I am a current CA-1 at Maimonides and I was searching through here and there aren't any updated posts regarding the program so I wanted to post here to give everyone an updated (and hopefully positive) view of the program. For starters I will briefly introduce myself and say that I graduated medical school from the University of Virginia, did a surgery internship in Washington, DC, and am now at Maimo. I recently posted on scutwork so I am just copying and pasting my review from there into this post, but I would add that the research opportunities at Maimo are also excellent. We sent numerous residents to the ASA this year and there are at least 5 projects going on simultaneously that I am aware of. In addition there are two trips abroad that the department offers to central america, one in cardiac anesthesia and the other in pediatric anesthesia. Enjoy the post and feel free to ask me any questions.
A typical day for me starts by coming in at 6am and setting up my room, then we have lecture from 6:30-7:15 (except on Mondays when we have grand rounds which is a fantastic learning opportunity lead by our chairman, Dr. Konstadt which starts at 7:00). After lecture we do cases and typically get one morning break, lunch break, and one afternoon break. Im usually done with my clinical duties by about 4:30, then I see pre ops for the next day and am usually out of the hospital by about 5:30. I typically take 6-7 calls a month as a CA-1 but get 2 full weekends off every month. The CA-2s average about 5-6 calls/month and the CA-3s take 3 calls/month. The best part of the program in my opinion is the acuity of patients we take care of, the diversity of the cases, and the case load. As a CA-1 I have already done things that a lot of my friends at other big name programs have not even come close to doing. I have done ruptured AAAs, CEAs, emergent ERCPs, stat C-sections, and over 100 epidurals. I have ton mostly ASA 3 and 4 cases, and even some ASA 5 and 6s. Bottom line, if you will see the sickest of the sick and be able to handle just about anything that comes your way.
The faculty for the most part are outstanding. The are very enthusiastic about resident education, but whatever you put into this program is what you will get out. All CA-1s are required to call their attending the night before to discuss the cases for the following day. The best approach is to tell the attending about one or two topics you want to discuss so that both parties can adequately prepare. Calling the attending the night before is also a great opportunity to ask to try other techniques such as fiberoptic intubations, fastrach LMA, TIVA, etc. Most of the attending are very receptive to you trying whatever you want as long as it is safe and you have read up on the subject. In addition to intra op teaching we have didactics everyday which include formal lectures, board review, mock orals, TEE lectures, journal club and key word discussions. The lectures are usually excellent, but there are a few here and there that could use work. Also the TEE lectures are a bit much for the CA-1s to absorb when you are still focusing on basic anesthesia, but we get so much cardiac here that its ok.
The camaraderie among the residents is excellent! It is one of the best aspects of the program. Everyone is looking out for each other and we all get along really well together. Its a relatively small program (25 residents) with a large case load so we are all pretty close and work well together. In addition we have a really informal relationship with the attending and the residents are on a first name basis with many of them. This is a very benign program with only 1 or 2 malignant attending out of about 35+ attendings. The physical work environment is great too. We have 9 brand new ORs and are in the process of renovating the old ones. We also have a computerized intra op record keeper which is very nice. In addition, the ambulatory surgery center is state of the art as well. As for my life outside of work like I said, this is a small residency with a very big case load so you have to make time, but it is very doable. I am able to go out mostly on my post call days and enjoy Manhattan. Some of my colleagues go out far more than I do though. Its all about your priorities and proximity to the city. The closer you live to the hospital the less there is to do, but most of the residents live in Brooklyn closer to Manhattan (Park Slope, Brooklyn Heights, etc) and some live in Manhattan itself.
Overall this is a great program that I think gets underappreciated. This is evidenced by the caliber of residents that come out of here at the end of 3 years and also the types of fellowships that our grads get (MGH, Pittsburgh, Mount Sinai, etc).
First the pros:
1) The acuity of the patients and diversity of case load. The average ASA of our ambulatory surgery center is 3. I have done more ASA 3, 4, 5, and 6 cases then my colleagues at other institutions. We do A LOT of cardiac, OB, and regional.
2) The camaraderie amongst the residents and between the faculty and residents is unparalleled I think.
3) This is very much a hands on program where what you put in is what you get out. You could easily fly under the radar if you wanted and not do much, but if you are enthusiastic the faculty is very amenable to letting you try a variety of anesthetic and airway techniques to enhance your learning so that you are not doing a fiberoptic intubation in an emergency for the first time. Having said that, if you are the kind of person who needs a lot of hand holding, this program is not for you.
4) There is tremendous cultural diversity here which allows for some interesting challenges, such as doing a CABG on a Jehovahs witness and using a variety of blood salvaging techniques.
5) Great training .you will leave this program far more technically competent than many of your peers. The trade off is that you spend more hours in the hospital doing more cases on sicker patients and have less time to read on your own. In my opinion it is worth it because residency is a unique opportunity to see and learn as much as possible. That opportunity does not exist as easily for an attending, especially one that did not get the same opportunities during his/her residency.
5) You get paid handsomely for moonlighting.
6) The faculty are really excellent and come from varied backgrounds so you get a lot of diversity in your training which I think is a huge positive since there is not just one right way to do anesthesia.
The cons:
1) As mentioned in #5 above, you work about 70 hrs/week which leaves less time for outside reading, fun, etc, but like I said before it definitely can be done.
2) This is not a hand holding program and no one coddles you. If you need help you will get it, but it is a small program with a large volume and anesthesia intrinsically has a steep learning curve so you have to pick things up relatively quickly and progress along the learning curve. Having said that, there is a lot of great leadership in the senior residents and faculty. Nobody gets left behind.
3) Only 2 CRNAs which is either good or bad depending on your outlook. I think its great because we get better cases and it still allows us to get out on time at the end of the day when rooms are still running.
I hope this helps shed some positive light on the program!
A typical day for me starts by coming in at 6am and setting up my room, then we have lecture from 6:30-7:15 (except on Mondays when we have grand rounds which is a fantastic learning opportunity lead by our chairman, Dr. Konstadt which starts at 7:00). After lecture we do cases and typically get one morning break, lunch break, and one afternoon break. Im usually done with my clinical duties by about 4:30, then I see pre ops for the next day and am usually out of the hospital by about 5:30. I typically take 6-7 calls a month as a CA-1 but get 2 full weekends off every month. The CA-2s average about 5-6 calls/month and the CA-3s take 3 calls/month. The best part of the program in my opinion is the acuity of patients we take care of, the diversity of the cases, and the case load. As a CA-1 I have already done things that a lot of my friends at other big name programs have not even come close to doing. I have done ruptured AAAs, CEAs, emergent ERCPs, stat C-sections, and over 100 epidurals. I have ton mostly ASA 3 and 4 cases, and even some ASA 5 and 6s. Bottom line, if you will see the sickest of the sick and be able to handle just about anything that comes your way.
The faculty for the most part are outstanding. The are very enthusiastic about resident education, but whatever you put into this program is what you will get out. All CA-1s are required to call their attending the night before to discuss the cases for the following day. The best approach is to tell the attending about one or two topics you want to discuss so that both parties can adequately prepare. Calling the attending the night before is also a great opportunity to ask to try other techniques such as fiberoptic intubations, fastrach LMA, TIVA, etc. Most of the attending are very receptive to you trying whatever you want as long as it is safe and you have read up on the subject. In addition to intra op teaching we have didactics everyday which include formal lectures, board review, mock orals, TEE lectures, journal club and key word discussions. The lectures are usually excellent, but there are a few here and there that could use work. Also the TEE lectures are a bit much for the CA-1s to absorb when you are still focusing on basic anesthesia, but we get so much cardiac here that its ok.
The camaraderie among the residents is excellent! It is one of the best aspects of the program. Everyone is looking out for each other and we all get along really well together. Its a relatively small program (25 residents) with a large case load so we are all pretty close and work well together. In addition we have a really informal relationship with the attending and the residents are on a first name basis with many of them. This is a very benign program with only 1 or 2 malignant attending out of about 35+ attendings. The physical work environment is great too. We have 9 brand new ORs and are in the process of renovating the old ones. We also have a computerized intra op record keeper which is very nice. In addition, the ambulatory surgery center is state of the art as well. As for my life outside of work like I said, this is a small residency with a very big case load so you have to make time, but it is very doable. I am able to go out mostly on my post call days and enjoy Manhattan. Some of my colleagues go out far more than I do though. Its all about your priorities and proximity to the city. The closer you live to the hospital the less there is to do, but most of the residents live in Brooklyn closer to Manhattan (Park Slope, Brooklyn Heights, etc) and some live in Manhattan itself.
Overall this is a great program that I think gets underappreciated. This is evidenced by the caliber of residents that come out of here at the end of 3 years and also the types of fellowships that our grads get (MGH, Pittsburgh, Mount Sinai, etc).
First the pros:
1) The acuity of the patients and diversity of case load. The average ASA of our ambulatory surgery center is 3. I have done more ASA 3, 4, 5, and 6 cases then my colleagues at other institutions. We do A LOT of cardiac, OB, and regional.
2) The camaraderie amongst the residents and between the faculty and residents is unparalleled I think.
3) This is very much a hands on program where what you put in is what you get out. You could easily fly under the radar if you wanted and not do much, but if you are enthusiastic the faculty is very amenable to letting you try a variety of anesthetic and airway techniques to enhance your learning so that you are not doing a fiberoptic intubation in an emergency for the first time. Having said that, if you are the kind of person who needs a lot of hand holding, this program is not for you.
4) There is tremendous cultural diversity here which allows for some interesting challenges, such as doing a CABG on a Jehovahs witness and using a variety of blood salvaging techniques.
5) Great training .you will leave this program far more technically competent than many of your peers. The trade off is that you spend more hours in the hospital doing more cases on sicker patients and have less time to read on your own. In my opinion it is worth it because residency is a unique opportunity to see and learn as much as possible. That opportunity does not exist as easily for an attending, especially one that did not get the same opportunities during his/her residency.
5) You get paid handsomely for moonlighting.
6) The faculty are really excellent and come from varied backgrounds so you get a lot of diversity in your training which I think is a huge positive since there is not just one right way to do anesthesia.
The cons:
1) As mentioned in #5 above, you work about 70 hrs/week which leaves less time for outside reading, fun, etc, but like I said before it definitely can be done.
2) This is not a hand holding program and no one coddles you. If you need help you will get it, but it is a small program with a large volume and anesthesia intrinsically has a steep learning curve so you have to pick things up relatively quickly and progress along the learning curve. Having said that, there is a lot of great leadership in the senior residents and faculty. Nobody gets left behind.
3) Only 2 CRNAs which is either good or bad depending on your outlook. I think its great because we get better cases and it still allows us to get out on time at the end of the day when rooms are still running.
I hope this helps shed some positive light on the program!
