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NYC Prelim-- North Shore LIJ
- Thread starter chocomalt
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How is that possible? It's only 16 miles from the midtown tunnel.
I'm sure there are some flaws with the scheduling, but you have to compare it against other prelim programs in NYC which are brutal most of the time.
D
deleted103644
I'd say it's probably a 30 min commute from Manhattan minimum, but traffic is unpredictable. I'm guessing he's referring to people commuting from the West side of Manhattan where you can get stuck in serious crosstown traffic.
I'm going to disagree with point number 4. I spent 3 months at NSLIJ, and the residents I worked with were outstanding, in my opinion. In addition, I thought the teaching was excellent. Morning report and noon conference, when I was there, were done as a series of lectures. A week of rheum, a week of renal, etc. It was quite helpful.
It sounds like you had a bad time of because of lack of choice, which may very well be the case, but it seems to have soured your outlook on the whole program. In other words, BECAUSE you were unhappy, everything else seemed to suck as opposed to it sucking that made you unhappy.
There has to be a reason that you decided to go there in the first place, and I highly doubt that it's because "they lied to me!"
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That's dissapointing to hear that elective time is partially a consult service.. How late do these elective days go?
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[FONT=Arial,Helvetica]11 of 44 people found the following review helpful:
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[FONT=verdana, arial]Attending. [FONT=verdana, arial]Overall Rating:
[FONT=verdana, arial] [FONT=verdana, arial]Teaching:.
When I read the post from 7/7/04, I was physically sickened with the remembrances of the worst year of my life. I had blocked out much of the horror, but the post of 7/7/04 brought it all back. It is amazing that after 10 years things don't change much. It is hard to change when the program is so inbred as I see it still is. Based on the 7/7/04 post, things really don't change too much there. Oh, they may fiddle with the schedule a bit, but don't be fooled it is the same program.
If you are preliminary as I was, please don't make the worst decision of your life and end up here. Probably you are preliminary because you are going into a competitive field. The only people coming from the top of the med school class are the other preliminary people. The rest are from weak schools and most are weak interns and residents.
The schedule is grueling, tedious, and boring. There is nothing cush about this program. It is a dump factory of uninteresting cases and tedious grunt work. I dont think it would be helpful to go into detail about how things were 10 years ago. However, nothing that is posted from 7/7/04 is untrue. In fact the poster was quite nice in his descriptions. I remember being told I would have my birthday off and ended up working that day. I also lost promised vacation time. I ended up without elective time and did extra CCU/ICU. The best thing was that I was fortunate to have housing behind the hospital. It was old and nasty, but there was free food in the hospital and I managed to save some money that year.
Teaching
The faculty was inbred. They cared more about dumping their uninteresting patients on you than anything else. The Faculty from the program directors to the nursing staff was malicious and this behavior was condoned from the top down. Conferences were mediocre and included the same tuna fish sandwiches and milk every day. I still cant eat tuna fish. Im glad to see they are putting some different kinds of sandwiches during the conferences. As a preliminary, teaching was pitiful and not on par with my med school training. It is crazy that the consult game still goes on. Ill never forget what a resident told me on rounds when services changed. I was on a two intern team on the aids floor taking care of 27 patients between us. He told me the first thing to do when you switch services is to order ID consults on all your patients. The result was the ID fellow would come by and read the whole chart and summarize it in one concise consult note so you would not have to do the work. Your job is to organize all the many consults ordered on each patient. You will learn to order and draw chem. 20s on all your patients, everyday. You will learn from the best shotgun practitioners in the business. I can still remember how proud and smart they were when one of the 10 consults they ordered resulted in a diagnosis of their patient. As a preliminary intern, you do not need to be subjected to the cruelty of this program, because you succeeded and managed to get a competitive residency.
Atmosphere
I did manage to have some minimal time to myself. On night float, I would leave at 7AM to drive down to Jones Beach to sleep the day away and look for pretty girls. I would return in the afternoon and shower and get ready for another grinding night. I had a few dates and girlfriends that year, but I was so mentally drained by the abuse of the program that it made dating hard. I really enjoyed going to Sloan Kettering in the City for a week or two, but preliminary interns were not treated well there either. I agree with the 7/7/04 poster as we were not allowed in any of the resident teachings, board reviews or reports. We never saw a drug rep and I believe this privilege was reserved for a certain few or the chief residents. The atmosphere overall does not appear to have changed at all. Petty politics, meanness, and the poster child for dumming down of medicine appear to be imbedded in this program.
Conclusion
The most important statement I could make is that I would not allow my children to an internship at this hospital. I think the program breeds mediocrity at best. For the preliminary intern its a group of mean slow bullies taking advantage of the smart kids, resenting them, and kicking them around for one last time. The program is really an embarrassment for medicine in general. The year did not improve me. It was an unnecessary wasted year. I am sorry I had to relive some of the year by reading previous posts and writing this. I do not wish this experience on anyone. I still live in fear of the people at this program and wish not to be contacted. If I were to do it again, I would choose elsewhere.
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[FONT=Arial,Helvetica]40 of 61 people found the following review helpful:
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[FONT=verdana, arial]Intern. [FONT=verdana, arial]Overall Rating:
[FONT=verdana, arial] [FONT=verdana, arial]Teaching:.
I was a preliminary intern in this program. On the floors, sign in rounds start at 7 am, and you never sign out before 5PM. Getting out at 5 pm definitely depends on how efficient you are, and how efficient your resident is. Some months I got out at 6-7 PM every day.
The schedule this year has changed drastically from last year. The program director has altered the schedule in an effort to "enhance" the learning environment... Unfortunately, the changes did nothing but enhance the misery and general disdain of the residents in the program. Call is now Q4 on the floors, and admissions are capped at 16 per team... thats 8 admissions for each intern (2 interns and one resident per team, plus or minus a Sub-Intern). The call at this hospital is ridiculous...it is really a patient factory, and if there are open beds, they will get filled almost without fail. (and it is a big hospital) You can be assured that you will cap admissions almost every call, and that 90% of your admissions will be very uninteresting.
Night float comes in at 9 pm and takes admissions through the night. Our post-call day we get all the night admissions dumped onto our team at 7 am, making post call days just as hectic as on-call days. Then we go into "purge" mode, and madly scramble to reduce our census in the following 2 days before the next call, discharging like crazy. I found myself to often have 12 patients post call, and that just hurts. Time to read?? Forget it. You can bet on the floors, which is most of your year, you'll have an average of 8+ patients. If you are on call on friday, you get to stay all night and admit all night till the following day at 10 am, and one intern gets to do cross-coverage all night on like 80-90 patients. Expect to work 74-80 hour weeks at this internship. The cross coverage is a nightmare, as the nurses on the wards will page you if the patient sneezes.
Teaching
Here's where it gets juicy. If you are a prelim looking for a nice year in medicine before your real residency, LOOK ELSEWHERE. Prelims get SCREWED at this program. I was promised during my interview at North Shore the following: 3 months of elective, 4 months of floor at Q5 call, one micu month, free food, cheap hospital subsidized housing which was "guaranteed" if you wanted it, and 4 weeks vacation. What we GOT as prelims: 8 months of floors (6 days a week, Q4 call), one measly month of elective which was CHOSEN FOR US, one MICU month at Q4 overnight call, One month of night float (6 days a week 12-hour nights), none of us got the housing (this area expect to pay $1,000 minimum for an apmt), they revoked our free food (cafeteria food, which makes Purina dog food taste good), made friday call overnight on the floors, and only gave us 3 weeks vacation (the last being "banked" for sick days). They neglected to tell us of these changes until a week after they made us sign the contract. In any other profession, this type of practice would be illegal and probably the subject of a successful lawsuit. But, since we are only medicine interns, we arent classified as human beings at North Shore. Really though, I found it extremely dishonest of the program, as did my fellow prelim interns. To boot, they took away our resident lounge and replaced it with a lounge (a hallway with a false wall and a couch) so far away from the patient floors, that it was completely impractical go to. I almost pissed myself laughing when, in a resident meeting, the program director told the female residents to not go to the lounge at night alone. Needless to say, all these changes caused a lot of resent and anger among the preliminary interns, who for the most part had the board scores and records to go to just about any preliminary program. We met with the Program director and the Chief Residents, who actually had the gaul to tell us that our schedules were "no different" from the categorical interns, whom most had 3 months of elective. Night float is rough, and very very busy. As an intern we did not take admissions, but rather covered the cross coverage beeper, which ranged from awful to managable depending on the night. You will rarely sleep, if ever, both on night float and on overnight call. Nurses will call you to see if they should wake a patient up to give them ambien. The good points of the schedule and hospital in general? There is excellent ancillary services, and social workers are very adept at getting discharges under way. The turnover is quick, and very often most of your census will turn over in 4 days. So all in all, you see ALOT of cases. A LOT of cellulitis, ROMIs, PNA, and other completely uninteresting cases. The hospital is nice, clean, and well kept.
Atmosphere
So now youre saying "ok, so what...internship is supposed to be painful". I agree with that insomuch as if you work your butt off in an internship, you should be rewarded by learning a lot from the attending physicians and senior residents. Unfortunately the teaching at North Shore Hospital is piss-poor-pathetic. For the most part, the private attendings (which have most of your patients) will have nothing to do with you but will shiver in joyful glee as you do their job for them on resident covered floors. Many of them after 8 months of floors I had yet to even speak with. None of them teach you anything, but are more than happy to yell at you if you dont do something they scribble in their illegible chicken-scratch. They are also for the most part gutless (they all shake in fear of being sued) and most will refuse to manage well . anything without a pan-consult from every specialty imaginable. Hrmmm anemia, low MCV, high RDW, high TIBC . Hrmmmmm You, INTERN, call a heme consult But go figure, most of them did their residency at North Shore. The senior residents at this program are hit or miss... about a fouth are not exactly stellar, a 4th make idiots look brilliant, a 4th are decent and a 4th are great. Overall if you want to come to a place with really intelligent, well-read peers, this is not the place to do categorical medicine... In fact, interns are not allowed to attend morning report or board reviews, and when I inquired as to why this was, one chief resident told me it was "so the interns didnt make the residents look bad or feel embarrassed to ask questions". I was quite vexed by this response. Ridiculous! Thats like admitting that your categorical residents arent exactly cream-of-the-crop. To make matters worse, when you are fortunate enough to get a strong resident, they are constantly given additional teams to cover and hence have little time to teach the interns or students. The interns attend noon conference, which for the most part are good lectures, but unfortunately are not accompanied by many drug lunches... Maybe one a month. Instead they bring a food cart from the cafeteria which consists of cold cuts and buns, sometimes a tad moldy. Again, as a prelim you are not given a month on the oncology ward or the HIV service, which the categoricals are. Also if there is a line or procedure to be done, they will give it to the categorical interns or residents, so as a prelim, you dont get to do much in terms of procedures. A real disgrace to this residency program is that no one is keeping tabs on what cases goto the teaching floors, and if a case has really no learning value, the case is NEVER moved off of the teaching floor. Many times I was knee deep in gomers with hip fractures and foot ulcers, some of which stayed on my service for MONTHS, while the babesiosis case went to an non-resident covered floor. In fact, as it turns out, a freaking BED NURSE (yes, thats right, an R.N.) decides what cases come to the teaching floors. Anyone see anything wrong with this picture?? Anyone at all?? Also as it turns out, the private attendings will do just about anything to get their patients on a covered floor, not limited to bribing the bed nurse, even when their cases are completely uninteresting and when these attendings have absolutely NO INTENTION to teach the housestaff anything. There seems to be a complete lack of policing the cases on the teaching floor by the program director. The Chief residents last year were completely non-supportive of the residents (especially prelims) and would only talk to you in person to chastise you about something. Numerous times I overheard a specific chief using slang and profanity to belittle an intern or resident. The lack of professionalism they displayed made me physically sick to my stomach. And strangely, the program director did nothing to subvert this blantant abuse of power. The chiefs were also extremely unforgiving when it came to schedule changes or requests, and would show blatant favoritism to certain residents/interns. One prelim who complained to the program director about the fact that the prelims were lied to in the interview was then singled out by this chief, who would call this intern in to yell at them often for such mundane things as being 2 min late to conference. Again, the complete disgusting lack of professionalism was too disturbing to adequately comprehend. Attending rounds are for about 1 hour a day in the AM, and overall were pretty poor in terms of teaching. Another real downside to this new "system" is that the patients often come up to the floor after being completely worked up in the ER, some of them after 12-24 hours, with orders already written or faxed in by an attending. This IMHO robs the residents of seeing the case as it truly, acutely presented to the ER. Instead you get to make no decisions but get to follow a completely worked up patient. This has resulted in alot of the senior residents spending their entire day on the phone for fear of actually making a decision on the patient for themselves. ALL in all, the teaching program at North Shore is very weak with the "new system" and has created a great many disgruntled residents. A good many of the strong categorical interns are speaking of transferring programs.... the strange thing about this fact is that the administration is doing little to correct these issues, and surely they know the problems that exist. I had very little free time as a prelim intern and was genuinely miserable with how this program turned out, and most of the interns share this sentiment. About half of the intern class started on antidepressants, and the other half began to wish they had. One thing which kept us going was the commeradarie between interns and many residents, which made the work environment less painful
Conclusion
My conclusions: GOOD: Nice facilities, good pay, minimal overnight call, great cammeradarie between residents. BAD: Pathetic teaching, long work hours, painful floor months, non-supportive administration, lack of policing teaching cases, no time read, worthless nursing staff on wards. IF you are looking for a prelim year, avoid this program at all costs. The work-to-benefit ratio simply is very low, and prelims are abused in terms of schedule and elective time. For the categoricals, I also feel the program is very weak and overtly paternalistic to the residents. I would apply only if there was evidence of the system being completely overhauled again, this time for the benefit of the residents. While no program can be perfect, it is reasonable to think that striving for positive change would be in the best interests of the program. Would I apply again? NO. Please do not contact me about this review.... .[FONT=verdana, arial]
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[FONT=Arial,Helvetica] 7 of 33 people found the following review helpful:.
[FONT=verdana, arial]Intern. [FONT=verdana, arial]Overall Rating:
[FONT=verdana, arial] [FONT=verdana, arial]Teaching:.
They are going to have major changes on the floor next year. The details are not out yet but it is bound to be chaotic. They will have some overnight calls so for those who don't like staying overnight stay away.
Teaching
Morning teaching rounds are usually ok. However, most so called volunteer faculty don't teach at all. The attendance of conferences is poor. Not only do the residents/interns not show up but a lot of time even the speakers don't show up. Although there are supposed to be morning reports they often get canceled for one reason or the other. Lectures don't tend to be too interesting but lunch is provided.
Atmosphere
I have to agree that people definitely talk a lot in this program. Gossips are constant and everyone goes talk to the chiefs about everything!
Conclusion
For me, I am only here for a year so I don't mind. After all, housing is cheap and food is free. However, if you are looking for real teaching or to work with competent people I will look elsewhere. Would I come to this program again? Not with the way things are going to be.
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[FONT=Arial,Helvetica] 40 of 71 people found the following review helpful:.
[FONT=verdana, arial]Intern. [FONT=verdana, arial]Overall Rating:
[FONT=verdana, arial] [FONT=verdana, arial]Teaching:.
As an intern, on a floor-based rotation (not unit), I get sign in from the night-float at 7am. I use 7-7:30 (the time the resident's are getting the hold-overs - from night float admissions) to round on my patients. From 7:30-8:30 there are attending rounds which depending on the attending have been anywhere from fantastic to mediocre at best. There are anywhere from 1-3 hours of mandatory conference a day. I eat lunch during noon conference. I consider myself to be an efficient intern. The earliest you can sign-out to NF is 5pm. I would say 70% of the time I sign out then. 20% of the time I sign out at 6-6:30. If a patient starts crashing, I stay leaving 10% of my days that I've signed out past 7-8pm. Call is Q5 that ends at 9pm. That's the last time you can get an admission. I leave 50% of my calls at 9:30, the remainder I probably get out anywhere from 10-11:30. The next day is a full day.
Interns have 3 full months of electives. Typically 7 or 8am till 5-6pm. No call, but one weekend in four is spent covering the night float.
Teaching
Despite the fact that there are many hospital based attendings, most are private. Depending on your reputation and your own relationship with each individual attending, you can do more or less with your patients. An extremely competent intern with a reputation that follows can be relatively independent 50% of the time. There are some attendings that want to be phoned if you tie your own shoes
Every admission is followed by a phone-call to the attending to sum-up the management of the patient. If you can discuss a case very concisely and very accurately, you can convince the attending to follow your management. EVERY attending at this hospital believes in consults. My personal belief is because of a referral-economy. Would you consult a hematologist for anemia in a GI bleeder who has cancer?? The teaching by some attendings is fantastic, some have stayed with me an hour just for fun. Making themselves late. Unfortunately, there are others who are only about business, never even stop to discuss the case with you, but somehow mysteriously know your pager number when they want to harass you to do work or are unhappy and want to chastise you. Fortunately, this is only 10%. Attending rounds are usually sit-down, rarely walk around. Noon conference in typically good, but could be better. Conference with the chief residents is also typically very good.Atmosphere
The physical environment in clean and beautiful. Altogether well-kept for a hospital. I do very little scut. I only do radial-stick for bloods if a phlebotomist can't draw. I do ABGs and other procedures. Camaraderie amongst peers and residents is a hoax. Everyone is your best friend, but they are always willing to talk to the chiefs about you. My personal feeling is that professionalism begs you to discuss issues directly to someone first before reporting them to higher authorities, which is conveniently anonymous.
Conclusion
What stands out? I have a life: time for myself & my girlfriend. Drawbacks? I can't stand the politics. Do I feel prepared? Yes. Would I reapply? Yes, I would reapply..
Both reviews are from years ago, from a website full of outdated opinions (not always, but sometimes...this may or may not be one of them).
Not everyone loves every place.
Different people have different experiences.
Also, in my opinion, the writer of one of those opinions who felt like a "picked on smart kid" and who drove to the beach to "check out pretty girls" sounds like a douche.
Then again I don't know him, or the OP.
I don't go there, but as an MS4 who spent my sub-I months there, I can tell you I had a fantastic time.
The newer reviews on scutwork.com seem to be great as well.
Not everyone loves every place.
Different people have different experiences.
Also, in my opinion, the writer of one of those opinions who felt like a "picked on smart kid" and who drove to the beach to "check out pretty girls" sounds like a douche.
Then again I don't know him, or the OP.
I don't go there, but as an MS4 who spent my sub-I months there, I can tell you I had a fantastic time.
The newer reviews on scutwork.com seem to be great as well.
D
deleted103644
Yeah, scutwork is too old to be useful. Considering the 16 hour day regulation only went into effect last year, most of the complaints are no longer relevant.
Very disappointed that the 4+1 system isn't as nice as it was sold to be - is this true at the Stony Brook program too?
Very disappointed that the 4+1 system isn't as nice as it was sold to be - is this true at the Stony Brook program too?
D
deleted103644
Anyone have any last minute things to say about NSLIJ?
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I just finished my prelim year at this program and had a great time. I have a hunch who chocomalt may be and if it's who I think it is.... well all i'm going to say is that working or learning wasn't exactly this person's objective for internship. Personally, I think it's really sad to complain of 10-12 weeks of elective time. What other program gives you that as an intern? And do you really think that if you had gone to any other program as a prelim and gotten the measly 1 month of elective that you would have gotten to do a month of optho or radiology. What's the point of spending a month doing what you are going to be doing for the next 3+ years. I can definatively say I learned alot on my electives -it's what you put into it and how much you want to learn that matters. And as for the rest of the year and floors, units etc. the teaching was great. Yes the hospitalists are young, but where exactly do you see a hospital that has an army of old teaching hospitalists. They are young all over the country. And they couldn't have been nicer or more flexible. I think what we were told on interviews was exactly what I got. And I think this program with the new medical school is certainly on par with alot of the big nyc programs. And much more friendly. Best of luck to all!
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