I can comment on this. It was actually not about work hour issues. There were 2 interns who left this last year, which is a relative rarity. For the most part, people are very happy with hopkins. The malignant Hopkins is truly a thing of the past (basically since the first hour rules went into place).
The first intern realized he actually didn't want to do internal medicine. He was between ortho and medicine when he chose to do his residency and chose medicine. He realized he wanted to do ortho and actually reapplied and matched to ortho during the year. The program was very accomodating and changed his schedule around to allow him to interview and pulled some strings to get him into the program he wanted. He left in great standing, he just didn't want to do internal medicine.
The second intern quite frankly had an abnormally hard time adjusting to intern year.This person apparently took multiple days off to cope with internship and a coverage resident had to be called in. It seems it was a mutual decision. The program was integral in finding this person another residency (basically this intern didn't even have to do the match). Now I worked with the first intern and I didn't ever work with this second intern personally so a lot of my info is coming second hand since this intern ended up leaving at the halfway point in the year.
Osler medicine at Johns Hopkins is W I T H O U T question T H E medicine residency to train at in this nation for a certain type of medical student. I'll continue by saying it is not for everyone, nor should it be. Applicants need to find their fit.
Here's the Osler fit as I've experienced it: This program creates leaders, largely because it selects those people who want to be in charge, want to be given responsibility, and from the earliest stages truly want to be the doctor making many of the care decisions. As an Osler intern you are the doctor patients and family will communicate through. And during overnight call you are in charge of your firm (aka service) including 30+/- usually sick as stink patients. When you are overnight, you will be the one signing off a chest pain EKG saying "Yup, that's a STEMI. Nurse, page the cath lab." or "Yup, that's an NSTEMI. Nurse, hang the heparin gtt, ASA, BB if needed, NTG, MSO4 to taste." or "Yup, that's Hyper-K. Nurse IV Ca, insulin, albuterol, telemetry, lactulose (Please don't give Kayexalate. Only orthopaedic surgeons give Kayexalate. It's expensive and no better than lactulose)."
Sound terrifying to you?? Then please don't apply to Hopkins. You'll be miserable. You'll die. Apply to Northwestern. You'll still come out exceptionally competent, but my fellow residents there don't see patients as interns without supervision. Or if you want something in between, U of Mich is a nice hybrid, or so I hear.
No other program in the country will train you like Hopkins does. It's unique. It's heritage. It's tradition. It's a family that will change you for the better and into something greater than yourself. People scoff at that, stroke at that, but it's the truth. And it's something that you will never fully appreciate until you roam these halls at night in that blasted short coat for another year. When you finish training here, you'll come out with the brains of Einstein and the balls of Patton, because you will know exactly what you are talking about. Every complex bleeding cirrhotic, every cold-clammy volume overloaded LVEF 10% cocaine user, every neutropenic fever s/p bone marrow transplantee you may see in your future career, you will feel rockstar-confident in dealing with. You'll tell that OSH attending, "Sure, transfer your acute leukemic. From what you've told me I already know it's TTP and hematology will be waiting with the plasmapharesis catheter at the door. And for the love of god, please stop transfusing platelets."
Frankly a name change from Johns Hopkins to Johns Honeybadgers would be completely acceptable. They get the job done and are trained to do it well. Osler interns do more central lines I think than SARs/ICU fellows at many programs. At UPMC, you need to call the MICU attending if you want to place a central line. At Hopkins, you are trusted to know when it's indicated and how to do it because through the Procedure rotation, senior residents, and some of the brightest co-interns you will meet, they will train you and well. There are few if any programs out there where an intern will ask/trust another intern to perform a clinically-indicated LP...on them.
Sanjay Desai is only in year two of his directorship, but he has in my mind managed to maintain the Osler way of training without any concern greater than how the housestaff are doing, how regulations are being met, and where people want to end up down the round (which is oftentimes Hopkins since having Hopkins medicine housestaff as a fellow means a significantly easier year for that fellow). Sanjay is responsive, savvy, and always looking to improve the training and patient care. If an intern thinks they're wasting time on a task that could be done better, he wants to hear about it, he will work on it, he will find funding for it, and it will very likely get changed. Honeybadger Program Director and approachable. He truly wants to hear how things are going when he asks you "What's up?" I mean, the man just owned a Tough Mudder. For example, on that course I caught up to him at a very tall, slippery half-pipe, only to have him turn to me, flat out sloppy-mud-covered hug me, say "It's damn good to see you!," then return his attention to a friend who had given up on that obstacle: "THERE IS NO WAY YOU ARE WALKING AROUND THIS THING!!! GET YOUR BUTT BACK TO THAT RUNNING LINE! YOU WILL RUN, JUMP, AND SUCCEED HERE!! NOW!!"
Hopkins is truly an incredible place. In the Osler program, the training, the co-interns, the tradition, the leadership are a cut above for sure, and more likely several cuts above the rest.
I have little bias, but if you ever see an orthopaedic surgery resident titrating dilt and IVF on a hypotensive aflutter patient with diastolic dysfunction in the ED or convincing an ED attending that a liver cirrhotic is at baseline, does not need an IM admission, and most of all, does not need another un-indicated paracentesis irrespective of how much their family-member nurse manager demands it "because that other hospital was going to admit him for more belly taps," well, there's a slight chance that bro might have got some training in the Osler program.
i'm curious too.
awesome. If you're ever in Texas I'll buy you a beer.
