. Let me start by saying that I'm a baseline skeptic. I used many of you guys to guide me through my job choice and navigate amc/pp/academic.

    I'm all for questioning the true intentions of anesthesia programs that pop up. This actually applies all the way down to medical schools opening up. I'm not an expert but to me it appears that it's possible for places to profit off of young hopeful people that are hardworking and just need a chance. Plenty of places out there take advantage of these type of folks.

    That being said....I do not believe this is the case with brown. Full disclosure: I KNOW THE OP PERSONALLY. He was my chief resident. And I believe that he is a fantastic person. He could have had many different jobs, but this dude went to brown for several very good reasons and one of them is because he believes in educating young people. Now I realize that there are likely to be shortcomings in a new residency program. But let me tell you something, THIS DUDE GIVES A SHI". If you go there as a resident he will look out for you, he will teach you, he will mentor you. NOT MANY PROGRAMS CAN SAY THAT. THIS DUDE CARES MORE ABOUT EDUCATING RESIDENTS THAN MONEY. I know this because he told me so prior to taking this job. And you know what, I feel guilty because I know that I'd like working in an academic environment more than pp, but I wasn't willing to make the sacrifice that he did. Enough vouching for him because I think you get the point. He isn't in it for the money or to trick stupid young people into joining his program so they can be a warm body on a stool while he chills in the lounge. He will challenge you , look out for you, teach you, and have your back. Thats a hell of a lot more than what can be said for many PD or assistant PD out there.

    Onto the next point...:there is a dude there named Steve Panaro. He is one of the best teachers and biggest resident advocates I've ever met. He takes on the majority of the resident teaching. You would be lucky to learn and work for him. I won't go any further on this point, but I learned just as much from him as I did during my two months of thoracic during fellowship at Bwh (a very high volume thoracic center with people who wrote text books in thoracic surgery and thoracic anesthesia).

    Next point...there is a dude there named Andy Maslow. Google him. I'll just go ahead and say it: HE IS A BAD ASS. Look up some of the articles he has written for jcva. Ever hear of SAM risk factors? Ever read his two part special on tee for mitral valve surgery in Jcva that I think he solo authored? I'd give up a week of vacation to go shadow the guy. He will give you a better education than any resident in the city of Boston receives.

    Now that's only a couple of people that work there and I realize that it takes more than a few good attendings... they have hired some pretty strong people that I guarantee if you are a normal dude/gal you will love working with them. They are decently trained as well...u mich for Icu and Virginia mason for regional...and they LIKE TEACHING AND WILL LOOK OUT FOR RESIDENTS.

    I've rambled enough but I think you all get the lint. The place is fine on its own and doesn't need a residency. They have people that want to teach. They have GOOD PEOPLE THAT CARE!!. Should you rank brown over mgh? Next year?...probably not,m. But I guarantee you that it'll be a better experience than 75% of the shi''y places out there that eat use residents and have lazy old attendings that don't care. And I won't be surprised if in 10 years they match better than the current "top tier" programs out there.

    I won't deny that going offsite for three months of OB is a pain in he a"" and I hope these guys create an all under one roof experience. Every program out here has its flaws. At least find a place where people care to teach you and make you better.

    -Brian
     
  24. anes121508

    anes121508 ASA Member
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    Pardon the language , misspellings , and the rambling....but I feel like these guys are getting killed on this thread and they are the furthest thing from "just another workhorse place"
     
  25. anes121508

    anes121508 ASA Member
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    Also, I hope those of you that interview there grill them on the shortcomings of the program. They won't lie. They will likely try to make it better if they aren't already working in it.
     
  26. FFP

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    Glad to hear that. Still, there is no need another program, especially in the Northeast.
     
  27. anes121508

    anes121508 ASA Member
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    You have a point. However I would argue that there is a need for better programs. Programs that are truly invested in educating our residents. The guys/gals at brown are a great example
    Of the type of people we need leading the way.
     
  28. anbuitachi

    anbuitachi ASA Member
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    Crna will take over anyway and I don't think their training is that great
     
  29. dchz

    dchz Avoiding the Dunning-Kruger
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    As a guy who's interested in cardiac, the things i would do to sit in the same room as Maslow and pick his brains...
     
  30. CECC110

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    I'm just an M3 at this point (class of 19), and I have limited knowledge of what the exact details/implications of a "soon-to-be approved ACGME" program are, but would this program be in play for me during next year's match?
     
  31. Temeraire

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    I was wondering how long it would take to mention Steve in this thread. He was my favorite attending as a med student. His intraop teachings were phenomenal, and he was so facile with fiberoptic intubations that people joked about him being on the difficult airway algorithm. I wish he could transfer to my residency program and harass some more knowledge into me.
     
  32. rakotomazoto

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    Cedars.
     
  33. MedEdGasDoc

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    It is with great excitement that I inform you that the Brown/Rhode Island Hospital Anesthesiology residency program was officially approved by the ACGME yesterday at the Anesthesiology RRC meeting. We are in the process of registering for ERAS and NRMP. We will also have our website "go live" within the next several days. We will be interviewing for both advanced (CA1 starting July 2018) and categorical/advanced (CA1 starting July 2019) during this application cycle. Our current plan is to start interviewing in November.
     
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  34. parcus

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    Hello, are you considering FMGs for your program?
     
  35. MedEdGasDoc

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    Yes, we will be considering FMG's for our program.
     
  36. ToKingdomCome

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    Will a Brown Anesthesia residency website be up soonish?
     
  37. MedEdGasDoc

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    Yes - hopefully within the week. There has been some unanticipated "red tape" in terms of getting it published. In the interim, if you have any specific questions, feel free to contact me.
     
  38. skankhunt42

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    Brand new residency! You'll have some star residents for sure! WIll kinda be like the Bad News Bears- only with more substance abuse! TROLLLLLL!!!!
     
  39. physicianado

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    Hi, thank you for sharing all the info. Will you be accepting DO students in the upcoming cycle? If yes, would you be able to share how many residency spots you intend to fill in total, and out of that how many DO students you intend to take (this is if there is form of a minimum quota on DOs and FMGs)?
     
  40. Dr.Jekyll75

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    I am also interested on how DO friendly this program will be
     
  41. MedEdGasDoc

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    Hello physicianado and Dr.Jekyll75 - We accept and review applications from MD, DO and foreign applicants. This past cycle, we interviewed many applicants from each of those cohorts. We have no "quotas" that we use in terms of ranking of these applicants and instead rank based on merit of the application and fit with our program (based on personal interview). We have DO residents in each of the two classes which we matched during this past application/match cycle. We do highly encourage DO applicants to submit USMLE scores. I hope that helps!
     
  42. Dr.Jekyll75

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    Something I have not see asked so far, how many spots are advance vs categorical . Lastly what you target/cut offs for boards


    Sent from my iPhone using SDN mobile
     
  43. MedEdGasDoc

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    Currently all of our spots are advanced. We are negotiating with the hospital and IM residency program to secure preliminary positions for all of our spots, but that is not yet finalized. We perform a holistic review of the application and do not have a clear "cutoff" in terms of board scores (i.e. if your board scores are weak, make up for it somewhere else in your application).
     
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  44. Twiggidy

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    Just came across this thread. More power to Brown/RIH for their ability to open a residency program and I hope they do a good job, but the point does still remain. More anesthesiology residency programs is probably the last thing our field needs. We continue to saturate a field that is oversaturated.

    And we wonder why our salaries continue to drop.......

    Anyway, I understand politics, but get that OB issue worked out. It'll make the program more attractive, although 3 mos in Boston may be a selling point to some.


    Edit: What I'm getting at is that if a new program opens another "bad" program should be forced to close.
     
    #43 Twiggidy, May 9, 2018
    Last edited: May 9, 2018
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