An insider perspective on Vanderbilt

[CardsGuy]

I don’t come to this forum often, but I’m a (recent) grad from Vanderbilt and figured I’d post an honest assessment as a former resident. I’ll attempt to be objective, but I’ll be honest in saying that I think it’s probably amongst the most malignant programs in the country. I’m passing this info along as I know I would have found it helpful when I was a looking at residencies…

Rotations
The main inpatient services are the Rogers (subspecialty) and Morgan (general medicine) service. There are technically 4 main Rogers services – ID, Renal, GI/Hepatology, and Pulmonary. Unfortunately, you don’t actually get a ton of exposure to the subspecialty aspect of care for patients in each service. ID means you get almost all HIV patients – regardless of what they come in for. Renal means you get HD patients – regardless of what they come in for. I think you get the hint. The residents end up taking care of the basic medical issues while the Fellows handle any of the more specialty specific issues. The Cardiology and CHF services are fairly the same and self-explanatory. Morgan tends to be the catch-all where if a patient doesn’t fall into any other category, they end up on Morgan. In turn, it often ends up being a bit of a social work nightmare and is incredibly painful for the intern. The VA tends to be extremely busy – probably busier than the main hospital. It kind of sucks like any VA, but since it’s a major VA in the South, you have quite high volume. For interns, expect you’ll often be close to your cap and be fairly frustrated with life. I would say that Vandy residents work more than most, and don’t be shocked if you are consistently violating work hours.

Hospital
I won’t spend a ton of time since hospitals are hospitals. Vandy is a big academic center that prides itself on its EMR, which is actually quite good. Stuff does work fairly well, and the new ICU tower is supposed to be state-of-the-art. One thing I will say is that the hospital is under-staffed, so the residents end up having to pick up the slack. I remember one time when I was really sick with a fever and got scolded by a chief resident for not coming to work because the service was so busy. A little ridiculous in my opinion.

Residents
This is one area where the program struggles, for I think the IM program lacks the camaraderie of many programs. Many of the residents are nice, but there are quite a few (including Fellows) who will spare no expense to make you look bad or get you in trouble. It’s not even for competitive reasons – just a sad fact about the culture. Don’t let the Southern politeness fool you – I’ve seen people do some harsh, even malicious things to other people. There is a hierarchy based on year, and the residents as a whole don’t hang out a ton. If you’re drawn to cities or single, I would stay away as Nashville is far from a big or diverse city (consider it conservative and fairly Deep South) and most of the residents are married or in very serious relationships. During my time at Vandy, this was a huge let-down that I didn’t think it was a supportive, nurturing culture at all. And as for the chief residents, some end up being cool but they are mostly pawns of the administration and not “one of the residents”. Be careful with that one. Overall, I would say most of the residents are not happy or invested in the program. That’s true to some extent at many places, but over time that unhappiness is quite palpable – more so than I heard from friends at other programs.

Program Leadership
This is probably my biggest warning area. Dr. Sergent (program director) comes across like this soft, folksy, super-nice guy. During interviews, he drops that deep Southern charm and makes you feel like he’ll be your grandfather. However, once you join the housestaff, it’s a very different feel. He has his favorites and, in my opinion, has minimal genuine concern for the residents. He prefers the appearance that everyone is happy and everything is great – regardless of reality. By the time one gets to 2nd or 3rd year, many of the residents refer to him as a “used car salesman” and have a fairly negative view of him as he’s neither transparent or honest. I don’t trust him personally and am actually quite glad I won’t have to deal with him anymore. I won’t divulge details, but he’s definitely been less than fair with several residents I know when they’ve had issues arise, and I know he’s pushed several residents out of the program while letting his favorites slide by.

Fellowship Match
For a program that likes to consider itself so prestigious, Vandy’s match list is a bit underwhelming. People tend to stay at Vandy or more regionally, and it’s not uncommon for people to not match in non-Cards/GI specialties. Forgetting the subjective rankings, I view a program’s success based on its ability to place people in fellowships or where they want to be. I don’t think Vandy does nearly as well relative to its competitors on that front. It’s match list is not that impressive.

Overall
Vanderbilt is considered a prestigious Southern program, and on some levels it is. It’s a major academic center, and you’ll see a ton of good medicine. But I think the program has some major flaws. It’s a very formal, stuffy, hierarchical place with a huge emphasis on tradition. It’s mostly a group of older men and is run like a bit of a fiefdom. If I were to do it over again, would I go to Vandy? Short answer – probably not. I got what I needed out of it, but it was not a pleasant experience. I would warn any of you to really probe past the surface with this program and not accept the veneer.

Hope some people find this helpful. I don't check this site often, so best of luck to y'all.

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[Superstarz34]

thanks for your insights, very helpful information to know.

 

[Pkboi24]

Wish this had been posted before I bought my plane ticket...

 

[LadyJubilee8_18]

Wish this had been posted before I bought my plane ticket...

I really disagree with lots of what was said there. I'll reply shortly.

 

[LadyJubilee8_18]

I am a current Vandy intern, and I must say that this post could not be further from the truth. Maybe things have changed since this person finished, but I'd also like to share my take on things.

Rotations
The main inpatient services are the Rogers (subspecialty) and Morgan (general medicine) service. There are technically 4 main Rogers services – ID, Renal, GI/Hepatology, and Pulmonary. Unfortunately, you don’t actually get a ton of exposure to the subspecialty aspect of care for patients in each service. ID means you get almost all HIV patients – regardless of what they come in for. Renal means you get HD patients – regardless of what they come in for. I think you get the hint. The residents end up taking care of the basic medical issues while the Fellows handle any of the more specialty specific issues. The Cardiology and CHF services are fairly the same and self-explanatory. Morgan tends to be the catch-all where if a patient doesn’t fall into any other category, they end up on Morgan. In turn, it often ends up being a bit of a social work nightmare and is incredibly painful for the intern. The VA tends to be extremely busy – probably busier than the main hospital. It kind of sucks like any VA, but since it’s a major VA in the South, you have quite high volume. For interns, expect you’ll often be close to your cap and be fairly frustrated with life. I would say that Vandy residents work more than most, and don’t be shocked if you are consistently violating work hours.

So I've done a couple of sub-specialty services including rogers and oncology, and I partially agree with what was said. On the renal service, the fellow is there to put in the dialysis orders and to round with the team in the mornings, but the rest of the show was run by the residents. The attendings were very big on teaching and very big on allowing the residents to be involved as much as possible. On oncology, I rarely even saw the fellow! I definitely felt like I was making most patient decisions. The only rotation that I've violated duty hours on was my VA rotation, but that was in July. Duty hours can also be a problem on the GI and CHF services, but otherwise residents are well within hours. The average work week is about 70 hours. Coming from a medical school with a community hospital, I must say that I've very rarely experienced a "social nightmare" here. The social workers, nurses, and other ancillary staff members are outstanding! Most teams have a specific social worker assigned to them so that residents don't have to get involved in social work issues.

Hospital
I won’t spend a ton of time since hospitals are hospitals. Vandy is a big academic center that prides itself on its EMR, which is actually quite good. Stuff does work fairly well, and the new ICU tower is supposed to be state-of-the-art. One thing I will say is that the hospital is under-staffed, so the residents end up having to pick up the slack. I remember one time when I was really sick with a fever and got scolded by a chief resident for not coming to work because the service was so busy. A little ridiculous in my opinion.

I have never felt that the hospital was understaffed. I've never had to draw my own blood, transport patients, or do any ancillary tasks that I felt were inappropriate. When you order something it gets done, usually within a few hours. I've never once been yelled at by a chief resident, and there is a Jeopardy system that prevents uncovered shifts in the event of emergency. Residents who have independent study time on clinic or elective months can be called in to pick up last minute shift openings. One of my friends had a grandmother pass away in another country and was covered for a week while he spent time with family.

Residents
This is one area where the program struggles, for I think the IM program lacks the camaraderie of many programs. Many of the residents are nice, but there are quite a few (including Fellows) who will spare no expense to make you look bad or get you in trouble. It’s not even for competitive reasons – just a sad fact about the culture. Don’t let the Southern politeness fool you – I’ve seen people do some harsh, even malicious things to other people. There is a hierarchy based on year, and the residents as a whole don’t hang out a ton. If you’re drawn to cities or single, I would stay away as Nashville is far from a big or diverse city (consider it conservative and fairly Deep South) and most of the residents are married or in very serious relationships. During my time at Vandy, this was a huge let-down that I didn’t think it was a supportive, nurturing culture at all. And as for the chief residents, some end up being cool but they are mostly pawns of the administration and not “one of the residents”. Be careful with that one. Overall, I would say most of the residents are not happy or invested in the program. That’s true to some extent at many places, but over time that unhappiness is quite palpable – more so than I heard from friends at other programs.

This is by far the most ridiculous assertion of the post (well maybe the next section about Dr. Sergent is more ridiculous). The best part about Vandy is the way the residents get along! I spend lots of my free time with my co-interns and even residents in other departments. Every Tuesday is trivia night at a local bar, I host pot luck dinners at my house, every weekend someone has a gathering (lately centered around football games), I was invited to hang out at someone's boat on the lake, etc. etc. If I'm not hanging out with residents at least twice per week, something is wrong. This translates to the hospital environment. I got along with almost all of the residents extremely well. We laugh and joke on call even when things are busy, and if I'm ever unprepared for something on rounds, I know a team member will step up to make sure I don't look bad. The support is tremendous all the way through the staff. My nurses in clinic even baked me cupcakes for my birthday even though I didn't tell them when it was!

The part about there being few single residents is true. Most people are married or on their way to being married. I still have found a good group of friends to hang with which consists of about a third of the intern class and some of the upper levels. Nashville is the biggest draw back for me because it isn't a diverse or very big city. It's growing on me though.

Program Leadership
This is probably my biggest warning area. Dr. Sergent (program director) comes across like this soft, folksy, super-nice guy. During interviews, he drops that deep Southern charm and makes you feel like he’ll be your grandfather. However, once you join the housestaff, it’s a very different feel. He has his favorites and, in my opinion, has minimal genuine concern for the residents. He prefers the appearance that everyone is happy and everything is great – regardless of reality. By the time one gets to 2nd or 3rd year, many of the residents refer to him as a “used car salesman” and have a fairly negative view of him as he’s neither transparent or honest. I don’t trust him personally and am actually quite glad I won’t have to deal with him anymore. I won’t divulge details, but he’s definitely been less than fair with several residents I know when they’ve had issues arise, and I know he’s pushed several residents out of the program while letting his favorites slide by

I'm not sure what this person went through, but as far as I can tell, this could not be further from the truth. Dr. Sergent personally attends the intern report so that he can get a feel for the problems that we're having. When we heard about the work rule changes, he allowed the residents to form committees so that we could decide what would work best for our program. He started the holiday party where attendings cover the hospital so all housestaff can have an evening off to mix and mingle. He even meets with each resident personally every quarter so that he knows how we're doing. I'm not sure where this "used car salesman" thing comes from. Sounds like a bitter individual to me.

Fellowship Match
For a program that likes to consider itself so prestigious, Vandy’s match list is a bit underwhelming. People tend to stay at Vandy or more regionally, and it’s not uncommon for people to not match in non-Cards/GI specialties. Forgetting the subjective rankings, I view a program’s success based on its ability to place people in fellowships or where they want to be. I don’t think Vandy does nearly as well relative to its competitors on that front. It’s match list is not that impressive.

People stay at Vandy because they like staying at Vandy! People stay regionally because they are from the south and want to stay in the south. There are at least 8-9 program directors at other institutions through out the country who have come from Vandy in the recent past, so I'm quite sure our graduates could easily find fellowship spots elsewhere. We are quite known for both cards and pulmonary critical care, so we tend to match well there. As far as the matching residents to "non-Cards/GI specialties" um...not everyone wants to do Cards or GI.

Overall
Vanderbilt is considered a prestigious Southern program, and on some levels it is. It’s a major academic center, and you’ll see a ton of good medicine. But I think the program has some major flaws. It’s a very formal, stuffy, hierarchical place with a huge emphasis on tradition. It’s mostly a group of older men and is run like a bit of a fiefdom. If I were to do it over again, would I go to Vandy? Short answer – probably not. I got what I needed out of it, but it was not a pleasant experience. I would warn any of you to really probe past the surface with this program and not accept the veneer.

Hope some people find this helpful. I don't check this site often, so best of luck to y'all.

I'm quite happy I went to Vandy and that's despite a long distance relationship, no friends or family in the area, and my never having moved from my home state. It is traditional and formal, but quite supportive. I must say that it is an easy place to start over and make friends because people are so open and helpful. I totally disagree with the OP on this one.

 

[snowbank]

You know, thanks for posting - both of you. They say whenever 2 people come together, you'll have 3 opinions or something similar to that effect!

While I cant say anything about the genuine-ness, or the reasons behind the OP's post, and that he hasn't posted anything else and doesn't come here often - Ladyjubilee is a much more 'authentic' SDN-er. And while I myself am not as authentic as her - I can say this - I personally have experienced, first-hand, malignant programs and malignant personalities/attendings at other programs, as well as vindictive 'peer' residents. All this boils down to favoritism, and we're all guilty of it - but to varying degrees. Whether you show it openly and whether you let it cloud your judgement is an entirely different story. Some programs are open about their 'likes' and 'dislikes' and others are not.

A wise SDN-er posted elsewhere that some progs will tell you how lucky they are to have you, and others will tell you how lucky YOU are to be at their program. Definitely dont want the latter! Also - the culture of a program flows from the 'top-down' - so a lot depends on PD and attending personalities - that you cannot tell in 1 day of interviewing. Can only find out by talking to other residents who've borne the brunt of it all. Most con-men are not psychopathic murderous criminals per se, but instead are highly refined, cultured, socialites who can jive well with everyone in the room and understand psychology enough to gain other people's trust. Similar story for attendings. What you see AINT exactly what you get.

In the end I guess thanks to the OP for the courage to post this, I can certainly identify with most of the things that he's mentioned, and have no doubt in that similar programs exist elsewhere and things like he mentioned happen at other programs too. Which programs, and whether this 'really' happens at Vandy, is a totally different question (that I dont have any CLUE about).

 

[EPADHA]

Appreciate the original poster for being so candid with his/her assessment. It does not amaze me to see that all is not well in the 'House of Vanderbilt'. Unfortunately almost all big southern programs are run or tend to run like fiefdoms with things always rolling down. I had interviewed at Vandy few years ago, and have to say that besides all the glitz and glamor of a top US hospital, there was some malignancy that I could sense (besides the notion that all top places have some inbuilt malignancy). I got the same vibe at UTSW and Mayo. But this was in 2006..

Anyways my random musing aside, would really advise all interviewing medical students to pay close attention to little details at your top choice programs. Talk to people you know at that program or talk to students from your medical school who are residents there. Or else do a second look if that place is among your top choices and you think your assessment may not be correct. We all try and put a show during interview season.. dont let that fool you!

 

[EPADHA]

Just finished reviewing Vandy's match list on its website. It looks like every year only 3-5 people match in cardiology. That's little low for a top 20 program like Vanderbilt ( remember it gets rated above its rivals like UAB and Emory on this forum so I wd think it gets more gung-ho competitive applicants).
Moreover their match list is also a bit underwhelming. I am not sure why this-poor mentoring by residency program, little time for research, high burn out in residents, generic letters written by program- I dont know what is at play here.

 

[LadyJubilee8_18]

Just finished reviewing Vandy's match list on its website. It looks like every year only 3-5 people match in cardiology. That's little low for a top 20 program like Vanderbilt ( remember it gets rated above its rivals like UAB and Emory on this forum so I wd think it gets more gung-ho competitive applicants).
Moreover their match list is also a bit underwhelming. I am not sure why this-poor mentoring by residency program, little time for research, high burn out in residents, generic letters written by program- I dont know what is at play here.

What is with this "non-cards and GI" talk? According to last year's stats, Hem/Onc was more competitive than cards. If you look at the top three competitive specialties (cards, GI, hem/onc) Vandy matched 10 last year and 15 the year before with 30 categorical medicine residents over all. Last year, UCSF matched 9 in those top three, does this make them a bad program Further, people go to Vandy for pulmonary critical care because that's what we're know for. If more people match in PCC, it follows that fewer would match in Cards. There are ample research opportunities, you come in with a mentor, and Dr. Sergent writes very personal letters. Everyone has the opportinuty to do research months for electives, and you can even fast track into a sub-specialty leaving room for a whole year of research. We are #6 in NIH research dollars, so funding isn't an issue either. Bottom line is that people who go to Vandy get to do what they want to do. Not everyone wants to do cards.

 

[Superstarz34]

oh snap, crackle, pop!

 

[gutonc]

Just finished reviewing Vandy's match list on its website. It looks like every year only 3-5 people match in cardiology. That's little low for a top 20 program like Vanderbilt ( remember it gets rated above its rivals like UAB and Emory on this forum so I wd think it gets more gung-ho competitive applicants).
Moreover their match list is also a bit underwhelming. I am not sure why this-poor mentoring by residency program, little time for research, high burn out in residents, generic letters written by program- I dont know what is at play here.

You've got a couple of fallacies in your logic here. As Lady_Jubilee pointed out, while Cards and GI are historically the most competitive IM fellowships, Onc is basically just as competitive these days.

Also, there is some self selection going on here (and everywhere). If you are a person who will kill yourself if you don't get a top Cards spot and you want to do residency in the South, you're probably going to choose a place like Duke or UTSW over Vandy or Emory. If you want to do Onc, you're probably going to choose a place like Vandy and if you want GI, Emory is a better choice.

Finally, just saying "X people went into specialty Y last year" is a meaningless statistic since you don't know the relevant denominator. You might think that it's the # of people in the residency class that should be denominator but it's not. What matters is how many people applied for the specialty, which is a number you'll never know (unless you ask a well informed resident who cares about that kind of stuff). This is a complaint leveled at my former program every year as well. "Well, they only matched 3 people into Cards and 2 in GI so it must not be very good." Well guess what genius? Only 3 people applied to Cards and only 2 to GI, so I guess we did OK.

 

[Stealmyrecords]

I am a current third year resident in Internal Medicine at Vanderbilt and was stunned to read the “CardsGuy” original post – I could not disagree more with his impression of Vanderbilt. Every program has a small number of bad apples and the post above is from one of Vanderbilt’s very few bad apples.

Rather than spend time dwelling on all the nonsense in the original post, I just wanted to take a minute and express how great my experience at Vanderbilt has been. I am not from the South and knew little about Vandy and Nashville generally when I first interviewed here. I had the opportunity to interview at a lot of strong medicine programs across the country (UCSF, MGH, Brigham, Duke, Johns Hopkins) but was won over by the unique combination of clinical training, camaraderie, and departmental support that exists at Vanderbilt. I could not be happier with my decision.

The residents at Vanderbilt are outstanding. I moved here knowing no one. Within two weeks of starting internship, I had friends not just in the IM program but throughout the hospital. In the last week alone I attended the Avett Brothers concert at the Ryman with a group of EM residents; dressed up for a Halloween party with friends in anesthesia, ENT, and Heme/Onc; and had band practice for the indie-country band I share with two other IM residents and a peds resident. Any night of the week, there are residents who are eager to grab a bite to eat or go hear live music. This leads to great relationships within the hospital.

I feel like the clinical training at Vanderbilt is comparable to any big medicine program. We have a wealth of interesting cases, great exposure to general and subspecialty attendings, and a resident-driven system. For example, I am currently on Pulmonary and on our service today we have a pt with SLE and autoimmune angioedema, a pt with CF and candida glabrata endocarditis, and a pt with recurrent bilateral hydropneumothorax, among others. Our attending is Dr. Light (of Light’s criteria) and we have a pulmonary fellow who is available but who is there only as a consultant – the fellows are not in house overnight so it is truly the residents who “own” the patients.

In retrospect, I think the unique combination of clinical training and housestaff collegiality that exists within the IM program at Vandy is largely a testament to our program director, Dr. Sergent. His gifts as a teacher and role model are complemented by a genuine affection for the housestaff and willingness to fervently defend our interests. He has gone to bat for us with the hospital administration, with other departments, even recently with the ACGME. I feel extraordinarily lucky to have had such a dedicated and outstanding mentor at the helm of our program.

If you have any questions about the Vanderbilt program, please feel free to get in touch with me personally.

Matt Semler
[email protected]

 

[lanzarlaluna]

Consider me a member of team Stealmyrecords and LadyJubilee8_18. I am currently an intern at Vanderbilt and will be sticking around for neurology, so you could argue that I have little reason to defend the medicine department. Just a few thoughts I'd like to share. I completely agree with everything the previous Vandy defenders have mentioned. Internship here is very, very busy, regardless of rotation (well, except for that sweet clinic month), and it's the collegiality amongst the residents that allows us to survive. Like what was mentioned already, I have made friends in other departments as well.

Many of my resident so far have been great teachers and know how to manage the service, and many of the attendings are very hands-off (in a good way) and allow the residents to lead the team. Teachings conferences here are generally very good, and who can argue with lunch being provided four days a week? Chick-fil-a, anyone?

Regarding Dr. Sergent, the OP mentioned that he tries to put up this grandfathery front. To me he is more of a father figure. He will be warm, genuine, and will crack some skulls on your behalf, but he will also turn the screws on you if he is concerned about your performance. This isn't to be malignant; he wants you to succeed. Personal story: There was some concern about my efficiency early on this year. It was taking me forever to get my crap done on a daily basis. I could have easily been left to drown, but my attending relayed his concerns about me to Dr. Sergent, who met with me personally and provided some strategies to help improve my performance. On top of that, he put me in contact with one of the chief residents so that I could meet with him occasionally to track my progress and give me additional tips for intern survival. Did this whole situation scare me at first? Absolutely, but I realized that Dr. Sergent actually gave a damn about my training. And again, I am a prelim!

 

[tomatopie1]

CardsGuy's post is outrageous!! Vanderbilt has to be one of the friendliest, most supportive IM residency programs and Dr. Sergent (PD) is a big reason why. Is there a Vanderbilt IM program doppleganger that I don't know about?!

I'm a second year IM resident at Vanderbilt and have loved my experience. I am hoping to stay on as a fellow if I can. Like Stealmyrecords, I interviewed at top programs (UW, Stanford, UCSF, UCLA, MGH, Hopkins) and ranked Vanderbilt #1 because I could get top tier training without sacrificing my soul (also possible at those other places...but you get my drift). My co-residents have a life outside of medicine. If you need support from an upper level it is not frowned upon like some places - instead it's an opportunity to be taught by your peers. We joke with attendings. Fellows have our back. It IS residency so some days and even months suck (let's be realistic) but it's as positive as it can be.

Dr. Sergent is an amazing advocate - finding research mentors, paying for conferences, finding significant others jobs (including mine), open door policy. He's a true academic (former head of American College of Rheumatology) but has also written books about humanity in medicine - it is a creed he lives by. Spend 5min with the man and you will see. He still stis down with all 500+ people who interview at Vanderbilt. Unreal.

The EMR and order entry is out of this world, the hospital is a hospital (every hospital tour is the same...), ancillary stuff is good. I am thankful every day that I followed my gut and put Vanderbilt first.

PM me if you have any questions - I promise that I'm really a Vanderbilt resident...but I'm not so sure about CardsGuy (?)

 

[jdh71]

To our young and impressionable med students applying this year . . . please apply a healthy dose of cynicism to any and all posts here on SDN. I think based on this thread it is safe to say that is is possible to have a bad experience at Vanderbilt, or anywhere else for that matter; however, it appears that for the most part people who match there, like it.

For instance, at my very own program we had an intern last year asked to not come back for very good reasons. I bet if you asked him how nice and supportive my program was you'd get a negative report. Context . . .

You can't make everyone happy all of the time. Expectations being what they are . . . I know a peep or two at Vandy and it's a . . . take that with as much salt as you would like.

 

[SonofMaupin]

First of all, I am a current third year resident at Vanderbilt. Let me start by saying I was completely shocked when I read the post by CardsGuy. My initial reaction was "this makes no sense. No one here is unhappy with the program." However, I think I know now who posted this, and he is not, in fact, a recent graduate from Vanderbilt Internal Medicine (as is evidenced by the fact that he signed up a week ago but is still listed as a resident). He isn't at Vanderbilt anymore, and that is all I am going to say. No mud-slinging.

With that being said, I would like to refute a few things and give a brief impression of Vanderbilt Medicine.

I originally applied to 20 IM programs, then added Vanderbilt on as my 21st at the last minute. It was the only program in the south that I applied to (Nashville is sort of borderline-south, really). It made it to the top of my rank list by February (and has proved to be a GREAT decision) because of a few things.

1. Camaraderie
2. Program Director John Sergent
3. Incredible Electronic Medical Record and Order Entry system
4. Location (which sort of surprised me)
5. Attending Physicians

I got a sense of the camaraderie when I visited, but have been blown away by the collegiality I have experienced in my 2 1/2 years here. It is ludicrous to suggest that "Many of the residents are nice, but there are quite a few (including Fellows) who will spare no expense to make you look bad or get you in trouble." I really could not imagine a more false statement than this. The fellows and other residents are incredibly nice here, because that's the culture. People are nice to each other. I laugh more at work than anyone really probably should, at any job. Just like Stealmyrecords and LadyJubilee, I have made lifelong friends here. I was married last year, and three of my four groomsmen were current residents at Vanderbilt (2 IM, 1 anesthesia). There is no point prior to this (college, med school) where this would have been the case had I gotten married earlier.

I will have to agree with all other posters other than CardsGuy that Dr. Sergent is second to none. He has been extremely friendly and supportive from day 1 to day...~800? He advocates for us. He jokes with us. He attends on the wards (he was my attending on general medicine and was awesome). When an intern was falling behind last year, he made a point to schedule her as his intern on general medicine. Why? Because he wanted to know what she was specifically having problems with so that he could use his experience to pinpoint solutions. This is the way he thinks. Also, with the new work hour regulations taking effect for interns, who did he appoint to figure out what new schedules would make the most sense for housestaff? Us. The housestaff. Did I mention he invites us to his house multiple times yearly? Did I mention he walks, or drives a Volkswagen, to work? Did I mention how he has met and exceeded the first impression I had when I met him originally?

Our Electronic Medical Record and Order Entry is as good as it gets. Vanderbilt has had EMR since I was in grade school, I think, and has a huge internal informatics staff that is constantly upgrading it. They take suggestions directly from us, the housestaff, and tailor it to our needs. For most of this, you just need to interview here and have someone show it to you. However, here is a brief description. The initial view just shows the whole patient record (inpatient and outpatient color-coded blue and white respectively) with all notes and anything else you might want to see organized in reverse chronological order. Scroll down to go back in time. If you want, you can make it only show all echo reports, for example. You can instantly do a fulltext search of ALL notes, clinical communications, whatever, for any word or phrase you want. Display labs in every imaginable way (Would you like to instantly see every creatinine someone has ever had drawn? Would you like that in graphical format?). The order entry is like a search engine. Would you like to order a test for celiac disease? Not sure what it is called? Just type in celiac. It will pull up a list of options. You just need to have someone show it to you to really understand.

Nashville surprised me as being my favorite place I've ever lived. It has a small-city feel with lots of neighborhoods easily navigable through sleepy streets or main thoroughfares. As for CardsGuy's assertion: "fairly Deep South." I don't even know what to say to that. There are about a hundred ways I could refute that. First, look at a map. Second, visit the town. Third, ask anyone you know who has spent significant time in Nashville. Vanderbilt itself is right next to an area called Hillsboro Village, which is basically an old brick-building type of area that is very artsy and a great place to go out for drinks or food. It has coffee shops (Fido is a favorite among residents), music stores, salons, clothing stores, used clothing stores, an art gallery, and many restaurants and bars. There are about eight other areas within a few miles of there that are also great to hang out, such as 12South, East Nashville, Green Hills, West End, Downtown, and Sylvan Park. Did I mention the weather? The weather here is outstanding. Coming from the midwest/plains, I would say the summer is the same or better here (it just doesn't get quite as hot, look on weather.com). The spring and fall are beautiful for months. Most of the restaurants/bars have transparent garage-style doors on the front that are open for several months straight. The winter is really very mild. I am a runner. I don't like running when it is really cold, but I manage to stay in shape all winter without ever using a treadmill. Oh, and you can probably afford a house here.

The Attendings here are great. People are very supportive, very approachable. Now that I am in my third year, most of the medicine attendings say hello and call me by my first name when I meet them in the halls. At Vanderbilt, you don't just rotate on general medicine. We have individual specialty services for just about everything. You want to learn about HIV? Would you like to learn it from internists (who may or may not know more than you do about it) or would you like to learn from ID physicians. When you are on the ID service, your attending is an ID physician. Same for general cardiology, CHF (your attending is a heart failure specialist), GI, pulm, renal, heme, onc, you name it. Rheumatology and endocrinology do not have their own services, but otherwise if it is a medicine specialty, it has its own service, and you will rotate on it. Also, of course, there are many general medicine teams (four at Vandy and six at the VA). And lastly, MICU and CCU, of course. If an attending turns out to be a better researcher than an educator, they no longer round with inpatient teams.

There are a lot of other things that CardsGuy said that are blatantly wrong. Vanderbilt Hospital is not understaffed, and anyone who says so is lying. I've never drawn my own labs, started my own IVs (other than a LOT of central lines in the ICU), transported patients, etc. I have never even heard of people doing this. Not even at the VA. I am not sure if any hospitals are still doing this, but it sounds like a big waste of your time, if so.

People do not have any trouble matching into fellowships. I know for sure that everyone who wanted to match into cards and GI have matched for the last few years (I wasn't around before that and don't keep as close of tabs on other specialties). LOTS OF VANDERBILT PEOPLE MATCH AT VANDERBILT BECAUSE THEY LOVE IT HERE! Lots of people match in the south, mid-south, and midwest because they want to. If they wanted to live in Boston, they probably would have gone there for residency. Vanderbilt is a great medicine program that is currently 6th in NIH funding. Is that the reason I am here? Nope. Does it hurt? Nope.

Hopefully, this makes it clear what I, and pretty much everyone else, thinks of Vanderbilt. Top-notch training (including specialty training directly from sub-specialty attendings). Wonderful collegiality. Great town. Best program director there is. Unsurpassed informatics. All of these posts, except the first, seem to be creating a theme.

 

[Pkboi24]

Gotta say, I am extremely impressed with the number of people that have come out in defense of Vandy.

 

[LadyJubilee8_18]

Gotta say, I am extremely impressed with the number of people that have come out in defense of Vandy.

I think the OP was just so shocking to read for all of us who are at Vandy. I opened this thread fully expecting a glowing review of the program. People at Vandy are very happy. I did not expect to like the program as much as I did when I interviewed, I wasn't sure I was going to rank it first in February, but I did and I'm so happy about my decision.

 

[yayarea]

I'm a second year resident at Vandy going into cards.

As above, 90% nonsense from "cardsguy".

My class, (the 2nd year class), are the nicest, smartest people I've ever worked with. Seriously.

If I had seen malignancy, I would let ya'll know, as I appreciated what I heard when I was applying.

This was my practice interview and I went on many more interviews like an idiot before choosing to come to Vanderbilt. That was a waste of money.

I don't have time for point by point analysis of the nonsense that started this post, but this program's awesome for many different reasons.

PM me for deets, will write more later.

 

[sga1120]

(whoops, duplicate post)

 

[sga1120]

Total BS. I am a 3rd year at Vandy, and I absolutely love this program. I can't imagine my life anywhere else. I hate to defend Vandy by attacking the OP, but my gut reaction to this was, "I wonder what kind of personality disorder this person has?"

First of all, as far as the comments about Dr Sergent.. I think he is exactly what a PD should be; but I will give you the benefit of a doubt. Maybe you had a bad experience with him. But to say that there's no camaraderie among the residents? If you can't get along with this group of people, then perhaps you're the one with the problem. When Nashville got flooded in May of this year, I was one of the many people who weren't able to get to the med center. I felt terrible that I wasn't able to take care of my responsibilities on the wards; but the people who were able to get to work covered for those who couldn't. And no one held it over anybody's head. I don't know how I got to be lucky enough to have these people as my co-residents, but I am glad that I did.

Yeah, the Morgan service sucks. Yeah, we're overworked. Welcome to residency. If you didn't want to deal with difficult patients, you should have gone into radiology.



PS-- to all the current Vandy residents who posted on here: I really do consider myself lucky as hell to be working with you all.

PPS-- my thing says "medical student" because I haven't posted on here in 3 years. Don't read into it.

 

[yayarea]

totally hate those guys with "medical student" under their names...

yeah, ditto on that. Haven't had a lot of posting time since 2008 so I'm still a medical student apparently.

Now the fun part. Systematic analysis!

Rotations
ID means you get almost all HIV patients (yep, pretty much the point of ID)
Renal means you get HD patients (yep)
The residents end up taking care of the basic medical issues while the Fellows handle any of the more specialty specific issues (The residents handle everything, and the fellows advise us, like any other program)
Morgan tends to be the catch-all where if a patient doesn’t fall into any other category, they end up on Morgan (yep, again, medicine kind of works that way)
VA wards have lots of patients (yep)

Hospital
I won’t spend a ton of time since hospitals are hospitals (yes they are) Vandy is a big academic center that prides itself on its EMR, which is actually quite good. (best EMR ever... I think Duke bought it)
Stuff does work fairly well, and the new ICU tower is state-of-the-art. One thing I will say is that the hospital is under-staffed (this hospital has more staff than I've ever seen at a hospital. The fact that there are both case managers and social workers for all the teams blew my mind, but I'm from new york where there aren't any ancillary services. I would go with above average ancillary services at vandy for a conservative estimate)

Residents
This is one area where the program struggles (I suppose if people are too nice that would be struggling?) Many of the residents are nice, but there are quite a few (including Fellows) who will spare no expense to make you look bad or get you in trouble. (generally I suppose you'd get in trouble for doing things that are unsafe. I dunno, as I've never even seen anyone get in trouble. also the whole 'team' concept seems pretty firmly entrenched in everything I've done for two years)

Don’t let the Southern politeness fool you (now see this is true, but not in the program. If someone says "well ain't that nice" that means something very different than a literal translation). There is a hierarchy based on year(yep, that's how residency works). If you’re drawn to cities or single, I would stay away as Nashville is far from a big or diverse city (consider it conservative and fairly Deep South) and most of the residents are married or in very serious relationships.
(Now this is true. The majority are in serious relationships, and this is the South. I was worried about this when I came here (from ny) and found this to not be an issue. My buddies do grilling often, and things are easy to do. Coming from nyc, I would recommend it. Less stress, easier to do things, CHEAP.)
During my time at Vandy, this was a huge let-down that I didn’t think it was a supportive, nurturing culture at all. (nah, I legitimately like these residents. Just look around on your interview day. Silly thing to say, original poster.)
Overall, I would say most of the residents are not happy or invested in the program. (Oh come on! This sentence is the least true so far! Silliness abounds! When I sign out and give a few things to do, they get done. If a patient needs to go home and something isn't set up, the overnight team will make it happen. I'm trying to think of a pun with investments and failing....)

Program Leadership
I erased this whole section. I made my decision on our program director in about 2 minutes. He is awesome. Seriously awesome.

Fellowship Match
For a program that likes to consider itself so prestigious, Vandy’s match list is a bit underwhelming. People tend to stay at Vandy or more regionally, and it’s not uncommon for people to not match in non-Cards/GI specialties. (almost all of these two sentences is legit. The match list is regional, but I can't tell if that's because the residents are regional. I'm going to apply all over the country for cards, so I'll let you know how it goes. But generally, the only people who don't match suicide match (apply to one program only for a personal reason.) This is something that I still don't have a solid answer on. Good news is that Vandy takes a lot of their own and there isn't one giant contingent going into any one fellowship, although there is currently a weird spike in heme-onc.)

Overall
Vanderbilt is considered a prestigious Southern program, and on some levels it is. It’s a major academic center, and you’ll see a ton of good medicine. It’s a very formal place with a huge emphasis on tradition. (I fixed this sentence.)

So that actually wasn't that painful for me to do, surprisingly.


I literally went to every top IM residency other than Michigan, wash u, u wash, and columbia, across the entire country, and chose vandy. Zero regrets. I am in one of the true happy periods of my life here.


Seriously, PM me with questions.

 

[Shoop]

I am a current 3rd year resident at Vandy. I won't make this long because this thread is filled already with messages that mirror my sentiments about Vanderbilt's program. However, I am so offended by the original post and it's false statements that I had to write...briefly.

My only new addition is to reiterate the personal and emotional support readily given (not just available) at Vanderbilt. I have had a very difficult past 2.5 years in residency. The hours, the time away from loved ones, the ups and downs of patient's illnesses has really taken an emotional toll on me. And it had nothing to do with Vanderbilt. I would have felt this way at any institution. Being an intern is hard. I truly believe that Vanderbilt made it better than it would have been at other institutions because of all of the internal support.

January of my intern year was an ultimate low point. I really wanted to quit. I made an appointment with Dr. Sergent because I was at my wits end. I didn't know what I was going to say to him or what I even wanted from our meeting. All I knew is that I was struggling emotionally. I sat in his office, told him I didn't think I would be able to finish residency. Instead of brushing me aside and telling me intern year is hard and it will blow over, he handed me a box of kleenex, waited for me to catch my breath, and listened. He obviously couldn't tell me what to do. But he offered support. He reiterated that his job and his one goal is for me to be happy, fulfilled, successful...in life and my career. He told me that whatever choice I made he supported. One week later I got an email from him asking how I was doing and the next week he took just me to lunch to see how I was doing and what progress I had made. He offered up plenty of resources of other people I could talk with to determine my career path. He even offered up people to talk to about OTHER specialties if I thought internal medicine wasn't right for me.

Needless to say, I got over my January blues and stayed in IM. I knew that I was supported here. I also couldn't have survived the hardships of residency without my co-residents. I am surrounded by truly wonderful people. In spite of the long hours and emotional work, I laugh every day. If I am having a bad day (which can show on my face), other residents I pass make a point of inquiring about what's going on. These people have sustained me. They have helped shape the person I am and the physician I am becoming. Thank you to each and every one of you.

 

[mkpjdmd]

i am not shy about the fact that i am a vandy lifer. i have attended undergrad, law school and medical school here and choose to stay for residency because i truly believe this to be one of the best institutions in the country. Vanderbilt has plenty of statistics to back it up, but what makes it fantastic is the people. Cards guys can say what he wants, residency is hard. But Vanderbilt as an institution is a wonderful place to work. Everyone along my journey from my freshman year at Vandy to my intern year at VUMC has been only supportive and helpful. They go out of their way to make sure you succeed and the people you meet along the way couldn't be happier to help or share in your success. I have a non-traditional career path that i am sure i could not have forged at most institutions, but this one did everything it could to help me along. They wanted me to stay for graduate school, they did everything they could to help me design my own program and they even accepted me as an employee when i finished my education. Dr. Sergent was also an integral part of that. He is a kind and compassionate soul, and as many places as I interviewed, I never interviewed with both the chair of the department and the PD. I did at Vanderbilt. It may be in the south, but the beauty of southerners is that they are humble. They don't care if you know how smart they are or how fantastic. They just want you to be happy and feel welcome. Vanderbilt exudes that on every level daily. And finally, I have to reiterate comments about the house staff. This is the most intelligent and kind group of people you will ever meet. Once you are at Vandy, you are family. You worked very hard to get here and the assumption is that you are a member of the team, a member of the family, and as all good southerners know, you love and support your family.

I understand there is a plethora of comments on this post, but that only reflects the dedication and commitment of our house staff. I respond to support them, but also to note that as someone that is in their 11th year at this institution, it is not even confined to the IM program. It is university wide. Vanderbilt is committed to excellence, but also to making the lives of those under its care fruitful and rewarding.

 

[secretariat]

I have to say, I was so offended and outraged by the original poster's comments that I created this user account just so that I could post a response.

I was an intern at Vanderbilt last year. I ended up transferring to a program in another state for family reasons. That was hands down the hardest decision of my life. And while I like my current program, and the people are great, I STILL MISS VANDERBILT. It is a truly special program, and the biggest reason for that, in my opinion, is the people.

The residents are amazing...they are smart, fun, and motivated. I have no idea why the OP said that there isn't much camaraderie at Vanderbilt. That's simply not the case. In my one year there, I definitely bonded with my fellow residents. I always felt like they had my back when things got busy. The seniors were amazing teachers and motivated me to learn. And these were people that I genuinely enjoyed spending time with outside of work.

And I can't say enough positive things about Dr. Sergent. He is a phenomenal program director. He truly cares about each and every one of his residents. I will never forget how supportive he was last year when I was trying to decide whether to transfer. He said to me, "As the program director, I really want to see you stay, but as the father of grown children, I will tell you to go with your heart." He and all of the residents and faculty made me feel like no matter what, I was always part of the Vanderbilt family.

I just wanted all of the medical students out there to see yet another positive post about Vanderbilt. I promise you, it is a great place to train. And for those current Vanderbilt residents reading this thread, thank you for a wonderful year. I LOVE AND MISS Y'ALL!

 

[gutonc]

OK, OK, we get it. You can call off the other 90 residents at Vandy, we get it and don't really need 5 dozen more people to register at SDN just to tell off CardsGuy. The OP clearly has a grudge (which is his/her right and experience) but the vast majority of folks at Vandy (and nearly every other program BTW) overall like their residency experience.

 

[dragonfly99]

I would say there is some truth on both ends of this argument.
That's the way it usually is when there's a disagreement (on SDN, on the wards, etc.). Sometimes the truth is in the eye of the beholder.

 

[KRichards62]

we get it and don't really need 5 dozen more people to register at SDN just to tell off CardsGuy.

Amen.

 

[StlwrtHsptlst]

Speaking as someone who finished Vanderbilt Medicine in 2003 (did you know that residents used to have to admit on the Rogers service post-call?), I am pleased to see so much support for John Sergent and the program. I worked hard there, but I got great training and it has served me well since.

Stalwart Hospitalist

 

[atsai3]

I would be extremely interested in seeing whether the Vanderbilt evangelists could find someone in the program to post a non-gooey, saccharine, sticky-sweet, nothing-but-sunshine-here review of the program.

I get that there are a lot of happy Vandy residents. I get it. But what I don't get is why the OP would post what s/he did. I assume there must be some sort of half-shade of reality underlying the post, so retorts on the level of "he's just psychotic" don't do it for me. What would be more compelling than post after post of Vandy Kool Aid is something more like, "He's 90% nuts. This is the 10% of his post that was non-nuts: X, Y, Z, P, Q, R, S, T. The administration has realized that there is some truth to Z, Q, and T, and they are doing ABC about it." Something like that.

-AT.

 

[LadyJubilee8_18]

I would be extremely interested in seeing whether the Vanderbilt evangelists could find someone in the program to post a non-gooey, saccharine, sticky-sweet, nothing-but-sunshine-here review of the program.

I get that there are a lot of happy Vandy residents. I get it. But what I don't get is why the OP would post what s/he did. I assume there must be some sort of half-shade of reality underlying the post, so retorts on the level of "he's just psychotic" don't do it for me. What would be more compelling than post after post of Vandy Kool Aid is something more like, "He's 90% nuts. This is the 10% of his post that was non-nuts: X, Y, Z, P, Q, R, S, T. The administration has realized that there is some truth to Z, Q, and T, and they are doing ABC about it." Something like that.

-AT.

The OP is not psychotic but he certainly has his reasons for posting what he did. That being said, I was quite honest about my experience in my post. Anyone who is still interested in knowing what life is like at Vandy should email a resident (Matt offered his contact info above), read about the program online, or show up to the interview and experience it for him or herself.

 

[gutonc]

The OP is not psychotic but he certainly has his reasons for posting what he did. That being said, I was quite honest about my experience in my post. Anyone who is still interested in knowing what life is like at Vandy should email a resident (Matt offered his contact info above), read about the program online, or show up to the interview and experience it for him or herself.

But since you're the only poster defending (or slamming for that matter) Vandy with >1 SDN post, I can see why atsai3 would feel that way. I had pretty much the same thought 5 weeks ago but phrased it differently.

But you're posts are quite helpful.

 

[jbish828]

Hey folks. I imagine this isn't the place for this question, but I was led straight here from google. I'm an M2 with dreams of IM at Vanderbilt. Knowing what and who y'all know right now, can you offer any advice on how to best make that happen? Thanks.

 

[jdh71]

Hey folks. I imagine this isn't the place for this question, but I was led straight here from google. I'm an M2 with dreams of IM at Vanderbilt. Knowing what and who y'all know right now, can you offer any advice on how to best make that happen? Thanks.

This might not be the most representative thread for Vandy at times.

Go to the main Internal Medicine forum page and search for the "what are my chances thread" - bump that with your question.

 

[Instatewaiter]

I don't have direct experience with Vandy but the fellows that I have worked with from Vandy have all seemed to love their experience there. They chose their a different fellowship spot not because they disliked Vandy but because of research, family or likeing the fellowship.

I don't think I've yet to meet a person who didn't like their time there.

 

[nerdology123]

I'm a med student applying to neurology, and here mainly to check out what to expect for my prelim year (since I'm considering Vandy neuro my #1 choice), but just thought I'd share my mentor's advice (at least as it relates to neuro): statistically, every program has a disgruntled resident who has had a bad experience. Obviously Vandy's IM program is no exception, and he/she is entitled to his/her views. The question should be whether its a common theme among residents (indicating a malignant program and major red flag) or if the majority of the residents are happy, which appears to be the case here. Just my two cents.

Also, question. I think the consensus is that its a busy program. But what do you guys/ladies mean exactly? Like, long hours (over 80?? I think some people said so here...) or meaning that you see a lot of patients in the same amount of time? Basically whats your work schedule like in intern year and roughly how many patients do you see daily?

 

[footballyus]

Sorry to post on such an old thread. I'm down to making my final decision between my top places. I have no doubt in my mind that Vanderbilt would be an excellent/fun place to train. I was just wondering if anyone can explain more about their match list. Is it regional by choice and residents want to stay in the South or is it a slight limitation?

 

[gutonc]

Sorry to post on such an old thread. I'm down to making my final decision between my top places. I have no doubt in my mind that Vanderbilt would be an excellent/fun place to train. I was just wondering if anyone can explain more about their match list. Is it regional by choice and residents want to stay in the South or is it a slight limitation?

It's regional by choice. The same way that NE programs tend to be NE heavy on their match lists and Cali programs tend to be West Coast heavy. Don't stress about it. You go to Vandy, where you match is going to be on you, not the program.

 

[footballyus]

It's regional by choice. The same way that NE programs tend to be NE heavy on their match lists and Cali programs tend to be West Coast heavy. Don't stress about it. You go to Vandy, where you match is going to be on you, not the program.

Thanks for the response.
Any anecdotal evidence of people interviewing in West Coast/East Coast/Chicago. As per usual SDN rules, I will take it with a grain of salt. But would like to hear it from a Vandy resident (or at least one that pretends to be).

 

[gutonc]

Thanks for the response.
Any anecdotal evidence of people interviewing in West Coast/East Coast/Chicago. As per usual SDN rules, I will take it with a grain of salt. But would like to hear it from a Vandy resident (or at least one that pretends to be).

Well, you can just look at their Match List (2011-13) yourself.
UC-Davis, UCSD, Cornell, NYU, NW, Pitt, Penn, Hopkins, DFCI, UIC...all on that list. Not to mention a smattering of other top programs in the Midwest and South (Duke, WashU, MDACC, UAB, Mayo). Seriously, of all the things to possibly worry about at Vandy, your fellowship match isn't one of them.

 

[RustBeltOnc]

Also, props to Vanderbilt medicine for this:

https://medicine.mc.vanderbilt.edu/abim_harrisonsociety