发信人: puh80 (jim), 信区: MedicalCareer
标 题: Re: 面经三：flushing hospital medical center, NYC (by yf)
发信站: BBS 未名空间站 (Sun Dec 16 16:35:37 2007)
Each person has diff opinion regardless whatever we are talking. As a
veteran IM physician, personal experiences are:
Pt is always the best teacher, the book stuff are nearly useless when you
are facing someone really sick. Let’s say, one came to you with coma or
shock, without any info available. I have seen so many pathologies in 3 yrs,
much more than my 8 yrs exp in shoebox hospital. Many of them are so
bizarre. The reasons I think NY is better based on:
1)Pt numbers. 8 millions people in NYC, which constitute diverse pathologies
and extremely high working load. I have no precise No for other places. But
I had IV many yrs ago in a big Boston program, one intern told me he had
only one admission for the week. What a Bxx! I was trained in Stan many yrs
back, and also knew more or less there. I also knew some other places
outside NY, interns/residents sleep after 12 on most of the calls. It is
even unthinkable in NY! Our residents are taking care of 80+ patients when
2)Diverse physicians. Many of them are highly experienced IMGs from all over
the world. From them I also learnt a lot. For instance, I had one intern
colleague who was Oxford trained and former dept chairman in a major
university outside US. He was a visiting prof in UCLA, with tons of good
publications before his residency. It is more fun to work with some people
with enriched life experiences, maybe I am old too??.
3)Working intensity. It is nearly brutal, and inhumane. Each time, I had
more than one pt to access, started all the things needed by myself, which
including labs/imaging,EKG reading/IV fliud/intubation and ventilator
management/consults coordination, which take enormous efforts and hrs.
However, I believe it is the key for a person to be a competent physician.
Strictly speaking, nearly 30% my admissions met ICU criteria, but just few
of them really transferred, they all ended up with our hands. As a former
attending in Union hospital, I realized this is precisely what our residency
training lacking. In another word, incapable of functioning independently
and effectively, due to lousy training.
4)Enormous ICU procedures, which also important for good clinicians. You
will have far better pictures about your pt once you managed them from the
beginning to the end, from head to bottom.
5)If apply the working load/pt number cap regulations, I bet at least half
of the NY programs constitute the violation and should have been closed.
Thus, having gone through this arduous training, it is almost impossible for
someone to be non-competent.
6)Finally, I didn’t deny many other places are also good, or better than NY.
I am just talking my own feeling through my limited experiences in
residency, certainly shouldn’t be generalized. However, the most important
thing I obtained from NY program is the Self-Confidence. I have no
hesitation to tell anyone who needs medical assistance by saying "I can help
you and make you fell better".
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【 在 acne (ARBITRAGE) 的大作中提到: 】
: 为什么local training就好一些，我刚听说的是academic就是要多走几个地方，才能
: build up自己的network？