Official 2013-2014 Help Me Rank Megathread

[NaOut]

any other opinions? in particular, concerning the order AND my biggest concerns for each? thx!

In regards to BID, the most important aspect of an EMR is the ability to place orders. I've spoken to a few attendants who trained Pre EMR and they state that it has actually made them less efficient. As in you waste a lot of time on the computer and not seeing patients. One guy said he used to see at least 20 patients per half day clinic, but now cut down to 10-12. The gist of the conversation was basically if they kept progress notes on paper and orders on computer that wouldve been the best combination. I can see how not having one particular thing on the computer could be annoying, especially in ICU where vitals are ordered more frequently. ICU is a geographic space so I'm sure if the nurse did measure abnormal vitals you would be alerted immediately. This is probably true on the floors as well. I can definitely see how it could be annoying tho, but I wouldn't use it as deciding factor.

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[slugjat]

In regards to BID, the most important aspect of an EMR is the ability to place orders. I've spoken to a few attendants who trained Pre EMR and they state that it has actually made them less efficient. As in you waste a lot of time on the computer and not seeing patients. One guy said he used to see at least 20 patients per half day clinic, but now cut down to 10-12. The gist of the conversation was basically if they kept progress notes on paper and orders on computer that wouldve been the best combination. I can see how not having one particular thing on the computer could be annoying, especially in ICU where vitals are ordered more frequently. ICU is a geographic space so I'm sure if the nurse did measure abnormal vitals you would be alerted immediately. This is probably true on the floors as well. I can definitely see how it could be annoying tho, but I wouldn't use it as deciding factor.

ah. thanks for the response. appreciate it!

 

[visari]

thoughts on the following?

gtown
rush
rwj
umiami
christiana care
njms

I agree with your list as it is

 

[visari]

any other opinions? in particular, concerning the order AND my biggest concerns for each? thx!

not having a sophisticated EMR system is definitely a negative point but it has to be a really ******ed EMR to make me change my rank list. And I don't agree that all-electronic EMR systems make you less efficient. This's the first time I hear something like that. Writing progress notes on paper and having to dig out vitals out of stacks of flowsheets is soon going to disappear from modern medicine. Not having a MAR included in the EMR is trouble waiting to happen. I worked in all environments from all paper to hybrid electronic-paper systems to full electronic (EPIC) system and I think patient care has improved as a result.

 

[dynamics]

Jefferson vs. Georgetown. I currently have Jeff ranked higher.

Both PDs solid. Seemed like better teaching/learning experience at Jeff. I love DC and am neutral toward Philly.

Opinions on reputation/perception nationally? Eventual goal is hospitalist/administration near NYC.

 

[HelpPleaseMD]

Middle of my list. Interested in GI as well. pretty much set but open to opinions

Emory, Case, USC, GT, UIC, Maryland in that order

 

[jturkel]

Middle of my list. Interested in GI as well. pretty much set but open to opinions

Emory, Case, USC, GT, UIC, Maryland in that order

i didn't like emory at all. many other applicants interviewed with that day didnt either. seemed malignant, residents unhappy, they seem to have leadership and financial issues. fwiw, it's the only program i interviewed at that i'm not ranking.

 

[HelpPleaseMD]

how does the rest of the list look?

 

[HelpPleaseMD]

emory I must admit is a strange one. I liked the interview day/dinner night before but not sure how I felt about leadership

 

[jturkel]

how does the rest of the list look?

didn't interview at any of the others so can't give helpful comment otherwise. sry

 

[HelpPleaseMD]

np.

 

[10987654321]

So, I'm trying to decide whether to put UNC vs. UTSW at #4 on my list. I've got Vanderbilt, UVA, and Wash U at #'s 1, 2, and 3. I'm thinking possibly general medicine vs. Pulm/CC vs GI as future plans maybe in academics. I would love to go with my gut on this one but I really loved both programs on interview day. Does either one really set me up particularly well in Pulm/CC or GI vs the other? Is this basically a coin toss decision? I know UNC is supposed to be great for General Medicine. I really like the +1 schedule of UTSW as well. Any thoughts? Thanks for all of the advice.

Any opinions. Right now I have UNC at 4 with UTSW at 5 due to having some family in the Chapel Hill. If UTSW sets me up better post-residency I'd be willing to move it to 4. Thanks.

 

[jturkel]

Any opinions. Right now I have UNC at 4 with UTSW at 5 due to having some family in the Chapel Hill. If UTSW sets me up better post-residency I'd be willing to move it to 4. Thanks.

didn't apply or interview at either of these programs. however, have heard good things from GI fellows at my program about UNC's GI program. No clue about pulm/cc. For IM, UTSW > UNC

 

[cognoscente]

Hi all, would like some input on #3-9 in my rank list. I'm thinking about cardiology. Right now I have:

UChicago: city seems cool to live in, residents seemed nice, like 4+2, good reputation
NYU: would love to be in NYC, reputation from what I've heard is not quite as strong
Pittsburgh: good reputation, city seemed better than I thought it would be, liked program director
Hopkins-Bayview: liked match list from last year a lot (matched like an elite program), though this year not quite as impressive; also, don't love that it's a small program and might be too touchy-feely
OHSU: closer to family on west coast, not sure about so many fellows staying in house, city may be too hip for me
UTSW: good reputation, really liked program director and APDs, pretty persistent in recruiting emails; reputation is that you work harder here compared to other places, not sure about living in Texas but that's not based on much
Emory: didn't like PD, never got to see Atlanta; good reputation, but heard residents not as happy from other people

Just typing this out helped me think through things a little bit. My main thoughts now are about moving UTSW higher (maybe just below NYU?), but want to avoid any last-minute rash decisions. My rank list has looked like this for a while now, though I haven't been spending any dedicated time thinking about it besides glancing at it every once in a while. Any input would be appreciated!

 

[Thama]

didn't apply or interview at either of these programs. however, have heard good things from GI fellows at my program about UNC's GI program. No clue about pulm/cc. For IM, UTSW > UNC

Luminal is great at UNC, but there's little hepatology.

 

[tallash]

Posting for a classmate. Interested in Pulm/CC but not 100%, possibly planning to return to home program (midwest, middle-tier) for fellowship.

1. JHH
2. UCLA
3. Stanford
4. UWash
5. OHSU

Uncertain about #3-5. He felt like he would be happiest (quality of life-wise) at OHSU but doesn't want to shut any doors for fellowship if he changes his mind on pulm. Reputation of program is reasonably important. The question is, would it be unwise to move OHSU up to #2 or 3?

Yes. For someone interested in Pulm/CC UDub should be higher than both UCLA and Stanford based on quality of residency training and Pulm/CC exposure. Stanford recently lost a training grant for their fellowship as well, whereas UWash is one of the premier programs in the country. I looked at some of those programs and I would personally go:

1. UWash given apparent West Coast bias
2. JHH
3./4. Stanford/UCLA based on personal preference - would he rather be in an overpriced suburb or the L.A. wasteland?
5. OHSU

 

[Hopeful M D]

Does USC use a fully electronic EMR?

 

[drillingstudent]

Does USC use a fully electronic EMR?

No. All orders and some consult notes are still paper. I also remember paper charts for some other stuff too.

All three LA county hospitals are supposed to be switching to the same full EMR soon, but Harbor-UCLA will be first according to their PD.

 

[HelpPleaseMD]

good luck everyone. hope you have all certified your list by now. no need to wait till last 30 mins

 

[disorder]

good luck. may everyone get within their top 3.

 

[NaOut]

Its been real sdn. I wish you all God speed!

Sodium Out.

 

[gutonc]

I have never been so happy to close a thread as I have this one.

I hope all goes well for everyone.

But...just...wow.