Input on MGH4Children Peds residency?

[mdphd2b]

Their website is not the best in the world...Can anyone compare/contrast it to other academic-friendly programs?

Thanx!

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[ChildNeuro]

I have read on another post that MGH children is not as good as (obviously) Boston Children's hospital, and it actually shadowed by it. There are some pediatric programs that are the "only show in town", i.e. not a huge city like Boston and get all of the interesting referrals.

 

[mdphd2b]

There are some pediatric programs that are the "only show in town", i.e. not a huge city like Boston and get all of the interesting referrals.

Yup, that would be Pittsburgh

 

[mdphd2b]

So, I have my interview at MGH for children in Jan, and I would like to revisit this thread. The website leaves me with many unanswered questions. I believe the Peds program is fairly young (only "a decade old"), and it seems from all the satellite sites in the community, the program would be more suited for Med-Peds or primary care rather than subspecialty training (I'm interested in GI). Are all subspecialties represented? What about transplant? Is fast-tracking an option that's been utilized?

Can anyone comment on the MGH experience? How is the call schedule at each site, and more importantly how much time/blocks are spent per year at each location? (My impression is that MGH only has 2 peds floors, but I could be wrong.) Does the program seem well integrated or very disjointed? Do the residents get to interact with each other often, or do they hardly know each other?

Also, is there call-free elective time for international rotations? Is funding available for this?

Hopefully someone can comment more on this program 😳

Thanx!

 

[mytirf]

I did a rotation at MGH as a student and did really like it. There are two floors, divided by age and the residents see a large amount of general pediatrics. There are 2-3 pediatric surgeons and residents do spend one month on pediatric surgery. There is one cardiac surgeon who does do pediatric cases and two neurosurgeons who do have interest in pediatric cases. There is a new 8 - 10 bed PICU and I think a 20 or so bed NICU. The community sites are mostly ER and triage experiences, though I'm fairly sure that at two of the sites, there are small in-patient wards.

The downsides are as follows (in my opinion).
The ER is very, very small, really only 4-5 rooms inside of the huge adult ER. Unfortunately the pedi-ED docs are not well respected by the other services and that can be frustrating. I think all of the subspecialties are represented, except for rheumatology. There is exposure to oncology, some cardiology, and some GI, but not a large number of admissions for any one specialty. Now this can also be an advantage, because there really is a great deal of bread/butter pediatrics and more independence as residents.

So I think if you are looking for a more primary care or typical pediatric experience in a large academic hospital, I think it is a great place.

-MT

 

[mdphd2b]

So I think if you are looking for a more primary care or typical pediatric experience in a large academic hospital, I think it is a great place.
-MT

Yeah, I understand it's surprsingly small compared to the number of residents. I get the impression it would be ideal for med-peds or primary care. I guess I'll learn more in Jan. That's too bad about the ED though.


Having lived in Beantown for 6yr, it would be nice to go back 🙂

 

[mdphd2b]

So, I have my interview at MGH for children in Jan, and I would like to revisit this thread. The website leaves me with many unanswered questions. I believe the Peds program is fairly young (only "a decade old"), and it seems from all the satellite sites in the community, the program would be more suited for Med-Peds or primary care rather than subspecialty training (I'm interested in GI). Are all subspecialties represented? What about transplant? Is fast-tracking an option that's been utilized?

Can anyone comment on the MGH experience? How is the call schedule at each site, and more importantly how much time/blocks are spent per year at each location? (My impression is that MGH only has 2 peds floors, but I could be wrong.) Does the program seem well integrated or very disjointed? Do the residents get to interact with each other often, or do they hardly know each other?

Also, is there call-free elective time for international rotations? Is funding available for this?

Hopefully someone can comment more on this program 😳

Thanx!

So, OK back to my OP--any residents out there from MGH? If so, please comment on your experience, especially at the community hospitals, or PM me if you prefer...

Thanx 🙂

 

[drbetty]

bump

 

[umass rower]

Anecdotally, people from my medical school who have gone to MGH have given very positive feedback about the program. I interview there in January, and I'll be asking people I know there what they think beforehand.

 

[drbetty]

any further thoughts?

 

[umass rower]

Are all subspecialties represented? What about transplant? Is fast-tracking an option that's been utilized?

Can anyone comment on the MGH experience? How is the call schedule at each site, and more importantly how much time/blocks are spent per year at each location? (My impression is that MGH only has 2 peds floors, but I could be wrong.) Does the program seem well integrated or very disjointed? Do the residents get to interact with each other often, or do they hardly know each other?

Also, is there call-free elective time for international rotations? Is funding available for this?

Since the thread has been bumped, presumably people still have questions about these and other issues. I don't have my notes with me, but I'll do my best from memory. I believe that every subspecialty is represented, although there are only fellowships in Pulm, Critical Care, Endocrine, and GI (although GI appears to be absent from their website). They have a very good track record for matching people into specialties. MGH does indeed have two Peds floors, each with 20-something beds. There's also a brand new, beautiful NICU.

As I recall, call schedules are q4, and on inpatient units at least, there is a special schedule for your call day (don't have to show up until like 11 am). From my understanding, you spend on average 2-3 months per year at one of the outlying hospitals, with each one having a different atmosphere, level of responsibility, and workload. The residents seem very friendly, and definitely interact quite a lot.

There are call free elective months, although I don't remember exactly how many. There seems to be very strong support for doing work abroad, and I know that there are some well-established relationships with several different countries for doing medical work.

I was happy with my interview day. I think concerns that it is "overshadowed" by Children's are unfounded, because the two are completely different kinds of institutions. Children's is very much a quaternary center, fellow-oriented and awash in fascinomas. MGH is more on the primary->tertiary spectrum, and resident-oriented.

 

[drbetty]

As I recall, call schedules are q4, and on inpatient units at least, there is a special schedule for your call day (don't have to show up until like 11 am).

There are call free elective months, although I don't remember exactly how many.

Hi Rower, thanks for sharing your thoughts about MGH. Re: call schedule, I saw this on the other thread:

• PL-1: call-free Newborn nursery month

• PL-2 and 3: 6 wks call-free elective

5-6wks of backup call each year

I agree that are q4 except for the pediatric surgery month during intern year during which they are q3 (following surgery resident call schedule). I like that call days start at 11am (admit after2pm) to prevent work-hour violoations, but I can't remember which rotations employ that schedule.

I agree that the NICU is beautiful - it is the only hospital that I have visited with private rooms for each patient. I can't remember how much time is spent there versus the NICU rotation at Brigham. For what it's worth, I have heard that the Brigham NICU is the "hardest" MGH rotation, while it is a relatively "easy" BCRP rotation.

Any thoughts about the ED experience at MGH? I also thought it was interesting that they do not have a continuity clinic month like most programs, but in reading past posts, they seem to get plenty of primary care experience in general.

 

[antihero94]

Since the thread has been bumped, presumably people still have questions about these and other issues. I don't have my notes with me, but I'll do my best from memory. I believe that every subspecialty is represented, although there are only fellowships in Pulm, Critical Care, Endocrine, and GI (although GI appears to be absent from their website). They have a very good track record for matching people into specialties. MGH does indeed have two Peds floors, each with 20-something beds. There's also a brand new, beautiful NICU.

As I recall, call schedules are q4, and on inpatient units at least, there is a special schedule for your call day (don't have to show up until like 11 am). From my understanding, you spend on average 2-3 months per year at one of the outlying hospitals, with each one having a different atmosphere, level of responsibility, and workload. The residents seem very friendly, and definitely interact quite a lot.

There are call free elective months, although I don't remember exactly how many. There seems to be very strong support for doing work abroad, and I know that there are some well-established relationships with several different countries for doing medical work.

I was happy with my interview day. I think concerns that it is "overshadowed" by Children's are unfounded, because the two are completely different kinds of institutions. Children's is very much a quaternary center, fellow-oriented and awash in fascinomas. MGH is more on the primary->tertiary spectrum, and resident-oriented.

Just wanted to start by saying that I LOVED MGH and ranked it second. But ended up at the BCRP (Children's Boston).

Just wanted to quell the ideas stated above that we are a "quaternary center, fellow-oriented and awash in fascinomas".

First, children's see's everything from Primary to quarternary care. Our primary care center (the CHPCC) is one of the largest (if not the largest) primary care center in the state. You will get plenty of time there. Second you will see plenty of bread-and-butter pediatrics. We don't screen kids who show up at our ED and say they can only come if they have Menkes Kinky Hair Disease. We certainly see our fair share of asthma, gastro, cellulitis. On the flip side you will get to take care of Menkes Kinky Hair Disease (no lie) as a resident. So you get the full spectrum.

Second, we are not a fellow run program. I recall one insident where a fellow was verbally reprimanded in front of the whole team by their attending for placing a simple order. Residents do all orders. They formulate plans. I think of the fellow's as "junior attendings" who are usually extremely interested in their field and willing to teach. Another point is that programs with fellows vary greatly by fellow quality, and we have some of the best fellows.

Finally, the BCRP is both Children's and Boston Medical Center. So even if you want a more urban care experience you will get plenty of time at BMC caring for sickle cell, etc. But just like saying Children's is a "fascinoma" institute saying BMC only does "nuts and blots" of pediatrics is a lie. I took care a girl with (altered some facts to hide her identity) with steroid dependent nephrotic syndrome, sickle cell who developed (what was likely) steroid induced psychosis.

I guess what I am saying is find the program that fits you best! And don't trust programs reputations as "fellow-driven" or only dealing with the esoteric, or "community based" or even "non-academic."

 

[umass rower]

Just wanted to start by saying that I LOVED MGH and ranked it second. But ended up at the BCRP (Children's Boston).

Just wanted to quell the ideas stated above that we are a "quaternary center, fellow-oriented and awash in fascinomas".

First, children's see's everything from Primary to quarternary care. Our primary care center (the CHPCC) is one of the largest (if not the largest) primary care center in the state. You will get plenty of time there. Second you will see plenty of bread-and-butter pediatrics. We don't screen kids who show up at our ED and say they can only come if they have Menkes Kinky Hair Disease. We certainly see our fair share of asthma, gastro, cellulitis. On the flip side you will get to take care of Menkes Kinky Hair Disease (no lie) as a resident. So you get the full spectrum.

Second, we are not a fellow run program. I recall one insident where a fellow was verbally reprimanded in front of the whole team by their attending for placing a simple order. Residents do all orders. They formulate plans. I think of the fellow's as "junior attendings" who are usually extremely interested in their field and willing to teach. Another point is that programs with fellows vary greatly by fellow quality, and we have some of the best fellows.

Finally, the BCRP is both Children's and Boston Medical Center. So even if you want a more urban care experience you will get plenty of time at BMC caring for sickle cell, etc. But just like saying Children's is a "fascinoma" institute saying BMC only does "nuts and blots" of pediatrics is a lie. I took care a girl with (altered some facts to hide her identity) with steroid dependent nephrotic syndrome, sickle cell who developed (what was likely) steroid induced psychosis.

I guess what I am saying is find the program that fits you best! And don't trust programs reputations as "fellow-driven" or only dealing with the esoteric, or "community based" or even "non-academic."

I was mostly going by what people I know at Children's have said about the program. Different people are likely to perceive the same program differently, but the phrase "cog in a machine" has come up independently from several different residents there (although, to be fair, I'm pretty sure they went for the BMC side of things more so than the CHB). I also work with one fellowship director right now (I'm doing research there at the moment), and his opinion is that while fellowship experiences there are second-to-none, he finds that residents are often more sheltered and less independent than those coming from other programs.

Like I said, though, a lot of it comes down to opinion and preference. It probably wouldn't have been the best place for me, which made me feel better about not getting an interview there.

 

[antihero94]

I was mostly going by what people I know at Children's have said about the program. Different people are likely to perceive the same program differently, but the phrase "cog in a machine" has come up independently from several different residents there (although, to be fair, I'm pretty sure they went for the BMC side of things more so than the CHB). I also work with one fellowship director right now (I'm doing research there at the moment), and his opinion is that while fellowship experiences there are second-to-none, he finds that residents are often more sheltered and less independent than those coming from other programs.

Like I said, though, a lot of it comes down to opinion and preference. It probably wouldn't have been the best place for me, which made me feel better about not getting an interview there.

Well in most programs residents are doing the finances of the hospital (the CFO), administering the medications (RN), taking care of all the social issues (social workers), doing physical therapy (self explanatory) etc. In that sense all residents could all be described as "cogs in a machine." We have an incredible amount of autonomy at the BCRP and unless you are talking to someone who is training there (and not some HMS student or part time attending) you wouldn't know that. Don't buy the rumors perpetuated by people outside of the institution!

The reality is that you need to find a program that is right for you. But, you will get a second to none training at the BCRP. Our residents are well prepared for any post-training experience from primary care to the fellowship of their choice. Take a look around academic pediatrics, or pick up any textbook, the journal Pediatrics, etc. and you will see.

 

[umass rower]

unless you are talking to someone who is training there (and not some HMS student or part time attending) you wouldn't know that. Don't buy the rumors perpetuated by people outside of the institution!

But that's exactly what I said. I talked to three different residents that I know personally, at Children's right now, and I'm reporting what they said. Plus, the attending who reported this is not a junior attending, he's a fellowship director. I'm not just pulling comments out of my ass, here. You're perfectly free to have a different opinion, I'm just going by what I heard from people I trust.

 

[tovah66]

As a former HMS student who has spent a lot of time at both CHB and MGH4C and who has good friends that are residents at both programs, here is my take on the differences between the programs. It is not that one program is necessarily better than the other, but both are dramatically different in design and administrative structure.

MGH offers its junior residents with a lot of supervisory time. MGH is a resident-centered place that encourages and rewards good teaching at every level. MGH4C seems to be understanding that its residents are people and willing to make accomodations for residents who are pregnant or who have other unexpected events and need to take leave from the program (illness, death of loved ones, etc). Perhaps because it's a smaller program every attending seems to know each and every resident well and the program administration seems personally invested in the career path and personal growth.

From a structural standpoint, MGH4C has truly family-centered rounds. During the months I spent on the general wards at CHB, I hardly saw any children, since we rounded in a conference room every day.

All that being said, there are incredible and caring residents at both programs. My friends who went to CHB have at times felt like "a cog in the machine" but at other times they have felt like they are at the greatest hospital on earth. My friends who went to MGH4C seem happy and fulfilled.

 

[tovah66]

PS: The structure of pediatric practices and satellite hospitals in the Boston area is that some refer/admit to CHB and some to MGH. Both hospitals see the unusual and the usual cases in pediatrics.

 

[CTWhale]

Hey guys,
I'm not gonna rehash all of the arguments made above, because certainly people are entitled to their own opinion. I just want to make one point, which is that you will not find a program more flexible in terms of accomodating family crises, pregnancy, illness, or other emergencies than BCRP. There are more people doing part-time residencies here than any other place in the country (there was a recent Newsweek article about this), and about a dozen current residents that I know of have had babies during residency. Having a larger program allows you to have a full-time sick call pool, which means that if you have a family emergency or you get sick the chief resident's only response is "let me know how much time you need."
Certainly it's a challenging program (btw for all of you med students, residency is hard anywhere!) with strengths and weaknesses versus other places, but personally I am really happy there. I would encourage anyone seriously considering it to get info from people with first-hand knowledge of the program whenever possible, rather than friends of friends of friends.
Good luck!