Hi everyone,
We landed at JFK yesterday afternoon, ending our two-week adventure in Poland, Germany, and Bulgaria. It was the perfect trip for amateur historians, especially if you’re into Eastern European Judaism, the rise and demise of Nazism, and the Cold War. In Plovdiv, Bulgaria, we traveled back to Rome and early Christianity, exploring ruins, which until recently were entombed beneath the city’s streets. We also reveled in food and wine, from pierogi, sausages, and kebabs to luscious Bulgarian reds.
Someday, if you become a program director like me, you’ll find you never fully get away. Thankfully, we had no residency crises while I was gone (that I know of), but I did have to sign forms and answer urgent emails. I also spent a couple of evenings tweaking the ginormous “rotation distribution spreadsheet,” which the Rising Chiefs will use to build next year’s schedule. Here’s what’s in the spreadsheet:
- Numbers: We have to staff 17 services, depending on how you count them, and we have to ensure each resident gets the right number of ICU, floor, and night rotations. Rotation numbers vary by training year (PGY1-3), track (categorical, preliminaries), and program (Traditional, YPC, Med-Peds, anesthesiology, psychiatry, OB-Gyn, EM, IR, PMR, and Bridgeport). We need to staff 26 two-week blocks with 163 interns to fill 390 ICU and 1095 floor blocks, and 189 seniors to fill 407 ICU and 1118 floor blocks.
- Distribution: Each resident group has different needs. Anesthesiology interns need 4 MICU rotations. Traditional interns need to do Cooney to meet their geriatrics requirements, and we aim to give them all two MICU rotations and one block of CICU, floor cardiology, DEFINE-HM, Boudreau, and Klatskin. Traditional PGY3s are assigned to capstones, which include a combination of Whitman, HM, MICU MARS, MICU Red, Boudreau, and VA MICU. We also try to ensure each Traditional resident rotates on each specialty during their training.
- Restrictions: Electives aside, YPC residents don’t do VA inpatient floors, YSC MICU, Whitman, or HM. Except for Cooney, Traditional residents don’t do SRC floors or MICU. Bridgeport residents do only Klatskin and some Duffy blocks. EM does their MICU at SRC. And so on.
- Negotiations: To the extent that it is mathematically possible, we aim to meet the requests of our partner programs. But a service with two interns per block can only accommodate 52 interns a year, which caps who can participate. I work with 12 other program directors to ensure fairness.
- Adjustments: The final numbers need to be adjusted to account for special schedules (e.g., special tracks and leaves).
Fortunately, the spreadsheet was nearly finalized before I left for Europe, so I just needed to make minor tweaks while away, for example to account for recently recruited transfer residents and the hospital’s decision to staff Duffy Nights with hospitalists beginning this summer. With the spreadsheet complete, our next project will be to create the actual schedule, filling in ambulatory blocks, vacations, electives, and all inpatient rotations. This year, we’re taking an exciting new approach to building the schedule, which I’ll share with you next week.
Enjoy your Sunday, everyone. I’ll be recovering from jet lag today and getting ready for my upcoming week on MICU Green. First, I’m heading to Olmo for bagels.
Yours,
Mark
P.S. What I’m reading:
- Connecticut’s camera-wearing bears reveal how they roam neighborhoods — and grab Doritos By Jordan Nathaniel Fenster
- It’s the End of the Internet as We Know It By Raffi Krikorian
- Here Where We Live Is Our Country: The Story of the Jewish Bund By Molly Crabapple
- Is Caring About Sudan Too Much to Ask? By Ann Curry
- The Paradox of Modern Medicine By Meghan O’Rourke
- You Can’t Game Your Way to a Real Education By Molly Worthen
- Google Has a Secret Reference Desk. Here's How to Use It. By Hana Lee Goldin