I spent this last October in Anchorage which was a great experience.  You are provided lodging in a modest apartment and a rental car.   October was a great time of the year to go, as it wasn’t too cold and there was no snow on the ground so exploring the surrounding areas was not particularly difficult.

I split my time between the hospitalist rotation and the outpatient clinic. The hospitalist I was paired with was none other than Ted Wright, former UW Boise track graduate.  I carried about 7-8 patients and admitted every weekday.  The hours were not bad. The case mix was bread and butter medicine (pneumonia, urinary tract infection, chest pain, DKA). One of the more interesting parts was discharge planning as the patients you take care of come from some very remote areas in AK.  In fact, they have a hotel in the hospital to stay at while you get outpatient follow up if needed.

The outpatient clinic experience was subspecialty medicine (renal, ID, pulm, rheum). The paired faculty are great and there was a lot of teaching.

All in all, a great month.

Still cold, but an amazing four weeks.  I highly recommend rotating at the Alaska Native Medical Center in Anchorage!

Clinical rotation:

• You will be given a choice of (1) outpatient clinic, (2) inpatient medicine, or (3) ICU.  You can pick 2 of 3 if you want to mix/match.  I chose a mix of outpatient clinic (and requested a GI focus) and inpatient medicine.
• For outpatient clinic, you can work with a general internist and see everything, but you can also request to work with the specialists, assuming they are available.  There are two infectious disease docs, a gastroenterologist, a rheumatologist, a neurologist, a dermatologist, nephrology PA, pulmonary, etc.  Many of the specialists see patients in the clinic, but also perform inpatient consults.  You get more weekend time off.
• For inpatient medicine, I was assigned to an Attending (who rotates weekly).  I carried about 5 patients of a 12-15 pt service.  Rounds are pretty informal and you have independence, but still have opportunity to discuss the plan with the Attending.  I admitted from the ED.  There is good support for PT/OT, social work, etc.
• ICU is a busy service, generally.  Less weekend time off, but a lot of procedure opportunities.

Alaska Native Medical Center:

• Beautiful facility.  Very modern.  The patients are also amazing, mostly Native and from villages hundreds of miles away requiring travel in by a bush plane.  I learned so much about Alaska geography and native culture throughout the month.  The patients are very warm and friendly.  I really enjoyed interacting with them.

Anchorage:

• A big city.  Plenty of supermarkets, coffee shops (Kaladi Bros!), restaurants, gyms, museums, etc.  Even in March, snow can be challenging and I would recommend considering upgrading to a slightly nicer car with all-wheel or 4-wheel drive, especially if you plan to take some road trips.

If you have time off, consider going to:

• Anchorage museum
• Drive 2.5 hrs south to meet up with the Soldotna resident and then continue on south to Homer, AK
• Hatcher’s Pass
• Talkeetna
• Seward (I never made it here)
• Fairbanks is quite far and unless you have a lot of time, you would probably need to fly.  You can also take the Alaska Railroad
• In winter, plenty of downhill skiing, cross-country, snowshoeing.  You can even organize dog-sledding/mushing, ice fishing, snowmobiling or a flight over Denali if you want.
• If in March, try and see the start of the Iditarod (pretty amazing!) and the Northern Lights.

Steve Vindigni

Despite the negative five degree weather, snow, and a highly functional Kia Forte… this was an absolutely amazing rotation. I spent 4 weeks in the ICU working as a fairly independent entity with my own patients and responsibilities. The highlights of this were close interactions with the attending, making vent changes on your own, and the procedures. I did somewhere around 13 subclavians, 5 IJ, 1 tunneled line, 2 broncs, and helped with an EGD. The staff are great and they are interested in you and your education. I would get in around 7:30, round at 8:30 and usually leave around 7 pm unless it got busy. Overall a great rotation. Anchorage is nice, but cold. Although I did do a fair amount of running which was spectacular! I would totally recommend this to anyone interested!

Andrew Prouse

I just got back from a month at ANMC in Anchorage.  I did 2 weeks of hospitalist and 2 weeks of outpatient clinics.  Like previous posters have said, you see a lot of cancer and alcohol-related complications on the inpatient side.  And it’s true that you can get exposure to EGDs and doing treadmills, if you like those kinds of things.  You can pretty much see whatever you want, in terms of procedures or surgeries and whatnot since the place is small enough and the staff are very accommodating.

I’d like to put in a plug for the outpatient experience, since not many people have posted about that thus far.  You rotate through different clinics everyday, including a combined rheum/pulm connective tissue disease clinic (where you see more scleroderma with interstitial lung disease than you have ever seen in your life), GI clinic, hepatitis clinic, general medicine.  The outpatient attendings are all great teachers and excited to have us there.  The patients are great, appreciative, and come from very interesting places.

Aside from the clinical experience, the rotation is very well-organized with great support from the coordinators.  They give you a long weekend so you can go explore Alaska.  I made it to Seward for a glacier/wildlife tour and also to Denali National Park.  I don’t know if I was unlucky with the weather but by the second week of September there were more rainy days than sunny ones.  But no matter what the weather, the Alaskan wilderness is majestic.

Just make sure you have one of those nice cameras with the big lens if you want to take good pictures of wildlife.  You don’t want to have to be too close to a grizzly.

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
zshiue@uw.edu

Hi, this is Jason Goldman (jdgold@uw.edu) and I was at Alaska Native Medical Center, in Anchorage, AK during the Sept 2010 block. Looking back at Kanishka’s post, he pretty much said it all so I won’t reiterate all those details which are very accurate.

I did the intensivist rotation, although they would be OK if you did 1/2 and 1/2 of any combination of the intensivist, hospitalist or outpatient. My wife also came with me and did a rotation (for her NP training) at ANMC at the Ob/Gyn clinic. The intensivist was a bit longer hours than the other rotations (Justin Schram was there at the same time
and did 1/2 hospitalist and 1/2 outpatient), but very rewarding. It’s just you and the Pulm-Crit Care attending. The ICU is ~15 beds and you’ll carry usually half the patients. There is a mix of medical and surgical patients, so that’s a bit of variety in taking care of some trauma patients (although the surgeons also round). The cases were bread and butter mostly (they don’t get over medialized there!) with a mix of some cool presentations (Takotsubo’s, Liver abscess & shock, etc).   You’ll have plenty of autonomy, but enough supervision, you’ll likely get to do some cool procedures too! 

ANMC is a sort of cultural center and when you’re leaving in the evening, sometimes there will be some ceremonial chanting or dancing in the lobby (this circular meeting place). The patients and their families were really sweet and gracious people.   

You’ll definitely get time to travel around the state, we went to Denali, canoeing/fishing on Kenai Peninsula and sea kayaking out of Seward. The long days are pretty sweet!

Please email with any questions!

Howdy, my name is Kanishka Garvin, and I’m currently an R3 and just finished my WWAMI rotation at the Alaska Native Medical Center in Anchorage. It was a great experience and strongly encourage anyone interested to do it.

The rotation had been primarily a hospitalist rotation, though now, they have opened opportunities for more critical care experience by adding an intensivist rotation as well as a clinic/outpatient component. You can choose one of the three exclusively or do some combination. The experience is whatever you make it of it. (FYI, they provide you with free housing and car rental.) I chose only the hospitalist component. You rotate with a different attending each week and usually carry 4-6 patients of your own. When you change attendings, you carry those patients with you for continuity. The attendings are great teachers and have been at ANMC for a long time. They really like UW residents and enjoy teaching. They give you full autonomy with your patients. You round by yourself and usually touch base with your attending if you have any questions later in the morning. The hours are usually 8:30 to 4 (very flexible, no overnight call obviously) unless your attending is admitting that day, then you stay a little later til 6 or 7. (this is only once a week.) You do work one weekend but they give you a 4-day weekend to make up for that. (which is great for long travels into Alaska).

The medical center itself is a beautiful facility with a unique patient population. It is a referral center exclusively for the Alaska Native population and you will frequently meet patients from the Arctic Circle, the Aleutian Islands, or somewhere else in the middle of nowhere. I’ve learned a ton about a variety of Native cultures and some of the medical issues related to them. There is a lot of bread and butter here with a lot of alcohol-related issues (dilated cardiomyopathy, GI bleeds, etc. ) However, there are fair number of cases you will see here not in the lower 48 states. There is a high prevelance of post-partum cardiomyopathy in Native women which you will take care of. In addition, there are a high prevelance of infectious diseases unique to here due to the dietary and hunting pratices of Alaska
Natives. They include botulism (the highest anywhere in North America), echinococcosis, and trichinosis (from bear/walrus meat).

Alaska is probably one of the most scenic places I’ve been. I think Washington State and the rest of the Northwest pale in comparison. I recommend coming between April and September for good weather and daylight. Anchorage itself is like any other American town with everything you need, though surprisingly diverse. You can still retain some of the ethnic fare from Seattle with decent Thai and Indian but there are a lot of good local restaurants and bars for that “Alaska” experience. There is a nice downtown area and tons of parks around for cycling or hiking. And it’s not unusual to encounter a moose or two since they are everywhere. The best thing about Anchorage is that it is a great launch pad to visit the rest of Alaska. I was able to go north to Denali National Park (use your long weekend for that) which was only 4-5 hrs away. If it’s a clear day, one of the most scenic places in the world with Mt. McKinley and tons of wildlife. I saw grizzly bears, moose, caribou, coyotes, and even a lynx. You could even go further north to Fairbanks and beyond to the Arctic Circle. Then, to the south of Anchorage, there are a lot of places to go on the Kenai Peninsula. I went to Whittier (1 hr) for glacier viewing and to the coastal town of Seward (2.5 hrs) where I saw killer whales, sea lions, and other wildlife in the ocean. Homer is another coastal town (6 hrs) that would be a good overnight trip to launch from Anchorage, and you could stop in Soldotna (3 hrs) or other towns along the way.

In conclusion, I had a great month getting to experience Alaska. And my clinical experience was fantastic both from a medical and cultural standpoint. I highly recommend this WWAMI site! Please feel free to contact me with any questions.

My name is Adam Corson and I was an R3 when I did my WWAMI month at Alaska Native Medical Center in 5/09.  This is a hospitalist rotation.  The town of anchorage has all the resources you need, but is somewhat laking in character/things to do.  Once outside of Anchorage, however, there is more outdoors things to do than you can handle.  Outside of the city is absolutely beautiful.  While I was here I went to Denali National Park and Seward, both of which had scenic drives and were well worth the trip.  I would recommend doing the rotation between March and October if not May to Sept.  It does not get dark until 11pm and high most days was 60-70 degrees in May.  This made outdoor activities very doable.  In the winter it is cold (-20) and dark (4 hours of daylight).   You routinely see moose wandering around and if you are lucky you can see a bear or a lynx.

The hospital itself is a good facility and the patient population is different from that seen in Seattle.  Alcohol abuse permeates this population.  I had never seen a case of dilated cardiomyopathy prior to this rotation and I saw at least 10 while I was here.  The attendings are good to work with, just try and stay away from the locums people (they will assign you a different attending every week, so this will probably be out of your hands).  I realize these people will change by the time someone else visits, but the permanent guys are all solid.  You carry 5-7 patients per day, 1-2 in the unit.  Hours are 8:30 to 4pm most days, weekends off.  I would flip around your schedule so you can get 3 or more days off in a row to travel around.  You also get to do EGDs, as all of these are performed by the hospitalists.

All in all a great rotation.  Not enough free food though.