Program Review
Staff / Faculty / Chairman
UAMS has the only ortho residency in Arkansas, so the faculty really have a desire to produce quality physicians for the state. While not all of the residents are from Arkansas, there is definitely a preference (as their should be). The faculty I worked with are top notch - they all love to teach and most of them really advocate for the residents. Once a month they have a "meeting with the boss" before their Tuesday morning conference where they can bring up any problems they've had to the chairman (Dr. Nicholas). Apparently, the faculty really do consider resident input on a number of matters (they recently adjusted the amount of time required on spine rotation because the residents agreed it wasn't as valuable an experience).<br />
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As with anywhere, the expressions "doctors don't play nice in each other's sandbox" holds true here. Dr. Aronson, the main peds guy is a genius (seriously, look in any peds ortho text at how many times he's referenced). But, he has a personality to match. Depending on the day, he can be a great guy who appears laid back. A second later, he can explode and chew a resident out in front of patients. While I was there, he absolutely tore apart one of the chiefs just coming on to peds - very uncomfortable situation. <br />
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The chair, Dr. Nicholas is a tumor guy. He's extremely laid back and soft-spoken. Most of the residents dread the three months of tumor in their third year - they don't know how to handle Dr. Nicholas' passive-aggressive demeanor. A lot of the other faculty seem to wish he'd be a more aggressive leader. In my week-long experience with him, I really enjoyed my time. He loves to teach and he really loves his residents.
Didactics / Teaching
I really like the structure. Didactics occurs on Tuesday mornings from 7am - 12pm. Usually a rep will provide breakfast. The time is set aside and nearly all residents and faculty attend weekly. I think they get more out of it because the residents know they've got nothing else to do. In addition, there is a good mix of teaching done by the faculty and residents. And, since all the faculty are there, the residents have extra motivation to do a good job on whatever they're presenting.
Operating Experience
Unbelievable. These guys are operating EARLY, and by their second year they're doing simple cases (wash-outs, nails, etc) by themselves. Interestingly, they do not do trauma as a 2. They do it as a 3 and a 5. They seem to have a love-hate relationship with the trauma guy (Dr. Gruenwald). On one hand, he doesn't stick around to help in clinic or in the OR which bugs a lot of residents (even the chiefs have to discuss clinic patients with him). On the other hand, the 3s and 5s were operating ALONE all day while on trauma. And we're talking big stuff - pilons, plateaus, etc. I asked one 5 about it and he said the only thing he hadn't done solo were acetabulums. So, the impression I get is most of them leave the program essentially ready to be orthopaedic traumatologists.<br />
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With that said, the operative experience is a little unbalanced. I didn't see that their total joint experience was all that great. There is one dedicated rotation which they have as a 2 and a 5 with Dr. Evans. From what I saw, he'd jump in and take over cases from the chiefs fairly quickly. I do think they got a better experience with Dr. McCoy at the VA, but I can't speak personally to this.<br />
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I also got the impression that they struggle with arthroscopy (which seems to be the case in most residencies). The loss of their upper extremity guy (Dr. Hasan) has amplified the problem. But, they have several prospects to replace Hasan and the chiefs who intend to do sports are able to get the arthroscopic cases they want (the chiefs often trade cases - even while on different services to help each other out).
Clinic Experience
There is plenty of it. Usually one or two days a week per service are spent in clinic. And clinic is busy. With as much autonomy as the guys have in the OR, I was a little disappointed they didn't have more in clinic...it really slowed things down that the residents had to present every patient to the attending who then went and saw the patient.
Research Opportunities
They're there if you want them and the resources are certainly available. However, this program isn't known for being extremely academic (which is the way most of the residents prefer it). They are required to present one research project during their chief year at an orthopaedic forum in the fall. Other than that, it's up to them. One chief had done two projects and everybody talked about him like he was a genius.
Residents
Extremely close and definitely one of the strongest points of the program. These guys enjoy working together and they go out of their way to help each other out. I saw 3s stay to help the intern finish rounding. <br />
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The PD, Dr. Blasier meets the residents weekly for "beer church", which is basically a time for the residents to drink and talk openly with an attending. Also, one of the reps holds saw-bone labs about once a month at their office in town. They call it "beer and bones" and the residents look forward to it.<br />
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One point I will make is that resident camaraderie is a two-edge sword. If you fit in, its great, if not, you will probably feel out of place (and you will probably be out of place).
Lifestyle
These guys work hard - no doubt about it. Remarkably, it's hard to tell because they work so well together and have such good attitudes about the work load. The program doesn't have night float and there are no "post-call" days. I'd say until their chief years they rarely are within the 80hr work week. On paper, they get around this by saying that all call is "from home". In other words, if you're on call and nothing's going on you can go home. However, as busy as UAMS is, I wouldn't expect to step outside the hospital while on call until the 4th or 5th year. <br />
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In fairness, a few of the guys live literally right across from the hospital and so they could go home to eat dinner. But if you live 10-15 minutes like most do, it doesn't make sense to leave. And call is q4 the entire five years, though chief call does seem to lighten some.
Location / Housing
This was the most surprising thing to me. Little Rock is actually an amazing place to live. I was coming from Georgia so the drive in from Memphis wasn't much to talk about (flat farmland). But, Little Rock has hills, rivers, etc. The entire state is known for it's outdoor activities (i.e. "the natural state"). I'm told excellent fishing, hunting, and hiking are only a few hours away. One weekend, I hiked Pinnacle Mountain which is only 15 minutes outside LR...Google it - it was pretty cool.<br />
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AS far as housing, it runs the gamut. There are plenty of neighborhoods and apartments within 10-15 minutes from UAMS. The stuff really near the hospital is pretty expensive.
Limitations
Here are my list of limitations:<br />
1. not as strong total joint or upper extremity/arthroscopy experience<br />
2. pretty tough call schedule<br />
3. cliquishness of residents (you will either totally fit in which case this is a huge positive, or totally not in which case you will waste an rotation/interview)
Overall Rotation Experience / Conclusion
I had a blast rotating at UAMS. I worked my tail off...they assign students like 4 nights of call, but it becomes clear what the residents really want is to see who is the last medical student standing. I probably put in 100-110 hours during my trauma week. They don't ask you to take extra call or come in on weekends, but if you're serious about the program you'd better just show up and do it.<br />
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These guys are great to be around. They do a great job teaching and get medical students involved - especially if you prove yourself by sticking around and working hard. <br />
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Some of the faculty are intimidating but most are as down-to-earth cool guys as you could ever hope to meet. They teach but allow for significant autonomy. Overall an excellent experience.
