U. Arizona

[crewmaster1]

Advertisement - Members don't see this ad

BELOW IS A QUOTE FROM SCUTWORK.COM REGARDING U. OF ARIZONA.
I'm just wondering if anyone else can comment on some of the statements made in this review. Is this an accurate, insider review or a resident that just didn't click with the program? Either way it sure raises some questions to discuss during interviews. See below or visit scutwork.com:

PGY3 30-May- 2006

Schedule

There are 20-22 9 hour shifts per month depending on your year (8 hour shifts in the Urgent Care). This makes for a nice schedule with available time for a personal life.

In internship year, life depends on the rotation. OB/Gyn is universally known as hell on earth here. Q2-3 call on a habitually slammed service. They manipulate the 2 weeks you are there to max out an 80 hour schedule that will be closer to 90 hours. You run the triage side much of the time and some residents struggle to get their 10 deliveries in... one had to return to the service to complete.

Anesthesia couldn't give two ****s that you are there; they find emergency residents bothersome and have no desire to teach - with one great attending who is the exception.

Trauma is challenging, yet full of learning. Like most other trauma rotations, you are the note writer, wound checker, and all around punching bag for the senior residents (ask Michelle why she hates the EM residents so).

Orthopedics can be interesting. How much hands-on reduction time depends on your senior residents. I had a great one and learned a lot. Their was one exceptionally malignant female chief who is now checking out feet on the indigent in Detroit who was power-hungry and malevalent. Since she is gone, things have improved.

The ED time allows you a good experience with patient management. Be very clear that during a trauma, the trauma residents are in charge of ALL lines and ALL chest tubes unless they permit us to put them in. We cannot put in a chest tube on even a sponteous pneumo without their blessing and agreement to admit the patient.

Second year gives the SICU service which is challenging but high yield learning. CCU-ICU... good services, but the CCU service is very much "here is a pager... I am going home, page the fellow, call the ED or internal medicine folks if the patient goes down, I only live 20 minutes away". Things pick up from the learning standpoint during second year when you "move the meat". Nursing staff starts to respect (instead of resent) you and you are reduced by a shift a month.

Another huge problem they fail to tell you about when you interview is that there are days (entire days or days in a row) where there is no coverage for some specialties.... historically it was hand and neurosurg. The hand thing did get better, but the off-service, out-of-hospital, on-call docs cringe when they get our page and fight like stink not to come in.

Third year is so busy moonlighting, looking for a job and finding some type of project that the director finds acceptable, that time flies by. You have the opportunity to teach the younger residents and learn more independent practice. This is primarily a single learning experience program (although we rotate at another facility for a short time), unless you moonlight, it is difficult to know what the real world looks like.

Teaching

The faculty are hit and miss. Some seriously sit in the attending chair the entire shift and listen to presentations/sign charts without seeing the patient, unless they are seriously ill. There is a senior male attending reknowned for his appetite to be condescending. He and another attending are in a relationship which often makes the department awkward. In general, the attendings do not come from strong training programs. There are a couple of enthusiastic attendings who want to teach; the assistant residency director is a great asset to the program. Airway experience is good. The didactic sessions are informative but drag. We do journal club in the classroom setting. Some of the residents sleep through the session.

Atmosphere

The camaraderie among residents varies by class. Attendings do have some face time at resident functions. If you are not in the department, you are pretty much in no-man's-land socially until you return. Physically, the department is a typical department. There are no FMGs in the program. The short work schedule allows plenty of time to have an outside life.

Conclusion

The programs main strength is the resident's belief in our training. Most graduates find a job where they want. The drawbacks are the attendings that are not interested in teaching. The lack of trust of the department chair, who is known more as a politician than a resident advocate. Also in regards to him, the change in contracts for the graduates hired on to faculty is well-known. The romantic relationship between two of the attendings can make some shifts weird. I am one of those folks that believes all emergency medicine programs make you compotent if you put forth the effort. Most graduates from here enter into private practice; this program does not produce a large population of academic physicians. I would have thought twice about coming here had I known then what I know now. I would caution applicants to rotate here and experience the environment before signing up. I am sorry that I am not a cheerleader for the program I come from - am am being completely honest as I wish someone had been with me.

End quote

 

[The White Coat Investor]

Well, let's take it step by step. I'm still trying to figure out which of my classmates wrote this. I suspect it was the one who left during her third year, but who knows. If you would like to speak to the 10 residents who remained in that class, I suspect you would hear a VERY different picture.

Let's see 20-22 9 hours shifts. That's correct. You do some urgent care shifts as a PGY1 and PGY2. Also true. This is about average for EM programs, not too cush, but not crazy either.

OB/GYN month is Q3-4 call, and I easily stayed under 80 hours. I got 15 deliveries, although I suppose it would be possible if you had very bad luck to not get your ten in the 2 week rotation. Did you hear that? Two weeks. Sounds pretty good huh. Everyone else has to do a month.

Anesthesia rotation is one of those things that you get out of it what you put in to it. I put in about 5-6 hours a day, 4 days a week, and ended up with lots of lines, an epidural, and 35 intubations. That one great attending is a stud, but the key to the rotation is to find some great residents to help you be the procedure monkey. If you did lots of intubating as medical student, you can use it as a pseudo-vacation month since there is no one making sure you show up.

Trauma is tough and similar everywhere. Michelle is a b--ch, but hey, where else can you find a surgery program that doesn't have a few jerks in it. Besides, I think she graduates this year.

Ortho, that resident is gone, but the program is kind of weak. Unfortunate, since a weak residency program makes it tough to have a great rotation for us. But I got lots of reductions and plenty of splinting experience. What else were you looking for in an ortho rotation?

Trauma residents in charge of lines and chest tubes? Maybe if they ever showed up. There is so much trauma going through that ED you'll be glad if anyone shows up to help out. I certainly didn't ask permission to put in lines and chest tubes. If the patient needs the procedure, nobody wasted any time asking anyone's permission.

ICU/CCM rotations are awesome. CCU sucks as always. Who wants to admit chest pain patients? Why did you go into EM after all? Of course it is going to suck to be on the other end of that pager. But I can't say I didn't learn anything. PICU rotation is AWESOME! Great pathology, you get first crack at the procedures (neonatal central lines are pretty frickin tough it turns out), and the attendings teach like mad.

There are a few gaps in the call schedule. Hand was a big problem my intern year, but that problem has been fixed. ENT was an issue, but that was fixed my second year. Neurosurg was never an issue.

There is now a third hospital associated with the program so it is in no way a single hospital program, although that would have been a fair criticism a few years ago. You used to only spend 3 months away from the university hospital, but it is much more now.

The faculty are a huge strength of the program. Yes there is one who sits in the attending chair and doesn't see patients much. You hate it as an intern, but as a senior it is nice to have a bit more autonomy. The remainder are fantastic. They are nationally recognized and well known. The department head is probably the best EM teacher I've ever met. He is an adept politician (nothing wrong with that when he is working for YOUR interest.) The airway man teaches nationally. The department head trained under Rosen. One of the newer faculty members came from Denver. One is from Hennepin etc etc etc. Not sure what this evaluator feels is a weak program, but just because the residency director trained at Drew 20 years ago isn't a bad sign.

Didactic sessions are informative and usually are great, whether done by a resident (40%) or an attending (60%). Of course, they do drag on if you just came off the night shift, but come on, what is anyone supposed to do about that? Journal club was recently changed from faculty members homes to the classroom setting, but monthly social activities were instituted in their place at faculty homes. And yes, I have even seen a resident asleep during a lecture! Can you believe that?

I would say the camaraderie among residents is excellent with the exception of a certain resident from my class who was never social with the rest of us and left the program during her third year. (Part of the reason I suspect this post might be from her.)

The physical plant is overcrowded like most places, but is currently going under construction. Should be great when finished. No, there are no FMGs or DOs in the program. Not my choice, but perhaps a reflection of the applicant pool and the strength of the program.

Most graduates find a job they want? All graduates got THE job they wanted without difficulty.

Nearly all the attendings are fantastic teachers and heads and shoulders above the residency program where I am now a faculty member.

I'm not sure what the poster means by the lack of trust of the department chair, but as you might expect in any department the faculty members always have differences of opinion and the chair is the one who has to do the firing and hiring. In my experience he is a fantastic resident advocate and he made several phone calls to ensure me career opportunities. He is a tough negotiator regarding hiring contracts, but what do you expect? You'll run into a tough negotiator in many jobs you go to. If you don't like working for him, don't stay on as faculty. It certainly doesn't affect your resident education. Two of the attendings live together outside of wedlock. They occasionally bring food to each other on their shifts. Apparently that made the evaluator feel a bit weird. I didn't really notice an issue. They were both great teachers and two of my favorite faculty members to work for.

Most graduates (like most graduates everywhere) go into private practice. But 4 out of 10 of us went into academics. We were well prepared.

"I would have thought twice about coming here had I known then what I know now."

Perhaps you shouldn't have flown in an hour before your interview and flown out immediately afterward, then you could have met more of the residents and experienced the area. Then you would have realized that Tucson isn't the Bay Area, doesn't have the world's great shopping, isn't the most racially/ethinically/religiously diverse city in the country, and that it is really hot in the summer.

I ranked Tucson # 1 (as did all of my classmates but 1, who ranked it number 2) and would do it again. I received a fantastic education and had a great time. My family loved Tucson and I can't say enough good things about the program. Is it perfect? Of course not. Every program has its problems. But I can tell you the issues at the U of Arizona are very small ones in the grand scheme of things. They only interview about 6 people per slot (most programs do about 10/slot) because that is all they have to interview to fill.

Great faculty, great support staff, great residents, great city, great residency program.

 

[crewmaster1]

Thank you for your time replying to that post. I really appreciate it. I have heard great things about U. of Az and was a surprised (and a bit scared) when I read the scutwork post. This post seemed out of place from what I have heard previously, but this makes sense if you envision some pissed off resident who is leaving the program.

 

[EctopicFetus]

Well, let's take it step by step. I'm still trying to figure out which of my classmates wrote this. I suspect it was the one who left during her third year, but who knows. If you would like to speak to the 10 residents who remained in that class, I suspect you would hear a VERY different picture.

I would also agree. As a current PGY-1 who has a pretty good sense of the feelings of my classmates I can tell you we are happy hell very happy when in the department.

Let's see 20-22 9 hours shifts. That's correct. You do some urgent care shifts as a PGY1 and PGY2. Also true. This is about average for EM programs, not too cush, but not crazy either.

Actually they changed the interns to 4 week block scheduling. We work 20 shifts in 28 days. They try to break them up into 4 Days, 4 evenings, 4 nights, 4 Kino shifts (more on that later) and 4 urgent care shifts. Each yr you work 1 fewer shift. All are 9 hour shifts.

OB/GYN month is Q3-4 call, and I easily stayed under 80 hours. I got 15 deliveries, although I suppose it would be possible if you had very bad luck to not get your ten in the 2 week rotation. Did you hear that? Two weeks. Sounds pretty good huh. Everyone else has to do a month.

I hate OB and to be honest it was no different here. I easily got my 10 deliveries. They do make it a priority to make sure you get your 10. I had 12 about 9 days into my 2 weeks so I let the students catch some babies. I probably could have done 20 if I really pushed. My experience is that in those 2 weeks you will take 3 or 4 calls which just depends on dumb luck.

Anesthesia rotation is one of those things that you get out of it what you put in to it. I put in about 5-6 hours a day, 4 days a week, and ended up with lots of lines, an epidural, and 35 intubations. That one great attending is a stud, but the key to the rotation is to find some great residents to help you be the procedure monkey. If you did lots of intubating as medical student, you can use it as a pseudo-vacation month since there is no one making sure you show up. This is what I heard as well.

Trauma is tough and similar everywhere. Michelle is a b--ch, but hey, where else can you find a surgery program that doesn't have a few jerks in it. Besides, I think she graduates this year.

Trauma blows but you learn a lot. Hours of rounding, pages from nurses for nothing and being q4. sucks... You do get procedures if you want and basically let them know you want to do it.

Ortho, that resident is gone, but the program is kind of weak. Unfortunate, since a weak residency program makes it tough to have a great rotation for us. But I got lots of reductions and plenty of splinting experience. What else were you looking for in an ortho rotation?

Ortho is ok. I have reduced some people and put in a skeletal screw for a femur fx. you get what you want.

Trauma residents in charge of lines and chest tubes? Maybe if they ever showed up. There is so much trauma going through that ED you'll be glad if anyone shows up to help out. I certainly didn't ask permission to put in lines and chest tubes. If the patient needs the procedure, nobody wasted any time asking anyone's permission.

Agree. Best part is most of the non-interns have already gotten all of their procedures in and as such if you aks they will let you do whatever needs to be done and they will take time and teach/explain what to do. Of course sometimes things are so busy this isnt the case.

ICU/CCM rotations are awesome. CCU sucks as always. Who wants to admit chest pain patients? Why did you go into EM after all? Of course it is going to suck to be on the other end of that pager. But I can't say I didn't learn anything. PICU rotation is AWESOME! Great pathology, you get first crack at the procedures (neonatal central lines are pretty frickin tough it turns out), and the attendings teach like mad.
PGY-1 so I dont know too much about these.

There are a few gaps in the call schedule. Hand was a big problem my intern year, but that problem has been fixed. ENT was an issue, but that was fixed my second year. Neurosurg was never an issue.

We occasionally 2-3 times a month have some issues with hand but as desperado said Neurosurg has NEVER been a problem. ENT is not an issue at all for us.

There is now a third hospital associated with the program so it is in no way a single hospital program, although that would have been a fair criticism a few years ago. You used to only spend 3 months away from the university hospital, but it is much more now.

As mentioned 1/4 of our shifts are at kino which is more like a true county hospital and less like an academic place you get some unique and different experience.

The faculty are a huge strength of the program. Yes there is one who sits in the attending chair and doesn't see patients much. You hate it as an intern, but as a senior it is nice to have a bit more autonomy. The remainder are fantastic. They are nationally recognized and well known. The department head is probably the best EM teacher I've ever met. He is an adept politician (nothing wrong with that when he is working for YOUR interest.) The airway man teaches nationally. The department head trained under Rosen. One of the newer faculty members came from Denver. One is from Hennepin etc etc etc. Not sure what this evaluator feels is a weak program, but just because the residency director trained at Drew 20 years ago isn't a bad sign. Desperado, I am wondering who this person is who doesnt see anyone? I have spent 5 months in the dept and I dont know who that is. (PM me please). I think our faculty are great. We hired 2 EM/Peds combined people who are an amazing resource on Peds in the ED. Our chair is great and is a phenomenal teacher. We have one of the foremost airway people in the country and the world. Nothing is scarier IMO than not being able to get an airway. Also we have new faculty from Penn Indiana, Maryland etc. Overall we have attendings from the East coast, the west coast and the midwest.

Ill reply later to the rest.. Sorry I have to go to bed.. Ortho calls.

 

[Apollyon]

What is "Kino"? In Polish, "kino" means "film" or "movie" (as it has the same root as "cinema").

 

[The White Coat Investor]

What is "Kino"? In Polish, "kino" means "film" or "movie" (as it has the same root as "cinema").

Father Kino was an important historical figure in Tucson's history and as such had a hospital named after him...Kino Hospital.

No time for the PM ectopic, but you'll notice he carries a knife to work in that little black bag of his. Black scrubs, need I say more?

 

[EctopicFetus]

ahh he is real nice i thought.. he is the kino man.. rarely at umc.

 

[EctopicFetus]

to those who want to learn about kino...

http://www.discoverseaz.com/History/Kino.html

 

[EctopicFetus]

Still not sure on the attendings.. i assume they are referring to the attending who is with another attending? IMO he is super nice and always makes sure to grab the resident when we are at kino to do procedures and not scut BS. I dont know who this person is/was but I have found all the attendings to be pleasant and willing to teach. The only thing is some are harder than others because of their lack of desire to DC people.. one has a nickname of the tank cause he just forced admissions..

the thing is he is so nice and incredibly brilliant so while it can be frustrating you learn a ton.. other Qs to be answered later.. im exhausted.