UCI vs CHOC

[E2W]

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Anyone familiar with the the pros and cons of UC Irvine and CHOC? I know UCI Peds has Miller's Children's Hosp and that this program has academic affiliation, whereas CHOC is a community-peds hosp. with no university affiliation. But being so close to each other, does one get more patients or see better cases than the other? Anyone doing residency or a rotation at either of these programs? Which is better?

Thanks

 

[hellfish69]

I can only speak for CHOC but I can tell you first hand what my experience has been briefly.

1) Family environment. From the adminstration to teh faculty, it is a very supportive environment that listens to the needs of its residents and actually institutes change to address issues.
2) For an non-affiliated free standing children's hospital, I am always surprised as to how academic the institution is. You have to be if your constantly trying to do the best for your patients. Our morning reports and rounds often reflect what is new and evidence based. We often do challenge ourselves and ask why we do what we do, and can we do it better based on the data out there.
3) We are a high volume place. If you learn by doing and seeing pathology first hand, this is the place for your. If you learn by admitting 2-4 patients a night and reading, then this may not be the place for you.
4) Pathology: its a wide variety from great general pediatrics to the rare metabolic seizure disorders to strange cardiac anomolies, we have a wide variety. It helps to build a solid general pediatric base for where ever you may want to go.
5) Both UCI Miller's and CHOC are great programs for different reasons. The best way is to interview and see for yourself the difference.

 

[165808]

So, the fact that I'm actually posting on SDN while on call at UCI should tell you something right off the bat....😀

I'm a UCI peds intern, so I figured I'd respond and give you my input. At UCI we rotate between two hospitals, as you know: UCI Medical Center in Orange and Miller Children's (part of Long Beach Memorial) in Long Beach. The two hospitals are vastly different, and we spend (on the whole) more time at Miller's.

Miller's is high-volume, pretty busy, great teaching. It's a night float system on wards there, so you obviously don't expect to sleep on call. You see a lot of pathology, and some pretty complicated kids come through there. It's your basic children's hospital.

UCI is lower-volume and tends to have less complicated kids. Though the kids currently on service are pretty complicated, so that's not always the case. Teaching is still great. A lot of our kids will get transferred over to CHOC for higher level of care on some things (we have a newly diagnosed Wilms that will go there for management after we do her nephrectomy), and a lot of CHOC specialists have privileges over at UCI.

It seemed a little backward to me....the community hospital being more high-volume/intense than the university hospital, but it is what it is.

As far as which is better, that's totally subjective. Like hellfish said, if you learn by doing and admitting 10 patients per night, CHOC is for you. If you would rather have a slightly more chill residency with plenty of time to read in addition to seeing lots of patients during certain rotations, then UCI is for you. UCI has had GREAT board passage rates in the past, so I think that shows good things about the program. We learn a lot, sleep adequately for the most part, and have TONS of fun together in our spare time (my intern class is probably the coolest around 😎).

If you have any more questions, lemme know. When it comes closer to interview season, I can answer any more specific questions that'll come up....

 

[PedsGuru]

I have rotated through both programs and let me tell you there is no comparison. When I rotated through UCI (Millers Children Hospital), I noticed a more laid back atmosphere where the attendings laughed and joked with the residents. Everyone seemed happy. Their night float system is awesome as you only do a week of night float and the rest of the weeks on wards and more shiftwork. They see a lot of pathology and are very knowledgeable. Their admissions overnight are reasonable and you never feel like you are sitting around doing nothing. You have time to think about your admissions and read about them. This seems trivial but I felt the UCI residents had more experience with making their own decisions about care and were very autonomous. Of course, you always had someone to talk to for complex cases. The residents are so awesome. Very funny, laid back and down to earth. They have a lot of fun, but are in no way slackers.

At CHOC, the cases are good. A lot of zebras, so I am not sure how practical it is. They have good morning report and noon conferences, but do pimp a lot which is very different from the atmosphere at Millers. The CHOC residents are very knowledgeable as well, but seem to use consults for almost every admission and don't get much autonomy. The nights are outright miserable at times. Back to back, non-stop admissions all night. No time to read, or think about your patients. Yes they have made some changes, but it is still bad. They also have a lot of trouble with staying within their work hours. Most of the residents are nice, but very overworked. Nice hospital as well.

I am in no way trying to promote one program over another, just posting my experiences. I am in the fortunate position of being able to compare the two programs as I did a sub-I at both places. Like others have said; if you learn by being able to think things through then UCI is your program, if you learn by sheer volume without much time to think then CHOC is for you.

 

[WhatUpDoc!]

Sweet timing! I was just looking into these two programs earlier this morning to round out my list 😀

 

[healthykidz]

Well I have PLENTY of thoughts on the subject, far too many to list here. Let me say that I have spent several years at both programs, and currently I am at CHOC, and I am SO happy here.

There are many differences, and they coorilate with different learning styles. I agree with a previous comment that you should interview and/or rotate at both programs and decide how you learn better.

First off, in medical school I realized the difference between Night Float and Q4 call, but I thought the 2 were a wash when it came to the For-and-Against columns when ranking residency programs, and i wasn't going to let it weigh in on my decision. Let me tell you - I am so happy (and lucky) that I picked a program with Q4call - because I realized that, with the way I learn, my best learning takes place in the post-call rounding. I really like presenting (or letting my intern present) the patients we've admitted overnight. I like the discussions that follow. I like putting myself out there describing what I did to manage the pt in the middle of the night, and watching the attending review all the info, examine the pt, and then comming up with his own assesment. It solidifies my decisions overnight (either to ammend my thinking or to continue with the same). I couldn't get this, the learning i"m getting now, at a night float system. Again, this is my way of learning, and it's something you need to realize about yourself. In terms of autonomy - i am very rarely calling consults while I am on call - and since I get to round post call - the pt i admitted is MY pt, ownership of a pt is a great part of learning. I'm not sure what program asks for more consults, but even on those that we do have consults on, I feel very involved in the decision making (often the specialist is asking me what I want to do - and uses it as a teaching point).

Also - I wanted to be in a higher volume place (again, the way I learn - are you seeing a pattern yet?). I definately learn by seeing and doing, and I wanted to see a lot and get to do a lot - and CHOC is perfectly living up to that. I somewhat disagree with one of the last commenters - even though we are busy, by no means does that mean there isn't time to read. I read up on just about every pt I admit overnight.

About the work hours - what was said earlier is also untrue. We have no problems keeping within our work hours - I know this because we just had the review last year. - I think the previous writer might have noticed a lot of attention paid to the "hours" issue, and figured it must be because we are not compliant. The truth is, our Residency Director feels so strongly about the 80hour rule, that he is constantly checking in to make sure we are doing fine. There are plenty of safetynets built to protect the ward residents to assure their compliance, and his regular "check-ins" are to see if he needs to use these safety nets.

Lastly - the family that is at CHOC is ultimately what made this my #1 choice when ranking. It is neat to work at a hospital where you are the only residents. Your picture is plastered throught the hospital. Everybody knows you from the nursing assistants, to the Surgery attendings. (one of my favorite stories happened my intern year. It was about 3am on a Sunday - i was writing orders on a new admit. The head Surgeon sat down next to me, he had to come in to do an appy in the middle of the night. He sat down right next to me and said "so how's your night going, are you enjoying your intern year?" - I think i peed my pants a little. First of all - how did he know my name. Secondly - YOU ARE THE HEAD SURGEON, YOU HAD TO COME IN AT 3am ON A WEEKEND - SHOUDLN"T YOU BE YELLING AT SOMEONE?- and you are taking the time to CHECK IN WITH ME TO SEE HOW I"M LIKING MY RESIDENCY!! - it is definaly a very warm environment. I feel very close to my fellow residents, and also very close to all of the attendings, and regularly sit and discuss with the attendings on a interpersonal level (i don't know what the previous writer was describing when stating that they seem stand-off-ish).

I think wherever you go in peds you will find commonalities. It is very rewarding to toil the night away to try and help a child feel healthy by the morning. - For this reason we work in the BEST field of medicine, bar none. Pediatric attendings are always going to be more kind than any other specialty (honestly, can you imagine your Internist attending wearing cartoon ties every day?) - Wherever you go you will work hard as a resident - but the learning curve is so steep, and so valuable - and like I said before, what better thing is there to work so hard for, but for the health of a child!.

Good luck each of you during your applications/interview/list-making processes.

 

[dsherida]

I can only interview at one of these programs and trying to decide. I think I have a grasp on the differences from the above, but anybody have any sense of which program will be better for a student planning on going into a peds specialty. I will most likely not be staying at either of these programs for a fellowship, but curious if either would be an advantage or a disadvantage with regards to a future fellowship. Thinking cardiology. Thanks!

 

[CoDeReDMeD]

Let me start off in defense of UCI that our night float system works great. I don't think "healthykidz" actually spent time at Miller Children's Hospital as he would know that the night float team does round with the day team and presents the patients they admitted overnight. That gives the attendings a chance to teach and critique the night team as well. On night float you start at 7pm so there is no rush to get out as you do with Q4 call. However, they do let you leave after presenting your patients as they understand you have to sleep and be refreshed for the following night. It is not the typical night float system that is in place in other institutions. Another argument against the night float system is continuity of care. Again, we do round with a day team, and they sign out to the night team when they come in at 7pm. So there is good continuity. It is sort of like shift-work. Because of our Night Float system, we have never had problems with our work hours at Miller Children's Hospital. Surprisingly, the only time any of us have had an issue with work hour violations has been while we rotate through CHOC. I am not trying to talk bad about any program, just stating one person's experience and being as honest as possible.

Also, for fellowships it depends where you want to go. I think both UCI and CHOC are well known and respected in California. I think outside of California, the University of California name carries more weight since it is a well respected academic and research institution.

I think you will get adequate training wherever you go. Just pick a program that fits your needs, personality, and supports your career goals.

 

[hellfish69]

Regarding fellowship applications, I think both names, CHOC and UCI carry their weight across the country. Having gone through fellowship applications and interviews across the country much like my other colleages in my class, it became quite evident that CHOC is known as a growing tertiary care pediatric facility. I would often get asked questions regarding the merger as well so news travels to opposite coasts. Also people do recognize CHOC as the Tertiary care Children's Hospital for Orange County.

Coming from CHOC, I felt confident that I have seen and managed "bread and butter" pediatric cases , complex multi organ dysfunction patients and the occasional "zebras." CHOC does see some interested cases as our coverage spans the Orange county, inland empire, Riverside, and parts of San Diego county.

During my fellowship interviews, I was able to reference many examples from my training. As the hospital is primarily RESIDENCY driven with at least 95% of patients followed by residents, you see and manage everything. We have a sense of ownership and pride in our patients, care and our hospital.

I am very sure no matter where you go, you will find good and bad parts about a program. I personally can not speak for UCI but having friends in that program they are happy as well.

Good luck to everyone this interview season.