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too much ICU???

Discussion in 'Surgery and Surgical Subspecialties' started by tomplatz, May 17, 2007.

  1. tomplatz

    tomplatz Member
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    does this sound like too much to you senior guys: as a 2nd year we do 9 months of ICU. as a 3 it used to be 12 weeks, now it's 18 frigging weeks of SICU. yeah you drain pus and do an occasional appy, but that's about it.

    i think this is really to the detriment of our operative skills. thoughts anyone?
     
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  3. eastcoastyall

    eastcoastyall Wisdom Onslaught
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    I would be psyched. The ICU is a great place to learn how to care for acute problems. You get so much more exposure in such a short period of time. You'll come out of that for the better.
     
  4. dynx

    dynx Yankee Imperialist
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    Is this a certain southern california program?
     
  5. Pilot Doc

    Pilot Doc SDN Angel
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    Dear god.

    I'm at a program with great ICU experience - to the extent that several large community hospitals hire our lab residents to moonlight/attend in their MICUs. But we do a total of 4-5 months over PGY1 & 2.

    You're talking about well over a year of SICU. That's more SICU time than I would have - TOTAL - after finishing a GS (or anesthesia) residency and CCM fellowship at my institution.

    You're clearly being exploited as a labor force.

    But the question is ... do you get your numbers and can the chief's operate?
     
  6. Winged Scapula

    Winged Scapula Cougariffic!
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    While I certainly agree that the SICU is a valuable learning experience, it appears to me that your program may be in violation of the ACGME requirements for general surgery residency.

    As far as I understand it, you must have at least 36 months total during your 5 year residency devoted to the principal (essential) components of general surgery. The principal (essential) components of general surgery include:abdomen, alimentary tract, breast, skin and soft tissue, comprehensive management of trauma and emergency surgery, endocrine, head and neck, surgical critical care and vascular.

    Therefore, if you spend 9 months doing SICU during your 2nd year and 4.5 months during your 3rd year, that means that you are seriously eating into the rest of the essential components of general surgery.

    How much vascular are you doing? How much GI, skin and soft tissue,etc.? That is a LOT of time to do ONE specialty at the risk of not doing so many others which require a certain case load to be BE and graduate. Being in the SICU means you are not in the operating room and most SICU procedures don't count toward major cases on your log.

    I am worried about the same things as Pilot Doc and I did about the same amount of devoted SICU time (not including rotations like CT and trauma which have lots of patients in the SICU which I managed) as he did. Are you going to be able to get enough cases? Are you Chief residents going to actually be able to operate? Will you have enough exposure to other parts of general surgery?

    Have they given you a reason for so much SICU? Because it sounds to me as if they are violating the intent of the ACGME requirements - to give you a well rounded general surgery experience - if not the letter of the law.

    BTW, you can find the ACGME requirements on their website.
     
  7. tomplatz

    tomplatz Member
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    But the question is ... do you get your numbers and can the chief's operate?[/QUOTE]

    no and no. our 3's can barely do inguinal hernias but they can drive a ventilator like no one else..

    it's total crap. i'm pretty fed up with my program for this and a number of other reasons. 37 months to go...

    and no, it's not in CA. TX.
     
  8. tomplatz

    tomplatz Member
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    our PD and chairman are both trauma/critical care. the chairman also fires people (residents and faculty) like it's a sport.

    that ought to clue folks in to which program this is if they haven't figured it out already.

    thanks for the input Kimberli. the way they get away with it is to stick us on transplant, which is a non-operative service except for the 4th year, who gets to retract for the 2 attendings who do the case. we are medicine's b!tch basically and just do scut. so it's considered an operative month, when in fact it isn't. things like this.

    very depressing. i'm so incredibly disappointed with my program, it used to be a great place to train and turned out good surgeons. now, we only attract FMGs, no one wants to come here. rightfully so.
     
  9. Yikes that's a lot. We do 2 months as a PGY-2.
     
  10. Winged Scapula

    Winged Scapula Cougariffic!
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    Still doesn't seem like it would still be enough. Are you guys due for a site visit soon? Its too bad that residents really find themselves in a bind over complaining about their programs, even rightfully so.

    I sympathize - we too had rotations that were supposedly "operative" but much of the time you spent was watching the attendings double scrub (especially livers and some of the more unusual or complicated neonatal stuff).
     

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