<p>The ACGME (the group that accredits residency programs) requires that pediatric residents (and those in certain other fields - IM, FM, OB/GYN for sure) take part in activities that include acting as the primary clinic physician for a distinct panel of patients. So essentially, every resident has their own “clinic practice” that’s entirely made of patients that they are the primary doctor. You tell the family to ask for you when they schedule appointments including well child checks. Residents are able to recruit into their continuity clinics. In peds, this most often takes place when on newborn nursery when the parents don’t have a designated pediatrician for their newborn. You’ll then do all the well-baby checks and gives you the opportunity to develop a relationship with the patient and their family. Most places I’ve been by the end of three years, residents usually have patient panels of about 250-300, but sometimes it’s more.</p>
<p>Night float is a system in which ward coverage follows more of a shift schedule setup. There are designated people who only work nights for 2 or 4 weeks. What results is a more benign call schedule because there’s an assigned person coming in for that time period. It also means there’s better continuity of care because the person coming in at nights is the same (what’s common, particularly for supervising residents - 2nd and 3rd year residents - is “cross cover” so the person doing the call is coming in from another service and doesn’t know the patients). After seeing it in place, it’s become something that I desire from my programs. But since it is a disruption of sleep schedules, I’d rather go for 2 or 4 weeks so that at least I can get in a pattern. The one week on system that Program C does, is not a good thing in my mind. </p>
<p>Program E:</p>
<p>This is the place where I did my away rotation in the PICU back in August, so it was much more of a known entity for me, but I’m definitely glad that I came back out to get the full court press of being recruited.</p>
<p>Missed the resident dinner because of travel, but did get in earlier than originally planned. I’m getting good at flying standby 
One of my best friends is a resident out here, and he and I and some of his friends in other departments went out and got a little tipsy. It made Friday morning a little rough, but not that bad. </p>
<p>Because of my time out here, and the fact that I learned about my love of Peds Critical Care from my month here, even if I don’t come to this program, I’ll be forever indebted to this place.</p>
<p>This department really puts a huge emphasis on teaching, which is important to me. They have won multiple “best clerkship” awards from third year students in the past, which is very encouraging. I know that I got a lot of good bedside teaching and some great impromptu lectures while in the PICU. </p>
<p>The biggest thing about this program is that it will be opening a brand new children’s hospital in early 2010…or right in the middle of my intern year. Construction of the structure is pretty much done, but the insides aren’t anywhere near complete, but it makes it extremely difficult to assess the program. What I do know is that this program is about ready to launch. There are plans to roughly double the faculty size, there is a significant amount of research funding that’s been secured, and they are expanding the size of the residency program by two residents. </p>
<p>The PD is AWESOME, and he really goes to bat for his residents to get them things they ask for. You can tell that he’s well aware of the coming future and the opportunity it represents to transform the program. He’s definitely the type of guy who thinks about hwo the tiny things play into the larger picture. </p>
<p>Socially, I already know a lot of the residents, and I know a lot of residents in other fields (obviously including one of my best friends). </p>
<p>What it comes down to is that I could do very well here as well. This is not quite the “wow” that I got from Programs B and D, but I’m not sure what that really means in this context: I’ve been here already so it’s more familiar, and perhaps more importantly, the things that wowwed me at the other places are coming to this program.</p>
<p>I think the one thing that is a drawback is the location. It’s not a place that I would have chosen (either for my away rotation or to apply to) were it not for my friend who lives here. I don’t want to say that I felt pressured to come/apply/interview but it was one of those things that wasn’t my decision…which may also play into the lowered excitement level. </p>
<p>As I go forward, I keep reminding myself that about 85% of US M4’s that match get one of their top 3 choices. Right now, Program E is solidly in position 3 and I know that I would be happy here. So it’s comforting to know that I’ve got 3 programs (B,D,E) that I can rank and be well assured of my future. And with 8 more interviews to go, it’s likely that I’ll find a couple of other places that I also really like. On the other hand…this is going to be an extremely difficult decision to really go through and rank all these programs and make a final decision.</p>