NSLIJHS/Hofstra North Shore-LIJ North Shore (Manhasset) Residency Reviews

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3 year program

Residents: 10 per yr. They seem happy and normal and enjoy being around each other. The night before the interview, the program sponsors a tapas and sangria event in Manhattan and a good number of the residents show up. About a third live in the city, a third in between Manhasset and the city (i.e. Queens), and a third somewhere around Manhasset. Subsidized housing is available near the hospital grounds which are available to tour. There is a "resident panel" interview which may sound intimidating, but is actually pretty chill. Especially because you've already spent most of the day and part of the night before getting to know them.

Faculty: The department chair, Andrew Sama, wasn't present for my interview day - he had another obligation, as a member of the national board of ACEP. The PD, though, was super chill - Joseph LaMantia - recently elected to the board of CORD. He gave some basic boilerplate talk early in the day about qualities they want to see in their residents and then talked some more about North Shore specifics. Very laid-back interview style.

Hospital:
North Shore is a Level 1 Trauma Center with a BRAND NEW FACILITY. The place is freaking gorgeous. Critical care rooms have the ability to record video of codes, etc to review them later for instruction. Some of the rooms even have tinted windows you can turn on/off with the flip of a switch! They have a similar sort of triage division system within the ED as other programs. They don't have a designated psych area and dismissed that by saying there many other facilities in the region where psych patients are triaged.
North Shore has a very high admission rate: 39%! They attribute that to the fact that many in the community already have primary care docs so they only come to the hospital when they really need to (i.e. when they're REALLY SICK). All the residents were touting this as one of the best aspects of the program. High volume and SICK patients.

Ancillary Stuff: You don't get a great feel for ancillary staff on an interview, but the residents and interns are highly complimentary. Labs and blood cultures are often already drawn before you even see the patient, so you just have to click off the tests you want on the computer.

Documentation: They use EMSTAT for patient tracking, labs and rads, and use paper documentation for the rest of the charting. The faculty were a little hesitant about saying whether or not a transition would be made to electronic charting in the near future.

Curriculum: No medicine floor time! That's a huge plus for me, although one of the residents said that sometimes they have no idea how to direct patients around the hospital. That's probably not the best thing. 1 month is spent at Elmhurst Hospital for penetrating trauma (North Shore receives mainly blunt trauma) and 1 month in the 3rd year is spent at SHOCK in Maryland. A lot of emphasis is given to doing procedures during the 1st year, with emphasis on patient load ramped up more in the 2nd year. A full month is also devoted to pediatric anesthesiology at Schneider Children's during the 2nd year.

Didactics: Wednesday conference runs from 7am to noon with protected Tuesday nights starting at 9pm. Lectures, presentations, and away-site SimCenter time occur during Wed conference.

City: Manhasset is very ritzy without really affordable housing (other than the subsidized spots, given on lottery basis). 2/3rds commute from either Manhattan or Queens, so the city is definitely within reach if that's your thing. Or you can live a bit further out and keep your car.

Extras: Starting salary $56,500 plus $1,800 for housing! 4 weeks vacation, meal allowance, coverage benefits. Fellowships are available in Ultrasound, Critical Care (Medicine) and others.

Negatives: If you're planning on working in an urban environment, you probably want to train in a place where you can learn how to manage all the urban social issues and you definitely don't get that to as great a degree at North Shore.

Overall: North Shore definitely moved up my list after the interview day. Great facilites and great staff mean you can focus on learning emergency medicine and doing more techinical procedures. Manhasset has a lot of the advantages of being close to the city, without the cramped living space and lack of a car. In-house fellowships and happy residents are also a big plus.

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North Shore-LIJ Health System

Residents: 10 residents per year. Residents play a large role in the residency selection process and were actively involved all day as well as the night before. They were all very friendly, down-to-earth, and intelligent. They were an extremely happy bunch of people – and they seemed to genuinely enjoy the program and each other’s company. There is a mix of married and single residents, and a few with kids. According to the residents I spoke with, 1/3 live in Manhasset, 1/3 in Brooklyn/Queens, and 1/3 in Manhattan.

Faculty: The people I met were all very nice and open about the program. The PD, Dr. Lamantia, is very resident-friendly and is on the CORD board of directors. The chairman, Dr. Sama, holds a position on ACEP – and I think he also has some other position in the administration of the overall hospital system. Residents report a first-name-basis relationship with almost everyone. Additionally, the faculty responds very well to resident input, as evidenced by the evolution of the curriculum based on resident suggestions.

Hospital:
There is one major training site, with several short rotations off-site.

North Shore University Hospital: 700+ bed tertiary medical center, Level 1 Trauma center (mostly blunt). The ED is new, and extraordinary. It’s huge, with mostly private rooms broken into 3 regions (critical care and 2 regular adult units), plus a pediatric side, a “fast track”, and 4 big trauma bays. It still kinda smells like a new car :) Everyone makes sure to mention the very high acuity of patients seen here – almost 40% admission rate – due to the fact that the patient population is largely insured and with PMDs (they only come to the ED when they’re actually sick). They supposedly do very little “primary care” in the ED. There is on-site X-ray and dedicated CT, staffed with Radiology residents for quick reads. There is electronic patient tracking and ordering, with paper charts. Residents each have phones so they can be reached anywhere in the ED and have calls from outside attendings forwarded to them. The waiting room is insane – like the lobby of a fancy modern hotel with flat-screen TVs. The conference room is also refinished and very nice. The physical plant is really outstanding.

Schneider Children’s Hospital: I didn’t see it, heard its pretty standard.

Huntington Hospital: Didn’t see this one either, sounds like a smaller, community ED.

Ancillary Stuff: We were told the ancillary support is amazing. Residents only do IV’s, blood draws, and other minor procedures if they want to do them. There are clerks who document and place all your calls – since there are so many private patients, there seems like a lot of resident-to-PMD interaction.

Admitting/Documentation: Full admitting privileges. Paper Charts, but computerized ordering. It seems like the rest of the hospital may use electronic charting, because you can look up old charts on the computer.

Curriculum: Dynamic (they keep tweaking it) 3 year curriculum with emphasis on critical care and ED time. There’s a one month intro course, no floor months, 4 total unit months, plus 2 weeks in the burn unit. Two dedicated Peds Ed months, plus Peds shifts interspersed as a senior. 1 month adult anesthesia and 1 month Pediatric anesthesia (sounds cool), also there is no anesthesia residency at the hospital (that means EM residents have 100% of the airways). Residents spend 1 month at Shock Trauma for experience with penetrating trauma, and currently do an additional month of trauma at Elmhurst for more. There is one elective month, one EMS (FDNY) and one at the New York Poison Center. Residents work all very busy 12 hour shifts, but the scheduling is arranged so that everyone gets 2 weekends totally off per month (while in the ED). We were told there is an un-written rule in the dept that PGY1’s get first shot at procedures, and most of the PGY2s said they feel so comfortable with intubating and lines that they are more than willing to pass them off to the interns. They also report lots of ultrasound exposure.

Didactics/Research: Standard didactics, one morning a week. All residents are off the night before conference. The research is really starting to pick up. North Shore is affiliated with (and right next to) the Feinstein Institute for Medical Research, a huge independent research facility with extremely productive basic science labs. There is a PhD who is chief of basic sci research for the EM dept with NIH funding in sepsis work, as well as a research fellowship for basic science. Additionally, they have an active clinical research program, equipped with a group of undergrad “academic associates” that work full time on projects for attendings and residents, leading to numerous abstracts and publications. They also have fellowships in Tox, ultrasound, critical care – and are starting a sports medicine fellowship soon. The faculty seems devoted to fostering an academic environment here that has a lot of opportunities for research.

City: The hospital is in Manhasset, a beautiful, well-to-do suburb of NYC on the north shore of Long Island. The community is known for great schools, coastal parks, safe environment, and relative exclusivity. Long Island has some very nice beaches in the summer time. Aside from the housing near the hospital, it would be difficult to afford this area on a resident salary. However, relatively cheap housing abounds in nearby Queens and other parts of the island. Obviously, being this close to NYC (15 miles – about 30min to midtown by train or car) is a big draw. Many residents live in the city and commute (against traffic, but it’s still not a short ride).

Extras: Salary is among the best anywhere (starting $56,000+ as PGY1), subsidized housing is offered – or residents get a small additional housing stipend. They also provide excellent benefits, including good health/dental and retirement plans deducted pre-tax, as well as some moonlighting opportunities in the smaller hospitals for senior residents.

Negatives: With so many private patients, the residents deal with PMDs quite a lot – and don’t get very much practice with the indigent patients that frequent inner city EDs. As such, this doesn’t seem like the place to train for someone who wants to have a career in an urban county setting. Residents felt the Elmhurst trauma rotation was not organized very well, and that they still want more peds exposure. They may trade the Queens rotation for another pediatric month. For what it’s worth, North Shore does not carry with it the name/prestige of some of their neighbors in the city.

Overall: Diamond in the rough alert!! I was extremely impressed with this place – from the happy residents and the critical care/ED-based curriculum, to the research opportunities and the gorgeous new facilities. They have a ton of resources, and some very motivated leadership. I think this program is really going in the right direction…
 
1. NYU - County + Academic. Patient population was major determining factor. Great didactics. I guess only drawbacks would include the extra year (only 4 year program on my list) and the poor ancillary staff at Bellevue. But, training here would be worth the extra work.
2. Emory - Again County + Academic. And, again liked the patient population at Grady - uninsured, underserved. Also, great didactics. Location was also a plus. It's a superb program overall. But, it's not the sort of program that is right for everybody. Some people would be very miserable here. Residents in general are outgoing and enthusiastic. I would recommend rotating or doing a second look before deciding.
3. UNC - Loved the program director and the residents. Community + Academic. Was not as thrilled about living in NC. This program is really well-rounded. Almost anyone would be happy here.
4. NYHQ/Cornell - Community. Very diverse, immigrant population (which is a plus for me). Great schedule and benefits (includes subsidized housing). Dr. Ryan is very friendly and active in resident education. A great group of fun residents. Would be very happy to match here. I guess it ended up not being in top 3 just because it isn't as academic as the ones above.
5. North Shore - Was really impressed with North Shore. Community hospital and population but an academic program. The best benefits ever (really high salary + great housing). I liked the critical care emphasis. Lots of high acuity stuff in the ED. So many fellowships available. The residents are super-friendly, laid-back. This one moved up and down my list alot. But, at the end, what didn't really do it for me is the patient population. Though most people would enjoy working with patients who are neatly dressed and have insurance, not exactly my cup of tea. (Just personal preference.) Like UNC, well-rounded program that almost anyone would be very happy with.
6. Thomas Jefferson - Overall, I liked this program and would be happy if I matched here. New global health fellowship with public health focus is a major plus. They also have a whole building dedicated to simulation, special course on intubation, and other unique opportunities that makes the program stand out from others. I was also impressed that some of the residents volunteered at local, nonprofit clinics (more impressed that they didn't think it was a big deal). Moreover, pretty diverse and some underserved patient population across its many sites (which is a plus for me). BUT, the drawback to this program is having too many sites. Though I prefer more than one site in general, having multiple sites gives diminishing returns after a certain number (I would say 3). Not only that, these many sites are not all that close to one another (one was in Delaware). I think the residents only have to go to Delaware like one month out of the year or less. But, still...
7. Metropolitan/NYMC- New PD at this program is very energetic, enthusiastic. I get the feeling he is the sort of person who would really advocate for his residents and try to get them far as he can. Considering how small the program is (8 per class), many (at least from this year's graduating class) seem to go onto do fellowships - impressive ones at that too. (This was a plus for me... not necessary a plus for everyone.) That said, the interview day in itself seemed very disorganized, which made me concerned. The Metropolitan ED needs to be bigger and better-equipped. Housing is cheap and available but dorm-style. And, again, number of sites is so that cost outweighs the benefits (at least for me).

Did not rank one program that I interviewed at. PM me if you have questions about the above programs.
 
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I can't seem to find a list of their current residents anywhere. I am a DO setting up ACGME away rotations and would love to know if they have any DO's as current residents? Can anyone speak to this?
 
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