IM residency with most procedures

[jgl1980]

I was just wondering how to find out what IM residencies let the IM residents do most of the procedures. Things such as Central lines, intubations, thoracocentesis, stress tests maybe even a colonoscopy (that one might not happen anywhere). Does any one know of a places like this or what to look for while researching residency programs.

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[Tigerz_Fan]

Hmmmm...dare I ask are you interested in critical care??

I can't think of any one source to find out that information. While researching the programs you may be interested in, it is always easy to ask....

 

[jdh71]

I was just wondering how to find out what IM residencies let the IM residents do most of the procedures. Things such as Central lines, intubations, thoracocentesis, stress tests maybe even a colonoscopy (that one might not happen anywhere). Does any one know of a places like this or what to look for while researching residency programs.

This is very program specific and there is no central clearing house of information regarding this . . .

In general, any program that has three "things" will get you a lot of procedures

1. A county hospital

2. A VA hospital

3. ICU heavy program

While on general medicine floor months County and VA hospitals will give you more procedures generally because the patient population tends to not show up until they are really sick, and really sick people need lines, or they've been ignoring their SOB and and coughing up blood, and are now at the ED only because they can't breath 2* to a hugh pleural effusion

Obviously ICU months are where most residents will get most of their procedures if they are aggressive - you can't let the surgeons and gas-trolls snake your procedures. If there is a fellow, get familiar with them (I'm not talking about kissing ass), but if they know you are interested in procedures and they feel comfortable with you they, they may be more likely to not only chief your procedures but let you know when there are procedures.

Be willing to stay late - I'm signed off on my LPs largely because no one wanted to stay late to do them, for isstance

 

[drfunktacular]

UTSW pride themselves on being very procedure-heavy. For instance, the interns all observed that they were signed off on all their required procedures within the first 6 months of internship.

 

[jgl1980]

thank you for the helpful replies and the one not so helpful reply (i.e. tigerz_fan)!! The reason I asked was to see if someone else has asked!! But to the others thank you. I will never understand why someone would take the time to be a jerk on a message board. By the way tigerz let everyone know what program you are at or going to so we will know to avoid it.

 

[Reddpoint]

thank you for the helpful replies and the one not so helpful reply (i.e. tigerz_fan)!! The reason I asked was to see if someone else has asked!! But to the others thank you. I will never understand why someone would take the time to be a jerk on a message board. By the way tigerz let everyone know what program you are at or going to so we will know to avoid it.

???? Im not sure that tiger fan was trying to be rude.

Another way to look for procedure heavy places would be to consider the patient volume and the autonomy offered to residents. In general avoid "cush" programs were you might have wealthy patients.

IM in general is not very procedure heavy unless you do a fellowship in cards/pulm/CC or GI. The procedures you do during residency are not really that exciting and Im sure you will get enough experience doing them at any residency. I would probably not let procedure exposure be the highest priority in your residency search.

 

[Tigerz_Fan]

thank you for the helpful replies and the one not so helpful reply (i.e. tigerz_fan)!! The reason I asked was to see if someone else has asked!! But to the others thank you. I will never understand why someone would take the time to be a jerk on a message board. By the way tigerz let everyone know what program you are at or going to so we will know to avoid it.

Wow. Grow up. I was trying to be helpful. You had asked a very broad question, therefore, I asked about critical care because to know your interests (cards/GI/CCM/etc) helps us to guide you. Obviously, each program is unique.

I would suggest that you try to avoid attacking people (unprovoked) on these message boards. Program directors, attendings, your future senior residents, and your future fellows all use this message board. And you have provided enough information on past posts that your identity is not so secret.

 

[Tigerz_Fan]

???? Im not sure that tiger fan was trying to be rude.

.

Thank you!

 

[dragonfly99]

I agree that how "procedure heavy" a place is should probably not be at the top of your list of things you look for in an IM program. Not that it shouldn't be on your list, but there are a lot of programs where you could do plenty of central lines and LP's, if that is your thing. I don't personally know of any IM programs that let house staff do colonoscopies, althought there are fp programs that still do. Colonoscopies are generally done by GI fellows, GI attendings and general surgical residents (the latter are apparently required to do these as part of their training...which seems weird to me).

I agree with the comments above that you should look at programs that have more ICU months if you like procedures. Also, county hospitals and VA's do tend to have more procedures. Don't pick a cushy community hospital with lots of rich, "private" patients b/c the attendings are not gonna let you touch them.

Internal med isn't really a very procedure-heavy specialty, though. I do think it would help us to know what subspecialties you are interest in, and/or maybe you just want to go into private practice and want to be "ready" from that standpoint.

 

[jgl1980]

tiger fanz,

I guess I read into your post a little to much. I am not to big of a man to admit when I am wrong therefor I apologize.
I am not one to attack someone and not sure what got into me. Anyways thank you for the info

 

[Tigerz_Fan]

tiger fanz,

I guess I read into your post a little to much. I am not to big of a man to admit when I am wrong therefor I apologize.
I am not one to attack someone and not sure what got into me. Anyways thank you for the info

Fair enough. We all have those days......

Most IM people that I have met who are really interested in procedures are also interested in critical care. If that is the case for you, definitely go to a program that is heavy with ICU, and also has a pulm/CCM or CCM fellowship. If you are interested in CCM, PM me and I can give you a little more info on programs.

I agree with Dragonfly, that I have not ever seen a program that allows residents to do colonoscopies, or bronchs for that matter. Those ususally are done by fellows (except in anesthesia and surgery).

 

[jgl1980]

Right now I am not sure about at fellowship I have batted around a few ideas but now I am back to being not sure. I know I will end up in a smaller place and don't want to be the guy that always has to call the general surgeon every time I need something done like put in a central line, operate a vent ect... just those small boring things nothing like heart stents or appendectomies. The reason I brought up the colonoscopy is because I came across a hospital that the IM guy did all of the colonoscopies. I never had the chance to ask him how he did it.