University of New Mexico Residency Reviews

I am happy to elaborate more about the places I interviewed...
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1) Denver: (+): amazing program, amazing location, 4th years blew me away managing ED. (-): almost no elective time
2) Hennepin: (+): very surgery-based program, Pitbosses run the ED 3rd year, critical care emphasis. (-): Minnesota.
3) Highland: (+): autonomous training, great group of people, nice location, self-sufficient residents. (-): unsure about strength of off-service rotations.
4) MGH/BWH: (+): great city, great resources, phenomenal international health program. (-) young program, 1 million potential consultants to be called
5) New Mexico: (+): great program, super nice people, SICK patients, nice outdoor recreation nearby, critical care strong. (-): location seemed a little ghost-townish for me, issues with movement of pts through department & flow
6) UMichigan: (+): huge critical care, no medicine wards, diverse training sites. (-): not a huge fan of the location/weather, worried about the # of consultants that could be called.
7) Bellevue: (+): big time autonomy, self-sufficient residents, reputation. (-) I am a little intimidated about the idea of living in Manhattan .
8) Maine: (+): the most friendly people ever, location. (-) seemed a little cushy for me
9) BMC: (+): location, underserved patient population, lots of trauma. (-): 2-4, PGY2s do ALL procedures in dept.
10) OHSU: (+): location. (-): didn't gel with the people
11) UC Davis: (+): sick pts. (-): nothing really set them apart, location
12) UCSF Fresno: (+): Yosemite, nice people. (-): couldn't really see value of 4th year, living in Fresno.
13) Stanford: (+): Paul Auerbach, lots of resources, bay area. (-): pts not sick enough, a little too academically snooty for me
14) BIDMC: (+): location. (-): unfriendly, extremely academically snooty people
15) Indiana: (+): fantastic program. (-): location

I also interviewed for the UVM Preliminary Medicine Year and the Transitional year at UC San Diego, so feel free to ask me about those...

Please note: the (+) and (-) are only my opinion. I'm sure there are several other people who had totally different experiences and therefore completely opposite opinions (which is why the match works!)

Disclosure: I rotated at UNM but have not interviewed there yet. I'm going to post my review and then edit it after my interview if I have anything else to add.

Program: University of New Mexico

Residents: This is a laid back group of people who are, you guessed it, very active and outdoorsy. I seemed like about half of them have families. A smaller group, which I think is nice. A few of the residents were always pulling my aside to show me some cool physical findings or procedures. Maybe a little more family oriented and a little less into the nightlife than other programs. Journal club was well attended and folks were having a great time.

Faculty: I don't know the exact numbers, but I think about 50-70% trained at UNM. There are a lot of different styles amongst the faculty, and I found this to be one of the challenges of my rotation – figuring out which faculty member likes what kind of work up or presentation. Some of the most hands on faculty that I've come across in that they will really sit down with you, listen to your full presentation, then challenge you with questions. They are a very active group – many are climbers, runners, etc. I really gelled with some of the younger faculty who were a lot of fun to work with and very on-the-ball.

Facility: Brand new, very nice, clean, and modern. Computer tracking system for labs, vitals, integrated PACS, past medical history, etc but they still do use paper charting. I prefer paper charting because I hate entering orders on the computer – seems like it chews up a lot of time. So here you just write your orders on a blank order sheet and give them to the clerk. Residents document on a standard H and P template. There are two pods of about 15 rooms a piece but there is no triage filter for either (i.e. no trauma vs. medicine side). The pods are named after the local mountain ranges – Mazammas and Sandias (gotta love that). There's a beautiful resus bay with 7 monitored beds where the sickies go. There's also a fast track pod staffed by PA's and you won't be there as a student or resident. PA's also work in the acute pods.

Ancillary Services: Not great, but not horrible. There's a nursing shortage here so they have more beds in the ED than they can staff. The nursing staff are stretched thin so I think they have a tough job. There are techs there who will get all your IVs. The techs love working there because there's tons of trauma.

Patients: Quite a mixture. Heavy on the urban poor but there are referral patients as well. Lots of Spanish speakers. UNM is the only tertiary referral center and the only trauma center for the entire state so they get complicated cancer patients, tons of blunt trauma, some penetrating trauma, burns, transfers, as well as all your bread and butter EM stuff. The pathology here is quite impressive given the fact that you're in a mid sized city. These people are sick. They are also quite appreciative of your care on the whole.

Clinical Training: The strength here really is in the patient pathology. I think it would be hard to get through this residency without seeing a little bit of everything and coming out quite comfortable with a hectic, busy, high acuity, county ED. Interns get a lot of responsibility here, more than many other places I've been, as the place is staffed a little thin. One pod may have just an attending, a medical student, an R2/3 and an intern although at other times the staffing was a little more redundant. One of the interns in my pod got to run a few traumas because the senior was tied up, so that's a plus. Some of the attendings have a very hands on style and were taking formal presentations from R2's but others were giving a lot of leeway to the interns, so it really varies. The pods alternate going to the resus room, which is usually quite busy with anywhere from 2-10 resus cases in a shift. During just one shift I saw 2 STEMI's and a few other trauma cases. You'll get some outdoors injuries – mountain biking, skiing, etc, and environmental tox such as rattlesnake bites to round things out. Progressive responsibility is less clear cut than some places I've rotated at – the interns and students present directly to attendings so the R3 does not do any teaching or supervision of the department. I heard something about red shirt shifts where seniors are only precepting but never actually saw this (maybe it happens during a different part of the year). The R3 does have a lot of autonomy, however, sees lots of patients, and often pulls the medical student or intern aside to show them something. For trauma, from what I observed - unless the patient needs a thoracotomy or will go to the OR then EM runs it. If they do need a surgical procedure done in the ED or the OR then surgery tends to step in.

Didactic Training: I only attended one session as I was always post-overnight on conference day. On the day I went there was a critical case conference presented by an intern and it was excellent. There were a reasonable amount of faculty there but not all. I don't know if they also do M and M and will have to clarify this. They have a sim center and sometimes do cases down there during the didactic time. There was an intro U/S session for the interns when I was there which was great. The seniors were separated out during one hour and I'm not sure what they did. I saw my first and only thoracotomy here and it was done by the surgery attending with the surgery chief as the assistant.

Peds: Solid. A strength of this program. They are seeing a nice peds volume in their own ED staffed by both dedicated peds EM docs and the regular faculty. The peds seemed like great acuity – mostly bread and butter, with lots of minor trauma and a decent amount of adolescents as well. When I was there they were staffing the peds ED 7a-1a, and were planning to go to 24 hrs in December.

U/S: I hung out a little with the R3 on Ultrasound and he seemed like he was pretty competent. Dr. Macias is a big ultrasound proponent and working with him is a lot of fun (not just for the U/S experience, but for his Hawaiian shirts and hippie attitude). They only have one ultrasound machine although I think they were talking about getting another. I don't know how many other faculty are credentialed. I don't remember doing any pelvic ultrasounds while I was there but I don't know if the capability is there or not. I would say the Ultrasound program seems average but I need to clarify some things when I go for the interview.

Research: The faculty are doing some. It's not like some places where there are tons of resources and lots of research assistants crawling around the department. Not known as a research powerhouse. In fact I did not hear much about what studies were going on while I was there. Another thing to ask about on my interview. Residents must do a QA project.

Other Curriculum Stuff: There's a month or two of community experience at some of the more rural and private EDs about an hour or 2 away from UNM. They are big into disaster medicine and have a few faculty quite interested in that. They are trying to start up a fellowship in air transport EM. I've heard great things about the unit time – residents getting lots of procedures and working on a team with a junior and a senior EM resident. I've heard that the trauma service is intense, but there are a few attendings who have dual appointments with surgery (JH trained critical care fellowships) and EM so this is making some bridges between the two specialties.

Location: An easy town to live in – traffic is not too bad, houses are cheap, it's close to the mountains and the Rio Grande, lots of active outdoor people. Most of the residents live up near the Sandias and some of the faculty actually live in the Sandias. If you love New York or Boston, then Albuquerque may not be for you. The town has a lot of strip malls but there are some more trendy areas as well. A great place to live if you love the outdoors.

Strengths: Great pathology, UNM is only game in the state so you're not competing for a referral base, tons of trauma and critically ill patients, great location if you like the outdoors, cheap cost of living, great peds and critical care, laid back people.

Weaknesses: ED throughput is a challenge. Some admitted floor and tele patients stay in the ED for 2-3 days I would say that at any given time you have about 20% boarders in the ED, but many of these have been there under one day. They work around this by sending patients to a holding room called "flow" when they are just waiting for labs or waiting to be discharged. U/S and research program might be average.

Rotation Specifics: This is an awesome rotation. You get to work directly with faculty all the time, but the residents help you out and will show you their interesting cases. You learn how to work with a ton of different attending styles. Sick sick patients, lots of variety, lots of great bread and butter EM. Since the staff are stretched a little thin you get a little more responsibility than most places. You can see a lot of trauma cases if you want to (but you are observing). The only thoracotomy I've seen was here. The didactics for the rotation are in a different league and are so good that they can't even be compared to the other programs where I rotated. We got to do a peds sim and adult sim. Each week the faculty would have us take a 10 question multiple choice board style test and then go over the questions with us. This was great because they picked high yield questions that were also great pearls. Then the faculty would have an article or two pertaining to one of the questions. There were very few of the standard powerpoints – all very interactive.

Overall: Excellent residency training, very sick patients, great peds and unit experience, maybe a little behind on U/S. I would be happy to match here and will be ranking it highly.

UNM

Residents: 10 residents/yr. The residents get along well with each other and have monthly meetings with class to give PD feedback, as well as frequent get-togethers. All the residents were friendly, nice, outdoor enthusiasts, and seemed to really enjoy the program. Residents are evaluated after each shift informally and give feedback every month in class meeting with PD. Residents are also evaluated by nursing staff once per year. Residents are some of strongest in hospital and looked upon favorably by other services. Apparently, surgery is really weak in this hospital and one resident was told by attending surgeon that codes run much better when just being run by ED vs. trauma helping. Ortho also really strong. 60/40% do community/academics with most popular fellowships being critical care and US.

Faculty: 41 faculty that all seemed extremely nice. Per residents, ED teaching is excellent with offservice teaching being average. Most attendings are on first name basis with residents and apparently hang out often with residents outside of work. PD is super nice and very authentic. Chief was never mentioned. PD will go to bat for you when it comes to job searching time, but only said he gives you contact info for alumni and will call/write on your behalf. It appears most alumni stay in west with large concentration in NM and a few in OR, CA, WA, TX, CO. It appeared as if many of the attendings grew up, went to school, or did residency there which makes me question how much inbreeding there is (17/37 that I counted)….but it does say something for the program and city.

Ancillary Staff: Half of nursing staff is core group with other half apparently coming and going on rotating basis. Nursing is good, but varies depending on which nurse. Nursing overall seems to be stretched thin.

Curriculum: Three year program heavily focused on critical care. I think they work 6 critical care months and noted that neurosurg hates doing critical care so ED residency practically runs the NSICU. PICU month was recently discontinued to add another peds ED month. Likewise, medicine floor month will be no more starting next year! International is really big here with a fellowship starting up. They are currently creating a separate division of International medicine before starting the fellowship, which should be up and running within next 2 yrs. LOTS of contacts all over the world with one faculty having lived in Nepal and another faculty working 3 mo/yr for Doctors Without Borders. Amazing wilderness elective for students that you can help teach on, but don’t know how active you can be in taking the class. US used to be really lacking at the program, but they just hired alumni who did US fellowship. She has turned around US program and everyone raves about it now saying they get lots of exposure. She lectures monthly in conference and holds extra optional lectures for those interested. All ultrasounds are filmed and reviewed. Helicopter is optional and per one resident is still being worked on (contacts aren’t stellar). Despite this, they have very active EMS program/fellowship that can specialize in helicopters or Disaster. DMAT is most active in country and does really cool stuff. There is an active simulation center (BATCAVE) that has several dummies including one hi-fidelity manikin. On tour, this seems to be a single manikin in a single room that does not resemble a real trauma bay, but still suffices for any need. I assume they just switch out the different manikins. Simulations occur 2x/mo. Residents also go through a performance exam on manikins once per year. Residents can moonlight within system in third year if research project is finished. I assume residents moonlight for fun/extra money b/c cost of living is pretty cheap. Every resident is required to do a research project. Active public health/injury prevention program as well. ED is set up in 3 pods with one being the fast track/obs unit and the other two taking the same kind of patients. Traumas/resuscitations are handled by upper-level in separate resuscitation room. These trade off between pods which can often leave the intern(s) responsible for moving the traffic in the other 2 pods. There is also a separate section for psych patients with supervision - also alternates between the 2 pods. ED gets all airways and all medical resuscitations. ED responsible for primary exam and airway in traumas, and trauma surg is responsible for secondary survey. Surgery does all thoracotomies; lines and chest tubes go back and forth. Off service rotations seem to be pretty good with average amounts of scut. One elective is guaranteed to be out-of-state if you want it with second elective being questionable. Two elective months total.

Peds: Strong peds experience with new peds center increasing volume. Will have peds fellowship soon. Residents do 2 peds month as PGY1 and then get a couple of shifts/mo for other years. No PICU rotation (used to have one but did away with it b/c residents felt they did more/learned more in the peds ED).

Didactics: Weekly; protected time. They read Rosen, going through same curriculum every 1.5 yrs so you go through it twice. PD said they attract high caliber applicants and therefore don’t teach to the test or overemphasize the in-service exams – they just teach EM. Despite this, they have a 98% board pass rate on first time.

Research: Scholarly project mandatory. Didn’t seem to be too heavy on research.

Facilities: New ED with 3 pods. Fairly large and spacious with individual rooms and sliding glass doors. CT and MRI in ED with ICUs directly above ED. Radiology reading rooms and cath lab in old hospital (far walk), so you can call radiology but don’t plan on running over to talk to them. Nice call room which you will never use. Only level 1 trauma center in NM. Peds ED also new and equally nice. You have access to UNM’s library and other facilities (e.g. undergrad gym). Boarding is a bad problem. Two rooms are designated “Flow Rooms” which are run by Paramedics and are essentially for people just waiting on CT results who will go home – this frees up another room for another patient.

Charting: Paper charts and orders with labs/rads coming through on computer. Per resident, orders are going to start being placed electronically as well.

Location: Albuquerque is an extremely outdoor oriented city. While definitely not the prettiest city, with most of the city being brown and without grass, it is made up for by close mountain ranges on the horizon. Crappy skiing is nearby with decent-good skiing being a couple of hours a way. There is also white water rafting close by and lots of hiking, biking (road and mountain), and rock climbing on the outskirts of the city. Cost of living is dirt cheap with most residents owning new homes. Apparently the housing market is still fairly good here, as is the economy, but as one resident put it – New Mexico is used to living on less than the average amount. City is on same altitude as Denver so summers are mild (with avg highs in low 90’s without humidity).

Extras: Elvis picture shrine in the ED conference room – just really random. Shifts currently being phased into a ~20x overlapping 9’s with decreasing shift load each year. Chiefs make the schedule and you can schedule days off. Schedule progresses naturally (days->evening->nights). You have 3 weeks off that can be taken at any time and in any way (don’t have to take 1 week at a time). If you take time off in ED month, it only counts as shift reduction instead of week (e.g. if you take 1 week off this is really only 4 shifts off with 3 days normally being scheduled off…so you are only docked 4 days of vacation instead of an entire week). Extremely diverse population seeing indigent and tertiary population, and lots of Mexicans and Native Americans. Very family/pet friendly residency program with majority of PGY2+3 yrs being married with opposite in PGY1 (I think).

Interview: Talk with the PD; no breakfast provided. 4 interviews - one with PD and one with resident. Interviews followed by lunch (mmm….green chile) and tours. Interviews conversational in nature.

I'll post this caveat before each of my reviews: I'm not really a numbers person, so I don't really remember all the details like annual number of patients seen, board pass rates, etc. etc. So, forgive me if some of my details are slightly off and feel free to correct them.

Residents: Very outgoing and talkative bunch. Interestingly, I didn't run into many PGY2s or 3s. Mostly interns at the functions I was at, so I didn't get a really strong impression of life beyond the first year. A lot of residents with kids and spouses. It also seemed as if there were a lot of people from the West Coast and mountain states and that everyone -- everyone -- was big into outdoor activities like hiking, skiing, climbing, biking, etc. Almost to the point that if you're a bit of a couch potato like me you feel somewhat left out.

Faculty: Kind of an eclectic group of people, which was a really good thing to me. Interviewers talked to me about books and reading, innovation grants, and vegetarianism. They seemed to have a very diverse set of interests, and I was impressed by the number of faculty who were involved in disaster medicine and international medicine. I was also impressed by the faculty who expressly stated that they were in academic medicine so that they would be more free to practice with underserved populations. I liked the PD; he seemed laid back but also on top of things. As a matter of fact, I would say they were a pretty chill group overall. This wasn't a program that was too full of itself by any stretch.

I was also told that the faculty are incredibly responsive to resident concerns and will constantly work on the curriculum to meet resident needs.

I asked residents if they spent much time fraternizing with the faculty (which is something I look for in a program), and I got the sense that it wasn't as much as in some other programs.

Curriculum: The thing that I liked best about this curriculum was its flexibility. It seems as if students have only 17-18 shifts (8-hr) per month and are encouraged to use their free time to pursue their own academic interests. A lot of residents get involved in teaching, EMS, wilderness medicine, and disaster medicine. I think it would be kind of easy to skate by in this program if you were lazy, but I also think that if you're motivated you would have the resources and opportunities to really excel.

Facilities: Outstanding ED. Otherwise, meh.

Location: ABQ was a little bit of a paradox. The town itself was kind of poor and definitely had that small town feel that, if I had grown up there, I would be hell-bent on escaping. But as a transplant, I really liked the Mexican and Native American influence on the city. And there are sections of the town, like Nob Hill, that are kind of hopping. But the best thing about ABQ is the geography. You're surrounded by mountains and some of the most beautiful country in the Southwest. And I hear the weather is phenomenal pretty much year-round.

Negatives: From what I understand you don't get to ride the helicopter anymore. Is this right? Also, I was told by one of the senior residents that some of the off-service rotations aren't that great. Some people could get turned off by ABQ.

Other points: This seemed like a very impoverished area. With the poverty and the Indian and Mexican populations, you get to work with a very unique population, which was attractive to me. However, being as poor as it is, I wonder if some of the residency programs suffer because of it.

I didn't get a sense that there were many opportunities for moonlighting. For example, some of the hospitals that 3rd years could moonlight at were over an hour away.

Oh, also, they have some really great fellowships. I'm not sure how much emphasis to put on that while applying for a residency, but if I didn't want to move again, that would be a factor.

Overall: I'm not sure what I was expecting going in as I hadn't heard much about this program, but it exceeded my expectations. I loved the faculty, the emphasis on working with the neediest patients, and the flexibility of the curriculum. I'll be ranking this program in my top handful.

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.

This review is by a user who interviewed at this residency and wishes to remain anonymous.

Hospitals:
• University Hospital (80K>) – main one for ED and offservice training. Level 1 trauma center, regional burn center, referral center, new ED opened in 2007, 82 beds, high admit rate (>16%), all private rooms

Resident Life:
-Vacay: 3 weeks plus 1 week for educational conferences (can use educational time however you want, $500 funding).
-Hours: 17-18 9 hr shifts/month PGY1 (1 hr built-in check out), 20 9 hrs as PGY2, 16 9’s as PGY3. Hours are less while acting chief resident 3rd year (all residents have opportunity to act as chief resident).
-Facilities/Ancillary: All patients have their own room (with a door) in the ED, except for the trauma bay which can fit 7 patients at once (which does happen, and the resident I was talking with got so animated, clearly pleased by the trauma here). Ancillary staff very good. No need to draw blood, give meds, take patients to X-Ray, ect. Only problem is that the emergency radiology reading room is in another part of the hospital, and it can take a while for the reads to come back. So they have to call them, but aren’t looking at the scan/image with them.
-Culture: All the residents I spoke to love the program, one resident told me that “Aside from 4th year, these have been the best years of my life.” Sounds like many of the residents are from the West Coast. Faculty and PD very supportive, residents get along well and socialize often. As for the patient population, there is a high rate of poverty and indigent care, drug-seeking, ect. But since it’s also the only tertiary care facility around, you get affluent and middle-class patients as well. Very mixed, but very few African Americans. The ED is busy, but everyone was extremely laid-back. Most of the faculty appear young and enthusiastic, very supportive of the residents. They don’t have to see a certain number of pts/hr, not as concerned about throughput. Program has a great reputation, residents get jobs wherever they apply although most tend to stay west of the Rockies.
-Moonlighting: Internal moonlighting starting PGY1 ($30, $40, $50/hr), outside moonlighting through locums tenem office at UNM spring PGY3.
-Living: Relatively low cost of living, 15 min away from trailheads, 1.5 hr away from skiing. The residents I spoke to sound like they have a lot of time to do things they enjoy, in particular big on outdoor rec here. Some of the other non-medical fields (esp teaching) are depressed. School district isn’t that great. City itself is 700K-1M people. City can be culturally lacking in terms of fine arts, but rich in terms of the multicultural area.
-Benefits: Meal allowance is ridiculous (can’t eat enough to spend it all), unionized, 5 holidays off/year, textbooks covered + $500 educational allowance.

Curriculum:
-3 year program. Heavy on Intensive care: 3.5 mo PGY1 (Trauma/MICU), 2 mo PGY2, 1 mo PGY3. MICU is a great month. Off-service rotations: Only 4 months of call the entire 3 years (MICU, Cards consult, ?). Two months elective time 3rd year (flexible, can do 1 mo 2nd year with good reason), 1 of which can be spent out of state with multiple int’l connections (or more than 1 mo if you want to take LOA or if there is funding available). Faculty do international work in South America (starting an EM program in Argentina), has established programs in Nepal, Kenya, Japan. Ultrasound 20hrs during Tox/US as PGY1, 20 hrs during EMS/US as PGY2. Curriculum requires research & community project to be completed by end of residency, very flexible can make it what you want.

Didactics:
-5 hrs weekly, designed as 18 mo curriculum so go thru everything twice. Weekly M&M, joint trauma conferences, monthly journal club, “Bat cave” sim lab.

Research/Fellowships:
- EMS, Pediatric, Sports Medicine fellowships. Might be starting a wilderness medicine and/or international fellowship in next couple of years. A lot of residents go on to do critical care fellowships since the program is so critical-care heavy.
-Faculty research interests are varied, lots of good mentorship and funding available for international work.

Faculty:
-40 full-time faculty, most very young, laid back, go by first name basis with residents. Very supportive, great mentors. I absolutely LOVED the PD, as well as the associate PD. Great support of residents, very powerful department at UNM and well funded.

Overall:
-Great program with a huge catchement area, strong commitment to underserved care, very laid-back and happy faculty and residents. Only drawback is Albuquerque, which could be a +/- for some people, it can feel very "in the middle of nowhere" and while the city has a large Hispanic & Native American population, it doesn't seem very ethnically diverse beyond that.

There are some great reviews above, but no one has commented much on who owns the trauma, airway, procedures. Can someone familiar with the program (preferably a current resident or recent grad) give an update on the following?

• What are the average number and length of shifts (in hours) per month for each PGY year?
  
  
• Are shifts stratified by acuity (e.g., “trauma” shift or “resuscitative” shift), or is the entire spectrum of pathology/trauma seen on each shift?
  
  
• Who runs the trauma, EM or surgery residents, or is it an alternating schedule?
  
  
• Who does the emergency procedures (intubations, chest tubes, resuscitative thoracotomies, etc), is it shared with anesthesia/surgery residents based on an alternating schedule?
  
  
• Are there any emergency procedures that EM residents are not allowed to do (RSI, thoracotomies)?

Thanks so much for your time and contribution.

While it is kind of annoying to see these posts everywhere, I understand the rationale. I rotated and interviewed at UNM so I think I could offer some insight. To be honest, I would say that all of the previous reviews of UNM are still relevant. The program is really critical care heavy and they have continued to add ICU fellowship trained faculty.

The shifts are as above - basically 8 hours with an hour built in for charting (Cerner). There are two duplicate teams working in the ED (plus a resuscitation shift made up of an attending and senior on weeknights) whose shifts are staggered by an hour. This allows a protected amount of time for shift change and the residents seemed to get done pretty close to the 9 hour mark. Compared to some of the other places I rotated at, UNM had probably some of the most efficient shift changes around.

As others have mentioned, there are two pods of ~30 beds each that are identical. The patients are sent to either pod randomly without any stratification. There is also a low acuity pod and a psych/ETOH pod; the low acuity pod may become integrated into the main ED workflow soon but it is currently run by an attending and mid-level (occasionally a student as well). The ETOH pod is covered by both teams on an alternating basis. The resuscitation area is normally covered by one of the two teams on an alternating basis except during high volume times M-F when it is covered by an attending and senior resident. When a patient triaged to the resus bay comes in, the interns do not pickup that patient for the first half of the year.

Level 1 traumas are handled by the trauma team, with EM handling the head/airway. The two services get along well and procedures alternate between them. Also, there is usually an EM resident on the trauma service. The only procedure EM is "not allowed" to do is probably a resuscitative thoracotomy (although if you're on the trauma service, you may get your hands wet in this case).

As for everything else, not much has changed. The ED is newish and just as nice as any other major ED I've seen. The EM dept moved a few years ago to their own building which also houses the EMS training academy, disaster medicine program, etc. The nursing staffing seemed adequate when I rotated there; they, along with the techs, are fantastic. The techs will actually clean and anesthetize lacs for you! I thought that was pretty dang cool.

ABQ is a great place if you're into the outdoors, less so if you're into fancy-pants operas and stuff. When I was there, I was able to ride my mountain bike almost daily. While it is not the safest city in America, I never felt as though there was a constant threat of harm. Just like anywhere else, make good decisions and you'll be ok. ABQ is not the hottest job market for young professionals unless you work in defense/atomic energy/garage-based chemistry stuff.

Overall, I can't imagine why anyone wouldn't want to be a resident at UNM. The faculty are really supportive and represent a wide range of interests and backgrounds. The pathology is diverse; in my month there I saw a ton of things I never had before as well as plenty of routine stuff. As a medical student, I found the residents to be approachable, enthusiastic, and interested the quality of our experience. I think that they wouldn't be like that without them having similar levels of support.

Below is a collection of brief reviews based on interview days/rotations from the ROL 2014-2015 and 2013-2014 threads. They aren't full reviews, but they do add some recent review-type of information.

From the ROL 2014-2015 thread:

TimesNewRoman said:

Anonymously posted: University of New Mexico: (+) Huge catchment area leading to high volume of sick patients, diverse residents who all seemed very strong, impressed by the commitment of residents and faculty to their patients, ABQ is a really cool place to live with cheap COL and great outdoor access, Dr Rimple is amazing (-) Too much boarding in the ED, Personally I didn’t click as well with the residents here

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racerwad said:

University of New Mexico
Pros: single site; I like the faculty and love the PD; residents are super cool; EMS experiences can be longitudinal (and there is a fellowship); nice facilities; afternoon didactic time (starts at 1100 w/ lunch); dept has really effective shift changes; EM well represented in University leadership; really great ED nursing/ancillary staff; strong US and ICU experience both in and out of the dept; lots of ICU time; integrated peds
Cons:

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Beets said:

University of New Mexico - I really liked the PD here and had a nice chat with her. Albuquerque is a pretty cool city and this is a well respected program.

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From the ROL 2013-2014 thread:

TimesNewRoman said:

University of New Mexico: Positives: friendly atmosphere, awesome PD/APD/chair, EP's in many leadership positions throughout the hospital and EM recognized as their strongest residency, generally recognized as a strong program, excellent job placement in the rocky/west region, emphasis on wellness/ giving enough time for reading/research/EC's outside of the ED, off-service rotations well thought out, older/tried and tested program, awesome mix of county and academic with some time spent in the community, cool resus bay with lots of autonomy/responsibility there as a senior, good set up of graduated responsibility overall, only Level 1 for the entire state. Lots of time in ED second and third year. Strong global health/disaster/wilderness and somewhat flight programs, living in New Mexico with hiking literally in albuquerque, Taos not far, tons of outdoorsy opportunities and the quirky vibe of ABQ. Works great for SO. Felt very fortunate to interview here.
Negatives: Lots of other residencies at UNM make me concerned that I won't get as many procedures as at a community program (don't get level I trauma's unless on trauma team), some issues with boarding which makes me wonder if the shorter hours in the ED may translate to not enough patient contact time.
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1. Maine Medical Center (+) No sub-specialty residency program (ortho, oto, ophtho) means you will be doing all reductions and procedures. Only level 1 trauma center in state. Majority of faculty are fellowship trained. Portland is an amazing city that is close to mountains and right on the ocean. By far the friendliest group of residents. 85K volume with only 10 residents/year. (-) diversity.
2. Hennepin (+) Prestigious. High volume >100K, lots of diversity. Lots of critical care. down to earth group of residents. Minneapolis is a great city. Manage whole ED as 3rd year "pitt boss", trauma surgery comes to level 1 trauma IF consulted (-) learn by brute force, very very high level of autonomy, no airway until 3rd year, lots of neurosurgery
3. UC-Davis (+) good balance of academic and county feel. high acuity, good volume 85K, Outdoorsy group - close to Tahoe. Bike to work 365 days/year. Spend time at Kaiser and academic center, good fellowship opportunities (-) serious boarding problem
4. Denver Health (+) prestigious. High volume. Spend time at both academic and county hospitals. Location. Reputation will take you anywhere after graduating (-) malignant, 4 year program, proud to be worked to the bone
5. New Mexico (+) good balance of academic and county access hospital, lots of diversity, residents were super cool, Sandias mountains extremely close, full time U/S teacher, 9 double boarded EM/CC faculty (-) albuquerque was a little too weird for me
6. Iowa (+) distinguished faculty, global health opportunities, good critical care, 9hr shifts (-) Iowa city, 60K/year
7. Oregon (+) location, variety of training sites, awesome turnout at interview dinner (-) 50K volume at main site, very small ED.
8. Utah (+) location, outdoors access. Community site was amazing, but only spend a few months out of three years there. (-) small academic low volume ED, pretentious.
9. Pitt (+) good variety of training sites, great reputation, jeep seems baller and great way to get admin and field experience (-) Pittsburgh seems a little rough, not much going on outside of pro-sports, new PD this year,
10. Cincinnati (+) well-oiled machine, prestigious, 6 mo. elective time, 90K volume and 100K at Cincinnati childrens, PD lets you transcutaneously pace him on interview day, full time U/S teacher (-) 4 years, location, 12 hour shifts
11. Regions (+) very laid back, 80K volume, international fellowship opportunity (-) didn't get a great gut feeling, only work evenings and nights 1st year
12. Arizona - University (+) diverse patient population, border health, global health, 85K/year, Rosen on faculty (-) Tucson is not super cool, 1 resident came to pre-interview dinner, like to do research, recently acquired by Banner HMO

Hey all, I used these threads (for better or worse), so figured I'd return the favor:

I liked UNM a lot on paper, but my geshtalt just wasn't all that high day of. I also interview there late in the season so I might've just been burnt out. Anyways...

Pro: social was great the night before, residents were a lot of fun and relaxed, big outdoors scene in the area. EM Critical care and wilderness medicine are big here. PD was great, and my interview with her was very momrable. The other faculty I met were very nice. This is a very underserved population, and going to UNM you have the opportunity to really impact the community. Well established and competitive program. A good mix of academic and community. I appreciate the pod system they have set up (outlined in other posts above). Trauma experience seemed plentiful.

Con: ABQ is not the most happening place, but it's quirky in a lot of good ways (for me), CoL is stellar, and the outdoors scene is really great. Bigger cities are not far (Santa Fe, Denver). I had poor resident turn out for the interview day, but friends who interviewed on different days did not have that experience.

I thought Santa Fe was a smaller resort town compared to albequerque ?


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bravotwozero said:

I thought Santa Fe was a smaller resort town compared to albequerque ?


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It is. ABQ is the largest city in NM by far, trailed by Las Cruces, the 2nd largest.

bravotwozero said:

I thought Santa Fe was a smaller resort town compared to albequerque ?


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Santa Fe is probably more comparable to an Austin or Boulder. More like a yuppie town with great food than a true tourist town like Vail or Aspen.

mega_colon said:

Santa Fe is probably more comparable to an Austin or Boulder. More like a yuppie town with great food than a true tourist town like Vail or Aspen.

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Was in both in 2014. I thought both towns were pretty sweet. My wife asks to go back all the time.

RustedFox said:

Was in both in 2014. I thought both towns were pretty sweet. My wife asks to go back all the time.

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If you go back, check out Silver City. It's a bit of a drive, but it's a very cool Old West kind of town. You can stay in a historically preserved hotel and hire a guide to take you around the mountains on horseback for pretty cheap.

WilcoWorld said:

If you go back, check out Silver City. It's a bit of a drive, but it's a very cool Old West kind of town. You can stay in a historically preserved hotel and hire a guide to take you around the mountains on horseback for pretty cheap.

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We'd love that.

We drove south from ABQ about 3.5 hours to the Trinity test site on the ONLY day of the year it was open to the pubic. What a long, dusty drive.