New England Interviews

I had a direct flight that got me into Hartford, CT around 11pm on Sunday, December 17th. Luckily, I missed several days of snow from a major storm. Getting my rental car and driving to the hotel went smoothly. But I heard lots of stories of people stuck in traffic for hours after 13 inches fell in eight hours during the workday.

It was a little crazy getting the 2-3miles to UConn Monday morning due to the snow and icy conditions, plus I missed a turn-off. It was a little stressful but I made it to the interview exactly on time.

I started out not being too impressed with the UConn program for the initial didactic lecture we sat through the PD's program overview. But during the interviews and lunch the warm fuzzy feeling about the people returned. By the end of the day, they were right back at the top tier of my ROL and I was looking forward to driving Tuesday for dinner with some of the residents.

I spent the night in Springfield near the Baystate EM offices. The Baystate/Tufts also gave me the warm fuzzies about the people, but I just wasn't as impressed with the actual program. I was actually irritated that they made applicants get on the hotel shuttle at 7am and sit around the ED offices for an hour and a half while the PD drove in. The cooridinator, a nice lady, did the program no favors by mentioning how the facility was falling apart and one resident almost got by falling ceiling debri while snoozing in the oncall room. As I remembered from my previous visit, the place is packed and very efficient in an old school way. They put more patients through fewer beds than any other program I know of. By the end of the day, after mentally bouncing them up and down my ROL, they returned to the same I had them before starting the trip.

I headed back down to Hartford for the UConn resident dinner and had a chance to ask lots of questions that came up during the interview. I had a really good time and enjoyed the people and atmosphere a lot.

Then I drove an hour or so to Worcester, MA. It sure looked familiar having finished my month there only 6-7 weeks ago. I arrived on time for my UMass interview of the trip and immediately got the "wow" impression I had had from reading about the program and my initial visit. The offices, ED and hospital are all brand new and gorgeous. The new sim lab being built in the new building across the street will likely be just as impressive. Like the other applicants, I was on their leash through the PD's introduction and the resident slideshow. On paper, the place has everything going for it including a month in HI for a PGY-III hyperbaric elective. I even enjoyed the interviews. However some of the problems quickly came to the forefront. The Attendings don't do much teaching and you don't see them at conferences. Jeremy, whom I had rotated with, and I compared notes afterwards and came to the same conclusion. There is great training, but it isn't a warm place and do get very busy moving meat in the ED.

So the I started to question the value of the whole trip since all three programs ended exactly where they had started in my ROL. Of course I had to make the interviews in order to rank the programs, and I will rank all three. It just seemed like a lot of time and energy for not a lot of new information or gut feelings.

My drive back to Hartford, night at the hotel and flight back was uneventful. I shouldn't have scheduled a 5:30am flight because I had to get up at 2:30am East Coast time. But I managed to sleep a bit on the plane and start studying for my upcoming COMLEX Level 2 PE exam the following week.

Finished plastics

Get getting around to this rotation summary a week and a half late. My Emergency Medicine post-rotation exam and several interviews side-lined me for awhile. I passed the exam and will blog about the interviews next.

Well I am very impressed with Dr. Kotoske's practice. It's almost unique in medicine today to have a sole practice with its own operating room and over twenty employees (6-8 at any given time). But cosmetic surgery, as cash pay service, is one of the last truly lucrative fields in medicine.

More importantly, Dr. Kotoske has a great reputation for his Quicklift procedure, breast augmentation and tummy tucks. I also saw him do one nose job (rhinoplasty) on a gorgeous young lady that had had a life-long complex about a slight asymmetry. But who has a naturally symmetrical nose anyway?

Breast jobs are just fun. You take young, generally already attractive females and give them these large, shapely breasts that are incredibly attractive. But the best part is seeing their new self-confidence and huge smiles (many times with smiling significant others present as well) at the post-op visits a couple of days after surgery. I guess if I was a breast guy I would find the artistry more appealing. I'm just not a perfectionist like Dr. Kotoske when it comes to breasts.

The Quicklifts are a great invention. They are the perfect surgical treatment for the majority of women over 50 that want to look 10 years younger. I might be interested in one myself someday, except that I'd need something for my forehead wrinkles. I don't see myself doing botox anytime soon.

The tummy tucks were the most physically demanding procedures and the most "barbaric" on the patient. Lots of flank and abdomen liposuction followed by blunt dissection of the abdominal tissue from belly button to ribs. Then two big, generally several pound, flaps of flesh get removed. Finally, there's a multi-layer closure with multiple deep sutures and staples on the skin.

All the patients looked great at the post-op visits, were thrilled with the results and couldn't stop thanking Dr. K. for his work. Not a bad gig!

If it wasn't so competitive and cut throat to get into with a masochistic residency I would be tempted. However, Emergency Medicine is definitely a better fit for me and for the family. It was an easy rotation that convinced me cosmetic surgery isn't too vain and Dr. K. is one of the surgeons I would consider using for myself someday.