I rotated through Palmetto General Hospital in Hialeah as a student
Advantages:
1. Lots of ICU. The second floor is essentially one huge ICU and Cath lab.
2. As a tie-in to #1, lots of pathology.
3. There are some extremely talented residents there
4. There is food during didactics
5. If you are an attractive woman rotating through the hospital, you will have the best experience ever, i.e. the CT surgeon will be more apt to let you scrub in and hold the heart.
Disadvantages
1. For me, the Spanish language. It's 99.9% Spanish speaking population there. This has unfortunately heavily biased me as a resident. I really have to bite my tongue when I come across a Hispanic patient now, because as a student I came across men and women alike who cried like children at the smallest injuries.
2. Evidence based medicine is not practiced here. Defensive medicine is. A lot of the imaging and labs ordered were completely unnecessary. There were comprehensive labs ordered daily on the most benign patients in the hospital.
3. As a tie-in to #3, save for one attending in the ER, who is the only board-certified ER physician I am aware of down there, they essentially admit anyone and everyone who comes through the doors. Why, because the ER docs are incompetent. I remember seeing a patient on the hospital floor admitted for post-herpetic neuralgia, another for the flu
4. The IM docs on the floors are very knowledgeable, but otherwise they are temperamental and careless people. It was a common sight to see an "attending" throwing a fit in plain sight of patients and hospital staff. Residents were chewed out for ridiculous reasons. I was chewed out as a third year student by an attending for allowing a patient to be discharged who maybe shouldn't have.
5. They were careless because they kept a daily census of 50-80 people per service and relied on the medical students and residents to see the patients and write the notes. There were patients there who would see the attending once every 1-2 days. In retrospect, this meant that the system there was a gold mine for these physicians, and from what I understand the hospitalists were pulling upward $500,000-$700,000 a year there because of it.
6. The DME has been there since the early 90s, and has no influence there because he is disabled and has not practiced medicine in years. He is essentially a hospital employee, whereas the hospitalists and IM specialists bring in millions for the hospital. Therefore a lot of threatening takes place when, for example, a Cardiologist service does not have the number of students or residents they want.
7. This may have changed, but the didactics had a heavy bent toward Cardiology. Like 80-90% of the lectures there were Cardiology.
