Case (MetroHealth) vs. Case (University Hospitals)

[FirstAid]

Could anybody who knows these programs help me compare the 2 in terms of pros and cons? I'm not very familiar with the programs in Cleveland, but I am strongly interested in Midwest programs and it seems like both "Case's" carry a good name and reputable training. Could anybody provide me with any further information? I also trying to decide whether I should interview at one or the other, or both. Thank in advance!

FA

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[FirstAid]

I assume that there's not many people applying to Cleveland programs. Is Cleveland Clinic basically the only show in town?

FA

 

[amyl]

have only heard a thing or two by word of mouth so take it for what it is worth. university program is supposed to be better than metrohealth. heard they have a schedule on the cushy side.
are you a third year or applying now?

 

[Trisomy13]

CWRU (Univ. Hosp) = bigger program, university setting, attached peds hospital, supposedly "cushier" schedule, and i believe a crna school (for what it's worth). i got a good vibe from the faculty, and residents seemed happy. No trauma. one faculty interviewer ranked you on the list as you sat in front of him... you can see whether you're recommended, highly recommended, or neither. i thought that was poor taste. didn't care for the lunch where we were told that residents will be basically observing us and providing feedback -- i'm not the type to be myself and be your buddy at our first lunch knowing i'm being judged. ranked it high on the list.

MetroHealth = "affiiliated" with CWRU, county hospital. Only Trauma service in town. A little smaller I think, older hospital. People here struck me as very genuine (faculty and residents). Not everyone was cheery, but the general sense was that the residents were all happy to be there. Seemed to be workign harder with a busier schedule than Univ Hosp, but that can be a plus as well as a minus. Ranked high on my list...I liked the scenery at CWRU better, but the overall feel at MetroHealth connected with me more.


CCF = canceled my interview to check out a different program in Boston. rumor is it's very busy, and the brand name is there.


downside to all three is cleveland... not the city per se, but the awful weather, and of course, the Browns.

 

[FirstAid]

Thanks, everybody.

Amyl - I'm a 4th year currently applying right now. Pretty much just trying to guage the programs in Cleveland.

Thanks, again.

FA

 

[mini_mucci]

Im from the area and alot of the anesthesiologists that I have worked with have trained at the Cleveland Clinic, so perhaps there is some bias to what they have told me. They pretty much told me not to even apply to Metro, and that the Clinic performs so many more big surgeries (ie transplants, cabg, etc.) that it is much better looked upon when looking for jobs later in the future. Yes, the volume is unreal, but if you train there, you will feel comfortable doing just about any case once all is said and done. Case (UH) is also good, but a less reputable, and not as busy place (# of surgeries and strength of program).

I personally did not apply to metro, applied to UH and CCF, have an interview at the Clinic, but havent heard from UH yet.

 

[fakin' the funk]

Im from the area and alot of the anesthesiologists that I have worked with have trained at the Cleveland Clinic, so perhaps there is some bias to what they have told me. They pretty much told me not to even apply to Metro, and that the Clinic performs so many more big surgeries (ie transplants, cabg, etc.) that it is much better looked upon when looking for jobs later in the future. Yes, the volume is unreal, but if you train there, you will feel comfortable doing just about any case once all is said and done. Case (UH) is also good, but a less reputable, and not as busy place (# of surgeries and strength of program).

I personally did not apply to metro, applied to UH and CCF, have an interview at the Clinic, but havent heard from UH yet.

Although I'm not going to deepthroat the Clinic quite like that, I'll second the notion. My impression is, in terms of program size, program reputation, department size, surgical volume, research programs, etc etc: Clinic > UH > MetroHealth, with the Clinic and UH being more similar to each other than than either is to MetroHealth.

 

[PGY2]

The Clinic is an IMG factory. Strong middle eastern influence there. In fact they reserve mid year starting spots which gets taken up by foreign grads. UH in general does not take any foreign grads anymore. They used to when times were lean, but they havent taken any in the last 5 years or so.

The clinic is well known for its heart program. However, they send their residents to the outlying hospitals because there arent enough cases for residents given that the CT fellows take them all.

UH is an overall well rounded program. Not too tough, but tough enough. You will get worked hard at the Clinic and learn alot. I personally dont need to be abused to learn though.

Metro- no organized scheduled rotations. You do whatever is on the board. No guarantee or certain types of cases except for lots of trauma.

 

[Stimulate]

I am a ca-3 at CCF I can tell you that I wouldn't follow "PGY2"'s advice regarding the Clinic. The Clinic is a huge heart center...CCF residents DO NOT go elsewhere for hearts. On a typical day CCF does between 18 and 26 open hearts. I think you will have difficulty finding institutions with greater volume. You will be comfortable doing hearts on your own by the end of your rotations, plus, jobs typically will not require a cardiac fellowship (unless you need TEE certification) for graduates of CCF. By the way construction is under way on a $450 million heart center that will expand the cardiac ORs from 8 to somewhere around 10, and the cardiac surgery ICU will grow from 60 to 100 beds.

Also, CCF is not an IMG "factory". Back when anesthesia was not a popular career choice CCF did take quite a few IMGs to fill their 20-27 positions. However, in the past few years there have been no IMGs in the July class.

There is a January class of residents that typically are outside of the Match and often from South America, Ireland, Egypt, etc. I have never found that working with IMGs detracted from my education. First, they typically outscore us US grads on the in-training exams, and because they are pretty bright (almost all have been anesthesiologists in their home country) they can be sources of learning and also help get all the cases done so you can go home at the end of the day.

CCF is a hard-working program, however, there are endless moonlighting opportunities because of the high volume of cases that are being done. The place is basically a surgical factory and I wouldn't paint a picture of a rosy lifestyle where we all get done early each day. But you will get a great job and the opportunities for fellowship are great (especially Pain and Cardiac).

Overall the best-trained (which is probably what all applicants are looking for) in cleveland are CCF>Case/Univ Hosp>Metrohealth.

 

[PGY2]

Good to hear things have changed then... when i was in cleveland, residents were going to Hillcrest and Fairview to do cases. The January starting classes were usually from Egypt (is it coincidence that the chairman and most of the attendings were from Egypt at the time?). I know Roizen is there now... hope he does great things there.

 

[Stimulate]

Residents do rotate to Hillcrest for OB (because CCF moved all OB to Hillcrest/Fairview). We used to rotate at Akron Children's Hospital (about a 45 minute drive but we are paid for mileage at 0.445/mile) but that affiliation is ending as of December 31st. We have elective rotations at some of the other local sites like Beachwood Ambulatory surgery center, and Huron road hospital for a combined trauma/ob/regional experience.

Roizen is doing a pretty good job so far at CCF, however, we still have much ground to gain in terms of taking control of the OR schedule. Right now the anesthesiology division has very little control over the surgical schedule and the residents are working late pretty frequently. Regaining control of the schedule is taking some time...

I know this thread really isn't aimed at discussing CCF but I just wanted to clarify some of these issues.

 

[bigdaddygas]

The anesthesia program at MetroHealth of Clevend is a hidden gem. When I applied to anesthesia programs several years ago, I almost cancelled my interview to Metro because of time constraints, but was glad I didn't when I showed up and saw what they had to offer. The ORs are relatively brand new, the residents are sharp and likable, and they get all the required numbers.

FYI, I received interviews from Harvard, John Hopkins, CCF, UH and some other top ranked training programs. I ranked all of them lower than MetroHealth except for CCF.

MetroHealth is a county hospital but it surely doesn't look like one.

This place is simply amazing. There is a lot of one to one contact and teaching with the attendings. In my CA-1 year I did about 250 epidurals, spinals, and CSEs (we have high risk OB). I have over 25 CABGs under my belt in the middle of my CA-2 year and I was the primary anesthesia resident in virtually all these cases. I've done many regional blocks even before I've had my regional rotation. I have grown to love this residency. Yes, you will work hard when you get here but you will be competent.

Our trauma cases are great learning cases as they teach us how to think quickly. Imagine infusing over 50 liters of fluids/blood products in a case that lasts 2 hours to save a persons life.

As for our reputation, our residents get hired all across the country. There is so much more good that can be said.

Sorry I have to go and cut this short, but there is a gun shot wound X 4 in the chest that I have to go take care of!!! God Bless America.

 

[Etomidator]

I came to anesthesia from another specialty and applied to UH and Metro along with CCF. I was fortunate enough to receive training opportunities from all three, but chose Metro for a number of reasons.

The facilities are very good. The ORs are new and the equipment is state of the art. We have a broad pharmacopia and get experience with a lot of drugs in situations that other residents in the City do not get to see.

The faculty get to know you well and take time to teach. Residents are also treated like people, not bodies that do anesthesia. The administration goes to great lengths to make it clear that one of the main goals is to train residents and as such, we get the best cases at all times. You will not see that at other places in town.

The reason I mainly chose Metro is that the clinical experience is unparalleled. No, we do not do ped hearts or transplants, but we do everything else. We see a lot of the rare intrinsic disease experienced at other institutions in town but the level of extrinsic disease is far far greater and we usually have very complex patients. There is a lot of autonomy in decision making compared to the other programs and you are challenged to arrive at your own solutions. When you include the trauma experience, you end up with the strongest clinical program in town. I have no hesitation in saying that Metro produces the strongest clinicians in Cleveland. We also did extremely well on our boards this year too.

If anyone has any preconceived notions about Metro, you should visit and see for yourself.

 

[Sammich81]

Stimulate - do you think the peds exposure will be adequate with the Akron affiliation coming to an end?

 

[Stimulate]

Stimulate - do you think the peds exposure will be adequate with the Akron affiliation coming to an end?

I have mixed feelings about the ending of the affiliation with Akron Children's Hospital (which hasn't actually been officially annouced yet for some reason).

I think overall it will be a better move the residents, however, I do think it has the potential to have a negative impact on our pediatric training.

The background of the story is that Akron Children's offers a different type of exposure (i.e. generally healthier kids with quick OR turnover times so you get a lot of cases) than what we get at CCF. In my experience the kids at CCF were sicker and undergoing bigger operations. I haven't rotated through Peds at CCF in a while but I have heard that the number of cases has gone up significantly so the Akron cases are no longer needed for our "numbers".

At Akron children's the anesthesia residents from CCF were to some extent used to improve the quality of life of their staff CRNAs. Residents took all weekend and holiday on-call shifts. They also would not allow residents to schedule vacation during the rotation for any reason (imagine the problems that arise with that). The secretary was difficult to work with as well. The akron childrens group is essentially a private practice who were getting CCF residents as free labor. We had to drive the 40-50 miles each way to get there so you ended up spending a lot of time in the car each day and putting miles on your vehicle.

The only nice thing about Akron was the different case types, relatively nice attendings, and you were always done around 3pm each day. Also you didn't have to come in for call-shifts until 2 or 3pm.

The positive thing about CCF now is that there will be 4 peds fellows (peds is in vogue again I guess), several CA-3s, and a number of CA2s. We counted probably 12 residents/fellows per month. This should allow for a nice call schedule, excellent backup for tough cases (fellow + a resident in room possibly) and more time for teaching.

After spending 12 weeks doing peds I feel comfortable with doing healthy kids age 3 or over which is pretty much what is expected of general anesthesiologists. Also as a CA-3 we do an additional month so that will be a total of 4 months of peds so I feel the exposure will be adequate. Of course a fellowship would be ideal if you are going to be performing anesthetics on congenital kids, preemies, etc.