Did a sub-I a few years back pre-Lawton departure. Things may have changed.
Set-up: 4 weeks. 2 weeks at Parnassus campus. 1 week at SFGH. 1 week at VA or Benioff
Hours: Depends on rotation. Parnassus 3-4 AM to 8-9 PM. SFGH always on. VA/Benioff varies but hours are usually better, depends on caseload
Expectation: Parnassus -> You will be be placed into spine service, vascular, or tumors/general?, you present to senior resident. VA->No patient presentations, no pre-rounding, see patients together depending on resident. SFGH->You will see a # of patients and present to senior/chief/attending.
Positives:
-Parnassus - You'll hear a lot of opinions but the caseload at Parnassus was pretty substantial. Always an OR going until late. A fellow would always be scrubbed into Lawton cases and proceed with the exposure alone. Lawton would come in just to clip the aneurysm. Berger rarely operates and not the best idea to go to his room. He will ask if you changed into new scrubs before going into his OR. Aghi is relatively laid back and will make small talk, gives residents a good amount of autonomy. Didn't go into Mumammeni's room often, he blew up the first time I was in his room and chewed out his fellow and referred to me in 3rd person throughout the case. Ames is awesome but usually operates alongside an Ortho attending. Most of the Ortho residents at UCSF were not interested in spine which led to the nsgy chief having a good operative experience. Chang was awesome, would do 2-3 cases and would give the chief a good amount of autonomy; always had his research staff involved in his cases. Kunwar was very nice and interactive, did his own approaches to TSR's.
-VA - Usually only one senior resident there. The faculty there is amazing. Gentleman's environment. Senior resident usually did most of the cases with minimal attending intervention. Faculty there would usually try to get to know you at a more personal level and they try selling the program to you. The senior resident would go to the OR while midlevels would manage the post-operative patients. Best part of the UCSF experience.
-SFGH - This experience has changed. Apparently sub-I's years later complained that it was an unjust experience. The hours are more lax and the experience is no longer 1 week straight. You practically lived in the hospital and they would tell you to bring snacks/food/tooth brush/etc.. In the mornings you had to start jotting down vitals and other pertinent stuff at 2-3AM since the EMR was horrible. The intern came in around 5AM and you gave him print-outs and you would pre-round. You would present during AM rounds as a group. After the OR you would help the general surgery intern on the floor and see consults. If an operative case came in you would join the senior resident and then afterwards go help out the gen surg intern. If you had a good intern they would let you go sleep for an hour. People have passed out during this "hell week" and some were even sent home. Wasn't for the feint of heart. Hardest rotation that I've had and I think will ever have even as a current resident.
Negatives: The resident on call seems overworked at Parnassus. Lots of scut work. At other programs residents that were on call would have some time to at least catch a quick nap, not the case when I was here. Everyone seemed miserable, more than other places. San Francisco is expensive and gloomy. Resident camaraderie outside the hospital is pretty minimal. During my time there, I had a jackass resident running the vascular service who would make us come in at 2AM to write notes which he would critique/copy/and sign because he wanted to sleep in.
Conclusion - Didn't match here, ranked it lower than I initially anticipated. Nonetheless, I think UCSF residents are extremely well trained. A lot of the residents were very successful during medical school. Residents had a good amount of autonomy and I would almost equate the skill level of a PGY-4/5 here to a PGY-7 at other programs. Residents were also very successful in terms of publishing and obtaining academic careers. You can tell from their alumni list; some had the option of skipping a fellowship and obtaining attending jobs without it. I'm not sure if things have changed, but when I interviewed people were impressed that I did a sub-I at UCSF. It was a main talking point and it makes it seem like you could survive tough environments.
Overall this was quite the experience in terms of a sub-I. Let's you put things into perspective. Prior to doing a sub-I here I would seriously look into your CV/medical school/etc. and see if you are competitive. The meeting with Berger will last 2 minutes and he will simply look at your CV to determine if you would be a good fit. It's very hard to match here/almost impossible without doing a sub-I. The senior residents have a big say in what applicants they end up taking. Overall it was quite the experience. Good luck to those of you who do it.
P.S. Berger writes a ton of letters. He determines what to write based on your CV and sometimes senior resident feedback. A program will know whether or not they liked you based off one sentence. If you have a bad CV he'll just write "will make a good resident at a neurosurgery program". Keep in mind that your LOR will be compared to others on the trail. It can actually hurt you to have a mediocre letter.
Set-up: 4 weeks. 2 weeks at Parnassus campus. 1 week at SFGH. 1 week at VA or Benioff
Hours: Depends on rotation. Parnassus 3-4 AM to 8-9 PM. SFGH always on. VA/Benioff varies but hours are usually better, depends on caseload
Expectation: Parnassus -> You will be be placed into spine service, vascular, or tumors/general?, you present to senior resident. VA->No patient presentations, no pre-rounding, see patients together depending on resident. SFGH->You will see a # of patients and present to senior/chief/attending.
Positives:
-Parnassus - You'll hear a lot of opinions but the caseload at Parnassus was pretty substantial. Always an OR going until late. A fellow would always be scrubbed into Lawton cases and proceed with the exposure alone. Lawton would come in just to clip the aneurysm. Berger rarely operates and not the best idea to go to his room. He will ask if you changed into new scrubs before going into his OR. Aghi is relatively laid back and will make small talk, gives residents a good amount of autonomy. Didn't go into Mumammeni's room often, he blew up the first time I was in his room and chewed out his fellow and referred to me in 3rd person throughout the case. Ames is awesome but usually operates alongside an Ortho attending. Most of the Ortho residents at UCSF were not interested in spine which led to the nsgy chief having a good operative experience. Chang was awesome, would do 2-3 cases and would give the chief a good amount of autonomy; always had his research staff involved in his cases. Kunwar was very nice and interactive, did his own approaches to TSR's.
-VA - Usually only one senior resident there. The faculty there is amazing. Gentleman's environment. Senior resident usually did most of the cases with minimal attending intervention. Faculty there would usually try to get to know you at a more personal level and they try selling the program to you. The senior resident would go to the OR while midlevels would manage the post-operative patients. Best part of the UCSF experience.
-SFGH - This experience has changed. Apparently sub-I's years later complained that it was an unjust experience. The hours are more lax and the experience is no longer 1 week straight. You practically lived in the hospital and they would tell you to bring snacks/food/tooth brush/etc.. In the mornings you had to start jotting down vitals and other pertinent stuff at 2-3AM since the EMR was horrible. The intern came in around 5AM and you gave him print-outs and you would pre-round. You would present during AM rounds as a group. After the OR you would help the general surgery intern on the floor and see consults. If an operative case came in you would join the senior resident and then afterwards go help out the gen surg intern. If you had a good intern they would let you go sleep for an hour. People have passed out during this "hell week" and some were even sent home. Wasn't for the feint of heart. Hardest rotation that I've had and I think will ever have even as a current resident.
Negatives: The resident on call seems overworked at Parnassus. Lots of scut work. At other programs residents that were on call would have some time to at least catch a quick nap, not the case when I was here. Everyone seemed miserable, more than other places. San Francisco is expensive and gloomy. Resident camaraderie outside the hospital is pretty minimal. During my time there, I had a jackass resident running the vascular service who would make us come in at 2AM to write notes which he would critique/copy/and sign because he wanted to sleep in.
Conclusion - Didn't match here, ranked it lower than I initially anticipated. Nonetheless, I think UCSF residents are extremely well trained. A lot of the residents were very successful during medical school. Residents had a good amount of autonomy and I would almost equate the skill level of a PGY-4/5 here to a PGY-7 at other programs. Residents were also very successful in terms of publishing and obtaining academic careers. You can tell from their alumni list; some had the option of skipping a fellowship and obtaining attending jobs without it. I'm not sure if things have changed, but when I interviewed people were impressed that I did a sub-I at UCSF. It was a main talking point and it makes it seem like you could survive tough environments.
Overall this was quite the experience in terms of a sub-I. Let's you put things into perspective. Prior to doing a sub-I here I would seriously look into your CV/medical school/etc. and see if you are competitive. The meeting with Berger will last 2 minutes and he will simply look at your CV to determine if you would be a good fit. It's very hard to match here/almost impossible without doing a sub-I. The senior residents have a big say in what applicants they end up taking. Overall it was quite the experience. Good luck to those of you who do it.
P.S. Berger writes a ton of letters. He determines what to write based on your CV and sometimes senior resident feedback. A program will know whether or not they liked you based off one sentence. If you have a bad CV he'll just write "will make a good resident at a neurosurgery program". Keep in mind that your LOR will be compared to others on the trail. It can actually hurt you to have a mediocre letter.
