Sparrow Hospital/Michigan State University (MSU)-Lansing Residency Reviews

I'm a second year resident at MSU/SPARROW. I really like it here, and I'm from NYC. The program is not flashy by any means, I really never heard of it before I started looking to get out of the city for residency and I've been nicely surprised by the experience.

We cover two different hospitals, Sparrow and Ingham Regional Medical Center, both in Lansing. Sparrow, the level 1 trauma center, now has a census around 100,000. We have mostly blunt trauma, except during hunting season when the guns come out, along with the Dick Cheney's of Michigan. The traumas are run by the EM residents, with a concurrent FAST exam and secondary survey by the Trauma team (surgery), and the overall supervision of the Trauma Surgeon. There is absolutely no conflict with surgery here. We do the intubations and share the chest tubes, etc. I see anywhere from 18-24 patients on an average 12 hour shift, and more on the busy ones. Yes, we have the drug seekers and the drunks and the diabetics who seem to have a second home in the ED, but I've had some good variance in cases, and I feel challenged by what I've been seeing.

Ingham is more of the "old folks home". There are far more cardiac cases, and the population is an older and more frail one. This is just the way the two hospitals have diverged over the years I guess. There seem to be more intubations and central lines in the ED here.

Overall the clinical teaching is great I feel. I'm not one for lectures, and the conferences are not the high point. But that suits me fine, I prefer working to learn, and then reading on my own to put things together. The nuance is in the shift work with the attendings, most of whom I feel a genuine interest in our education. The first year is really dedicated to critical care. We spend time in the NICU, PICU, and ICU's. The ICU months are usually all EM residents together, with 7 juniors and 3 seniors. The nurses on these rotations love the EM residents because we're so interested in actually working, compared to some of the other programs who don't see the need for critical care in their lives. I did tons of lines and intubations at both places while on call. It's kind of classic old school residency. At Ingham you're really on your own. If a code is called at night it's usually only yourself and maybe a senior medicine resident who gets there first, an intimidating experience at first, but one that really builds confidence fast. Some of the residents feel Ingham overworks us during the medicine rotations, with a seeming endless number of admissions exacerbated by floor calls on the pager, literally one every 2-3 minutes, all night. I found it challenging and extremely 'trial by fire', and loved it.

It's a big change for me nightlife-wise, but there's the MSU bar scene of East Lansing and the small downtown bar scene of Lansing. There's a Law School downtown and a couple of nice lounge-like bars, one with live music. I truly feel I haven't had a lack of single-life social encounters, and as a matter of fact feel they've been easier here than back in New York at times. Tail-gating at the MSU football games is a blast, it's almost as good as tailgating back at Ohio State where I did undergraduate school.

Finally, there's the schedule. We do 14 x 12 hour shifts at Sparrow, and 16-17 x 9.5 hour shifts at Ingham, with a 60%/40% Sparrow/Ingham split. It's pretty nice. And we can do moonlighting shifts @ Sparrow; 10 hour shifts @ $50/hr. I usually do between 3-4 extras/month, which grosses me an extra $1500-2000/mo. Many choose to just enjoy the time off. We have a back-up call schedule (rarely activated) where we're on call if someone can't make their shift. This is 2 days/mo. one of them being a weekend day.

I think, overall, this place is way, way, way under the radar and should be given a look. I've been told by some of the MSU medical students that the program is percieved by some to be a DO program that has some MD's. I'm not sure why that would be a criticism of the program anyway, but I know, even as an MD, that this place is a prized residency by DO's and I think we definitely have the cream of the crop here. We're one of only 2, I think, programs that have dual accreditation, taking 5 DO's/5 MD's per year. The DO's don't even have horns or stuff, and my neck and back have never felt better . Perhaps one of the best attributes is the attending staff. Three are EM Board oral examiners, including the residency director, with ABEM having it's headquarters here. One writes a chapter in Tintanelli and also has a couple of books, most notably one on Emergency radiology that is stellar. As one of the oldest EM residencies in the U.S. there are past residents all over the country, and it appears incredibly easy to land a job anywhere you'd like to go, with the residency director actively keeping in touch with these guys constantly.

These guys have been doing this a long, long time. Perhaps we're not shiny and bright, but I think the program is solid, and has aged well. I feel like I'll be able to go anywhere after this with confidence, even back to NYC.

Thanks for starting this thread, I think it's a great idea. A few things I'd like to add about MSU/Sparrow: I worked last night at Ingham Regional Medical Center, the other ED we cover in our residency. I hadn't been there in two months, having been at the main Sparrow/trauma center ED. I was not looking forward to 3 months in a row after having been at the usually busier Sparrow for 2 months. Ingham seems to have the lower socio-economic patients, many of which are not that sick, just in need of attention. Well, it was bedlam! When it gets busy at Ingham it can be a blast, and on the verge of overwhelming, which I personally enjoy. The atmosphere is much more loose at Ingham, the attendings tend to be more hands off if they feel you're capable. There are a few who are very understated but watch closely, giving you just enough rope to hang yourself before they intervene, then give you some nuance that cements the bigger picture. The admitting service was overburdened, which happens perhaps too often, but that gives us in the ED a chance to shine.

I had a septic older woman who presented at the same time as a full arrest. The other resident and I split up and ran the show on each. There were two attendings on, and one was closely involved with the arrest, but allowed the resident to run the code without much interference (he's a second year, and knows his sh** well). My attending was busy with other patients, so I just went ahead with the business. The patient was hypotensive, with SBP in the 50's/60's, but awake and talking. I got the fluids running, gave some antibiotics and a stress dose of steroids (she had been in for adrenal insuff. just last week), put in a quick femoral central line (I looked with ultrasound, and her jugulars were both scarred from recent lines, and she had a port in the L subclavian. She was having trouble breathing, and I didn't want to chance the R subclavian while in a hurry) and got more fluids going. She responded well initially so I went to pack some guy's bleeding nose which I had already started with some TLE/cotton. When I got done with this I went to check on sepsis lady and found we had a chest pain via EMS. This lady had what looked to be a right sided MI. I had no idea where the attending was, so just went ahead and got things going, ASA, heparin, some Zofran, and called the Cath lab.

Anyway, I've never been a resident anywhere else, so I don't know if that's a typical night everywhere (probably is), but with those patients, along with the other 15 or so I saw yesterday who weren't as dramatic, I felt a real sense of being on top of my game, even as a fairly new 2nd year. Even with some attendings who can drive you crazy with admissions and testing we may feel is not warranted at times Ingham can get roudy and wild in a good way. The admitting service, as I said earlier, can get overwhelmed, and my septic lady spent way too long in the ED by any standard. But I feel this is often old school medicine at Ingham, in the real world were all the bells and whistles, and scientific data, and hand-hold-teaching go out the window when the poo starts to fly.

I came home last night, re-read the sepsis guidelines, re-read Right sided MI, and re-read nasal packing. I saw a few things I could have done differently, thought about what could have been more efficient without blaming the medicine residents for being too slow, or the hospital for being out of beds, or the staff for being less than enthusiastic at times.

My attending, who I hadn't seen in about 2 hours looked at me as she was leaving and said simply; "Hey, you did great tonight, thanks". I slept very, very well.

If you're looking for big university academic medicine, this ain't the place. If you're motivated and like being independent come up and see us. If you're into research and have a great idea we've got the back up of MSU and their statisticians and a couple of great research guys on faculty. If you hate research, we'll give you some easy way to get your project done that's required. If you need to have your hand held and learn via force feeding and lectures, don't come, this isn't the place. If you can shove 20 pounds of sh** into a 5 pound bag, and like the idea that imperfection always leaves room for you to help improve things, give us a try. Out of our 30 residents I'd say we don't have many whiners. We know how to work up here, and we like it. We get ample time off and many like to play hard (me included, it's a big-10 town), with 14 shifts/month at Sparrow (12 hours), and 16-17 at Ingham (9.5 hours). We can moonlight at Sparrow for $50/hr x 10 hr shifts, I add $2000/mo to my salary. It's old school, grind it out medicine and I feel I'm learning more than what I need easily. We have a nearly 100% passing rate on the boards, and 3 oral board examiners as attendings. I look forward to seeing you.