George Washington University Residency Reviews

SecretReviewer said:

George Washington (1-4):

Residents: 10 per class. Didn't get to meet very many of them, but the ones I did talk to were intelligent and seemed to be laid back. They have many IMG's (which doesn't bother me but thought I would mention it in the review in case some elitists did care). I believe that I would fit in well with the ones I did meet.

Faculty and Administration: Dr. Lucas (PD) and Dr. Shesser (the chair) both spoke to us in the morning and seemed to be good people to work with. According to most of the residents, the faculty are friendly. One person I interviewed with was a total type A personality and that turned me off. Apparently that person has a reputation of being intense to work with. Other than that, residents had good things to say about all of the other faculty.

Hospitals/Facilities: GWUH is where about 50% of the ED time is spent. It's in a new hospital and has close to 40 beds. It's very modern in appearance and seems to have everything we would need to treat patients readily at hand. INOVA Fairfax is where about 25% is done, and its the community hospital in VA. It's a Level I trauma center and has good volume. Prince George's in MD is where the "county" type experience is at. It's a Level II trauma center but is staffed by attendings from Shock Trauma, and the PD mentioned that he "does not count the experience there" as part of their trauma because attendings are not too open to teaching. Children's National is where some peds experience is held.

Curriculum: Just became a 1-4. There is still 2.5 months of ward medicine which is a turn off for me, and also a peds wards month. The Ortho month is not with the ward team, but based out of the ED. The peds anesthesia 2 weeks seemed like an interesting and fun learning experience. For a 4 year program, I was disappointed to see just 3.5 months of elective time. They do have a unique "mini-fellowship" based on a personal interest that if you become involved with, it would decrease your PGY-4 shifts from 17 a month to 14 a month. Also, at GWUH as a PGY-4, you are in charge of supervising a section of the ED so the extra year seems like a worthwhile experience.

Didactics: Conferences are held on Wednesdays. The lectures are apparently well done and the speakers tend to put a lot of time and effort into them according to the residents.

Pediatrics: The peds experience seemed good. There are dedicated peds ED months at Childrens, Prince Georges, and Farifax. There is also a PICU month as a PGY-4. Residents said they felt very comfortable treating kids, but did say that the block schedule may have hindered seeing seasonal things that happen in peds.

Patient population: Tertiary care patients at GWU, and bread and butter EM patients at Fairfax and Prince Georges. Diverse groups of people with all kinds of illnesses, so nothing to worry about on this end.

Location: Washington DC. Great city but pretty expensive to live in. Buying is usually not an option within the city, but can be possible with a second income toward the suburbs. Good public transportation, but bad traffic.

Conclusion: I liked this program. It's an established program and has some strong programs in things like health policy and international medicine. Despite that, i'm a little weary since nobody mentions there name as a top program despite them being around for so long, dating back to the 70s with the likes of Cinci, Carolinas, Emory, Hopkins, etc. Nothing much more to say really, I think i'd be a good fit overall and would be happy if I did match here. I'll be considering it fairly high.

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Just a few, minor corrections...

1) The program used to have a working relationship with Iran, so it used to have 2 Iranian IMGs/year. It also was 2-4 which was a more favorable situation for IMGs than going into a 1-3 or 1-4. My class has one. I think our IMGs are pretty dang smart.

2) Fairfax Hospital is a tertiary care community hospital which gets a monster of a patient population. It also has a pediatric EM fellowship, from which most of those faculty split their shifts 50/50 peds/adult. GWUH gets a mix of tertiary care patients, locals, VIPs, out-of-towners.

3) The peds ED months are split between Children's and Fairfax, both see huge volumes. Along with the theme of diverse experiences, you'd find differences between the peds-peds EM Children's MDs and the EM-peds EM Fairfax MDs.

4) As a PGY-4, you actually co-manage the entire ED with the attending. As a PGY-1-3 you manage 1/3 of the ED with progressively less supervision and progressively sicker patients (in a nutshell, patients are triaged to three resident services with increasing acuity of illness).

5) Unless things have changed recently, the "mini-fellowship" isn't optional. In any case, I personally don't know why you wouldn't want to do it (in the context of a 4-year program) + get your shift load down to 14 shifts/month.

6) I can't argue that wards medicine don't suck as an intern, but in retrospect (I did 6 months of it during my prelim medicine year. good grief.), it was a valuable experience and, shockingly, I picked up useful skills for the ED.

7) Traffic. Most people live in Arlington or NW DC which means that you are driving against traffic (out of the city) for your shifts 95% of the time. My typical commute is 5-10 minutes to GW, 20 minutes to PG/Fairfax... worst is 45 minutes coming back from Fairfax/PG coming off an overnight weekday shift.


Glad you had a good visit.

Anyone have any thoughts on GW's program? I interviewed there awhile back and liked it but there's very little information on SDN about it. Any thoughts welcome.

while not anywhere near being a doctor as I'm still applying to med school, having gone in and out of the GW ED, PG County ED and other hospitals in the area as EMS, ED tech student and EOC tech, I can easily say that GW residents LOVED the emed program. I knew a few over the years, and no complaints. They were all very close, and I would often see them out after shifts at the local bar.

It's an amazing environment, the ED staff at GW is very likable and there is a steady flow of traumas/codes/brain attacks/VIPs/whatever gets you going. Lots of drunk college students on the weekends due to some policy, but otherwise, awesome hospital, great attendings, great staff. DC fire is not always pleasant to deal with, but that's something to get used to.

Not sure what hospitals are included, but transportation isn't too bad with metro and buses.

Sorry to jump in, but I thought I would share what little I knew about the environment.

when we were toured through the ED I saw all the attendings sitting wearing shirts and ties and clicking away at a computer while a resident patiently waited to present. That atmosphere just wasn't for me.

Apparently, GW's medical school dean who is also one of the EM faculty stepped down (or was forced to step down) from his position in November. The VP for Health Affairs and former dean also stepped down. Does anyone (i.e. current GW students or residents) have more insight into this restructuring?

Also, will the medical school's recently lifted LCME-probation have any effect on the residency training programs?

cookiedough123 said:

Anyone have any thoughts on GW's program? I interviewed there awhile back and liked it but there's very little information on SDN about it. Any thoughts welcome.

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Hi, I did my away rotation there and had a great experience. I'd def recommend this program to anyone applying and should be in their top 3.

The EM physicians have a very good presence in the hospitals they work at, GW is the main one, Fairfax is another huge hospital w/ lots of trauma (also where you would do your trauma rotation), and PG county hospital which is in a very bad neighborhood and you will get an amazing county experience with tons of autonomy. You can get more details about the rotations at SAEM.

Dr. Shesser and Dr Lucas are great. They are the Chairman and Director respectively, really down to earth and people you can easily walk in and speak with on a regularly basis.

The residents are great, you should try and contact Ashish Lal, hands down the best, he will be one of the 4 years when we are interns next year, but in general really fun and smart people. They do a wine thing every month at someone's house where they get together and everyone brings two bottles of wine - so lots of time to hang out and spend time with each other. (plus one lucky person keeps all the 'second' bottles as part of the event, lol).

They have a very well thought out curriculum. A new change is no more medicine floor months (used to have 2) because the medicine people had to pull their interns given the new hour restraints from the ED. So Dr. Lucas who will always be a GREAT advocate pulled his residents from the floors, mainly because without the medicine interns he needed more people to staff the ED.

Shifts
PGY-1 19 mainly 12s
PGY-2 17 mainly 12s
PGY-3 16 mixed 8, 10, 12s
PGY-4 14 mixed 8, 10, few 12s
might not be exact but if anything its actually less hours, they really like for the seniors to do more and get really involved in the specialty track, e.g one of them this year is getting his Masters in Public Health while a 4th year, i.e. you will have time to focus on your niche (oh and GW pays for it).

So I'm biased given the amazing experience I had, but you should def look into the program and even go as far as sending an email directly to Dr. Lucas (yes the program director) and you'll be surprised how nice he is and willing to give advice.

best of luck with your decision.

GoGetEM said:

Apparently, GW's medical school dean who is also one of the EM faculty stepped down (or was forced to step down) from his position in November. The VP for Health Affairs and former dean also stepped down. Does anyone (i.e. current GW students or residents) have more insight into this restructuring?

Also, will the medical school's recently lifted LCME-probation have any effect on the residency training programs?

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Can anyone speak for this? I did not hear this when I interviewed in November, but I guess it could have happened after then?

Also, thought the shifts were mostly 8-10 hrs in all the years and not 12?

cookiedough123 said:

Can anyone speak for this? I did not hear this when I interviewed in November, but I guess it could have happened after then?

Also, thought the shifts were mostly 8-10 hrs in all the years and not 12?

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I am a new attending at GWU, and yes the above mentioned situation did occur, I do not know the details or motivation. As for the shift hours, there are 12 hour shifts in the system especially on weekends.

TL

ThymeLess said:

I am a new attending at GWU, and yes the above mentioned situation did occur, I do not know the details or motivation. As for the shift hours, there are 12 hour shifts in the system especially on weekends.

TL

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Has the leadership change affect the EM residency at all? Also, do you know anything regarding the LCME lifted probation of the med school? (Is it true and has it impacted the EM residency program?)
Thanks!

cookiedough123 said:

Has the leadership change affect the EM residency at all? Also, do you know anything regarding the LCME lifted probation of the med school? (Is it true and has it impacted the EM residency program?)
Thanks!

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To my knowledge, the leadership change at the medical school has no impact on the residency. About the probation, I don't know anymore than whats in the papers on that one....

TL

I’m one of the current PGY2’s. Since there’s not a whole lot of updated information about our program on this site, I’ve written a short summary so that any of you interested in coming here can get a feel for what our residency program is all about.

George Washington emergency medicine residency, PGY 1-4

Residents: 10 per class. My co-residents are a group of wonderful people, which is one the greatest aspects of this program in my opinion. Most people tend to be very nice, easygoing, and fun to work with as well as spend time with outside the hospital. We are a fairly diverse group, a pretty even mix of married and single people, and come from all areas of the country.

Faculty and Administration: The program director is Dr. Colleen Roche. It is her second year as PD, however she served as assistant PD for many years prior to this and has a ton of experience working with the administrative aspects of the program. She is a strong advocate for the program and has been open to making changes to improve the program throughout her leadership. She is extremely supportive of her residents and clearly cares about everyone’s personal wellbeing. Dr. Shesser is the long-time chair of the ED and is well-liked by the residents, enjoyable to work with, and involved in the residency program. The medical director of the hospital, Dr. Gary Little, also happens to be an emergency medicine physician. While splitting his time between his administrative and clinical duties, he ensures that the ED is well-represented within the hospital. Generally speaking, the faculty is both knowledgeable and approachable. We enjoy working with them in the ED as well as occasionally spending time with them outside of the hospital – we have a fun soccer team made up of ED attendings, residents, and staff.

Hospitals/Facilities: Your time is split between the GW and Inova Fairfax ED. Both are busy Level 1 trauma centers, and they tend to complement each other nicely. Between the two facilities you will see all sorts of pathology. The GW ED is high-volume, sees a mix of patients from all walks of life and socio-economic backgrounds, and residents have a high degree of autonomy with a large patient load even as interns. Fairfax is a tertiary care center that sees a large number of high acuity patients, and you will see frequent medical and trauma resuscitations and have a chance to do a lot of procedures. The patients there include a large immigrant population. There is a high attending to resident ratio at Fairfax, which usually leads to great one-on-one teaching opportunities. We do 8 hour shifts at both EDs during the week, and 12 hour shifts on the weekends so more people can have weekends off (20 shifts per month as a PGY1, 18 shifts as a PGY2, 16 as a PGY3, and 14 as a PGY4). Your pediatric EM experience is divided between the Fairfax pediatric ED and Children’s National Hospital, and you also do a PICU month at Fairfax during your PGY4 year.

Curriculum: 4 year curriculum. Perks include a toxicology rotation at the National Capital Poison Center, a pediatric anesthesia month, and a wound care rotation that focuses on suturing technique in addition to the standard ED, ICU, OB, trauma, anesthesia, ortho, etc. The beauty of our PGY4 year is two-fold: first you have the opportunity to co-manage the entire busy GW ED with the attending during your final year of residency, which most graduating residents feel has set them up beautifully for future life as an attending; and second, during your PGY4 year everyone does a mini-fellowship (while taking a reduced shift load in the ED), where you pursue any subspecialty or research interest that you want. The combination of being at GW and in the middle of DC allow you access to every EM subspecialty you could dream of, and the GW faculty is happy to help you get involved. There is for example a special elective sponsored by the Department of Health Policy that is unlike any other in the country, which affords you the opportunity to learn about US health policy through lectures and site visits to Congress and local and federal government agencies. We have a strong international medicine department with established partnerships in India and St. Croix amongst other places where residents often rotate during their PGY3 and PGY4 years. There are frequent opportunities to participate in event medicine – highlights of the past year include the AT&T National PGA Tiger Woods Golf Tournament, local marathons/triathlons and festivals, and various presidential and government events. Wherever your interests lie, you are likely to find opportunities in DC that you cannot find elsewhere.

Location: In the heart of Washington, DC. Residents live in DC or northern Virginia (free parking for all residents at the garage next to the hospital, also located right next to the Foggy Bottom metro stop). Great location to spend 4 years.

My perspective on the program: I am very happy to be here. The residents make the program a wonderful place to train, DC is a great city to spend a few years in, and I truly believe that you will find opportunities here that you won’t find anywhere else. In addition, GW is one of the oldest EM residency programs in the country, and as such is well-known, has alumni everywhere, and is in prime position to help you find a job in any part of the country you may wish to go after residency.

Hi,
I'm a second year D.O. student, interested in EM, and was curious as to GW is open to taking D.Os. I'll be taking the USMLE and the program at GW caught my eye, but I did not see any D.Os on the current resident list so I figured I'd ask. Thanks!

We have taken them in the past, but do not have any currently. I'd recommend coming and doing a rotation with us and kicking butt while you are here.

It’s a 4 year program, which was my biggest apprehension about the program. Everyone is super friendly and the program director Dr. Roche is phenomenal. It’s about $1500 to pay for rent near GW. One of the residents was talking about how there is subsidized housing in all nice new condos so you can live in a swanky place for $1500 if you make under $80,000. DC is a cool city with lots of young people. They talk about 4th year being a time to do a "mini-fellowship" since you have much fewer shifts in the ED. It’d be interesting to maybe do public policy “min-fellowship” especially if you want to enter politics but it’s still a $200,000 mistake. Lots of residents moonlight around the area for extra cash. You rotate at Children’s, VA, GW, and Fairfax. You have fast track, not too many peds though. They talk about their great relationship with trauma but every trauma I saw while doing an externship, the trauma team was leading the survey. As a fourth year you’re a pre-attending. That means as a 1-3rd year you might be presenting to an upperclassmen which is a little silly in my opinion. Also, there’s basically 2 people above you as a PGY1-3 which means there’s more diffusion of responsibility which I’m not a huge fan of. For a lot of people including myself, allergies are really bad in the DC area.


Big Positives

1. the program director is amazing and she’s a great influence

2. Diverse experience being in Fairfax and DC


Big Negatives:

1. It’s a whole extra year of residency!

2. Don’t like having a 4th year “pre-attending” teaching me

Hi All,
Few questions regarding resuscitations...

Was curious as to the relationship between EM and surgery during the trauma resuscitation?
Does EM handle the airway, do surgery and EM switch off/on for running the resuscitation and preforming procedures ( chest tubes, lines, emergent thorocotomies)?

In regards to medical resuscitations in the ED...
Is there ample opportunity for taking care of critically ill patients in the ED, or are they really only available to the EM resident during ICU blocks?

Thanks,

PNN

Hi, in addition to Primum non noce's question above, can someone familiar with the program (preferably a current resident or recent grad) comment on the following:

• Is the average number of shifts per month still 20/18/16/14 x 8-12h for PGY-1/2/3/4, respectively? Do interns work all the weekend shifts? Is there enough time to pursue academic/professional/extracurricular interests?
  
  
• Are shifts stratified by acuity (e.g., “trauma” shift or “resuscitative” shift), or is the entire spectrum of pathology seen on each shift? In other words, is trauma only seen during concentrated blocks of training or throughout the entire residency experience in the ED?
  
  
• Are there any emergency procedures that EM residents are not allowed to do (RSI, thoracotomies)?
  
  
• Are there any other off-site locations other than the ones listed (GWUH, Fairfax, Children's National, Washington VA)? Is there any commuting between these locations (outside of the dedicated training blocks)?
  
  
• Is there an EMR? Is it Epic quality or a horrendous excuse for a computer program? Is there still paper charting?
  
• How is the scut work for EM and non-EM months (e.g., transporting own pts to CT, obtaining vitals).
  
  
• Is the environment family friendly? What percentage of the residents are married, have children?

Thanks for your time and help! It is greatly appreciated.

Recent Grad and former Chief: Answers from the top!
Trauma (This is all for GW...we do Trauma at Fairfax as well):
*Airway alternates with anesthesia - we each have our assigned days. On the EM days though its meant for the more senior resident on...but juniors can usually sneak in too...i did!
*Primary/Secondary trauma survey - the team leader alternates between EM and "Surg"...i put Surg in quotes, because the Surgery person is sometimes the EM intern.
*Team leader of trauma - again it alternates with the EM senior and the Surgery senior... and on the not so infrequent occasion where more than one trauma comes in at once we each do one.
*Procedures are usually left side/right side.
*I actually think we have a really good relationship with surgery on trauma and we all get along and get a great experience

Medical Resuscitations:
*Yes, you get plenty! The intern does not tend to run the most acute team in the ED...that is typically the PGY2...but the intern will still get codes and tubes and central lines

Schedule:
*Is the average number of shifts per month still 20/18/16/14 x 8-12h for PGY-1/2/3/4, respectively? - YES
*Do interns work all the weekend shifts? - Of course not! And that has never been the case...interns work 20 shifts which is a lot...but we all share the load. Everyone gets a 3 day golden weekend in their GW ED months, and then another weekend day or two otherwise
*Is there enough time to pursue academic/professional/extracurricular interests? - If you are dedicated to getting something done, absolutely. You are going to work a lot as an intern...thats true anywhere...but the faculty are all dedicated to helping you grow and develop throughout all of residency
*Are shifts stratified by acuity (e.g., “trauma” shift or “resuscitative” shift), or is the entire spectrum of pathology seen on each shift? In other words, is trauma only seen during concentrated blocks of training or throughout the entire residency experience in the ED? - No, shifts are note stratified by acuity...its what ever walks in the door

Misc:
*Are there any emergency procedures that EM residents are not allowed to do (RSI, thoracotomies)? - No, we do it all...throacotomies are rare, but they still fall within what we do
*Are there any other off-site locations other than the ones listed (GWUH, Fairfax, Children's National, Washington VA)? Is there any commuting between these locations (outside of the dedicated training blocks)? - You do a month at the National Capitol Poison Center in DC. Wednesday conference is sometimes at Fairfax
*Is there an EMR? Is it Epic quality or a horrendous excuse for a computer program? Is there still paper charting? - Man you must be old school...there has not been paper charting in the ED in FOREVER! GW and Childrens use Cerner, Fairfax uses EPIC and the VA uses their own system
*How is the scut work for EM and non-EM months (e.g., transporting own pts to CT, obtaining vitals) Our nurses are great and I miss then dearly now that I am gone! I have taken a patient to CT before...its about 30 feet from the ED and I was not doing anything else...I think I may have done in 3 times total in residency...and once it was because the patient was my friend. Our techs are equally as awesome and one is dedicated as the "runner" who will help with transports, etc. I have gone into see a patient immediately as EMS unloaded them and therefore I put them on the monitor and helped get vitals, but its by no means mandatory.
*Is the environment family friendly? What percentage of the residents are married, have children? Very family friendly and supportive. Every class is different, yes its family friendly, the single/taken mix is about 50/50...and there was a baby boom this past year. I personally started residency with a 9 month old and survived. Its also DC which is a young, active and interesting city...lots of places to go, things to do and people to meet

Hope that helps!
I worked really hard for 4 years, got a phenomenal education and would not have had it any other way!
Good luck!

Thanks for the awesome response and update!

Last question, are the shift lengths still 8 hours on the weekdays and 12 hours on the weekends?

Hi, I see there's an opening PGY-2 spot.. I wonder if GWU will accept a resident who already did 2 years of IM?

Shifts are 12's on the weekends and 9's during the week (8 seeing patients and an hour of overlap to get things tied up).

Regarding the open spot... I am no expert at this by any means...and if you are interested you should reach out and apply. I want to say it has something to do with GME funding that makes taking someone who has completed 2 yeas of IM more complicated than say someone who has done 1 year of surgery...but I really don't know