Barrow Neurology?

[NeurologyICU]

I have already looked at old threads and opinions, but there aren't that many discussions about them pertaining to Neurology. For SDNers, who are current residents there, or past residents or who have interviewed there this year, what is your opinion on this program? What do you all perceive as the strengths/weaknesses of this program? How is the workload there and do residents there have enough time to have a life outside? How is the camaraderie between the residents? How is the relationship between residents and the attendings? Where is this program heading in the future? I'm considering this program quite highly, so I wanted to take your opinions on it.

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[JoeBarrow]

Hey guys, I'm one of the current chief residents at Barrow, and I suppose the original poster will be hearing my whole spiel in one of our upcoming interview dates this month, but I'm seeing some incorrect information being spread on one of the other threads so I do feel the need to speak up here.

Personally, I've been quite happy about residency at Barrow... it's a unique place that essentially is a giant neuroscience center attached to a community hospital that combines the clinical volume of a County hospital (I was a student at USC) with first-rate support services and facilities. Call can be very busy, but it's balanced by the fact that we're a large residency with a fair night float / short call system. PGY-2's do 4 weeks of nights and average 2 short calls per four weeks ("Q14", if you will); it gets even better for the seniors. The philosophy here is to minimize the amount of time in the hospital with the understanding that when you're there, you will be working your tail off. Bottom line is that you get superb clinical training at Barrow, and I can tell you it was really nice that this reputation preceded me during the fellowship process...

To the claim that we are "neurosurgical scut monkeys," I'm not sure what that means. I make it a point to make sure that our applicants know that the Neurosurgery department here is likely the #1 program in the country. There are 19 attending neurosurgeons on staff, and the Neuro-ICU is 64 beds so I'm sure we're consulted on a lot more neurosurgical patients than other places (more tumors, more bleeds, more seizures, etc.) Maybe some people don't like that... Ultimately, I see the strength of our neurosurgical colleagues as an asset.

Also, regarding the whole EEG thing... I am rotating in EMU/EEG (10 adult beds, 5 peds beds) this month, and I can assure you that there is a ton of exposure to reading EEGs.

If you're a medical student, you're just going to have to come check us out for a rotation or an interview. I'm quite proud of the program here and would be happy to answer any more specific questions people have via e-mail - [email protected]


Julian P. Yang, MD
Chief Resident, Neurology
Barrow Neurological Institute
St. Joseph's Hospital and Medical Center
Phoenix, Arizona

 

[LocusCeruleous]

I have also heard that Barrow is a solid program.

 

[typhoonegator]

Please explain how Barrow has a 64 bed neurocritical care unit. There are roughly this many total ICU beds in all of Mass General (SICU, MICU, RACU, neuroICU, CCU, CVICU). I have a hard time believing that these are all monitored beds with ventilators and 1:1 nursing with neurocritical care coverage.

 

[fanondelaterre]

I don't know... I have never been to Barrow but I find it conceivable. Maybe someone from Barrow can weigh in but I had a friend while in medical school who interviewed at Barrow for neurosurgery and he described it as a 'factory assembly line' and with its very strong neurosurgery program I can see its need for a very large Neuro ICU.

On a separate note, I thought Mass Gen would have more ICU beds. The university affiliated community hospital I am rotating at this month has 64 ICU beds.

 

[typhoonegator]

It all depends on how you use them. If all of your post-op patients need "ICU care" just so they can get frequent exam checks and vitals, while they are babysat for 24h, then you will burn through a lot of beds quickly. I've never been to Barrow, but I imagine that they probably use a lot of unit beds for post-ops. I would be very surprised if they have 64 patients all intubated getting CVVH and Licox bolts.

If use use stepdown units creatively and tolerate sicker patients on the floor, then you can make do with fewer ICU beds.

 

[95439]

It all depends on how you use them. If all of your post-op patients need "ICU care" just so they can get frequent exam checks and vitals, while they are babysat for 24h, then you will burn through a lot of beds quickly. I've never been to Barrow, but I imagine that they probably use a lot of unit beds for post-ops. I would be very surprised if they have 64 patients all intubated getting CVVH and Licox bolts.

If use use stepdown units creatively and tolerate sicker patients on the floor, then you can make do with fewer ICU beds.

Typhoonegator, I don't want to waste your time..but if I don't know what a Licox bolt is, should I drop out of residency? Thank you in advance.

 

[danielmd06]

A Licox bolt is a neurosurgical tool designed to assess intracranial oxygen. They look like unicorn horns. They aren't exactly new, but may be uncommon at many universities.

Here's an article:

http://journals.lww.com/neurosurger...=2008&issue=12000&article=00029&type=abstract

I tried to get a picture here:

http://www.google.com/imgres?imgurl...en&gbv=2&tbs=isch:1&ei=DBBHTe34EoT48AaNqtTCAQ

I wouldn't drop out just yet.

 

[95439]

A Licox bolt is a neurosurgical tool designed to assess intracranial oxygen. They look like unicorn horns. They aren't exactly new, but may be uncommon at many universities.

Here's an article:

http://journals.lww.com/neurosurger...=2008&issue=12000&article=00029&type=abstract

I tried to get a picture here:

http://www.google.com/imgres?imgurl...en&gbv=2&tbs=isch:1&ei=DBBHTe34EoT48AaNqtTCAQ

I wouldn't drop out just yet.

Everyone loves unicorns! Just another reason I'm glad I'm going into Neurology.. ;o)

 

[studentjerry]

I am not affiliated with Barrow but have known graduates of that residency program. The graduates of that program are excellent clinicians and have a good overall knowledge of general neurology (including those who have gone into subspecialties). The program is very academic in that there is a lot of good teaching and depth in terms of subspecialties represented. The program director is genuinely interested in resident education (in other institutions, the job of pd is often seen as scut work for a junior attending-- lots of extra work and no extra pay. On top of an attending's usual duties).

Hours? Hours are controlled and the residents have a reasonable amount of free time. One thing to note is the high caliber of the residents (not a given in other programs). Ppl who trained before the current rules (and who stayed up 40 hours straight-- tough if you didn't even get 15 min. of sleep) will laugh at your concerns at being overworked. But to answer your question, the hours at Barrow are no better nor worse than any other program. If you are really worried about hours, try derm or pathology. Virtually no night work at all.

There was a comment about Phoenix. Phoenix is considered one of the better cities to live in and if you have ever lived in the snow belt, Phoenix is heaven. In any case, if you don't want to go to Barrow, many, many other ppl would be happy to.

 

[digfast]

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[danielmd06]

The one area they seem completely empty in is Sleep Disorders.

Not sure about neuroinfectious disease and a couple of the other more super-specialized areas.

 

[LocusCeruleous]

The BNI does have a sleep guy named Dr. Rama Maganti. However, they do not have a really big sleep business.

 

[danielmd06]

The BNI does have a sleep guy named Dr. Rama Maganti. However, they do not have a really big sleep business.

Cool. I've never seen sleep listings in the various subsections they advertise. They certainly don't seem to offer a fellowship. How many beds does the sleep lab have?

I note that Dr. Maganti is an epileptologist first and foremost (per his profile). Does he have a true sleep clinic or does he just see rare sleep stuff on the side amongst lots of epilepsy patients?

 

[LocusCeruleous]

I think they have a shared sleep lab facility and do contract work in sleep. You are right though; they do not have a sleep fellowship and Maganti is primarily an epileptologist. I you really are interested, I would recommend contacting Dr. Maganti for the real story.

 

[LocusCeruleous]

I have heard from my friends in Phoenix that there has been a major change in the Barrow Neurological Institute's Department of Neurology. Last Friday (2/15/2013) the chairman abruptly resigned (or was fired?). Everyone says that this guy was liked by the faculty and residents and had apparently been doing a good job bulding up the department. There had recently been a management change at the institution and the Department of Neurology was under attack by the admistration. The chairman had been successfully resisting the changes (some of which consisted of salary cuts for members of the Department and a take over by the neurosurgeons). I am really sad to hear this and the likely result is a going to be a long period of decline for neurology at the BNI and the institution as a whole.