Hey so I rotated at Hopkins 2 months ago and wrote this up to share my thoughts. Before I had decided to rotate there I read this thread and was almost convinced to not even rotate because of the malignant atmosphere that was talked about. However my experience after having spent a month there was the complete opposite.
So I will preface all of this by saying that YES, Hopkins in the past WAS MALIGNANT, and the residents, particularly the chief residents will tell you this. X-ray rounds WAS a beat down session and call WAS insane because it was just you covering all of the orthopaedic services for the entire hospital. But with the change of Dr. LaPorte as the PD and a concerted change by the chair to improve the atmosphere, for the past 4 years the program has been completely different and when I arrived to do my rotation I didnât notice even a hint of malignancy. X-ray rounds in the morning are mild even when the resident missed something or could have put on a better splint. Call is still crazy, but is getting more cush as they have hired PAs to do the floor scut leaving you to mainly take care of the ER consults. In 2 years they should have 24 hr PA coverage which also frees up the PGY-2s to be in the OR more. Coming from a home program that isnât malignant at all, I didnât feel uncomfortable at Hopkins. They work you very hard but it definitely is not malignant at all. And most reports of malignancy at Hopkins are from attendings or fellows who were there before the program changed its atmosphere, or heresay from people who talked with people who were familiar with the old Hopkins.
Okay so now that that is out of the way, I will talk about my rotation. When you rotate at Hopkins you have the choice of rotating in Peds, Trauma, Spine, Hand, Tumor, or Joints. I chose Peds which I think is hands down the best experience. My days were involved waking up at 4 a.m. to get to the hospital by 4:30, to start pre-rounds. After pre-rounds and rounds, then we met for X-ray rounds which like most programs involved the resident who was on call overnight going through all of the patients they saw overnight. At my home program, the attending on call is the only attending at X-ray rounds. However at Hopkins the attending over each service comes in to observe patients that would have been admitted to their service, so itâs a little bit more intense, but barely, and this is from someone coming from a lax mid-west program. After X-ray rounds then we head to the OR. Something that impressed me the most is that the PGY-2s are primarily in the OR, not running the floor and doing scut work like other programs. On the peds service the PGY-2 was with either the attending and the chief, or the attending and the fellow. On the other services, the PGY-2 was first assist a lot of the time. And even though the peds service has a fellow, the cool thing about Hopkins is that the chief resident actually sets the OR schedule for residents and the fellow, so while the fellow does need to learn they donât run the show at all. And there are 4 peds ortho attendings so there is plenty to go around. For peds ortho the volume is unbelievably high, which is why UMD and Union residents come to Hopkins for their peds experience. There is just nothing better. As a student I wasnât pimped really at all. They mostly wanted to get to know me and see if I was a hard-workerâ¦that was their main criteria because they work hard, and they donât want to pick up someone elseâs slack.
In terms of the atmosphere, like I said before there was not a hint of malignancy. The residents there worked hard, but they seemed very happy for my month rotation. Early into my rotation they took all the rotating students out to dinner just to get to know them and they were very cool to hang with and extremely funny. During those drinking sessions the residents loosened up a bit and vented about different aspects of their program, but none of those things were any different from any academic program: OR turn over time, eccentric attendings, BS ED consults, etc. I had a chance to get to know a fair number of residents on different ortho services and all of them very quite nice and diverse too. Some were from Ivy League schools, some were from the south, some were definite silver spoon guys, others seemed more blue collar, some were from overseas, some were from Cali schools, some were women, some were Hispanic, Asian, Blackâ¦it was just a good mix that all seemed to gel. Iâm a pretty laid back guy and I really felt like I could get along with the residents for 5 years.
The hospital is absolutely monstrousâ¦thatâs all I can say. Navigating the place took 3 weeks to really get down and I wasnât even visiting the adult hospital side much. I didnât get the chance to observe the other services much, but when I was on call covering all the services with my resident, the trauma team seemed to get very good volume. While the Hopkins residents donât go to UMD-Shock Trauma anymore, they hired/stole one of Shock Traumaâs best attendings, Dr. Osgood, who really is just an amazing teacher. Because of that Hopkinsâ trauma volume has been steadly increasing, but nothing will ever compare to the volume at Shock Trauma. And if residents are interested in going into trauma, they are allowed to do an elective at Shock Trauma as part of their curriculum. But I feel that the trauma you get at the main hospital is quite adequate. Besides this though, you also rotate at Good Samaritan and Bayview which give you a lot of trauma too, so itâs a good mix. The Spine service at the main downtown hospital gets the unbelievably complex cases that other spine surgeons donât want to touch. In fact I was told that if a Hopkins resident bases their decision off of the downtown hospital rotation as to whether they would want to go into Spine, they would never chose it, because the cases are crazy. The more bread and better spine is done at their other hospitals (either Bayview or Good Samaritan..canât remember). This is where they get to learn the type of Spine surgery that most Spine surgeons are doing and itâs a very good experience where you are first assistantâ¦just you and the attending. There is a fellow on spine, but only at the downtown hospital, not at the other 2 hospitals. At the downtown hospital, the fellows run the show, not the residents, but this is balanced by the great experience they have at Good Sam and Bayview. I didnât really have any experience with Hand or Tumor so I canât comment on those, but from questioning the residents, their only weak service is Trauma since there is one main attending and maybe Foot & Ankle. Like I said before, I think the Peds service is the best in the country. They see a lot of common cases and completely rare cases that are only done or were pioneered at Hopkins, like pelvic osteotomies for bladder exstrophy where the Urologist and the Orthopaedic surgeon are operating together (blasphemy right, lol).
The thing I liked about Hopkins the most was the well balanced experience. At Mayo (which I think is #1 right?), you have amazing teachers and rare cases being flown in, but your trauma experience is pretty light. At Hopkins you are in Baltimore, which is the city where The Wire was filmed, so you get your inner city and homeless patients coming in off the streets in the ER which you have to see and evaluate and you get your private millionaire that is flown to the hospital on their private plane. There arenât many places that you can get that type of experience. I also liked you can see a nice mix of common bread and butter cases and rare cases too.
At the end of my month I was required to give a research presentation between 20-30 minutes on a topic that they selected. All of my other rotations allowed me to chose the topic. Either way this really pushed me to research my stuff so that I would know it well on the day of my presentation. And I would say that this represents the overall atmosphere of the placeâ¦it really pushes you to get into research and make a mark on the field of medicine, however nobody is stuck-up or stuffy about it. The Hopkins name is big, but they have great hands on experience to back up that name. And by the end of my 1 month rotation, I was very impressed by the skill, patience, âcool under fireâ attitude of the chief residents. I would be happy to be like them after 5 years.
And while fellowship placement is generally a piece of cake, having a resident from Hopkins seems to make placement a little easier. I know this is out of order, but another thing that I was impressed with was that most of the pediatric ortho books I was reading, were contributed by or edited by the attendings at Hopkins. So when attendings have that type of academic clout, it can only help the residents in the end.
So overall, I had a great time with the residents and really liked the program. Forget all the other crap about Hopkins on orthogate. My experience as a rotating student from another state is more on par with what Hopkins is like now. Hope this helps future students considering away rotations.
