What have you heard of Cleveland Clinic's Anesthesiology Residency Program?

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anim

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You know what is funny? It is usually the new CA-1s who pound their chests and declare "our training here is second to none".
 
Hehehehe thank you for your info... BUT, I'd like to know a lot more than that: schedules, rotations, size of the program, atmosphere, teaching, research opportunities and so forth. THAT WUOLD BE SPECIFIC ENOGH... I know it's a lot to ask, but a huge lot of modisms and funny expressions is NOT what I'm looking for to consider applying to any residency... Please, I know the guys are probably the best in the country, but I'd really want to know the program per se and not just descriptions of how wonderful it is. The thing is that I'm considering applying to the program and I'd like to know what my life will be like during the rrsidency if I do it... it's not laziness, I just want to know what I'm getting into so I can prepare myself
 
anim said:
Hehehehe thank you for your info... BUT, I'd like to know a lot more than that: schedules, rotations, size of the program, atmosphere, teaching, research opportunities and so forth. THAT WUOLD BE SPECIFIC ENOGH... I know it's a lot to ask, but a huge lot of modisms and funny expressions is NOT what I'm looking for to consider applying to any residency... Please, I know the guys are probably the best in the country, but I'd really want to know the program per se and not just descriptions of how wonderful it is. The thing is that I'm considering applying to the program and I'd like to know what my life will be like during the rrsidency if I do it... it's not laziness, I just want to know what I'm getting into so I can prepare myself
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http://more.studentdoctor.net/residencylist.php?program=2337

I'd always look at the interview feedback for any school you're considering applying to. Some of them are not helpful if they only have 1 or 2 reviews and they're kind of skimpy, but CCF has 6, so it should answer a fair number of your questions.
 
It is my impression that they are very crna friendly. Meaning that crna's are being trained there as if they are going to replace docs.

Maybe someone can address this issue. I have spoken on another forum with an attending there who doesn't see anything wrong with training the crna's to do everything their residents do. It sounds very crna friendly to me and I would research this aspect of the program very closely b/4 considering it.
 
Camel said:
Wish I could see that... unfortunately MS4 DNE MD.

Will definitely join sermo once I have a license.
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Let me try to post some of the quotes:


djdoyle Anesthesiology Posted Aug 14, 2009 at 6:55 AM
Our SRNAs are trained in spinals, arterial lines, central lines and more. While early on in their training they are booked in a room with a CRNA, later on they are given more responsibility and are booked to be alone with a patient (generally with MD supervision of two rooms). When on call after 5 pm we supervise up to four rooms, but only if none of those rooms have SRNAs.

John Doyle, Cleveland Clinic




SmilingBob Anesthesiology Edited Aug 14, 2009 at 2:45 PM
I also agree, but this thread has me wondering what Dr. Doyle believes is the value of a medical degree to a professional anesthesia provider. is the MD or DO degree completely superfluous? If I can get all of the required knowledge to be an anesthesiologist, including the knowledge ordinarly associated with a medical degree, from non-medical school sources, why bother to go to medical school at all? Do anesthesiologists at the Cleveland Clinic actually administer anesthetics, actually sit through five hour cases without breaks, taking care of the patients one to one, as I did for many years in an all-anesthesiologist group? Or do they confine their activities to preop evaluations and writing research papers?

I don't mean these comments in a negative way, I really want to know. Why bother being a doctor? Why take many years out of your life and go into debt an average of 200K if you can go to trade school and get the same education? I ask these questions seriously, from the standpoint of a doctor who has been supportive of CRNA's, and from the standpoint of a father who has encouraged his brilliant daughter to go into nursing and CRNA school.
 
Noyac said:
While early on in their training they are booked in a room with a CRNA, later on they are given more responsibility and are booked to be alone with a patient (generally with MD supervision of two rooms).
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:eek:

Like I have said before, at CCF it is only about turnover and $$$ -- NOT training
 
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anim said:
Hehehehe thank you for your info... BUT, I'd like to know a lot more than that: schedules, rotations, size of the program, atmosphere, teaching, research opportunities and so forth. THAT WUOLD BE SPECIFIC ENOGH... I know it's a lot to ask, but a huge lot of modisms and funny expressions is NOT what I'm looking for to consider applying to any residency... Please, I know the guys are probably the best in the country, but I'd really want to know the program per se and not just descriptions of how wonderful it is. The thing is that I'm considering applying to the program and I'd like to know what my life will be like during the rrsidency if I do it... it's not laziness, I just want to know what I'm getting into so I can prepare myself
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I'm sure you can find all that info at your interview.

Historically, threads about particular programs yield little beneficial or objective info. One camp tells you how great the training is, the other camp tells you something completely different. You will typically close the window of a program-specific thread feeling more confused.
 
Noyac said:
djdoyle Anesthesiology Posted Aug 14, 2009 at 6:55 AM
Our SRNAs are trained in spinals, arterial lines, central lines and more. While early on in their training they are booked in a room with a CRNA, later on they are given more responsibility and are booked to be alone with a patient (generally with MD supervision of two rooms). When on call after 5 pm we supervise up to four rooms, but only if none of those rooms have SRNAs.

John Doyle, Cleveland Clinic
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Great, so basically SRNAs are treated like residents but get to go home at 5 pm, while residents will be doing BS add-ons until the room is finished?

Am I right to make the assumption? Any CCF residents?
 
Mac4 said:
Great, so basically SRNAs are treated like residents but get to go home at 5 pm, while residents will be doing BS add-ons until the room is finished?

Am I right to make the assumption? Any CCF residents?
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That's how I read it but I'm not there. It would be nice if someone from the program would weigh in.
 
anim said:
Hehehehe thank you for your info... BUT, I'd like to know a lot more than that: schedules, rotations, size of the program, atmosphere, teaching, research opportunities and so forth. THAT WUOLD BE SPECIFIC ENOGH... I know it's a lot to ask, but a huge lot of modisms and funny expressions is NOT what I'm looking for to consider applying to any residency... Please, I know the guys are probably the best in the country, but I'd really want to know the program per se and not just descriptions of how wonderful it is. The thing is that I'm considering applying to the program and I'd like to know what my life will be like during the rrsidency if I do it... it's not laziness, I just want to know what I'm getting into so I can prepare myself
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Dude you can't realistically expect to come on this forum and have all these questions answered ona whim eespecially when you really haven't contributed much to the forum that I am aware of. Furthermore a quick review of your rather limited post history suggests that you may be interested in other specialties.

If you are interested in any program (and this advice applies to everyone) and you think that you can live in a particular location for a few years I suggest you:

apply to a program
see if you get an interview
go to said interview
see how much you like the place
ask all the questions you have listed above
compare it to the other places you interview
make the best decisions for yourself and family if you have one
 
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Anim asked a reasonable question. It would be nice if some people with first hand knowledge of the program would respond. Maybe they did in PMs. Not sure why he got so many useless answers. If this forum is not an appropriate place to gather information about residency programs, then what is?
 
nimbus said:
Anim asked a reasonable question. It would be nice if some people with first hand knowledge of the program would respond. Maybe they did in PMs. Not sure why he got so many useless answers. If this forum is not an appropriate place to gather information about residency programs, then what is?
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See Narcusprince's offer earlier on the board.

It's an internet forum, if you ask a question you are guaranteed to get useless answers. If he wants first-hand knowledge of the program he can get in touch with Narcusprince or contact residents/faculty at the program directly. That would be the appropriate place to gather information about residency programs.

The internet is kind of like a color commentator in sports; you get a lot of pomp and fluff, some anecdotal stories, occasionally some useful info. But if you really want to know what's going on in the game, you have to listen to the play-by-play announcer.
 
On the interview trail last year the word on the street was the CCF was a "work horse" type of program. Work you really hard, pound through a lot of cases, etc.... however, not always the most interesting cases for residents to learn on (but cases none the less). Also, word on the street was that they have tons of fellows... some feel this may take away the opportunity as a resident to do certain things as much (or with as much independence), like TTE in heart cases, etc...

This was just "word on the street" though, you'll have to check it out for yourself to be sure. That being said, I'm sure there are many good learning opportunities to be had at CCF (and most likely the name could help in applying for jobs, etc). Just remember that location is important as well and we're talking about cleveland here... it has been getting better in the last few years... but still not may favorite city exactly, however, to each their own I suppose...
 
CCF is a great program for the right person. I do think that our clinical exposure is second to none. As an intern I did enough blocks to get my numbers. in the icu we are exposed to the management of ecmo, lvads, artificial hearts, etc. my CA1 class members and I have gotten to do ruptured AAA, carotids, cranis, sitting cranis, acute stroke stentings, etc. here, you see everything.
it is not a home at 3pm residency. typical days are 6 to 6, some earlier and some longer but I think thats pretty typical. they just changed overnight OR call to 21 h instead of 24h. icu call is 24h, except in the cvicu which is 3pm to 7-8am. anes runs the sicu.
dr brown is very committed to shifting the balance of work and teaching. he is hiring more crnas, reducing the number of residents and focusing more on education. his goal is to get us home by 4-430 to give us more time to read, etc. comparing my classmates and myself to some of the places i rotated as a med student, we are, in general better clinically.
all in all the staff is great. the crnas here at ccf are much better than ones i have come across other places... recently i have heard that the srnas think they are working too late, but thats just gossip I heard second hand.
moonlighting is a nice bonus. if you stay past 7 you get back pay to five. i probably moonlight one to two times a month.
any other questions ask away....
 
amyl said:
CCF is a great program for the right person. I do think that our clinical exposure is second to none. As an intern I did enough blocks to get my numbers. in the icu we are exposed to the management of ecmo, lvads, artificial hearts, etc. my CA1 class members and I have gotten to do ruptured AAA, carotids, cranis, sitting cranis, acute stroke stentings, etc. here, you see everything.
it is not a home at 3pm residency. typical days are 6 to 6, some earlier and some longer but I think thats pretty typical. they just changed overnight OR call to 21 h instead of 24h. icu call is 24h, except in the cvicu which is 3pm to 7-8am. anes runs the sicu.
dr brown is very committed to shifting the balance of work and teaching. he is hiring more crnas, reducing the number of residents and focusing more on education. his goal is to get us home by 4-430 to give us more time to read, etc. comparing my classmates and myself to some of the places i rotated as a med student, we are, in general better clinically.
all in all the staff is great. the crnas here at ccf are much better than ones i have come across other places... recently i have heard that the srnas think they are working too late, but thats just gossip I heard second hand.
moonlighting is a nice bonus. if you stay past 7 you get back pay to five. i probably moonlight one to two times a month.
any other questions ask away....
Click to expand...

"our clinical exposure is second to none"!!!:laugh: q.e.d
Are you still testing for cotinine there?
Now I have to edit:
"The clinical experiences we offer are second to none"
http://www.kumc.edu/anes/
 
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amyl said:
CCF is a great program for the right person. I do think that our clinical exposure is second to none. As an intern I did enough blocks to get my numbers. in the icu we are exposed to the management of ecmo, lvads, artificial hearts, etc. my CA1 class members and I have gotten to do ruptured AAA, carotids, cranis, sitting cranis, acute stroke stentings, etc. here, you see everything.
it is not a home at 3pm residency. typical days are 6 to 6, some earlier and some longer but I think thats pretty typical. they just changed overnight OR call to 21 h instead of 24h. icu call is 24h, except in the cvicu which is 3pm to 7-8am. anes runs the sicu.
dr brown is very committed to shifting the balance of work and teaching. he is hiring more crnas, reducing the number of residents and focusing more on education. his goal is to get us home by 4-430 to give us more time to read, etc. comparing my classmates and myself to some of the places i rotated as a med student, we are, in general better clinically.
all in all the staff is great. the crnas here at ccf are much better than ones i have come across other places... recently i have heard that the srnas think they are working too late, but thats just gossip I heard second hand.
moonlighting is a nice bonus. if you stay past 7 you get back pay to five. i probably moonlight one to two times a month.
any other questions ask away....
Click to expand...


You just described my residency with the exception of ICU. We worked longer in the ICU w/c BTW was anesthesia and surgery run. We had 4 attendings, 2 anesthesiologists and 2 surgeons when in the SICU.
 
Im a resident at CCF as well so i'll chime in my sentiments about the program. first of all, i think if you're somebody who tends to complain about things, you can find complaints about any program.

i'm very happy to be training at CCF, primarily because the intern year is awesome! our lone internal medicine month is 8-5 without call, lone surgery month is 6-6 without call. ive done almost 30 blocks 2 weeks into my regional month as an intern, and finally we start anesthesia intern year, which is a plus in my opinion.

overall, our chairman is highly committed to changing the culture in favor of education and this is already obvious in my short time here. our vice chair of education (PD from penn state) also seems committed to education and making this program better on a day to day basis. our anesthesia dept protects us from most scutwork while rotating on other services. with the addition of more crnas to decrease the workload/hours for residents, i think i can speak for my co-residents when i say we're looking forward to all the positive changes that have been set in motion in the recent months

potential negatives: ccf is not a place that nurtures your ego. respect is earned over the course of your training. with such a large program, i think it can be easy to feel lost in the crowd.

of note, there is no longer a january class for attendings practicing in other countries. the match is purely the traditional july match.

hope this helps anyone interested in watching Lebron James for the next 4 yrs!
 
igot5onit said:
Im a resident at CCF as well so i'll chime in my sentiments about the program. first of all, i think if you're somebody who tends to complain about things, you can find complaints about any program.

i'm very happy to be training at CCF, primarily because the intern year is awesome! our lone internal medicine month is 8-5 without call, lone surgery month is 6-6 without call. ive done almost 30 blocks 2 weeks into my regional month as an intern, and finally we start anesthesia intern year, which is a plus in my opinion.

overall, our chairman is highly committed to changing the culture in favor of education and this is already obvious in my short time here. our vice chair of education (PD from penn state) also seems committed to education and making this program better on a day to day basis. our anesthesia dept protects us from most scutwork while rotating on other services. with the addition of more crnas to decrease the workload/hours for residents, i think i can speak for my co-residents when i say we're looking forward to all the positive changes that have been set in motion in the recent months

potential negatives: ccf is not a place that nurtures your ego. respect is earned over the course of your training. with such a large program, i think it can be easy to feel lost in the crowd.

of note, there is no longer a january class for attendings practicing in other countries. the match is purely the traditional july match.

hope this helps anyone interested in watching Lebron James for the next 4 yrs!
Click to expand...

this sounds like a great synopsis except lebron will only be there for about 6 more months.
 
Bertelman said:
bingo.

And there was no mention of the Browns.
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lebron is absolutely staying in cleveland, he told me so. and as for the browns/indians, yes they stink right now but on a positive note, as residents we get occasionally get free tickets from the clinic.
 
igot5onit said:
lebron is absolutely staying in cleveland, he told me so. and as for the browns/indians, yes they stink right now but on a positive note, as residents we get occasionally get free tickets from the clinic.
Click to expand...

Because nobody wants them.:rolleyes:



Seriously though, I'd take the Indians tickets.
 
Noyac said:
Let me try to post some of the quotes:


djdoyle Anesthesiology Posted Aug 14, 2009 at 6:55 AM
Our SRNAs are trained in spinals, arterial lines, central lines and more. While early on in their training they are booked in a room with a CRNA, later on they are given more responsibility and are booked to be alone with a patient (generally with MD supervision of two rooms). When on call after 5 pm we supervise up to four rooms, but only if none of those rooms have SRNAs.

John Doyle, Cleveland Clinic




SmilingBob Anesthesiology Edited Aug 14, 2009 at 2:45 PM
I also agree, but this thread has me wondering what Dr. Doyle believes is the value of a medical degree to a professional anesthesia provider. is the MD or DO degree completely superfluous? If I can get all of the required knowledge to be an anesthesiologist, including the knowledge ordinarly associated with a medical degree, from non-medical school sources, why bother to go to medical school at all? Do anesthesiologists at the Cleveland Clinic actually administer anesthetics, actually sit through five hour cases without breaks, taking care of the patients one to one, as I did for many years in an all-anesthesiologist group? Or do they confine their activities to preop evaluations and writing research papers?

I don't mean these comments in a negative way, I really want to know. Why bother being a doctor? Why take many years out of your life and go into debt an average of 200K if you can go to trade school and get the same education? I ask these questions seriously, from the standpoint of a doctor who has been supportive of CRNA's, and from the standpoint of a father who has encouraged his brilliant daughter to go into nursing and CRNA school.
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The achilles heel of anesthesiology, as I have said a million times before, is that willingness of GREEDY AND LAZY ANESTHESIOLOGISTS (of which there are many) to train others to do their job while they sit on their ass and collect the money. Let's get real folks, just read a few posts and you'll see this attitude is very prevalent.

here's an example:

"It's a hundred times better than residency because I'm not rotting in the room and I'm getting paid more,"
 
DreamMachine said:
WTF are you talking about? I wrote that.

I'm not lazy, nor do I sit on my ass. I am running four rooms at a time in private practice. Rooms that turn over quick. We do a ton of regional. We do a ton of sick patients that need lines and adequate pre-ops. Our CRNAS do NO PRODCEDURES and NO PREOPS. Our CRNAS do nothing of significance alone, without us present. Are you are saying that everyone that works with CRNAs is lazy and greedy? Well, where I live, there are NO MD ONLY groups. And yes, I would rather be doing spinals, epidurals, blocks, lines, inductions, difficult intubations, extubations, preops etc. than turning the sevo dial.

The fact that you took my quote out of context and applied it here is ridiculous. Are you ******ed or something?
Click to expand...



So say you have 7:30am start times and you have been assigned four rooms? How are you able to do that all at once?

Ans yes you trained to take of care a patient in the OR and "rotting" in a room as you call it, is actually called working.
 
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So what about CCF anesthesia?
 
DreamMachine said:
I arrive at 6 am every day. ALL our lines and blocks are done awake in holding from 630 am to 715 am, after completing the preops from 6 am to 630 am. The MDs help each other out and it gets done.

No ****. I wouldn't have figured that rotting in a room was "working" for others if it wasn't for your critically informative post.
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:rolleyes:
 
DreamMachine said:
Here's my post...

"No kidding! I work longer hours now. I feel more stress now, than as a CA3, also. This is because I have a lot to learn about private practice, I'm typically managing four rooms at any given time, and I take more call where I am the only anesthesiologist in the hospital. I'm not a resident b*tch, but more a surgeons b*tch...trying to keep four of them happy at once. It's a hundred times better than residency because I'm not rotting in the room and I'm getting paid more, but point is: a lot less time to study. I'm really hoping for that April date."

I'm explaining to SleepIsGood that it may be harder to take orals in private practice because you work harder. Meanwhile, you take one line out of that to explain how laziness and greediness is prevalent in anesthesiology. That's beyond stupid. Good luck in life dude, I wouldn't let you touch me if you were the only anesthesiologist in town and I was choking to death with epiglottitis. :laugh:
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So Mr. CRNA supervisor who thinks that doing your job is rotting in a room and yet expects a big paycheck. What do you call that?
 
ProRealDoc said:
So Mr. CRNA supervisor who thinks that doing your job is rotting in a room and yet expects a big paycheck. What do you call that?
Click to expand...

Come on, take a step back.

First of all, he said he was happy to be paid more as an anesthesiologist than as a resident. He didn't say he's happy to be paid more as an anesthesiologist supervising CRNAs than as an anesthesiologist doing one case at a time by himself. There's nothing in anything he posted to suggest laziness or selling out the specialty.

In fact, it sounds like he works quite a bit harder than I do. I do only my own cases and don't supervise CRNAs (here, the CRNAs work completely independently). Am I a lazy greedy sellout?

There aren't enough anesthesiologists in the United States to do every case. It appears he's in a practice with a well-implemented and efficient ACT that incorporates CRNAs. What more do you want?
 
I know that the CCF main campus has 150 CRNA's working there. The oldest AA program in the country is across the street at Case Western. Yet, not one AA is on staff at CCF main although I heard that there are AA's at CCF satellites. Why is it that CCF main doesn't have one AA? It's because the pressure from the CRNA's on the department. The anesthesiology leaders have to show some real leadership and stand up to the nurses.
 
pgg said:
Come on, take a step back.

First of all, he said he was happy to be paid more as an anesthesiologist than as a resident. He didn't say he's happy to be paid more as an anesthesiologist supervising CRNAs than as an anesthesiologist doing one case at a time by himself. There's nothing in anything he posted to suggest laziness or selling out the specialty.

In fact, it sounds like he works quite a bit harder than I do. I do only my own cases and don't supervise CRNAs (here, the CRNAs work completely independently). Am I a lazy greedy sellout?

There aren't enough anesthesiologists in the United States to do every case. It appears he's in a practice with a well-implemented and efficient ACT that incorporates CRNAs. What more do you want?
Click to expand...



It bothers me when attendings describe doing their work using a pejorative term. Why in the world did they go into anesthesia then? Are they that special now that doing their work is somehow beneath them ? If that's the case, something is seriously wrong.

I've worked with anesthesia attendings/surgeons, whom I greatly respect, who have actually mopped the OR floor between cases just to move things along. That is showing humility, respect and appreciation for what you have.

Let me be clear, no one should think of themselves as being too good to do this job. We should be privileged we are in a specialty that compensates us well. Once we start appreciating what we have, maybe our outlook as a specialty will change.
 
ProRealDoc said:
I've worked with anesthesia attendings/surgeons, whom I greatly respect, who have actually mopped the OR floor between cases just to move things along. That is showing humility, respect and appreciation for what you have.
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We have an orthopod who makes his fellows do this. Definitely not the way to get turnover to happen. They do a half assed job, leave blood on the floor behind for your next patient (assuming they've mopped it dry too). If they just streamlined the number of people needed to make sure we didn't forge the patient's signature on the consent we'd get turnover done faster.

BTW I hate it when people refer to taking care of a patient as rotting. Those are the ones who viewed being in the OR as a punishment.
 
DreamMachine said:
I have a low attention span. I would much rather being doing a procedure or actively thinking or solving a patient's problem than charting vitals on a stable patient with nothing else happening. The latter takes me away from the former and so I refer to it as "rotting." This does not mean I don't enjoy the field of anesthesiology or taking care of patients directly.
Click to expand...

in case anyone is wondering....this is not me....because it sounds like me...

and as for prorealdoc....he's a good guy....I asked him to think about joining my group.....the dark side...:)
 
amyl said:
his goal is to get us home by 4-430 to give us more time to read, etc.
Click to expand...

4-430 sounds incredibly early. During residency I almost always got out of my room at a reasonable hour but there were always preops to do and a conference to go to at least a couple of times a week. I did my residency at a very reasonable place and I probably averaged getting out at 5 or 6 pm everyday.
 
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