too many interviews?

[marathon chick]

Hello Everyone,
I recevied too many interview offers (20) but I can only afford to go to 10 interviews. I am trying to make up my mind to choose and my last interview date with one of the following: Mt. Sinai, Temple or Emory. Which one of these do you think is the strongest program? Any Pros or Cons you've heard about concerning any of these programs?

Thanks for any input

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[Ligament]

Marathon Chick,

Firstly, Congrats on your interview offers.

I'm sorry but I do not know much about these programs. I'm sure somebody will clue you in.

regards!

 

[Discount]

Maybe most PM&R programs are desperate for quality applicants. From my little observation in New York City programs (i am not mentioning any particular program)... it just seems that PM&R programs will accept any warm-blooded individual that can do some scut work. I mean several programs in NYC programs have residents that barely speak English... even some of the with "good reputations."

Unless PM&R is getting more competitive (which I somehow don't think it is getting anymore competitive), most programs just want to find people to fill their spots.

So.. don't be fooled by the "i got too many interview" syndrome. Consider yourself warned...

Good luck in the match.

 

[marathon chick]

Thanks for the input discount,
I also have interviews at U Washington, Baylor, RIC, Stanford, Harvard, Mayo and so on. Do you believe these programs only want warm bodies to do their scutwork too?

I would like to hear anyone's thoughts on this.

 

[Discount]

I believe your body temp is near 98.6 give or take a few degrees. I don't know if you would consider that warm.

Even many of the well known programs have problems. A word of the wise when checking out PM&R programs.

1) Ask to see and speak to current residents... make sure they speak English. Find out what schools they are from. There will be a good number of FMGs (including carribbean) and/or DOs. I guess the good programs will be almost all US Grads from real accredited medical schools. I think only a few programs will fall in that category. You make the judgement yourself. ASK and ASK again. Don't be afraid to ask.

2) Find out the pass rate on the PM&R boards for the residents. Find out how many residents are having problems with USMLE Step 3 also. Strong programs will have strong residents.

3) Ask about research or lack thereof. There should be a handful of research projects that are in the process of publication.

4) Ask about call schedule and ancillary services. Ask about Phlebotomy, IVs, call rooms, call frequency and be very very specific.

5) Remember, if you are from a US med school, USMLE > 200, and in the middle of your class.. you should be in control. They will want you so you should be picky in which program you select. They will be honored to have u as a resident.

Good luck on the match.

 

[Ligament]

Discount wrote: "1) Ask to see and speak to current residents... make sure they speak English. Find out what schools they are from. There will be a good number of FMGs (including carribbean) and/or DOs. I guess the good programs will be almost all US Grads from real accredited medical schools. I think only a few programs will fall in that category. "

Discount: You give very good advice here. One should certainly steer clear of programs with DOs in them. A good program only has residents from real medical schools as you say.

I'm sure Drusso, the PM&R forum moderator, will back up your sentiments.

In fact, when Marathon Chick interviews at the Rehabilitation Institute of Chicago, considered one of if not the top PM&R program in the country, she shoud be certain to ask the residency program director, James Sliwa, DO if he went to a real medical school. On top of that, RIC must not be a good program because there are plenty of DO residents in it.

Discount, you need to be a little more mature in your attitude. Please stop trolling around on the PM&R forum. We are a peaceful group here.

 

[Stinky T]

I think part of Discount's perception regarding PM&R may be due to the fact that he is in New York. Personally, I think New York has too many PM&R programs. NYU alone has almost as many spots as all of the programs in CA (Stanford, UC Davis, UCLA, UC Irvine, and Loma Linda). Even though RUSK itself has a great reputation, it is certainly not high on the list of most PM&R applicants. When I applied, NYU only filled a little over half of its spots (although last year they did fill) and I think this was due to the malignant nature of the program. I've heard similar things about the other PM&R programs in New York. I'm not sure which program you're at, but the programs in New York (except for Columbia/Cornell) are not highly regarded. I think the reasons are that there are too many spots in too many programs. There are roughly 20 programs in the New York/New Jersey area. Given the number of spots and the fact that New York, I think that as a whole, the quality or residents there are not as good as in other areas. For instance, CA programs are not generally considered the top programs yet they consistently fill with AMGs.

PM&R is becoming more competitive. In fact there was an article regarding this trend from the AAMC:

http://www.aamc.org/newsroom/pressrel/2002/020321.htm

One of our PGY-2s graduated from Mt. Sinai and said that New York is a difficult place for PM&R. She decided against doing a residency there. With so many programs, it's hard to get the same quality of residents at other places. I personally feel that we should cut down on the number of spots in New York and open more spots elsewhere. Then again, if this were the case, I guess Discount might not have had a warm place to call home.

P.S. I would avoid Mt. Sinai. I don't know anything about the program at Temple or Emory.

 

[Discount]

Stinky,

Why is Cornell/Columbia the programs that is highly regarded. It is supposedly the cushiest PM&R program. The merger is a little unstable filled with internal political strife. There is only a 20 bed rehab unit in Columbia with some rotations at Helen Hayes. Columbia is also very Neuro dominated.

There are bascially no outpatients at Cornell to see.. like 4-5 patients for a whole clinic. True that you get to see some stars at NYPH, but most patients are too high profile for learning. I have heard from reliable sources that the residents basically just sorta hang out with no real clinical responsibilities.

HSS is super ortho dominated. There are 2 PM&R HSS fellows so residents get little exposure there also. Why is Cornell/Columbia supposedly the #1 program in NYC?

I think MT SINAI is #1... it has both MODEL TBI and MODEL SCI program. It has a large inpatient unit - about 75 or so beds. Also with affiliations at Elmhurst and VA Bronx. Definitely #1 program.

St Vincents is #2 in my opinion.

Here is MY NYC ranking for PM&R

1. Mt Sinai
2. St Vincents
3. Einstein
4. LIJ
5. NYU - Rusk
6. Kingbrook Jewish
7. Nassau Cty
8. Metropolitan
9. Cornell/Columbia
10 SUNY Downstate

OH, oh .. I forgot. Spaudling is considered a good program, right. I assume all your residents are MDs from accredited medical schools? Right? If Spaulding started admitting bunch of residents from foreign med school/carribean or DOs--- it may not be an elite program anymore. Disagree or agree? Just wanted to stir up some controversy. Each PM&R program should publish the american med grad ratio to guide future PM&R applicants.

Thank u for your support.

 

[Discount]

Let me just clarify and make my point more explicit in terms of attracting american grads to the field of PM&R.

In a recent impromptu survery of PM&R residents, the following was found.

1 out of 5 PM&R residents graduated from Carribean medical schools.

1 out of 2.5 PM&R residents are D.O.s and 1/2 of those had a MCAT score <23. I assume all those DOs applied to real accredited medical schools but "decided" not to go for one reason or the other. I won't go into the reasoning but none continue to practice osteopathic medicine... all seems to be practicing allopathic medicine with some manipulation medicine.

1 out of 5 PM&R with MDs failed either Step I or Step II and/or Step III. 1 out of 10 failed more than 2 steps.

1 out of 2 nurses wonder why PM&R residents have problems with the English language.

1 out of 2 PM&R residents cannot name the most distal motor innervation of the radial nerve.

9 out of 10 US Citizens cannot differentiate between Physiatrists and Chiropractors, Psychiatrists, and/or Drug Rehab docs.

PM&R IS IN DESPARATE NEED OF STRONG RESIDENTS.

 

[Stinky T]

Which impromptu survey is this? The one conducted at your program by you? Why would a survery include a question about whether or not PM&R residents have problem with English?

Anyway, I do agree that some programs (mainly in New York) do have a large percentage of FMGs. I think your perception of PM&R residents is skewed by this fact and that many of the things you describe are exaggerated.

By your own reasoning (good programs do not have FMGs who can't speak English), Columbia/Cornell would be at the top of the programs in New York and Mt. Sinai would be close to the bottom. I know that Sinai does attract quite a bit of FMGs because I know PM&R residents that interviewed there or attended medical school there. Having a TBI and SCI model system does not necessarily translate into a good residency program.

With regards to the Steps, again, this may be true for yourself and your program, but I've never heard of such a survey elsewhere. Plus, if so many PM&R residents did fail Step 1 and Step 2, and were such lousy clinicians, then I guess the Internship programs are to blame for letting them sneak through and get a license to practice medicine.

Also, if these PM&R residents are so deficient, why does a prestigious hospital such as HSS allow two PM&R residents to do their Fellowships there?

I completely disagree with your rankings of New York programs. If you are a quailty applicant who is getting multiple interviews in the New York area, the programs I would consider are:

1) Kessler
2) Columbia/Cornell

I realize that the Columbia/Cornell program probably will have growing pains, but there are better opportunities there and the name certainly won't hurt you. Kessler is a great program too, with great teaching, quality residents, and excellent attendings.

By the way, Spaulding has never had a Caribbean (you weren't included in that 50% were you?) graduate in its residency program (not that I would be opposed to it). The last four classes (including the class of 2006) have all been AMGs. In fact, the only FMGs have been the ones who have also wound up getting an advanced degree (such as a PhD) in the U.S. Our resident list hasn't been updated for a couple of years, but here's a listing of residents and faculty:

http://www.hmcnet.harvard.edu/pmr/resident.html
http://spauldingrehab.org/body.cfm?id=71

I'm guessing that all of them have a good command of the English language. Instead of being part of the problem, why don't you try doing something constructive that will attract better applicants to your program. Since you seem to know so much about the residency programs in New York, tell me where the residents from your program and Columbia/Cornell are from?

 

[Discount]

Stinky,

I don't think Spaulding even has any DO residents. What is the deal with your institution.

Is Harvard too good for DOs. Come to NY- they are everywhere. Actually, I thought DOs were doctors of optometrists at first... then I asked myself why are optometrists doing internal medicine.

Personally, I'd rather get a MD from Ross or St. George.

Oh, you were right... the impromptu survey was done by me. By no means is it scientific. I still think Mt Sinai is #1 because of it model stature. Only one other program in the nation can claim model TBI and SCI. I don't think spaulding is model anything is it? Actually, I understand u guys have like 300 beds (almost) at Spaulding.. how do you keep the beds filled?

Eat, drink, and be happy...

 

[Stinky T]

"Actually, I thought DOs were doctors of optometrists at first... then I asked myself why are optometrists doing internal medicine."

Actually, unlike your previous posts, your first guess wasn't too far off. DOs are doctors of Optometrists, Pediatricians, Ophthalmologists, etc. Just like MDs are doctors for many different types of doctors out there as well.

"Only one other program in the nation can claim model TBI and SCI. I don't think spaulding is model anything is it? Actually, I understand u guys have like 300 beds (almost) at Spaulding.. how do you keep the beds filled?"

Regarding Spaulding, we do have about three hundred beds. We keep them filled with patients, believe it or not. Our floors include, Stroke, Pulmonary, Cardiac, Amputee, Pediatrics, Pain Management, SCI, Musculoskeletal, and TBI. We also have a Rads floor, Sleep lab, and Gait Analysis lab. Additionally, we have clinics and beds at MGH, BWH, and BIDMC. Yes, Spaulding is involved with model systems, but that in and of itself doesn't mean much to the residency program. I guess your program is a good illustration of this.

"Is Harvard too good for DOs."

No, actually, you'll find them as attendings at HMS in Orthopedic Surgery, Neurology, and PM&R. They also serve as residents and fellows.

"Personally, I'd rather get a MD from Ross or St. George."

I'm sure you did, I mean would've. I guess it's our loss than we weren't able to attract a resident of your caliber. To be honest, I find it hard to believe that you are a resident at all.

"Oh, you were right... the impromptu survey was done by me. By no means is it scientific. "

You think?

 

[rehabdoc]

I agree with many points that stinky tofu has made. Being in PM&R and at the end of the tunnel, I can't say enough good things about it.

The profession is a young profession, and is where more sexy residencies were decades ago. There are only 6000 and change board certified physiatrists for the entire USA (for comparision there are in excess on 3000 Internists graduating yearly). It might have been the trend to get FMGs as primary care candidates for programs, but the trend is changing these days.

Our program has a great mix of FMG / AMG (1:2) with USMLE scores in the range of 200-230 and more. It dose not make a difference if you are FMG or AMG as long as you know your stuff. Medical school in many places in the world is many fold more difficult and challenging than in the US and they sure train capable physicians.

I disagree with Discount on many of the points he has edited. I would like to have the source of his ranking and statistics. What subspeciality do you belong to?

I would also consider Kessler as the first choice in the NY region especially if one is interested in SCI.

And last, PMR is a speciality and unlike psych ,internal medicine that patients need to directly go to, our knwledge is needed as consultation basis. It is correct that ordinary jo in the street might not know diferent between Psych and Physiatry but once our services are needed , refering MD's are well aware of the importance and service we could provide. People with previous exposure for sure appreciate the value.

 

[Discount]

Rehabdoc,

My field is PM&R. I am a little disappointed being a "glorified" PT however it sure pays well for what I really do... which consists of writing PT and OT orders. I don't think anyone reads what is written anyways.

Actually, I think some aspects of PM&R are unnecessary- like inpatient consults. Personally, I don't think rehab guys even know basic PT stuff yet they write the prescriptions. I think PT guys should be autonomous... they know more than us docs about PT stuff. They see the patient everyday in therapy... we just take care of pseudo medical issues--- i mean we make calls to consultants b/c our medical knowledge has declined since internship.

USMLE between 200-230... please. I agree it doesnt matter anyways. All that counts is your SAE scores.. yea right. Actually all that matters is learning how to do impairment ratings and workers comp. I'm gonna hook up with a good lawyer to feed me the cases... MRI, EMG, unnecessary x-rays, injections, months of intensive PT with computer assisted ROM, prolotherapy, accupuncture, hell... i'll even fry their discs and do discograms if insurance will pay for it. Then once I cause SCI admit them to the SCI unit. They'll fall and have a TBI. Then they'll be in pain all their lives which will necessitate morphine pumps.. oh oh and also become spastic requiring baclofen pumps/botox injections. The give them some gait analysis. Then they'll get an pressure ulcer... infection and then amputation. Then they will need prosthetics and orthotics. Geez.. one patient can pay my salary.

Rehab is awesome...

I still think you guys are jealous because MT SINAI has model systems in both TBI and SCI. MT SINAI is also ranked top 20 in US NEWS.

 

[rehabdoc]

Originally posted by Discount
Rehabdoc,

My field is PM&R. I am a little disappointed being a "glorified" PT however it sure pays well for what I really do... which consists of writing PT and OT orders. I don't think anyone reads what is written anyways.

Actually, I think some aspects of PM&R are unnecessary- like inpatient consults. Personally, I don't think rehab guys even know basic PT stuff yet they write the prescriptions. I think PT guys should be autonomous... they know more than us docs about PT stuff. They see the patient everyday in therapy... we just take care of pseudo medical issues--- i mean we make calls to consultants b/c our medical knowledge has declined since internship.

USMLE between 200-230... please. I agree it doesnt matter anyways. All that counts is your SAE scores.. yea right. Actually all that matters is learning how to do impairment ratings and workers comp. I'm gonna hook up with

a good lawyer to feed me the cases... MRI, EMG, unnecessary x-rays, injections, months of intensive PT with computer assisted ROM, prolotherapy, accupuncture, hell... i'll even fry their discs and do discograms if insurance will pay for it. Then once I cause SCI admit them to the SCI unit. They'll fall and have a TBI. Then they'll be in pain all their lives which will necessitate morphine pumps.. oh oh and also become spastic requiring baclofen pumps/botox injections. The give them some gait analysis. Then they'll get an pressure ulcer... infection and then amputation. Then they will need prosthetics and orthotics. Geez.. one patient can pay my salary.

Rehab is awesome...

I still think you guys are jealous because MT SINAI has model systems in both TBI and SCI. MT SINAI is also ranked top 20 in US NEWS.

I think you are in the wrong buisiness for the wrong reasons and definitely a wrong representation for the profession.

Most people interested in PMR are residents that get into it , not to write PT/Ot orders but to become effective Diagnostician and clinicians.

I think you are either underestimationg yourself or your medical institution looks at your rehab departments as a second rated department.

A well thought after rehab department gets appropriate inpt and outpt consultation including Electrodiagnosis, musculosleketal trauma, Acute stroke and Acute TBI, Wound care management, , Regional blocks and Muscle selective spasticity management. Spine management is a huge portion of this profession and noninterventional and interventional pain management is the newest addition. Peds by itself is another story.... I don't know why I am explaining this to a rehab resident but I think I need to tell you .....

Programs like the one I am in are quite selective in who they get; and they do their best not to attract individuals who misrepresent the profession. USMLE scores mentioned before are not uncommon in good programs around the country.

I hope you realize that scientific and well educated physiatrists / physiatry residents do not sound like you. If money is what you are after, you might want to reconsider your choice before it is too late.....

 

[Discount]

I heard from recruiters that if u do workers comp stuff-- you start off at like $200,000. NCS pays per nerve and EMG pays per limb. I always like to do unnecessary F waves and H reflexes. Adds more to the overall bill.

Or you could do inpatient rehab and work your ass off for approx 100,000/year. You tell me 9-4pm 5 days/week or working your ass off for now money.

That is why physiatry is so attractive.

Do you really think people go into PM&R to help people and "improve function"? people go to PM&r to make money and have the easy life. I know... i am lazy and i like money.

What is your opinion?

Discount
PGY4 from anonymous univ program

 

[gwen]

"From my little observation in New York City programs (i am not mentioning any particular program)... it just seems that PM&R programs will accept any warm-blooded individual that can do some scut work"

For all the hard work every medical student and resident puts in, its a shame I had to read that. Everyone has a story behind their MD, DO or FMG degree...regardless of their path, I do know that we all reach our destination through hard work. I'm sorry that you have such a hard time understanding foreigners' English or the philosophy behind osteopathic medicine.

You really remind me of the physiatrist I worked with who made me question my career choice...only to be saved by ligament, stinky tofu and many other wonderful physiatrists. This physiatrist was bitter and angry with PTs/OTs, chiropracters, orthopods, neurologists and rheumatologists for HIS sad life. Everyone according to him was a *****...but if you looked at him, he lived a pretty pathetic life himself, his wife left him, his children stayed away from him, his old hospital gave him the boot, and no one in the community respected him b/c he was always putting people down. In the end, he has loads of money and a sad life. So, "discount", let me warn YOU that your attitude may sadly affect you as well. And please, keep our forum peaceful.

A well wisher...
Gwen

 

[Ligament]

You git 'im Gwen!

I think it is painfully obvious at this point that Discount is a troll and implore the other PM&R regulars on this forum to ignore his/her posts.

Why pick on us peaceful physiatrists? Too much excitement makes us dangerous.

Regards.

 

[Voxel]

Obviously a disgruntled soul. I wonder if he/she would be happy in any other field of medicine. I was about to state some obvious benefits of the medical profession and PMR in particular but then I realized I'd be wasting my breath on Discount.