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soaplover: zt 两个面经from sdn
作者:USMedEdu
发表时间:2008-10-10
更新时间:2008-10-10
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现代医学vs“中医”
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发信人: soaplover (Ha), 信区: MedicalCareer
标 题: zz两个面经from sdn
发信站: BBS 未名空间站 (Fri Oct 10 11:46:24 2008)

班上有好几个要去UTSW,精华区怎么没翻到内科面径.在sdn找到了两个,虽然是AMG的,拿
来参考一下吧.


http://forums.studentdoctor.net/showthread.php?t=458242

by BlackNDecker
Random thoughts:
1) one of the most intense clinical training programs I've interviewed for.
I am basing this in terms of volume of patients seen, number of ward and ICU
months intern year, level of autonomy and hands-on procedurally-oriented
training. It was stressed over and over that "Residents run the hospital,"
from the morning introduction by the new PD to the attending on wards, and
even the UTSW M4s looking for some respite at the Baylor-Dallas interview...

The "mission statement" given in the introduction summarizes this with the
ABCs - Autonomy, Back-up, and Comraderie. I definitely believed that
autonomy was encouraged, if not expected...you will hit the ground running
full speed with bullets whizzing by here. I cannot comment on the level of
back-up as I only saw interview day, but on wards you obviously have an R3
whom I suspect will help out with problems encountered. The comraderie was
questionable from the R3 I observed on rounds...he seemed to focus his
positive comments on the fact that "the program is so large that if you have
a problem with other residents you will probably never have to see them
again." If this is a shared perspective then it's concerning. There was
absolutely no talk from the residents about going out together (or even
going out for that matter) or team building exercises, or any other shared
activities. So, again this calls into question the level of comraderie.
There appears to be less here than any other program I've interviewed at.

2) I got the impression from speaking with an R2 at lunch that residents don
't get much time to enjoy Dallas or outside interests. Everytime I brought
up something interesting about the city or things I hope to do during
residency the resident sitting with us at lunch quipped, "when do you think
you're gonna find time to do that?"

3) Parkland is a very old hospital and it shows in the facilities. I think
this lends well to the intense training experienced here. Contrast this with
the newly built Grady hospital decked out in marble, which seems a little
extravagant for the purposes of indigent care. <While touring Grady, it's
hard to forget the close relationship with Coca-Cola>.

Call me old-fashioned, but if I'm in the trenches I'd rather be surrounded
by beige paint and floors needing a fresh coat of wax...rather than enclaved
in marble and exotic wood. Again, purely a personal sentiment.

4) I was pretty disappointed by the lack of variety in food choices. With
such a large population of employees and patients, I expected more than a
single cafeteria and a McDonald's. I must admit that though I asked to tour
the cafeteria, it never happened...so I'm basing this on what I was told by
my tour guide (an R2). Lunch was held in a very nice dining room that, from
what I understand is open daily to attendings but residents rarely step foot
into.

5) Dallas is a great city. Lots of world class restaurants, plenty of bars
and clubs, and extremely friendly people. I made friends in every bar I went
to. I was in town for 4 days, so I was able to see most of the nightlife
spots within the downtown area. It's reasonably cheap to live close to the
hospital, and many residents choose to do so. Traffic can get backed-up, but
it's nothing compared to Houston. It might be hard to ride a bicycle within
the city, if you're the type, which was a disappointment cause I'd like to
bike to work for exercise as well as to avoid the traffic.

6) Historically, fellowship matching has been very strong to excellent (will
update later, don't have sheet on me). Unfortunately...and this is a BIG "
unfortunately", the old PD just moved on to UT-San Antonio, and this might
greatly affect Cards matching because he was kind of a big deal in the field
- co-authored Lange, many pubs, well known in other programs. Most people
within the program simply shrug their shoulders and say "it was time for a
change," but this seems like a very BIG change if you're interested in Cards
. Also, the new PD is freshly minted from UTSW's IM residency, so her
networking (i.e. word of mouth, name-dropping) ability is questionable.

7) Potpouri was quite fascinating. First of all, this was an opportunity to
witness the sheer size of the housestaff, even with many interns and
residents absent, the large amphitheater was filled. I didn't necessarily
get the feeling that the entire housestaff was cohesive, rather that there
were "pockets of friends." Again this was one day of interviewing. Everyone
enjoyed a good laugh at the expense of the attending or intern on the spot..
.though, as spumoni620 stated, it was all in good fun.

Summary:
- intense training...prepare to work ur arse off.
- level of autonomy unsurpassed...any more autonomy and you'd be the
attending.
- old facilities
- lack of dining choices (given the size of the hospital).
- questionable comraderie among the housestaff
- lack of free time
- new PD (outgoing PD highly respected in the field of, and probably very
influential in residents matching into Cards).

Overall, all of the above are positives and/or acceptable given the size and
reputation of the program. The reputation of the program (positives and
negatives) is well known within the south, and as a result I was not
surprised by what I saw on interview day. I plan to rank this program high.



----------------------------------------------------------------------------
----by spumoni620

Interview Day: I interviewed a while back at UTSW. Well organized. LOTS of
people - ~ 40 in the small room when I went. Takes place in a rather hard to
find area of the school; for sure I'd have been lost if I hadn't
fortuitously found a UTSW med student wandering the halls (who even then
didn't really know where this odd room was). Lots of UTSW interviewees and I
felt the majority of students were from within Texas. Definitely if not in
Texas, had roots in Texas (like me). Corny as it sounds, the Texan twang and
general super-niceness of everyone from the staff to faculty made me feel
as though I were "back home" - I think people really are friendlier in the
South. The day began with an intro by the PD, followed by intro from chiefs
talking about the amazing pathology you see at Parkland. One of the chiefs
pulled out a book of cases and read some off just seen from the past two
days, including tularemia, mycosis fungoides, elephantiasis or something
similar, lots of TB. Then we were escorted on rounds, attended conference,
lunch, tour, interviews, and then a faculty meet & greet ("liver rounds") at
the faculty club. Day was longest I've been on among several interviews,
ended around 4:30 - 5:30 but could have gone on longer if you wanted to
schmooze.

Didactics[/b]: My favorite part of the day was the "Potpourri" conference.
This was a session in which interns call on basically anyone in the audience
(attendings, residents, not interviewees) and present a case which they
have to work up in front of everyone. And the cases are tricky. It's of
course all in good fun. It was actually really interesting and the cases
were awesome - unusual cases that left you wondering until the punch line at
the end. It was also nice to see the camaraderie everyone seemed to share -
there was a laid-back, non-malignant air that was enjoyable to see.
Residents and attendings do seem to have a great relationship of "equals".

Rounds Was placed with a post-call team, so they all understandably looked
exhausted. They were finishing up sit-down rounds in a rather dingy, poorly
lit room when we came. The resident was no-nonsense but helpful, seemed a
decisive leader who was working hard to get his team out on time. amazingly,
he was not in the least irritated at the prospect of being followed around
by relatively unhelpful suit-clad interviewees while trying to tie loose
ends and attack a pile of work post-call. Lots of new admissions, including
UGIB, LGIB, a man with end-stage esophageal cancer requiring esophagectomy,
liver disease, altered mental status, etc. Attending was really nice, young,
seemed to be a caring/good teacher who actually took time to incorporate us
into rounds and explain things to us. There is no question the teams work
hard here. The med student had about 4 patients, if I recall correctly.
Presence of med student is actually a factor that determines how many
patients you can admit!

Hospital: Bulk of training is at Parkland, some at the VA, also have private
hospital rotation (forgot name of hospital, but only a month or two I
belive). To be blunt, Parkland will never place in the "100 most glamorous
hospitals in America". It's crowded, poorly lit and has the general smell of
"things are really busy here". We walked by the ER and there were literally
people lined up outside the door and crammed in the waiting room- I have
never seen such a busy ER before! People apparently have waited 10 hours to
be seen. Residents state the hospital functions well and the ancillary staff
are good, but do admit to there being some tension when calling consults on
certain fields, i.e. surgery. No electronic medical records here, so much
is still handwritten. Residents didn't seem particularly bothered by it.
Although, of course, they are working to change that. I have to double check
(things are bit blurry) but I think labs were online. I also believe there
is no access given to UpToDate, which I found surprising. Most info is found
on patients by looking at discharge summaries which contain the H&P, meds,
etc and are dictated.

Residents: I talked to a few interns and a resident. I did not attend the
dinner before so do not have as comprehensive of a view on this. Overall,
they seemed to be happy but tired. They also seemed very knowledgeable,
competent and hard-working. There was the general attitude that "you work
really really hard but you come out competent and capable of handling
everything". Now a night-float system is in place for 2nd years but the
resident I talked to did express some concern about whether this was really
better, as hand-offs and late admissions can sometimes pose trouble in
getting out on time. However, all residents I spoke to stated they were
within 80 hours. ICU months, however, they stated it was difficult to meet
this at times. Another oft-repeated theme was resident autonomy. The intern
I had lunch with rattled off a list of procedures she had done including
intubation, para/thoracentesis, LPs, lines, etc. etc. I sensed from the
rounds and the general atmosphere that residents do seem to run the show.

PD: Young, recently appointed, but seems very genuine and dedicated to
students and education. She has the advantage of being "closer" in terms of
age and memories to that stage of training.

Fellowships/Research/Career: The match list for fellowships is really, truly
impressive. They routinely place several in cards/GI every year and the
sites are stellar. I don't know what the secret is, as my gut feeling is
that as a resident or intern you would have to be very proactive to find
time to research something substantial. There is no formal program for
mentorship or research that I know of, although opportunities apparently
abound if you are so inclined.


City: Dallas in itself is not really so bad. People tend to live in Uptown,
about 10-20 minutes away. Rent is beautifully cheap in many cases. Some live
in houses in suburbia and commute. Weather is nice in fall/spring, somewhat
cold (rarely snows, rarely ices) in winter, very hot and humid in the
summer. I actually don't mind this at all as I'm a warm-weather/sun type of
person. For example, it was 75 degrees when I went to interview. As far as
things to do, there is a pretty active nightlife scene, tons of good
restaurants, trails and parks, etc. etc. Traffic is congested at predictable
times but otherwise not bad at all from what I've seen.


Overall impression: The day was organized if quite long, but I left with a
positive impression of the program. I feel this program is not for the faint
of heart as you would work very, very hard here. There may almost be too
much autonomy for some. However, in exchange, you get to experience a vast
array of patient pathology and seem to be able to leave as a very capably
trained physician. At least by track record, you'd also have a decent chance
at matching at top fellowships in the country. I worry about there not
being more of a structured curriculum or path for things like research,
international electives, career exploration, mentorship, etc. Not clear how
well residents can get to know one another.
__________________





Interview Day: I interviewed a while back at UTSW. Well organized. LOTS of
people - ~ 40 in the small room when I went. Takes place in a rather hard to
find area of the school; for sure I'd have been lost if I hadn't
fortuitously found a UTSW med student wandering the halls (who even then
didn't really know where this odd room was). Lots of UTSW interviewees and I
felt the majority of students were from within Texas. Definitely if not in
Texas, had roots in Texas (like me). Corny as it sounds, the Texan twang and
general super-niceness of everyone from the staff to faculty made me feel
as though I were "back home" - I think people really are friendlier in the
South. The day began with an intro by the PD, followed by intro from chiefs
talking about the amazing pathology you see at Parkland. One of the chiefs
pulled out a book of cases and read some off just seen from the past two
days, including tularemia, mycosis fungoides, elephantiasis or something
similar, lots of TB. Then we were escorted on rounds, attended conference,
lunch, tour, interviews, and then a faculty meet & greet ("liver rounds") at
the faculty club. Day was longest I've been on among several interviews,
ended around 4:30 - 5:30 but could have gone on longer if you wanted to
schmooze.

Didactics[/b]: My favorite part of the day was the "Potpourri" conference.
This was a session in which interns call on basically anyone in the audience
(attendings, residents, not interviewees) and present a case which they
have to work up in front of everyone. And the cases are tricky. It's of
course all in good fun. It was actually really interesting and the cases
were awesome - unusual cases that left you wondering until the punch line at
the end. It was also nice to see the camaraderie everyone seemed to share -
there was a laid-back, non-malignant air that was enjoyable to see.
Residents and attendings do seem to have a great relationship of "equals".

Rounds Was placed with a post-call team, so they all understandably looked
exhausted. They were finishing up sit-down rounds in a rather dingy, poorly
lit room when we came. The resident was no-nonsense but helpful, seemed a
decisive leader who was working hard to get his team out on time. amazingly,
he was not in the least irritated at the prospect of being followed around
by relatively unhelpful suit-clad interviewees while trying to tie loose
ends and attack a pile of work post-call. Lots of new admissions, including
UGIB, LGIB, a man with end-stage esophageal cancer requiring esophagectomy,
liver disease, altered mental status, etc. Attending was really nice, young,
seemed to be a caring/good teacher who actually took time to incorporate us
into rounds and explain things to us. There is no question the teams work
hard here. The med student had about 4 patients, if I recall correctly.
Presence of med student is actually a factor that determines how many
patients you can admit!

Hospital: Bulk of training is at Parkland, some at the VA, also have private
hospital rotation (forgot name of hospital, but only a month or two I
belive). To be blunt, Parkland will never place in the "100 most glamorous
hospitals in America". It's crowded, poorly lit and has the general smell of
"things are really busy here". We walked by the ER and there were literally
people lined up outside the door and crammed in the waiting room- I have
never seen such a busy ER before! People apparently have waited 10 hours to
be seen. Residents state the hospital functions well and the ancillary staff
are good, but do admit to there being some tension when calling consults on
certain fields, i.e. surgery. No electronic medical records here, so much
is still handwritten. Residents didn't seem particularly bothered by it.
Although, of course, they are working to change that. I have to double check
(things are bit blurry) but I think labs were online. I also believe there
is no access given to UpToDate, which I found surprising. Most info is found
on patients by looking at discharge summaries which contain the H&P, meds,
etc and are dictated.

Residents: I talked to a few interns and a resident. I did not attend the
dinner before so do not have as comprehensive of a view on this. Overall,
they seemed to be happy but tired. They also seemed very knowledgeable,
competent and hard-working. There was the general attitude that "you work
really really hard but you come out competent and capable of handling
everything". Now a night-float system is in place for 2nd years but the
resident I talked to did express some concern about whether this was really
better, as hand-offs and late admissions can sometimes pose trouble in
getting out on time. However, all residents I spoke to stated they were
within 80 hours. ICU months, however, they stated it was difficult to meet
this at times. Another oft-repeated theme was resident autonomy. The intern
I had lunch with rattled off a list of procedures she had done including
intubation, para/thoracentesis, LPs, lines, etc. etc. I sensed from the
rounds and the general atmosphere that residents do seem to run the show.

PD: Young, recently appointed, but seems very genuine and dedicated to
students and education. She has the advantage of being "closer" in terms of
age and memories to that stage of training.

Fellowships/Research/Career: The match list for fellowships is really, truly
impressive. They routinely place several in cards/GI every year and the
sites are stellar. I don't know what the secret is, as my gut feeling is
that as a resident or intern you would have to be very proactive to find
time to research something substantial. There is no formal program for
mentorship or research that I know of, although opportunities apparently
abound if you are so inclined.


City: Dallas in itself is not really so bad. People tend to live in Uptown,
about 10-20 minutes away. Rent is beautifully cheap in many cases. Some live
in houses in suburbia and commute. Weather is nice in fall/spring, somewhat
cold (rarely snows, rarely ices) in winter, very hot and humid in the
summer. I actually don't mind this at all as I'm a warm-weather/sun type of
person. For example, it was 75 degrees when I went to interview. As far as
things to do, there is a pretty active nightlife scene, tons of good
restaurants, trails and parks, etc. etc. Traffic is congested at predictable
times but otherwise not bad at all from what I've seen.


Overall impression: The day was organized if quite long, but I left with a
positive impression of the program. I feel this program is not for the faint
of heart as you would work very, very hard here. There may almost be too
much autonomy for some. However, in exchange, you get to experience a vast
array of patient pathology and seem to be able to leave as a very capably
trained physician. At least by track record, you'd also have a decent chance
at matching at top fellowships in the country. I worry about there not
being more of a structured curriculum or path for things like research,
international electives, career exploration, mentorship, etc. Not clear how
well residents can get to know one another.
__________________


--

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