Brown University Residency Reviews

overall, i think brown's program is great.
- their new chairman is awesome! (i went to med school there.)
he was very supportive and seemed like a true resident advocate.
- there's a good peds hospital and ed right next to the adult ed. i think both are high volume.
- the injury prevention center there is pretty active.
- the em dept runs the beautiful and new sim center so i think there's pretty freq sim training during grand rounds.
- the ed facilities are new and beautiful.

Brown

Residents: 12 residents/yr. The residents seem to get along well with each other, as well as with the faculty. One faculty member told me it is not uncommon to see attendings and residents hanging out outside of work, whether it is going to get breakfast/dinner after a shift or doing something fun (e.g. biking, surfing, skiing, etc). Each class has one night per month scheduled off together to facilitate a close-knit group. All the residents were extremely friendly and very enthusiastic about their program. They truly love being there and spoke amazingly high of the program. Resident are evaluated twice per year formally and after “every” shift informally.

Faculty: 70 something faculty with very diverse interests. All residents spoke highly of the faculty and said most are great at teaching, but vary as with everything. Residents felt like they really knew each attending and vice versa. The faculty seems very outgoing and friendly, cultivating the same in their residents. The Chief of EM used to be the Pres of SAEM and knows everyone. Apparently, if you want a job he will sit down with you and make calls on your behalf. Because of this, people have recently broken into the West Coast market (Seattle, San Fran, other Cali) as well as Boulder, and some other highly desired places outside of NE (I consider the area around your residency program as a gimme). PD is super nice and seems to be a stand-up guy. Both PD and the chief work a decent amount of shifts in the ED, but I’m unsure of how many.

Ancillary Staff: Pretty good from what I’ve heard, but forgot to ask the question specifically. One resident did say that if you put an order in, consider it done unless you know the nurse is new in which case you may have to tell them about the order placed.

Curriculum: Four year program with lots to offer. They did a very good job selling their curriculum and the benefits of having a fourth year. Graduated responsibility is present with the PGY3 year being the real kicker – a whole year in the pod that deals with nothing but the sickest of the sick. You rotate some through the psych pod, but not too much – the perfect amount per one resident. Everyone spoke extremely highly of this year. Plenty of elective time is present to pursue interests with people often going to Liberia and Kenya. One resident recently went to Samoa where one of the faculty members now runs the ED down there. It sounds as if the school pays for your trip, room, transportation while on these trips and everyone really has fun. International medicine is highly focused upon and is one of the real benefits of this program. There is an International Fellowship, a course in Dublin for Tropical Medicine, and ties with numerous countries for multiple trips. They have a tox rotation and just hired on another 2 tox people to increase the strength of this program. One PGY4 speculated that they would like to create a Tox fellowship, but nothing is officially being talked about right now. Everyone graduates with ACEP certification in US. Once per month you go down to their sweet sim lab and do simulations in front of your peers. Scary and intense, but great learning experiences per the residents. The sim center is a really big deal here and is a big plug of theirs on the interview day as well. Apparently, the faculty is very receptive to people complaining about off-service rotations so there is little scut. GYN and ORTHO were the two off-service months complained about, but might be currently getting tweaked. Other services are equal in strength and in general there is a good relationship with the other services. Heavy on ICU months. Four months of electives. Very active DMAT team.

Peds: Strong peds experience with high volume peds center. Residents do 1 peds month as PGY1 and then get ~4 shifts/mo for other years.

Didactics: Every wed morning; protected time. I think they go through Tintinalli, but not 100% on this one.

Research: Really big on research here. Dr. Jay brings in a ton of NIH money and there seems to be a giant amount of research going on. You have to do a scholarly project, but they don’t really care how big or impressive it is. Nobody forces you to get really active in research, but it’s there if you want it. Also, tons of grants come out of the Injury Prevention Center so if you want to just learn about how to write grants, etc., you can pick it up fast through them without having to get involved in a research project.

Facilities: Fairly new ED with multiple pods. Extremely large space with natural lighting (sweet). Two CT scanners and a cath lab IN the ED! Right up there with UMass in how nice it is. Busiest ED in NE and is the only game in town, so no pre-arrival triaging patients. Peds ED is older, but not bad in the slightest. You have access to Brown’s library and other facilities (e.g. undergrad gym). No boarders.

Charting: T sheets with all orders, labs, rads coming through on computer.

Location: Providence seems to be a really fun city. It is cheaper than many NE cities with half of the residents owning homes in the ‘burbs and the other half renting in East part of town (area where Brown undergrad is). Some people bike to work. Apparently, RI is progressive overall but is conservative relative to rest of NE.

Extras: EM3 runs all resuscitations and determines who does what line. If a code is called the cavalry comes down, but the EM3 still runs it with the surgery team there. You work 20-22 overlapping 9’s, usually getting out on-time. Chiefs make the schedule and take 2 weekday + 2 weekend day requests off per month. Most everyone gets what days they want off. Schedule progresses, but is not true circadian so as to allow requests off. Moonlighting opportunities are present in 2nd yr with transporting pedi/adult critical care patients from hospital to hospital. People that do this purely do it for the extra spending money, but say they can get around fine without it. Apparently, Miriam hospital (community) is where Scrubs is based off of. Yearly retreat, membership dues for ACEP, SAEM, and EMRA, and $$ for conferences.

Interview: Talk with the PD; small breakfast provided. Tour or interviews followed by lunch, then followed by the other. There are 3 30-minute interviews and 2 15-minute interviews back-to-back-to-back….rapid fire. Very conversational and laid-back – didn’t get too many “hard” questions.

Here are some quick facts about programs from last year of interviewing. I tried to be non-biased as possible, but sometimes I threw in some subjective comments. Hope this helps.

FYI, some things may have changed at programs so be sure to ask.

Christiana - 3 years, 12 EM residents/year (+3 EM/IM and 2 EM/FM), 9 hr shifts with 1 hr overlap, 40 hr/wk as intern, 1 mo of night shifts with minimal night shifts on other ED months, >110k volume at main hospital with 72 beds, ~200k combined volume, 5 hrs lecture/week, daily morning conference, monthly animal lab, 1 month orientation, dedicated CT and radiology dept, OR in the ER, $200 mil expansion of Wilmington hospital by 2011, EM gets airway AND procedures in trauma, no anesthesia residents to intubate, no ortho/ENT/NS/optho residents either, fellowships in admin/EMS/US, 6 U/S machines with great U/S faculty, $49k as R1, 6 mo of ICU rotations over 1st two years, interns work >1/2 shifts at Wilmington, no floor months, no state sales tax, 30-45 min to Philly, 1 hr to Baltimore, 2 hours to DC/NY, 90 min to Atlantic City, moonlighting available

Hennepin - 3 years, 11 residents (+2 EM/IM)/yr, 9 hr shifts, >100k volume, very little floor months but surgery heavy, 2 mo neurosurgery as R2, believer in "graduated responsibility" (AKA delayed gratification) so that as R1 you don't have many duties but by R3 you are running the dept, "pitboss" as R3 with no note responsibility, free food, 4 stabilization rooms with U/S mounted on each bay, airways only as R3, 12 U/S machines total which are directly linked to PACS, U/S tech hired to teach residents, EM on ALL traumas and surgery as consult, 1 mo community experience, OB/gyn involves inpt and outpt care, EMR (Epic), sim lab integrated into curriculum, great EMS relationship, 1 wk hospital orientation and 2 wk EM orientation, hyperbaric chamber

Brown – 4 years, 12 residents/yr, >100k volume, brand new ED with cath lab, 2 CT scanners, 72 beds with 6 crit care beds, awesome sim lab 1 day/mo, no boarding in the ED (is that possible?), strong peds EM program, large amount of trauma since they are the only show in town from New Haven to Boston, strong U/S program with fellowship available, 4.5 mo electives, trauma surg without scut work, conferences supposed to have more small group discussion this upcoming year, 20-22 shifts/mo, 9 hr shifts with 1 hr overlap, great international EM, 75 full-time facult, $50k salary as intern

Yale – 4 years, 12 residents/yr, 1 full month orientation, stong U/S program, 12 hour shifts, 18-20/mo as intern, 6 mo crticial care over residency, tox month at NYU Bellvue, 2 hours sim lab per month, 6 mo elective time, $51k as intern

USC – 4 years, 17 residents/yr, 12 hour shifts, 20? shift/mo, top-notch U/S program with over 20 machines, 12 resus bays, tons of procedures, EM has ALL hospital codes, work in the underground jail ED, excellent teaching with tons of videos uploaded every month, attendings doen’t write notes so that have more time to teach, observation unit run by attendings and NPs, new hospital with good facilities, no EMR using all paper notes but plans to upgrade

Highland – 4 years, 10 residents/yr, one month EM orientation, awesome U/S training with 2 U/S fellows, county program, great salary, uses EMR, ski cabin in Tahoe that residents share, one month off per year, 3 informal teaching session in the ED per day, free food all the time, no OBS unit so you must admit all low risk chest pain, rotate though many hospitals (Kaiser, UCSF, Children’s, SFGH), ortho rotation includes time in OR, great tox month at SFGH, weaker IM program can be frustrating

Carolinas - 3 years, 14 residents/yr, >100k volume, very nice hospital, only 1 hospital to rotate through, labs results broadcast to free PDA, didactics daily with free lunch and protected on off-service rotations, fellowships in tox/EMS/US/peds/research, large amount of off-service rotations but I was reassured that they are important, $45k/yr as intern, no EMR but orders by computer coming soon, no orientation month, 4.5 resus bays, no direct medical school affiliation, residents go to SAEM 2nd year and ACEP 3rd year

UMass - 3 years, 12 residents/yr, no medicine floor months but lots of ICU, 10 hr shifts, 20-22 shifts/mo, 5 u/s trained attendings and 8 toxicologists, volume 80-90K and growing, 200+ million dollar ED, new CT scanner, located in worcester (pronounced wooster), helicopter medicine - one month in PGY1 with a 2 or 3 running the show (the bird never flies without a resident) but can be grounded often in winter, every U/S is recorded and Q/A'd by U/S doc, likely elimination of PGY3 elective to Hawaii with free housing/car, 45-60 min from boston, plenty of trauma with all procedures/airway being done by EM residents, residents can moonlight in the ICU starting 2nd yr, 5 hours weekly of didactics, computer tracking system with labs/rads results but orders/vitals/nursing notes/MD notes are all paper and then scanned into computer that you can pull up later if needed.

Vanderbilt – 3 years, 12 residents/yr (increased by 1 this year), no floor months, 1 hr lecture each morning by PD or chair of EM, 1 month orientation with reduced ED shifts and great teaching, awesome EMR, >100,000 combined volume of main hospital and children’s, teaching by U/S fellowship trained EM physician, >3k level 1 traumas/yr, video review for each trauma, 2 BS toxicologists, ED radiology 24 hrs/day, emergency cardiologist in ED, 6 wks community ED, moonlighting allowed, 2 CT scanner, 4 active trauma bays, 10 hr shifts as R1, great sim lab with 1 day/mo, Keeping Up! (EBM review website) run by attendings, $49k as R1, fellowships for EMS/international health/peds, no anesthesia residents/attg necessary for PSA, tons of airway devices, evals p every shift/month/6mo, great EMS relationship

Previous years' ROL threads were a great help to me when I decided where to interview, so here's my part this year.

My list would also be much different were it not for 1) a spouse in the picture and 2) my interest in international EM, so take it with a grain of salt and to echo SuziQ, feel free to PM me with questions regarding any of the programs I interviewed at. Honestly, I'd be thrilled to land anywhere on my list.

1. Vandy Pros: INCREDIBLE faculty, residents, unparalleled teaching, the PD and chair are a dynamic duo that are very involved in resident education. Busy, busy university ED where you see ALL the trauma in a large catchment area, plus all the weird tertiary stuff, and your bread and butter. Great international opportunities with the Guyana residency, New Zealand, ect. Off service rotations are great, peds shifts are mixed into your regular ED months, residents are happy, 10 hr shifts with 1 hr built-in overlap, COL is incredibly low, Nashville has a great live music scene. Cons: Less diversity (in both staff and patient population), you're in a smaller southern city (+/-). Caveat: I rotated here, so I'm bias in that I'd already spent a month getting to know and love the people. But honestly, couldn't find a better program on the interview trail.

2. Brown Pros: this was the program that snuck up on me. I even considered canceling the interview. Like Vandy, a university program with a large single hospital program with a huge catchment area, very busy ED. Happy residents, warm faculty, great peds experience, strong support for international work and opportunities (currently setting up a training program in Nicaragua), 9 hrs shifts all 4 years, Providence has surprisingly low COL for the northeast and is a great little town with amazing food and recreational opportunities. Cons: It's in Rhode Island, 4 yrs > 3yrs.

3. New Mexico Pros: another single-hospital system with a huge catchment area (which I like for the reasons above), incredibly nice PD, down to earth faculty, happy happy residents, strong commitment to underserved care with a large indigent community, great international/wilderness opportunities, one of the best programs for critical care exposure, great reputation, large Spanish-speaking population, only 4 months of call all 3 yrs of residency, 9 hr shifts with 1 hr built-in overlap, you have skiing and hiking less than an hour away. Cons: the city's economy somewhat depressed, less job opportunities for spouse (this program would be my #1 or #2 if not for this), less ethnically diverse.

4. Highland Pros: well-respected program, hard-core county training, in a beautiful part of the country. Great service commitment, residents are happy, strong pedi exposure at CHO, tox at SFGH, 8 hr shifts. Cons: the faculty are quirky (+/-) and somewhat inbred, very weird interviews, draw your own labs as PGY1, ED itself felt a little small, not a Level 1, the cafeteria food (yes, that's picky).

5. OHSU Pros: old, well-respected program with happy residents in a beautiful part of the country, diverse hospital exposure (university, VA, community), faculty very supportive of residents, 1:1 with attending as PGY2.10 hr shifts PGY1, 8 hr shifts PGY 2-3. Cons: low-volume primary ED, only 1 mo elective time, have to drive a lot.

6. Stanford Pros: Dynamic faculty, content residents, 3 hospital system with exposure to university (Stanford), community (Kaiser) and county (Valley), an AMAZING amount of resources for anything you could possibly be interested in, great fellowships, great international and wilderness opportunities, beautiful part of the country to live,time for research/scholarly project built into rotation schedule. Cons: COL (highest of anywhere I interviewed-this was huge for me), low-volume at primary ED (Stanford) which is where you spend 1/3-1/2 of your time, intern year spent with a lot of off-service rotations (including medicine and surgery wards and NICU time), 12 hr shifts, "country club" feel (the catered lunch comes to mind).

7. Carolinas Pros: incredible community program with great training, I loved the PD and faculty I met, residents are very tight and social, 1 hr conferences daily instead of a 5 hr block, single-hospital system, great U/S experience, starting an international fellowship, great COL. Cons: I thought Vandy was a better fit for me when it comes to Southern programs, their int'l focus is in Tanzania (my interest is Latin America), medicine and peds wards months, Charlotte, a very "proud" program.

8. USC Pros: Incredible faculty and residents who obviously enjoy working at LAC, probably the most amazing county training out there (certainly busiest ED in the country). Great diversity in both staff and patients, huge volume ED that probably sees some of the craziest trauma and pathology, residents run their own "pods" and jail ED, commitment to indigent care, in SoCal. Cons: 12 hr shifts all 4 years, maybe a little too autonomous for my taste, can only do international rotations on your vacation time, LA is not my favorite city.

9. BWH Pros: amazing resources for international EM, great U/S program, friendly, well-connected faculty, great opportunities for research and an interesting mix of pathology, shifts are a mix of 8,9, and 12 hrs. Cons: residents were the geekiest bunch of the trail (but seemed very happy!), greater focus on research, Mass Gen's ED felt very cramped, COL in Boston, 4>3 yrs.

10. Emory Pros: great service commitment, huge county program that is also academic, diverse residents and patients, busy ED. Cons: the number of patients I saw in hallway beds!, not as much international support, very county feeling, strange interview.

11. Harbor UCLA Pros: amazing country program in LA, great training, well-respected, good autonomy. Cons: not much international support, LA.

12. Baylor Pros: amazing county hospital with incredible pathology and young, enthusiastic faculty. Shifts 8's on weekdays, 12's on weekends. Cons: too new of a residency program.

13. Duke Pros: Dynamic PD, good mix of faculty, happy residents, time for scholarly track, COL. Cons: not very diverse, Durham, still young residency program, hard PGY1 year with lots of off service rotations, not as many intl opportunities.

1. Brigham/MGH: POS: Two amazing institutions, The Name (Partners) which helps if you want to do something in addition to medicine, faculty, resources, admitting powers, off-service education, true SIM-lab along with true integration into curriculum, fellowship in US (not that i'm interested in doing US fellowship, but having a fellowship makes it more likely that we will get a good ultrasound experience), getting an expanded ED at MGH, impressed with 4th years (they get experience running obs unit and getting presentation from PAs- say what you will about the importance of knowing how to run OBS unit and PAs, but all you need to do is look at the news and realize the possible future of EM), can use propofol, You get bread and butter at both hospitals (albeit, you're more likely to see zebras at these hospitals). NEG: Surgery floor rotation (I don't mind medicine floor), only 4 ICU months (I wish there was one more instead of surgery floor), slightly worried about admission pushback (but ED has admitting powers, so it's okay).
2. BMC: POS: "Boston City Hospital"- so many people have trained there, admitting powers, ED is powerful there, trauma is truly run by ED, largest ED visits in the New England area, largest number of trauma (penetrating) in Boston, sees the most number of patients in the New England area, Boston EMS medical control, great number of fellowships. NEG: Ortho experience is what you make of it, POTENTIALLY a weaker peds experience as it's a Level II peds center, limited propoful use, trauma is run sort of inefficiently (3rd year does tube AND leads the trauma, which is contrary to the principles of leadership)
3. UPenn: POS: this place has everything I want (perfect number of ICU rotations), true integration with trauma, residents can use propofol, admitting powers, great off-service rotations, great airway toys, Pharmacy is in the ED to help with codes (drug calculations) and drug questions. NEG: The number of ED visits they see seems a little low, weaker/building from scratch a SIM lab curriculum.
4. NYP (columbia and cornell): POS: Two great hospitals, best peds experience in NYC (which is tough in NYC), subsidized housing available, resources, admitting powers, can use propofol. NEG: relatively new (that being said, it's made a name for itself). High cost of living in NYC
5. Beth Israel Deaconess Medical Center: POS: Academic, 3+1 option, the name, the residents, the faculty. NEG: lower number of ED visits compared to other programs in Boston, many off-site rotations (which are worth it for this program, but driving can be a hassle)
6. UMass: POS: Great toys, helicopter- TRUE integration of residents and nurses as a team, residents, the BEST facilities of any program on my list, PD is AMAZING, busy level 1 adult/peds, great number of fellowships, ED is very powerful here. NEG: location in Worcester (but that being said, cost of living is great with it still being relatively close to Boston)
7. Brown: POS: Amazing number of fellowships in everything you could want to do in the future, VERY busy with large volumes of patients (second largest in New England), Large sim lab, has access to basic science research (if you're into that thing). NEG: location
8. Northwestern: POS: perfect number of ICU rotations, well known, great facilities, great location in Chicago, gets a lot of trauma from the South side of Chicago (since U. Chicago is not a level I trauma center). NEG: No fellowships, except a research fellowship (I'm worried I won't get a good US experience if there is no US fellowship)