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Rush Anesthesia Revisited

Discussion in 'Anesthesiology' started by desflurainman, Jan 2, 2017.

  1. desflurainman

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    My sole purpose of making this thread is to shed light some new light on the Rush Anesthesia program as it currently stands in 2017. I really care about this program and i really want to see it attract great resident candidates, and that has to start with telling the truth as it stands.
    I'm a current Rush Resident and just like many med students, i read the disparaging posts here on SDN and it gave me pause about the program, but i stand here today with confident saying that things have been dramatically different than i expected.

    1) Work horse program? i don't know what constitutes a work horse program but a typical day at Rush starts at 6am and you are relieved by 5, latest by 6pm. But this varies depending on how many cases you are assigned and how busy the board is. Some days you get out by 3pm if it's a light day, and there is typically at least 1 light day a week. If you are pre-call or post-latecall, you are definitely out before 3pm (i've been out as early as 1:30pm). The people running the board are very cognisant about getting the right people out at the right time. So i would say my average logged hrs per week is roughly 48-50hrs a week. I would imagine this is is closer to 55-60hrs on subspecialty rotation (cards, peds, ob, etc...)

    2) call schedule? typically you take about 3-5 24hr calls a month, and 1 late call a month. You get most of your wknds off, you might take 1 wknd call a month. To me this is great and very fair.

    3) Program director? First i like to say I personally have a lot of respect for the old program director, despite the things that has been said about him, he is truly knowledgeable and cares a lot about his residents. Having said that i can see how his method and personality (even though he is really a nice guy) can rub some people the wrong way. But all of that is irrelevant since we now have a new program director, who is way more approachable and is passionate about the program, and she is really working hard to make things better.

    4) faculty and teaching? protected didactic time has improved drastically, it's actually great now. 2-3 lectures a week + morning conferences on wednesday, and 1 grand round a month. This was better than most places i rotated at as a med student. In addition, there is a new wave of newly hired younger attendings (from places like duke and harvard) who are passionate about teaching. Most of the attendings do some form of teaching, a few don't teach but you can learn somethings by watching them. Again most attendings are relatively easy to work with, but a few will give you headaches but i think this is typical of most places. Lastly, last year Basic exam pass rate was 100%.

    5) Anesthesia techs and Room turnover issues? this is no longer even close to being an issue anymore, you simply call the anesthesia tech at the end of the case and they promptly come in to turn the room over, no questions asked, end of story. And if there is something you need that is not in the room, simply pick up the phone and they bring it in right away.

    6) Scheduler/Scheduling? I haven't had any issues so far, but maybe i will down the line, but as of right now, i can't complain.

    7) Resident Morale? The classes above mine might not have the greatest comradery but my class definitely hangs out together, study together, and help each other out. I have had co-residents help put in IV in my next patients and i have done the same for people. We help each other setup rooms etc...I would say most of us are happy overall.

    Overall, i think Rush has dramatically improved in the last 2 years and most of the thanks goes to the current Chief Residents and PD. They exemplify everything i strive to be. Smart, approachable, and passionate about the program. And lastly, it's indisputable that you will get excellent training at Rush, even those that spoke bad about the program admitted to this. The fellowship list is impressive every year and those that venture into PP do well for themselves.

    I urge everyone to consider this program when formulating their Rank list, things have dramatically improve over the last couple years and will continue to improve with the new PD. Beside Chicago is a great place to live, there is a lot to do here.

    PS: If you are considering Pain fellowship, this is undoubtedly where you want to be (certainly, the best program in chicago for that) the Pain attendings here are well known in the field and can open some doors for you.

    Good luck with match this year everyone! PM if you have any personal question i didn't cover here.
     
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  3. San Marzano

    Physician

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    Speaking as someone currently in a well known program that's well known for treating residents like crap, don't treat your residents badly please. Treat them well because they are people and should be taken care of. Also, if you have someone with poor English language typing skills, don't ask them to post on an internet forum. You aren't doing your program any favors. Lastly, make sure your program has a 100% boards pass rate like this posters program has. My program works residents to the bone and wonders why they fail boards year after year!
     
  4. CriticallyCarED4

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    My Two Cents for an applicant perspective:

    Despite the massive bad press about Rush I had a few good thoughts after interviewing there. First, the dinner was well attended and the residents were a lot of fun and brought up the notorious SDN post at the very beginning. No one denied that there were many problems or that the bad press was unwarranted. Indeed most of the improvements stated above were accomplished by this year's chiefs and the year before.

    Second, the program director was very nice and approachable. Being new, there were a few questions she couldn't give definite answers to during the Q&A, and her honesty and lack of politicking impressed me. She even admitted outright that financial considerations are a high priority in regards to resident initiated policies or changes to the curriculum. Which is understandable considering anesthesia at Rush is private practice but I still think I'd prefer a true academic setting.

    As a stand alone comment, the chair left the impression that every graduate must do a fellowship to be relevant. While I don't disagree I'd prefer a chair that was more accepting of any career path my peers and I choose. At least they can back it up. The match list was extremely impressive.

    That being said, I also felt the vibe of the program was a bit stiff. The residents who helped during the day were very enthusiastic but they and the others we encountered on the tour looked exhausted. A sure sign of overwork. This may be improving but I can't prove it one way or the other.

    All in all I can say I was pleasantly surprised by many aspects of my interview. Though I won't be ranking it highly as I want a program that prioritizes learning over income, Rush doesn't have trauma, and it has a larger class size than I want to be a part of.




    Sent from my iPhone using SDN mobile
     
  5. desflurainman

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    I'm glad to hear your honest and refreshing opinion and agree with a lot of what you said. Rush has always been a great place to train but it wasn't always the easiest place to get through residency but that has definitely changed in last couple years, which is why I now think candidates should consider ranking it high. Because now you not only get the excellent clinical training, but you now also get a "nonmalignant" environment and much improved didactic (many places won't lecture you 3x a week like they now do in Rush).

    Overworked? Maybe in the past but right now, avg hrs are 48-55hrs on general month (you can add 5hrs to that in your CA2 yr and on subspecialty rotation), to me that's a really good work hr for residency training, to me anything less than that you are not getting adequate training.

    The other things you mentioned are fair criticism but I would argue that the trauma thing is really not as important as you think, because once you have done transplant you have really done trauma. Again I don't know what your ultimate career goal is.
     
  6. TIVA23

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    Hi everyone,

    Interviewed at RUSH and I have to say I was very happy with the program. I did however forget to ask about the Intern year (Things can get a little foggy on the interview trail after a while). We were given a USB with most of the info but I guess I would like to just hear some opinions on the PGY-1 year with respect to hours, usefulness of rotations, treatment by other departments etc. If anyone has any info on this I would love to hear it!

    Thanks again!
     
  7. Wiscoblue

    Wiscoblue ASA Member

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    Isn't Rush a CRNA training program?
     
  8. Consigliere

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    Yep. When I went there, the program was ranked #1 in the US.
     
  9. cybercops

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    I am another current resident at Rush, and I would like to 2nd the original poster and add my thoughts to this thread. I am not a traditional applicant. In fact, I was offered a spot here after failing to match and the previous PD gave me a spot after hearing recommendation from the previous GSurg PD. I worked as general surgery resident for 2 years in different places, so I interacted with different anesthesiology residents of different programs. After working at Rush as a resident, I think Rush is a strong clinical program because:

    1. While Rush does not give you specialty rotation during your CA1 year, you do have to take care of very sick patients (being a 3rd referral center), and I feel very comfortable taking care of these population now.
    2. In the last year, we had 4 new attendings with more to come. They are very approachable and very willing to teach. We love them, and these young attendings, together with our current ones, make our program more learning-oriented.
    3. The support system is very good now. Now, I do not have to call the techs to turn over the room (unless you need special equipment like art line setup or Glidescope). Now, you even have preoperative techs who go around and place IVs for you. It is very helpful for us in high turn over rooms. If you want to practice IV, they will respect your demands too.
    4. The leadership: We have our new PD this year. She is great. She keeps asking us what she could make the program better, and she actually follows with our recommendations.
    5. We have good relationships within our classes. We are a big program, so getting along with everyone is hard, and we do have conflicts sometimes, but people are mostly happy with each other.
    6. We match well if you want to do fellowships. If you want to get jobs, our attendings and our reputation of training good clinicians are well-known, so getting them is also easy.

    CONS:
    With all the good things, I do think Rush has some shortcomings. The most important thing that people touch is we are not a trauma center, so ZERO trauma experience. Currently, our CT ICU is close to us, but it will change in the future when our attendings are going there.

    Feel free to PM me if you have any questions.
     
  10. ItBurnsInMyHand

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    Word on the street is that the old PD is coming back?
     
  11. dchz

    dchz Avoiding the Dunning-Kruger
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    I was a mid-ranged applicant that interviewed at rush a few years ago.

    As a current resident looking back, i have a few points to contribute:

    I recall the dinner at rush, it was great. Everyone was friendly and it was a great experience at a nice Italian restaurant. Hands down the best part of the interview days.

    perspective as a previous interviewee:

    The program director outright addressed the SDN posts and how they are working on things. However, the things during the speech that i remember were red flags: even though they admit there were tons of things they need to improve on, their emphasis was "things don't change overnight". what i got from this: you're gonna be the guinea pigs (at best) while we transition the program. I know i'm not the most competitive applicant, but if i'm someone that cares my training, why would I sign up to be the guinea pigs while you work things out? This tells me you need at least another 4-5 years to really attract the good residents, this speech happened 2-3 years ago, so i guess OP's public relation post timing is right on track.

    Tour of the facility: may be i'm spoiled by my institution's new hospital, but i recall the ORs at rush wasn't particularly impressive or state of the art.

    Resident that showed up during the interview process: I recall the chief resident showed up and barely interacted with the applicants, didn't really tell us anything that echoed the "change in process". Kinda gave me this vibe that he thinks he's a hot shot because he matched pain, and didn't really care too much about the program because he is literally months away from being outta here. The other residents that showed up looked outright tired and worn out, which really matched the workhorse reputation and emphasized that it was a program in transition (at best).

    For the above reasons, i didn't put it very high on my list. However, Chicago is a very desirable location for a lot of people. That should be considered a huge plus for Rush.

    Looking back as a current resident in a mid range mid-sized program:

    Having no trauma experience is probably the biggest downfall. As someone that transfused 120+ of RBC and FFP and all the PLT in the hospital on day 1 of anesthesia, the hair you grow on your balls during trauma cases should be essential to all residency training. Not because all pp jobs require trauma, but the experience and perspective you get while doing a huge GSW with a bullet in the LV makes you a better doctor in all aspects of anesthesia.

    Work hours: my logged work hours are approx 60-70/month, so if OP's post is correct, General OR for a Rush resident is less hour intensive than my program. I agree anything less is probably inadequate training, but I also believe not having done trauma is also inadequate training. As a resident, i would work extra 10 hours a week just to do level 1 traumas. However, not a lot would share this sentiment as many pp jobs require 0 trauma.

    OR teaching, many programs boast about OR teaching, but few really delivers (really a knock to my program since i never experienced teaching at Rush). message to future residents: expect your learning as your own responsibility.
     
  12. anbuitachi

    anbuitachi ASA Member

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    I'd say it's a chill program hour wise If only 48-50 hrs for ca1
     
  13. Triple AAA

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    If this is true, it would be a HUGE mistake on the part of the program.
     
  14. Izzyman

    Izzyman ASA Member

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    Can anyone here comment on why Rush won't let me know who my co-interns will be in 2018? I'm doing advanced. I've asked the administrative staff before and they ask me why I need that information or how I'll use it. Weird.
     
  15. DrCommonSense

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    Sounds worrisome about Rush. What was wrong with the last PD?

    If the PD was so bad, I have to question if the Chair is equally bad allowing the PD to be horrible. Sounds like the Chair was fine with that.
     
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  17. nimbus

    nimbus Member

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    Maybe they have a privacy policy and they don't want you to spam them. You can always ask people to PM you here...or try setting up a private Facebook group. Then those who want to can opt in. Sometimes salespeople will try to get these lists to sell crappy mortgages or insurance policies and things of that nature.
     
  18. Izzyman

    Izzyman ASA Member

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    Yea but it's not like the administrative staff doesn't know me or my email. Also I'm not asking for personal information like phone numbers or even emails. Just weird.


    Yea the chair seemed very stoic on interview day.
     
  19. Ronin786

    Ronin786 ASA Member

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    Maybe they didnt fill yet and don't want to show people.
     
  20. Consigliere

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    Who is the chairman nowadays?
     
  21. Izzyman

    Izzyman ASA Member

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    Kenneth tuman.

    Also, they filled pre-soap process. I had access to unfilled positions b/c a friend didn't match.
     
  22. anesthopeful92

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    Current anesthesia applicant here (interviewing this cycle), living in the Chicagoland area. I would likely rank the place high in order to avoid moving. If I got an interview, it would be nice to hear some more opinions from current residents but from what I have heard, the new PD seems indifferent regarding the best interests of the residents and has a reputation of having 'favorites.' I would appreciate someone who has been a resident under this new regime to shine some light on this aka say otherwise. Doesn't it make sense for a PD to serve as a positive role model and be invested in all of his residents? Or is this just something I'm idealizing and is relatively uncommon?
     
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  23. Mehd School

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    I have an interview here and I'm pretty excited for it, despite the negative press. I'm not crazy interested in living in the midwest or a city the size of Chicago, but if I'll be trained well I won't be picky.

    But one thing that is more concerning to me than anything is people saying that Rush doesn't get trauma. Surely they get some trauma, right? I will be extremely reluctant to go to a program that doesn't train you to handle trauma on your own. Even as a lowly med student I have seen and can appreciate the disadvantage of training at a program without trauma.
     
  24. FFP

    FFP Grunt, cog, body, pompous ass, pissant
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    Trauma is all about having the right priorities and speed, and knowing how to work as part of or leader of a team. As long as you know what you're supposed to do, in what order, and you can execute it safely and fast, you don't need so much trauma experience. I would be much more concerned if I didn't get the proper regional or OB experience.
     
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  25. leaverus

    leaverus New Member

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    why, what's the big deal about trauma?
     
  26. Mehd School

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    You don't want to be learning as you go when you're on your own. When it comes down to it, trauma (and transplants) are some of the big reasons AOBA certification is poo poo'd. Why should ABA programs be any different?
     
  27. Mehd School

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    I appreciate your insight.
     
  28. AdmiralChz

    AdmiralChz ASA Member

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    Ehhhh... AOBA programs from what I’m told aren’t looked favorably typically due to the lack of sub specialty exposure as well as the absence of fellowship-trained faculty involved in the programs. That’s the primary things required by the ACGME - for example, something like 50-75% of your ICU experience needs to be supervised by a CCM-boarded anesthesiologist.

    It doesnt matter, at some point in the near future all osteopathic programs will be rolled into the ACGME flag. If they don’t address deficiencies (if they are there) the programs will be forced to close.
     
  29. rushgrad

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    Recent Rush grad here. Wanted to give my two cents on the program as it stands now compared to when I started. As the OP stated, the program has undergone some pretty significant changes recently. When I started it was known as the good old malignant Rush. I was not a fan of the program pretty much from start, but there are some things that are undeniable about this program:

    1. You will get worked. Get used to it, it's good for you. It's a high volume hospital with busy ortho and neurosurg groups, so you're bound to be stuck in the OR.
    2. You're going to leave as a pro. There's not a single resident from my graduating class that I wouldn't let take care of my family.

    To be honest, it wasn't nearly as bad as I thought it would be. The OP must be a CA1 because you're definitely not going to be working 50 hours a week; it's just not realistic. It was mentioned that there's some pretty high acuity patients, and that's the truth. The problem with that is you're not going to be working those cases until the board runners trust you. As you approach the end of CA2 year and into CA3, you are going to stay later and you are going to be taking care of sick people every case, all day and night, with no softball cases. You are going to be expected to switch gears from ortho/neuro/cardiac/peds/etc at the drop of a hat and do each of them exceptionally well. And that's the way it should be. So, yeah, it might seem like roses when you're starting out and taking some junior calls, but as you progress it gets stressful and you are relied upon to be both highly skilled and efficient.

    They have done a good job of phasing out some of the older attendings who were only interested in supervising CRNAs or watching youtube while the residents suffer. The didactics still aren't great, but they're improving. Its kind of understood that you do most of your studying on your own, and I kind of liked it that way. My whole class passed basic and boards with no issues. I got 85th percentile on boards just studying on my own and almost never went to lecture during residency.

    As far as the PD thing, the previously mentioned PD was not kicked out for doing a bad job or whatever gossip people want to start. She made a personal decision that she didn't want to be in academics anymore. The newest PD is an absolutely fantastic guy and he's going to take this program to a great place. He's super approachable and knowledgable and was always one of my favorite attendings to work with.

    As far as the trauma thing, I honestly don't know who would care about this. We do plenty of livers that don't go well, so it's not like you're not going to know how to transfuse properly....

    The fellowship match is undeniable. People want Rush grads because they know what we go through and they know they're going to get a highly capable fellow. I got a fellowship in my desired location, so no complaints here.

    To be honest, I didn't have fun during residency. It's not supposed to be fun. But I will say that I have met residents from every other Chicago program and have seen a lot of them work. All I can say is this: we are trained well. Really well. I regretted matching at Rush during my CA1 year. But looking back at it now, it wasn't such a bad thing at all. I would highly, highly recommend this program.
     
  30. Mehd School

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    I appreciate your reply. There will surely be people here casting doubt over any new user submitting to threads like this, but what can you do outside of posting your damn ID badge or something. Looking forward to my trip to Chicago. Thank you.
     
  31. Teeny91

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    I recently interviewed at Rush and was pleasantly surprised. The residents, including the chiefs, were around for the duration of the interview day for questions. A good number of residents showed up to the dinner as well, all seemed friendly. PD and chair seem like good guys, residents spoke highly of them. Again, strong fellowship match list. I still haven't figured out how much to factor in trauma exposure when ranking programs (none here in case you missed that). Large resident class of around 20. Chicago is fantastic. Anyone else have anything to add?
     
  32. pokiepoke

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    Current Rush resident here. I too agree with OP's posting. Weekly hours normally range from low 50s to mid 60s. I've worked less than 40s hour weeks (consults months intern year, holiday weeks since we get most major holidays off except when we are placed on call), more than 70 hours (icu months, thoracic surgery month as intern), but those are outliers and they are rare. Normal weekly hours range from low 50s to mid 60s. I know the op listed upper 40s to 50s but it depends on which rotation he and she has done. I may have done more icu and a couple specialty rotations. I have kept in touch with medical school friends in other anesthesia programs and our hours are comparable if not less. And for those people who inferred that tired looking residents = overworked. I am one of those tired looking residents. But I also have 2 kids and one just turned one. More than half of the graduated class had infants during their CA3 year. A couple CA3s this year have infants/toddlers. So yes we are overworked, but a big contributor to us being overworked is our family. I feel very fortunate that Rush supported me throughout my pregnancy (allowing me time to make it to appointments) and after. Some of the interviewees have been jokingly and truthfully told that the call rooms were temporarily converted into a day time lactation facility for all the pumping mothers last year. More importantly, I still have time to come home to have dinner with my family, help my kindergartener with her home work and put her to bed between 830-900. In terms of didactics, it's what you make of your time. I go to lecture as often as I can (offered 3 x a week) and I think they are great and very helpful in studying for ITE and boards. A good number of the attendings are enthusiastic about teaching in the OR and I learn a lot from them. As for training, I don't feel we are at a disadvantage for not doing trauma since we have liver transplants and complex ortho and vascular cases. I honestly don't see why not having trauma is an issue. I recently went on an away rotation and worked with residents from other programs in Chicagoland, and I got the sense in talking to these residents that Rush is giving me a far better clinical experience (types of cases, case load and complexity of cases). As for the comment about Rush changing and us being guinea pigs. Wouldn't you rather be in a program that is willing to continue to work with residents to improve the work environment than a program set in their ways? The previous and current PD are always asking for feedback and making an effort to improve our experience. I don't see how that is a bad thing. As for work environment, my co-residents are like family. For the example, my class just had thanksgiving dinner together and we support each other. This makes the whole residency experience in general a lot more enjoyable. Anyways, mommy duty calls. I hope those interviewing the best of luck and please don't let Rush's past and outdated reputation turn you away. Enjoy you MS4 year and safe travels!
     
    #30 pokiepoke, Nov 29, 2017
    Last edited: Nov 30, 2017

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