Recent trainee at UH for prelim intern year here...
Overall I think it is a very solid program.
Pros-
1)3 months of elective time, which is great. I interviewed at TY programs with less elective time than that. Elective time = amazing, no weekends, and the program gives you tons of flexibility. For example, I was able to use elective time to study for Step 3, do lots of research, ect. The scheduling for electives is extremely independent. Basically you control what you rotate on, and you just email the coordinators letting them know what you are up to.
(For 2 weeks of elective time you are on jeoprady and can get called in to cover for other interns who are out sick, but usually you don't get called in more than 3-4 times over 2 weeks and you still get the weekends off). I can't reiterate how great this elective time is...
2)Friendly people and really nice cointerns. A definite strength of the program are the people who you interact with on a daily basis. Obviously every class will be different but I found my cointerns to be awesome (every class has 1-2 weirdos but that is to be expected). The attendings are mostly great. I would say 85% of the attendings I worked with were wonderful, 10% were fine, and 5% were a little difficult. I only have an n size of 1, but those are pretty good odds of having a nice attending. The environment is academic but not malignant at all. Greatly appreciated that aspect of the program.
3)Cool hospital, lots of research opportunities, chance to rotate with some pretty big names in internal medicine. Best way to learn is to learn from some of the best.
4) Competitive pay. The salary was relatively high when I went through, especially for Cleveland. Residents lived well. Many of us lived in really nice buildings downtown or cool townhouses in Tremont, Ohio city, ect.
5) Rotating at the VA. Most prelims end up at the VA for at least several months of wards and this is a blessing. VA has it's quirks but also big advantages, including, lower patient cap (8 patients at VA, at the main campus it is 10), dedicated social workers who do tons of paperwork you would normally have to do...and the VA patients are for the most part great.
6) Autonomy. You will have lot's of it. It is a pro if that is your style. You will be put into position to make a lot of really difficult medical decisions.
Cons-
1) You work very hard. I know this seems to go against my biggest pro of the program...You get great elective time but expect to work hard when you are on wards. The year definitely can be a grind. The hospital is extremely busy from Oct-March/april, often nearly full. Services are busy. Most people spent a good portion of the time capped or nearly capped with regards to patient load. Don't expect this to be a cakewalk transitional year, you will be managing very complicated and very ill patients.
2) Lack of ancillary support staff at UH- lot's of patient's not a lot of social workers...meaning you have to wear a lot of hats as an intern in order to avoid sinking on busy rotations
3) Call system. This could go either way, probably up to personal preference. You are on a 4 day cycle. Long, Medium, Short, Happy.
-Long days are from 7am (signout time) until 9pm. You are open to admit 3 new patients on a long day, you can get new patients until 7pm. They protect you by saying you can only get 2 new patients after 5pm, and only 1 after 6pm. In theory if you are efficient you can sign out at 7pm to night float and leave if your work is done.
-Medium call, 2 new patients until 4pm, you stay and sign out at 7pm
-Short call, open for 2 overnight admissions (already admitted patients assigned to you in the morning), no new patients, until 1pm. You can leave once your work is done, usually by 2-3pm.
-Happy call, no new patients. Sign out after your work and notes are done (and after conference...sigh). Usuallly can be done by 1pm.
Sorry this is getting long....but the call system is great if you are efficient and lucky, you can sometimes get out before 11am on short and happy days if your seniors aren't sticklers for conference attendance. On the flipside, you can also get crushed on long and medium days if you are slow or get overly complex and really ill patients. There are people in my class who stayed until 11pm or later numerous times....
So its all about efficiency. I rarely had to stay late and would get out @ 7pm on medium days like 99% of the time, and 7pm on long days like 65-70% of the time. Staying super late sucks. Getting out at 11am is amazing and makes you forget about it....may the odds be ever in your favor.
4) Conferences. 1 hour at lunch every day. Tues/Thur mornings interns have an additional conference for 1 hour. They reallly divide up the day and hurt work flow when you are busy. It fluctuates but usually they are pretty adament about conference attendance.
So in summmary, if you are a fast/efficient person who does well with autonomy and decision making, I think it is a very goood prelim program. Expect to work really hard, enjoy your time off, and you will learn a ton on the job. If you like structure and predictability, choose a different place.
