Loma Linda GAS

[AssMan]

Hello everyone......I was hoping that somebody could comment about Loma Linda's anesthesiology program. Maybe some info about the call schedule, teaching, atmosphere, city and overall quality of the program. I looked up some info on scutwork but some of it was a little dated. Thanks for the input.

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[AssMan]

A little help here please!!

 

[Painter1]

don't bother. save the money and the time--that place is gravely inbred. unless u went to medical school there, or rotated in the dept and they fell in love with you--there's no point.

 

[ecCA1]

Sounds like something someone who doesn't want you to go there would say.


Perhaps others care to weigh in with their views.

 

[EuroMutt]

I actually did my residency training there. Won't say when I graduated, but it was within the past 6-7 years. Bottom line: many -- not all, but many -- of the attendings who work there are not there because they feel any particular calling to teach anesthesia residents, but because they would rather not do their own cases when they can have residents and CRNA's doing their cases for them. They will typically park you in a room, show up only during induction of anesthesia, and then split when induction is over. Yes, they will come back to your room to check on you occasionally or if there is a crisis, but overall, they spend most of their time loafing around in the docs' lounge, chit-chatting, reading the paper, surfing the 'net, and/or gossiping to each other about the residents, sometimes even badmouthing residents behind their backs. The entire 3 years I was there, I can't recall a single incident where one of them stuck around during a case for any prolonged period of time to pick my brain and actually TEACH me how to think like an M.D. anesthesiologist.

Also, they are farming their residents out to more and more hospitals, which means more call and longer hours for everyone. When I was there, I rarely got done with the day before 6pm, even when I was not on call. Very little time to study.

Some of the didactic lectures are pretty good, but many are half-assed, in which case you are better off just reading the book. They may try to tell you about how well their residents do on the boards, but I would wager that most people from Loma Linda's program who go on to do well on the boards probably owe it to whatever aftermarket review course they took, and not necessarily Loma Linda's anesthesia training. Loma Linda puts a lot of emphasis on the written anesthesia boards, but gives you virtually no preparation for the oral board exam, which is exponentially tougher.

And for the icing on the cake, I believe Loma Linda pays their residents the least of any residency program in California.

Hope this helps...

 

[AssMan]

I actually did my residency training there. Won't say when I graduated, but it was within the past 6-7 years. Bottom line: many -- not all, but many -- of the attendings who work there are not there because they feel any particular calling to teach anesthesia residents, but because they would rather not do their own cases when they can have residents and CRNA's doing their cases for them. They will typically park you in a room, show up only during induction of anesthesia, and then split when induction is over. Yes, they will come back to your room to check on you occasionally or if there is a crisis, but overall, they spend most of their time loafing around in the docs' lounge, chit-chatting, reading the paper, surfing the 'net, and/or gossiping to each other about the residents, sometimes even badmouthing residents behind their backs. The entire 3 years I was there, I can't recall a single incident where one of them stuck around during a case for any prolonged period of time to pick my brain and actually TEACH me how to think like an M.D. anesthesiologist.

Also, they are farming their residents out to more and more hospitals, which means more call and longer hours for everyone. When I was there, I rarely got done with the day before 6pm, even when I was not on call. Very little time to study.

Some of the didactic lectures are pretty good, but many are half-assed, in which case you are better off just reading the book. They may try to tell you about how well their residents do on the boards, but I would wager that most people from Loma Linda's program who go on to do well on the boards probably owe it to whatever aftermarket review course they took, and not necessarily Loma Linda's anesthesia training. Loma Linda puts a lot of emphasis on the written anesthesia boards, but gives you virtually no preparation for the oral board exam, which is exponentially tougher.

And for the icing on the cake, I believe Loma Linda pays their residents the least of any residency program in California.

Hope this helps...

Yowza.......you wouldn't think it was anything like that if you use scutwork.com as a source for info. Thanks for your post EuroMutt, personal experience and honesty is always appreciated.

Can anyone else add to this? Thanks in advance......

 

[lame_brain]

I interviewed at Loma Linda recently and the residents (the ones assigned to meet with us as well as random residents we saw in the lunchroom/hallway) seemed pretty happy. Also, both the program director and the chair stressed that they did not have a quota on how many Loma Linda students were accepted and they are actively looking to increase the diversity of their residents.

Obviously, EuroMutt would have the best information on resident/faculty interaction. But it's also possible that certain aspects of the program have changed so it's always worth investigating.

 

[EuroMutt]

When I trained at Loma Linda, I probably WAS one of the residents who interacted with medical students/potential new residents, and I remember saying how great it was -- and it honestly seemed so at the time, but then again I was a CA-1. I was probably just happy to be done with doing H&P's, discharge summaries, and rectal exams. And I also just didn't know any better and didn't have any reference point to compare. Then later, after I graduated, I began hearing from some of my new attending colleagues about THEIR residency training, and I gotta say, I felt a bit cheated once I found out how much better their respective programs and training were.

 

[EuroMutt]

Actually, I felt much more than a bit cheated, as you can probably tell. If you do decide to go there, get an early start on training yourself for the orals. Use some of your vacation time to attend at least one oral board review course (either Dr. Jensen's or Dr. Ho's) during your CA-2 year, so you can at least get an early idea of what you'll be up against. They're pricey, but if I had to do it over again at Loma Linda, that's what I would do.

www.boardprep.com

www.anconsultants.com

 

[TheSandMan]

I actually did my residency training there. Won't say when I graduated, but it was within the past 6-7 years. Bottom line: many -- not all, but many -- of the attendings who work there are not there because they feel any particular calling to teach anesthesia residents, but because they would rather not do their own cases when they can have residents and CRNA's doing their cases for them. They will typically park you in a room, show up only during induction of anesthesia, and then split when induction is over. Yes, they will come back to your room to check on you occasionally or if there is a crisis, but overall, they spend most of their time loafing around in the docs' lounge, chit-chatting, reading the paper, surfing the 'net, and/or gossiping to each other about the residents, sometimes even badmouthing residents behind their backs. The entire 3 years I was there, I can't recall a single incident where one of them stuck around during a case for any prolonged period of time to pick my brain and actually TEACH me how to think like an M.D. anesthesiologist.

Also, they are farming their residents out to more and more hospitals, which means more call and longer hours for everyone. When I was there, I rarely got done with the day before 6pm, even when I was not on call. Very little time to study.

Some of the didactic lectures are pretty good, but many are half-assed, in which case you are better off just reading the book. They may try to tell you about how well their residents do on the boards, but I would wager that most people from Loma Linda's program who go on to do well on the boards probably owe it to whatever aftermarket review course they took, and not necessarily Loma Linda's anesthesia training. Loma Linda puts a lot of emphasis on the written anesthesia boards, but gives you virtually no preparation for the oral board exam, which is exponentially tougher.

And for the icing on the cake, I believe Loma Linda pays their residents the least of any residency program in California.

Hope this helps...

euromutt, i'm currently a ca-1 (though not at loma linda) and am a little curious. i tend to take it as a complement when the attendings leave me alone to do my own thing, and kind of thought this was the norm. sometimes they will give me some questions to think about/research(if i have few minutes between cases), which we discuss throught out the day. do attendings stick around for most of the case at most programs?

 

[EuroMutt]

I remember thinking the same thing while a resident -- "Wow . . . these attendings must really think I'm great, leaving me to do the case all by myself!" And I never had any major complications with any of my cases -- no deaths, no strokes, no MI's and only one arrest (a liver transplant with a poorly skilled surgeon, but there were 2 other residents and an actual attending in the room at the time, only because the case was going so poorly).

The problem with the above situation is that you get overconfident, thinking you must be really good, especially if you make it through your 3 years without having to deal with a major complication or acute crisis. Hopefully you can see why this doesn't contribute to preparing you for the boards.

If I were a teaching attending, I would gear my questions for my resident toward such issues as, (1) how do this patient's co-existing diseases affect your anesthetic plan?, (2) what are the potential complications of your anesthetic plan?, (3) what are the potential complications from the surgical procedure?, (4) How would such complications present themselves, in terms of the patient's vital signs, physical exam, other monitors, lab values, etc., and (5) How would you treat these complications?

When I was at Loma Linda, the questions went more like this --

Attending: "So, what's your plan?"
Me: "I figured general anesthesa, induction with [propofol/thiopental/etomidate], maintain with [iso/sevo/des]."
Attending: "Sounds good to me."
(Attending then stays briefly to watch the induction then quietly leaves after the ET tube is secured.)

 

[EuroMutt]

But to answer your question SandMan, the important thing is not simply that they "stick around," but that they stick around long enough to propose and discuss the questions I mentioned above, and do so in a manner similar to how those questions will be proposed to you by the board examiners during an actual oral board exam.

Obviously, if they're just hovering around and watching, and not interacting with you, that would be pointless, unless they just didn't trust you...

 

[EuroMutt]

Even if your a CA-1 and not doing very complicated cases yet (e.g., open hearts, cerebral aneurysms, thoracotomies with 1-lung ventilation, aortic aneurysms, etc.), there are still crisis scenarios your attending could propose to you hypothetically -- a few examples:

(1) what if you induce this patient and paralyze them, and you cannot ventilate or intubate?

(2) If this general anesthesia patient's blood pressure suddenly took a dive, how would you initially react? (You: "I would ensure adequate ventilation and oxygenation, repeat the blood pressure while observing the rhythm on the EKG monitor and feeling the pulse, and look for potential causes such as blood loss, hypovolemia, myocardial ischemia, pneumothorax, etc. I would also temporize with some phenylephrine or ephedrine if necessary, and lighten up the anesthesia if I thought it was too deep.")

Anyway, no matter how simple a case is, or how healthy a patient is, a good teaching attending should be able to come up with some hypothetical scenario which could be applicable to any patient, and test you on it. Their job should be to get you to think this way about every case (what could happen, how would you react).

Otherwise, you're just learning cookbook anesthesia (if A do B, if C do D, if E **** your pants and scream for the attending) and are no better skilled than a CRNA.

[That wasn't meant as an insult to CRNA's -- they're good as far as what they do/are.]

 

[TheSandMan]

Even if your a CA-1 and not doing very complicated cases yet (e.g., open hearts, cerebral aneurysms, thoracotomies with 1-lung ventilation, aortic aneurysms, etc.), there are still crisis scenarios your attending could propose to you hypothetically -- a few examples:

(1) what if you induce this patient and paralyze them, and you cannot ventilate or intubate?

(2) If this general anesthesia patient's blood pressure suddenly took a dive, how would you initially react? (You: "I would ensure adequate ventilation and oxygenation, repeat the blood pressure while observing the rhythm on the EKG monitor and feeling the pulse, and look for potential causes such as blood loss, hypovolemia, myocardial ischemia, pneumothorax, etc. I would also temporize with some phenylephrine or ephedrine if necessary, and lighten up the anesthesia if I thought it was too deep.")

Anyway, no matter how simple a case is, or how healthy a patient is, a good teaching attending should be able to come up with some hypothetical scenario which could be applicable to any patient, and test you on it. Their job should be to get you to think this way about every case (what could happen, how would you react).

Otherwise, you're just learning cookbook anesthesia (if A do B, if C do D, if E **** your pants and scream for the attending) and are no better skilled than a CRNA.

[That wasn't meant as an insult to CRNA's -- they're good as far as what they do/are.]

thanks for the reply euro. thankfully most attendings at my program do like to get us thinking alot and are always pimping us on different senarios. they also check in on us often and are always giving feedback on how we are doing with the case and usually stick around for a while to do some teaching. after your clarification, really makes me appreciate their efforts

 

[ecCA1]

Is it possible in the several years that you've been away from LLUMC that things have gotten better?

I think I know the answer, but will await your response nonetheless...