Say I was interested in Surgery but I wanted to attend a residency program with the fewest Trauma rotations as possible. How should I go about figuring this out? Thanks in advance.
Programs with less trauma?
- Thread starter ShyDr
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Why would you want that?
Trauma as a resident provides you with independence in decision making, critically ill patients, experience in thinking outside the box, and at times complex operations.
I would suggest training at very busy trauma centers with many rotations not the least.
Trauma makes you a better surgeon!
Trauma as a resident provides you with independence in decision making, critically ill patients, experience in thinking outside the box, and at times complex operations.
I would suggest training at very busy trauma centers with many rotations not the least.
Trauma makes you a better surgeon!
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I think the patient population and mechanism of trauma is pretty important to keep in mind when looking at trauma, otherwise it's all like this:
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Wow......that is awesome.....I dont think I would have ever expected a Con Air line on this forum.
Took me a second to place the Cameron Poe reference.
Simply awesome....
Wow... you just made my day.
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As opposed to flaming you for your lack of trauma interest, I might answer the question. The best way to find out is look at the residency websites. Many of them have the resident block schedules... a rough overview of how many months on what type of services during what years. The second best way is to ask while on the interview. You can phrase it however you like, but ask what trauma experience the place has. Best bet is places that send their residents to outside institutions for their trauma rotations, for example, Residents at Columbia only do 6 weeks of trauma their entire residency, and that is done in Newark, NJ. Mt. Sinai, I'm not sure how long the experience is, but they go to Shock Trauma if I'm not mistaken for their experience. Same with St. Luke's / Roosevelt.
That being said, I too have no interest in trauma, and thought I didn't want that much exposure to it. Then decided to go to a level 1 trauma residency where I will be rotating on the team all 5 years, with about 20% of my residency dedicated to trauma, and after 1 rotation I totally agree with the above comments of how worth it an how valuable a rotation it is, even though I was worked like a dog
My brother did ER in Kalamazoo (Mich State), and he mentioned that the traumas were sort of "optional" for the surgery residents, and they would come down "if they weren't busy," which means they wouldn't come down in the middle of the night.
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I'm at a place where I've already done 2 months of Trauma during internship as well as 2 months of night float which is basically Trauma Call for 2 months. While Trauma may be a good thing for training a General Surgeon, there is such a thing as too much of a good thing. If I where looking into programs again I would choose a Level 1 proram that did abount 6 months of Trauma total, and where you only took trauma call when you were on that service. The constant babysitting for ortho/neurosurgery get pretty old pretty quick. Oh, be sure to ask how much penetrating trauma they get if you are interested in going to the OR at all.
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The worst of all options is a program where you have to cover trauma a ton, and you don't get a good operative trauma experience. You're basically used as a warm body by the trauma staff and other services such as ortho/neuro.
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You should also look into whether the trauma service is a combined trauma/acute care surgery service. We do a lot of trauma, but our trauma service also handles all acute general surgery problems, so its one of our heaviest operative rotations.
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Trauma experience is such a weird thing to pick out during interviews. I am still confused as hell about it. So words like penetrating trauma, vs blunt, non operative trauma, knife and gun club trauma, etc float around which makes everything so vague. For example Mayo had tractor rollover type of trauma, other metropolitan areas have Cinco de Mayo type trauma, it's just too confusing. I guess if you are that concerned you have to specifically ask what type of trauma do you experience as a program.
In many ways it's the same as asking, do you have resident autonomy in your program, which is inevitably answered by, oh yeah.
I just picked out good programs by reputation and location to put on my rank list and figured they will take good care of their residents when it came to diversity of experiences.
In many ways it's the same as asking, do you have resident autonomy in your program, which is inevitably answered by, oh yeah.
I just picked out good programs by reputation and location to put on my rank list and figured they will take good care of their residents when it came to diversity of experiences.
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If the hospital is in an area you would NOT want to live in (due to safety concerns), then you'll have a much higher percentage of penetrating trauma than if it's in a real posh area.
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Community programs tend to have less trauma.
Case in point, Detroit is a bad place to be a surgical resident if you hate trauma. I was told be a good friend that Detroit recieving has something like 5 trauma teams that are on call at all times and just rotate taking trauma codes.
Same can be said of any other major city with urban and more suburban hospitals. If you know your hospital is a level II trauma center you probably are not going to be on the hook for a major trauma experience.
that being said, I would argue that a medium volume center is the best of both worlds. Trauma is a service where you really learn a lot about taking care of seriously sick people.
some of the most educational experiences I ever had were on trauma. Anyone here ever given someone 150 units of blood products (PRBC's+FFP+platelets) and 3 doses of factor seven over a 16 hour time period. They still died, but it was very educational for me. I was at the bedside for 10 hours.
Before anyone calls me out for futile care, I will say that I had several conversations with the trauma attending and was told to keep going.
Case in point, Detroit is a bad place to be a surgical resident if you hate trauma. I was told be a good friend that Detroit recieving has something like 5 trauma teams that are on call at all times and just rotate taking trauma codes.
Same can be said of any other major city with urban and more suburban hospitals. If you know your hospital is a level II trauma center you probably are not going to be on the hook for a major trauma experience.
that being said, I would argue that a medium volume center is the best of both worlds. Trauma is a service where you really learn a lot about taking care of seriously sick people.
some of the most educational experiences I ever had were on trauma. Anyone here ever given someone 150 units of blood products (PRBC's+FFP+platelets) and 3 doses of factor seven over a 16 hour time period. They still died, but it was very educational for me. I was at the bedside for 10 hours.
Before anyone calls me out for futile care, I will say that I had several conversations with the trauma attending and was told to keep going.
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If I may give my perspective on where trauma's go as a medic, please also keep in mind that my experience only reflects Central Ohio. We are almost always the ones who decide which hospitals get which traumas, and it's always based on acuity/proximity. We have 2 level 1 adult centers, 1 level 1 ped center, and 2 level 2 adult centers nearby. We also have 3 hospitals within the major Columbus area with no trauma certification and as far as I know, all hospitals in Central Ohio outside of Franklin County have no trauma certification.
The true outliers, with no trauma certifications, are getting no trauma unless the patient is in arrest and someone on scene decided we need to transport. These patients are dead, will stay dead, and don't seem to make it out of the "trauma room". Viable trauma patients within the vicinity of these hospitals are generally being flown into a trauma center by MedFlight.
The level 2 centers get almost all trauma patients who are injured within the vicinity of the hospitals. Both of these centers (one more than the other) are in nasty enough areas that they stay busy and seem to get a good volume of trauma. It should be noted that I don't work near either of these hospitals, so I don't ever transport there, so I cannot comment on how many of those cases are operative or not.
The two level 1 centers see a pretty constant stream of trauma, one is a burn center also so it gets the bulk of those. These two trauma centers are also alternated by medflight, the local helicopter service, for all scene run or inter-hospital trauma transports. In addition, there are cases where the level 2 is bypassed in favor of the level 1 (they're all really within about 10 minutes of eachother).
With that in mind, I can say that from my experience, the vast majority of the "trauma alerts" are for little more than mechanism and/or a particular s/s. To echo the more experienced surgeons on this thread, a good bulk of these "trauma" patients don't end up in surgery and are merely observed for however long and then released. I am NOT one of those nerd medics who screams into the radio "WE'RE BRINGING YOU A LEVEL 1", because to be honest that's not my call. I tell them MOI, ABC Status, LOC, GCS, and interventions, and let them make that call. My portion of this decision making process is simply to decide where I want to tell the driver to go, or whether I want a helicopter to come.
Again, I realize I'm not a surgeon, I just figured some perspective as to which patients go where might be helpful to the OP. It's important to look at the integration of the system as a whole in the area you're looking at rather than just the trauma certification of the particular hospital you are ranking. You might be ranking a "community hospital" in the middle of nowhere thinking you'll get no trauma, but in reality, these end up being the primary care point for trauma patients prior to being transferred into a trauma center. From my perspective on the street, if you truly want to minimize your exposure to trauma, I'd pick a slightly outlying hospital with no trauma certification that has a level 1 trauma center within 20 minutes. YMMV, as stated this is based on my experience in Central Ohio.
Ok, back to your regularly scheduled thread.
The true outliers, with no trauma certifications, are getting no trauma unless the patient is in arrest and someone on scene decided we need to transport. These patients are dead, will stay dead, and don't seem to make it out of the "trauma room". Viable trauma patients within the vicinity of these hospitals are generally being flown into a trauma center by MedFlight.
The level 2 centers get almost all trauma patients who are injured within the vicinity of the hospitals. Both of these centers (one more than the other) are in nasty enough areas that they stay busy and seem to get a good volume of trauma. It should be noted that I don't work near either of these hospitals, so I don't ever transport there, so I cannot comment on how many of those cases are operative or not.
The two level 1 centers see a pretty constant stream of trauma, one is a burn center also so it gets the bulk of those. These two trauma centers are also alternated by medflight, the local helicopter service, for all scene run or inter-hospital trauma transports. In addition, there are cases where the level 2 is bypassed in favor of the level 1 (they're all really within about 10 minutes of eachother).
With that in mind, I can say that from my experience, the vast majority of the "trauma alerts" are for little more than mechanism and/or a particular s/s. To echo the more experienced surgeons on this thread, a good bulk of these "trauma" patients don't end up in surgery and are merely observed for however long and then released. I am NOT one of those nerd medics who screams into the radio "WE'RE BRINGING YOU A LEVEL 1", because to be honest that's not my call. I tell them MOI, ABC Status, LOC, GCS, and interventions, and let them make that call. My portion of this decision making process is simply to decide where I want to tell the driver to go, or whether I want a helicopter to come.
Again, I realize I'm not a surgeon, I just figured some perspective as to which patients go where might be helpful to the OP. It's important to look at the integration of the system as a whole in the area you're looking at rather than just the trauma certification of the particular hospital you are ranking. You might be ranking a "community hospital" in the middle of nowhere thinking you'll get no trauma, but in reality, these end up being the primary care point for trauma patients prior to being transferred into a trauma center. From my perspective on the street, if you truly want to minimize your exposure to trauma, I'd pick a slightly outlying hospital with no trauma certification that has a level 1 trauma center within 20 minutes. YMMV, as stated this is based on my experience in Central Ohio.
Ok, back to your regularly scheduled thread.
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that's a nice perspective, thanks for sharing
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