Yale Waterbury Preliminary Medicine Program 2016

[RableRable]

Just wanted send a post to for people in the 2016 match. Hopefully your eyes reach this before you make your ranks lists, as the prelim schedule had a change this month that you would not be made aware of since interviews were in November and December.

To preface, YWIM is a relatively good place to do prelim year in medicine. No where near as intense as an academic medical center, but not as chill as a super cush Transitional year. You get a good training in a non-malignant community hospital (only 10-12 weeks of the year are in New Haven and they are all for electives). Yale also get a diploma at the end of the year that says "Yale School of Medicine" on it as it is a Yale Sponsored program (Not affiliated like St. Mary's for example). However, the program just made a change mid year that makes the ICU months much more difficult.

Unfortunately the ICU PAs have left, and this significantly increases the work of the Day ICU teams (and specifically prelim residents as you have 2.5-3 months of ICU). 2.5 to 3 months of ICU sounds terrible, but again since Waterbury is a community hospital & does not have a step down unit, the ICU is not a complete ****-show that is seen at major centers.

Previously, prelims cross-covered their patients on the one day (leaving around Noon-1pm) on the weekend, then had the other day off. Now with the PAs gone we have an extra admit day, so 1 weekend day is admitting till 7:30pm, and your day off may fall on a Friday, Saturday, Sunday, or Monday with the 2 team alternating admit every other day structure. This makes the ICU schedule way more intense then it previously was, and I feel you should know about this when formulating your rank lists. Admittedly, this makes the program less attractive for prelims going into other specialties because this makes you more of an ICU workhorse during your intern year, and there is no reason to put yourself through that if you are going into a ROAD specialty, PMR, etc.

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[CherryRedDracul]

Thanks for the heads-up.

 

[chipwhitley]

Thanks! I wish there was some way we could get good info like this about programs. It's funny how every business or product or service or school out there has thousands of up-to-date reviews, but you can barely find any info on residency programs, and anything you do dates back at least 5-10 years. People are afraid to spill the beans on their programs I guess, but even anonymously??

 

[Dr.Fresh]

BUMP. Does anyone have additional information on the prelim program at Yale-Waterbury? Hours/ residents/ living arrangements/ culture etc...

 

[medresident25]

As a current resident of Yale's Waterbury internal medicine program, i would like to clarify some of the concerns made by RableRable regarding the ICU schedule. The information is very outdated, and must have been posted by one of the prior prelims at the time when the change was taking place (probably before they even experienced its implementation). The ICU schedule has been well balanced for my past 2 years in the program. Historically, ICU has been one of the best inpatient rotations at Waterbury (dating back to the Yale Primary Care days when that program used to run the hospital). In terms of the schedule, there are 3 teams two of which are resident team (1 resident, 1 intern) and 1 PA team. There are no issues with PA staffing, and interns have a cap of 6 ICU patients. Hope this clarifies, now to the important points.
Few things distinguish the Waterbury ICU, and these include easy access to a new high tech GE Echo Machine that was exclusively purchased for the Critical care attendings/ICU residents/and ICU interns to use for better data-driven decision making in critically ill patients. It is routine for a resident or intern to do bedside US/Echos on patients while pre-rounding in the morning, to assess the IVC collapsibility (for ?volume status), cardiac chambers, valves, pleural effusions, pericardial effusions, hydronephrosis...etc. This might sound crazy and unorthodox as most programs don't give residents such an opportunity. You will be so good at ultrasound/bedside echoes very quickly at Waterbury for that reason. There are currently US/Echo machines in the ED as well (none of those machines are used by techs, they are only for residents and ED or ICU docs) so residents get so used to the quality US data that even when admitting patients in the ED, many would do a quick comprehensive US with their own hands as part of the physical exam (none of those studies are saved or billed for).
You might be wondering why don't all programs adopt such awesome techniques? The answer has to do with $$$$ on two fronts, #1 the cost of those machines, for ex: ICU machine was ~$80,000 and the Board agreed to purchase it for educational reasons few years ago (educational culture is strong here), #2 Money lost by the hospital, for lost orders of STAT echoes..etc, it goes without saying if residents are able to rule out pericardial effusions...etc with a quick bedside echoes then we do NOT order as many "Formal" echoes on patients and the hospital can not bill for those echoes...thus the hospital makes less $$$.
That's why such access to residents and attending is frankly Forbidden at the majority of programs, well not at Yale-Waterbury
Lastly, no fellows, you work directly with Superb Attendings that love teaching (they teach a lot of bedside US for Ex, and btw there is a longitudinal US curriculum that runs throughout the year, led by the residency faculty).
One of the best aspects of being part of this program are the amazing people that work here.
Goodluck to all of you on your interviews. Post on this thread if you have more questions about the program!

 

[medresident25]

Here is also a video by on of our current interns about the program, everyone loves it here

 

[CherryRedDracul]

I didn't go to Yale-Waterbury for prelim year eventually, but one of the reasons I ranked it highly was because of its ICU experience.

 

[eyeseethelight]

Hi medresident25 thanks for the helpful information!!

I'm in the process of ranking my prelim programs and realized I do not have a breakdown of the ambulatory/elective schedule for Yale-Waterbury's prelim program. Would you be able to clarify for me how many weeks of continuity clinic vs. subspecialty clinic/elective prelims have? Are the prelims able to schedule most of their ambulatory/elective time at Yale if they'd like?

Thanks so much!!

As a current resident of Yale's Waterbury internal medicine program, i would like to clarify some of the concerns made by RableRable regarding the ICU schedule. The information is very outdated, and must have been posted by one of the prior prelims at the time when the change was taking place (probably before they even experienced its implementation). The ICU schedule has been well balanced for my past 2 years in the program. Historically, ICU has been one of the best inpatient rotations at Waterbury (dating back to the Yale Primary Care days when that program used to run the hospital). In terms of the schedule, there are 3 teams two of which are resident team (1 resident, 1 intern) and 1 PA team. There are no issues with PA staffing, and interns have a cap of 6 ICU patients. Hope this clarifies, now to the important points.
Few things distinguish the Waterbury ICU, and these include easy access to a new high tech GE Echo Machine that was exclusively purchased for the Critical care attendings/ICU residents/and ICU interns to use for better data-driven decision making in critically ill patients. It is routine for a resident or intern to do bedside US/Echos on patients while pre-rounding in the morning, to assess the IVC collapsibility (for ?volume status), cardiac chambers, valves, pleural effusions, pericardial effusions, hydronephrosis...etc. This might sound crazy and unorthodox as most programs don't give residents such an opportunity. You will be so good at ultrasound/bedside echoes very quickly at Waterbury for that reason. There are currently US/Echo machines in the ED as well (none of those machines are used by techs, they are only for residents and ED or ICU docs) so residents get so used to the quality US data that even when admitting patients in the ED, many would do a quick comprehensive US with their own hands as part of the physical exam (none of those studies are saved or billed for).
You might be wondering why don't all programs adopt such awesome techniques? The answer has to do with $$$$ on two fronts, #1 the cost of those machines, for ex: ICU machine was ~$80,000 and the Board agreed to purchase it for educational reasons few years ago (educational culture is strong here), #2 Money lost by the hospital, for lost orders of STAT echoes..etc, it goes without saying if residents are able to rule out pericardial effusions...etc with a quick bedside echoes then we do NOT order as many "Formal" echoes on patients and the hospital can not bill for those echoes...thus the hospital makes less $$$.
That's why such access to residents and attending is frankly Forbidden at the majority of programs, well not at Yale-Waterbury
Lastly, no fellows, you work directly with Superb Attendings that love teaching (they teach a lot of bedside US for Ex, and btw there is a longitudinal US curriculum that runs throughout the year, led by the residency faculty).
One of the best aspects of being part of this program are the amazing people that work here.
Goodluck to all of you on your interviews. Post on this thread if you have more questions about the program!

 

[Durty-Trixxx]

Holy crap --- prolly the happiest bunch of IM residents I ever seen?

Almost seems too slick and happy --- paid actors? They spend 20 hrs. a week at sporting events

Here is also a video by on of our current interns about the program, everyone loves it here