Overall: This impressed me as a program very dedicated to teaching, incredibly responsive to residents, with a great PD. Has been ranked as the #1 site by UCLA students for IM for at least 3-5 years in a running (this struck me as a very big +). Focus here is on education and clinical training; basic research possible as well although perhaps not THE strongest area of the program. For me, the day provided confirmation of the general impression - on these boards, in any case - that the program is just all around nice, friendly and a very benign place (though NOT NOT cush by any stretch of the imagination) to train.
PD: Dr. Wali spoke to us for about 30-45 minutes at the beginning of the day. She gave a very nice, non-rehearsed and comprehensive speech that actually answered nearly every single question I had about the program. It was actually somewhat eerie. From what I gained by hearing her speak and talking with the residents, she is terrific - incredibly dedicated to resident education, very responsive, really working genuinely to address any grievances with the program. She also has an impressive background:
http://www.uclasfvp.org/management.htm . As you can see from the rest of the site, the whole "management team" is well credentialed with lots of recognition/awards for clinical teaching.
Residents: We ate lunch with the residents (no pre-interview day dinner) and I was interviewed by a resident. By the way, the latter does confirm one nice point about the program- residents are able to be as heavily involved in the "education" and "residency training" process from an administrative angle as they want. Their input is taken quite seriously and they are involved in all aspects of curriculum reshaping, etc. This is nice for me coming from a medical school where students were treated the same way. Anyway, I spent some time talking to the chief resident (really, really nice and knowledgeable, going into Pulm/CC), a 2nd-year resident, two med students and an intern. The intern had just come off a MICU month and did seem a bit tired, although she was quite personable and nice. She admitted that you "do work harder than you ever have" and that at times the county population (very underserved, often with chronically untreated problems) can get a bit depressing (in that you can't really help them at times). However she loved the program and emphasized the great teaching she had received. Autonomy is also amazing here. Another resident mentioned he did a rotation at Cedars/UCLA where the difference was tremendous in terms of how involved he was in decision making. Also, (I think - hopefully I'm not confusing this with Harbor) you have a dedicated procedures rotation where you get to specifically insert all types of lines, tubes, etc. The intern also mentioned that even though it was a county hospital, there were phlebotomists at all times, no scut/blood draws/wheeling etc. etc. The med students seemed to love the program and raved about it: "There is something really special about this place - the attendings are just amazing, some of the nicest people you have ever met" etc. etc. I talked to some other UCLA students on the interview trail who pretty much gave the same impression. Morning report was attended by attendings, residents/interns who all knew their stuff quite well. .
Hospital: Okay, so much like Parkland or perhaps any county hospital this is not your VIP luxury private facility. It's sparse but clean and well-maintained. I entered to security detectors and the front room looked sort of like an INS immigration office in terms of decor (plastic chairs attached to bars and a bleak looking tile floor). No-one was at the information "desk" but I did manage to find my way to the right place (just take the elevators to the right floor and then there are signs). ICU beds are separated by blue curtains instead of doors. Rooms are small but everything did look clean. The cafeteria food was actually quite good, in a different way - i.e. more authentic-tasting homemade Cal-Mex food (yum!) as opposed to make-your-own-salad-grab-a-bag-of-baked-lays-and-odwalla-smoothie etc. Cafeteria only open until 7:30 pm though, after which...you're kind of on your own. You do get free meals/parking 365 days/year though. Nice things: since you're affiliated with UCLA, you get the UCLA "perks" of online journal access, UpToDate, etc. Note there is NO electronic medical record - intern I spoke with didn't mention this as a big problem. There is supposedly plans in place to switch to an EMR due to national regulations, but people are somewhat skeptical as to when.
Research/Mentorship: I got the feeling that people would be very willing to work with you at this program. Dr. Wali mentioned that since Olive View per se did not have a lot of "basic" science opportunities, she had put together a booklet of basic science research opportunities available at UCLA which interns/residents could select from. Apart from that, residents are encouraged to present abstracts (from the vast pathology you see here) at national conferences (this is paid for) and often win awards. Apart from research, there is focused teaching on things like echocardiograms, treadmill tests, scopes (you can apparently become certified in these and sign off on the latter two if you want), workshops on suturing, casting, etc.
Fellowships: Looks like 1/2 - 2/3 of the class went to pursue subspecialty training in the past two years. From their website: "There is a fairly equal balance between residents who choose to go into general internal medicine (primary care or hospitalist practice) and those who go on to do subspecialty training. Most of the residents pursuing additional training choose to stay in the Los Angeles area for their fellowships. Those who decide to leave the UCLA system often get their first choice of fellowship. However, given the changing nature of internal medicine training and the nationwide movement towards decreased availability of subspecialty training, future trends cannot be predicted and fellowship positions are not guaranteed."
Rotations: Mostly at Olive View. 4 months wards as a PGY1, 3 months ambulatory, 2 elective months, 1 month vacation. Cap of 5 new admits per intern. Call q4 on wards, q3 ICU (I think), overnight. However, for CCU/MICU (2 months) you have the option of rotating at Cedars or UCLA. This is a plus if you want to experience the private or tertiary-care setting but don't want your entire residency to take place in this setting. Also, there is a combined IM/EM residency which (as the APD and other residents mentioned) sets up for a "camaraderie" between IM and EM...so no bogus admits, poorly worked up pts, IM-EM battles, etc. On that note, the interns mentioned consulting other services here is a breeze in that you never are made to feel small or ignorant and everything is always imbued with teaching. There is a really cool feature of the program - the "Post-Discharge Clinic" - where you see patients you admitted before, maintaining some continuity (especially when a lot of the patients are poor and you weren't able to keep them in house long enough to f/u on test results, finish w/u, etc.) During your ward months, this counts as your continuity clinic, I belive. Also, there are opportunities to do international rotations - Olive View residents who had done this mentioned their in-house training left them feeling well-equipped to handle the actue issues abroad.
Location: I'm not familiar with Sylmar, but apparently most residents live south or west of Sylmar and drive "against traffic" so that it only takes 20-25 mins to reach work in the am and pm. (The only time when this is a problem is during the night float shift where you actualy are driving "with" traffic. Then I think it takes 40-45 minutes)This is great in LA (where I was ready to burn my driver's license after 1 week of facing traffic in this city) and also means you can live in an area with more to do. There is definitely not much going on in the immediate vicinity of the hospital. The scenery is gorgeous - there are huge mountains and things - but even the comfort inn I stayed at was more than a tad ghetto...I kind of get the impression you are slightly isolated from the city. However, others can feel free to correct me as I am not from CA and my only knowledge of the area comes from Google Maps...
Summary:
Pros (for me, at least): GREAT teaching, attendings who are truly great teachers, teaching opportunities (med students on rotations very frequently), very benign attitude overall, responsive to residents, amazing outreach/service opportunities with patient population, focus on clinical education, international training possible (certain sites paid for), PD who really seems to care, stability of program (too popular/important of a site for UCLA to close down, for ex.).
Cons: location (kind of isolated), smallish w/o all subspecialty exposure (i.e., must refer complex cardiac cases to Harbor), no EMR (big change from what I'm used to), hospital faciltiies may not be as luxurious as some are used to (not a big problem for me, but you do have to come here to work every day - might turn others off), county hospital means needing to f/u on tests, etc., patient population means it could get frustrating/depressing trying to address issues stemming from neglect/lack of access to care/lack of education.
Other things, FWIW: According to other UCLA students I talked to, it's not as "academic" as Harbor (whatever that means) This program is definitely not for everyone: you would work hard in a relatively unglamorous setting...you would be taking care of indigent patients for the most part...it's a county hospital. The focus of this program is definitely clinical education, but if you're interested in specific research areas I really do think you could achieve that as well...after all, you are in the UCLA system...there were plenty of residents I talked to who seemed fellowship-bound.
Anyway, that's my take on it. I liked the program a LOT and at least as of now, will be ranking it pretty highly.
I mean, if you can't be bothered to read through my application at least have something to discuss...I felt like I was interviewing him! Asking about what his days in clinic were like, how long he had lived in the area, where he grew up...you get the idea.👎 I don't see why I couldn't have just teleconferenced the interview.
Plus he can give alot of insider info. that you won't/can't get anywhere else. Apparently, he's also the man to go to if you wanna buy a house in the area...
. It appeared that about half the graduates take hospitalist positions with a large private group. Not really sure what % were unable to match into their specialty, no one on interview day spoke of not matching.
