Seattle Programs

[gasapplicant]

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I've looked through previous threads but would like some insight from residents/recent grads into the University of Washington and Virginia Mason. I loved both programs and the area, but have questions about how to rank them.

At VM, residents seemed very happy, and obviously amazing at regional (which I'm very interested in), but they seem very reliant on UW for rotations at Harborview, Childrens, etc.

At UW, I was very impressed and it didn't seem like a workhorse at all, with hours quoted at 56/wk (surprisingly low). Everything is in the UW system, so you don't have to go out for anything. Hard to find a fault, except maybe the residents didn't seem as cohesive/happy as VM.

They're both fantastic and I'd be thrilled to match at either...just looking for opinions on ranking them.

 

[anesdoc10]

I've looked through previous threads but would like some insight from residents/recent grads into the University of Washington and Virginia Mason. I loved both programs and the area, but have questions about how to rank them.

At VM, residents seemed very happy, and obviously amazing at regional (which I'm very interested in), but they seem very reliant on UW for rotations at Harborview, Childrens, etc.

At UW, I was very impressed and it didn't seem like a workhorse at all, with hours quoted at 56/wk (surprisingly low). Everything is in the UW system, so you don't have to go out for anything. Hard to find a fault, except maybe the residents didn't seem as cohesive/happy as VM.

They're both fantastic and I'd be thrilled to match at either...just looking for opinions on ranking them.

Both are good programs, but having experience at both and knowing residents at both, the answer seems pretty unanimous....Virgina Mason by far.

The residents seem FAR happier at VM, the comraderie at VM among the residents is far better than UW, the relationships between the residents and attendings are just as uncomparable. They might try to hide the fact that their residents dont get overworked but that is definitely NOT true compared to the VM residents. Back to the attendings...at UW they have MANY FMGs who seem like teaching is the last thing on their minds where VM is the complete opposite. I cant even count the number of times and residents that have expressed that if they could do it again, they would 100% have chosen VM over UW. And if you are interested in regional, than it is a no-brainer as the amount of experience and procedures that you will have at VM versus UW is again uncomparable. I have heard of UW residents complaining of fighting not only each other but even CRNAs for blocks! I can go on and on, but it would take all day.

 

[gtb]

Yikes, anesdoc10 did you really create a new account just to respond? Good things for UW? Big cases, and lots of them (if that's what you want). Livers (5 in my CA1 year), heart, lung, bowel transplants. CABGs, but also LVADs, AVRs, ruptured aortic aneurysms from root to infrarenal. More blunt and penetrating trauma than most people want to experience. Plenty of complicated neuro cases. The ruptured cerebral aneurysm goes to Harborview, not VM. True, lots of foreign trained attendings, but many of them also retrained w/i USA and are ABA and subspecialty boarded. If you've any interest in research, then imho, UW is the clear choice (talk to VM residency director about that to get a more unbiased idea). You definitely earn your residency salary at UW, and there is no spoon feeding during your time there. Our weakness is regional. We have CRNAs, and Washington is an opt out state, so the CRNAs are just trying to improve their own skill set. Rarely, I think anyway, a resident will lose a block to a CRNA. Much more likely is that you'll lose it to the acute pain service residents. I will most definitely finish my residency at UW weak in complicated regional blocks. I have no doubt that my overall quality of life in Seattle would have been better at VM, and very likely the intraoperative teaching would be much more consistent. The long, grey winters bug me, but you'll have that in either Seattle or Oregon. Since residency is just 3 short years, given the choice again, I'd choose UW again. Feel free to PM me if you have more questions.

 

[nap$ter]

Yikes, anesdoc10 did you really create a new account just to respond? Good things for UW? Big cases, and lots of them (if that's what you want). Livers (5 in my CA1 year), heart, lung, bowel transplants. CABGs, but also LVADs, AVRs, ruptured aortic aneurysms from root to infrarenal. More blunt and penetrating trauma than most people want to experience. Plenty of complicated neuro cases. The ruptured cerebral aneurysm goes to Harborview, not VM. True, lots of foreign trained attendings, but many of them also retrained w/i USA and are ABA and subspecialty boarded. If you've any interest in research, then imho, UW is the clear choice (talk to VM residency director about that to get a more unbiased idea). You definitely earn your residency salary at UW, and there is no spoon feeding during your time there. Our weakness is regional. We have CRNAs, and Washington is an opt out state, so the CRNAs are just trying to improve their own skill set. Rarely, I think anyway, a resident will lose a block to a CRNA. Much more likely is that you'll lose it to the acute pain service residents. I will most definitely finish my residency at UW weak in complicated regional blocks. I have no doubt that my overall quality of life in Seattle would have been better at VM, and very likely the intraoperative teaching would be much more consistent. The long, grey winters bug me, but you'll have that in either Seattle or Oregon. Since residency is just 3 short years, given the choice again, I'd choose UW again. Feel free to PM me if you have more questions.

i would also choose UW again. regional is a weakness, but you can rotate to the VM for 2 months if you get one of those slots. having spent time at both hospitals, have to say regional isn't THAT weak at the UW. you'll get tons of interscalenes, sciatics, femorals, and TEP's. you won't get a lot of supraclaviculars, lumbar plexus blocks, or axillary blocks. fewer indwelling catheters. but, you can get enough experience to get a running start into any practice. also, the learning curve is so steep with U/S guided blocks i don't think it makes a difference whether you've done 40 or 80 interscalenes. when i went to VM, i felt up to speed already, just got some valuable fine-tuning and introduction to alternative techniques.

we work harder at the UW, and the severity/complexity of cases is way higher far more frequently. my general impression (although not universal, VM guys) is that VM residents freak out a little bit when they come to Harborview and see the acuity we have there.

VM is a "nicer" program - tighter knit, more camaraderie, etc. VM residents hang with each other AND their attendings. almost no social interaction between UW residents and attendings outside of the OR. UW is an impersonal academic giant. gotta give the friendly prize to VM. that being said, i don't want my hand held during residency. i want to see some bad-ass **** so when i go to private practice, i can handle anything that comes my way. UW residents have a leg up when it comes to fellowship and academics - in general. i like the fmg attendings at the UW - their foreign training shows you another facet of how the rest of the world does it.

CRNA's are gonna be CRNA's everywhere you go - VM and UW have 'em. i've never felt like a CRNA stole a block or procedure from me.

my two bits. feel free to ask me more as well.

 

[ProRealDoc]

i would also choose UW again. regional is a weakness, but you can rotate to the VM for 2 months if you get one of those slots. having spent time at both hospitals, have to say regional isn't THAT weak at the UW. you'll get tons of interscalenes, sciatics, femorals, and TEP's. you won't get a lot of supraclaviculars, lumbar plexus blocks, or axillary blocks. fewer indwelling catheters. but, you can get enough experience to get a running start into any practice. also, the learning curve is so steep with U/S guided blocks i don't think it makes a difference whether you've done 40 or 80 interscalenes. when i went to VM, i felt up to speed already, just got some valuable fine-tuning and introduction to alternative techniques.

we work harder at the UW, and the severity/complexity of cases is way higher far more frequently. my general impression (although not universal, VM guys) is that VM residents freak out a little bit when they come to Harborview and see the acuity we have there.

VM is a "nicer" program - tighter knit, more camaraderie, etc. VM residents hang with each other AND their attendings. almost no social interaction between UW residents and attendings outside of the OR. UW is an impersonal academic giant. gotta give the friendly prize to VM. that being said, i don't want my hand held during residency. i want to see some bad-ass **** so when i go to private practice, i can handle anything that comes my way. UW residents have a leg up when it comes to fellowship and academics - in general. i like the fmg attendings at the UW - their foreign training shows you another facet of how the rest of the world does it.

CRNA's are gonna be CRNA's everywhere you go - VM and UW have 'em. i've never felt like a CRNA stole a block or procedure from me.

my two bits. feel free to ask me more as well.

UW anesthesia has a few brits on staff who are excellent ICU attendings as well.

 

[gasapplicant]

Thanks everyone. If anyone else has other opinions on this let me know.

 

[gasdoc80]

My 2 cents... Some of the comments about UW are unjustified.. Yes, there are a lot of FMG attendings here, but only because the UW actively recruits these guys from overseas because they are regarded as the top players in their field.

Talking to friends at VM when they rotate at UW, their average case complexity is much less than ours. VM residents need to come into oursystem to make their case numbers, and when they do come, they tend to struggle during the neuroanesthesia, trauma ICU, neurosurgical ICU, and of course their trauma rotation in the OR. As an R2 i did at least 4 liver transplants beginning to end, at least a dozen crash cranis, and a number of ASA 4E cases. Remember that UW is the big academic giant in the northwest and harborview (our trauma hospital) covers 4 states, so we end up taking care of the sickest patients in a 4 state radius.

There has been some changes this past year to increase the amount of regional that we get and there is plenty of opportunity to go to VM or one of our outpatient clinics where we can do plenty of blocks. Meeting the ABA requirements is never a problem.

On the flip side, the good things about VM is that it is a much smaller program and you're mostly at that one site so you will get to see your buddies more often and the attendings are a lot closer to the residents than at the UW, where we are spread between 4 large hospitals and have a large faculty at each.

if i had to choose again,.. UW without a doubt.

 

[22go]

As an ex-UW grad from outside the Seattle area, I can say that either program is excellent and you will know how to deliver a top notch SAFE anesthetic by the time you are done.

There is a great deal of cross pollination at both programs with some attendings having taught at both institution.... The dividing line is the size of the programs... VM as a smaller program is more tightly knit...hard to fly under the radar...and if you don't get along well with someone....kind of hard to avoid them. The VM case mix and call schedule is a lot like what you would see at any other decent sized hospital in private practice.

UW is your typical large academic center..lots of great cases....at times you are not on the same rotation as your buddies.. I agree that the foreign attendings(Brits, Kiwis, Aussie, Swedes, and others) actually offer a different perspective which is great once you are done but can be painful as a resident. And at times you really don't feel like doing another lung transplant in a really sick patient...

The work hours on average are about 56hrs.. some rotations worse than others.....call at UW rocks at least when I was there....overnight call ran from 4pm-7am with the next day off...great for getting things done during the week..

After being out in private practice and s/p fellowship I routinely look back on cases I had as a resident(both at UW and VM) Comparing what I was taught vs the current practice environment that I entered, I feel like I was taught a much safer, thought out anesthetic than most of my colleagues..

Either way, Seattle was a great city to spend 4 years in and both programs are well thought of outside the PNW.. I didn't have any trouble getting the fellowship or job that I wanted...

more than happy to answer any questions...

 

[gasapplicant]

Thanks again.

I have heard some rumors that the calls will be changing for the worse at UW in the future? I don't know if those sweet 4p-7a calls will still be around.

Also, could someone address changes in the call schedule at Harborview (I believe from 24 hr to 2 12 hr calls?).

 

[starsop93]

After being out in private practice and s/p fellowship I routinely look back on cases I had as a resident(both at UW and VM) Comparing what I was taught vs the current practice environment that I entered, I feel like I was taught a much safer, thought out anesthetic than most of my colleagues..

.

This is an important quote which I have also felt since I left UW(also spent 2 months at VM). My fellowship was at an institution frequently though of as a "top program" but UW and VM were clearly superior in safety. Those I work with now also can be pretty sketchy from the safety standpoint.

You will know how to approach a very sick patient with a rational and safe anesthetic if you are a UW grad. You will have an upper hand at typical fast-turnover outpatient cases (and regional) if you are a VM grad. You will probably enjoy your residency a bit more if you go to VM. You will have a lot more exposure to different ways to do the same thing if you go to UW (VM has their "standard anesthetic"/toyota plant thingy), which is a valuable skill. (As a side note, I wonder whether VM is rethinking that whole Toyota plant thing right now!)

I would eagerly hire grads of either program.