Hey 4th Yr
I did a fourth year elective at Brown. Overall it's a pretty good program. It's a PGY1-4 format. The hospital is unique in that it has a very large patient catchment area, and the ED sees ~250 pts/day. Shifts are 10 hours long. Sometimes they can be very busy, and sometimes they can be super-light (but this is rare). You get to see a wide variety of pathology because of the high census, with a mix of county-type and private patients coming in. Traumas are mostly blunt, and there is always an ED resident on the trauma team. There is a separate fast-track area for minor complaints, which is run well. The Peds ED is in an adjacent building, and the experience there is excellent in my opinion with strong attendings. Peds shifts are mixed into each adult ED month, so you get continuous exposure.
There is morning report three days/week, run by the chief resident which are usually very good. Didactics on Monday mornings, mandatory for all. Usually a mix of resident and attending presented lectures, which were all very informaive and organized when I was there. A combined EM/IM conference once/week discussing one or two interesting cases from both perspectives. Overall the lectures were good.
So basically plusses are great variety of pathology, great faculty with diverse interests, great peds exposure, good lectures.
Downsides from what I saw and what I heard from the residents is that sometimes the shifts are so busy that bedside teaching is not possible. Some say the schedule is too busy to be conducive to personal reading time. The physical plant of the ED is very crowded for the volume, but they are in the process of building a brand new building. I can't comment on the EMS exposure or the off-service rotations though.
Hope this helps! Good luck!
