Utmb im

[mesm]

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Does anyone have input about the residency program at UTMB. They were hit by hurricane Ike in late 2008, but in general what's the program like compared to Baylor and UT-Houston?

 

[Pkboi24]

Does anyone have input about the residency program at UTMB. They were hit by hurricane Ike in late 2008, but in general what's the program like compared to Baylor and UT-Houston?

I see UTMB students rotating here at Baylor all the time. Seems like they have all just dispersed to whatever Texas programs will have them. The residency itself I'm not so sure about. I know for a fact that surgery residents do a lot of their training at Brackenridge in Austin but I don't know about IM.

 

[Moonglow]

UTMB has a lot of residency and fellowship prorgams, every year the med-school turns out ~180 doctors, and the School of Health Professions awards a lot of post graduate degrees - and will continue to do so.

UTMB is now an institutional member of the Texas Medical Center and are finished in Austin as of June 30, 2010. For the 2010-2011 year all UTMB residencies will be located in Galveston, Houston and at other near "off-island" community hospitals and clinics.

UTMB will return residency and fellowship programs back to Galveston as the facilities are rebuilt.

UTMB is also responsible for the medical needs of inmates at Texas state correctional facilities (ninety state-wide sites), and is losing around $100 million a year due to state funding cuts. There will be ongoing changes to those operations which may affect the location of rotations for UTMB students, residents and fellows.

 

[rosiean86]

I'm a MSIII at UTMB, so I can respond a bit to the question, but I'm not fully knowledgeable about the internal medicine program because I'm one of the students who decided to go on the Houston track, which means that I did most of my clerkships in the medical center and St. Joseph's in downtown Houston.

Everything Moonglow has said is correct. When I compare my experience to those of the Baylor students and my colleagues who did internal medicine back in Galveston, I feel that UTMB is still weaker. We lost a lot of good faculty members, and the patient load is still not the same as it was before. That being said, they are working very hard on re-hiring a lot of faculty and TDCJ always provides us plenty of patients with lots of good pathology. The internal medicine residency director, Dr. Goodgame, is my advisor for the upcoming application year, and he is amazing. I think he will do really good things for the program, and from what I hear it's not a malignant program at all.

I hope this helps!

 

[Pkboi24]

I'm a MSIII at UTMB, so I can respond a bit to the question, but I'm not fully knowledgeable about the internal medicine program because I'm one of the students who decided to go on the Houston track, which means that I did most of my clerkships in the medical center and St. Joseph's in downtown Houston.

Everything Moonglow has said is correct. When I compare my experience to those of the Baylor students and my colleagues who did internal medicine back in Galveston, I feel that UTMB is still weaker. We lost a lot of good faculty members, and the patient load is still not the same as it was before. That being said, they are working very hard on re-hiring a lot of faculty and TDCJ always provides us plenty of patients with lots of good pathology. The internal medicine residency director, Dr. Goodgame, is my advisor for the upcoming application year, and he is amazing. I think he will do really good things for the program, and from what I hear it's not a malignant program at all.

I hope this helps!

I love Goodgame! That guy is so awesome. I was devastated when he decided to move to UTMB from Baylor. You bastards.

 

[sarahwy]

I love Goodgame! That guy is so awesome. I was devastated when he decided to move to UTMB from Baylor. You bastards.

I take it you went to Baylor? If so I wondered if you could provide some answers to a few questions about the IM program. I want to come back to Texas but have heard of somewhat bad reps from Baylor and UTSW. My questions are:

1. What is the support system like? Do they toss you in and its either sink or swim?

2. Is there adequate teaching? What percentage of residents pass the boards?

3. Do they histories of firing residents? ( I ask because they seem like such large programs, maybe they get lots of labor and then get rid of some each year)

4. Is there adequate time for research?

5. Do they comply with 80 hr wk requirements?

 

[Pkboi24]

I take it you went to Baylor? If so I wondered if you could provide some answers to a few questions about the IM program. I want to come back to Texas but have heard of somewhat bad reps from Baylor and UTSW. My questions are:

1. What is the support system like? Do they toss you in and its either sink or swim?

2. Is there adequate teaching? What percentage of residents pass the boards?

3. Do they histories of firing residents? ( I ask because they seem like such large programs, maybe they get lots of labor and then get rid of some each year)

4. Is there adequate time for research?

5. Do they comply with 80 hr wk requirements?

1. Yeah, it's one of those sink or swim programs as you put it. You have to do a lot of learning on your own. They don't baby you.
2. The teaching is good, depending on what attending you get. Just like at most places. I want to say the large majority pass the boards. I haven't heard of anyone failing.
3. I have also never heard of a resident being fired.
4. There is plenty of research to be had. You will have time on certain months of of cushy electives.
5. They do their absolute best to comply, but there is a sense of the old school residency here. First, don't leave your patients high and dry, then if you can do your best to comply with your hours.

Hope that Helps.

 

[drfunktacular]

1. Yeah, it's one of those sink or swim programs as you put it. You have to do a lot of learning on your own. They don't baby you.
2. The teaching is good, depending on what attending you get. Just like at most places. I want to say the large majority pass the boards. I haven't heard of anyone failing.
3. I have also never heard of a resident being fired.
4. There is plenty of research to be had. You will have time on certain months of of cushy electives.
5. They do their absolute best to comply, but there is a sense of the old school residency here. First, don't leave your patients high and dry, then if you can do your best to comply with your hours.

Hope that Helps.

This is a pretty good encapsulation of the Baylor IM program.

 

[mesm]

I am surprised by the negative input about Baylor. What about UT-Houston and Methodist? Thanks.

 

[drfunktacular]

I am surprised by the negative input about Baylor. What about UT-Houston and Methodist? Thanks.

"Negative" is in the eye of the beholder. BCM offers excellent exposure to very sick patients with a wide range of diseases in multiple treatment settings (county, VA, private) with a large faculty made up of many well-known clinicians, educators and researchers. The workload is probably slightly higher than some other programs.

TMH is probably a "nicer" place to work and has better hours overall, but you are sacrificing some independence and breadth of experience to work there.

UT-H is similar to BCM in many ways, but my impression is that many of the residents there tend to be less satisfied than at BCM, they work harder on certain rotations, have more faculty who are less than progressive in terms of how they treat housestaff, and their institution overall probably has less prestige than BCM (although that is subject to change in the near future with some ongoing instability at BCM that may be for the positive or negative... right now it's hard to say)

 

[Mingxie]

Hi everyone -

I wanted to address some of the things on this thread regarding UTMB and the Internal Medicine Residency Program itself. I am a recent graduate and a current Chief Resident. We have been to a residency fair up at BCM and we were surprised that people still thought we were underwater! Anyway, we wanted to get the word out that we are back.

1. UTMB John Sealy Hospital and the TDCJ Hospital are up and running. We have 300 inpatient beds in the "free world" and 108 inpatient beds in the TDCJ hospital. We have moved the blood bank, the pharmacy and the hospital kitchen on different locations after they have been flooded.

2. The Department of Internal Medicine matched a full class of residents that started this past June. They are all working in Galveston at UTMB’s main campus. We have opportunities for residents to work in neighboring clinics in the Clear Lake area. UTMB has also become an official member of the Texas Medical Center, and our residents rotate at St. Luke’s Episcopal Hospital one month out of their intern year.

3. There are no plans to move UTMB to Austin. UTMB recently opened a specialty care center in League City, TX, and there are plans to expand the campus in Galveston.

4. Our residency program had a 100% match rate for fellowships in 2010. Many of our residents chose to stay at UTMB for their fellowship training.

5. The city of Galveston is undergoing a revival after Hurricane Ike. Businesses have returned, the beaches are open, and there are plenty of nice, affordable housing options available. Residents can also live in the Clear Lake-League City area, which is a 40-minute drive from Galveston. There is very little traffic, even during rush hour.

6. Dr. Goodgame is our program director and he is just wonderful. We regularly spend time at his house in Galveston. He knows all of us by name and our families. He is very much involved in the resident and medical student education. Since his tenure at UTMB, he has completely restructured our Grand Rounds. He supports resident research and has brought back our annual IM Quality and Research forum where our residents showcase all their research work and Quality Improvement research.

7. We have telemedicine! This is the future of medicine and we have the latest equipment that allows our residents to zoom in for physical exams, listen to the patients' heart through the audio and even look through an otoscope to examine patients' ears.

8. All of our inpatient and outpatient facilities have the same EMR (Epic). All our notes and order entry are done through one centralized system... which is really handy.

For those of you who are interested, I really would encourage you to do an away rotation with us to get a good feel for our program 🙂

 

[texasguy]

"Negative" is in the eye of the beholder. BCM offers excellent exposure to very sick patients with a wide range of diseases in multiple treatment settings (county, VA, private) with a large faculty made up of many well-known clinicians, educators and researchers. The workload is probably slightly higher than some other programs.

TMH is probably a "nicer" place to work and has better hours overall, but you are sacrificing some independence and breadth of experience to work there.

UT-H is similar to BCM in many ways, but my impression is that many of the residents there tend to be less satisfied than at BCM, they work harder on certain rotations, have more faculty who are less than progressive in terms of how they treat housestaff, and their institution overall probably has less prestige than BCM (although that is subject to change in the near future with some ongoing instability at BCM that may be for the positive or negative... right now it's hard to say)

To the Baylor residents on this thread, do you get elective months to do solely research? (someone mentioned doing it on the side on cush months but practically speaking,what kind of research can be done 'on the side'? - ie retrospective studies or even answering a simple hypothesis doing basic science research and hoping to get a poster out of it at most takes much more time)

Also, for those interested in Heme Onc, do your students match at MD Anderson? How is Baylor's heme/onc program?

Thanks!

 

[Tius]

Current resident at baylor and former med student at utmb during ike. As far as I know from utmb, they acquired dr goodgame who is awesome gi-wise. I'm sure he's still got connections to bcm so for those who wanna do gi, it maybe a good deal. However, utmb did lose a couple of key faculty. They lost sellin in gi, birnbaum in cards, i think his name was amad (spelling) from gi, and neelon in surgery. however, some of my old buddies are down there for medicine still and they have a fulll class, and matched to fellowship (though they mostly stayed at the same program). I think the overall problem is still recovering the former patient load that was there at utmb.

As far as perspective for bcm medicine, it is a challenging program. The level of autonomy you get is pretty high on va and ben taub wards and you take care of very sick complicated patients that frankly, a lot of times you have to due to the micu being at full capacity. As far as teaching, I think its the same for any other residency in that there's a spectrum of attendings. Some sit you down and teach for 30 minutes a day, others show up for rounds, write "i agree with dr. xxx" and leave.

From a fellowship standpoint, bcm still matches well. 13/14 matched to cardiology last year, all who applied matched to renal, the people who applied for gi, majority matched. Not sure bout heme/onc but if i remember correctly, they all matched also last year. I think two years ago we had one resident match to md anderson for heme/onc. For research, you have the option of doing a clinical research elective month your second year where you have a dedicated month to do research. Range of research is anything from restrospective, chart review to clinical prospective.

Things that have changed, no more overnight call for medicine admissions. We have a night resident who does a month of pure admissions, generally 12-15 shifts from 7pm-7am. The only time interns are on call overnight is for units and medicine float, where you crosscover all the medicine teams, which is twice a month when you're on wards. Also ER shifts are shortened from 12 to 8 hours during the weekdays, but still 12 hours on weekends.

 

[meddstudd]

I'm an MSIV at UTMB, also happen to be in the Houston track but I did an AI at Galveston so I'm actually reasonably familiar with UTH, BCM, and UTMB when it comes to the IM residencies (regarding UTH and BCM my knowledge is limited to the overlap I had with them at St. Luke's). I am not particularly likely to stay at this program but I am a very strong candidate and I will rank UTMB (I have other geographical preferences)

UTMB was reshaped by the storm but I am not sure that it would be accurate to describe the program as weakened. For some convoluted financial/legal insurance reason there are large parts of the hospital that are still not repaired (including the first floor), but generally the functions of these areas have simply been permanently relocated. There is extensive construction occurring and in the works soon as well, which may be part of the reason for that.

There was a lot of realignment of faculty peri-Ike and many great folks left but the IM program is actually in much better shape financially and patient-load wise than it was in the year or two preceding the storm. According to Dr. Goodgame, the program is actually on pace for the best year in 4 years from a research funding perspective (Ike was 2 years ago). This trend is only going to improve. The storm appears to have forced the school to reevaluate its approach and, since Goodgame came just before the storm, it seems to have allowed him to rebuild it more soundly with a stronger emphasis on teaching, diversity of patient experience (exposure to world-class research facilities and private medical opportunities at TMC, a stronger emphasis on EBM training, etc.). The camaraderie of the program is also very good and you get the feeling it is a very laid-back program (good for some people, maybe not for others).

Faculty at UTMB are strong--not amazing, but consistently strong. I can say from personal experience that they are generally comparable to the faculty at Baylor, although I would suspect that Baylor might have more faculty in the "awesome" category than UTMB. I can only speak based on my month with occasional lectures, etc. from 3-4 faculty at SLH. The pathology from TDC is awesome. Dr. Goodgame is great, not just for GI, but meet the guy and you'll see; he knows his stuff all around and he is a very hands-on PD (in a good way). You just get the impression in meeting with him that the program is in good shape and will only get better. Again, you should meet the guy. The residents all seem to think he's some type of Jesus/Osler hybrid. Dr. Karnath is also a fantastic doctor and wonderful educator. He does a board review series for residents that is great and is always on the wards. Good research is also very easy to get into at UTMB.

My impression of Baylor's program was also mostly favorable. The residents were very sharp and interested in teaching. The same for the attendings. I do not have any information on the rumored financial insecurity of the institution, it may or may not be a problem, if I were you I would not worry about it too much. Research opportunities abound here as well.

UTH I don't want to bash, but the month I spent with an intern and attending (and I can corroborate my experience with that of a few colleagues) was terrible. This is anecdotal experience and, unlike BCM, does not include their upper-levels or didactic opportunities, so take it with a grain of salt. But I have not met a single example of such uncommitted-to-teaching, poor examples of attending physicians at UTMB ever in all of my time there. And I know of two such attendings. Additionally, the intern I worked with, when asked about the program, kinda shrugged like "it's not that great but oh well". He said many residents are unhappy with it. Again, this is an anecdote and I would not be surprised if the opportunities for great experiences exist in the UTH IM program, but that has been my experience. I do not know much about research opps, but I suspect, beingin the TMC, that good ones exist. I am not applying there.

So, in summary, UTMB is solid to good (particularly if you are a laid-back individual) and will see sustained improvement throughout your time there, BCM may be as good as its reputation (very good/excellent) with a bonus if you're especially into the sink or swim model of education, and UTH is probably not too great an option, but it'll get you where you want to go if you're sure you wanna go there. If you prefer the island to Houston or vice versa, you might have your answer (for me, who has lived in both, give me the island, but many would disagree).

All of this is my two cents.

 

[punk]

Previous resident at Baylor, doing Cardiology fellowship elsewhere. Wife went to UTMB for residency/fellowship. So, I think I can throw in my 2 cents here.

Baylor
-------
has 3 hospitals: VA, Bentaub and st Lukes. St lukes is private, never liked it that much except for Cardiology rotations (Texas Heart is affiliated with Baylor).

Pros: Training at the VA/Bentaub is very hands-on. There is lots of autonomy and I liked it actually. I am now training at a West Coast institution and in retrospect, I can say that the culture at BCM was not to call consults at the drop of hat. The emphasis was to try and figure out stuff on your own and I think that this enhanced the quality of medical training. The medical specialities were only available as consult services. All patients whether oncology, HIV with weird infections and of course the chest pain patients were admitted to medicine and we took care of all of them. Teaching as you will realize later is very much attending dependant. I had several awesome attendings who taught a lot and some who did not.

Emphasis on EBM is great. In fact journal clubs are now integrated as part of morning reports/noon conferences. Learn about 1 latest article every week.

I got 2 months of research elective in my second year: churned out 2 abstracts for ACC and 1 manuscript for publication.

Fellowship match results were great and are available for everyone to see at the residency website. At least 1-2 ppl go to MD Anderson for Hem/Onc. Baylor Heme/Onc program is good too.

Houston is cheap. I had my own house as resident.

Cons: Heard that several people went over 80hours work limit but this number has dropped considerably after the new night float system.
Less number of call free months.
Less flexibility to changing vacation schedules as the program is huge.

 

[texasguy]

Thanks so much for the input, it was very helpful!

Do any of the current Houston residents have any insights from their programs how the new ACGME rules will effect scheduling (ie ward months and elective months?) Just like everyone else, I enjoy my free time and time to read/study but I for one think that doing away with overnight call will severely limit the hands-on learning experience residency is meant to give us...

thanks again!

 

[geoffreyy]

sorry just an update about utmb - inc resident here and info based on what i learned from interview and folks-
here's a bit of info:

1. the program has interns trained in u/s (very pocus based which is awesome esp for future hospitalists)
2. from interview, the program has close to 100% fellowship match (in the website it says 92% but from our 2016-2017 app cycle talks, the list is being updated for the 2016 grads and its close to 100%)- pulmcc, cards, gi hemonc (the main ones) and then the rest
3. they have night teams to avoid night calls and allow for better pt care continuity
4. utmb is the oldest medical school in tx, and has a substantial research background (if you want to do bench then you have the galveston national lab one of the few labs that house the bubonic plague)
5. galveston is a beach town (cheap $800-1000), and 50min from houston
6. utmb LOVES TO KEEP ITS OWN PEOPLE (for faculty or fellowships), good if you wanna settle down (the pd has been there since med school)
7. very nice folks esp the faculty! they prioritize resident wellness even in a university program
8. $6 meal cards? or was it 8. i forget/ multiple garage/open parking for employees)
9. public hospital (new!) + prison hospital (pretty unique for case pathology/mgt) + specialty/op clinics (then you have the burn centers, etc- just look it up)
10. and we get to work w//teach med, pa, nursing students
11. tacos