Livingston December 2010

Overlooking Livingston and Livingston Peak

My month in Livingston was wonderful.  The small town (~7000) is in a beautiful setting…”A River Runs Through It” was filmed there for reference.  Dr. Wadle is a great doc and good teacher.  The entire staff at the clinic, nursing home, and hospital are welcoming and really make you feel like you belong.

Nuts and Bolts:  The 25 bed hospital has a med-surg floor and a 4 bed ICU.  I had a bit lighter month with only a few inpatients at a time and no ICU patients.  You round on them each morning and stop back in the pm if there are any active issues.  Then head over to clinic for a usually pretty full day of patients.  Easy to go back and forth b/c the clinic is right next door to the hospital.  Also run over to the hospital for stress tests throughout the week and colonoscopies every other friday alternating with nursing home visits.  There are also 24 hr ER shifts…I saw ortho stuff and kids which was a bit different than usual but great.  I had a ton of continuity between the ER, inpatients, clinic, and nursing home visits.  Was on one weekend to round but otherwise had weekends free.   The patients are great, all ridiculously friendly and welcoming.

Despite the various work activities that keep it interesting, the pace  is  more laid back and there is plenty of time for fun especially if you are into outdoor activities.  Yellowstone is only 50 miles away and is gorgeous any time of year.  Spent a few days snowshoeing and exploring the wildlife.  Dr. Wadle is big into cross country skiing and running so took me out for both of those activities and even provided the ski equipment.  There is also a fair bit of downhill skiing close by that is supposedly wonderful ( i was too chicken to try and too busy with other fun activities).  In addition, because it is somewhat of a tourist area, the restaurants in Livingston are actually pretty darn good, as is the local gym I joined for super cheap.  There are also a ton of small art galleries downtown (big artist community).  And, of course, can not forget the hot springs of which there are many, but I recommend Chico just south of town.

I could say so many more wonderful things.  I highly recommend this rotation and would be happy to answer any specific questions.

Lookout point from a snowshoe/ski trail in yellowstone
Moose on the snowshoe trail at yellowstone

anchorage, december 2010

My month in anchorage at the Alaska Native Medical Center was a really wonderful! Most of the nuts and bolts have been posted by Kanishka so I won’t belabor them. I went in December in the middle of my R2 year and despite being shorter days (yes there is about 7 hours of light at the worst), the city in the snow was beautiful. There are multiple trails within the city if you enjoy cross country skiing, showshoeing, nordic skiing.  Its also very close to Alyeska, the local ski resort.

In terms of my medical experience, I did 2 weeks of ICU and 2 weeks of hospitalist. I think one of the biggest advantages here is that the internists do nearly all the procedures and I had the opportunity to learn to  intubate, do a lot of lines, and EGDs.  All the specialty services that you consult are just the attendings (no fellows) so often times they will allow you to be a part of any procedures they may do as well (I was able to go to the O.R. w/ ENT to help w/ a trach). The teaching in the ICU is great as well. On the hospitalist service you are able to be fairly independent and many of the attendings you work with are pretty close to residency so you can really see the transition if that’s what your interested in for a future career.

I would definitely recommend this experience to anyone. It’s a great opportunity to work very closely with attendings and they are very excited to have us!

Zita Shiue, R2

Soldotna, December 2010

I loved my month in Soldotna, couldn’t have asked for a better experience! December was a lovely time to be there–the days weren’t as short as it would seem, due to extended dusk and dawn, and the fresh snow was beautiful. Peninsula Internal Medicine is a very special clinic–the docs and patients are wonderful. The hospital, which is across the street, has recently gone to a hospitalist system–a big change for everyone, and one that is still playing out.  I spent most mornings at the hospital following a few patients, then went to clinic in the afternoon, and worked primarily with John Bramante, who is a fabulous individual and doctor and community leader. The division of time between inpatient and outpatient is flexible, depending on the resident’s interests. I found the clinic time so valuable and fun that I ended up slanting things that direction.

The apartment residents stay in is feet away from the Kenai river, and is very nice and cozy. Currently one of the hospitalists and his wife live next door. There is cross-country skiing just outside of town, with groomed trails that are lit until 9pm. The beach in Kenai is a short drive, and Homer is about an hour and a half away. The doctors and clinic staff are very welcoming.

I recommend this rotation highly and would be happy to talk more–feel free to contact me.

Jocelyn James, R2