Musc

[usmleed]

hi guys, does anybody have any info on MUSC gas prog? cant find much info on scutwork.
any thoughts?

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[Pir8DeacDoc]

maybe if you start a new thread a few hours from now someone might reply. Seriously, one thread on a topic a day is enough.

 

[VolatileAgent]

/

 

[adastra]

I am a medical student who did an away rotation at MUSC recently. I had a lot of high hopes for this program because I had heard it was in Charleston but after rotating there, I don't think it is the place for me. First of all, the residents told me that they recently lost their Chairman and their residency program director left. No one could tell me exactly why the chairman was asked to step down and it sounded like the director went into private practice because he wasn't happy there. So now they have an interum chair and director and it didn't seem like alot of progress had been made as to finding a chair. I guess they are also up for residency review by some committee that accredidates residencies and many of the residents seemed to be a little worried about whether or not the program would be put on probation. I am not sure exactly how you get put on probabation but more than 3 residents had told me they were a little worried. All of this made me a little nervous about the future of this program. Second, a majority of the residents seemed unhappy with the new changes that had been made with the departure of the chairman and residency director. The residents are now required to do a research project to complete their residency. Some people said it was a case presentation and others said it was a 15-20 page paper. Some people might be into research but I am not (especially required). Third, the lack of teaching in the OR. I was really surprised by the way attendings were hardly around during most cases to teach. I don't know if it was just the attendings I worked with but the attendings would come in to start cases and after the tube was taped they left and you never saw them. This appeared to happen at every level (CA1-CA3). I asked alot of the residents about this and they all seemed to agree that very little teaching goes on in the OR. Fourth, their didactic program didn't seem that strong. The first year's lecture series is once a week in the afternoon and many times residents would not get relieved by CRNA's to goto their lecture or they would be late. This seemed to happen on a weekly basis. They had a weekly lecture series in the am which seemed pretty good. It did surprise me that the CRNA and CRNA students attended this once a week morning lecture too. I think the second and third years had once a week lecture also. Fifth, the CRNA's at MUSC seem to have a lot of power over the residents. Residents told me that CRNA's would tell residents what rooms to go into if a case was cancelled or if they were on call. A couple of the residents also told me that a CRNA made out the residents daily schedule, which I thought was crazy. The CRNA's also provide the residents with break and lunches. Many residents complained about the fact that sometimes they would not get breaks or they would get a late lunch because the CRNA's would all relieve themselves before residents. And for some reason the attendings never gave breaks or lunches to residents. I thought that was kind of weird.

As for a typical day, I think most the residents would get there at 5:45-6 in the am. The residents did seem to get out early. Most left the hospital around 4:30 pm after they did their preops. But there was alot of concern that in the future residents would have to start staying later. Most took call 4-5 times per month. I never took call but most of the residents said that call was usually pretty bad since the surgeons were allowed to do alot of elective cases at night. I don't know the specifics about that. I think Charleston is a cool city but it seems to be very expensive. It is very difficult to find a home for under $200,000 that is within 30 minutes of MUSC. If you are single it seems like you would probably have to live in an apartment for another 4 years of your life. Overall, I got the impression that this program was on shakey ground. Maybe if they find the right Chairman things would get better but I am not willing to wait that long and take the chance. In my opinion, there are alot of good residency programs out there and this one didn't seem to be one of them.

 

[no oxygen]

Great review, adastra. Now I definitely do not care that they haven't knocked on my door yet.

 

[Arch Guillotti]

I would agree with most of what you have said about MUSC. Unfortunately their anesthesia program isn't all that strong. However, they do fill every year, presumably based on location. I think that you would come out of there clinically competent but as you state, their didactics are weak. Don't know about their board pass rates.

I wouldn't make too much of the CRNA business. It seems to me that the programs that have them all have certain issues with the nurses that just don't seem to go away and the residents LOVE to bitch about them. So far in my CA-1 year I have found my intraop teaching to be hit or miss. Usually it is miss, even when I specifically bring up topics to discuss. Some days the attendings leave the room before the tube is taped (usually in the morning when we are starting multiple cases). And no attending has ever broken me except on call in the middle of the night during long cases.

Although housing is relatively expensive, decent houses can be had under 200K if you look in the right places. Oh and the reserach or scholarly project isn't uncommon - I am required to do one as well.

 

[adastra]

I would agree with most of what you have said about MUSC. Unfortunately their anesthesia program isn't all that strong. However, they do fill every year, presumably based on location. I think that you would come out of there clinically competent but as you state, their didactics are weak. Don't know about their board pass rates.

I wouldn't make too much of the CRNA business. It seems to me that the programs that have them all have certain issues with the nurses that just don't seem to go away and the residents LOVE to bitch about them. So far in my CA-1 year I have found my intraop teaching to be hit or miss. Usually it is miss, even when I specifically bring up topics to discuss. Some days the attendings leave the room before the tube is taped (usually in the morning when we are starting multiple cases). And no attending has ever broken me except on call in the middle of the night during long cases.

Although housing is relatively expensive, decent houses can be had under 200K if you look in the right places. Oh and the reserach or scholarly project isn't uncommon - I am required to do one as well.

Arch, I agree with alot of what you are saying but I just got the overall feeling that alot of the residents were unhappy (at all levels). And that stands out. You have to wonder about a program that loses its chairman and residency director in one months time and no one seems to know why. I think the residents should be told why they lose two key figures. I am glad that I rotated there because it taught me alot of things to look for and what questions to ask of a program. But knowing what I know, I just think that there are alot better programs out there. I know that their program does fill every year because they only take 7 residents and because of the location; However, I don't want to be in a place where I am unhappy and broke living in an apartment for four long years (i.e. medical school). And I actually did look for property while I was there and there really is hardly anything available for less than $200,000. The average cost of a home in Charleston is $223,000 which is alot when you only make $37,000. These home prices seemed like a lot to me, but I am not from the northeast. I guess it is all about where you feel the most comfortable. I hope this thread helps. Maybe some residents from MUSC will respond.

 

[nineeight]

I agree with most of the other away rotator's post. I would just like to add....I asked about board pass rates; last year was 100%, and is usually pretty high,90's%. The residents definitely finish at a decent time every day so I guess they have time to study. It is not a place that will spoon feed you. Other than being unhappy about the new research requirements I did not get the feeling the residents were unhappy. Housing can be found under 200,000. Lots of residents own homes. I also wonder what happened with the chair. Maybe some musc residents can comment. I thought the old pd was assuming the current chairs role so really they did not lose a chair and a pd.

 

[Liver_7]

To address some of the points discussed.

The resident / CRNA debate will always continue, and residents will always complain (so will the CRNAs).

All decisions about placement MUST go through an attending. Either the doc of the day, or the call attending (only doc there). The information may be relayed by a CRNA, but all decisions are made by the attending anesthesiologist.

Weak didactics may or may not be true. Even with the mediocre diadactics, most residents still sleep during the presentation or think about other things. That being said, would you want that 3-5 times a week? Waste of everyone's time, IMHO.

Weak didactics may be the impression, but with a 100% board pass rate . . . You would be hard pressed to criticize.

House prices are ridiculous, but many residents that bought houses, and are leaving are making from $50,000 to $110,000 in real estate profit. The market is not slowing in Charleston.

Residency director left the job because of personal reasons. It was fallout from a bad divorce, leave it at that.

Chairman stepped down because he found a position in informatics he could not turn down. MUSC has a weak computer infrastructure, but is rapidly improving. Dr. Waller is spearheading that endeavor. He wanted to be on the beginning of such a large undertaking. In fact, rumors are that MUSC will get automated charting in 2006.

It was poor timing that both vacancies occurred within a month of another.

The interim chairman is Dr. Dierdorf, a core author of one of the major texts in anesthesia (Coexisting Disease if you did not know). MUSC has several boards certified oral examiners, and their skills are available for the asking.

OR teaching is over rated. A couple of quick points is key, the OR teaching is most important with techniques and salient points. Salient questions should be asked by residents. Many attendings do teach, just that some don't and that is an unfortunate truth at any program.

Some residents are unhappy with the restructuring. Any change will lead to unhappy people. Understand that about human nature.

About accreditation, I have little to comment. Expectations are high for a universal pass, probation is very unlikely.

Another point of human nature. When a group of people get together misinformation travels a whole lot faster than the truth. Unhappy (not in the clinical term) people are more vocal with their opinions and concerns, the satisfied one do their job.

If it helps,

Liver

 

[Cali5921]

To address some of the points discussed.

The resident / CRNA debate will always continue, and residents will always complain (so will the CRNAs).

All decisions about placement MUST go through an attending. Either the doc of the day, or the call attending (only doc there). The information may be relayed by a CRNA, but all decisions are made by the attending anesthesiologist.

Weak didactics may or may not be true. Even with the mediocre diadactics, most residents still sleep during the presentation or think about other things. That being said, would you want that 3-5 times a week? Waste of everyone's time, IMHO.

Weak didactics may be the impression, but with a 100% board pass rate . . . You would be hard pressed to criticize.

House prices are ridiculous, but many residents that bought houses, and are leaving are making from $50,000 to $110,000 in real estate profit. The market is not slowing in Charleston.

Residency director left the job because of personal reasons. It was fallout from a bad divorce, leave it at that.

Chairman stepped down because he found a position in informatics he could not turn down. MUSC has a weak computer infrastructure, but is rapidly improving. Dr. Waller is spearheading that endeavor. He wanted to be on the beginning of such a large undertaking. In fact, rumors are that MUSC will get automated charting in 2006.

It was poor timing that both vacancies occurred within a month of another.

The interim chairman is Dr. Dierdorf, a core author of one of the major texts in anesthesia (Coexisting Disease if you did not know). MUSC has several boards certified oral examiners, and their skills are available for the asking.

OR teaching is over rated. A couple of quick points is key, the OR teaching is most important with techniques and salient points. Salient questions should be asked by residents. Many attendings do teach, just that some don't and that is an unfortunate truth at any program.

Some residents are unhappy with the restructuring. Any change will lead to unhappy people. Understand that about human nature.

About accreditation, I have little to comment. Expectations are high for a universal pass, probation is very unlikely.

Another point of human nature. When a group of people get together misinformation travels a whole lot faster than the truth. Unhappy (not in the clinical term) people are more vocal with their opinions and concerns, the satisfied one do their job.

If it helps,

Liver

If you don't mind me asking, are you a med student, resident, or attending?

 

[tachyphylaxis]

To address some of the points discussed.
OR teaching is over rated. A couple of quick points is key, the OR teaching is most important with techniques and salient points. Salient questions should be asked by residents.

Since when did OR teaching become over rated? Isn't that why we do a residency so that we can learn from others who have more experience? I agree that residents should ask questions but I think it is a cop out to say that teaching is overrated and it is up to residents to ask all of the questions. In my experience as a senior resident, attendings who pride themselves on teaching (in any specialty) tend to foster inquisitive residents who have good critical thinking skills, whereas lazy attendings foster apathetic residents.

 

[belle007]

I am a CA-0 at a different program, but I went to MUSC for medical school and know the department well. I think Liver's post was the most accurate that I've read.

MUSC residents were of course nervous with the shake-up of the department. However, the interim chair Dierdorf is extremely well known, and the new PD is extremely resident-oriented. She is a great person and really into teaching and the residency. There is not a question of whether they will remain accredited or will be put on probation.

MUSC anesthesia residents are very happy. They work hard, have a good varied caseload and also have time to read. As with any department, there will be attendings who teach more or teach less. I think the attendings for the most part strike up a good balance between allowing resident autonomy in the OR with teaching in the OR. Plus with 100% pass rate, they can't being doing a lot wrong. After doing aways and OR visits I came back impressed with how good MUSC residents were in comparison. They knew their stuff and were not sloppy.

As for Charleston, it is an amazing and beautiful city...it can only be considered a pro of the program.

I interviewed at mostly top tier programs and still ranked MUSC highly--because I was I was impressed with the program, the attendings, and how happy the residents are. Anyways, that was just my impression after two years of getting to know the department--hope it was helpful.

 

[foxtrot]

I am a CA-0 at a different program, but I went to MUSC for medical school and know the department well. I think Liver's post was the most accurate that I've read.

MUSC residents were of course nervous with the shake-up of the department. However, the interim chair Dierdorf is extremely well known, and the new PD is extremely resident-oriented. She is a great person and really into teaching and the residency. There is not a question of whether they will remain accredited or will be put on probation.

MUSC anesthesia residents are very happy. They work hard, have a good varied caseload and also have time to read. As with any department, there will be attendings who teach more or teach less. I think the attendings for the most part strike up a good balance between allowing resident autonomy in the OR with teaching in the OR. Plus with 100% pass rate, they can't being doing a lot wrong. After doing aways and OR visits I came back impressed with how good MUSC residents were in comparison. They knew their stuff and were not sloppy.

As for Charleston, it is an amazing and beautiful city...it can only be considered a pro of the program.

I interviewed at mostly top tier programs and still ranked MUSC highly--because I was I was impressed with the program, the attendings, and how happy the residents are. Anyways, that was just my impression after two years of getting to know the department--hope it was helpful.

Just wondering why you decided not to match at MUSC?

 

[belle007]

I thought it would be best to train elsewhere so as to broaden my experience, especially if I want to come back to Charleston to be an attending.

 

[Smokenchoke]

I would like to make a few comments...
1. Teaching in the OR. It's a double edged sword. Having one hand on the neo and the other hand frantically loading the pressure infusor with an attending blythely discussing the nuances of this or that in your ear may change your opinion. Some would think our teaching in the OR is deficient. I think it's enough. If we do have a question, the attending is often available. What you learn from this residency is proportional to your own effort, as with any other residency. I think teaching in the OR is not always feasible and you have to supplement it with teaching outside the OR, which brings me to my next point...

2. Didactics. Trust me, one or two lectures a week is enough. We have one class-specific lecture on either monday or wednesday. The CA I's cover Morgan and Mikhail, while the CA 2-3's cover Dierdorf's Coexisting disease. We have M&M/grand rounds on tuesday am. Tack on an additional TEE lecture by a CT specialized anesthesiologist every other week, and the occasional 4-hour Sim-Man session, airway workshops with the rotating students, and additional practice management lectures (Given by accredited financial advisers and lawyers--excellent class)...good god--we're drinking from a firehose here.

3. The new 'Academic Project'. Ah yes, the source of much grumbling from residents in this program, including myself. We were told at the beginning of the year we would be doing this. We objected, of course, but I can tell you, few residents on this planet will know more about that topic I picked than I will, and I will finally have some literature to stand on when I make a statement other than 'That's what my attending said.' In the end, I will definitely be a stonger physician in part because of this project.

4. CRNA's. There's bad ones, there's good ones. It's like that everywhere where there are CRNA's. At first, most of the CRNA's have been in the business longer than you have, so of course you're going to be all defensive and yes they know more than you. The comments regarding the CRNA's from a previous post must stem from from a student who shadowed CA1 or CA2's frequently. As you mature in residency, and especially as a CA3, you know your stuff and they definitely show you more respect. Regardless how it seems, you're actually all members of a team. All decisions are made by the doctor of the day/call attending as previously posted. If I don't agree, I make it known. And something is usually changed. No the CRNA's don't make the final assignments. The Attending does. The CRNA is often times the messenger, so of course we want to shoot them as the old saying goes. I have more to add, but am out of time. I will be happy to respond to any other thoughts posted on this forum.

 

[LostTommyGuns]

Anyone have any updates on MUSC and their Anesthesia program? It's been a year or so since their big players were replaced right?

 

[souter]

Anyone have any updates on MUSC and their Anesthesia program? It's been a year or so since their big players were replaced right?

The interim chairman is Dr. Dierdorf, a core author of one of the major texts in anesthesia (Coexisting Disease if you did not know).

Dr. Dierdorf is great to work with.

 

[ttrack]

Actually Dr. Scott Reeves became Chairman of the Department in January 2006. Overall the department seems to be doing great. They just received three additional resident slots from the ACGME and received 4 years approval from their last site review. From what I have been told the Program Director is great and is extremely liked by the residents.

 

[Ventil8]

I also did an away rotation at MUSC. The residents I worked with all had serious questions about the direction of the program and clearly stated that they wouldn't rank it #1 (which they had to do to match) if they were doing it over. I was surprised by the consistency of that answer.


That being said Charleston is an awesome place to live!

The program director is great (hebbar), but there were rumors that she might be stepping down/leaving. Reeves is received rather poorly.