12-26-2016, 06:42 PM
Disclaimer: Seems to be chief-dependent and may change with new incoming chiefs.
Structure: 1 week and Children's, 1 week at Denver Health (Level 1 Trauma), 2 weeks at University. You'll be busiest at University. The had a lot of rotators, and they split us up into groups of 1-2 per location.
Children's: Call q2 with one resident and two fellows (this year). A ton of students from other specialties rotate here, and there are only a few call rooms available, so secure one early in the day when you're expecting to stay the night. Operative experience was great with many very complex procedures, with them allowing a great degree of participation. You'll of course do much of the suturing, though something I personally was unprepared for was the lack of clipping hair. Show up at 5-5:30 and prepare a list, gather labs, etc. and preround on your post-op patients. They have 4 surgeons that work there, and the chair is a very colorful character. You can best impress him by following his suture instructions to keep the needle driver open (no palming) and by following generally efficient practices (push, push, pull with the needle already set up for another bite, etc.). The other guys didn't seem to care about that so much. Plenty of opportunities to participate more if you show you know what you're doing. No clinic time really here, and it'd be good to read up on the conferences you'll attend during the week. You see consults and are strongly encouraged to call the attending after working with the resident to report, so get your presentations down.
Denver Health: Call q2 with the night float intern. The chief and another resident (could be research or VA) will take home call, and you'll directly report to him/her after going over your presentation with the intern. Paper charts are used here, so you'll be able to contribute a bit more work, though it will take some digging when you preround in the morning. Operative experience is pretty normal here, where you work with the trauma cases, doing opening and closing.
University Hospital: Call q2-3 with the on-call resident. Chiefs were taking in-facility call here, which was unusual, and they said they want to get rid of that on the interview...but we'll see. You rarely get to sleep here (main competition being Swedish for a multi-state catchment area), which sounds bad initially if you hear about services where you only shadow, but it's truly fantastic experience because of the degree to which you actually get to participate. If you feel like you're only shadowing, something's wrong. You can actively participate in many of the regular ICU procedures, which are plentiful because of the massive NS-ICU. The philosophy here was that you're learning to be a full-fledged physician, and they regularly take over care from other services when they feel things would be better optimized with them as the primary. You, similarly, will be expected to be able to know what to do in a critical care environment for basic problems, and you are expected to pick up the number of patients you can handle and present during morning table rounds with independently-thought-out plans. There is a boatload of attendings here, so you see a very wide variety of approaches (with a similarly varying degree of participation in the OR). This rotation is the money rotation, where you get to know Lilihei (pronounced lilly-high...something I was thankfully corrected on before meeting him) and Breeze. You might not see the PD, Brega, much because she works out of the VA pretty often. You also get some quality time in the endovascular suite, if that's something you enjoy. Finally, at the beginning of your second week, you'll do a presentation here for the residents and attendings without any real "gotcha" questions.
Residents: Generally pretty friendly bunch of folks that will gladly allow you to show your skills with consults, in the OR, and in the ICU. You'll get written off if you don't actively participate, though, of course. Most are married with many having kids. They actively teach you and ensure you're picking up good things to know wherever you end up in residency.
Misc: Cellphone reception was a huge issue for me, mainly in Children's where your call room is separated by multiple floors from the resident call room. Find a spot where you can set it to avoid missing anything. Try to make sure you're around someone with a pager in the other hospitals. I didn't get any time to ski, hike, mountain bike, or anything, but if you wanted to make this your last rotation so you can spend some vacation time in the mountains, that might be something fun to end your sub-I season!
Structure: 1 week and Children's, 1 week at Denver Health (Level 1 Trauma), 2 weeks at University. You'll be busiest at University. The had a lot of rotators, and they split us up into groups of 1-2 per location.
Children's: Call q2 with one resident and two fellows (this year). A ton of students from other specialties rotate here, and there are only a few call rooms available, so secure one early in the day when you're expecting to stay the night. Operative experience was great with many very complex procedures, with them allowing a great degree of participation. You'll of course do much of the suturing, though something I personally was unprepared for was the lack of clipping hair. Show up at 5-5:30 and prepare a list, gather labs, etc. and preround on your post-op patients. They have 4 surgeons that work there, and the chair is a very colorful character. You can best impress him by following his suture instructions to keep the needle driver open (no palming) and by following generally efficient practices (push, push, pull with the needle already set up for another bite, etc.). The other guys didn't seem to care about that so much. Plenty of opportunities to participate more if you show you know what you're doing. No clinic time really here, and it'd be good to read up on the conferences you'll attend during the week. You see consults and are strongly encouraged to call the attending after working with the resident to report, so get your presentations down.
Denver Health: Call q2 with the night float intern. The chief and another resident (could be research or VA) will take home call, and you'll directly report to him/her after going over your presentation with the intern. Paper charts are used here, so you'll be able to contribute a bit more work, though it will take some digging when you preround in the morning. Operative experience is pretty normal here, where you work with the trauma cases, doing opening and closing.
University Hospital: Call q2-3 with the on-call resident. Chiefs were taking in-facility call here, which was unusual, and they said they want to get rid of that on the interview...but we'll see. You rarely get to sleep here (main competition being Swedish for a multi-state catchment area), which sounds bad initially if you hear about services where you only shadow, but it's truly fantastic experience because of the degree to which you actually get to participate. If you feel like you're only shadowing, something's wrong. You can actively participate in many of the regular ICU procedures, which are plentiful because of the massive NS-ICU. The philosophy here was that you're learning to be a full-fledged physician, and they regularly take over care from other services when they feel things would be better optimized with them as the primary. You, similarly, will be expected to be able to know what to do in a critical care environment for basic problems, and you are expected to pick up the number of patients you can handle and present during morning table rounds with independently-thought-out plans. There is a boatload of attendings here, so you see a very wide variety of approaches (with a similarly varying degree of participation in the OR). This rotation is the money rotation, where you get to know Lilihei (pronounced lilly-high...something I was thankfully corrected on before meeting him) and Breeze. You might not see the PD, Brega, much because she works out of the VA pretty often. You also get some quality time in the endovascular suite, if that's something you enjoy. Finally, at the beginning of your second week, you'll do a presentation here for the residents and attendings without any real "gotcha" questions.
Residents: Generally pretty friendly bunch of folks that will gladly allow you to show your skills with consults, in the OR, and in the ICU. You'll get written off if you don't actively participate, though, of course. Most are married with many having kids. They actively teach you and ensure you're picking up good things to know wherever you end up in residency.
Misc: Cellphone reception was a huge issue for me, mainly in Children's where your call room is separated by multiple floors from the resident call room. Find a spot where you can set it to avoid missing anything. Try to make sure you're around someone with a pager in the other hospitals. I didn't get any time to ski, hike, mountain bike, or anything, but if you wanted to make this your last rotation so you can spend some vacation time in the mountains, that might be something fun to end your sub-I season!
