Posted anonymously on behalf of a student who interviewed there.
Texas Tech Review
Pre-Interview Social: Dinner with the residents was at Carlos and Mickeys, a Mexican restaurant. It was very casual. Very few residents showed up, just three with one from each year. I only really got to talk to two of them because the third guy was down at the other end of the table. At most places it seems like half the residents show up for the pre-interview dinner, so another applicant and I were wondering why so few of them came.
Interview Day: We started at 8:00 with a brief presentation by Dr. Greer, the PD. A lot of the information she provided isnt posted on the TT website, so make sure you take notes. After that we had five interviews with the chairman, PD, assistant PD, resident, and one other faculty. The interviews were fairly laid back. I got asked why EM, why El Paso, what do I like to do for fun, tell about one of the activities on my ERAS, what do I see myself doing in five or ten years. Everyone also asked me what questions I had, so make sure youre prepared to ask questions! Interviews ended around 11:30, and we had a brief tour by the same resident who interviewed us. The day was over by noon. You should eat breakfast before you go and factor in needing to get lunch yourself afterward, because no food was provided during the interview day.
Curriculum: TT is a three year program. The residents work 12 hour shifts: 19 during first year, 18 during second year, and 17 during third year. (It is possible that some 8 hour shifts will be added in the future, and residents work four fewer shifts during any month when they take a weeks vacation.) Shifts are assigned in blocks as opposed to circadian. The hospitals include UMC of El Paso (primary site) and St. Josephs in Phoenix where they do two trauma months. (This may be stopped in the future since the volume at St. Joes has decreased and they have a new surgery residency there.)
The first rotation for all residents is an orientation month with didactics and a few shifts thrown in. The new interns review all of the basic EM things that they need to know to hit the ground running. There are four EM months first year, 8 second year, and 8 third year. They have two floor months in IM and cards, although the cards is actually CCU for 15 days and 15 days of consult/EKG. There are only two weeks of OB/gyn, which I see as a plus, but others may not. Other rotations include the usual like ICU, PICU, tox, admin, peds EM, EMS, ortho, anesthesia.
One really nice feature of the TT curriculum is that there are three elective months, which is a lot for a three year program. There is one elective month in PGY1 and two in PGY3. Options include ultrasound, ophtho, derm, rads, community EM, research, and more. One of their faculty does a lot of work in Papua New Guinea and could help residents go abroad if they want. Another cool feature is the scholarly tracks, which are like mini-fellowships. The residents choose which track they want to do halfway through their first year. There are six of them: research, ultrasound, education (med students, simulation, education), tox, EMS, and admin. Each track is mentored by a specific faculty member and has its own requirements that must be completed before graduation. Doing the tracks helps fulfill RRC scholarly project requirements.
Didactics: There is weekly conference every Thursday and a procedure didactics lab during the July orientation month. They have a new sim center that was built along with the new medical school. The residents also do cadaver labs. Both are used for low volume, high yield cases and procedures that residents might otherwise not get enough experience with in the ER. There are also special topics for each year, with the interns getting lectures on EBM and US, the PGY2s getting peds and EKG, and the PGY3s getting business in medicine. In addition, there are several resources in place to help with test preparation and remediation if needed (annual inservice exam each Feb, monthly mock oral boards, and MD challenger, a 4000 question bank for board review that the program purchases for each resident).
Benefits: Their benefits are really excellent compared with most other programs. Vacation is three weeks per year, plus the Kilgo plan which is one week off per month during every EM month. So that comes out to four weeks off during PGY1 and eight weeks off each in PGY2-3! Every resident receives an EM text of their choice plus $100 for a textbook stipend. There are no assigned readings, so residents can get whichever major EM textbook they want. EM organization dues are paid by the program. Residents get $420 worth of free food per month in the hospital cafeteria as long as they keep up with their charting. They have free secured, covered parking near the ED. The salary for interns is currently only around $43,000, but cost of living in El Paso is so cheap that this is more than enough to live comfortably. (About 80% of the residents buy houses.) Medical insurance is covered for the residents and their families. All of the residents get free medical Spanish classes. Internal moonlighting is available. Also, there is no state income tax in TX, so that is another bonus.
Administration: Dr. Nelson, who is the chairman, posts on SDN (screen name BKN) to help answer questions. I dont know of any other program where you can just post a question to the chairman of the EM department! Dr. Greer is the PD, and she seems very concerned with resident welfare. For example, she has instituted a resident wellness day where instead of having their Thursday didactics one week, the residents go do something fun like bowling, paintball, shooting, or just have breakfast together.
El Paso: I love El Paso as a city. Its proximity to Juarez (Mexico) where there is so much drug gang activity worried me at first, but CQ Press ranked El Paso the second safest city over 500,000 this year (first was Honolulu). They ranked El Paso as the third safest city last year. Cost of living is ridiculously cheap. The desert scenery is gorgeous. If you like outdoorsy things, there are a lot of nearby parks and the mountains are a few hours drive away for skiing. There are also college sports, an art museum, and oddly, a Holocaust museum.
Summary: TT is an older EM program that was originally a county hospital program and is now becoming an academic program. Besides the new med school and nursing school, they are building a new peds hospital that will be finished around Aug. 2012. The ED is currently being expanded and will be complete this August. This will increase the ED size to 35 beds plus 6-7 resuscitation rooms. There are many other changes planned, including adding fellowships. (They just started med tox and want to also add US, EMS, research, and maybe peds if the peds volume increases enough after the new hospital opens.) I definitely got the impression that this is a program on the move, and its going to have incredible opportunities once the transition to an academic institution is completed. I think the major pros are the cheap COL, beautiful scenery, nice weather, amazing benefits, and cool curricular features like the extra elective months and the scholarly tracks.
To me, the biggest con is that it was hard to get a good feel for what the social environment of the program is like, and what I did get was mostly negative. It really bothers me that I only met two residents, and I wonder why more of them didnt want to come to the pre-interview dinner like they do at every single other program Ive interviewed at. Of the two I met, one wasnt very social with the applicants, and I didnt feel like I gelled very well with the other. Its kind of harsh to judge the whole program based on two people, but since these are the people they picked to meet with us, I think its still legitimate to be concerned about social fit. The lack of even a glass of water on the interview day makes me wonder too. Also, the info on their website is like three years out of date, and they dont give any informational handouts at the interview day. The whole interview experience really doesnt do justice to all of the great features of the program that I listed above.
Overall, this is a great program, but my gut feeling is that its not the best fit for me personally.
