I spent the month of January 2017 in the ICU at St. Patrick’s Hospital in Missoula, which was awesome.
The work: St. Pat’s is different than many other WWAMI locations I’ve heard about, it is still in a rural setting but is actually a level II trauma center and provides a fair amount of specialty care, so a lot of patients get flown there from the surrounding smaller hospitals. This means the ICU takes care of a wide variety of medical, trauma/surgical, and neuro patients. The ICU team is more focused on the medical patients, but you can get involved with the others if you’re interested in getting more experience with these patient populations in the critical care setting. The attendings were all great to work with and motivated to help you get procedures, and there was ample opportunity to do them. I spent a day in the OR with a couple different anesthesiologists and got some concentrated time doing intubations, which was set up for me by one of the ICU attendings when I asked to do it. There is a family medicine residency program there and medical students from UW, so there are conferences during the week and they ask you to present a journal club and a morning report, which was fun.
The fun: Missoula is like a mini-Seattle. There’s tons of great outdoors activities, numerous breweries, and a nice downtown area with some good restaurants. In general, if you like Seattle and Seattle-type things, you will love Missoula.
The WWAMI rotations are a big part of what make our residency program special, and I recommend prioritizing at least one of these experiences during training. The ANMC rotation is an incredible experience that I would recommend to all comers, particularly those interested in specialty medicine. The people who work at ANMC are delightful, and the attendings (particularly Dr. Lovely and Dr. Gitomer) are so fabulous that they alone make the experience worth the trip. It was a fantastic month, both for my medical training and for my life experience. Since so many of the other posts go into detail about the rotation structure, amenities, etc., I’ll spend more time her talking about my personal experiences.
In the hospital: I spent my first two weeks at ANMC in the ICU and my second two weeks in outpatient specialty medicine. The ICU is a general critical care unit, so you take care of a combination of medical and neuro patients with all sorts of different pathology. This rotation is a great opportunity to do procedures (including subclavian lines); the attendings knew that I wanted to do as many procedures as possible, so even after I had gone over to the outpatient part of my month, the attending would come get me to place non-urgent lines. You see a lot of advanced pathology, and it’s a great way to start feeling comfortable with independence in the ICU setting. The outpatient specialty rotation was also tremendous. I rotated cafeteria style with several different specialties over the two weeks, but if you have a particular area of interest in mind, you have the freedom to focus your time. Alaska is tricky for delivery of specialty care, as the population is so spread out and sparse, so patients often fly 700 miles to come to Anchorage to see their specialists. This experience enriched my medical training profoundly, and I hope as many of you as possible choose to take advantage of it.
Outside the hospital: There is a lot to do in and around Anchorage, and I really enjoyed getting out of the hospital and going hiking, halibut fishing, sea kayaking, and getting to know the city. I was there during September of 2013, which is the rainy season in Anchorage. That time of year it was generally overcast/rainy and in the mid-50s, not unlike a slightly warmer version of a Seattle winter. Anchorage is a wild place, and I saw a lot of wildlife. Kinkaid park is a great place to see moose, but I also saw one in my attending’s neighbor’s yard one night. University Lake right next to the hospital has a nice walking trail around it and is home to a lot of beavers. Potter Marsh on the south edge of town is a must-see, and you can frequently spot swans there. Alyeska ski resort is a short drive south of town if you like beautiful views of glaciers and the off-chance of seeing a bear.
In short: go to Anchorage! Please feel free to contact me if you have any questions. I love talking about all the things I got to do and see in Alaska!
This picture was taken on a Sunday afternoon, Dr Loge and I cross-country skied out to a spring by his cabin. Once there we made a fire and roasted hot dogs :)
just got back from my WWAMI rotation in Dillon, MT a few months ago but it feels like it was so long ago – being back in the Seattle residency chaos does that…
My experience in Dillon was excellent. I plan on going into primary care and this was really the first opportunity I had to be in a primary care clinic on a regular, daily basis. The experience is completely different than the constantly rotating schedule we have in Seattle. Working in a small town was also different – by week two I was recognizing people in the grocery store and running into patients downtown, an experience I’m yet to have in Seattle. But I think the highlight of the rotation is the mentors. I was lucky enough to work with both Dr Loge and McIntyre. They are both very welcoming and involve you in both the care of the patients and the small town Montana experience. We went cross-country and downhill skiing, I was invited over for Sunday dinner, and went out to Dr Loge’s beautiful cabin with his family.
I recommend a WWAMI rotation to everyone, even if you’re not interested in primary care, the continuity of being in the same clinic on a daily basis is something we never experience of in Seattle. In addition, Dr Loge does many procedures — EGDs, bone marrow biopsies, treadmills, joint injections — regularly, and manages patient who would be managed by specialists here in Seattle, so there’s something for people with all interests.
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