University of Louisville Residency Reviews

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DOCOFMED07

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First I must say that I agree with EVERYTHING ElZorro had to say about Vandy. It is EDUCATION, EDUCATION, EDUCATION. The residents are really nice (good southern hospitality) and they genuinely love where they are. As with every other program I've been to "it was my number one" was pretty rampant when talking about ranking. The free-standing children's hospital was a definite +++: who doesn't like seeing children ONLY in a peds ED and adults ONLY in the adult ED?!! Research is not very strong, and there was no mention of a required "scholarly project." Which could be a + or - for some of you (definitely a plus for me). I'm sure most of you have at least heard about how the interview is so different in that they don't ask you anything about your file but it's simply a "what do you want to know about me" kind of thing. That throws some people off, but as my first interview, it was definitely quite refreshing. Okay, okay, PM me if you want to know more about them....
Now on to the main topic - Louisville. I can't say I've seen many posts on here about this school. So not sure who will really care about this post.
Interview day: started late with an hour-long + presentation by the chair herself. She's relatively new into the position and has a lot of great ideas on the way she wants her program to be and where she sees it going. There was interview "tag teaming" where you have a faculty and resident together, however, because some residents and/or faculty like to talk more than the allotted time, the interviews were ran in tandem by the end of the day. I remember specifically Dr. Vicario (who may or may not be the program director - it says he is on the website, but his actual position was never confirmed during the entire day) was pretty malignant (more than what I was used to) by grilling me on my application and trying to put words in my mouth. I'm not kidding. "So since you live in X, you would naturally want to match at Y and not here, right?" What is that?!! Aren't YOU trying to sell your program to ME?!! So anywho, they definitely pride themselves on being the second EM program in the nation, flaunt that they don't fly (risks outweight benefits to them), and are quick to tell you average board scores and how honored we should be that we were granted an interview with them "as it is very hard to even get your foot in the door."
Wow, this is getting long so I'll cut down to the pros and cons
Pros:
- LOTS of autonomy. If any word would sum up the program, that would be it.
- It is "resident run," where the residents certainly have a HUGE say in how their education is going to be. Any suggestions made by the residents are taken seriously.
- There is a didactic orientation month with minimal ED shifts, which I find is not that unusual these days. It may be more unusual if you DON'T have this month. Apparently the residents have *great* bonding time with lots of mention of beer and beer.
- GREAT shift time. Apparent good spread with 8-10 (can't remember which one) hour shifts during the week and 12 hours shifts on the weekend. Interns only work about 18 shifts/month on average. And it progressively declines from there (R2s about 17 and R3s 14-16).
- Pretty decent curriculum in that you really don't have much off-service after intern year. Peds anesthesia is only 2 weeks and you have a month of MICU in R2 year. Other than that, you're either doing EM, an elective or on vacation. That's SUPER sweet.
- There are 2 or 3 (can't remember) chief residents who are R3s. Nice you wouldn't have to stay an extra year for this position if this is a goal of yours.
- Separate peds hospital - so again, kiddies seen in peds ED, adults in adult ED. :thumbup:
Cons:
- Medicine floor is still an off-service rotation here. Yuck. :thumbdown:
- No real diversity in residents. All from mainly one region (southern or KY specifically). Can't really blame this on the program, but if it were REALLY strong, perhaps people would be willing to leave their midwest/northeast/northwest comfort zone to come here?!! Not sure. Perhaps they got the same question from Dr. Vicario as I did - that REALLY turned me off. :mad:
- MC trauma are farming accidents. :confused:
Pro or Con:
- No mandatory flights. Yes, you can try to fly optionally (didn't ask if it would replace a shift or not! I can still email....), but if this is very important to you, you may not like this program very much.
- Location. They say they're "northern" but KY is backwards enough to truly be considered the south. In the same vein, they pride themselves on having lots of undeveloped land to "play" with: good parks, hiking, etc. So lots of outdoor activity if you want it. Great place apparently for singles and couples.
- Trauma EVERY DAY. One resident mentioned he did not care for trauma by the time he finished because you get SO MUCH of it. So this could be good or bad for some of you. You have your main patients in the 20+ bed area, but then you abandon all when the traumas come in and the nurses run everything while ALL of you are gone. You are supervised (by upper levels)as an R1 but you're pretty much running it all by yourself as an R2. One 4 bed trauma bay coined "Room 9."

So in totality, it was a great day besides the one interviewer. Lots of perks, but not really loving the location. No pro football or basketball team (who doesn't like cheering for the home team?!!), but U of L gets LOTS of love (as you could imagine). Won't rank them high, but hopefully this will help someone else....
PM me for more questions.

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UofL is my home institution. Going there, you'll receive ungodly amounts of autonomy and a load of excellent trauma training. The 2nd and 3rd year residents run the traumas (coined room 9s) and have the say on whether or not to page the trauma team, anesthesia gets nothing unless they're called also. The attendings are always in the room, but they stand in the bay across from the one in which the action is occurring and observe, unless you ask them a question. The PD, Dr. Mallory, is great, as are the rest of the faculty. They're all very approachable and interact with the students and residents as peers for the most part.
There are no admitting privilages, so you still have to 'sell' your patient, which usually doesn't receive too much push back from other services (except occasionally cards and trauma). The nursing staff is great and there is really NO scutwork to be done by residents or students. You get a meal allowance of $7 per meal for breakfast AND dinner everyday, but this has to be used bt 630AM-730AM and 6PM-7PM. Parking is subsidized, the insurance plans are great and fully paid for by the institution. The monthly schedule is pretty nice too (while in the ED). Pay is very decent bc Louisville's cost of living is so fantastic. The park system here is truly unbeatable (except for maybe Portland or Denver), the weather is good, AND we have bourbon and horses, what more could one want, (besides maybe US training). I've been speaking with the PD and one of the attendings about this though, and there are efforts under way to institute a two week US training course as part of the curriculum as well as making a 4 week rotation in US an elective option. PM me with any additional questions.
 
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Posted anonymously on behalf of a student who interviewed there.

U of L
Faculty: Very accomplished and pleasant. The PD said that the faculty was “older but still easy-going” and I think that’s true. However, they have a small faculty (10 FT and 8 PT) and most are program grads.

Residents: Were mostly southern/Midwestern.. Reportedly get along well and treat each other as partners; each class functions as a group and is self-governing & collaborative, per the PD.

Curriculum: Autonomy seems to be the keyword here. You will have exposure to all acuity/CCs early on. As a 2nd year, you do not have to staff all of your pts (you are NOT treated like a med student). As a 3rd year, you start to act as an attending. They focus on “experiential training” and stay very busy. Intern year PEM is separate; it is integrated in PGY2-3 (2-4 shifts/month during EM months). Residents do not work in the fast track area, but it is an internal moonlighting opportunity during PGY2-3. Do lots of other moonlighting too- double and single coverage in community EDs in KY. Trauma is huge (40% of ULH pts). Surgery only comes down for Level 1 traumas. EM PGY-2 and 3 alternate running the traumas. When it’s the 2nd year’s turn, they get to try but the 3rd year is there for back-up if help is needed.

Didactics: 2 hours twice per week plus various other activities. Content changes monthly. Become ACLS instructor during PGY-2 and teach med students. Also ATLS/PALS certification. M&M and S&S (saves and successes) conferences. Also have a Business of Medicine series done during 2nd year spring semester.

Sim: don’t use much sim because busy with real pts, said the PD. Do have “Trauma Man” labs where they get practice with crics, DPLs, CTs, central lines. Oral Board sims 1-2x/year.

Scholarly project: everyone does one. 30% present at regional or national conference; 10% publish.

Intern orientation: 1 month. 8 ED shifts, Fire Day, Tour Louisville clinics, 1 day U/S course, social activities.

Lifestyle: PGY-2s have 8 hr shifts only, PGY-3s have 12s on the weekend (this is by choice). Get food while on call at nights; not during the day. No textbook fund.

Hospital(s):
ULH: 55,000/year. ULH is pretty nice. ED is mostly divided by curtains, but there are a few private rooms. “Room 9” is the trauma/resuscitation room. It is separated a little bit from the main ED. When a relevant case comes in, the overhead buzzer goes off and a light lights up, and everyone quickly goes to Room 9 for the resus. It actually consists of 4 bays in one big room, and is right next to the CT scanner. Sometimes (but not usually) all 4 bays (and occasionally even the hallway) are in use in Room 9. The facilities are on par with what I’ve seen at most places.


Kosair Children's: 55,000/year. A little less autonomy than elsewhere, per residents. PEM fellows, PEM faculty, peds residents.

Jewish: community-ish hospital but transplant center and no peds. See lots of geriatrics here.

Audubon: community- peds and adults. 15 minutes away.

City: Louisville is pretty nice. Lots of bars and outdoor activities. Didn’t really hear much about the city during the interviews.

Interview Day: No breakfast- so eat before!! Day started out with a talk by the PD about the program- no slideshow, just a talk with some dry erase notes. She went over the main academic components of the program but didn’t really talk much about the social or city aspects. Then, we went to a conference for an hour. After that, we had a group interview. This part was (IMO) pretty strange, although apparently it is the first year they are doing it this way. It was supposed to be more “conversational” than a one-on-one interview but it just ended up being kind of awkward. After that, had lunch (still divided into 2 groups of interviewees), this time with 2 faculty and 2 residents- this was much more relaxed. After that, had 2 interviews (one with a faculty member and one with a resident). They were supposed to last 15 minutes but some people’s lasted much, much longer (like 45 minutes) and no one knocked on the door to end the interviews or anything. After that finally wrapped up, went on a tour of the ED and hospital. Then, since they did not have a dinner prior to the interview, we went to a bar/restaurant with a few of the residents.

Negatives: PAs/NPs in the ED serve in the exact same role as residents. They used to just work the Fast Track area but now work the main ED area (including Room 9) with the residents! It concerns me that they may take a lot of pts/procedures from residents- maybe someone else on here with more experience with UL can speak better to this?? Small faculty. Older chair and many older faculty- said program may be shifting a lot in 5-ish years when they retire. Relatively small patient volume (but awesome trauma).

Summary: Trauma and autonomy are clearly the perks to the program. Think it would be a solid place to train, obviously better for people who are very interested in trauma. Louisville is a nice city but nothing to write home about. Residents (only met a few) seemed very nice and happy. Very good program.
 
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Negatives: PAs/NPs in the ED serve in the exact same role as residents. They used to just work the Fast Track area but now work the main ED area (including Room 9) with the residents! It concerns me that they may take a lot of pts/procedures from residents- maybe someone else on here with more experience with UL can speak better to this?? Small faculty. Older chair and many older faculty- said program may be shifting a lot in 5-ish years when they retire. Relatively small patient volume (but awesome trauma).

Regarding PAs/NPs having the exact same role as residents: not true at all. Yes they work the fast track, and there may be one or two helping in the ED on most days (believe me, you'll want them there, bc it's ALWAYS slammed), but they don't take any procedures away from residents, there are plenty to go around. In rm 9 (the trauma bay), they're just helping you run the trauma in whatever capacity you request: get this or that, could you hold that and help here, and apply pressure there... etc- Maybe I'm misinformed, but I've been around for four years and I've never perceived that a resident felt threatened, for procedures, patient load, or otherwise, by a PA or NP.

And as for the small patient volume: the census is actually growing faster than the hospital can accommodate. The residents receive excellent clinical training and by the middle of their third year, they can really handle about anything and MOVE A ROOM, it's impressive. There is no time for residents to even sit down; I think if the patient volume was any larger, the residents would be completely overwhelmed.
 
Any post-2010 reviews please? Also, how exactly do these group interviews work?
 
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Hey all, current Louisville resident here. I saw that our program review was grossly out of date and wanted to take a few minutes to remedy that. As all of you are compiling your ERAS lists in the coming months (best of luck!), be sure to give us some thought! We're a great program in a great city with a lot to offer. Feel free to PM me with any questions.


Faculty: Accomplished, all approachable. 11 FT, ~10 PT, includes program founder, multiple regional directors for air and ground EMS groups, and a board certified toxicologist/director of the region’s poison control center. Dr. Melissa Platt took over as PD as of 7/1/2014.

Residents: Mostly from the midwest and south. We get along well; each class functions as a group and is self-governing. We have a good mix of singles, couples, people with fur babies, and people with real babies. Residents are active in local sports leagues, some camp/hike/climb rocks/do other things in nature, there are a few cyclists (some even ride to work), runners (including an Ironman finisher or two), home brewers, and a few who are content to cheer the rest of us on from the sidelines.

Hospitals:
ULH: The primary teaching facility for U of L, the ED sees 55,000+ visits a year. 420+ beds, it is the regions only level one trauma center. “Room 9” is a 4 bay trauma resuscitation room with immediate access to the ED’s CT scanner. The trauma team does not respond to a room 9 unless it meets the criteria for a level one or we invite them.

Jewish: Serves as the “community” ED. Residents work at two locations, Jewish downtown (440+ beds) and Jewish South, which is a stand alone ED attached to an outpatient care center. While rotating here, residents check out directly to attendings, many of whom are graduates of our EM program. World renowned for hand surgery, Jewish also handles most of the city’s transplants and has recently begun to take a larger portion of the sickest cardiac pts (those on LVADs awaiting transplant, STEMIs, etc).

Kosair Childrens Hospital: 260+ beds, Kentucky’s only full service, stand alone pediatric care center, is a designated level one pediatric trauma center. ED is staffed by Peds EM faculty, has a Peds EM fellowship.

Curriculum:
PGY-1: From your first shift as an intern you will have access to a wide variety of pathology and all acuity levels. Patients are checked out to the upper level residents. There are plenty of opportunities for procedures. Interns also report to all “room 9s” (traumas). The month of July serves as an orientation month with only 10 required shifts. Other activities include collecting all your acronyms (ACLS, PALS, ATLS), a tour of community resources, fire day (fun day getting to know pre-hospital providers at their land based training center and with the water rescue team), lectures, and LOTS of socializing. It’s a chance to ease yourself in, bond with your classmates, and get to know Louisville. Outside of July interns spend 3 months in the ULH ED (1 with some dedicated EMS time), 6 wks at Kosair in the Peds ED, 6 wks at Jewish, and 1 month each on OB, Trauma, Ortho, CCU, and MICU (ULH).

PGY-2: Starting as a 2nd year, you are no longer required to check out patients with an upper level/attending prior to implementing your A&P; they are there for support as needed. 2nd years also start running room 9s, alternating with their 3rd year shift partner, – aside from trauma these include acute strokes, severely ill medical patients, etc. Again, 3rd years/attendings are present during room 9s and available to assist as needed. After 3 months in the ED/pending faculty sign off, 2nd years can also start taking check out. Starting this year, both peds ED shifts and community ED shifts are integrated into all ULH ED months, constituting 3-4 shifts/month. Off service rotations include MICU (VA), SICU, two wks of peds anesthesia, 2 wks of ultrasound, and another ED month with dedicated EMS time. Pending program approval, 2nd years are able to start moonlighting around the halfway point.

PGY-3: As a 3rd year, you start to function as an attending. You take checkout from interns, off service rotators, and 4th year medical students. The 3rd years’ primary job is to learn to manage the department as a whole, and on an extra busy shift it is not unheard of to see upwards of 25+ patients. On certain shifts, scribes are paired with 3rd years to assist with charting. Off service rotations include 2 elective months and an administration/EMS month.

Didactics: As of July 2014, conferences have been restructured to follow an 18 month curriculum (you’ll work through it twice), divided by focus area (cardiovascular, pulmonary, GI, etc). Includes 3 hours of lecture/week. Once a month there is a combined trauma conference with the surgeons and a reading club that follows along with the conference topics (pick a textbook and stick with it). Monthly journal club meets at local restaurants or faculty homes – spend 20 minutes talking about articles and the rest of the time enjoying free food/beverages.

Shift Scheduling: Interns shifts are 10 hours (7a-5p, 1p-11p, 10p-8a) and 2nd/3rd year shifts are 8 /9 hours (8a-5p, 4p-12a, 11p-8a). At each shift change (8a, 4p, 12a) quick rounds and checkout are completed as a group. Depending on how busy a shift was and how much wrapping up of dispos/charts you need to do, shifts can run over by 1-2 hours.

City: Coming from a non-native, Louisville is a pretty great city – a little bit southern, a little bit Midwestern, a little bit its own thing. It’s a big city with a small town feel. Rent is relatively cheap, a car is necessary, but driving is relatively easy. Most residents live downtown, in the Highlands/Bardstown Rd area, or in St. Matthews. Amazing local restaurant scene, arts and theater are also readily available. A multitude of local festivals include the Kentucky Derby!!, Lebowski Fest, Forecastle (music festival), Jane Austen, Shakespeare in the Park, bluegrass, BBQ, etc. College basketball is definitely a thing, and the city also hosts the Cincinnati Reds farm team. Easy driving to Ohio cities, Nashville, St. Louis, and Chicago.

Summary: Autonomy is the name of the game. If you want to be prepared beyond a shadow of doubt for your first shift as an attending, this is the place for you. You will learn to handle 25-30 patients in an 8 hour shift, all with varying acuity levels, some trauma, some medical. Works great for independent learners, opportunities abound, you just have to reach out and take them. All of this in a pretty great city with some pretty great people.
 
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