I never saw a grizzly bear during my month in Livingston, even though I spent the entire time reading about them and keeping an eye out for them on hikes. This was probably a good thing. There were 9 grizzly attacks in Montana this year; two of the victims came to Livingston Hospital while i was there and I got to help care for a Hunter who had been severely mauled (had his face torn off). I heard about the attack on NPR the next morning.
The mountains surrounding Livingston are amazing (the Absorokas, the Bridgers, the Crazies). I spent my free time hiking among these mountain ranges and exploring Yellowstone. The Paradise Valley is literally a two minute drive from the house and is breathtaking. Be careful not to drive off the road while you ogle at the Absoroka Mountains.
The clinical experience is priceless, no matter what you go into, ranging from clinic, to inpatient, to ER. The main preceptor (Dr. Wadle) was a great teacher and host. The hospital staff treated me like one of the family. Pop me an email if you have questions about this experience; I can’t say enough about it.
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.
I am so glad that I chose to do a WWAMI rotation in Missoula. It was an eye-opening experience in so many ways. I spent the month with Dr. John Trauscht, an oncologist with the Montana Cancer Specialists. I felt spoiled to have so much one-on-one time for teaching. I spent time doing a mix of inpatient and outpatient work, and had much more autonomy than I thought would be possible. Every day after clinic we would sit down to review cases from the day, and sometimes review peripheral smears and bone marrow biopsies with his 2-headed microscope.Â We were able to generate learning points as well as new questions for me to look up in the literature. I felt like the learning was so high yield. The most amazing thing was the patients, who were so nice and down-to-earth. Dr Trauscht led by example in not over-medicalizing the conversations with patients, and he challenged me to do the same. Also, there was ample opportunity for exploring the area in my free time. There is a really neat ghost-town nearby, and futher out is Glacier Ntl Park. The town of Missoula itself is also super-fun. There are lots of cute cafes, boutiques, and local music venues. Overall, it was a fantastic experience. I highly recommend this site.