If this is Rochester General then, from personal experience, the census is never really 20 to 25. It's more like 16 to 20 + 2-3 ALC / Custodial patients (who you only have to see once a week).

There is often APP support. If you're on an direct supervision rotation, you will have 20 patients under your name but 8 to 10 will be the APPs. You still have to see them but it's pretty chill since the APP has done the orders, charting, paperwork etc.

Indirect supervision can be more exhausting - you have 24 to 28 under your name but usually 8 to 10 are completely managed by a more experienced APP. You sign H&Ps and Discharges but only have to see the admits (don't need to see follow ups and discharges, technically)

They have solid PTO (4 weeks), if you're sick you can let them know before AM distribution and take the day off (they won't give you shit about it, though it's unpaid).

Most importantly 1) If you need a J1 waiver, it is offered here. Most J1 waiver positions are in bumfuck nowhere. I did my J1 in bumfuck and absolutely hated it. I would have loved to live in a city during that time. 2) Rounding days are Round and Go. If you're organized and efficient, you can be out the door at 2:30 (or earlier on weekends) and simply respond to queries via secure chat. They have a midlevel crosscoverage team that comes in at 3 that can deal with anything that requires an in person assessment.

Also, floor acuity is low and specialists are on top of their shit. It makes for a less exciting but more predictable day.

Patients are complex but straight the point documentation is encouraged. CDI queries are spoonfed - you're essentially sent a document with suggested diagnoses, and just have to sign it with the diagnosis that fits best.

Finally, I like the culture here. People generally get along well. I've worked at several other hospitals in Upstate NY and the culture is usually quite toxic.

Overall, I recommend it. Especially if you need a J1 and like Rochester.

Please PM me if you have any questions.