Plans for the intern year

[Southpaw]

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What do you fellow applicants plan on doing for the first year? I initially thought a medicine year would be best so I applied for a few prelim medicine positions. After further thought I'm thinking a year in surgery would suit me well. I feel I'd learn more, definitely get more procedures, get used to working with the personalities of surgeons, and develop a strong work ethic as a resident. I have no interest in the TY year as it seems to be a repeat of the 3rd year of medical school. What are your thoughts?

Do you plan on doing 1) categorical 2) TY 3) pre-lim med 4) pre-lim surgery

What would you senior residents/attendings out there recommend?

Also, does anyone know our requirements or recommendations from the ACGME for our first year? I heard that we're now supposed to get 4 months of ICU throughout residency, so 2 months during the intern year would seem key.

 

[Southpaw]

Here we go:

http://www.acgme.org/acWebsite/downloads/RRC_progReq/040_anesthesiology_07012008_u03102008.pdf

Looks like we need 6 months of caring for inpatients in medicine, peds, surgery, OB, family med, neuro, or any combo of these. Looks also that we need rotations in EM and Critical Care, with atleast one month, and no more than two months of each. The other months could seemingly be filled with electives.

 

[nutmegs]

Definitely recommend categorical at YOUR program. I did a mix of peds (including NICU), medicine, surgery, and anesthesia and have definitely benefited from caring for a wide range of patients.

 

[G0S2]

CBY1 here:

-MICU
-SICU
-NICU
-Med Ward
-ENT
-Pit in ED/Trauma
-Peds ward
-Gen Surg
-Pain clinic
-Preop eval
-Anesthesia

 

[Plead the Fifth]

I'm a CBY in a categorical program:

2 months general medicine wards
2 months cardiology/CCU
1 month MICU
1 month Trauma Surgery
1 month Pre-Op clinic
1 month Neuroanesthesia ICU
1 month Anesthesia (OR)
1 month Internal Medicine clinic
1 month vacation
2 weeks EKG
2 weeks night float (IM)

So a total of 6 call months, 5 non-call months and 1 month of vacation.

Anesthesia prelims here basically do 4-5 months of general wards, 1 month MICU, 1 month cardiology/CCU, 1 month night float, 1 month vacation, and the rest electives.

 

[pillowhead]

I did a transitional year which consisted of-

4 medicine ward months
1 medicine ambulatory month
1 MICU month
1 Rheumatology month (total vacation)
1 Pulmonary month
1 Neurology month (also covers Neuro ICU)
1 Emergency month (painful)
1 Peds Emergency month
1 anesthesia month

Things that were suprisingly helpful included the Neuro month and the peds ER month, I guess because it was my only peds exposure the whole year. Neither would have been in a prelim med or surg year.

I do not recommend a prelim surgery year. If you do go that route, pick your programs very very very carefully. I've only met one person who was happy with the fact that they did prelim surgery; most were pretty miserable. The above months gave me quite a few procedures and honestly, you'll have three years of anesthesia to get yourself all the procedures you need.

 

[fakin' the funk]

I am jealous of the radiology, ophtho, derm people who get to truly slack off during internship. We get stuck with a minimum of 6 inpatient months, usually 8 including the 2 of ICU plus an ED month. Many medicine prelims don't even offer an ED month so it comes out of the elective time. Grr.

 

[glenoid fossa]

What do you fellow applicants plan on doing for the first year? I initially thought a medicine year would be best so I applied for a few prelim medicine positions. After further thought I'm thinking a year in surgery would suit me well. I feel I'd learn more, definitely get more procedures, get used to working with the personalities of surgeons, and develop a strong work ethic as a resident. I have no interest in the TY year as it seems to be a repeat of the 3rd year of medical school. What are your thoughts?

Do you plan on doing 1) categorical 2) TY 3) pre-lim med 4) pre-lim surgery

I am an intern who passed up a transition year in order to do a surgical year for this same type of thinking. I thought I wouldn't learn anything in a transition year, and even though I knew I would work harder in surgery, I thought I would be better for it. So, I will tell you now, as emphatically as I possible can, DO NOT MAKE THE SAME MISTAKE I MADE!!!!!!!!

I work longer hours (quite often over 80), I work harder while I am there, I am talked down to daily, I am commonly treated like I am stupid, I am often made to feel inferior because everyone knows I'm "not a real surgeon" and have "sold out to do anesthesiology", and for all my trouble, I don't think I have really learned all that much because I never have time to read. And I am supposedly at a benign program! I have probably done more procedures than my transition year or medicine colleagues, but in reality, you will get all the experience with the procedures that matter during your anesthesiology residency. Even if you are better at obtaining central access on day one of CA-1, in a few months, your fellow interns will have just as much experience as you and will not have suffered through a year of general surgery internship to get there. Furthermore, a lot of my intubations and central lines have come on unit months, and you are required to do those even as a transition year intern anyway. For the most part, it's endless consults, paperwork, discharge summaries, and floor calls. And no matter how much you do or how hard you work, it is never good enough.

Do a transition year if you can find one. If you are motivated, you will learn regardless of where you end up. If you are at a cush program, then you will have time to start reading baby Miller or something in advance of starting CA-1. At least this way you will spend your time learning something worthwhile for your future instead of spending your life doing scutwork.

 

[nutmegs]

What do you fellow applicants plan on doing for the first year? I initially thought a medicine year would be best so I applied for a few prelim medicine positions. After further thought I'm thinking a year in surgery would suit me well. I feel I'd learn more, definitely get more procedures, get used to working with the personalities of surgeons, and develop a strong work ethic as a resident. I have no interest in the TY year as it seems to be a repeat of the 3rd year of medical school. What are your thoughts?

Do you plan on doing 1) categorical 2) TY 3) pre-lim med 4) pre-lim surgery

I am an intern who passed up a transition year in order to do a surgical year for this same type of thinking. I thought I wouldn't learn anything in a transition year, and even though I knew I would work harder in surgery, I thought I would be better for it. So, I will tell you now, as emphatically as I possible can, DO NOT MAKE THE SAME MISTAKE I MADE!!!!!!!!

I work longer hours (quite often over 80), I work harder while I am there, I am talked down to daily, I am commonly treated like I am stupid, I am often made to feel inferior because everyone knows I'm "not a real surgeon" and have "sold out to do anesthesiology", and for all my trouble, I don't think I have really learned all that much because I never have time to read. And I am supposedly at a benign program! I have probably done more procedures than my transition year or medicine colleagues, but in reality, you will get all the experience with the procedures that matter during your anesthesiology residency. Even if you are better at obtaining central access on day one of CA-1, in a few months, your fellow interns will have just as much experience as you and will not have suffered through a year of general surgery internship to get there. Furthermore, a lot of my intubations and central lines have come on unit months, and you are required to do those even as a transition year intern anyway. For the most part, it's endless consults, paperwork, discharge summaries, and floor calls. And no matter how much you do or how hard you work, it is never good enough.

Do a transition year if you can find one. If you are motivated, you will learn regardless of where you end up. If you are at a cush program, then you will have time to start reading baby Miller or something in advance of starting CA-1. At least this way you will spend your time learning something worthwhile for your future instead of spending your life doing scutwork.

Oh, the sound of January of intern year. We feel for you so. Hang in there. Remember the promised land is coming, and it is so, so good.

 

[lane]

I'm a CBY in a categorical program:

2 months general medicine wards
2 months cardiology/CCU
1 month MICU
1 month Trauma Surgery
1 month Pre-Op clinic
1 month Neuroanesthesia ICU
1 month Anesthesia (OR)
1 month Internal Medicine clinic
1 month vacation
2 weeks EKG
2 weeks night float (IM)

So a total of 6 call months, 5 non-call months and 1 month of vacation.

Anesthesia prelims here basically do 4-5 months of general wards, 1 month MICU, 1 month cardiology/CCU, 1 month night float, 1 month vacation, and the rest electives.

hmmm that schedule sure sounds familiar 😀

 

[DO4lifer]

i'm trying to decide between prelim medicine and TY. the fact that I want to avoid surgery like the plague leads me to desire medicine...

im just happy being a 4th year and getting into anesthesiology.

life is good.👍

 

[SaintFrances]

Yeah, fourth year is so awesome right now! Sure, I still go to work every day, but at least there are no shelf exams, very little call, and I have most nights and weekends off. Best of all though...I got a phone call from an Anesthesiology program yesterday (where I would be very happy to go) and they told me I am definitely "ranked to match."

I am dreading my intern year however. I hope I get the only TY program at which I interviewed. If not, I will probably do a prelim medicine since I am ranking the categorical programs lower.

 

[Plead the Fifth]

hmmm that schedule sure sounds familiar 😀

WTF?! Are you stalking me? 👍

 

[akpete]

I'm banking on a categorical spot since about 3/4 of the spots I applied for are categorical.

Otherwise I just interviewed for home school prelim med and TY.

 

[Saladin MD]

EDIT: Never mind, figured it out.