What stands out in this program compared to others? Marshfield internal medicine was a phenomenal experience. The facility has had a long history of excellent teaching and has been quietly a medical powerhouse for the state of Wisconsin for years. It has a close affiliation with the U of Wisconsin and we had the privilege of working with a number of medical students who rotated through our ward and ICU service.
I think what made the place stand out was the incredible culture. I thoroughly enjoyed my colleagues and we fostered a wonderful learning environment that I had not yet experienced in my medical education prior.
The experience was robust with good patient variety and volumes, and probably it's biggest rotational strength was critical care and cardiology. I suppose it could be considered a drawback as there are no fellows at the institution, but it allowed for a very hands on environment for learning, in particular in the ICU setting, where all procedures and a large number of critical decisions were strongly influenced or decided by you the resident. As a result the amount of autonomy and confidence coming out of this program is unparalleled.
What are the drawbacks?
I'd say there had been some turn over in recent years, the buy out of the hospital and forming into a healthcare system has changed the dynamic a bit. There had been a lot of systemic uncertainty at the beginning of my training which improved with time. Unfortunately some of the departments such as GI were a little slim due to difficulty hiring to the cold north of Wisconsin. I actually enjoyed the weather and such, but at first glance it is indeed an acquired taste.
Would you choose this program if you had to reapply?
Absolutely. Hands down. It wasn't my first pick on my match, but in retrospect I totally would have chosen it now as my number 1 if given the chance again.
What do most of the graduates end up going into?
I'd say about 40-50% hospitalist 10% primary care 40% fellowship. We do match critical care and cardiology here, primarily in the Midwest as Marshfield actually has a surprisingly good name among cities in Minnesota, Iowa, Wisconsin, Nebraska and Illinois. I found it surprising but when interviewing in Chicago they were well aware of the program and viewed it positively.
My Schedule
Typical day on wards. Usually came in for 6:30-6:45 for sign out from the night float system. 1 in 4 for call days which were on pager from 7:00am to 8:00pm and would max out at 6 new admits and then receive 2-3 admits overnight from the night float. Calls days usually leave at around 8:30pm latest 9:00pm. Other days usually left at around 4:30. Averaged about 50-60 hours a week. Night float covers for 2 weeks at a time taking overnight admits and cross cover issues for all resident patients in the hospital, which actually was pretty manageable. Rarely called the attending, but they were available.
ICU rotations are every other day call arrive 6:30 leave at 8:00pm long call, and then 6:30 to 5:00 short call days. Probably closer to 70 hours a week. Strangely ICU was more chill in spite of the number of in house hours because of the excellence of the MICU nurses.
Otherwise outpatient clinic was usually half day seeing between 6-8 patients in a morning or afternoon and having the off morning or afternoon to catch up on research, QI or just paperwork. Usually 40-45 hours a week.
Absolutely no scut work.
Rotate well through all electives. Required to have each subspecialty of IM which is a strength. Generally on service each day 7-5 or so depending.
My Learning Experience
Probably one of the benefits of this place is the teaching. Faculty are approachable and value teaching which is something that has been embedded in the system for years. Usually would get 1.5 hours daily of didatics, half resident led, half faculty led. Well organized.
My Life and Environment
I thoroughly enjoyed my peers and attending-resident relationships. Everyone was approachable and kind. Probably another of this places strengths. Probably making up for this the cold of winter! I actually enjoyed it though, there's actually great opportunities for hiking, biking in the summer. If you like camping and fishing, this place cannot be beat. There's actually a lot of winter sports to take part in too. Excellent cross country skiing (which honestly you can go out in 0 to 10 degree weather and still easily break a sweat!) and a nice downhill ski area about 45 minutes away. Very affordable living. Absolutely no traffic. Not a lot in the way of stores which can be expected as the town is only 20,000. The beer... the beer is unparalleled as is the cheese! Many local festivals which I wish in retrospect I had attended more as they are great fun.
I'd say about 70-80% IMG, which is a many would say is a weakness, but honestly, the expertise from them is phenomenal!
Definitely had a life outside of residency. Enjoyed our first year my wife and I and had a baby in our second year and worked out great.
– Posted 04/28/20
Overall Rating4
Teaching
4
Atmosphere
5
Research
3
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Stands out: Everyone here is so nice and helpful. I noticed it right away when I interviewed. That actually applies to the city of Marshfield. Also, this program is special in that it has lots of research and funding available, but there are only 6 residents per class, so the faculty has time to help and work with you and you have an identity, your not just another intern.
Drawbacks are that Marshfield is only about 20,000 people, so there is limited shopping and other experiences you would get in large city. At the same time, because of that, you don't pay alot to live here and you never deal with heavy traffic. Also very safe to live.
I have felt prepared so far and yes I would choose this program if I had to reapply.
50/50 as far as primary care vs. fellowships. People that do research and plan apply on time, etc. get fellowships.
People can contact me if they would like.
My Schedule
A typical ward day would start with a pre-round. This is very flexible and depends on your patient load and how sick your load is. It also varies from intern to intern. Since we don't have formal rounds with the attending until about 10 AM, most interns come at about 6:00 AM to 6:30 AM to make sure that patients are okay and get labs and then go to morning lecture/report from 7:15 AM to 8:30 AM, which has a "theme" each month. See next question for details of the theme. Then my senior and I round after lecture (either together or divide and conquer depending on senior) and then meet with attending. After through rounding as whole team, my senior and I determine what still needs to be done and we get it done. How late I am there varies. Some days I don't leave until 7 or 8 pm and others I may be done at 2 pm. Most days the attending spends a period of time teaching. Call days are different, in that you are not required to go to morning lectures, the senior comes in at 9 AM and you start admissions at 10 AM. Post-call days you run around getting things done and have to be out the door by 1 pm, because of the new work hour laws.
My Learning Experience
I have not had a bad faculty experience. I am sure there are a couple who may not be as good to work with, but so far all of the faculty I have worked with have been great. They are patient and understanding and try to be flexible with our time and have reasonable expectations.
Teaching time varies. Formal teaching typically occurs on the two days in the call cycle when we are not
call or post call. The faculty is always "teaching" though, and each attending has a different style.
Didactics are very organized. Each moring there is a 7:15 AM lecture which covers themes. For example, one month was pulmonology. This theme also carries out into the outpatient clinic where we review an article with the faculty on the month's topic. So morning lectures and outpatient articles would be on the topic of pulmonolgy for a month and the next month the topic would change. Each Monday we are now doing "Evidence Based Medicine Rounds" where two residents are given a medical question or statement related to medical practice and are asked to find at least two research articles to support this. This has been a very good learning experience. There's also noon conferences on a regular basis and once a month on Friday morning we have a Renal Pathology Conference. At this the nephrologists both here and via teleconference videa, along with the pathologists, review and discuss interesting cases. They welcome questions from residents.
My Life and Environment
Relationships are good. I think, as with any job, you find people you have more in common with and you tend to do more with those people. But as a whole the residents get along well. I feel comfortable sitting at lunch or talking in the hall with any of them. The attendings are very personable, and they attend Christmas parties, picnics, etc.
The physical environment here is excellent. Always clean. If there is a mess, it is cleaned quickly (including patient excrement). The facility is very reasonable to get around and all is connected, so no going into the cold.
I never counted, but the percent foreign grads varies from 30 to 60%.
I do have a life outside of work. Wards are busy and you have less life, but I still get to exercise and I did get a puppy. I have seen my friends and family.
– Posted 12/29/03
Overall Rating5
Teaching
5
Atmosphere
5
Research
5
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