Thomas Jefferson Rehab - Philly

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pm2008

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Just posted a review over at scutwork.com, but thought I would post it here as well as this place seems to be more popular.

As it may seem obvious after the review, this was my top pick. Good luck to everyone in matching this year!


The following are my experiences as a medical student who did a 1 month rotation at two of their hospitals, Jefferson & Magee. I tended to ask quite a few questions on my rotation and on the day of my interview as I was very interested in this program.

The schedule for the residents seemed pretty relaxed, typically 7:30am - 4:30pmish for most inpatient rotations and 8-9am to 4pmish for most outpatient rotations (typically in the PGY-3 + 4 years). Nobody worked over 80 hours/week and they all seemed fairly happy with their schedule.

Overall, residents reported they had flexible schedules, though it seems their PGY-2 year was fairly standard with 5 inpatient and 1 outpatient rotations.

Call was about average from what I saw: PGY2 = 5 calls/mo, PGY3 = 3 calls/mo (weekday only) and PGY4 = 1 call/mo (weekday only). They take call at 2 hospitals. 1 resident reported "it's a bad night if you get a page after 11pm" at one of the hospitals (Jefferson). I was told the other hospital (Magee) kept you up a fair portion of the night with call, though they did get some sleep.

When they are on an SCI service at Magee, they have a nurse practitioner who is very nice. She seems to do much of the scutwork for you like follow up appointments, writing the prescriptions for the residents to sign, scheduling issues, writes up the patient signouts, etc.

The residents told me they rotate about 1/3 through Magee, 1/3 through Jefferson and 1/3 through other hospitals. The do rotate with other residents in the city (Temple for a few rotations and University of Penn does their SCI at Magee with the Jeff residents). They easily get 200 EMGs so I was told.

I’ve been to 2 other programs (though not for this long), but Jefferson definitely has impressive teaching. They have completely protected time from 7am – 1pm every Wednesday morning for lectures (mine always ended around 11:30 for a 1.5 hour lunch!). I had Dr. Formal, the program director. He generally sat down with his resident and student(s) for about 45 mins each morning (except Wed) and went over a different rehab topic. I also rotated with Dr. Fried and he met with the resident 2x/week for 1 hour each time to discuss a topic. Both attendings were very open and straightforward. Dr. Fried (Guy) even prefers to be called his first name by residents and students.

I did 1 week at their other hospital, Jefferson, which was also fairly relaxed. I worked with Dr. Jacobs (excellent teacher, spends more time teaching than rounding, which can cause rounds to go late sometimes). I got to meet Dr. Herbison. He is by far the residents favorite teacher and only does EMGs and lectures with the residents (one resident said he spends 2 hours/patient and sees 4 patients/day to give him time to teach the resident, I was told he is officially retired). He doesn’t pay much attention to medical students (i.e. me), but the residents absolutely love him. Dr. Marino does the acute spinal cord service at Jefferson and I worked with him for 3 days. He seems very nice and he is the author of the ASIA spinal cord examination booklet and was extremely knowledgeable about the SCI. He is in charge of a lot of the research the residents do.

Very laid back! All the residents seemed very friendly and cohesive. Everyone seemed smart and intelligent and knew their stuff and you could definitely tell a difference in the knowledge base of the senior residents and the fresh junior ones. Many of the attendings are laid back and from what I saw, my resident on SCI just called Dr. Formal (program director) on his cell phone for everything and didn’t bother beeping him. Some attendings were called by their first names. Basically, everyone seemed friendly to each other and the residents were extremely happy during my month rotation as well as interview day. Nobody works more than 80 hours a week with the seniors doing about ~40 hours/wk on their outpatient rotations.

The residents all went out as a group to drinks after work once while I was there.

The vacation seemed pretty nice – 1 week off on 5 out of 6 two month long rotations per year (was told that on the interview).

Their board review seems pretty good. Last year two of the residents got #2 and #7 on the rehab national board exam (and the one that got #2 is an attending there at Magee now). One of their residents didn’t take the boards, I was told he was running for Congress and didn’t have time. Most of the residents seem to do research of some sort, though I was told it’s not a requirement. One of the 4th year residents wrote his own book on physical examination and got it published. I saw it and it’s actually pretty good (very rehab oriented). All the other residents (I was told) typically have 1-3 research projects by the time they graduate.

Their fellowship placement seemed incredibly strong. 5/7 residents applied for fellowships and all got their first choice. One went in SCI and 4 went into pain. Two of their residents got 2/3 spots at the anesthesia based Jefferson pain fellowship which seems to be fed by the rehab residency.

I’ve been to two other programs rehab programs (each for 2 weeks) and, to me, Jefferson definitely stands out as a top-tier program.

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Thanks for sharing.

Dr Herbison has been partially retired at least since I have been affiliated with Jefferson in 2002 and has no intention of full retirement. He is very goal oriented in his lectures, therefore He has lectures geared directly for medical students, residents, or attendings. What he expects from himself is everyone in the room learn exactly what is teaching. Therefore in a resident lecture, he expects a certain level of baseline knowlege and is not going backwards to catch up people not at that level. Therefore, he commonly doesn't let students in lectures not geared for them. On the other hand, he does a lecture and workshop for the Jefferson Medical College students every three weeks and has residents teach the lecture and breakout exam skill workshops.

Other things... I agree that it is a cordial culture, many attendings expect to be called by their first name, as do I. The chairman and program directors perspective is that education is 1st priority for residents, therefore residents are often protected from clinical duties (for regular didactics or special didactics like a new hands-on EMG series and recent myofascial pain workshop), and attendings are expected to cover their own services during those times. Didactics are wednesday mornings and when you return the morning work is not your responsibility, nor did you cover pages in the AM. Weekend call at Magee, you are not expected to round or write progress notes, therefore there is no need for a back oncall resident; you are either oncall or not. Jefferson census (less than 1/4 of Magee) is considerable less and your duties are at the discretion of the attending, normally the work is split betwenn you and the oncall attending. On weekdays, there is no floating residents that covers you postcall, so when it is time to go, you go and a resident is never pulled away from another service. You do not have to cover any call at Moss, Bryn Mawr Rehab (some voluntarily do for moonlighting and extra income), or AI Dupont (children's hospital) which are your other inpatient rotations.

Scholarly work is advocated but not required. There are several researchers within the system with grant level research. Many attendings have less involved work such as case reports or retrospective reviews with the residents as primary author for the poster/abstract or article. You are funded entirely for the inner city courses on 1. orthotics and gait 2. prosthetics 3. electrodiagnostics in your 3rd and 4th years as well as attendence at the AAPMR in your 4th year (mine was in Hawaii!). If you have a scholarly project accepted at a conference which is quite common, the program will subsidize it at the discretion of the resarch director.

When I was a resident there was a reputation for being inpatient heavy, that was already a dated reputation that most older programs had. When Chris Formal took the program over the push for this was encouraged further so the residency training is pretty balanced. With 4 months of elective time, you can cater the the second half of your residency to your academic or clinical interest (some use this to rotate at potential fellowship sites) but are still ensured a solid uniform foundation of physiatric exposure. In my humble opinion, no electives or too many electives can really hurt your training. Things are pretty dynamic in terms of rotations, so we will see where the profession/patient needs takes us in the upcoming years!

Just a few quick thoughts as these are common interviewee questions.
 
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Very informative, thanks for posting. I will be interviewing there next month.
 
Very informative, thanks for posting. I will be interviewing there next month.

They did have the best lunch out of all my interviews last year... enjoy that and course good luck w your interview. I chose to go across town to Temple for a variety of reasons, but Jefferson is certainly a very solid program.
 
The above comments brought back very fond memories of my rotation at Jeff. You cannot go wrong with this program, excellent attendings and all very interested in resident teaching. Good luck to all those interviewing!

J
 
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