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Discussion in 'Internal Medicine and IM Subspecialties' started by rohsik, Nov 4, 2002.
Does any one have any info to offer about their program?
I've heard great things about the program. Not only is there a VA in their system (always a plus, I believe), it's very close to the main hospital. The hospital itself is huge and modern. Also, there is a real commitment to bringing in the best faculty possible--for example, I heard that they are using their cut of the money obtained from the State's class action suit against the tobacco companies to hire top people into their oncology program. The medical school itself is world class. Add to this a beautiful, small city (I went to undergrad there) with plenty to offer, and the program is unbeatable.
Just wondering, why are VA's a plus? Do you see more pathology there? I've been under the impression that those hospitals are tougher to work in, but maybe that's balanced by learning more?
I've done rotations in 2 VAs in med school, and they do offer an opportunity to see a variety of pathology (esp cardiology). But they offer a lot more. First, and I'm generalizing, the veterans just seemed to appreciate my effort more than patients in my ritzy university hospitals. Also, the computer system is very good (all daily notes are written on it), and the scutwork is minimal. In our system, three different residency programs make up the teams, so you have an opportunity to learn how things are done elsewhere. Also, there seems to be more time to attend the teaching sessions--most caps during call tend to be lower than at other hospitals in town.
I don't know so much about less scut in the VA system -- because VA employees are essentially government employees, its tough for them to get fired. Hence, they don't often do their job all that well. Admittedly, our VA ancillary folks have gotten better, but not much. The CPRS computer system is great, but does not infrequently crash, sometimes for hours at a time. Try admitting patients in that setting! When it works, it is pretty sweet however. Our VA has actually gotten busier with the closing of other VA's in the area, so capping on a weekday is a matter of routine.
Advantages to the VA -- whereas most University or big county hospitals are a good balance of zebras and bread and butter, the VA is truly a bastion of bread and butter pathology. For Medicine folks, that means we see a lot of coronary disease, COPD, HTN, DM. In fact, you might as well stamp the first line of every H&P "Mr. X is a 65 y/o wm with pmhx of CAD, COPD, DM, HTN who p/w....." -- but in all seriousness, taking care of vets is a real privilege, as they truly are some of the most appreciative patients you will take care of, and they'll let you do anything to them. Good learning all around.