"Stacking"

[bullard]

---

Members don't see this ad.

gasguy06 asked a good question on the Yale thread about pairing junior residents with senior residents on certain cases. I had heard from other sources that programs like Yale and Rush intentionally pair juniors with seniors on CABGs so that the juniors get some cardiac exposure earlier in residency. But I've also heard that some programs will pair residents at the same level for certain cases because of lack of volume of that type of case (like pairing CA-2's for open AAA or something).

So, my questions:

1. The intentional "stacking" thing: is this a better way to train? I guess supahfresh likes it. An attending on one of my rotations said this practice is going to become prevalent in a few years.

2. Anybody know which programs stack because they're deficient in a category? I'd especially like to hear about Boston, Chicago, and NYC programs.

Thanks in advance, and sorry if this is a commonly asked question.

 

[davvid2700]

Probably pretty prevalent in programs that dont have enough cases for each resident. so they stack.. ive never heard of this.. It may be a good way im not sure..

 

[supahfresh]

gasguy06 asked a good question on the Yale thread about pairing junior residents with senior residents on certain cases. I had heard from other sources that programs like Yale and Rush intentionally pair juniors with seniors on CABGs so that the juniors get some cardiac exposure earlier in residency. But I've also heard that some programs will pair residents at the same level for certain cases because of lack of volume of that type of case (like pairing CA-2's for open AAA or something).

So, my questions:

1. The intentional "stacking" thing: is this a better way to train? I guess supahfresh likes it. An attending on one of my rotations said this practice is going to become prevalent in a few years.

2. Anybody know which programs stack because they're deficient in a category? I'd especially like to hear about Boston, Chicago, and NYC programs.

Thanks in advance, and sorry if this is a commonly asked question.

It's not really something I like and it doesn't happen very often. However I think it's a good way to get into some CABG's as a CA-1. thats all. we certainly don't get paired up at the same level....that would be terrible. I've only been paired with CA-3's on CABG's or something else beyond my level.

 

[UTSouthwestern]

Always a good question to ask of any program as it would be of no benefit to have two CA-2's or two CA-3's, or even one of each, together doing cases, unless it is a massive blood letting requiring extra pairs of hands. You need to do as many tough cases individually as possible and from a technical standpoint, only one resident in a case can claim it toward their case numbers, although this is frequently violated at certain programs. The RRC has had a field day with a couple of programs for resident subspecialty case numbers that exceeded the actual number of subspecialty cases done at the program.

 

[Monitor]

Don't forget the Fellows when you discuss stacking. I rotated at a big name program and in the CABG rooms the attending explain to the Fellows how and what to do as the CA-3 and CA-1 looked on. How are you going to feel when you are a CA-3 and you're not doing the CABG rooms SOLO? You're going to feel like you need to apply for a fellowship.

Food for thought.

 

[bullard]

Good point.

Anybody want to name names?

 

[supahfresh]

they let one of our CA-1's do 2 CABG's the other day solo. The fellow was another room doing his own. we gots cabgs out the yin yang here.