UCSF Experience?

[RandomDawgydawgy]

Anyone who did a SubI care to share their experience? Thanks!

[Guest]

Tons of people (not me, fortunately) did sub-I's there. From what I recall them telling me, it's a horrendous experience and unless you're made out of a piece of wood and enjoy working 24/7, it's not the best learning experience.

[UCSF SubI]

(01-09-2017, 09:46 PM)Guest Wrote: Tons of people (not me, fortunately) did sub-I's there. From what I recall them telling me, it's a horrendous experience and unless you're made out of a piece of wood and enjoy working 24/7, it's not the best learning experience.

So if people don't rotate there, their opinion doesn't really matter too much. As a learning experience there is nothing quite like it. If you go in there not knowing anything you'll be quietly laughed out. They have incredibly high standards for who they will accept into their residency and your time there is meant to show them how much you know. Parts of the rotation will crush you, and they want it to. Its meant to see if you can survive their grueling standards and lifestyle. Rotate there if you are more of an independent person who has their own agenda and wants the top academic experience in the country. If you're more of a team oriented person and want the clinical volume without the severe academic demand the Barrow is the place you would want to go.

[UCS-F-that]

(02-14-2017, 01:39 PM)UCSF SubI Wrote:

(01-09-2017, 09:46 PM)Guest Wrote: Tons of people (not me, fortunately) did sub-I's there. From what I recall them telling me, it's a horrendous experience and unless you're made out of a piece of wood and enjoy working 24/7, it's not the best learning experience.

So if people don't rotate there, their opinion doesn't really matter too much. As a learning experience there is nothing quite like it. If you go in there not knowing anything you'll be quietly laughed out. They have incredibly high standards for who they will accept into their residency and your time there is meant to show them how much you know. Parts of the rotation will crush you, and they want it to. Its meant to see if you can survive their grueling standards and lifestyle. Rotate there if you are more of an independent person who has their own agenda and wants the top academic experience in the country. If you're more of a team oriented person and want the clinical volume without the severe academic demand the Barrow is the place you would want to go.

M4s don't know anything anyway.  Expecting otherwise is pretentious.  More so, the attitude that you know everything as a junior resident is dangerous.

[Guest]

(02-14-2017, 08:06 PM)UCS-F-that Wrote:

(02-14-2017, 01:39 PM)UCSF SubI Wrote:

(01-09-2017, 09:46 PM)Guest Wrote: Tons of people (not me, fortunately) did sub-I's there. From what I recall them telling me, it's a horrendous experience and unless you're made out of a piece of wood and enjoy working 24/7, it's not the best learning experience.

So if people don't rotate there, their opinion doesn't really matter too much. As a learning experience there is nothing quite like it. If you go in there not knowing anything you'll be quietly laughed out. They have incredibly high standards for who they will accept into their residency and your time there is meant to show them how much you know. Parts of the rotation will crush you, and they want it to. Its meant to see if you can survive their grueling standards and lifestyle. Rotate there if you are more of an independent person who has their own agenda and wants the top academic experience in the country. If you're more of a team oriented person and want the clinical volume without the severe academic demand the Barrow is the place you would want to go.

M4s don't know anything anyway.  Expecting otherwise is pretentious.  More so, the attitude that you know everything as a junior resident is dangerous.

Junior residents don't know anything either and sometimes senior residents too.

[Neurofibroma]

Can anyone who Sub-Ied at UCSF comment about the experience?

[Guest]

UCSF Sub-i
 
As mentioned previously it is an intense experience.  I am not sure if they have begun to accept more rotation students at one time but the way it was set up as of a couple of years ago is as follows:
 
1 week at SFGH: Affectionately known as hell week by the UCSF residents.  I was there before they moved into the new hospital.  The old hospital was a war zone.  This segment of the rotation is a lot clinical duty and very little operative time.  There are three resident interns that rotate between nights and days who basically take care of all the notes, pre-op, post-op care and see all of the consults.  Often, these are interns from other surgical specialties so you actually should know more than them about neurosurgical patient and you are generally helpful (unique time in your medical student career).  You spend all of your time helping the intern.  They rotate in 12 hour shifts. You stay at the hospital whole time.  You get to leave for the academic day but come back that night.  That means you spend 7 days/nights in the hospital, the way residents used to live – interesting experience.  When this was at the old hospital, the bed you were given was in the same room where the intern does all of their work.  The positive is you know everything going on, the negative is you don’t sleep for a week.  In general, you are expected to see every consult with or without the intern.  While all of this sounds okay, the crippling issue is the EMR they use, it is straight out of the early 90's.  The consult notes are composed of drop down menus and it likes to freeze.  You have to manually enter everything and there is no good way to print any data off.  You will be awake at 2AM getting numbers from the ICU patients and plugging them into the EMR.  There are a lot of nights without sleep.  By the end, you are a complete zombie, but I assume this is the goal as they want to see how you respond to being exceedingly tired.
 
2 weeks at Moffit: spend all of your time in the OR.  You are usually split onto either the spine or the vascular service.  Lawton was obviously still there so they might have you do tumor (with McDermott) and then the spine cases as it is hard to envision that the vascular cases will not fall off somewhat.  These designations don’t matter that much as you can go to whatever case you want but you should probably put in some face time on whatever service you are on.  Overall, lots of cool surgeries – some of the best complex volume in the country.  However, they had a pretty significant complication a number of years back where a sub-I injured a patient.  As such, the sub-is are allowed to do next to nothing in the OR.  You occasionally get to scrub in to cut suture or provide suction.  Some attendings will prefer you don’t scrub at all so you should ask before scrubbing in.  Don’t go into the rotation expecting to do much in the OR (unless things have changed).  These weeks are still pretty hellish as you will usually be q3 call, 4th sub-I is SFGH.  If you are unlucky and only have 3 sub-is, you will get to do q2.  The call nights are pretty busy as there are a lot consults and high patient census so don’t expect to get much sleep.
 
We usually got in around 4AM to get numbers on patients/start notes for residents.  All residents are different in terms of their expectations but you will usually need to round on 10-15 patients and be ready to present around 6 or 630 to the resident on your service. 
 
1 week at the VA: Pretty enjoyable.  Less oversight.  Berger probably doesn’t care what goes on here so you might actually get to do some stuff in the OR.  It is just you and one 4th year resident so you get a lot of time to hang out and do cases.  Usually get in around 6:00 or 6:30ish as there are usually only a couple of patients to round on.  There are 1 or 2 days of clinic, 3 days of OR, and you are usually out by 5PM.  The attendings who staff the VA are enjoyable to be around and are interested in teaching.  You are still in the Moffit call pool so you go back at night to take call.
 
End of the rotation: You are expected to give a 20-minute presentation on your research.  If you have no research to speak of, you probably shouldn’t be wasting your time or money on this rotation.  I think it is best to have some basic science stuff to present but you have an extensive clinical background, that will go over well too.  Every neurosurgical subspecialty is well covered by faculty so someone will be interested in your presentation if you presenting stuff related to neurosurgery.  Your talk will be well attended and some of the attendings may ask you to give a presentation to their lab if they find your topic coincides with their interests.
 
There is an academic day every Thursday consisting of conference and other talks.  Usually stops by 3 or 4PM but your duties will go past this time.  There is no OR on these days.  The conferences are interesting and they try to have faculty make some time to teach the Sub-is.  The faculty teaching time is well received as they go over cases with just the sub-is.
 
Summary:  The rotation is one of the most intense in the country in terms of the amount of time you spend in the hospital.  You will never again spend as much time in the hospital as you will during your hell week.  Don’t plan to do anything besides work during this rotation.  This is not an opportunity to see SF.  In short, you really should only be going on this rotation if you have a legitimate chance to match to UCSF and have a strong interest in pursuing residency there.  I found the rotation enjoyable but others may not walk away with the same feeling.
 
Word is that Berger is retiring.  If that is the case, then don’t worry about getting a letter from him.  It is important to go to at least 1 case in his OR so that he knows who you are.  You have to email beforehand and get approval.  Unlike most neurosurgeons you will encounter during your travels, he is not very inviting inside or outside of the OR.  His residents live in fear of him and you will too during your rotation. Try to set up your end of rotation/ask for letter meeting before you even leave for the rotation as he is a busy guy and it can be difficult to get a meeting if you wait too long.  

[Millenial]

Would appreciate it if you could elaborate in detail on what "severe academic demand" entails. As in what you are gaining in training at UCSF that you aren't getting at Barrow?


Also thank you to whoever posted the UCSF Sub-I response above, very informative

[Guest]

(02-15-2017, 09:39 PM)Millenial Wrote: Would appreciate it if you could elaborate in detail on what "severe academic demand" entails. As in what you are gaining in training at UCSF that you aren't getting at Barrow?


Also thank you to whoever posted the UCSF Sub-I response above, very informative

3 first author papers a year, 1 basic science paper your PGY-5 research year, required grant application for PGY-5 research year

[Guest]

Berger inquired at UCSD chair position. Anyone know why