Columbia ancillary services?

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newenglandgal07

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does anybody have a insider's point of view on the nursing, phlebotomy, etc at columbia? The residents there didn't really make a big deal about it. For me, that's really the only thing that makes this program less attractive. I love the patient population, and New York.

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seriously?? does it really matter...it's an IVY league program in a nice area of NYC....i'd draw labs all day long if i could have a chance to go there.....
 
Yeah, I think it can totally matter...

My impression was that the ancillary staff is better than at NYU, but obviously not as good as at Cornell.
 
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I was going to say...the bad ancillary staff is one of the reasons I decided not to rank Columbia. That and just a generally unhappy vibe I got on my interview day...but you never really know about vibes.
 
Hi Im a columbia resident and can give u the skinny. ancillary services isnt horrible, but it isnt the best. For me personally, I feel that there has been constant improvement and even in the short time ive been there ive seen big changes in it getting better. some services are excellent, and some nursing services are great - so,me services arent so good (takes at least 24 hours to get an MRI) and some nurses arent so good. blood cultures can be done by regular phlebotomy which is a huge boon especially ont he onc floor where every temp needs a cx. On the flip side, most stat labs need to be drawn by the intern (then again, if its REALLY stat, shouldnt you be drawing it anyway???). My take on it is that lab drawing is something you do as an intern, you get good at it, and its a back pocket trick you have so that some day if ur a hospitalist, or someone needs a tough stick, you can use it. As a resident (R2 or 3) you will likely never again draw that needle. ABGs notably on the floor are all intern, but in units can be drawn by respiratory. In terms of other services, transport isnt great, but except going to the units, ive never transported someone (and then again, there are medical students to give you a hand right =). Really, I know that these small things seem important when you are applying, as it was to me, but when you are so knee deep in taking care of the twenty unit level people on the columbia floors, getting some of the roughest training out there (maybe only superceded by hopkins - those guys work hard too) it'll hit you - its an amazing training environment, with brilliant people, great attendings (the two attending system really is that good), great patient population, great fellowship matching, great location. Decide what's important for yourself, but a few lab draws isnt that bad, and who knows - maybe it will make you a better doctor someday anyway!
 
I think the quality of ancillary services is an important issue. Not just in terms of scutwork for interns and residents as seems to be the common concern, but poor ancillary care leads to poor patient care and for me that is the major issue.

I don't go to Columbia, but I do have personal experience with their hospital in terms of a family member who was treated there about 5 years ago. Our experience with ancillary services (nursing, patient transport, phelebotomy) were by and large absolutely horrible. When we approached the primary physician about the problems he basically acknowledged that this was a known problem and the best way to handle it would be to hire a private nurse (to at least deal with the nursing issues) who would be allowed into the hospital to help care for our family member. This may be a suitable solution for some well-off patients, but by and large most patients probably won't be able to afford such a luxury.

In any event, when I started applying to IM this season, I thought that Columbia would be high on my rank list given its reputation, location etc. However, during my interview there at least half a dozen residents brought up the fact that ancillary services were a major weakness of the program. The striking thing was that I never asked about ancillary services, all of these comments were totally unsolicited and voluntarily admitted. Even the program director indirectly acknowledged the poor quality of ancillary services by saying that the residents at Columbia had to learn a certain amount of savviness in learning how to successfully navigate their patients through the health care system and services at Columbia. It sounded like he was basically trying to mask the weakness and cast it instead as a "learning opportunity".

Given that my personal experience was a long time ago, I was surprised to learn that ancillary services was still an unresolved issue at Columbia. I see that people at this forum are now saying that things have gotten better in recent years, but my interview experience suggests that things are still pretty bad. And I think that this reflects really poorly on Columbia. If so many people at the institution know about this weakness, why have stronger measures not been taken to correct the problem. There may not be an ideal solution given the high cost of health care delivery in New York City, but based on my past and recent experiences I think that little has been done to correct the ancillary services issue. I find it quite appauling to think that patients continue to suffer due to poor ancillary care at Columbia and personally I don't want to sign up to go to an institution that places such little importance on improving its quality of care.
 
Based on my interview experience, it seemed that the ancillary staff in NYC in general was not ideal. At Columbia, Cornell, and NYU, I thought that the ancillary staff was all pretty much equally weak. Even Cornell residents, despite the patient population/location, talked about how frequently they had to draw blood and put in IVs. My feeling from the interview trail was that if you decide to train in NY you should be prepared to do a bit of scut work. I think for people coming from a place like Northwestern or other schools with phenomenal ancillary staff, it's probably a whole new experience to train in NY. I'm curious to see what other peoples' opinion on this is.
 
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