Virginia Mason

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Jimwood

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Any thoughts on this program? Hours per week?

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I'm currently a CA-1 at Virginia Mason. I've been really happy with residency here, so far. The attendings are really great and we have an excellent experience with both general and regional techniques. Let me sum up some of my thoughts...

Pros:
Lifestyle - We work an average of 50-60 hours a week and have 3 weekends a month off. Strict adherence to the resident hours rules (including 10 hour rule). Coming from 3 years in general surgery, it's a total cake walk. And, it's Seattle!
Teaching - Good combination of new, young attendings and older, well-established attendings. Morning conference 2 days a week. Additional lectures hosted at the University of Washington.
Research - Plenty of projects going on that you can get involved in, if you're interested. No pressure from the attendings, though.
Anesthesia Experience - General and regional at VM (tons of regional, even for younger residents such as myself), OB at a neighboring private hospital, outpatient experience at 2 surgical centers in the area, ICU and trauma at Harborview, and pediatrics at Childrens.

Cons:
Facilities - Old, but they're soon breaking ground on a new hospital wing next door.

Let me know if you have specific questions and I'll address them. It's a great program.

Tom
 
Let me say what I know about the program (which is peripheral so take my thoughts with a grain of salt - I didn't do residency there)

They have, I think, about 9 oral board examiners. This is by far more than any other program I know of. That speaks to the quality of the attendings, and the academic environment. It sounds like it is a great mix between academic and private, since it is a private hospital.

My cousin did a rotation there and loved it.

It used to be better for the residents. They have added more contracts so surgery schedules have increased a bunch, but the anesthesia support has not increased in number, so the residents now work longer hours (5-6pm) as opposed to 3-4pm that it used to be. I heard this from a VM resident, so please verify this Tom.

They have long been considered the regional mecca. I think when they say this, they mean neuraxial. However, when I think regional, I think peripheral nerve stuff. I know I am not correct in this, but that is what I think when I hear "regional." So, how is their "regional" experience? A recent graduate from the fellowship told me they never did an infraclavicular, less than five ax blocks, very few if any (I can't remember exactly what they told me) popliteal blocks. They did a ton of fems and interscalenes. I think they didn't have a hand surgeon so that may be why they weren't getting those numbers. Again, Tom can confirm this also.

I would have liked to go there in my day, but alas, I wasn't interviewed.

Apparently, from lectures on audio digest, they are using chloroprocaine spinals a lot. That right there is a reason to go, because no one anywhere else will let you even try it.
 
I'm a CA3 at VM and I have LOVED my residency here.

To answer some specific questions: I work about 60 hours a week. We typically take overnight call once or maybe twice a month. Usually once or twice a week we take non-overnight call, meaning we get out between 5:30-9 typically. Otherwise the hours are about 6:30 to 5 ish every day. We do get out earlier on days when we were on late call the day before (and every post-overnight call day is off). It's overall very fair and the attendings try to be fair with getting us out on time and with regard to how long our day was the day before. Lifestyle overall is great (and I have a 3 year old daughter and a life outside of medicine).

We do a TON of regional (not just neuraxial--though we do more epidurals, and thoracic epidurals, in our 1st year than most residents do during their entire residencies). We do lots of femoral nerve blocks and catheters, interscalene blocks and catheters, popliteal blocks and catheters. Also lots of axillarys. I've done both supra- and infraclavicular blocks, sciatics, rectus sheath blocks, lumbar plexus blocks, superficial and deep cervical blocks... Basically, if you want to do a block you can find someone to teach you/do it with you. We are ramping up outpatient nerve catheters and have hundreds of patients who have gone home with them.

There are also amazing research opportunities for those who want them. I have presented (posters and oral presentations) at the Western Anesthesia Resident's Conference every year, the ASA twice, and other residents present at ASRA, IARS, and others.

I love this program, and am more than happy to answer any questions.

Debbie
 
Thanks to everyone who posted the reviews on Virginia Mason, they were really helpful and I'm very excited about interviewing there!

I was wondering if you could maybe compare the experience at VM to UW (of what you know about it). Also, do the two programs do things together sometimes? I noticed that one of you mentioned some lectures at UW for VM residents and the website mentioned that they worked together sometimes.

Thanks a lot!
 
am a CA-3 at VM. In a previous life, I did research at UW dept of anesthesia, and subsequently chose to come to VM for my residency. I think I can speak to some of the similarities and differences between the programs. First, I would like to post my usual speech to applicants about the pros/cons of the VM residency program.

Pros:
1) program size & relationship with faculty. It is really tight-knit. This quality was one of the strongest draws of the program for me.
2) regional training. we have continued to be recognized as one of the top instutuions in this regard. enough said.
3) strength of the faculty. A great number of the faculty are nationally and internationally recognized. With the size of the program, they know you well and will assist in any way they can to help you achieve whatever you'd like after residency.
4) Strong academic rep for a private practice program. We have as many CA3s this year going into fellowships as into private practice.
5) The department listens to resident opinions and takes them seriously.

Cons:
1) longer work hours than in years past. This program used to be on the lower end of anesthesia resident work hours. Now we are average in that regard. The case volume has increased, and staffing has not. There are few CRNAs, leaving the residents to absorb a great deal of this increased volume of cases. It is difficult to be motivated to go home and read when you are exhausted from a day in the OR. The hours also take on toll on morale of the residents and OR staff in general.
2) Difficulty in getting research started. There are research projects ongoing, but getting something approved through our IRB is especially arduous. At the outset of my residency I thought this was a very big issue. Now I feel that to complete residency well-trained is enough of an accomplishment.
3) Less exposure to trauma and no large transplants. We only spend 2 months at the Level I hospital in town. We do not do Livers, Hearts, or Lung x-plants. This issue is not a downside unless you are firmly convinced that you want to work at an academic institution where you will be expected to staff these cases. For me, it was a trade-off for the excellent regional anesthesia training.

VM & the UW:
- Both programs work approximately the same number of hours per week. This is a large change for both programs. The UW got a new program director who became an advocate for adhering to resident work hour standards. VM got busier. The programs' work-weeks gradually came to resemble one another with the exception that call at UW is more arduous. VM however requires the on-call resident to staff the pre-operative clinic during the day & then to be on overnight call.
- transplants and zebra cases at the UW. We don't get these at VM.
- Regional at VM. Beating a dead horse.
- I believe our attendings at VM treat us with much greater respect and truly care about us (by and large). The UW is a very large program, with 60 attendings and 60 residents. There can only be so much individual attention in that environment.

A very lengthy answer to a simple question. In the end, it all depends on your personality and what you envision doing in your career. If you want to work at a large university hospital doing transplants and trauma, then the UW is a better program for you. If you would like to become known for being a regionalist and teaching others the skills you've learned at VM, then this program is the obvious choice. Either will allow you a career in academics. The reasons I came to VM still hold true, and I would make the same choice again.
 
I'll tell ya one strange thing about VM, they only allow 15 days away from training, but ACGME allows 20. That is a total of 45 days vs 60 days. That seems like a big difference to me. 5 days of vacation as a resident for sanity is huge!
 
Just to reply to the question of 3 weeks of vacation vs four:

I interviewed up and down the west coast and paid very close attention to the length of vacation per program. ACGME does offer 20 days away per year. The way it works at VM (and at all other west coast anesthesia programs I viewed) is three weeks of vacation and one week of "professional time" away to any US university sponsered anesthesia continuing education function. To be more specific, last year I went to Cozumel in February and this year will go to Peurto Vallarta in Feb. The department puts up $500 per year towards this educational fund. If you don't use it, it rolls over to your next year. Most of us take a well-timed skiing or beach conference, and there are no questions asked.

I found this policy similar up and down the pacific, except not all departments paid for the professional time off. We all get our 20 days out of the OR a year, plus additional reading days when they are overstaffed.
 
Any thoughts on whether the new chair at UW will stop allowing VM residents to rotate at Harborview? What if new faculty at VM are not going to get academic appointments at UW anymore? Of the two programs UW seems like it might be more stable now.
 
Just to reply to the question of 3 weeks of vacation vs four:

I interviewed up and down the west coast and paid very close attention to the length of vacation per program. ACGME does offer 20 days away per year. The way it works at VM (and at all other west coast anesthesia programs I viewed) is three weeks of vacation and one week of "professional time" away to any US university sponsered anesthesia continuing education function. To be more specific, last year I went to Cozumel in February and this year will go to Peurto Vallarta in Feb. The department puts up $500 per year towards this educational fund. If you don't use it, it rolls over to your next year. Most of us take a well-timed skiing or beach conference, and there are no questions asked.

I found this policy similar up and down the pacific, except not all departments paid for the professional time off. We all get our 20 days out of the OR a year, plus additional reading days when they are overstaffed.

Wow, that's great you get $500.

However, I don't think that conference days are counted by the ACGME as days away from anesthesia training, since these days are anesthesia training. I may be wrong on this however.
 
I'm only a second year med student but very interested in anesthesia at VM or UW (or OHSU for that matter). Can you guys give me a rough idea of what I should be looking at boards-wise (I know there are other factors)?
 
I'm only a second year med student but very interested in anesthesia at VM or UW (or OHSU for that matter). Can you guys give me a rough idea of what I should be looking at boards-wise (I know there are other factors)?

You should be looking at good board scores. The higher, the better.
Then again, if you score really high, it will look like you have no life, and they will wonder if you're some kind of nerdy misfit. So try not to score too high.
 
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