Rhode Island Hospital (Brown) IM

[theunderdog]

Rhode Island Hospital is the main academic hospital for Brown. I could not find much information from the SD search, except for the residency's website.

I'm just wondering if any of you could provide any details on what it's like and how competitive it is.

Thanks a bunch.

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[Pemulis]

From my standpoint (Brown med student: have done my core rotation and a sub-i in medicine there), it's a good program, but I suppose I haven't got a lot to compare it to. Most of the residents are pretty bright, and they seem to be well trained by the time they are done. There is generally good morale amongst the housestaff, in large part because the program directors are known for having their resident's back, and also because of very non-hierarchical relationships w/ attendings, and I think this helps to attract a crowd of residents that are balanced and have interests outside of medicine. Fellowship placements are generally very good; I haven't heard of anybody not getting what they want in the time I've been here. Especially strong departments include Heme-Onc, Pulm/CC, ID, and primary care, so a good number of residents go into these fields, but there are people heading into nearly everything, including cards, GI, etc. and they get good spots too. There is a lot of global health work going on here, so there's a visible subset of residents who come here for that reason.

The program is not just at RIH. RIH is the large, urban, academic center where most of the rotations take place, but residents also rotate through the Providence VA, as well as the Miriam hospital, a nice community hospital with a wealthier (and sicker) population, that is actually very well regarded locally. Each site has its own quirks, but all are generally considered to be educationally strong by the residents.

As for competitiveness, it's hard for me to say, as I don't usually ask the residents I work with what they got on their boards, or if they made AOA My sense is that it's definitely on the more competitive side of things, but it's not in the MGH/BWH/Hopkins/Columbia/UCSF/etc. tier. My guess is that it's similarly competitive to places like BU, NYU, and Einstein/Montefiore. If your school has sent people to Brown's IM program before, they can probably give you an idea of what your chances would be of getting a match here.

Hope this helps. Let me know if you were looking for something more specific.

 

[WeezerNY]

Bumping this up. What is the Brown program like? US Grads? FMGs?

This is what I found from 2007:

[FONT=verdana, arial]Schedule.
[FONT=verdana, arial]I arrive at the hospital around 6:30am (or earlier) to see my old patients (up to 12 = cap) at around 7:30am I invariably get new pts from overnight admission (from 1-5 given day on cycle). Ideally new pts should only be given on short call and long call days (thus every other day). however, the hospital is so busy now and staff is so short handed that I am now getting admissions everyday. hours per week: at least 80 often more. workload/scutwork consists of mosly secretarial stuff: phone calls, paperwork, tracking down lab results, etc. .
[FONT=verdana, arial] .[FONT=verdana, arial]Teaching.
[FONT=verdana, arial]faculty is generally good but everyone here, including attendings, are overworked secondary to increased patient load w/out increased staff. teaching mostly takes place on non admitting days but these are becoming few and far between (see above). basically, teaching is becoming overshadowed by scutwork/pt workload at this program. there are noon conferences with lectures everyday but the interns rarely get to attend these nowadays secondary to work load..
[FONT=verdana, arial] .[FONT=verdana, arial]Atmosphere.
[FONT=verdana, arial]camaraderie among peers is pretty decent, considering, but the impossible admission numbers are wearing on all of the interns. physical environment is ok - lounge is functional but not enought computers. I don't think there are any foreign med grads in the program. I rarely have a life outside work (unless I am on an elective rotation which is 3mos out of the 12mos year)..
[FONT=verdana, arial] .[FONT=verdana, arial]Conclusion.
[FONT=verdana, arial]I do think this used to be a great program with lots of teaching and a supportive environment. However, in the last few years, admissions from the ER have increased at an astronomical rate and nothing has been done to increase housestaff numbers. I would say this is becoming a borderline malignant program..

 

[applesbananas]

http://www.charter.net/news/read.php?id=15988783&ps=1020&srce=morenews_class&action=1&lang=en

 

[tele man]

Any updated thoughts on this program?

 

[unimaginative]

[FONT=verdana, arial]Disclaimer: Med Student spent almost all of my time at the main hospital RI hospital. This is probably too long and not gramatically correct.

Hospitals: There are 3 hospitals, RIH ~ 700 beds, Miriam smaller community hospital and a VA.
Schedule.: Most medicine ward months are fairly intense depending on the service. Most interns seem to show up fairly early to preround 6/6:30. Morning report 8 am usually pretty light on intern attendance. ~9 am attending rounds can last till lunch with some attendings and can be much shorter with others. Gen med is Q4 with night float system and Long call/short call. When your the intern on NF you only do X-cover, PGY2/3 does all the overnight admits. Teams are usually pretty full as RIH seems to often be bursting at the seams with admissions. I know they are trying to expand the hospitalists service to keep the teaching teams from drowning in admissions. ICUs are very busy at RIH/Miriam with Q3 call. Dr. Marino, author of the "ICU Book" is the new director of the Miriam ICU and is supposed to be a real great guy. Overall schedule varies by whether you are categorical or primary care. There is really no difference between the actual residents and they function without distinction on the wards, but the PC people have less inpatient and more ambulatory blocks with a primary care curriculum beyond the usual stuff. From what I hear if people decide to do fellowships from the primary care track they have no problem cause they receive essentially the same training and are indistinguishable fom the cats.
[FONT=verdana, arial].[FONT=verdana, arial]Teaching: I think. this is one of the strongest points of the program. Almost universally the attendings I have encountered are adept at teaching, especially on the subspecialty services be they inpatient or consults. There is morning report, which is 2 cases from PGY2/3s from the gen med services as well as noon-confernces with free lunch which is generally a presentation from some attending on a given topic, lots from the subspecialists. As well, most of the attendings do a fair bit of teaching on rounds when time allows. There is plenty of bread and butter stuff to learn the muscle memory for as well as tons of unusual things that you can only get at a big tertiary care facility.
[FONT=verdana, arial].[FONT=verdana, arial]Atmosphere: The residents are generallyfairly down to earth, normal and collegial group. However, these guys are definitely very busy, seemingly more so than on the two interviews I have seen thus far at other academic University programs. The hospital is fairly large and definitely has an academic feel. RIH while a "private" hospital is akin to the county hospital which accepts everything that arrives including the stuff the community hospitals balk push out the back door. This makes for a very interesting patient mix with plenty of low SES and indigent patients. Also a fairly high imigrant population which can be frustrating since the demand for interperters is very very high and they are not always available. The Miriam while a "community hospital" is distincively academic with many of the subspecialists attending at both hospitals. I have only spent a few weeks at the VA so I don't have much to say. From what I hear it isn't one of the crown jewels of the VA system but isn't a pit either. Like lots of places interactions with other services, especially surgery, can be trying at times.
.[FONT=verdana, arial] One other thing that I think is interesting about this place is I think the hospital administration apart from the residency program is a little behind the times. They seem to be playing catch up with the rest of the world and are not very forward looking. There is no EMR. There is a mutant of sorts with the orders by computer and the labs/studies/dictations online but the progress notes are by hand and if the old dictations are missing from the computer or are poorly done it is impossible to know what the hell happened on clinic visits or previous admissions. The ICU has it's own EMR which is not accesible outside of the physical ICU and then when a patient gets discharged from the ICU to the floors they print the whole thing out and by virtue of it's size it becomes useless. The whole place is awash in paper..
[FONT=verdana, arial] Outisde the hospital RI happens to be one of my favorite places on the planet. The possibilities for water based activities are truly endless, unfortunatley so many people can't seem to get themselves out of Providence. Providence does have a pretty reasonable amount of live music, theatre, events and lots of good food, especially Italian. 45 minute train to Boston and ~3 hr to NYC. Lots of good flights to Providence airport at very good prices given it's much cheaper for airlines to operate out of there.
Conclusion: The program directors for both the primary care and categorical tracks are some of the nicest and most helpful people I have met at Brown. They both have gone out of their way to help med students even those who are interested in matching elsewhere. They seem to be incredibly popular with current and former residents and for many of the med students that stay at Brown the PDs are a huge reason for that. This program seems to have a pretty large degree of autonomy.
I think one of the things that people always want to know is how this program compares to the Boston big boys. I think the one disticintion I can make is that there are many many hospitals in boston to spread the talented attendings and interesting patients around to. In Providence there is really only one show in town to catch the ~1 million population. People seem to do well with fellowships here and all are available in house. There are lots of former residents in all of the in house fellowships and they often seem to be particularly strong ones.


I can answer other specifics if you have any questions, PM me or post here.
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[brownrez2010]

as a third year categorical medicine resident at brown, i wanted to weigh in on some of the changes i've seen the program go through as well as where it stands now.

first and foremost, i've had a great experience at brown. the program directors and administrators are incredibly responsive to resident feedback; i myself have approached them regarding various issues over the past three years and have always been met with timely and efficacious solutions. the volume issues mentioned in the posts above have been handled by increasing the number of non-teaching hospitalists over the past year; the brunt of the problem now falls on the hospital rather than the residency - exactly as it should. during the course of my three years here, i've seen the administration redesign or axe multiple rotations that had a reputation for low educational value. as i write this, several more are in the process of being overhauled based on recent resident feedback.

the biggest draw of the program continues to be the quality of the teaching attendings and resident autonomy. our attendings (especially on the wards) are excellent across the board - great teachers focused on academic practice and great mentors helping us plan our careers. they offer a safety net for our patient care (i've never once felt as though i had no one to turn to for help in an acute situation - even on overnight shifts over the weekends), and still allow the residents to run the service. they let us decide how rounds will work and what teaching topics we'll cover each day, giving us a chance to make the most of each month from both a clinical and a leadership point-of-view.

any questions or concerns, please feel free to drop me a line.

thanks.