Missoula was my second WWAMI month and quite different from the first. Missoula is a university town and significantly bigger than Livingston. There are multiple hospitals, plenty of subspecialists, and even some UW students running around; it has less of the “small town doctor” feel. That said it’s quite different from Seattle, and the exceedingly well-connected Dr. Schlesinger is eager to customize the rotation – I did two weeks of sports medicine and two weeks at a Community Health Center. But one gets the sense Dr. S could arrange anything from the ICU to podiatry, probably with someone not used to having a resident and excited to do some teaching. Go to Missoula to get away, see a different place, do some hiking/skiing, and all of that, but also take advantage of the opportunity to learn whatever you want.
In August I saw grizzly bears, wolves, bighorn sheep, and more bison and elk than I can count. I also got to see a model of medicine very different from anything in Seattle: rounding on inpatients (including the small ICU) in the morning, then off to clinic for the bulk of the day. It’s a great combination and much more balanced than a Seattle ward/clinic day. With daily clinic you can establish continuity even over a single rotation. In my month, there was a lady with COPD who I saw in clinic, admitted to the hopital, transferred briefly to the ICU, and had follow up with me in back clinic a few days later.
The few ER shifts and visits to SNFs add some variety. The scheduling was very flexible, allowing for plenty of time to explore. Plus, Wadle, a former Boise chief, is an all-star doctor and preceptor.