Advocate Christ Medical Center Residency Reviews

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Well, I finally saw Christ yesterday, and no it wasn't in a vision or in a dream :laugh: And since my blog page is about 7 interviews behind, I'll just go ahead and use this thread to discuss what I saw. First of all, I never made it to the Bear's game because I decided my time would be better spent exploring the neighborhood. My plane got in at 9AM the morning before my interview so I literally had the entire day to venture. I started at Christ and used it as my reference point on the map. I went east a few miles, and it took nearly 30 minutes before I hit a part of town that started to make me uncomfortable....true south Chicago proper. Then I worked my way back through back neighborhood streets and found them to be exactly as I thought....a mix of blue collar and white collar people living together in a true middle class existence. The tree-lined streets looked like a scene out of a typical middle-class America flick. I was expecting to see John Cuso or Molly Ringwold walk out of one of the houses at any moment!

I found the coolest Italian deli down around 103rd a couple miles southeast where there were some million dollar homes nestled in some century old live oak trees. So much for the ghetto feel I was trying to find heh? The deli I went to had "real" Italian people speaking Italian. How do I know it was Italian???....because I speak Spanish pretty darn well and I only understood about 1/3 of it. And every other word ended with "ino" or "ito". While waiting for my "Calabrese" sandwich (I had no freaking idea what the hec this was, and I undoubtedly butchered the pronunication because the girl corrected me with a word that sounded nothing like what I called it). Okay, enough about my sentimental experience in the windy city....on to what makes Christ worth coming to (no pun intended...well sort of :)

The day started out with Dr. Harwood himself giving us a slide presentation that was like playing Jeapordy. He had categories of topics listed in Jeapordy-fashion on the screen, and he entertained questions about the topics (and anything else you wanted to ask). Each topic had a slide that went with it and answered everything you wanted to know about it. It was very casual, as there were only 3 of us interviewing. From the word go, there were residents all around and involved in our day. They have a true say in who their new counterparts are going to be, and I believe it helps them attract the quality of people they have. The individual interviews were next, and I have to admit once again that these were some of the best interviews I have had along the way. I believe it all starts with the small interview group. This is the cornerstone of a what makes this day special in my opinion and it all comes down to salesmanship. I could tell that each interviewer had reviewed my file intimately. I think they probably even knew who my high school girlfriend was and how many home runs I hit in my junior year of baseball. The interviews were more conversational than anything else, which in my opinion is way more useful than "Tell me your favorite color in a tie dye shirt and explain how it relates to your present emotional state". When they started to get slow, the interviewers had a list of questions that were not difficult to answer and helped get back on the conversational track.

On to lunch....the residents are what make Christ such an awesome place. To tell you the truth, I was a bit worried that I would show up and meet nothing but Dr. Bill Gates clones. This is because Christ is known for having only the top students enter their program. Of all my friends on the interview trail, I was the only one that got an interview at Christ. And these friends got interviews at places like Vandy, Carolinas, and Wake where I got rejected. I think it was the DO thing though in retrospect, and Christ has NO care in the world whether you are a DO or an MD. The whole hospital is full of DO's, as is the residency. The residents were anything but a group of geeks though. You could tell they were sharp, but they were social butterflies and more than capable of holding their own in a game of quarters I assure you. There was a great mix of single guys and gals, married with kids guys and gals, and an ethnic mix that only could exist in a place like Chicago. The choices are broad for social interaction, as they go on tons of trips together to SAEM, ACEP, and just fun outings to games, skiing, etc...

After lunch we had the resident presentation, the first of its kind I had witnessed along the trail. They literally took over after lunch and for 3-4 more hours we were theirs. There must have been 8 residents who took an entire day to devote just to hanging out with the 3 of us. It was absolutely incredible and made me feel like I was being recruited by the White Sox. I had to pinch myself a few times to realize I was not dreaming this all up. THIS IS THE REASON THEY GET THE BEST PEOPLE! I mean lets face it, when you come this far, and work this freaking hard to make it to the top, the last thing you want to happen is to leave an interview day wondering where the hec you stand with them.

So lets throw all this in a pot and let it boil over.....this is what is left to skim off the top from what I just said, and I will throw in some tidbits of EM stuff.

1) Probably the most human yet intelligent residents overall I have met, though every program had some, this place had tons of them!!

2) One solitary facility to learn the ropes in, and it is truly the mix of Wishard and Methodist in Indy...under one roof. What I mean is you get county, private, and a diverse population of patients without having to travel.

Side note: Now it makes sense what the esteemed Dr. Chisholm said in Indy when he allowed me to ask him a question during my interview. I directed his famous interview advice back at him and asked him what programs he felt were as good as his own. I knew this question would illicit a jackpot and I am so glad I asked it. He specifically stated without hesitation.........."I would say our program is a combination of Christ, and Cook County".

3) Faculty that have this drill down to a science. They have been doing this for 20+ years, and they exceed the RRC requirements in EVERY category by leaps and bounds. They are talked about so highly by the residents, and since the residents all come across so well, you believe them for sure.

4) There is no graduated learning at this place!! This means that if your learning curve is faster than someone elses, your level of autonomy can be earned more quickly and is not based on your PGY level alone.

5) Oak Lawn is a very nice place, and is a diverse city neighborhood pretty far removed from the big Chicago in the loop, but close enough to have any American's dream weekend vacation in just a 30 minute drive.

6) Internal moonlighting in the cardiac emergency unit, that allows you to easily add 20% or more to your income if you so choose. You can do it as an intern even once you complete a couple of required rotations!! What a beautiful thing!!!

7) No floor medicine month...God I love it...sign me up for this reason only!

8) In emergency medicine, this place carries a big name with all the others like Indy, Carolinas, Cinci, Pitt, etc... and if grandmother can't handle you not going to a place called Harvard, Mayo, Einstein, or Barnes Jewish, just tell her you are at University of Illinois-Chicago Christ Advocate, because they have some sort of affiliation.

9) Unlike some programs that find it necessary to work 60 hours a week in the ED, with 22 twelves a month, you will only work 16-18 10 hour shifts in a 4 week period. This probably means 20 per calendar month or less on average, equaling an incredible amount of time to read or chill.

Reasons NOT to come to Christ (God I feel like I am sinning when I say that):

1) Don't come if you are socially inept. These guys rival a group of Navy Seals when it comes to balancing fun with work!
2) Don't come if you think ghetto is defined by houses built before 1940, or if you get nervous when you see people with varying amounts of migratory neural crest cells in their dermis. This place is comfortably diverse....and thank God I saw no "W" stickers on any cars.
3) Don't come if you don't want to work hard as hell. They see 80,000 plus among 11 residents a year compared to many RRC accredited places I have visited that see like 35,000 for a class of 6-8. Do the math...there is no sitting on your butt around Christ (think I just sinned again with that phrase).
4) Don't come if you are going to bi**h about the cold all the time. Yes, Chicago gets cold, but it has 4 seasons that are all equally represented. All my favorite places have weather like Chicago or worse, and I am from Texas for God's sake! Suck it up :)
5) Don't come if you can't handle not having a big name on your wall in ten years. This is a big name in our world of EM, and if you can't understand that then you are coming for the wrong reasons.
6) And lastly, don't come if you think you already have your match ROL made, just expecting to bump up your number of programs for a safety net (I certainly didn't come for this reason, but it is honestly the reason I visited some programs). You could find yourself falling for this place, and it will totally ruin all the hard work you put into your ROL!!! There is no doubt that Christ has risen in my opinion........(on my list as well )!!!

So, thats my impression of Christ, and I hope it allows you to have a visual of what type of experience you might have if you decide to apply and are fortunate enough to receive an interview with them. All kidding aside....if your intention is to be the best EM physician you can be, then you should give Christ a very close look. Its worth it!!

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I am in my 3rd year at Christ and I can still say with confidence that it was the best place for me.

Leadership.
Second to the patients, your PD will likely be the most important factor in making or breaking your experience. Bob Harwood is our PD, and he was named PD of the year by AAEM in 2006. He's been doing this for over 25 years and the guy is brilliant, approachable, and completely dedicated to the residents. Any program that tells you they have no problems is lying to you. What is more important than a complete absence of problems is a willingness & an ability on the part of administration to address them. Earlier this year I went to Harwood about some inter-service beef & within 10 minutes he had tracked down the PD of that service & squashed said beef.

Experience.
We are incredibly busy & you get your hands dirty from day 1. As an intern I managed CC patients regularly. Attendings are always close by, but they would let me run codes as long as I was getting them right. As a result I have already run >150 resuscitations (with 9 months left to accumulate more) and met or exceeded nearly every RRC requirement.

$$$$
We have the opportunity to moonlight in out Emergency Cardiac Center after doing 1 month of ICU & 1 month of ED. You staff every patient with an attending, and are always able to ask questions, but for the most part you manage these patients solo. We make $700 to work a 6p-6a shift and in the process become a pro at reading EKG's, risk stratification, and managing CHF and tachyarrhythmias.

Ultrasound:
Mike Lambert is here, and he is a giant in the field of EM US. I have already logged > 200 scans and I fully intend to log my requisite 300 scans for certification prior to graduation. We have several great machines in the department and almost always have an attending working who can help you with a difficult scan. Multiple times a year we have US conferences where you'll get lectures followed by hands-on applications. You will certainly know how to scan before you leave Christ.

Research.
Erik Kulstad returned to Christ last year and the research has really taken off. Since he came we have had presenters at the major conferences in Vegas, Chicago, Sorrento, and many submissions. He is amazingly helpful, and always willing to guide you through any part of the process.

Camaraderie.
We are a tight-nit group. Some of us drink to much, some of us don't drink at all, some of us don't miss a single Iowa football game all season (I mean physically attending every game), some of don't know what conference Iowa is in, but we all stick together and help each other out. The importance of this can not be overstated when you need someone to cover a shift due to a family emergency or to pick up a time consuming patient for you when you're stuck in a code. All of the above aspects are nice ($, procedures, leadership) but you WILL NOT be happy in residency if you don't like your co-residents. On the interview trail, be sure to listen to your gut if it tells you, "I just don't think I'll fit in here."

The list goes on: Simulation, extraordinarily busy Level 1 Trauma Center, attached Peds Cardiac Center (with patients coming in through the ED), year-round Peds ED experience, 3 months of elective, no BS off service months, great performance on oral & written boards, 18 shifts per month...

OK, technically Christ is in Oak Lawn, but I live in the middle of Chicago and I ride my bike to work. Effectively Christ is a Chicago residency. As such, the commute kinda sucks.

Fell free to PM me with ?'s.
 
Christ

Residents: 11 residents/yr. Super friendly residents who get along well together. All seem intelligent and relaxed. Residents seem to be close-knit and hang out frequently, despite living all over Chicago. Residents get formal feedback q6mos and informal feedback after shifts. Graduates are all over the US (38 states) and due to the age of the program there are tons of contacts.

Faculty: All but a few of the faculty are excellent teachers who treat you as friends. Everyone is on first name basis and attendings really know you since you work with only one attending each shift. The PD is great and has been around for a long time. He won PD of the year 2 years ago. He and the chair both work ~6 shifts/mo. Faculty is expanding due to ED expansion. Faculty come from diverse places. There are 2 Toxicologists on staff with 6 (I think) US guys including one of the US guru’s.

Ancillary Staff: Nursing staff is great; no problems.

Curriculum: Three year program with all the standards. No medicine floor month, but there is 6 wks of floor peds that includes some time doing NICU. No SICU month because the SICU is run by attending surgeons instead of residents, but is made up for by another MICU month. 2 wks of Neuro which is apparently pretty useful in honing your neuro exam. 4 wks of floor surgery and no tox month. Flight is optional elective with standard EMS exposure. You only do EMS phone command during your EMS month and rest of the time is taken care of by paid people. Every night float shift is covered by a resident moonlighting and is an 11 hour shift where you get paid ~$500. Real moonlighting can be done as R2-3 outside of hospital but it is rare for someone to do this. One resident said that you can come out and if you have enough US scans, you can sit for RDMS certification. Lots of trauma with hospital going between 1st and 2nd most active trauma hospital in Chicago (trading with Cook) with lots of this being penetrating. One resident said he has done 4 thoracotomies in 1.5 years. Shifts are set up where ED is split into thirds during day with each third having same type of patients (half critical, half not) and each third is managed by one resident and one attending. This allows you to get individual attention from the attending and lets you see same type of patients all three years. There is no progressive responsibility, but obviously the attending helps out less as you mature. There is also a float resident who helps everyone out, with the night float resident being a moonlight shift. All procedures and resuscitations are done by you and your attending if the patient is in your area. Surgery and ortho only come down for procedures/reductions if you want/need them to. 30/60/10 do academics vs community vs other with most people doing fellowships (US, PEds, tox, sports, intrnl) rather than going straight to academics (but some do). Lots of residents do international trips, but have to fund and set-up yourself. No official international EM stuff. No restrictions on electives. Nice simulation center with several manikins and each resident being pulled out of didactics about q6wks (~6 residents pulled out per week) to do sim. R2’s + 3’s sims are recorded and televised to conference room where everyone else watches and attendings critique. 50% of sims are peds. Mock oral boards are done frequently with use of simulation added – they believe that oral boards will eventually incorporate simulation as well and want their residents to be prepared. CDU/OBS unit currently being built which will be run by NP’s. Residents sporadically rotate through Fast Track but see plenty of these patients when FT is closed. Everyone works 18 overlapping 10 hr shifts that are 6a-4p, 2p-12a, 10p-6a. 3 months of elective time!

Peds: Peds ED adjoined to regular ED with tons of peds volume. It is said that there is enough peds volume to have a peds fellowship, but they don’t have one. This is a big strength of their program. You do a few shifts per ED month. PICU rotation also present.

Didactics: 5 hours weekly; protected. Didactics are strong with 30% being on pediatrics. They use Tintinalli. Per some, there is some pressure to do well on boards (Christ is well known for having amazing in-service scores…#1 past 2 years running) but PD says he is more focused on making a great physician than a great test taker. Apparently one of faculty does a great review that helps a lot. Practice oral boards frequently. Difficult airway course yearly. Annual pig labs (don’t HAVE to participate if don’t want to).

Research: Scholarly project required with research available if interested.

Facilities: One ED that is effectively split into 3 parts, but is not actually split into 3 pods. Everything surrounds a central nursing station. When I toured there were tons of people in the hall (and sick people… e.g STEMI in hall, Tylenol OD in hall…). CDU/OBS unit being built. Beds separated by hard walls with glass doors. CT scanner in the ED. 24 hr social work.

Charting: Everything but orders are on paper, and orders are being transferred to computer soon. Use IBEX system which is great. PACS for rads.

Location: Chicago, IL. This program is in suburban Chicago, right on the border between South Chicago (bad area) and Oaklawn (good area) so they get a nice mix of diversity (race, language, insurance, and pathology). Some residents live in Oaklawn, but most live elsewhere with a wide distribution. Several live in other suburbs with lots living in Chicago. If you don’t live in Oaklawn, it seems like your commute is ~30 minutes but there is rarely traffic because of the way shifts are set up. Cold, long winters with beautiful summers that everyone says makes up for winters. I’ve never lived there, but it seems as if the long winters cause everyone to take advantage of wonderful weather so everyone is out at the beach on weekends playing volleyball, etc. Depending on what neighborhood you’re in, Chicago can be very different so I’m sure everyone can find something they like. Food is amazing.

Extras: 4 weeks of vacation that are taken in wk blocks but can be taken in any amount. Schedule is made by Chiefs and a computer program, with the option to request days off. US and Admin fellowships. 85k patients with 29% admit rate. More geared towards AAEM than ACEP from what I saw. Annual resident ski trip. Free meals and parking. There are 5 mentor groups comprised of a few faculty and residents, based on geography, that meet regularly. Matched savings plan (for all that money you’ll be saving with that massive resident salary).

Interview: Hour long Q&A session with PD (incl breakfast), 4 30-minute faculty interviews, lunch, tour, chief resident presentation on Chicago, 4 15-minute resident interviews, done ~2.
 
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Albany

Basics: 3 years, 10 residents per year. No floor months – off services are 2w ob/anesthesia, and unit months. CCU sounds a little floor-ish (and you, for some odd reason, cross cover a certain group of private pulm patients). Also do MICU, SICU, PICU (2nd year for that last one).

Shifts: 9 hours – 20 as intern, then 19, then 18. 2nd year about 1/4 of your year is more dedicated to trauma (but in the ED – which I think is great) and you work 12s with a shift reduction. Residents said they usually end up with fewer shifts than listed above.

Peds experience is integrated – one of the sections of the ED is dedicated to peds. They have just hired two peds EM boarded attendings, but otherwise you are precepted by EM attendings for peds. You have one dedicated month in the peds section of the ED and pick up peds patients during your shifts.

The PD is a Pitt grad who worked to build the Maine program before coming to Albany. He seems great –young, friendly, great relationship with the residents. He's very outdoorsy – rock climbs, etc. and it seems like a lot of the residents do too.



UMass

Basics: 3 years, 12 residents, no floor months. Effective use of off-service months (do your anesthesia, intro flight shifts, and u/s all in the same month).


Shifts: 9 hours (?)

Residents: northeast, some from outside region. All I spoke with said it was their first choice. Seem happy – but not the most cohesive group I've met on the trail.

Cost of living – much better than Boston (some do live in Boston, though – some have SOs that matched there)

Overall amazing opportunities and dedication to training. Integrated peds in last two years (I think). Good community experience without a huge commute. Powerful dept in the hospital (as evidenced by brand new ED, dedicated space on floor below it). Good sim training. Something like 5 u/s trained (RDMS!) attendings and 8 toxicologists. Very strong U/S and tox experience. Dedicated flight shifts in 2nd and third year (bulk in third). Volume is somewhere around 80-90K and growing. Supervisory rotation as part of third year (but not the entirety of third year)

PD – dynamic, funny, very involved in recruiting next class of residents. The faculty are about ½ UMass and ½ elsewhere (impressive list from elsewhere)



Boston medical center – "county with resources"

4 years, 12 residents/year. Just converted to 1-4.

Curriculum – first year lots of off service. 2 months ward medicine (which the PD pretty much admitted to me he HAD to do in order to get his 1-4 program), 1 months floor surgery, then lots of more fun stuff (ENT, MICU). One of the stronger departments in the hospital. The ED is theirs – consultants are there at the program's invitation and all turf battles have been long since fought and won. Residents have no assigned role on ob/gyn and ortho. They said it's "You get out what you put in." Probably not an issue for ob/gyn (10 deliveries and out) but ortho seems like it could get tricky. Ortho has to see EVERY fracture in the ED so that they can f/u in clinic – so unless you are aggressive with splinting/reductions I'm guessing you could miss out on a lot of that.

Electives – lots of opportunities but funding is up to you. International opportunities abound if you can save or beg the cash.

Residents: from all over, all said it was their first choice. VERY personable, anxious to share why they LOVE BMC. Shifts are 20 12s PGY2 year (I assume this will apply to PGY1 as well), mix of 8s and 12s PGY3 (but busy – you run trauma this year), and 8s during week/12s on weekends PGY4 year (NO NIGHTS in PGY4). Some of those details could be wrong – I don't pay too much attention to shift length.

Sites – Quincy, Lahey Burlington, the old Boston City Hospital ED (HAC) is the main site, and then HNC (I think) is the old BU Medical Center ED. Volume at HAC is about 130K if I recall correctly. HAC is divided into 2 sections – acute side (chest pain, SOB, trauma) and the less acute side. PGY2s work on both sides, PGY3s run the acute side, and PGY4s run the less acute side. PGY2 you are the "procedure resident" and essentially do all the procedures AND cover your patients – seems like this would be crazy busy and fun!

PD – personable, funny, very unassuming. Seems to genuinely want everyone to find their "happy place" on the trail. Was very very very involved in interview day – which I appreciated. Interviews are 2 faculty (or residents) to 1 interviewee.

Overall: I think this is a fantastic program and I think it will only get stronger now that it's 1-4. I liked the residents.



BIDMC

Format- 3 year (optional jr attending year), 12 residents/yr

Residents: from ALL over (actually seems to be a lack of people from the Northeast), 12/year. All are personable and excited about their program, everyone I spoke with said it was their first choice.

Curriculum – 3 weeks medicine wards, otherwise pretty standard. 6w elective time – including a "teaching" week in Italy if desired. Their u/s and tox programs seem to be works in progress. Just started an EM critical care fellowship. Optional fourth year during which you work ½ time as an attending and can pursue research, further education (MPH, Kennedy school). About 1/3 of the residents take advantage of this.

Faculty – amazing names, lots of research money, faculty are mostly from outside (Hennepin, Denver). Peter Rosen (the textbook author/editor) is part time faculty. PD is Dr. Carlo Rosen. Graduate of Denver, first PD of this 9 year-old program. Seems like a good resident advocate. Residents are getting jobs in competitive job markets.



Advocate Christ Medical Center

Advocate Christ is a medical center in Oak Lawn, IL, a suburb of Chicago. The hospital itself is a big community hospital with many subspecialties. It is a busy (90K, I think) ED. The ED itself has a very busy community feel – lots of patients, some in hallways but with everything running fairly smoothly, good ancillary staff. The program has good ultrasound and tox experience. They do a LOT of EM months for a 3 year program.

The attendings are from all over – many from ACMC (also known as "Christ). The resources at this program are phenomenal. There is lots of funding for conferences, etc. The residents have produced a HUGE number of posters at academic conferences in the last few years. The residents are paid well, many live in Chicago and reverse commute to the suburbs. They are a very happy group – well protected on off-service rotations and treated well during their EM months. Overall I felt like this program is the "hidden gem" of Chicago. Be aware, though, that it's supposed to be tough to get an interview – they only interview 80 candidates per year.



Uof Chicago

Large program (18/yr, 3 years), longstanding and very well-established with a great alum network. The well-known PD (Dr. Howes) will be handing over the reins to Dr. Tupesis (current assistant PD) in July. Howes will be the assistant PD for a year while they find a replacement. UofC Hospital is a peds level 1 trauma center, but adult level 2 due to financial concerns (when they were level 1, they were getting ALL the penetrating trauma and couldn't afford it). I had my interview at Lutheran, so didn't see U of Chicago, but from what I hear it is a busy, urban ED. Residents spend about 10 months at Lutheran General, which is out near O'Hare and is a busy, level I trauma center. They work 1 on 1 with the attendings at Lutheran (as opposed to the graduated responsibility model at U of Chicago) and really seem to like their time there. You also do trauma (I forget how many months) at Mt. Sinai (community hospital located in a knife and gun club neighborhood). UofC as a whole also just affiliated themselves with the hospital at Evaston, Illinois. This is a big, tertiary referral type hospital that used to be affiliated with Northwestern. The hospital is best known (in the EM world) for it's simulation center, so that is one aspect of EM at UofC that will grow overnight.

I did not get a good sense for what tox and ultrasound were like at UofC. Overall I did feel that they made a very good use of time by not having an OB rotation, but instead having you take OB calls to get your deliveries during your EM months intern year. They also combine your anesthesia month with NICU call – so you can get your neonatal resuscitations and procedures and your airways all at once. I think the PD mentioned that they really start preparing interns for flight shifts, so you WILL get the sickest patients early in your EM career rather than being protected from them for the first year, which is pretty status quo for programs.

Chicago has (mandatory, I believe) flight time. When you are the R2, you fly during your shifts in the department as well as see patients. They also do fixed wing transport flights, which are a moonlighting opportunity (you get about 1000). The residents at Chicago are a VERY social bunch. The department sponsors a monthly social event (they get money from the fixed wing flights as well) for residents.
 
I interviewed at Christ and loved the program and intended to rank them #1, but since have had a few issues arise that have me thinking. Multiple people at the more academic institutions have said that although Christ is a great program, it is more regionally recognized. If you want a job in the midwest following residency no problem, but if you want to go somewhere else it would be more difficult. Any opinions or experiences?
 
Em6771,

Hows it going? I'm currently a 2nd year at Christ. I don't know if I interviewed you while you were here, but if in case I didn't, I'll give you my thoughts. First, I came in EM wanting to do academics, so was looking for a program that would give me this opportunity. I wanted a program that could get me into an academic position, but also a program that would give me the best hands on clinical training while I was there. Although not every Christ grad goes into academics, it is definitely a place with an academic atmosphere and plenty of grads that do go on to academic positions. Ultimately, once that was settled in my mind, I decided it was the best place to train amongst the placed I interviewed. I moved here from out of state and interviewed from coast to coast, so I had a wide variety to compare it to. What makes it unique are the 3 years of access to the sickest patients. It was the only program I interviewed at that lacked the graduated responsibility structure of every other place I interviewed at. Combine that with the wickedly sick, and diverse, patient population, and it makes for a truly unique and awesome experience. I am only half way through residency and already have done more than I can imagine. The lack of other consultants in our hospital makes for a department that truly requires you to function at a high level. Already I have done crich's and floated transvenous pacers on real patients. I have been involved in (though not yet held the knife) on more thoracotomies than I can count. Add that to the sepsis, airways, lines, dysrhythmias, etc that I am already comfortable managing, and I can't believe I still have a year and a half left to keep learning! The final thing I want to try to articulate, but could not appreciate as an applicant until I was actually in residency, was how the atmosphere of autonomy as a department (ie. lack of other residents from other services) truly gives you an attitude of complete responsibility for the patients. You have to be confident in obgyne emergencies, slit lamp exams, complex suturing, dificult foley catheter and suprapubic placement, PEG tube replacements, reductions, and all the other small procedures that go into making an excellent and competent ER doc. Combine all this with a family atmosphere where you go out and have a drink with your attendings after a hard shift, and I cant think of a more unique and well rounded place to train. I consider myself lucky to have matched here. In the end, you gotta go where see yourself fitting in the best and being the happiest for the next 3-4 years. If that is here at Christ, than I'm sure we'd be happy to have you. Please feel free to contact me with any further questions and best of luck in your no doubt very difficult decision.

Sincerely,
ACMC PGY2
 
Sometimes, as the astutue med student said, you have to take things with a grain of salt. Every year I hear students who have interviewed at local academic/university based programs who have been told that Christ lacks a national reputation. I think that claim is unfounded.

Last night I wanted to see if there was any validity to what you heard regarding Christ being limited to a regional presence. The question comes down to two things, in my opinion: the network in place through which you get jobs and the national presence.

#1 Network

-Christ has been graduating residents (11 per year) for about 30 years now. Last year 6 of 11 left the state- 2 went out west; 1 went to the southeast. Of the 5 who stayed locally, 3 have gone on to fellowships.

-Christ grads are practicing in over 30 states, Europe, and Canada

-Christ grads are holding positions as program directors, US directors, research directors, in national academic positions, chairs of emergency departments, and obviously, as community docs


#2 National Recognition

-Two years ago Harwood and Girzadas won both PD and assistant PD of the year.

-Christ faculty and residents present at just about every national conference, yearly at the Mediterranean Conference, and give lectures in countries around the world

-This year a Christ resident won the Resident Presentation of the year at ACEP in Boston (out of over 500 accepted publications)

-We have top resident presentations at SAEM and ACEP twice in the last five years.

-faculty member recently named senior reviewer at Annals of EM

-We have had the highest score on the national inservice the last three years in a row.




In the end you really just have to be comfortable with whatever decision you are going to make. The intangibles are so important when looking for a program and in the end it really comes down to where you will get good training and where will you have a good time doing it. The jobs are out there, even in the competitive markets. Good luck in your decision...
 
Overview: A 3 year "community" program located near Chicago, Illinois. Not your average community program. This is a high volume place that takes care of a high-acuity, diverse patient population. You get a good amount of penetrating trauma here as well. There are about 3 months of ICU time, 2 month of trauma surgery, and 3 months of elective time. You will only be rotating at one additional site (Hope Children's Hospital) throughout your training. There are 11 residents per year.

Residents: Unfortunately, I was unable to attend the social events because I was out of town for pretty much the whole month of January. However, I got to meet a good number of them during interview day. All of the ones I met were extremely friendly and easy to talk to. They all seem to get along well together... probably because residents have input on ranking applicants. They are also super-smart, with many being in the top of their class.

Interview Day: The day started at 8:00am with some coffee, fruit, and pastries. This was followed by a Jeopardy-style overview of the program by the current PD where you pick certain categories/topics for the PD to talk about. Picking the topic leads to a short presentation addressing that topic. This was followed by interviews with 3 faculty members, tour of the ED, and lunch with some of the residents. Afterwards, you have more interviews (with residents this time) in the afternoon. I interviewed with a total of 6 residents. All of the interviews were low-stress and conversational. Some questions were scripted, and this was where I was asked probably the most difficult question on my interview trail. The day ended by 3:30pm.

Faculty: The current PD will be stepping down, and the job will go to the current associate PD. Diverse faculty with many areas of interest, ranging from toxicology to ultrasound. Per the residents, the faculty are great to work with and love to teach. They are also supportive and welcome resident input. Everyone is on a first name basis. The faculty I met with were all friendly and easy to talk to.

Curriculum: 3 year program. The specifics can be found on their website.

Some highlights:
- no medicine floor months
- 6 weeks of pediatrics
- 2 weeks of neurology
- 3 weeks PICU
- 3 months of elective time (a lot for a 3 year program)
- 4 weeks admin/EMS

There is no graduated experience here. You're thrown into the mix from the get-go, and the learning curve can be pretty sharp. A number of interns told me that they were nervous going in to some of their shifts early on because the patients are so complex and the volume is pretty high. But eventually you find your groove and get into the hang of things. This place is definitely resident-run.

Peds experience seems pretty strong with 6 weeks of floor peds and time in the PICU. Peds is integrated into your EM months so you'll get continuous exposure to the kiddos.

Ultrasound also seems really strong with an in-house fellowship, 2 weeks of US in first year, lab sessions, weekly US tape review sessions, and the chance to do an US elective.

You have 2 months of trauma surgery during your second year with the rest of your trauma experience happening during your EM shifts. Christ is a Level I adult trauma center, and they see a lot of it (especially penetrating). I think EM has every airway in the department... not 100% sure. Lots of procedures here.

Didactics as per required 5 hours a week. Standard core lectures by faculty and residents, procedure labs, simulation sessions, M&M conferences, journal club, board review.

Shifts are 10 hours with an hour or so overlap with the incoming/outgoing teams. You work about 18 shifts per month.

Facilities: You will only be rotating at one other institution (Hope Children's for Peds floors), otherwise all your time is at Christ. Medium-sized ED with about 50 total beds (including hall beds). This place definitely has a county feel to it. They see over 90,000 patients a year and 3,000 Level I trauma activations per year. There is also a new 19 bed CDU (residents do not rotate through here). Because of it's location, Christ draws in a very diverse patient population. Expect to see the full spectrum here... insured, uninsured, super-sick and complicated patients, recent immigrants, Caucasians, African Americans, Hispanics, Asians, Eastern European, Middle Eastern. They are all here. You will also get a good amount of penetrating trauma (again because of the location). Electronic charting and EMR/lab results, paper for orders.

Hope Children's Hospital is where you'll do your peds floor time. This place is the number one hospital in Illinois for pediatric open heart surgeries, so you'll be taking care of some sick and complex pediatric patients. Hope is right next door to Christ.

Location: Oak Lawn, Illinois, is a suburb about 30 minutes south/southwest of Chicago. Oak Lawn is your typical working class suburb. Not much to do around here in my opinion. Most residents live in Chicago and reverse commute, which usually takes about 30 minutes. See my review on Resurrection for my thoughts on Chicago as a city.

opb's final thoughts: This place is like a "wolf in sheep's clothing". It's a community hospital (with some type of affiliation with the University of Illinois), but it's a community hospital with major bite. I would say that this is more of a county environment: high volume, high-acuity patients, diverse patient populations (and when I say diverse I really mean diverse), and a good amount of trauma. You'll get all of it here... that's why the PD told me it's not necessary for you to go to other places to get your experience. Throw great teaching by great faculty, great residents, and a strong reputation within the hospital, and you get a top-notch program. All of this in only 3 years. Also, this program has been around for a while and has graduates in 38 states, so networking for jobs doesn't seem to be much of an issue. Some things you may have to think about are peds floor months, only one training site (a con if you're looking for multiple sites), and "only" about 3 months of true ICU time. Plus, Chicago's weather may be an issue for some.
 
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Interview day: Very small group, only 5 of us. Interviews with 8 people. 4 faculty, and 4 residents. Was a marathon. Interview with faculty a bit more structured, prior to interview PD states they each have a list of different questions met to get to know a different aspect of you. Very chill nonetheless.

Residents: 10 residents a year, very laid back bunch, all seem very studious and happy. Totally rave about the program. Seem to have a very good balance of work and play. Wide variety of interests from rock climbing, camping, beer drinking, football, just a really cool bunch. They dont have a pre interview social, instead they offer a few what seem like random dates for the social. Looking forward to meeting more of them during this time. ED is hands down the strongest department in the hospital and get tons of rep on off service

Alumni: All over the US. This year sent people into CC, U/S, Tox. Really extensive network. Seems youll have no issue getting a job coming out of here

Facilities: Very cramped. Told the ED was built for 60k but theyre seeing about 100k. New ED planned in next 5 years. Large trauma bays at front of ED

Peds: Seems like the peds experience is good. Hospital is very big on peds cardiology so get to see lots of sick kids from that.

Trauma: Its one of the busiest in Chicago, usually neck and neck with Cook

Faculty: Seem very warm and genuine. Felt like I could really be myself during the interviews without being judged. PD so far has been the nicest, most approachable PD I have met on the trail. Seems to really care about the residents.

Curriculum: Very tailored experience. 3 months of elective time. PD straight up said that if there's something you're interested in and there's not a position for it, we'll make one. Good amount of CC exposure, U/S exposure to be one of the best in the nation. One of the 1st U/S fellowships. International opportunities are lacking, but the general quality of the program makes up for it. Good amount of EMS exposure as well.

Patient Pop: Southside of Chicago! Wide variety, get the middle working class from Oak Lawn, but also only Lvl 1 trauma on southside. Admit over 40% of patients, so seeing very sick people

Location: Oak Lawn, south sub of Chicago, most residents live in Chicago, they say the reverse commute isnt that bad.

Overall: Got that warm fuzzy feeling everyone talks about while I was here. Will rank them very highly and would be ecstatic to be here. Lots of trauma, huge alumni, send many people to fellowship, very tailored experience, ballers of the hospital, and the most supporting faculty I have met so far.
 
Advocate Christ
PROS: great group of residents who seem smart yet really relaxed; truly enjoyed the interview day here—everybody has read your application and this allowed for a number of great conversations; seems like these guys get an outstanding number of procedures and they see an incredible amount of pathology and patient diversity for one site; Peds experience here seems solid since their ED gets sick kids (lots of congenital heart stuff) with no fellows or overbearing peds folks trying to take over complex/sick patients; one of the happiest places on the interview trail and EM is the powerhouse residency of the hospital, so it seems like they get on well with pretty much everybody from the trauma surgeons to the RNs; very forgiving schedule; get to see sick patients from day one and get to work 1 on 1 with attendings and residents say this leads to great learning; lots of moonlighting opportunities (including ped ED shifts)

CONS: All rotations are at a single site; no chance to practice "running" an ED or taking presentations from junior residents/PAs; commuting from Chicago to Oak Lawn not ideal; not many faculty involved with research (though the research director seems great)
 
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Pros: You'll see plenty of trauma.
Cons: You'll see plenty of trauma.

Wait, you mean shootings are still among the highest in the nation years after Obama outlawed guns in the city? I thought he said it would fix that:rolleyes:

Instead looks like normal citizens get to bring a knife to a gun fight.

In all seriousness I've been at Cook County this month and it's been unreal how $h!tty humans can be to each other.
 
I don't have any 1st hand knowledge of this case so it's not appropriate for me to speculate. The article says that no wrongdoing was found. Also, the person that the whistle blower accused doesn't work there anymore.
 
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Pre-interview social: At a bar in Chicago. Was pretty fun and had a really good resident turn out and applicants who were interviewing on all different days of the year since Advocate does about 6 socials a year and not before each interview day. Residents were chill and you could tell they were very close to each other and definitely didn’t hold back about their opinions (which were almost entirely good) about the program. Drinking was highly encouraged.

Interview Day: Overall decently chill. Most intimate interview day of my entire trail with only 6 applicants there for the day. Day starts with the 6 applicants and 2 people (PD and one APD) giving a jeopardy style presentation with applicants asking to hear about different categories, which was fun except that we didn’t get through them all so choose your categories wisely! PD is brand new to the position (March 2017) but seemed very in touch with the residency and made it clear that Advocate is so great because of the residents they attract and the overall culture at Christ. Both of the previous PD’s are still faculty at Advocate so even if you’re worried about the PD being new they still have plenty of support. 7 interviews total 4 longer ones (20 mins) with faculty that are supposed to ask standardized questions off a sheet but I found that a lot of the faculty disregarded most of the sheet or weren’t able to finish them all. A little more formal of an interview experience than I’ve had at most places, but by no means did I feel grilled at any point. The 3 resident interviews were shorter (15 mins) and much less formal and really just gave applicants a chance to ask what residents didn’t like or shoot the **** whichever you prefer.

Circumulum: The biggest difference about Christ is the 1:1 resident to attending ratio on all EM shifts and the lack of graduated responsibility. You are placed on the same teams as the chief residents are as an intern and are expected to hit the ground running here. All procedures are the interns until they get sick of them and apparently it is not uncommon for interns to see upwards of 3 patients per hour (ACGME only requires 2 patients per hour to graduate). Otherwise, pretty standard stuff in a 3 year program. Some unique aspects to me included, Trauma is only in second year and consists of both floor and trauma bay calls. Traumas are only run by the trauma team which the EM resident is an equal part of, but occasionally since Christ is so busy they get more trauma than even the Trauma team can handle and ED has to run the traumas as well. Residents get 3 months of elective time which I think is quite generous for a 3 year program (1 month in 2nd year and 2 months 3rd year) and do 3 weeks of Hand Surgery in the 3rd year which the PD acknowledged was weird but stated that the hand surgeon is one of the most awesome educators at Christ and residents love it and is pretty chill as a rotation over all. Biggest downside for me was 3 weeks of peds floors intern year which the current residents seemed to agree wasn’t the greatest use of time, but at least it’s 3 weeks. Speaking of peds, peds shifts are longitudinal so you’ll have a couple each ED month and also residents take extra peds nights shifts as internal moonlighting starting after the first 6mo of intern year which is 12 hours and pays 400$. Interns do 18 10 hour shifts with 1.5 hours of overlap. Not sure how this changes when you become an R2 or R3, but everyone I met seemed decently happy and not overworked.

Facilities: Christ hospital itself is very new in a lot of areas (Sim Lab, lobby, cafeteria, MICU, Peds ED), but unfortunately the Adult ED is not one of them. That being said it’s far from terrible but expect the classic curtain ED experience here. No shortage of US machines etc. and residents are able to use Dragon to speak their notes. EMR Is not Epic. Apparently they are planning on the expanding their current ED to match their patient volume in the near future but there are currently no concrete plans so I don’t expect this will be very soon.

People: Easily the biggest draw of Christ is the people. As I previously said some of the chilliest people I met on the trail all seemed super nice and generally friends with each other. However, this carried over beyond the residents as well. I didn’t hear enough about the nurses, 24h ED pharmacists or techs while I was there and Attendings were only referred to by 1st name. Even the chair of Emergency Medicine introduced himself by his first name to the applicants and the residents even threw him out of the room during the interview day. Most residents seem to hang out after shifts and are even given a day each month that all residents in the same year have the day off together to do social outings. Residents really stressed how much fun they have orientation month and how much they hang out with the attendings outside of work. (Tail gating with Attendings at Bears games appears to be a big deal).
 
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