THOMAS JEFFERSON (Philadelphia, PA)
7 Advanced PM&R Positions
1 Pediatrics / PM&R Position
Approx 15% of received applications are offered interviews.
~80 interview spots (avg interviewee has
USMLE Step 1 ~238, COMLEX 650, research publications,
and strong LORs, PM&R letter required)
Pre-Interview Happy Hour:
Residents smart, but social and laid-back. 75% MDs/25% DOs.
Residents are geographically diverse from Ohio, Minnesota, Pennsylvania, New York, Texas, and California. All U.S. grads from prominent
places such as Univ of Pennsylvania, Cornell, Mayo, Univ of Minnesota,
and Ohio State. One resident is a Board-Certified Orthopod trained at Mayo and another is a Board-Certified Internal Med doctor. Accomplished, yet
all were very approachable and easy to talk to. Can see they get along well. Easily can see myself hanging out with them outside work.
INTERVIEW DAY:
7am optional Grand Rounds. Given by Resident, who was articulate and clearly knew his stuff. Was honestly better than most attending Grand Rounds I've seen. Attendings and residents were engaged in a lively discussion and was obvious they there were all well-read.
8am: 10 min Film Presentation (
one of the most comprehensive films I saw, answered most of my questions see below), Casual Talk with Residents, Assistant Residency Director (Dr. Kupfer) and PD (Dr. Formal)
9am-11am: Interviews. Three ~25 min interviews.
2 with faculty, 1 with resident. Interviews were thoughtful,
was obvious they read my application, delved into what
I was looking for in a program and my experiences in PM&R. Half of time spent during interviews, other half talking with residents and attending lectures. Felt residents were very happy with their program.
11am-11:45am: Tour of Magee (Independent Rehab Hospital
of Jefferson, Model Systems SCI). Very nice facility, remodeled.
12pm: Easily the MOST AMAZING Lunch the whole season. At the 19th floor of a posh Downtown Philly hotel with private dining room. We ordered our meals in the morning and I had the Steak with Red Wine Sauce and Potatoes,
Fancy appetizer/salad, petite four/dessert buffet. Approx 8 residents
attended and all very open about discussing their experiences
and answering our questions.
1pm: Tour of Jefferson (~10 min walk through Center City,
Philadelphia from Magee, lots of nice shops, restaurants,
nearby hospital, pedestrian friendly, lively, yet not overwhelming
like NYC)
end at 1:30pm
HIGHLIGHTS (from presentation, folder, and asking residents):
CALL: Overnight In-House call at either Magee (60-88 avg patient census) or Jefferson (~20 pt census), never at both.
Admission Cap: 2 admits per call. Hospitalist does rest of admissions.
PGY-2: 4-5 calls/month (2-3 weekend calls/mo).
PGY-3: 2-3 calls/month (1 weekend call/month).
PGY-4: 1 weekday call/month (no weekends). there are NO additional note-writing weekends, as the attending on call does writes notes on weekends (at Magee). In-house. 5pm to 7am on weekdays. Sat Call is 7am to 7am sunday. Residents say they averaged 6 hours sleep at Magee and 8 hours sleep at Jefferson. The residents stressed that ALL the attendings give them their cell phone numbers and that attendings are very supportive. Residents on the services are also very helpful and taking care of their patients well during the day.
CLINICAL EXPERIENCE: PGY-2: 8 months Inpatient, 2 months Outpatient.
PGY-3: 4 months inpatient, 6 month outpatient. PGY-4: all outpatient
including 4 months of electives. Inpatient experiences include: SCI, TBI, Stroke, Pediatrics (2 months at A.I. Dupont Children's Hospital), General Rehab, 2 months General Consults, 2 months acute SCI consults, Amputee (Prosthetics/Orthotics). SCI-heavy (Jefferson admits ~3000 SCI patients/year), but all residents say they have enough knowledge as a SCI-fellow at the end of residency. Outpatient experience includes 4 months of EMGs, MSK, Sports, Botox, Ultrasound, Anesthesia Pain, MSK Pain, General Rehab (mixed SCI, Stroke, TBI, Amputee), Concussion/Spina Bifuda/Cerebral Palsy clinics during the 2 months at AI Dupont). Residents say they had a solid experience in the inpatient and outpatient setting to feel comfortable being an attending in academia or private practice. Most
of the rotations are in Center City at Jefferson, Rothman, or Magee. Only rotations that are a 30-min drive from Center City are 2 months Pediatrics (Wilmington, Delaware) and 6 months at Moss Rehab (Elkins Park, PA).
VACATION: 5 weeks/year. 4-weeks vacation, 1-week educational (elective conference). NO need to find coverage from another resident during time-off as attendings are capable or running their service without a resident. ++++
ELECTIVES: 4 months total. 2 months may be done outside of
Jefferson (great for auditioning for fellowships) and Jefferson provides malpractice coverage at outside institutions. 2 of the 4 months must be done at Jefferson affiliated hospitals/clinics, acting in a Senior Advisory/Junior attending role. Elective offerings are abundant (inpatient, outpatient, MSK, prosthetic/orthotics, gait, cardiac, Pain, EMG, etc.) They have an extensive network of over 52 clinical faculty, who are open to work with residents.
LECTURES: Wednesday Mornings (7am to 11:30am).
COMPLETELY protected. Residents are not allowed to turn on beepers or answer calls until 1pm Wednesdays. Attendings write ALL notes for inpatient services on Wed mornings. Didactics are organized by subject blocks (Anatomy, TBI, Stroke, SCI, Cardiac/Pulm, MSK, etc.) where the subjects are repeated at least 3 times before graduation. Residents
have review sessions at end of each block in a "game style" setting going over study-guide and previous SAE questions.
FELLOWSHIPS: For the current PGY-4 class,
all the seniors that applied for fellowship were offered positions at an ACGME-accredited fellowship. 2 Pain and 1 Sports. 1 will be at the Jefferson Anesthesia Pain Fellowship this July which usually takes 1-2 Jefferson PM&R residents/year. All felt they had good support from faculty, PD, and Chair in their applications. They all seemed helpful with each other and not cut-throat.
RESEARCH: Not required, but >90% of residents have presented
at the AAPMR, AAP, and published at either PM&R/SCI Journals or other Spine and Neurosurgery journals. Their Program Director stresses the importance of first learning to be an excellent physiatrist and doing well in the boards (residents proud that their PD scored #1 in the boards, and recent grads scored in top 10). MSTP Research available with Dr. John Whyte at Moss. Extensive research available in SCI. Other residents have presented in Pain Conferences and published in pain journals.
EMGs: All residents not only exceed 200 requirement, but also
see interesting rare pathologies (e.g. FSH Dystrophy), esp with
attendings (Dr. Sridhara at Moss, Dr. Herbison at Jefferson). At Moss (which both Temple and Jefferson residents rotate through), EMG attendings usually have bias towards Jefferson residents for their superior knowledge in anatomy and MSK physical exam skills (mainly because of Dr. Herbison).
MSK ULTRASOUND: 1 month rotation with Dr. Nazarian (editor of major MSK U/S journal and PD of the highly-respected Radiology Residency Program at Jefferson). You work 1 to 1 with Dr. Nazarian without any other radiology or PM&R residents. Residents are able to participate and they say they get additional MSK Ultrasound
experience during their outpatient rotations at Moss and Rothman.
SPORTS/JOINT INJECTION EXPERIENCE: Spend 2 months at Rothman Institute (regionally well-knowned orthopedic center), where 1/3 of docs are physiatrists. Work with Dr. Vitanzo seeing 65 patients/day with lots of joint injection (mainly knees/shoulers) experience. Work with official team physicians for Philles and Eagles players. Residents experience directly treating professional athletes from these teams.
SPINE INJECTION EXPERIENCE: They have required 1 month rotation with Jefferson Anesthesia, 2 months required at Rothman Institute, and additional experience with Jefferson affiliated private practice docs. Residents say they gained experience directing the C-arm, and driving the needle in ESI's, MBB's, and facet injections.
TEACHING MED STUDENTS: Jefferson Medical Students have been required to rotate through PM&R for over 25 years, so residents gain experience doing didactics for med students on MSK/anatomy topics and teaching MSK exams throughout the year. Currently PM&R is a 3-week rotation for 3rd year Jefferson med students.
MOONLIGHTING: Residents allowed to moonlight starting in PGY-3 year. Most moonlight at suburban rehab hospitals ($1200 for 24hr moonlighting call or $600 for 12hr overnight call). Others to disability evaluations in the outpatient setting (up to $1000/day).
LIFE / PHILADELPHIA: Residents mostly rotate at either Jefferson or Magee, which is both in the safest most vibrant area of Philly (Center City). 75% (mostly single) live in Center City, 25% (married with families) live in nearby suburbs in PA and South Jersey. I felt safe walking through the Center City area (feels like walking through an endless outdoor shopping district). Jefferson is only 2 blocks from the Liberty Bell and Independence Hall, so there's a nice mix of colonial rowhomes alongside high-rise apt buildings. The residents seem to be pretty social, hip (several are pretty good looking lol) and hang out a lot with each other outside of work at happy hours, dinner parties, sporting events, and concerts.
OVERALL IMPRESSION: I felt that Jefferson is a solid program to train to be either a comprehensive physiatrist or for fellowship. Residents are intelligent and well-accomplished yet were very approachable and not cut-throat with each other. I felt all the residents and faculty were very honest in answering my questions. Appears they all got along really well with each other. I was very pleased with my experience there and I plan to rank them very highly.
to those still on the trail!
