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  Best neurosurgery/medical jokes
Posted by: The joker - 12-27-2016, 09:44 AM - Forum: The OR lounge - Replies (20)

Oldie but goodie..  Anyone have some good jokes?

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  Very late CS
Posted by: guest - 12-26-2016, 09:29 PM - Forum: USMLE - Replies (3)

Due to family emergency, I had to move my step 2 CS from December to January. I didn't think anything of it but now realize my score won't come out until March 2nd. Has anyone else in the past taken a step 2 CS that late in the year they want to match?

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  Step I
Posted by: guest - 12-26-2016, 08:26 PM - Forum: USMLE - Replies (23)

M1 here on winter break.  What can I do to optimize my studying to maximize my Step I score?  Should I use my summer off to study?  Do I need all of the resources (USMLE World, Pathoma, Sketchy, First Aid, Brosencephelon/Anki?) or are there others I need too or instead?

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  Wake Forrest
Posted by: guest - 12-26-2016, 08:12 PM - Forum: Sub-internships - No Replies

From a resident:

   I've been meaning to post on here for a while but hadn't gotten around to it. I'm a PGY-3 at Wake Forest and I just wanted to provide some info for those interested. Personally, I'm very happy here (I think that all of our residents are). I think we're underrated because we don't put out a ton of research (we focus on operating more than research).
-We operate A LOT. We run 9 rooms at least once a week. We're 50/50 cranial/spine. We do a lot of big deformity correction. We average 1,300 cases logged at the end of residency (as a 6-year program). We have a ton of autonomy in the OR.
-850 bed hospital - the largest in North Carolina. Also the #1 comprehensive cancer center in North Carolina.  We cover a huge geographic area, from Asheville in the West to Burlington in the East and Galax, VA in the North.
-Winston Salem is AWESOME. Honestly, I thought it was a negative when I was making my rank list, but this is arguably the best city in the country to do residency. (I've lived in Miami, LA, Chicago, Detroit, Cleveland, and San Fran, so I've been around a bit). We have an insanely low cost of living (I have an awesome 3BR house in a safe area half a mile from the hospital and I pay $1100/month in mortgage), great restaurants, no traffic, great weather, clean air, and everyone is super friendly.  Maybe it's not as entertaining as a big city, but this is Neurosurgery, so it's not like we'd have time to go to a lot of things anyway. We have an IMAX theater, which is something that none of you probably care about but I love. We have the Greensboro airport like 20 mins away (and RDU and CLT are about an hour away as well) so travel is really easy.
-We have the lowest stroke and craniotomy mortality in the UHC (University HealthSystem Consortium), and it's not because of lack of volume (comprehensive stroke center).
-We're all on one campus, at one hospital. No driving back and forth when on call or splitting our service in half.
-Calls aren't bad. Approx 4/month for your first 4 years. We have a dedicated critical care team that absorbs a lot of nighttime pages.
-We're a level 1 adult and peds trauma center. We see all kinds of weird accidents (falls from deer stands, ATV accidents).
-We have a great Innovation Center. They'll take your ideas and patent them. I have one patent pending right now. Also we have one of the best inventor/institution splits out there - I think it's like 55/45 or something. Some other places are like 5/95.
-There's a bunch of cool research stuff going on here that another resident can tell you about, but it's not really my forte. We do have a great Institute for Regenerative Medicine.
-We have a resident clinic where we have our own patients that we do everything from initial visit to surgery to follow-up. It's great having this kind of continuity.
-We have a great cadaver lab that we have organized sessions in once/month. We also get to do procedures on live animals occasionally (just did a pig lab a few weeks ago).
-We're getting a brand new 22 bed NeuroICU (opening in a few months). We'll have new call rooms and a new workroom in it. We actually had a ton of input in its design.
-We have an amazing faculty.
 -Dr. Branch (Chairman) is one of the pioneers of MIS spine. I believe he invented the MAST system and he holds something like 29 patents for spinal instrumentation. He's great to work with.
 -Dr. Wolfe (Program Director) just took over about a year ago. She's phenomenal. She re-engineered our entire academic program and we learn a ton in conferences. She's on the CNS Executive Committee and AANS Board of Directors. She really, really cares about our education.
-Dr. Wilson - Chair of the Washington Committee, former CNS Secretary - great skull base surgeon
 -Dr. Tatter and Dr. Laxton are both amazing tumor/functional faculty. At one point Dr. Tatter did something like 4% of all the DBS in the world (we do these as junior level cases here since they're so routine for us). They both run our Gamma Knife (which we have a dedicated rotation on) - and we're the fourth largest gamma knife center in the country.
-Dr. Powers does a ton of big spine deformity correction. Depuy actually designed new rods for his camptocormia cases (usually C2-pelvis fusion).
-Drs. Couture and Powers both did Peds fellowships at Utah and St. Louis, respectively. We do have a pediatric hospital here, so we do about 20% peds cases.
-Dr. Hart just came from Case Western and will be doing mostly spine.
-Dr. Hsu does a bunch of spine and is one of my favorite to operate with - he's a really great teacher. He trained at Hopkins. He's our director of spinal oncology.
-Anesthesia - We have one of the best neuroanesthesiology programs in the country with 5 dedicated neuroanesthesiologists and 2 or 3 fellowship spots. I think it's the largest program in the country. Our patients wake up really nicely.
-Radiology - we have a great Neuroradiology program here as well. Dr. Geer, one of the attendings, actually did a Neurosurgery residency at UMich before switching into radiology. We have 8 or 9 MRI scanners ON CAMPUS - the most of any center anywhere.
-We have amazing ancillary services - everything from transport to phlebotomy. They'll all save you time as a junior.
-Our cafeteria is pretty good, just remodeled. We're getting a Chic-fil-a, Au Bon Pan, and a Starbucks in a few months. We also have a Subway.
-We basically park 5 feet from a heated walkway in the morning. This is excellent in the winter.

Sorry this ended up being so long - there are a lot of things I really like about this place.
tl;dr - Wake is a great program. We operate a ton. We get great training from a great faculty and we're all very happy here.
If you have any questions, feel free to ask. Also, please keep them civil.

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  Mobile Access
Posted by: socrates - 12-26-2016, 08:09 PM - Forum: Uncle Harvey Back! - Replies (1)

I listed the board on the Tapatalk app directory.  It is a relatively easy way to access via mobile if you prefer an app instead of the browser.

Alternatively, if you register an account, you can change your theme/layout for optimized mobile browsing.  


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  North-Shore LIJ/Hoffstra
Posted by: guest - 12-26-2016, 07:21 PM - Forum: Sub-internships - No Replies

I rotated at NS-LIJ and at this point on the interview trail I can confidently say that it is one of the most well-rounded programs in the country. Their operative experience is very strong; PGY-3 level and beyond is purely operative (aside from the PGY-4 research year) and the interns and 2's get in the OR more frequently than I saw anywhere else. I was very impressed with the operative competency of the chiefs and was even more impressed by the operative skill level of the 3's - they were on the same level as the 5's I've seen elsewhere. At North Shore (flagship, high volume center) there are probably 3-4 first starts a day w/ at least 4 additional cases (not including emergencies or angio); this is enough to require an intern or a 2 to cover a case almost every day, and there is definitely no double-scrubbing. Attendings are great in the OR and most will let the resident do the bulk of the case (except for aneurysm clipping/bypass/avm resection). By far the strongest aspect of the program is spine. Their spine surgeons do a huge variety of cases from minimally invasive to huge whacks for deformity and residents are all well trained in spine. As for crani, there are probably 3-4 tumor cases/week and 1-2 open vascular cases/week. Skull base is a relative weakness, but the residents will start rotating at Lennox Hill in 2017 and two of the faculty members there do primarily skull base and vascular (John Boockvar and David Langer). I can't really comment on the LIJ experience which is where they get their peds, but from what the residents say, it is a much slower service w/ much fewer cases than at NS.
Research wise, they have some phenomenal resources. The Feinstein Institute has a very busy brain tumor research center w/ plenty of basic science research in neuro-oncology going on, as well as TBI labs (Raj Narayan). Residents get a full protected year during PGY-4 and can opt for a second protected research year if they want. The program is also affiliated with Cold Spring Harbor, which is a mecca of basic neuroscience and oncology research.
I think a good overall gauge of a program is the fellowship track record and it seems like the guys/girls at NS-LIJ have a pretty damn good one. Fellowships taken by residents in the last few years include Stanford (peds), MD Anderson (neuro/onc), UPMC (skull base), Vanderbuilt (spine), UT Southwest (open vascular), Buffalo (endovascular), Stanford (spine), Wash U (peds).
I will definitely be ranking this program very highly. It is going to become a big program in coming years.

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Posted by: guest - 12-26-2016, 07:18 PM - Forum: Sub-internships - Replies (13)

First off, it's a chill subI. Nobody really cares if you take call or not and there's so many residents that nobody looks after you. You have no responsibility to round or take notes (this might change this year as the people who matched this year apparently told the program director to make the SubI more legit)
You're entire job is to be helpful in the OR- you go to cases all day. The Jefferson case volume is impressive.They have 3 endovascular rooms running everyday (which students barely go to), and they have 1 hospital dedicated to neurosurgery where they do vascular and tumor. They have 2 skull base attendings, 2 tumor attendings, 2 functional attendings, 2 epilepsy, 3 vascular attendings and 5 spine attendings. Many attendings run two-three rooms at once and PA rules state that attending doesn't have to be in the room for time out so this lets the residents start many of the cases on their own. This usually amounts to 6-8 rooms running per hospital. Even with 2 spine fellows, 1 skull base fellow, 2 endovascular fellow, and usually 1 enfolded epilepsy fellow, many rooms often go uncovered. I got to do a lot in the OR as many of the residents are very nice and want you to have fun in the OR- and many of the attendings are incredibly nice (Judy, Andrews, Evans, Farrell come to mind).
When you're not in the OR, you usually stick with the intern who has the pager and you either see consults on your own or just tag along with them depending on the resident. Many of the residents were awesome- obviously like every program there's 1 or 2 less friendly but for the most part they look after each other and are a good team (the three they matched this year are all very nice as well)
As for a letter, Dr Sharan the program director is the guy to ask. He can seem extremely intimidating (he doesn't respond to emails and won't talk to you on purpose in the beginning) but this is his way of removing himself from the match process to make an unemotional decision. In reality he's one of the most supportive program directors I've met and always has the residents best interests in mind and from all accounts wrote me a very strong letter. Rosenwasser the chair is barely around but the work he does on the business side of things is very helpful for the hospital and the program which allows Jeff to be the most profitable and highest volume program in Philadelphia.
All in all, a great place to rotate.

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Posted by: guest - 12-26-2016, 06:56 PM - Forum: Sub-internships - Replies (4)

Format: 4 weeks at the main hospital, with campus call or main hospital call q5-7 with the pgy-4
Residents: overall good group of residents, enjoyed working with them
-tons of NPs
-PGY2s were actually operating all day.
-Huge case volume and great autonomy
-only saw double scrubbing when appropriate (chief leading pgy- 3 through spine, etc.)
-Strong depth of faculty and Payner and Shah are amazing. Dr Jea joined recently in peds.
-Indianapolis is actually an a great city
-Plenty of interesting cases
-Take call q5-7
-Get to do a good amount in the OR
-No scut work, just came in early to round on my post-ops and pulled the occasional drain but it wasn't required
-More for residency but you take campus call for multiple hospitals

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Posted by: guest - 12-26-2016, 06:55 PM - Forum: Sub-internships - Replies (68)

Thought I'd post about my experience at the Barrow and regarding recent rumors about the chairmanship. The overall rotation was the best I've been on so far. It's tailored to get med students in the OR as much as possible. The day begins with rounds at 6 and you're expected to present 2 patients. Then you spend the rest of the day in the ORs until cases are done. Volume was impressive. 11 dedicated OR's with an average of over 20 cases per day - the lightest day I saw was 10 cases because half of the attendings were out of town. The residents have tremendous autonomy and it shows is how good they are in the OR. Most of the 4/5's were doing complex cases comfortably that I've seen chief residents at other centers just watch their attendings do. During the cases, the residents and attendings also teach you to do a lot as a med student beyond just opening/closing like placing spinal instrumentation and helping out under the scope. Despite being so busy, the residents were extremely nice, patient, and just positive - you could tell that they were happy to be training there and it really contributes a lot to the culture. The residents and staff were also very open about the recent leadership changes - Theodore leaving for hopkins and spetzler stepping down. Its now confirmed that Lawton will be taking over after Spetzler steps down. They're also interviewing several big name spinal guys, a lot of deformity and minimally invasive names to fill in for Theodore's role. Even with these changes, I think the BNI is still going to continue being the powerhouse that it is.

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Posted by: guest - 12-26-2016, 06:54 PM - Forum: Sub-internships - Replies (2)

Overall a light subinternahip without much responsibility and low case volume, often with multiple medical students in the same OR. Call responsibility mostly involves shadowing a resident and staying up not doing much - very few opportunities to stand out.
Pros: Boston is pleasant and the location of the hospital is great, despite being expensive. Residents are nice and laid back, overall very nice to be around. Subi has teaching sessions for students although many are canceled. Good for basic science research. Cafeteria is above average.
Cons: Chair is leaving this year and position is being advertised, so uncertainty as to whom will take his place. Program director not really invested or interested. Very low clinical volume across the board, most cases at least double scrubbed. Almost no vascular. Very little spine, and almost no complex spine. Lots of attendings don't let the residents do more than open and close which leaves very little for Subi to do.

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