UPMC IM Residency

[LordATPSynthase]

Hey guys,

Am a MS3 looking to do IM followed by PCCM (or something similar...). Am curious/interested in UPMC as a potential spot to look into (since their [P?]CCM is great).

I was just wondering about
the city and
cost of living [rent, food, just anything anyone can talk about] and
the program (anything bad/good about it other than what I can get by skimming their website).

Rent-- if I were to live somewhat close to UPMC at the Oakland site, what would it be like (1 Bed?) and is it an old city or are the places somewhat new/nice?

I'm assuming since it is a decent sized city that there should be lots of activities/hobbies to be entertained. I do plan on visiting it a few times because it is so close to me currently.

I'd like to start getting ideas about buncha places just so I know where I might end up. So might as well start somewhere...

I appreciate the help.

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[gutonc]

Never been there myself but I know some folks who live there now and they universally love it. Yes it's a old and a bit run down but that makes it cheaper than it might otherwise be.

Apparently a pretty vibrant arts/music/food scene and lots of sports if that's your thing (unless you're an NBA fan).

And you can't really beat Pitt for PCCM (well, you can, but just barely and really only at one or two other places in the country). I've also heard nothing but great things about their IM dept. It's one of the few places I didn't interview that I still regret not checking out (Utah being the other).

 

[LordATPSynthase]

Never been there myself but I know some folks who live there now and they universally love it. Yes it's a old and a bit run down but that makes it cheaper than it might otherwise be.

Apparently a pretty vibrant arts/music/food scene and lots of sports if that's your thing (unless you're an NBA fan).

And you can't really beat Pitt for PCCM (well, you can, but just barely and really only at one or two other places in the country). I've also heard nothing but great things about their IM dept. It's one of the few places I didn't interview that I still regret not checking out (Utah being the other).

Ah Thanks. Yeah I like sports, but not Pittsburgh sports haha. But I can tolerate it I'm sure.

Good to hear positive things about it.

 

[jdh71]

We like Pitt here.

Great residency. Nice city. Fantastic pulm/crit (though I'm not sure I'd be excited about the transplant population ).

 

[LordATPSynthase]

We like Pitt here.

Great residency. Nice city. Fantastic pulm/crit (though I'm not sure I'd be excited about the transplant population ).

So what would you say is the worst part of doing an IM residency at UPMC [Presby.]?
Or anything that could be improved. It can't be perfect!

would doing an IM residency at UPMC make it easier for me to get into their PCCM?

 

[jdh71]

So what would you say is the worst part of doing an IM residency at UPMC [Presby.]?
Or anything that could be improved. It can't be perfect!

would doing an IM residency at UPMC make it easier for me to get into their PCCM?

I guess from my syntax, it was confusing. I mean "here" as in the SDN IM forum.

As a general rule, you will always have a better shot at your home program than someone from outside. With that said any gunner applying to pulm/crit will be sending an application to Pitt, so you will be up against the cream of the crop, so you'd better have your crap squared away. I think the pulm/crit side of things tends to be research heavy, so if you're not interested in lots of academic research (basic or translational or clinical) then they may not consider you as highly.

 

[LordATPSynthase]

I guess from my syntax, it was confusing. I mean "here" as in the SDN IM forum.

As a general rule, you will always have a better shot at your home program than someone from outside. With that said any gunner applying to pulm/crit will be sending an application to Pitt, so you will be up against the cream of the crop, so you'd better have your crap squared away. I think the pulm/crit side of things tends to be research heavy, so if you're not interested in lots of academic research (basic or translational or clinical) then they may not consider you as highly.

Yeah I have heard about the research-heavy. Would I have plenty of time to develop all that during residency (the research to make me competitive?) because I just kinda figured out that's what I wanna do (IM -> some Critical care or PCCM) and also to be mentioned, have no research. Not sure if they look at Step 1 but it is high enough to not restrict me due to any score cutoff for any field.

Also I have no problems doing research. I get lots of wacky ideas in my head all the time about machines/solutions and would like to be funded for all that. I would love to change a field/make a new field.

I'm just concerned about (from stories I see from these boards) about malignancy [not specifically from UPMC, just in general] and I feel like 1 interview day won't be enough to get the feel from the residents (who may suppress true opinions?).

Also, of course, worried about crime (but not that much...) and the neighborhoods. Cost of decent apartment if I wanna live close by. Such things as that which I can easily figure out.

 

[san2]

upmc has a lot of im programs as satellite branches. upmc-mckeesport comes to mind.

 

[MedicalName]

You can find a lot of options right around the Oakland hospitals (if you are looking to rent) - when searching look for areas such as Shadyside, Southside, Squirrel Hill. A lot of grad students live in Shadyside and Squirrel Hill areas. Southside has more young professionals I would say, a LOT of bars and restaurants that may keep you up at night but also fun when you're not working. I didn't mention Downtown because Downtown in Pittsburgh is more of a business 9-5 district than your typical Downtown. All of these living options you can rent for <$700 a month.

Pittsburgh itself is safe and consistently voted one of the most liveable cities in the country and has a rather midwestern feel to it. It has everything you could want in a city but its not overly large/populated (300,000 w/in city limits and 1.7 mill metropolitan). Don't go to McKeesport though, not as good of an area and you start losing all the draws to being in a city.

Can't offer much on the actual residencies (still being pre-med), although my brother is an PGY-3 there for Anesthesia in Presby.

 

[LordATPSynthase]

I appreciate the response! Thanks

 

[WorkaholicsAnon]

Born and raised in the burgh. Also pretty familiar with the UPMC IM program.

Cost of living is rising but MUCH more affordable than the major East/West coast cities.

Lowest-crime areas that are near the main UPMC campus, as already alluded to: Squirrel Hill, Shadyside, North Oakland, Point Breeze, Highland Park.

Areas to stay away from if you're worried about crime: Homewood, East Liberty, Garfield, and West Oakland come to mind, also parts of the North Side, though increasingly gentrifying.

So-so areas that aren't too bad: Friendship, South Oakland (a lot of Pitt undergrads, so could be rowdy at times).

UPMC is top notch for many areas of medicine, in particular PCCM (among others)-- this is of course referring to the main campus program (Presby-Monte), not the residencies at the community satellites (forget about UPMC Mckeesport if you want to do fellowship). UPMC Shadyside has a decent IM program too, a bit easier to get into so tends to be largely (top notch) FMGs, pretty comparable to the main program (in fact their residents often rotate on the main campus) but still unfortunately seen as slightly inferior, though the residents still tend to match well for fellowships and many do end up at the mother ship for fellowship.

I do think that doing residency at UPMC may increase your chances for the PCCM fellowship there (for this specialty in particular) if only because of the opportunities to work with the faculty clinically and get involved in the research. The IM residency program last i knew as of a few years ago, is not malignant at all. If you're a hardworking, competent, collegial resident, you will be appreciated. Residents usually do very well in fellowship matches for whatever specialty they want in that they usually match where they want to go.

Additionally, a number of PCCM fellows there and as well as at other programs have commented to me that the fellowship program tends to be a bit more brutal than in most other programs. The MICU is enormous and the patients are SICK. The fellow has a lot of responsibilities from day #1. Doing residency at UPMC will give you a better idea of whether you even want that kind of rigor in a program--many aspiring fellows don't, and actually choose NOT to match there for that reason, which can make it less competitive for you if you do want that sort of training. If you decide ultimately you want to go elsewhere for PCCM fellowship for whatever reason, however, doing residency there is still advantageous in that it will give you the opportunity to get LORs from some serious bigwigs in the field.


Oh the last thing i wanted to make sure i mentioned about Pittsburgh as a city is that even though it tend to lag behind the major cities wrt things to do, it really has come a LONG way in the past 7-8 years in terms of development and retaining/attracting young people. I no longer live there but every time i go back i am amazed (and a little envious) of all the improvements that way. Like someone mentioned in this thread, the major leisure opportunities either involved going to bars or shopping, but that's not really the case anymore.

 

[WorkaholicsAnon]

oops i forgot to include South Side in the list of safe/gentrifying neighborhoods to live in. Didn't use to be though, when i was a kid, so it doesn't immediately come to my mind to suggest. It's completely rebuilt now with some sweet trails along the river, park areas, and outdoor malls with lots of venues.

 

[LordATPSynthase]

Born and raised in the burgh. Also pretty familiar with the UPMC IM program.

Cost of living is rising but MUCH more affordable than the major East/West coast cities.

Lowest-crime areas that are near the main UPMC campus, as already alluded to: Squirrel Hill, Shadyside, North Oakland, Point Breeze, Highland Park.

Areas to stay away from if you're worried about crime: Homewood, East Liberty, Garfield, and West Oakland come to mind, also parts of the North Side, though increasingly gentrifying.

So-so areas that aren't too bad: Friendship, South Oakland (a lot of Pitt undergrads, so could be rowdy at times).

UPMC is top notch for many areas of medicine, in particular PCCM (among others)-- this is of course referring to the main campus program (Presby-Monte), not the residencies at the community satellites (forget about UPMC Mckeesport if you want to do fellowship). UPMC Shadyside has a decent IM program too, a bit easier to get into so tends to be largely (top notch) FMGs, pretty comparable to the main program (in fact their residents often rotate on the main campus) but still unfortunately seen as slightly inferior, though the residents still tend to match well for fellowships and many do end up at the mother ship for fellowship.

I do think that doing residency at UPMC may increase your chances for the PCCM fellowship there (for this specialty in particular) if only because of the opportunities to work with the faculty clinically and get involved in the research. The IM residency program last i knew as of a few years ago, is not malignant at all. If you're a hardworking, competent, collegial resident, you will be appreciated. Residents usually do very well in fellowship matches for whatever specialty they want in that they usually match where they want to go.

Additionally, a number of PCCM fellows there and as well as at other programs have commented to me that the fellowship program tends to be a bit more brutal than in most other programs. The MICU is enormous and the patients are SICK. The fellow has a lot of responsibilities from day #1. Doing residency at UPMC will give you a better idea of whether you even want that kind of rigor in a program--many aspiring fellows don't, and actually choose NOT to match there for that reason, which can make it less competitive for you if you do want that sort of training. If you decide ultimately you want to go elsewhere for PCCM fellowship for whatever reason, however, doing residency there is still advantageous in that it will give you the opportunity to get LORs from some serious bigwigs in the field.


Oh the last thing i wanted to make sure i mentioned about Pittsburgh as a city is that even though it tend to lag behind the major cities wrt things to do, it really has come a LONG way in the past 7-8 years in terms of development and retaining/attracting young people. I no longer live there but every time i go back i am amazed (and a little envious) of all the improvements that way. Like someone mentioned in this thread, the major leisure opportunities either involved going to bars or shopping, but that's not really the case anymore.

I appreciate your response. I had it marked unread in my inbox this whole time so that I could come back and reply. I was just busy doing other stuff (step 2 cs, ck, our senior osce equivalent, sub-i) haha. I will take into account your information.

Thanks.

I am am currently in process of coming up with IM programs to apply to. As of now I only have 2 so I need to expand quickly. Unfortunately some of the most important aspects of the program can only be judged by interviewing there I'm afraid? We will see

Thanks

 

[evilbooyaa]

I mean it's UPMC. It's a good medical center AFAIK. I can't speak specifically for the program as I'm still a student, but if you're interested in radiology, I know it is very, VERY competitive to get a residency/fellowship there.

That being said, UPMC has a large number of hospitals, so try to make sure you end up at the oakland ones (Presby/Magee if they have residents) or Shadyside maybe.

 

[dakine doctor]

The UPMC PACCM and even immensely better their world famous CCM program (run the first separate Department of Critical Care Medicine not Department of Medicine) are two of the best Critical Care Medicien programs in the world.
The big "negative" with doing your IM residency at UPMC is that unlike most institutions, the CCM FELLOWS, not the residents do most of the work and have most of the procedural experience.
While doing my CCM fellowship at UPMC, most of the time the IM residents would stand idly by while the CCM fellows sprang into action. They did not participate much less run any of the Codes. They had very poor ICU procedural skills( as evident by the number of times I had to supervise them for basic procedures which they should have been able to do independently.) Worse off, they had very poor autonomy in the ICU arena.
If you want to train at UPMC, do fellowship there!!! Go to a residency program where you will get more hands on exposure and decision making opportunities for sick patients. - A UPMC Alum

 

[LordATPSynthase]

The UPMC PACCM and even immensely better their world famous CCM program (run the first separate Department of Critical Care Medicine not Department of Medicine) are two of the best Critical Care Medicien programs in the world.
The big "negative" with doing your IM residency at UPMC is that unlike most institutions, the CCM FELLOWS, not the residents do most of the work and have most of the procedural experience.
While doing my CCM fellowship at UPMC, most of the time the IM residents would stand idly by while the CCM fellows sprang into action. They did not participate much less run any of the Codes. They had very poor ICU procedural skills( as evident by the number of times I had to supervise them for basic procedures which they should have been able to do independently.) Worse off, they had very poor autonomy in the ICU arena.
If you want to train at UPMC, do fellowship there!!! Go to a residency program where you will get more hands on exposure and decision making opportunities for sick patients. - A UPMC Alum

Damn... when did you do your fellowship there?

 

[dazed1980]

Damn... when did you do your fellowship there?

I'd like to know the answer to this as well, 'cos if this is a recent phenomenom, my rank order will be changing.

 

[Blackcomb]

I'd like to know the answer to this as well, 'cos if this is a recent phenomenom, my rank order will be changing.

A non-ccm fellow at UPMC told me the same thing- residents don't run codes and in general do not handle emergency situations well because the fellows always take over. He didn't think the residents were as clinically capable (still very intelligent) as he thought they should be. This is anecdotal but I can imagine this happening when their mantra is "education over service."

 

[Blackcomb]

A non-ccm fellow at UPMC told me the same thing- residents don't run codes and in general do not handle emergency situations well because the fellows always take over. He didn't think the residents were as clinically capable (still very intelligent) as he thought they should be. This is anecdotal but I can imagine this happening when their mantra is "education over service."

This is based on his observations from last year.

 

[C5toC9]

It seems like running a code would definitely be educational too, right?

 

[FrisbeeDocIM]

A non-ccm fellow at UPMC told me the same thing- residents don't run codes and in general do not handle emergency situations well because the fellows always take over. He didn't think the residents were as clinically capable (still very intelligent) as he thought they should be. This is anecdotal but I can imagine this happening when their mantra is "education over service."

I interviewed there and asked specifically about residents running codes. Generally fellows/attendings run codes when on the floor, unless the resident is the first one there (it sounded like this doesn't happen often). In the MICU, however, residents do run codes once the fellow gains trust in the resident, assuming the resident wants to run them (which I think is similar at most places - if you don't step up to do something, you may miss out).

As far as "education over service," I got the opposite impression. It seemed like there was poor turnout at morning report on the day of my interview. When I asked about this, they said that attendance was not necessary, and that sometimes residents are too busy to make it. I also got the impression that it's a fairly busy residency, and that there's plenty of "service" to go around.

I suppose this just goes to show you how much things can vary from one interview day to another. Either way, I think UPMC is a great program that will provide great training & prepare you to do pretty much whatever you want to do.

 

[dazed1980]

Thanks for the responses,!

 

[coffeebeanjenn]

During my interview they also mentioned that the senior runs rounds on the floor. The attending usually isn't present for rounds, but checks out with the senior later. So as a senior you get a lot of autonomy/experience.

 

[Blackcomb]

During my interview they also mentioned that the senior runs rounds on the floor. The attending usually isn't present for rounds, but checks out with the senior later. So as a senior you get a lot of autonomy/experience.

I'm not trying to be difficult but does that mean the intern or medical student never interacts with the attending? That can't be good for education so I have a hard time believing that is universally true at UPMC (maybe its one attending's style?)

 

[FrisbeeDocIM]

I'm not trying to be difficult but does that mean the intern or medical student never interacts with the attending? That can't be good for education so I have a hard time believing that is universally true at UPMC (maybe its one attending's style?)

I also heard this on my IV day, and had to ask lots of clarifying questions. They still meet with the attending each day (they have a "back to the bedside" initiative, which I'm not 100% clear on) and have "attending rounds" at least once/week, which can involve bedside rounds, lecture, etc. The attending is usually present in the team room at several points during the day each day, and you do present each new admission to him on the day of admission. It sounded like it kind of lets you (as an intern) make & implement your plan, then present it to the attending who can make adjustments.

 

[coffeebeanjenn]

I also heard this on my IV day, and had to ask lots of clarifying questions. They still meet with the attending each day (they have a "back to the bedside" initiative, which I'm not 100% clear on) and have "attending rounds" at least once/week, which can involve bedside rounds, lecture, etc. The attending is usually present in the team room at several points during the day each day, and you do present each new admission to him on the day of admission. It sounded like it kind of lets you (as an intern) make & implement your plan, then present it to the attending who can make adjustments.

And they also said the attending is supposed to spend 1 hour/day with the team focused on education.

 

[Libertas]

As a (non-categorical) intern, I can comment briefly.

In terms of attending rounds, usually the residents walk round together in the morning, with the attending joining along 1-2 days a week. This occurs usually on the days where the senior has clinic, and on the day when the senior has off the pgy1s will round with the attending alone obviously. I don't know if its a rule per say, but in general, we have afternoon teaching style rounds with the attending. Often the attending pops in throughout the day to discuss plans, staff new admits, etc etc. They are of course available as we need them, but in general I think we have a good bit of autonomy.

In terms of 'codes,' I think I've been involved in 20-30 so far. Only 1 has been an arrest, the others were 'condition C.' It actually seems like arrests are pretty rare...It seems like they are called on the overhead only ever couple days or maybe once a week (though maybe there are more over night or in the ICU that aren't officially 'called'. ) Often we (the interns and seniors) will manage as much as we can on the floor before calling a condition. At least 90% of the time, calling a condition is mainly to facilitate the fastest possible transfer to an ICU bed because we've exhausted most of the available options for a floor/stepdown bed and invasive monitoring/lines are needed. In general, the acuity of the floors are extremely high, and I've gotten way more comfortable dealing with emergency situations. Certainly we didn't have as many where I trained for medical school.

 

[LikesJello]

As a categorical resident at UPMC, I can weigh in on this a bit...
On the floors, the resident, interns and medical students walk round every morning. Often the attending is not present during these rounds in order to provide the resident with more autonomy. Following rounds the resident will often check in with the attending with any issues or questions. The attending will walk round with the team in the am on the resident's day off and often 1-2 additional times (for a total of 3 times) wk. In the afternoon, the attending will often sit down with the team for dedicate teaching which can last anywhere from 30 to 90 minutes depending on the day and how busy the team is. Medical students and interns also present all new patients directly to the attending on a daily basis.

As a resident now, I enjoy having the additional autonomy and feel as though I make most of the decisions regarding patient care. That said, I do feel like I have great back up with the attendings if I need it. As an intern in the past, I still felt I had plenty of time with the attendings and got a great deal of teaching.

As far as running codes/conditions, I agree that this is one of the weakness of the program here. On the floors at Monte we have code team that will run most codes. In the MICU and CCU, residents who are interested and take the initiative can definitely run the codes. In the VICU, residents are expected to run the codes so you do get the experience there. Residents who want additional code experience can also take the code team elective, where you go to all the codes and conditions with the CCM code team. I know several residents who have done this and had a fantastic learning experience.

Hope that helps

 

[FrisbeeDocIM]

As a categorical resident at UPMC, I can weigh in on this a bit...
On the floors, the resident, interns and medical students walk round every morning. Often the attending is not present during these rounds in order to provide the resident with more autonomy. Following rounds the resident will often check in with the attending with any issues or questions. The attending will walk round with the team in the am on the resident's day off and often 1-2 additional times (for a total of 3 times) wk. In the afternoon, the attending will often sit down with the team for dedicate teaching which can last anywhere from 30 to 90 minutes depending on the day and how busy the team is. Medical students and interns also present all new patients directly to the attending on a daily basis.

As a resident now, I enjoy having the additional autonomy and feel as though I make most of the decisions regarding patient care. That said, I do feel like I have great back up with the attendings if I need it. As an intern in the past, I still felt I had plenty of time with the attendings and got a great deal of teaching.

As far as running codes/conditions, I agree that this is one of the weakness of the program here. On the floors at Monte we have code team that will run most codes. In the MICU and CCU, residents who are interested and take the initiative can definitely run the codes. In the VICU, residents are expected to run the codes so you do get the experience there. Residents who want additional code experience can also take the code team elective, where you go to all the codes and conditions with the CCM code team. I know several residents who have done this and had a fantastic learning experience.

Hope that helps

Thanks, this is super-helpful! It was pretty confusing on my interview day how much the attending is involved in the day-to-day running of the team. This clears things up, thanks for the extra insight!