NYC IM with low step scores

[ColdTurkiye]

Hi SDN

Long story short, I'm not the best student or test taker.

I'm currently at a medical school in New York City (it's not one of the Ivys) and I would really like to stay here for an IM residency and I am thinking about Heme/Onc or Cards for a fellowship.

Class Rank: likely in the bottom half, if not bottom quarter
Step 1: 219

I don't think that I will be ready to write Step 2 until August or September.

I've been taking a look at the better community programs in New York City that I might have a shot at. Mainly MS Beth Israel, MS St Luke's Roosevelt, New York Methodist, Jacobi Medical Center, and Downstate as all of them seem to take a lot of IMGs and someone told me a lot of IMGs = less competitive for AMGs.

Why are St Luke's Roosevelt and Jacobi seen as undesirable programs? Their fellowship matches look pretty decent to me as a community hospital goes especially this past year.

The graduating SLR class is sending 7 to Cards, 5 to Heme/Onc, 4 to GI, 5 to Pulm/CC, 2 to CC, 5 to Endo, 2 to Rheum, and 1 to Geriatrics. Jacobi is sending 7 to Cards, 8 to Heme/Onc, 2 to Pulm/CC, 2 to Allergy, 4 to ID, 1 to Endo, 1 to Geriatrics.

I don't really see why AMGs wouldn't want to go SLR or Jacobi.

Beth Israel and Downstate don't have the most impressive fellowship matches but they still give residents a chance.

Does anyone know about NY Methodist's match list? Are there any other programs I should be considering?

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[Cardonc]

There's more questions you need to ask about the matchlist. E.g. How many residents wanted Heme/Onc or Cards that did not match or were persuaded away from applying? Did the matched residents do a chief year? Strong research background?

Are you set on staying in NYC and will not check out other cities?

 

[TripleOpIMXD]

We have similar background stats. STEP I 220 and bottom quartile here. Low ranked MD school in TX though with connections to NY. Heard most of the community/IMG programs work you to death with little training. Not sure about your list though. My #1 choice is Northshore LLJ. Have you thought about program?

 

[Mad Jack]

Hi SDN

Long story short, I'm not the best student or test taker.

I'm currently at a medical school in New York City (it's not one of the Ivys) and I would really like to stay here for an IM residency and I am thinking about Heme/Onc or Cards for a fellowship.

Class Rank: likely in the bottom half, if not bottom quarter
Step 1: 219

I don't think that I will be ready to write Step 2 until August or September.

I've been taking a look at the better community programs in New York City that I might have a shot at. Mainly MS Beth Israel, MS St Luke's Roosevelt, New York Methodist, Jacobi Medical Center, and Downstate as all of them seem to take a lot of IMGs and someone told me a lot of IMGs = less competitive for AMGs.

Why are St Luke's Roosevelt and Jacobi seen as undesirable programs? Their fellowship matches look pretty decent to me as a community hospital goes especially this past year.

The graduating SLR class is sending 7 to Cards, 5 to Heme/Onc, 4 to GI, 5 to Pulm/CC, 2 to CC, 5 to Endo, 2 to Rheum, and 1 to Geriatrics. Jacobi is sending 7 to Cards, 8 to Heme/Onc, 2 to Pulm/CC, 2 to Allergy, 4 to ID, 1 to Endo, 1 to Geriatrics.

I don't really see why AMGs wouldn't want to go SLR or Jacobi.

Beth Israel and Downstate don't have the most impressive fellowship matches but they still give residents a chance.

Does anyone know about NY Methodist's match list? Are there any other programs I should be considering?

You might be sacrificing your future for location. You could match university in less desirable areas...

 

[Psai]

You guys have a lot of trouble with the names of your "top choice" programs

 

[ColdTurkiye]

Thanks everyone. I'm taking a look at Stony Brook and North Shore. But my preference is to stay in the city. A classmate of mine mentioned Maimonides in Brooklyn was decent too. Does anybody have info on their recent fellowship matches?

I really don't understand the NY residency programs "work you to death" mentality. Everyone has to comply with ACGME duty hours. And from what I can tell most programs, including the university programs, work their residents > 70 hours a week. So if you're at a NY program you work 80 hours per week? That's less than 10 hours extra. Can someone clarify if I'm wrong about that? Do people who go to university programs feel like they have/had it easy in residency?

Also, how does going to a NYC residency "sacrifice" my future? Not trying to be confrontational, but I'm just looking for more clarification and objective data on this point. Especially for programs like Jacobi and SLR who seem to have decent matches to fellowship matches at academic programs.

The fellowship match lists for North Shore & Stony Brook are not considerably more impressive than SLR and Jacobi's except that they match better into GI.

Not only that, North Shore is matching to Cards in-house, New Brunswick, Fresno, and the Bronx. Heme/Onc they matched 2 both in-house. So if I went there I could presumably expect to spend 6 years in a somewhat undesirable place like Manhasset or somewhere less desirable with only a small chance at landing back in New York.

Stony Brook is not much better. 5 to Cards. 2 in-house. 1 to JH in Baltimore. 1 to Chicago. 1 to Gainesville. Heme/Onc was similar.

Jacobi is sending people mostly to programs in New York, Philadelpha, Chicago, and Washington, D.C. for Heme/Onc & Cards.
Jacobi's Heme/Onc match
Montefiore x 4
Fox Chase
NYU
Georgetown WHC
Rutgers RJW
of those, Rutgers is the only place I'd loathe going, and they offer a great chance to stay in NY

Jacobi's Cards match
Montefiore x 2
Rush
SLR
Northshore Chicago
Jackson Miami
I'd gladly go to any of those for fellowship

SLR's fellowhsip match is a similar enough story. Less matches for fellowship in NYC than Jacobi but matches to good cities around America (New Orleans, Philadelphia, Atlanta, Miami, Cleveland, Pittsburgh)

With the programs that will "work you to death" it seems the odds are in your favor to end up in a good location and program for fellowship. While ending up in a good location for residency too. And a pretty darn good chance to stay in NY for fellowship.

With the programs that are university and in undesirable places is seems like you spend 3 years of your prime in a boring place for residency. And then then odds are against you going to a great city for fellowship. Which makes it likely you'll spend 6 years of your prime years in unattractive places.

 

[Mad Jack]

Thanks everyone. I'm taking a look at Stony Brook and North Shore. But my preference is to stay in the city. A classmate of mine mentioned Maimonides in Brooklyn was decent too. Does anybody have info on their recent fellowship matches?

I really don't understand the NY residency programs "work you to death" mentality. Everyone has to comply with ACGME duty hours. And from what I can tell most programs, including the university programs, work their residents > 70 hours a week. So if you're at a NY program you work 80 hours per week? That's less than 10 hours extra. Can someone clarify if I'm wrong about that? Do people who go to university programs feel like they have/had it easy in residency?

Also, how does going to a NYC residency "sacrifice" my future? Not trying to be confrontational, but I'm just looking for more clarification and objective data on this point. Especially for programs like Jacobi and SLR who seem to have decent matches to fellowship matches at academic programs.

The fellowship match lists for North Shore & Stony Brook are not considerably more impressive than SLR and Jacobi's except that they match better into GI.

Not only that, North Shore is matching to Cards in-house, New Brunswick, Fresno, and the Bronx. Heme/Onc they matched 2 both in-house. So if I went there I could presumably expect to spend 6 years in a somewhat undesirable place like Manhasset or somewhere less desirable with only a small chance at landing back in New York.

Stony Brook is not much better. 5 to Cards. 2 in-house. 1 to JH in Baltimore. 1 to Chicago. 1 to Gainesville. Heme/Onc was similar.

Jacobi is sending people mostly to programs in New York, Philadelpha, Chicago, and Washington, D.C. for Heme/Onc & Cards.
Jacobi's Heme/Onc match
Montefiore x 4
Fox Chase
NYU
Georgetown WHC
Rutgers RJW
of those, Rutgers is the only place I'd loathe going, and they offer a great chance to stay in NY

Jacobi's Cards match
Montefiore x 2
Rush
SLR
Northshore Chicago
Jackson Miami
I'd gladly go to any of those for fellowship

SLR's fellowhsip match is a similar enough story. Less matches for fellowship in NYC than Jacobi but matches to good cities around America (New Orleans, Philadelphia, Atlanta, Miami, Cleveland, Pittsburgh)

With the programs that will "work you to death" it seems the odds are in your favor to end up in a good location and program for fellowship. While ending up in a good location for residency too. And a pretty darn good chance to stay in NY for fellowship.

With the programs that are university and in undesirable places is seems like you spend 3 years of your prime in a boring place for residency. And then then odds are against you going to a great city for fellowship. Which makes it likely you'll spend 6 years of your prime years in unattractive places.

Many programs taper your hours down as training progresses- you might drop to 65 or even 60 hours by third year, for instance. But there are a great number of sweatshops in NYC that work you to the limit all the way through, and that have minimal support staff to boot, so you're working harder and longer. Working 60 hours in a place with solid support where you're largely evaluating and writing notes/orders is totally different than working 80 hours in a place where you're drawing your own blood, transporting your own patients to CT, etc etc.

 

[235009]

If location is the absolute most important thing to you, and it sounds like it is, then SLR is likely your best bet. Stay away from BI because it is having significant problems. You should seriously think about programs just outside of nyc though (both in long Island and NJ). It's up to you if a half hour train ride into the city is the end of the world. Also on a more personal note as someone who is from nyc and left: there's life outside of nyc and several awesome cities in the northeast alone. I had the opportunity to return to nyc for fellowship and didn't. It's hard to make ends meet let alone enjoy life on a resident/fellow salary in nyc.


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[ColdTurkiye]

Thank you for the perspectives. This has given me a lot to think about.

I think I'll apply to the lower end NYC university programs, plus Jacobi, SLR, NY Methodist, and Maimonides. Then also apply to NY-area, NJ, and Washington DC-area university programs.

 

[nebuchadnezzarII]

What exactly are the lower-tier NYC IM programs?

 

[Anicetus]

What exactly are the lower-tier NYC IM programs?

In my book, any place that doesn’t partake in the NRMP match, like brookdale hospital. Or any of the IMG heavy places. I would say elmhurst, Maimonides, Coney Island.

The snobbier people will define low tier as any academic or affiliated program that’s like lower than 100 on doximity.com. So like Lennox hill, Jacobi, even SUNY downstate.

 

[nebuchadnezzarII]

In my book, any place that doesn’t partake in the NRMP match, like brookdale hospital. Or any of the IMG heavy places. I would say elmhurst, Maimonides, Coney Island.

The snobbier people will define low tier as any academic or affiliated program that’s like lower than 100 on doximity.com. So like Lennox hill, Jacobi, even SUNY downstate.

Oh wow, how do you apply to places that don't take part in the Match process? Do you just communicate with them directly? Thanks for enlightening me on this issue.

 

[W19]

Can someone post the link of Doximity IM ranking?

 

[Anicetus]

Oh wow, how do you apply to places that don't take part in the Match process? Do you just communicate with them directly? Thanks for enlightening me on this issue.

If you are at an MD school in the US you won’t be considered for an interview with those places unless you have a glaringly bad app with step failures, multiple clerkship failures etc. Why are you considering those programs at this point?

 

[Anicetus]

Can someone post the link of Doximity IM ranking?

Doximity Residency Navigator - Internal Medicine Programs

Just make an account to see it.

 

[W19]

If you are at an MD school in the US you won’t be considered for an interview with those places unless you have a glaringly bad app with step failures, multiple clerkship failures etc. Why are you considering those programs at this point?

Lol... I made the mistake of applying to a few heavy IMG programs the vast majority of them did not invite me for an interview.

 

[Anicetus]

Lol... I make the mistake of applying to a few heavy IMG programs the vast majority of them did not invite me for an interview.

Same here. Didn’t get interviews from them. They’ve been through enough cycles to know you wouldn’t rank them in your top 10 even so why bother giving you the interview spot unless you have a reason you aren’t going to get interviews at the better places.

 

[W19]

In my book, any place that doesn’t partake in the NRMP match, like brookdale hospital. Or any of the IMG heavy places. I would say elmhurst, Maimonides, Coney Island.

The snobbier people will define low tier as any academic or affiliated program that’s like lower than 100 on doximity.com. So like Lennox hill, Jacobi, even SUNY downstate.

SUNY downstate is ranked 80+ in Doximity... Therefore, it's mid tier, but it's a brutal program. I actually interviewed there.

 

[nebuchadnezzarII]

If you are at an MD school in the US you won’t be considered for an interview with those places unless you have a glaringly bad app with step failures, multiple clerkship failures etc. Why are you considering those programs at this point?

I'm still a M2. Haven't failed anything yet (40th percentile in class) but I'm pretty sure I'm going to do poorly on the STEP-1 (if I pass at all...) since I don't remember a single thing from the first half of the year.

My top priority is staying in NYC so I'm willing to take any program that's in the city. The average program in NYC seems pretty competitive so I'm happy getting into one of the low tier programs.

 

[IMreshopeful]

I'm still a M2. Haven't failed anything yet (40th percentile in class) but I'm pretty sure I'm going to do poorly on the STEP-1 (if I pass at all...) since I don't remember a single thing from the first half of the year.

My top priority is staying in NYC so I'm willing to take any program that's in the city. The average program in NYC seems pretty competitive so I'm happy getting into one of the low tier programs.

This is why you take dedicated time to study for step 1... you sound like you’re gettig ahead of yourself here.

 

[IMreshopeful]

If location is the absolute most important thing to you, and it sounds like it is, then SLR is likely your best bet. Stay away from BI because it is having significant problems. You should seriously think about programs just outside of nyc though (both in long Island and NJ). It's up to you if a half hour train ride into the city is the end of the world. Also on a more personal note as someone who is from nyc and left: there's life outside of nyc and several awesome cities in the northeast alone. I had the opportunity to return to nyc for fellowship and didn't. It's hard to make ends meet let alone enjoy life on a resident/fellow salary in nyc.


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This

I went to medical school in the NYC area. I love life outside of the bubble. More money, more interesting people and options for things to do, places to raise a family, etc. keep an open mind about the rest of America...

 

[nebuchadnezzarII]

This is why you take dedicated time to study for step 1... you sound like you’re gettig ahead of yourself here.

I have 7 weeks of dedicated time, but I don't know if that will be enough. I'll try my best though. Just trying to be realistic about everything. Early awareness usually helps.

 

[Redpancreas]

This is why you take dedicated time to study for step 1... you sound like you’re gettig ahead of yourself here.

Agreed I was about the same and adored 250+ on Step 1. It’s not that uncommon.

 

[Anicetus]

I have 7 weeks of dedicated time, but I don't know if that will be enough. I'll try my best though. Just trying to be realistic about everything. Early awareness usually helps.

7 weeks wasn’t enough for me to get down all the details. Some of us aren’t built that way. Step 2 is a lot better with less rote memory and more reasoning.

 

[nebuchadnezzarII]

7 weeks wasn’t enough for me to get down all the details. Some of us aren’t built that way. Step 2 is a lot better with less rote memory and more reasoning.

I feel like I'm on the same boat as you. I am just desperately hoping I can score high enough to pass. I am certain I would horribly fail any CBSE/practice STEP-1 if I took it now.

 

[IMreshopeful]

Thanks everyone. I'm taking a look at Stony Brook and North Shore. But my preference is to stay in the city. A classmate of mine mentioned Maimonides in Brooklyn was decent too. Does anybody have info on their recent fellowship matches?

I really don't understand the NY residency programs "work you to death" mentality. Everyone has to comply with ACGME duty hours. And from what I can tell most programs, including the university programs, work their residents > 70 hours a week. So if you're at a NY program you work 80 hours per week? That's less than 10 hours extra. Can someone clarify if I'm wrong about that? Do people who go to university programs feel like they have/had it easy in residency?

Also, how does going to a NYC residency "sacrifice" my future? Not trying to be confrontational, but I'm just looking for more clarification and objective data on this point. Especially for programs like Jacobi and SLR who seem to have decent matches to fellowship matches at academic programs.

The fellowship match lists for North Shore & Stony Brook are not considerably more impressive than SLR and Jacobi's except that they match better into GI.

Not only that, North Shore is matching to Cards in-house, New Brunswick, Fresno, and the Bronx. Heme/Onc they matched 2 both in-house. So if I went there I could presumably expect to spend 6 years in a somewhat undesirable place like Manhasset or somewhere less desirable with only a small chance at landing back in New York.

Stony Brook is not much better. 5 to Cards. 2 in-house. 1 to JH in Baltimore. 1 to Chicago. 1 to Gainesville. Heme/Onc was similar.

Jacobi is sending people mostly to programs in New York, Philadelpha, Chicago, and Washington, D.C. for Heme/Onc & Cards.
Jacobi's Heme/Onc match
Montefiore x 4
Fox Chase
NYU
Georgetown WHC
Rutgers RJW
of those, Rutgers is the only place I'd loathe going, and they offer a great chance to stay in NY

Jacobi's Cards match
Montefiore x 2
Rush
SLR
Northshore Chicago
Jackson Miami
I'd gladly go to any of those for fellowship

SLR's fellowhsip match is a similar enough story. Less matches for fellowship in NYC than Jacobi but matches to good cities around America (New Orleans, Philadelphia, Atlanta, Miami, Cleveland, Pittsburgh)

With the programs that will "work you to death" it seems the odds are in your favor to end up in a good location and program for fellowship. While ending up in a good location for residency too. And a pretty darn good chance to stay in NY for fellowship.

With the programs that are university and in undesirable places is seems like you spend 3 years of your prime in a boring place for residency. And then then odds are against you going to a great city for fellowship. Which makes it likely you'll spend 6 years of your prime years in unattractive places.

RWJ is under an hour from NYC. How is that a place to “loathe” going to?

From the sound of it you’re basically limiting yourself to NYC and maybe DC (which has two university programs). What makes everywhere else “boring” and “unattractive” on the East Coast? Philadelphia not bougie enough for you?

You’re going to be a resident...meaning you’ll spend most of your time at work anyway. Try not to be too snobbish about where you end up.

Something about this post just rubs me the wrong way

 

[IMreshopeful]

I have 7 weeks of dedicated time, but I don't know if that will be enough. I'll try my best though. Just trying to be realistic about everything. Early awareness usually helps.

Fair enough, but then start at least reviewing earlier. At this point it’s practically a formula to be able to increase your step 1 score

 

[NewYorkDoctors]

It could be possible the OP has a significant other, family care responsibilities, real estate, future private practice, a proprietorship in a non-mediacl related business in NYC?

 

[nebuchadnezzarII]

Fair enough, but then start at least reviewing earlier. At this point it’s practically a formula to be able to increase your step 1 score

I have 2 weeks until dedicated starts, but I also have to worry about passing class exams. I've been doing Uworld + Pathoma + FA for every class exam we've had, but haven't had the chance to go back and REVIEW previous things we learned (like GI and Neuro which we learned back in December/November). Any advice?

 

[IMreshopeful]

It could be possible the OP has a significant other, family care responsibilities, real estate, future private practice, a proprietorship in a non-mediacl related business in NYC?

Well the gist of his post suggested that it was “boring” elsewhere. That irked me

 

[FutureInternist]

Many programs taper your hours down as training progresses- you might drop to 65 or even 60 hours by third year, for instance. But there are a great number of sweatshops in NYC that work you to the limit all the way through, and that have minimal support staff to boot, so you're working harder and longer. Working 60 hours in a place with solid support where you're largely evaluating and writing notes/orders is totally different than working 80 hours in a place where you're drawing your own blood, transporting your own patients to CT, etc etc.

When I was interviewing, I was surprised by the number of programs in TX, FL etc that made a point to mention that we wouldnt draw our own blood or transport pts etc.

It wasn’t until I interviewed in NY (just one program was enough) and ran into their atudents and interns that it was clear why that was.

Any extra time in residency should be spent sleeping or studying, not doing “below your degree” work.

 

[Trisphorin]

With regard to match list in Jacobi/SLR, a lot of the impressive matches you see are from IMGs with ridiculous amount of research and should be taken with a grain of salt. Also, the affiliation with Monte and Sinai in those two programs definitely plated a role in fellowship match. In residency, things like research and connections are far more important than step scores and such.

 

[Maria02]

SUNY downstate is ranked 80+ in Doximity... Therefore, it's mid tier, but it's a brutal program. I actually interviewed there.[/

SUNY downstate is ranked 80+ in Doximity... Therefore, it's mid tier, but it's a brutal program. I actually interviewed there.

how was the hospital? Is it a good place?

 

[W19]

@Maria02

Kings County hospital is ok , but the University hospital is old and ugly. Them two are right across the street from each other. We did not get to visit the VA and Memorial Sloan Kettering (MSK). A resident candidly told me that they do a lot of scut work (e.g.., drawing blood, transporting patients sometimes)... Salary was in the low/mid 60k/year, which I think is low for Brooklyn. They provide no parking space for residents, no free meals etc...

The one thing that Downstate has going on for them is that they get really sick patients from the Caribbean and Latin America... so you get to see rare conditions that would not probably see at other places... I ranked them pretty low, and I thanked God that I did not get that low in my rank order list (ROL) because Downstate was the only place in my ROL that I had a really bad feeling about. Other people might like the program, but it was not for me...

 

[235009]

I ranked them pretty low, and I thanked God that I did not get that low in my rank order list (ROL) because Downstate was the only place in my ROL that I had a really bad feeling about. Other people might like the program, but it was not for me...

Out of the dozen northeast programs I interviewed at for residency it was the only one I did not rank. That place is a complete joke. Almost all of their med students I met told me they didn't even apply there. If you're a US MD there's absolutely no reason to consider this program.

 

[W19]

Out of the dozen northeast programs I interviewed at for residency it was the only one I did not rank. That place is a complete joke. Almost all of their med students I met told me they didn't even apply there. If you're a US MD there's absolutely no reason to consider this program.

I quickly found that out while I was there.

Welcome back MT!

 

[235009]

I quickly found that out while I was there.

Welcome back MT!

I'm not back. This forum is still a huge waste of time because you inevitably end up getting into a argument with someone who has no idea what they're talking about. I still lurk occasionally and just felt the need to comment on this spectacularly awful program.

 

[JimBone905]

On the subject of IM matching in NYC, how difficult are the Staten Island programs to match into? I think their main hospitals are SIUH and RUMC.

 

[rokshana]

I'm still a M2. Haven't failed anything yet (40th percentile in class) but I'm pretty sure I'm going to do poorly on the STEP-1 (if I pass at all...) since I don't remember a single thing from the first half of the year.

My top priority is staying in NYC so I'm willing to take any program that's in the city. The average program in NYC seems pretty competitive so I'm happy getting into one of the low tier programs.

Then the better question is why are you content at staying at the bottom of your class? If you want hem/onc or cards, you will have to step up your game...esp if you go to an img heavy place and are looking to do fellowship...those fmgs that go to these programs looking fir fellowship are hardcore...

 

[collegestud2013]

To add to this list, some info about Northwell/Lenox Hill Hospital - would avoid the IM residency program if possible. Program leadership not responsive to fixing program-wide issues, and recently very poor results on the 2019 annual ACGME program survey which shows that residents as a whole are not happy here. High percentage of DOs and IMGs (with probably <50% of the Categoricals being USMD grads) since most USMDs do not want to come here. Limited research opportunities. Poorly staffed ancillary services and thus a very heavy amount of scutwork that falls on the residents (or "education compromised by service" if speaking in ACGME wording) including:

-All stat blood draws and any blood draws not performed during scheduled phlebotomy times. This is especially a major issue on nights since the last scheduled time is 10 PM and no phlebotomy services are available until the next day at 5:30 AM lab draw. This also affects the IM residents to a greater extent than the other specialties in this hospital since the nurses will do blood draws on the surgical floors (ie ENT, Ortho, Ob/Gyn, Gen Surg, Vascular Surg) but not on the Medicine floors or stepdown units
-All blood draws for blood cultures (until recently not even done by Phlebotomy). Except for the nurses in the ER, nurses in the floors are "not allowed" to do these.
-All ABGs (not performed by RTs like at most hospitals)
-Babysitting monitor patients in critical care areas when going off the unit for tests (eg an 1 hour long MRI for an ICU patient)
-All throat swabs for RVPs and nasal swabs
-All NG tube placements
-All PPD placements (eg for patients getting new dialysis)
-Calling providers to make discharge appointments
-Faxing requests to obtain outside medical records
-Placing U/S guided IVs (when nurses unable to)
-occasionally have to do own EKGs and transport own patients if needed urgently and no other staff available to do (although this is not routinely done by residents)
-In the one of the outpatient clinics, residents have to obtain their own vital and give all of their own vaccines
-Dealing with mostly incompentent and lazy nursing staff

In practice, the most scutwork falls on the interns (so a bit better for the PGY-2s and 3s, but still a lot). And on the floors during the days, the interns in turn frequently just pass a lot of the scut work to the rotating medical students. However, on nights and in the ICU and stepdown units, there are no rotating medical students so this work falls on the interns.

In addition, on the inpatient floors and stepdown units, the residents have to cover ALL the Neuro patients in addition to the Medicine patients (since there is no Neurology residency in this hospital and minimal midlevel support for the Neuro patients, so the IM residents here essentially function as a neuro residents as well). The residents have to also cover all the private patients (which usually amounts to 1/3 to 1/2 of the census). The private attendings never teach and just give a list of scutwork for residents to do, are often difficult to reach when emergencies occur, and their management guidelines are often extremely dated or simply incorrect.

The prelim year here is especially terrible since instead of continuity clinic, the prelim interns have more inpatient floor or unit blocks (where most of the scutwork occurs) and thus are being taken advantage of to do scutwork. This is in contrast with the prelim or TY year at other programs in the country, where the interns getting more elective time instead of continuity clinic.

 

[duanewade]

To add to this list, some info about Northwell/Lenox Hill Hospital - would avoid the IM residency program if possible. Program leadership not responsive to fixing program-wide issues, and recently very poor results on the 2019 annual ACGME program survey which shows that residents as a whole are not happy here. High percentage of DOs and IMGs (with probably <50% of the Categoricals being USMD grads) since most USMDs do not want to come here. Limited research opportunities. Poorly staffed ancillary services and thus a very heavy amount of scutwork that falls on the residents (or "education compromised by service" if speaking in ACGME wording) including:

-All stat blood draws and any blood draws not performed during scheduled phlebotomy times. This is especially a major issue on nights since the last scheduled time is 10 PM and no phlebotomy services are available until the next day at 5:30 AM lab draw. This also affects the IM residents to a greater extent than the other specialties in this hospital since the nurses will do blood draws on the surgical floors (ie ENT, Ortho, Ob/Gyn, Gen Surg, Vascular Surg) but not on the Medicine floors or stepdown units
-All blood draws for blood cultures (until recently not even done by Phlebotomy). Except for the nurses in the ER, nurses in the floors are "not allowed" to do these.
-All ABGs (not performed by RTs like at most hospitals)
-Babysitting monitor patients in critical care areas when going off the unit for tests (eg an 1 hour long MRI for an ICU patient)
-All throat swabs for RVPs and nasal swabs
-All NG tube placements
-All PPD placements (eg for patients getting new dialysis)
-Calling providers to make discharge appointments
-Faxing requests to obtain outside medical records
-Placing U/S guided IVs (when nurses unable to)
-occasionally have to do own EKGs and transport own patients if needed urgently and no other staff available to do (although this is not routinely done by residents)
-In the one of the outpatient clinics, residents have to obtain their own vital and give all of their own vaccines
-Dealing with mostly incompentent and lazy nursing staff

In practice, the most scutwork falls on the interns (so a bit better for the PGY-2s and 3s, but still a lot). And on the floors during the days, the interns in turn frequently just pass a lot of the scut work to the rotating medical students. However, on nights and in the ICU and stepdown units, there are no rotating medical students so this work falls on the interns.

In addition, on the inpatient floors and stepdown units, the residents have to cover ALL the Neuro patients in addition to the Medicine patients (since there is no Neurology residency in this hospital and minimal midlevel support for the Neuro patients, so the IM residents here essentially function as a neuro residents as well). The residents have to also cover all the private patients (which usually amounts to 1/3 to 1/2 of the census). The private attendings never teach and just give a list of scutwork for residents to do, are often difficult to reach when emergencies occur, and their management guidelines are often extremely dated or simply incorrect.

The prelim year here is especially terrible since instead of continuity clinic, the prelim interns have more inpatient floor or unit blocks (where most of the scutwork occurs) and thus are being taken advantage of to do scutwork. This is in contrast with the prelim or TY year at other programs in the country, where the interns getting more elective time instead of continuity clinic.

Saw this posted in Lenox Hill Hospital Program | Scutwork by Student Doctor Network as well,

are u the same poster?