Kaiser for IM

[Captopril]

I posted this in the Cardiology forum, but it's known to be dead over there so I thought I'd get the opinion of you IM peeps:

I will be applying for IM residency this summer, with hopes of going onwards to cards fellowship. I've heard that NorCal Kaiser (SF) now has a cards program. Would it be advisable to do a residency at a place like Kaiser if they have a cards fellowship...or does the stigma of the Kaiser name outweigh the badassness of having an in-house fellowship program?

Forgot to mention when I originally posted this in Cards forum: When I say "stigma" of the Kaiser name, what I mean is the lack of research, the fact that it's a community prog, etc etc...nothing specifically against Kaiser.

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[spumoni620]

hey -

in my current residency program, i work with medicine residents and cardiologists at kaiser. they are a great bunch. the cards staff/faculty there are top notch and it is a seriously prime cath center in norcal - see all types of crazy things including takotsubo's/dextrocardia/coxsackie myocarditis/amyloid/amiodarone toxicity/etc. etc (the things i've seen this year while working here). as far as medicine training, they actually emphasize research quite a bit - 90% of residents are involved in some research project. residents are required to complete a research project and there is a year long course dedicated to research that all residents must take. because kaiser has access to a huge clinical database, it's actually easier to initiate a retrospective study or data analysis if you desire.

the upside of this is that you actually have time/resources to pursue research if you're interested, because the schedule is not horribly taxing and the hospital runs very, very efficiently. no overnight call on wards and TONS of flexibility with your elective and research time. You can set up away rotations or research rotations with any mentor at Kaiser or UCSF. And you also get paid very well, get to enjoy a great city and work with nice, fun and happy people (for the most part).

The cards fellowship will hold a spot for one kaiser graduate each year. it's definitely feasible, if you know you're interested in cards up front, to work with key staff here and edge into that spot.

feel free to let me know if you have more questions.

 

[Captopril]

hey -

in my current residency program, i work with medicine residents and cardiologists at kaiser. they are a great bunch. the cards staff/faculty there are top notch and it is a seriously prime cath center in norcal - see all types of crazy things including takotsubo's/dextrocardia/coxsackie myocarditis/amyloid/amiodarone toxicity/etc. etc (the things i've seen this year while working here). as far as medicine training, they actually emphasize research quite a bit - 90% of residents are involved in some research project. residents are required to complete a research project and there is a year long course dedicated to research that all residents must take. because kaiser has access to a huge clinical database, it's actually easier to initiate a retrospective study or data analysis if you desire.

the upside of this is that you actually have time/resources to pursue research if you're interested, because the schedule is not horribly taxing and the hospital runs very, very efficiently. no overnight call on wards and TONS of flexibility with your elective and research time. You can set up away rotations or research rotations with any mentor at Kaiser or UCSF. And you also get paid very well, get to enjoy a great city and work with nice, fun and happy people (for the most part).

The cards fellowship will hold a spot for one kaiser graduate each year. it's definitely feasible, if you know you're interested in cards up front, to work with key staff here and edge into that spot.

feel free to let me know if you have more questions.

Spumoni-

Thanks for that great write up. I appreciate the details of the Kaiser environment. I would definitely be willing to do my residency at Kaiser SF working towards that one spot available for in-house...my only concern would be the big "what if", i.e. what happens if it gets taken by a better-performing classmate. Then you're stuck looking for a cards fellowship with a community hospital residency. Don't know how detrimental that would really be considering the vast research experience you are saying you achieve there, but I have read that univ progs are always preferred for cards/GI/etc.

 

[spumoni620]

Spumoni-

Thanks for that great write up. I appreciate the details of the Kaiser environment. I would definitely be willing to do my residency at Kaiser SF working towards that one spot available for in-house...my only concern would be the big "what if", i.e. what happens if it gets taken by a better-performing classmate. Then you're stuck looking for a cards fellowship with a community hospital residency. Don't know how detrimental that would really be considering the vast research experience you are saying you achieve there, but I have read that univ progs are always preferred for cards/GI/etc.

hey - no worries. you are right; that spot will definitely be competitive. there are 3 people in the current intern class applying for that cards spot. however, one girl has gotten several interviews across the country including good progs in NE and the south. if you are dead set on cards or some super-competitive specialty, it would make more sense to go to a big univ program simply because that's the way the snobbery/prejudice works in the system.
That's unfortunate, in my view. In my current program, I work at both at a big/top-ranked university program and Kaiser, and must note that the quality of many of the residents and attendings at Kaiser's program is quite on par. People may need to be slighly more self-motivated at kaiser to read and take the formal academic approach. I do think the system runs more efficiently and people are in general very benign at Kaiser, but the teaching may be slightly more hit-or-miss on the wards (not ICU, where you get SO much teaching and every attending is simply stellar - UCSF fellows run the team at night) you probably don't get as many procedures (unless you advocate for it).

bottom line is - apply to a wide range of programs, interview and talk to the residents, and figure out where you'd be happiest. No point in suffering for 4 years; you want to be around a happy, fun group of people and enjoy going to work every day.