Vanderbilt - ACGME Cycle Length

[soonermd]

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In a similar tone to the recent UMich accreditation thread, I was wondering if anyone has insight into why Vanderbilt only has a 2-year cycle length on the ACGME website. During my interview day, I did not realize they only had a 2-yr cycle but another applicant asked the PD and reported to the other applicants that a full answer was not given and maybe even the question was dodged.

I am not sure what to make of these cycle lengths, but as others have written, I have also been told to take great caution at programs who have 2 or 3 year cycle lengths.

 

[Coastie]

In a similar tone to the recent UMich accreditation thread, I was wondering if anyone has insight into why Vanderbilt only has a 2-year cycle length on the ACGME website. During my interview day, I did not realize they only had a 2-yr cycle but another applicant asked the PD and reported to the other applicants that a full answer was not given and maybe even the question was dodged.

I am not sure what to make of these cycle lengths, but as others have written, I have also been told to take great caution at programs who have 2 or 3 year cycle lengths.

Holy Cow, Vandy has a 2 year cycle!?!?!

 

[urge]

Vandy has a 2 year cycle!?!?!

That's not good. Wonder what is going on?

A low cycle for a program is like a low USMLE score for a med student.

 

[SexPanther]

It won't be a 2 year cycle for long. They are back in a couple o' months and all will be rectified.

I'm a CA-2; I think they were here last during my intern year and there had been some issues with didactics and the cardiothoracic rotation (I'm a little sketchy on the details as I was never affected by any of the issues - they were resolved by the time I started CA-1 year). Changes were instituted immediately and now no worries. Didactics are very strong and the cardiothoracic rotation was revamped (we also have a new, sick TEE sim which we are developing a formal curriculum with). This was an aberrancy and I'd hate for you or other applicants to pass up on us due to this.

I probably met you during your interview day and said this already, but it is worth repeating. I truly, honestly believe that we are one of the top programs in the country. We work hard, we play hard, Nashville is a nice city and the people in our program are great. I'm not the type of guy to blow smoke up your ass and would tell you if there were issues or something to worry about.

Also, I'm staying to do a cardiothoracic fellowship here thanks in large part to the CT facutly, revamped curriculum and great TEE training here.

Anybody who has ?s or concerns feel free to PM me if you want.

 

[Coastie]

Hopefully things will be fixed.

What's the story on Vandy CT fellowship? Haven't heard much about it other than you guys don't have a head of CT anesth dept.

It won't be a 2 year cycle for long. They are back in a couple o' months and all will be rectified.

I'm a CA-2; I think they were here last during my intern year and there had been some issues with didactics and the cardiothoracic rotation (I'm a little sketchy on the details as I was never affected by any of the issues - they were resolved by the time I started CA-1 year). Changes were instituted immediately and now no worries. Didactics are very strong and the cardiothoracic rotation was revamped (we also have a new, sick TEE sim which we are developing a formal curriculum with). This was an aberrancy and I'd hate for you or other applicants to pass up on us due to this.

I probably met you during your interview day and said this already, but it is worth repeating. I truly, honestly believe that we are one of the top programs in the country. We work hard, we play hard, Nashville is a nice city and the people in our program are great. I'm not the type of guy to blow smoke up your ass and would tell you if there were issues or something to worry about.

Also, I'm staying to do a cardiothoracic fellowship here thanks in large part to the CT facutly, revamped curriculum and great TEE training here.

Anybody who has ?s or concerns feel free to PM me if you want.

 

[SexPanther]

Hopefully things will be fixed.

What's the story on Vandy CT fellowship? Haven't heard much about it other than you guys don't have a head of CT anesth dept.

Things already are fixed.

As for not having a head of CT anesth., I haven't heard about that but will ask around. I don't get caught up in a lot of the political stuff so I may just be oblivious.

The fellowship is a good one, albeit much smaller than the likes of Cleveland Clinic or Texas Heart. We start taking 3 fellows this coming academic year. TEE is extremely strong, good case load and diversity but we don't do as many ascending aneurysms, dissections etc. as you'd see at one of the larger places. Nice balance between clinical work and reading time, strong didactics. For the most part, really good faculty w/research opportunities if you're interested.

 

[wcostell]

Justin (SexPanther) told me this thread was on here. I figured I should weigh in before match day rolls up on us. I am a CA3 here at Vandy and thus have some memory of the events surrounding it.

Here is the low down as I remember the RRC visit the last time around. We had a few representative residents that were scheduled to meet with their reps. A few of these guys were upset with the administration for personal reasons. Also, at the time, the cardiac rotation felt a little more like work than training. They complained to the RRC that the residents were being "supervised" by one of the cardiac CRNAs who had been delegated the responsibillity of scheduling staffing for the cardiac ORs, both with residents and with CRNAs. This would obviously be a very serious violation of the rules regarding resident supervision.

Not only did they fix that issue, they hired the Vice Chair from MD Anderson (Bernhard Riedel, MD PhD). He now serves as course director and works very closely with the residents to make our CT rotation one of the best we have.

I will say this: I was a CA-1 when this went down the first time. I thus did not have a lot of input or concern about how responsive the administration was to my concerns. Either their strategy to improve administration responsiveness to resident concerns worked, or there never really was a problem. These guys are aggressive when it comes to changing things to improve our experience.

As a CA3, I was specifically invited to a meeting this AM with each of the course directors to determine a way to improve the efficiency by which our residents accomplish the basic competencies, leaving more time to pursue research or advanced training interests (TEE, MBA, etc).

I do not anticipate problems with this review.

 

[wcostell]

Justin (SexPanther) told me this thread was on here. I figured I should weigh in before match day rolls up on us. I am a CA3 here at Vandy and thus have some memory of the events surrounding it.

Here is the low down as I remember the RRC visit the last time around. We had a few representative residents that were scheduled to meet with their reps. A few of these guys were upset with the administration for personal reasons. Also, at the time, the cardiac rotation felt a little more like work than training. They complained to the RRC that the residents were being "supervised" by one of the cardiac CRNAs who had been delegated the responsibillity of scheduling staffing for the cardiac ORs, both with residents and with CRNAs. This would obviously be a very serious violation of the rules regarding resident supervision.

Not only did they fix that issue, they hired the Vice Chair from MD Anderson (Bernhard Riedel, MD PhD). He now serves as course director and works very closely with the residents to make our CT rotation one of the best we have.

I will say this: I was a CA-1 when this went down the first time. I thus did not have a lot of input or concern about how responsive the administration was to my concerns. Either their strategy to improve administration responsiveness to resident concerns worked, or there never really was a problem. These guys are aggressive when it comes to changing things to improve our experience.

As a CA3, I was specifically invited to a meeting this AM with each of the course directors to determine a way to improve the efficiency by which our residents accomplish the basic competencies, leaving more time to pursue research or advanced training interests (TEE, MBA, etc).

I do not anticipate problems with this review.

 

[Sdp]

WTF is a Cardiac CRNA? 👎

 

[yasawa]

In a similar tone to the recent UMich accreditation thread, I was wondering if anyone has insight into why Vanderbilt only has a 2-year cycle length on the ACGME website. During my interview day, I did not realize they only had a 2-yr cycle but another applicant asked the PD and reported to the other applicants that a full answer was not given and maybe even the question was dodged.

I am not sure what to make of these cycle lengths, but as others have written, I have also been told to take great caution at programs who have 2 or 3 year cycle lengths.

You guys need to really stop stressing out about the ACGME cycle length unless a place is a no name program AND has a bad cycle length. The things programs get docked for during these site visits are picky and excessive. When I was interviewing, I was told to only rank places with a 5 yr cycle. Looking back, it was horrible advice and im glad i didnt follow it. Some of the best programs out there(vandy, michigan, hopkins, MGH, etc ) have 3yr cycle lengths. Im pretty sure the residents at such institutions are still getting top notch training and will def have the pick of any fellowship or private practice gig that they want. With that being said, there are a lot of weak programs out there that have a short cycle length for a reason. . . they are training ****ty anesthesiologists. Def avoid them.
Luck with the match and stop stressing. . . everything works out in the end.

 

[wcostell]

At Vandy, as you would know if you visited here or looked into it, we employ a ton of CRNAs. It was one of the reasons I came here. I have no interest in staying in the OR until 7:00 PM every night to finish add-on belly washouts when I can be relieved by a well-paid shift worker after I've finished the cases I wanted in those rooms between 7:30 and 4 or 5.

Within each subspecialty or location we serve (Cards, Peds, Outpatient Surge Center, GI, etc) there are a core group of CRNAs that work on that service. There is no actual certification involved. As you can imagine, there is a very broad spectrum of skill level in the ranks of the CRNAs. The sharper, more motivated CRNAs end up on cards, peds, etc.

 

[Bertelman]

At Vandy, as you would know if you visited here or looked into it, we employ a ton of CRNAs.

Dude, don't get offended. Lots of places employ a ton of CRNAs. That's one of the reasons I chose my program, too.

Most places don't let them get within a stone's throw of the cardiac ORs, though. What you are describing is the exception, not the norm for CRNA practice.

What exactly is their role at Vandy? You've got a pretty elegant AIMS. You don't need them to chart. You've got residents and fellows, so they shouldn't need to insert lines. Do they just babysit during bypass?

 

[SexPanther]

What exactly is their role at Vandy? You've got a pretty elegant AIMS. You don't need them to chart. You've got residents and fellows, so they shouldn't need to insert lines. Do they just babysit during bypass?

Pretty much. We have 3 residents on CT every month. 1 is always post-call. We have 1 fellow right now. We are running 3-4 cardiac and 1-2 thoracic rooms everyday except weekends. So, due to man power issues, there will be 1 or 2 rooms that are staffed by one of the CRNAs. In those rooms, the attending does the lines, TEE etc and the CRNA charts, babysits etc. The CRNAs also help break us out. Moreover, they usually cover the cath lab cases. Essentially, we get to pick and choose which cases we want and then they fill out the remainder which is nice for us.

Next year, we will have 3 fellows so that may change the system a little bit; I bet that we will open up some more CT rooms.

I think that we'd like to have more residents on the rotation, but we don't have enough to make that happen. Overall, it's a great rotation and I've got a lot of experience. I'm currently on CT and even on the long days I'm happier than any other time b/c I'm doing big cases, managing sick pts. and having fun. Having every 3rd day off (even if I don't get called in from home) is pretty nice too.