NYC anesthesia - programs to consider and away electives?

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Anes2BeNYC

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I'd like to come to NYC for anesthesia residency - my fiance has some pretty amazing career opportunities, and is likely headed to New York.

I'm having a hard time making heads or tails of the NYC programs. I see some old threads, but I've also heard that a lot has changed with program leadership in the last few years and would definitely be great to have a fresh take on these programs. I'm most interested in NYU, Sinai, Cornell, Columbia - maybe now that match is over someone who interviewed at these places can help me out?

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Adapted version of my interview notes from the 2012-13 interview season. It’s definitely worth applying to all of them, and making your own impressions. In my opinion there was no clear-cut “best program,” or obvious way to rank them. All of them have their strengths and weaknesses – and a strong case could be made for any of the four. It’s going to come down to personal fit and arbitrary gut feeling. So here it goes, in alphabetical order:

Columbia – the best name recognition, and strong research history. Also, notably the only pediatric hospital in the city. The Apgar Scholars program seems like a great opportunity for someone who wants to do research. Schedule seemed like more hours than Sinai/NYU, but less hours than Cornell. Residents also really liked the clinical base year here – they don’t send you out to other sites, and it seemed carefully designed to be the best experience possible - mainly on subspecialty services. On the downside, their leadership seemed very aloof and not involved in resident life (unlike every other program in the city). In comparison to Cornell, Columbia Presbyterian does not have as nice of facilities – and pretty much operates at capacity, when I visited residents complained about waiting for PACU beds. Location is by far the worst of the four, Washington Heights also leaves a lot to be desired, and residents commute from elsewhere… it’s a decent commute on the A Train from the UWS, which is expensive, and salary is not adjusted accordingly (PGY1- 54K, PGY2- 57K, PGY3- 60, PGY4 - 62) plus a laughable $3000 housing stipend. Overall this is a big program, and although the atmosphere and location is pretty gritty and I certainly wouldn’t describe it as a “warm-and-fuzzy” place, camaraderie among residents seemed very good, and definitely great as an academic heavyweight with strong commitment to research.

Cornell – Facilities stand out as possibly the nicest in the country, subsidized housing across the street, in beautiful area of the upper east side. Amazing regional experience at HSS, and affiliation with Sloan Kettering. Everyone likes the new PD, young attending who went through the program - he’s making changes but can’t do it all overnight. The culture of this program is still not warm and supportive, but it’s on its way there. Call is from home (for better or for worse - some residents said they love it, some said they feel like they never leave work). They still have the worst hours of any of the NYC programs, and the list seems to come out later than most other places (like 6ish, then preops), and it was hard to figure out the schedule on interview day. When I went back for second look, most were leaving between 6-7pm. Require many months of ICU (I’m pretty sure it was 7 months) – I went to check out ICU rounds, seems like a good experience, but it must eat into elective time and I thought it was a little extreme. Clinical base year seemed like it was mostly surgical, with some anesthesia mixed in. Intraop teaching seems pretty good – but didactics only about once a month – could be good or bad depending on how you learn. They have a PGY1 year attached, but mostly surgery, and you’ll also spend some time at NY Downtown hospital – which was described as the resident at the interview dinner as “the wild west.” I also interviewed here for a preliminary medicine year – NY Downtown is kind of a hole-in-the-wall (but likely changing in the future, they were just bought by NYP). The patient population is also the least diverse (and most healthy) of all the manhattan hospitals, no trauma, but still sure to have some big cases at MSK/HSS/NYP. Overall – a great program especially for regional and ICU, with strong clinical training.

NYU –I thought it was the most balanced of the bunch, but slightly less name recognition than the NYP programs. PD was refreshingly relaxed, and seemed to genuinely care about resident life. I also interviewed with the chairman who was also down-to-earth, but is stepping down to focus on his lab. Hours were very reasonable – relieved by the call team or CRNA between 4:00-5:00. Residents seemed really happy, great camaraderie, and reasonable hours. In my opinion, they have the best location of the four. Great variety of hospital settings and case mix – NYU (nice private hospital), Bellevue (public hospital – facilities are a little grungy, except the ICUs which are new and really nice, the major trauma center for Manhattan, team leader experience, and incredibly diverse pt population and case mix), and Hospital of Joint Disease (Strong regional – it’s not HSS, but you should get plenty of exposure at a dedicated ortho hospital). They have a great new simulation center, the nicest I have seen anywhere –but at this point it is underutilized by the anesthesia program. Research is not as strong as Cornell/Columbia, but it seems like they’re building it up, and there is a research scholars option with a substantial stipend to those who are interested. Didactics a few times a week (protected, CRNAs relieve the residents). Also a downside, this is an advanced only program – it sounds like the program prefers that residents are able to choose where they do a prelim, as IM there has a reputation of being a difficult year. Like Columbia, no housing, but pay is a little better (PGY2-62, PGY3-66, PGY4-68), and great location (short trip anywhere in lower manhattan, with rent in Kips Bay is a little better than other areas of manhattan) While the lack of housing is a downside, overall this program offers the most diverse case mix, patient population, and practice setting, supportive administration with happy residents, solid regional exposure, in a great location in lower Manhattan.

Sinai – The biggest strength of this program is an administration that is very involved in education. Per the PD “Some programs view residency as a job… this is anesthesia school” – great simulation-based education, didactics, intra-op teaching, and their chairman of anesthesia is now the interm president-CEO of the hospital. They also have a clinical educator tract which was kind of unique, with paid teaching time medical students (both clinical students, as well as preclinical physiology) and junior residents and building a education portfolio. Hours here were also reasonable – typically out around 5:00ish. If you have to stay late, you automatically get paid if you’re there past 7:00. Not a trauma center, but possible month at Elmhurst to get more trauma is you want it, and they have a huge liver transplant program. Clinical base year is pretty much a transitional year, even mix of medicine and surgery – although you do need to travel to Elmhurst for some rotations by campus shuttle. After the base year, residents spend almost all their time at Mount Sinai Hospital – which has a unique culture – tight knit, maybe even a little gossipy - people either love it or hate it. Location is near central park, with good subsidized housing options – it’s on the northern fringe of the upper east side, so the neighborhood becomes Spanish Harlem to the north, but a short walk southwest and you’re standing on museum mile and central park. Reputation is great in the northeast, less layman recognition outside of the area, but well-known among anesthesia people. As far as cases, cardiac is particularly good here. Regional is on the weaker side, compared experiences at HSS/HJD. Overall while they might not have the university/research powerhouse university affiliation, I was impressed with the program’s strong commitment to education and resident life – like the others, definitely worth checking out all four to see if it’s a good fit, you really can’t go wrong.
 
NYU actually did have some subsidized housing across from the main hospital, although it was pretty limited. If I remember correctly, priority was given to out of staters for this.
 
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Just chiming in as an NYU student - there is housing at NYU, it's just very limited and I wouldn't count on it. If you're from the northeast it's pretty much impossible, but occasionally out-of-state residents can get it. If you're trying to live by yourself, it might be worth applying. But if you know people in the area, and you're willing to play the NYC housing game, sharing a 2-3 bedroom works out to be comparable to an on campus studio (and you get a little separation from work).

Otherwise, great summary of the program here. Very consistent with what I've experienced so far and I couldn't have said it any better.
 
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Just curious if anyone has any thing to add in terms of doing an away elective at any of those four places? I've heard good things about Sinai for aways, not sure about the other 3 though.
 
Just curious if anyone has any thing to add in terms of doing an away elective at any of those four places? I've heard good things about Sinai for aways, not sure about the other 3 though.

I can vouch for NYU's elective -
particularly at Bellevue they are very good about letting students get involved (you'll be intubating, lines, get to know an attending and they will pretty much have let you function like an incoming CA1 by the end of the rotation.). Also some helpful daily didactics with Dr. Sutin, who runs the elective at Bellevue (co-author of the "ICU Book," and really involved in teaching here). Also a couple simulator sessions just for the rotating medical students, which was a pretty cool opportunity. You can also request a week or two of subspecialty in your schedule if you have a particular interest (regional/cardiac/peds/ob...etc).

I've also heard that people really enjoy electives at Mount Sinai - particularly if you're interested in delving into a particular subspecialty for 4 weeks (I think they offer cardiac/ob/neuro), or they also have an elective to design simulation modules which is also pretty unique. Definitely check them out too.

I know someone that rotated up at Cornell, he thought it was ok, but I got the feeling from him that it was kind of difficult to get involved in the cases. Also a little less structured in terms of lectures/conferences, which I personally find very helpful as a student.(a lot of times they might not talk you through everything in the OR, and by having some sort of didactics makes sure you're walking through the thought process...)

I don't know anyone who rotated at Columbia, so can't really comment. But I do know that NYU and Sinai are definitely worthwhile for an away rotation.
 
I can vouch for NYU's elective -
particularly at Bellevue they are very good about letting students get involved (you'll be intubating, lines, get to know an attending and they will pretty much have let you function like an incoming CA1 by the end of the rotation.). Also some helpful daily didactics with Dr. Sutin, who runs the elective at Bellevue (co-author of the "ICU Book," and really involved in teaching here). Also a couple simulator sessions just for the rotating medical students, which was a pretty cool opportunity. You can also request a week or two of subspecialty in your schedule if you have a particular interest (regional/cardiac/peds/ob...etc).

I've also heard that people really enjoy electives at Mount Sinai - particularly if you're interested in delving into a particular subspecialty for 4 weeks (I think they offer cardiac/ob/neuro), or they also have an elective to design simulation modules which is also pretty unique. Definitely check them out too.

I know someone that rotated up at Cornell, he thought it was ok, but I got the feeling from him that it was kind of difficult to get involved in the cases. Also a little less structured in terms of lectures/conferences, which I personally find very helpful as a student.(a lot of times they might not talk you through everything in the OR, and by having some sort of didactics makes sure you're walking through the thought process...)

I don't know anyone who rotated at Columbia, so can't really comment. But I do know that NYU and Sinai are definitely worthwhile for an away rotation.

Awesome, thanks!
 
Thanks for the great responses! I think I'm gonna plan on applying for aways at NYU and Sinai. I've been asking around, and those two keep getting mentioned as places I should rotate. When it comes time to apply, will definitely put an application out to all four.
 
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Ok, application time! The replies I got seem to be pretty consistent to what I've been hearing asking around. I haven't heard a lot about Einstein or Maimonides, are they worth considering? They seemed to get left out of the conversation so far
 
Ok, application time! The replies I got seem to be pretty consistent to what I've been hearing asking around. I haven't heard a lot about Einstein or Maimonides, are they worth considering? They seemed to get left out of the conversation so far

If you're competitive at the "Big 4," I wasn't impressed with Maimo. The interview day was the worst experience of interview season, waited for hours in a basement for my interview. Clinical training seemed decent, but if you're competitive major university programs...I'd look elsewhere unless you absolutely have to be in NYC.

Einstein was a little better, but the program is being overhauled. They had some issues with accreditation and duty hours -- but they've made some efforts to clean things up. Also keep be sure go google map the location -- I felt like a lot of interviewees were surprised the med center is a bit of a trek from Manhattan.

Here was my take of all of them:

1. Columbia or NYU
--- depending on preferences (location washington heights vs. murray hill, clinical vs. research), I thought that clinical exposure at NYU was the most well rounded (great ICU, the only manhattan hospital with good trauma experience, regional at HJD, pain service) vs. more basic science research and pediatrics sponger at Columbia (Apgar scholars sounded like a pretty great program if you want to run a lab).
2. Sinai
--- Enthusiastic, and the PD is awesome.
3. Cornell
--- Hospital is like a castle and nice housing perks, but residents were overworked and not enthusiastic. They were high on my list, until I went back to visit a second time and followed a resident for the day.
4. Einstein
5. Maimo/Downstate
 
1. Columbia or NYU
--- depending on preferences (location washington heights vs. murray hill, clinical vs. research), I thought that clinical exposure at NYU was the most well rounded (great ICU, the only manhattan hospital with good trauma experience, regional at HJD, pain service) vs. more basic science research and pediatrics sponger at Columbia (Apgar scholars sounded like a pretty great program if you want to run a lab).
2. Sinai
--- Enthusiastic, and the PD is awesome.
3. Cornell
--- Hospital is like a castle and nice housing perks, but residents were overworked and not enthusiastic. They were high on my list, until I went back to visit a second time and followed a resident for the day.
4. Einstein
5. Maimo/Downstate

I thought NYU was a fairly well kept secret -- but you just had to post this during application season. I really want to stay for residency! I agree with you, but please keep it quiet until after March ;) But seriously, glad you got a good impression.
 
There's no contest. Columbia is hands down the best program in NY. The administration isn't involved in resident life and you don't like the neighborhood? seriously? you're going to residency for the training, and that's what matters. You can train at the best medical center in the city, or that other hospital downtown. It's a small price to pay for superior training.
 
Seems to me that any program with good exposure to ALL subspecialties and decent fellowship placement is a good program in NYC to go to. IMO, I think NYU is the most well rounded of the NYC programs.
 
subspecialties
I hate this word. It makes things sound more complicated than they are. Its all anesthesia there are no subspeciatiesWhat good is fantastic exposure in peds cardiac, when you will NEVER do it? The best residency is the one that you fit in at and the one that accepts you. As I said, for me, I would pick a community program with private practice attendings ( sort of where i trained) over a bunch of academic harvard types.
 
I hate this word. It makes things sound more complicated than they are. Its all anesthesia, there are no subspecialties.. What good is fantastic exposure in peds cardiac, when you will NEVER do it? The best residency is the one that you fit in at and the one that accepts you. As I said, for me, I would pick a community program with private practice attendings ( sort of where i trained) over a bunch of academic harvard types.
 
I'm with you there. Not really into academics since that generally pays less. I think it helps if you get exposure into "subspecialties" since there's some areas of anesthesia that the private attendings just don't do. Therefore, it's easy to establish your value if you're the guy with experience in those areas and there's a need for in it the private practice you work in. I wouldn't want to be just another attending in a private practice. I'd want some unique skill that can make me $$$.
 
In your opinion.

Not really just my opinion - it's the most established program, with an extensive history in anesthesia. How is NYU more well rounded? Columbia has all the same subspecialties, but at a stronger training program.
 
Not really just my opinion - it's the most established program, with an extensive history in anesthesia. How is NYU more well rounded? Columbia has all the same subspecialties, but at a stronger training program.

Actually that's not true. I can name a few -- Trauma (Bellevue), Regional (Hospital of Joint Disease), and a solid pain service experience -- all of which are relatively weak at Columbia. Enjoy the Heights!
 
Not really just my opinion - it's the most established program, with an extensive history in anesthesia. How is NYU more well rounded? Columbia has all the same subspecialties, but at a stronger training program.

I'm confused -- I already said that Columbia and NYU were my top picks in NYC (I'm not sure if you actually read my review). I don't think there is any stronger program. All four have advantages and disadvantages, it comes down to personal fit.

Location: NYU > Cornell > Sinai > Columbia
Resident Support: Sinai = NYU > Columbia > Cornell
Clinical Diversity: NYU > Columbia > Sinai > Cornell
Basic Science Research: Columbia > Cornell > NYU > Sinai
Housing/Salary: Cornell > Sinai > NYU > Columbia
Name Recognition: Columbia = Cornell > NYU > Sinai
Schedule: NYU > Sinai > Columbia > Cornell
Trauma: NYU > Sinai = Cornell = Columbia
Transplant: Columbia > Cornell > NYU > Sinai
Regional: Cornell > NYU > Columbia = Sinai
Pediatrics: Columbia > Cornell = NYU = Sinai
Pain: Cornell > NYU > Sinai > Columbia
 
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