Is a VA essential for your residency program?

[rocketbooster]

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Is it a big deal if your program doesn't have a VA? I know va pts are known to be a pain but also I hear you usually have more autonomy there. What do you think?

 

[OPPforlife]

I don't think I interviewed at any programs without a VA

 

[survivordo]

Definitely have experienced the same. There is a LOT of autonomy for residents in our program when they rotate through the VA.

Survivor DO

 

[speyeder]

In my opinion, not having a VA is a big drawback. They provide a large referral base for surgical procedures and complicated cases (dense 4+ cataracts, extracap cases, floppy iris cases, etc). And to the contrary, VA patients are awesome. They are patient, understanding and grateful.

 

[MstaKing10]

VA is huge for surgical numbers and autonomy. Plus they usually are more well run than the University system and so can do more cases and have more ancillary services available as well. Patients are more compliant and really grateful. I would ask a lot of questions about these issues if you are considering a program without a VA.

 

[alleyez2011]

VA is huge for surgical numbers and autonomy. Plus they usually are more well run than the University system and so can do more cases and have more ancillary services available as well. Patients are more compliant and really grateful. I would ask a lot of questions about these issues if you are considering a program without a VA.

Of the top-tier programs, which ones don't have a VA? Do you also think it is worth knocking these programs down a few spots because of this?

 

[Eyefixer]

JHU does not have a VA

 

[alleyez2011]

JHU does not have a VA

What about Wills and Bascom?

 

[hurdlepup]

JHU does not have a VA

The UMD residents seemed to indicate that their surgical numbers were better thanks to their attached VA.

 

[DrZeke]

bascom has a VA - it's the Miami VA - residents get TONS of autonomy there.

 

[alleyez2011]

For programs that do not have a VA, where do they get their surgical numbers from?....resident clinics? Also, do the surgical numbers at these programs tend to be lower than those with a VA?

 

[billambeer]

For programs that do not have a VA, where do they get their surgical numbers from?....resident clinics? Also, do the surgical numbers at these programs tend to be lower than those with a VA?

The University of Chicago was the only program I interviewed with where there is no VA (I hit 15 schools). They acquired a presence at NorthShore, a community hospital that was formerly part of Rush U. They claimed that their surgical numbers didn't change in the transition, and they showed as much in their introductory presentation.

@alleyez: I ranked Chicago low for reasons other than their VA status. They were previously a department but the dean of the medical school (according to Dr. Greenwald) changed their status into a subdivision of the department of surgery, changing chairmanship to chief status. The former chair, William Mieler, left because of this change. My point is that VA status can be a symptom of a larger issue. It may represent tensions within a department, disagreements between faculty, and inter-city conflict (all of which were partially present in Chicago). In fact, the surround schools (especially Loyola) boasted of the fact that UChicago doesn't have a VA, but they do. To me that signaled stability.

 

[DrZeke]

The University of Chicago was the only program I interviewed with where there is no VA (I hit 15 schools). They acquired a presence at NorthShore, a community hospital that was formerly part of Rush U. They claimed that their surgical numbers didn't change in the transition, and they showed as much in their introductory presentation.

@alleyez: I ranked Chicago low for reasons other than their VA status. They were previously a department but the dean of the medical school (according to Dr. Greenwald) changed their status into a subdivision of the department of surgery, changing chairmanship to chief status. The former chair, William Mieler, left because of this change. My point is that VA status can be a symptom of a larger issue. It may represent tensions within a department, disagreements between faculty, and inter-city conflict (all of which were partially present in Chicago). In fact, the surround schools (especially Loyola) boasted of the fact that UChicago doesn't have a VA, but they do. To me that signaled stability.

Along this same line...I think there is a difference between a program that lost their VA vs. never had one in the first place. Like, any major changes that a department is undergoing, you want to hear the solutions and you want to hear how it impacts them and just make sure you feel like you're getting the whole story/the real deal. Not all changes are bad, but you need to know how to tell the difference.

 

[airplanes]

A VA is a great resource for a training program, but don't red flag a program that doesn't have one. It is essentially another way to see and operate on patients, in a setting that allows residents a lot of autonomy. Programs can still provide that experience without a VA, whether it is via a county clinic, resident clinic, etc.

 

[Eyefixer]

I know of several programs in So Cal ( UC Irvine, for example) that are affiliated with Kaiser. Probably just as good or better then VA and still get autonomy and surgical numbers.

 

[foureyes]

UCI covers the Long Beach VA.

 

[Eyefixer]

That's the point- VA AND Kasier = best surgical numbers of any program in So Cal