Call schedule at UCSF? Golden weekends?

[swib]

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Anyone know if they have golden weekends at UCSF? I totally missed this at my interview and a search of these forums plus their website turned up nothing.
Thanks.

 

[IM2007]

From what I recall from my interview day, they do not get golden weekends R1 year. You get 1 day off per week, chosen at the beginning of that rotation block.

They didn't give us out a list of rotations, but from what I gather it's roughly 10.5 months call R1 year.

R2 and R3 are 6 months inpatient 6 months outpatient/electives.

What did you think of the program?

 

[vkrn]

Mother of God! That call schedule sounds scary. I didn't interview at UCSF because I'm doing a prelim year, but was disappointed that UCSF didn't have a prelim set-up. So I'm always curious to find what people think of UCSF.

The scuttlebutt: UCSF = malignant.

 

[IM2007]

The residents seemed to work hard, but certainly no harder than BWH, MGH, Stanford, or a many of the other schools. The residents at UCSF seemed very friendly, and according to their chief who handles residency hours they rarely have a violation because a dayfloat ensures you are out by noon on post call. To call it malignant would probably just be misinformed. As a prelim year, it would be tough. Over 3 years however, it seemed pretty average.

The thing I have noticed during the interview trail is that many places are the same with workload. A front loaded 70-80 hour work week intern year with btw 9-11 months inpatient, with some sort of float system (day or night) in place to manage work hours. IMHO, there are many awesome programs out there whose differences seem far fewer than their similarities.

 

[turkleton]

I did not apply to UCSF but wouldn't label it malignant based on their call schedule... maybe for a prelim who understandably would want a lighter pgy1 year. Most other high level academic programs, it seems from the interviews, are pretty standard in their q4 overnight call and try to get you out by noon post call day. I havn't seen much variation amongst the "good" training programs. At one NYC program they were pretty candid, said outright their program was front loaded and expected interns to work hard. So for comparison purposes, if you're interviewing at UCSF, chances are the other places where you're interviewing are probably similar in their rigorous intern year.

 

[swib]

Actually I am surprised to hear about this call schedule. It seemed to me that other top programs are structured differently and a big difference is that after an intense, frontloaded intern year, there is virtually no call during the R2/R3 years, maybe 3-4 months, at other programs. UCSF has 6 throughout BOTH R2/R3! Plus this is the first program I have heard of that doesn't have golden weekends--many programs have moved to this structure.

I'm not sure the 10.5 months figure is totally correct as I know that interns get at least one month of elective time and I believe 1 month vacation, and I thought there was an ambulatory month in there too. That said, 10 months of call is definitely not unusual among many programs. I've found that somewhere like 8-10 months call intern year is pretty much the norm.

Any UCSF interns/residents out there to confirm?

 

[IM2007]

Just to add a little, UCSF does 1 month ER each year at SGH, which they include in their 10 months or so of inpatient.

During R2 and R3 year, ER counts as one of those 6 months, as does 1 month day float, which is obviously not overnight. I personally would prefer golden weekends because you can get away, but either way you get 4 days off per month with or without goldens. If you look at http://www.brighamandwomens.org/residency/Medical/categoricalMedicine.aspx for example, towards the bottom, you can see that BWH also has 10 months inpatient R1, but as you said less during R2 and R3.

 

[swib]

Thanks, IM2007. Clearly you are more up to speed on the nuts and bolts of this program than I am! I did ask residents these questions but didn't jot down the answers and it's all blurring together at this point. Is it definitely 4 weeks vacation each year? I thought I remembered hearing that but can't find proof of that anywhere. Did you come across a fellowship match list anywhere?

 

[vkrn]

Another issue:

UCSF pays crap.

 

[swib]

Another issue:

UCSF pays crap.

It's not as bad as it looks. UCSF supplements their salary with a housing stipend that is not reported in their base salary figure, so UCSF residents actually make more than other UC residents. They're not rich, but it's not as bad as it looks.

 

[EastCoast]

correct me if i'm wrong...if there are no golden weekends, and you're on call 10.5 months during intern year---then doesn't ucsf have the same call schedule as hopkins? then why do i always hear so much worse stuff about hopkins' intern year than ucsf?

 

[med12]

clarifications from a resident at ucsf:
1) interns have 10 call months
2) interns have 3 weeks of vacation PLUS 10 days off between 2nd and third year plus 6 days off for xmas or new years (works out to be more than 5 weeks)
3) residents have four weeks of vacation plus 6 days off for xmas Or new years
4) there are no "golden weekends" in the traditional sense at ucsf. You do arrange your days off for the month with your team at the beginning of the month. We still have the same number of days off per month (4) as everyone else. If you really want a golden weekend, it is certainly possible to arrange that with your team prior to the month's start (i have done that a few times). Coming from an institution where golden weekends were the norm, I didn't think I would like UCSF's system initially. however, it has been great. You never know when you need a weekday to a)go to the doctor/dentist, b) take care of some personal stuff that can only happen on a weekday, or c) go for a bike ride across the golden gate bridge into marin when there aren't that many tourists. it's fantastic.
5) salaries - as the previous poster said, we get a $500/month housing stipend in addition to our base salary. So, all told, intern's salaries are around $46,000, resident's salaries are around $48,000, and R3's salaries approach $50,000.
6) this is a great place to be! if you like SF, I hope you come!

 

[swib]

clarifications from a resident at ucsf:
1) interns have 10 call months
2) interns have 3 weeks of vacation PLUS 10 days off between 2nd and third year plus 6 days off for xmas or new years (works out to be more than 5 weeks)
3) residents have four weeks of vacation plus 6 days off for xmas Or new years
4) there are no "golden weekends" in the traditional sense at ucsf. You do arrange your days off for the month with your team at the beginning of the month. We still have the same number of days off per month (4) as everyone else. If you really want a golden weekend, it is certainly possible to arrange that with your team prior to the month's start (i have done that a few times). Coming from an institution where golden weekends were the norm, I didn't think I would like UCSF's system initially. however, it has been great. You never know when you need a weekday to a)go to the doctor/dentist, b) take care of some personal stuff that can only happen on a weekday, or c) go for a bike ride across the golden gate bridge into marin when there aren't that many tourists. it's fantastic.
5) salaries - as the previous poster said, we get a $500/month housing stipend in addition to our base salary. So, all told, intern's salaries are around $46,000, resident's salaries are around $48,000, and R3's salaries approach $50,000.
6) this is a great place to be! if you like SF, I hope you come!

Thanks for your reply! So interns don't get an elective month (or is that factored into the 10 months of call)?

 

[med12]

Categorical interns definitely get an elective - that is one of the two remaining months (weekends off during elective, no call). The other month is outpatient ambulatory block.

 

[swib]

Thanks! But just to clarify, is vacation for interns included in that "10 months" figure you describe above? Because unless I'm missing something, 10 months call + 1 month elective + 1 month ambulatory + ~1 month vacation = 13 months?? I'm assuming that "month" refers to a 4 week block and not an actual calendar month.

Thanks for your help!

 

[med12]

it is confusing. basically, you get one week of vacation in each of the two non-call months, one week of vacation during your call months, and the 6 day holiday time vacation which could occur during a call or non-call month, depending on what you have during december. The extra 10 days comes at the end of your year.
hope that helps!

 

[reallyanon]

A couple of questions about UCSF that I was wondering about that maybe someone could answer:
-How has the EIP affected if at all the clinic schedule for interns+residents. Is there clinic on call days at UCSF?
-I have heard wildly varying stories about whether UCSF is a malignant medicine program. Many students from UCSF that I met on the interview trail seemed to think that UCSF was a tough place to train based on the personal interactions in the hospital and how the residents are treated. I didn't get this sense on the interview day. thoughts?
- How is the PD (Dr. Hollander). Again I've heard very different stories about how involved/supportive he is especially in regards to career development (making calls, using connections, etc).
thanks

 

[ucla2usc]

A couple of questions about UCSF that I was wondering about that maybe someone could answer:
-How has the EIP affected if at all the clinic schedule for interns+residents. Is there clinic on call days at UCSF?
-I have heard wildly varying stories about whether UCSF is a malignant medicine program. Many students from UCSF that I met on the interview trail seemed to think that UCSF was a tough place to train based on the personal interactions in the hospital and how the residents are treated. I didn't get this sense on the interview day. thoughts?
- How is the PD (Dr. Hollander). Again I've heard very different stories about how involved/supportive he is especially in regards to career development (making calls, using connections, etc).
thanks

1) They are trying to abolish on call clinics (already abolished post-call clinics). Instead we will do clinic 2x week on elective and outpt months

2) THis program is difficult but not malignant. They try hard to make it reasonable, and everyone is very nice to us. Nobody makes you feel bad for mistakes, and the culture is super supportive. Sure we work really hard, but no matter how difficult it is, we rarely work past 80 hours per week, and the float system gets you out post-call by 1pm. Many of our inpatient months are q6, which is really not bad at all. So it's reasonable. There is time for fun and social life, and most residents are happy people. We get 5 weeks of vacation, and they also set asside ski trips, retreats, dinners. The interns organize "intern happy hour" weekly. It's actually been alot of fun.


The "tough" factor may come from the variety and complexity of cases we see in the three hospitals, the difficulty of transition through the different hospitals and their unique hassles and scut load, and the expectation to do 110% for your patients. Of course this all will likely make you a more competent doctor. Our hospitals are set up like this: 1) one university based hospital w/ an open-icu...very complicated and sick pateints; 2) a superb- county hospital known for its dedication to the underserved; plus 20% of its patients have HIV, again very complicated; and 3) a VA that in addition to bread and butter serves as a tertiary care center for VA referrals from other VA's, again complicated patients.

The attendings tend to be outstanding teachers and many are graduates of our program. There is alot of autonomy in all hospitals, event the university hospital. This residency is tough but the doctors that come out of here are excellent. The teaching is outstanding, and every one is very very committed. Our residents as a whole are a dedicated and compassionate group to learn from, and that only makes you a stronger doctor. You also are learning from some of the brightest people in medicine in the country...residents include. The people matching here are "Derm caliber," but acutally are dedicated enough to endure this hellish residency because they want to be a great doctor and maybe make a difference. My co-residents are genuine good people and I'm proud to work with them. In my opinion, the most important factor in your training will be working w/ great residents as these people will be your number one influence and they will spend the most time teaching you.

3) Can't say much about Dr. Hollander's involvement in getting us fellowship since I haven't applied yet, but undoubtedly everyone gets whatever fellowship they want, and most end up where they want to go. Most everyone matches at top academic programs even in the most competetive fields (Cards/GI). We also have quite a few people turn out to choose general internal medicine or to be teaching hospitalists because our program takes pride in core internal medicine.

The program has undergone many innovations in improving education including things like "intern half day" where we turn in our pagers and get dedicated intern level and practical teaching one half-day per month. We have "Areas of distinction" which is essential a major in residency, so you can get specialized training things like medical education, international health, clincial research, and underserved medicine. Noon conference is well attended and the food is excellent (and no drug companies cator our meals either). Morning report is always well attended and our chiefs are all amazing teachers.

Sure, day to day, I gripe about my workload. It's super stressful. But when I look up at the R3's and see that nearly all of them are amazing physicians and amazing people, I know it will be worth it, coming from this place there is no doubt I will be a great doctor.

 

[koch'spostulate]

thanks, that was really helpful. couple of more questions?

how accessible are the faculty in terms of taking on residents for research (and supporting them from their grants)?

apart from getting residents fellowships, how is Dr. Hollander as a PD? Does he support and go to bat for residents in other aspects? He seemed nice, but I didn't get a chance to ask more about him.

i was really impressed with the UCSF residents. Morning report there blew away all institutions I saw on the trail, including east coast counterparts...

1) They are trying to abolish on call clinics (already abolished post-call clinics). Instead we will do clinic 2x week on elective and outpt months

2) THis program is difficult but not malignant. They try hard to make it reasonable, and everyone is very nice to us. Nobody makes you feel bad for mistakes, and the culture is super supportive. Sure we work really hard, but no matter how difficult it is, we rarely work past 80 hours per week, and the float system gets you out post-call by 1pm. Many of our inpatient months are q6, which is really not bad at all. So it's reasonable. There is time for fun and social life, and most residents are happy people. We get 5 weeks of vacation, and they also set asside ski trips, retreats, dinners. The interns organize "intern happy hour" weekly. It's actually been alot of fun.


The "tough" factor may come from the variety and complexity of cases we see in the three hospitals, the difficulty of transition through the different hospitals and their unique hassles and scut load, and the expectation to do 110% for your patients. Of course this all will likely make you a more competent doctor. Our hospitals are set up like this: 1) one university based hospital w/ an open-icu...very complicated and sick pateints; 2) a superb- county hospital known for its dedication to the underserved; plus 20% of its patients have HIV, again very complicated; and 3) a VA that in addition to bread and butter serves as a tertiary care center for VA referrals from other VA's, again complicated patients.

The attendings tend to be outstanding teachers and many are graduates of our program. There is alot of autonomy in all hospitals, event the university hospital. This residency is tough but the doctors that come out of here are excellent. The teaching is outstanding, and every one is very very committed. Our residents as a whole are a dedicated and compassionate group to learn from, and that only makes you a stronger doctor. You also are learning from some of the brightest people in medicine in the country...residents include. The people matching here are "Derm caliber," but acutally are dedicated enough to endure this hellish residency because they want to be a great doctor and maybe make a difference. My co-residents are genuine good people and I'm proud to work with them. In my opinion, the most important factor in your training will be working w/ great residents as these people will be your number one influence and they will spend the most time teaching you.

3) Can't say much about Dr. Hollander's involvement in getting us fellowship since I haven't applied yet, but undoubtedly everyone gets whatever fellowship they want, and most end up where they want to go. Most everyone matches at top academic programs even in the most competetive fields (Cards/GI). We also have quite a few people turn out to choose general internal medicine or to be teaching hospitalists because our program takes pride in core internal medicine.

The program has undergone many innovations in improving education including things like "intern half day" where we turn in our pagers and get dedicated intern level and practical teaching one half-day per month. We have "Areas of distinction" which is essential a major in residency, so you can get specialized training things like medical education, international health, clincial research, and underserved medicine. Noon conference is well attended and the food is excellent (and no drug companies cator our meals either). Morning report is always well attended and our chiefs are all amazing teachers.

Sure, day to day, I gripe about my workload. It's super stressful. But when I look up at the R3's and see that nearly all of them are amazing physicians and amazing people, I know it will be worth it, coming from this place there is no doubt I will be a great doctor.

 

[grit]

Thank you to the UCSF interns/residents who have posted on this thread! Your input as "insiders" is definitely appreciated. I was wondering if there was a fellowship match list available somewhere online. They didn't hand them out at my interview, and I couldn't find one posted on the UCSF website. Any way to get my hands on one?

 

[ucla2usc]

thanks, that was really helpful. couple of more questions?

how accessible are the faculty in terms of taking on residents for research (and supporting them from their grants)?

apart from getting residents fellowships, how is Dr. Hollander as a PD? Does he support and go to bat for residents in other aspects? He seemed nice, but I didn't get a chance to ask more about him.

i was really impressed with the UCSF residents. Morning report there blew away all institutions I saw on the trail, including east coast counterparts...

--First off, last year UCSF IM was the #1 NIH funded IM Department in the Country...there is a hell of alot of research to go around. As far as getting residents involved they have to two "Areas of Distinction" that is designed to hep us get us do research: One of our "Areas of Distinction" is called PRIME and it is intended to help residents learn how to do clinical research, there is didactic teaching, mentoring, and time during R2-3 to build your own project. Many residents get a funded project off the ground from IRB to publication. Another pathway is molecular medicine and it most people in that do basic science research and many have PhD's. The culture of UCSF is warm, and faculty welcome interest...so I don't think it's too hard to find a project.


--I'm not sure what you mean by Dr. Hollander "going to bat for us." We swing a big stick on our own. If you go to a place like UCSF/MGH/BWH/JHU you will match in whatever speciality you want including Cards/GI. Last year 4/4 matched Cards: MGH/Columbia/UCSF/BU. 4/4 GI: all stayed at UCSF. In the past few years, Cards people have matched at Hopkins/Penn/Cleveland CLinic/Cedars Sinai (a top Cards program) and Stanford. I think the reason our residents get good placement has less to do w/ who makes phone calls and more to do w/ the quality of our graduates. You will be wanted if you complete this program.

 

[reallyanon]

Is the open ICU a big deal when you're an intern or does it not have much of an effect. It's just different from everywhere else I've looked and to be honest after doing two unit months in my fourth year of medical school I can't imagine having a bunch of patients in the unit AND a whole bunch of floor patients?

My second question which my be a little bit hard to answer, but do any BWH or UCSF interns/residents or applicants have any insight on why someone might rank one over the other and whether residents are generally happier at one vs. another. I really like both programs it just seems like Brigham is a little more friendly and supportive and UCSF is a little bit more hardcore, harder call, maybe more autonomy. also, it seems like the financial constraints of being a UC might have a negative impact on resident quality of life and education. not trying to knock either program as they are obviously both amazing just looking for some insight.

 

[ucla2usc]

Is the open ICU a big deal when you're an intern or does it not have much of an effect. It's just different from everywhere else I've looked and to be honest after doing two unit months in my fourth year of medical school I can't imagine having a bunch of patients in the unit AND a whole bunch of floor patients?

My second question which my be a little bit hard to answer, but do any BWH or UCSF interns/residents or applicants have any insight on why someone might rank one over the other and whether residents are generally happier at one vs. another. I really like both programs it just seems like Brigham is a little more friendly and supportive and UCSF is a little bit more hardcore, harder call, maybe more autonomy. also, it seems like the financial constraints of being a UC might have a negative impact on resident quality of life and education. not trying to knock either program as they are obviously both amazing just looking for some insight.

I think having an open ICU has it's +/- as one would expect. We have the ability to follow patients from beginning to end and that's a +; meanwhile sometimes if we have a lot of patients we can be spread too thin. But, we are a 3 hospital system, and open ICU is only one of the hospitals, so 2/3's of the time it's the traditional system. I'm glad to expereince in one of the hospitals, and it's the one where we have the sickest patients, so following them throughout their course is a real bonus.

As far as BWH vs. UCSF...I chose UCSF over BWH for a lot of reasons. I think our 3 hospital system is definitely adventagious over BWH. I also think we are not "fellow driven" at all, and definetly the workload and thinking is carried out by the residents. I also think UCSF is influenced by being in liberal San Francisco, so there is layed back atmosphere and we are very community service minded. ON the other hand, The BWH is very impressive, the faculty there are unparalleled and I think the residents seem the happiest of the top programs. But, I really wanted to get the best training available in 3 years and I felt UCSF had more to offer because of the 3 hospital system. Also, it's worth considering living in California in the winter is an advantage of it's own, and frankly I really believe there is no better place in the country to spend a few years in than california.

 

[IM2007]

Do the residents seem happy at UCSF?

You mentioned that the attendings at Brigham are unparalleled, how are the attendings at UCSF?

Also, I heard that with the open ICU, you don't get to put the lines in the patients you follow in the ICU. I think I remember hearing there is a separate service that does that. Do you feel you get good procedural experience?

Diversity is also really important to me, so I think I am going to rank them #1 regardless, but just wanted to check.

Thanks!

 

[indiamacbean]

I remember from my interview team that they have a seperate team run by gas that does vents/lines/sedation in the Moffit ICU but I could be wrong.

 

[ucla2usc]

Do the residents seem happy at UCSF?

You mentioned that the attendings at Brigham are unparalleled, how are the attendings at UCSF?

Also, I heard that with the open ICU, you don't get to put the lines in the patients you follow in the ICU. I think I remember hearing there is a separate service that does that. Do you feel you get good procedural experience?

Diversity is also really important to me, so I think I am going to rank them #1 regardless, but just wanted to check.

Thanks!

1) Yes, the residents sem happy here...see my above post from this thread.

2) The attendings at UCSF depend on the service...if you are on a subspeciality service you are likely going to have an attending that is considered a leader their field, and most have been outstanding teachers and role models. I was very impressed w/ my Cardiology attendings. If you are on general medicine at SFGH you may get world renown infectious dz or HIV specialist. At the VA we have the authors of "Current Medical Disgnosis and Treatment" such as Lawrence Terney who is also outstanding. In general our VA attendings get the reputation as some of our best teachers. It's also way laid back there and there a ton autonomy. At Moffitt, you tend to get younger hospitalists that are fun and very down to earth. So it's hard to group all attendings. I just remember at BWH during lunch they brought out their "all-star" attendings...well I don't think we have quite as many "all-star" people. Maybe we do, it's just not as obvious. We certainly don't parade them out to applicants...that's not UCSF's style...the program's culture is far too humble for that.

3) When we are at Moffitt w/ the open-ICU we don't put in lines on our patients unless we ask to do it. We also don't manage the vents. Thank god we don't, it would be impossible to to manage ICU patients and floor patients if we had to do the vents and lines for the ICU patients as well.On the other hand, when you are a resident at MOffitt doing your ICU rotation...all you do is manage vents and lines and codes...so you make up for not doing that during your general medicine month at Moffitt.

We do have "closed ICU's" at the VA and SFGH and manage everything in those places. Don't forget the "open ICU" is only 1/3 of your hospitals...not the whole residency.


4) Thus far ( a little past half way internship) I have done a dozen or so central lines (IJ's, Subclavian's, and Fem's). I have done a bunch of a-lines. I also have done about 15 thoracentesis/paracentesis's combined. I can do and have done thoracentesis's and fem lines unsuprivised.This seems like much more than the residents did at my home institution which is run out of county hospital and has a reputation for a "hands on" experience.

 

[IM2007]

ucla2usc, thank you so much for your replies. They have been very helpful. One thing they didn't give us on interview day was a sample yearly schedule. What is the breakdown (service, location, call) of the 10 months of required inpatient medicine?

Thanks again!

 

[GoodbyeTemecula]

Sorry non-IM person here and do not believe my med school rotation used a golden system so could someone tell me what a "golden weekend" or a golden-anything is? THnx

 

[reallyanon]

A question either for UCSF people or applicants. what's the deal with electronic medical record for the three hospitals? electronic order entry?

 

[bcsfiend]

A question either for UCSF people or applicants. what's the deal with electronic medical record for the three hospitals? electronic order entry?

My understanding is:

At Moffitt-Long: There is no electronic order entry. Vital signs, progress notes, H&Ps, procedure notes are electronic. Medication records and orders are not. ICU vital signs are also still at the bedside, not electronic.

At SFGH: Almost nothing is electronic, except for ordering discharge medications.

At VA: It's your typical VA.

 

[GooglieGoo]

Do you guys really believe that the better the program, the harder the call schedule needs to be? How much do you people learn after being up for 24 hours? Is seeing one more patient per call day really that great?

 

[indiamacbean]

Hey med 12 I PM'd you a question about UCSF. thanks.