Carilion AOA Program - Christiansburg

[CopToEM]

Can anyone who rotated through the Carilion New River Valley osteopathic EM program share some feedback? Being a new program there seems to be very little out there in terms of pros, cons, etc. Just looking for first hand experiences with the facility and preceptors.

Thanks!

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[noke]

Sent a PM...

 

[Makati2008]

Can anyone who rotated through the Carilion New River Valley osteopathic EM program share some feedback? Being a new program there seems to be very little out there in terms of pros, cons, etc. Just looking for first hand experiences with the facility and preceptors.

Thanks!

Personally I would avoid these new AOA places with the upcoming merger I suspect some of them will close.

 

[CopToEM]

Personally I would avoid these new AOA places with the upcoming merger I suspect some of them will close.

I don't think that's the case at all (especially for EM and primary care) but that's a debate for another thread.

 

[Petypet]

I don't think that's the case at all (especially for EM and primary care) but that's a debate for another thread.

It is the case, and some long standing EM programs have unofficially announced to students that future spots may be in jeopardy (rural Ohio). N = 2 from semi-anonymous now 4th year. Some small DO programs have ERs that average 30-40k and tons of pathology gets shipped elsewhere, and thus their residents barely meet AOA regulations, not much less AGCME standards. Some of even the larger DO FP practices have upper level residents that barely make their quotas.

I think moral of the story is tread carefully when choosing a DO residency.

 

[racerwad]

I don't know a thing about this program, but looking at their stats, I have to assume that the reason you want to go there is because it is close to home/family/etc. The main site is a 24 bed ED with 32k visits annually in a 110 bed hospital. Even with 6 residents per class, I would worry about volume and pathology. To compare another newish ACGME program, the Kaiser Permanete EM program in San Diego also has 6 residents per class in an ED with an annual volume of 100k.

As @Petypet said, choose carefully. Did you really work this hard to get into medical school, take USMLE and COMLEX (twice!), schedule auditions, and travel across all of creation for interviews to end up at a program with some less than desirable attributes?

 

[Makati2008]

I don't think that's the case at all (especially for EM and primary care) but that's a debate for another thread.

I would just ask their plan for the merger. What's the draw to the program?

 

[TeamZissou]

Many of the DO programs based at smaller community hospitals do out rotations to get their exposure which isn't a bad thing since they are typically at larger institutions.

 

[CopToEM]

Did you really work this hard to get into medical school, take USMLE and COMLEX (twice!), schedule auditions, and travel across all of creation for interviews to end up at a program with some less than desirable attributes?

Desirable for you and desirable for me are two different things. My wife (a teacher) and I grew up in a town of 4,000 and will return to live in this area. I have no desire to live in and she has no desire to teach in a large metro area where the programs you consider desirable are typically located. I'm older, my mother is aging, and I need to be close to home in case something happens. Yes, I want volume and yes I want pathology but the happy medium for me is a balance of those things and a safe, community-based environment in a reasonable geographic diameter.

As TeamZissou points out your valuation of many community-based programs is grossly inaccurate as well. Many community-based programs do away months at much larger institutions. This program in particular does away months at their 700-bed Level 1 sister hospital up the road and Trauma in Spartansburg, SC at a 588-bed Level 1.

That said - thanks for your input. I got the information I desired from some very helpful SDNers via PM. Happy to hear any other information on this program from those who stumble across it in the future.

 

[CopToEM]

It is the case, and some long standing EM programs have unofficially announced to students that future spots may be in jeopardy (rural Ohio). N = 2 from semi-anonymous now 4th year. Some small DO programs have ERs that average 30-40k and tons of pathology gets shipped elsewhere, and thus their residents barely meet AOA regulations, not much less AGCME standards. Some of even the larger DO FP practices have upper level residents that barely make their quotas.

I don't doubt there's truth in any of this. However, I feel one must also step back and look at the reality. Emergency medicine is in high demand because of ever-increasing utilization of the emergency department by the patient population. The very last thing they're going to do at this point is shut down programs en masse when the goal of both sides of the road is to increase GME spots/funding. Will there be some cuts? Possibly. Will it be as drastic as many doomsdayists predict it to be? Highly unlikely in my opinion.

 

[racerwad]

Desirable for you and desirable for me are two different things. My wife (a teacher) and I grew up in a town of 4,000 and will return to live in this area. I have no desire to live in and she has no desire to teach in a large metro area where the programs you consider desirable are typically located. I'm older, my mother is aging, and I need to be close to home in case something happens. Yes, I want volume and yes I want pathology but the happy medium for me is a balance of those things and a safe, community-based environment in a reasonable geographic diameter.

As TeamZissou points out your valuation of many community-based programs is grossly inaccurate as well. Many community-based programs do away months at much larger institutions. This program in particular does away months at their 700-bed Level 1 sister hospital up the road and Trauma in Spartansburg, SC at a 588-bed Level 1.

That said - thanks for your input. I got the information I desired from some very helpful SDNers via PM. Happy to hear any other information on this program from those who stumble across it in the future.

I am very aware that there are different strokes for different folks. Everyone should prioritize what is important to them. Something someone said to me that stuck was that residency is something you can do only once and for a fairly limited time. I am biased towards getting my version of "the most" during residency. In my defense, since I can't read your mind, I didn't know you'd put obligation X ahead of residency characteristic Y.

As community DO programs go, nothing I said was "grossly inaccurate". All I said were facts. I didn't cite my source (the program's website, the KP SD program site and the Opportunities site - my bad!) but I can't see that I said anything "grossly inaccurate" or even slightly scandalous. As you've mentioned in your last post, some of the things I said, while true, are not important considerations for you. Perhaps you took offense in my characterization that the facts I listed were "less than desirable." If you had lead with what you were looking for, I certainly wouldn't have mentioned the things I did since they were the very things you wanted.

It seems to me, if you were so knowledge about such programs, you'd know more about the specific community DO program in question. I have interviewed at community DO programs and while they are adequate, I knew I would rather cut to the chase and do residency at the institution residents are sent to, not vice versa. But, like you mentioned, different people want different things and that doesn't necessarily mean anything more.

 

[CopToEM]

It seems to me, if you were so knowledge about such programs, you'd know more about the specific community DO program in question.

Perhaps, except they didn't officially offer auditions last year and there exist only the 4 new incoming residents. The purpose of this thread was to seek out those folks with first hand experience and it was successful in doing so. A cursory search reveals effectively 0 other posts about the program. While the other unsolicited discussion is welcomed, pertinent, and healthy it also has nearly zero to do with the original post. Happy to continue it in private. Best of luck with your future path!

 

[racerwad]

Perhaps, except they didn't officially offer auditions last year and there exist only the 4 new incoming residents. The purpose of this thread was to seek out those folks with first hand experience and it was successful in doing so. A cursory search reveals effectively 0 other posts about the program. While the other unsolicited discussion is welcomed, pertinent, and healthy it also has nearly zero to do with the original post. Happy to continue it in private. Best of luck with your future path!

Fair, but it is always interesting to hear the reasons behind why someone is (or is not) interested in a specific program. Like yourself, I didn't know anything about the program but a discussion started that hijacked the thread (despite your best efforts). Mainly, I posted here because I was curious why you liked it since it wasn't evident from their site. As I suspected, it was more about the locale than the program itself.

 

[Makati2008]

I can't argue about wanting to be close to home( I'm transferring to a different EM program next year due to my S.O. but I would remain right here if it was going to cost me quality training). But you have to ask yourself- in ten years would you want your name attached to a program that shut down. I wouldn't. Also it wouldn't be the first AOA program to go belly up....

I know of one program that is established, good rotations, and has good residents that is having it's EM program go poof because it won't be able to meet Acgme requirements.

Also how many of these hospitals will be able to subsidize pay for the core faculty with the ACGMEs more stringent work hour/research rules? I can't remember the exact numbers but from what faculty has told me in the past it is not a small amount of money.

 

[crocoduck]

i'm familiar with the program. PM me with specific questions and i'll do my best to give my 2c.

i think the possibility of the program closing secondary to troubles stemming from the aoa/acgme merger is highly unlikely. there is an association with a larger, more established and experienced teaching hospital with acgme and dual-accredited programs. i'd speculate that, if threatened, a more likely outcome would be reshuffling the mix of out rotations to compensate for any shortcomings or maybe even the program somehow "merging" with the carilion acgme em program in roanoke once the details of the aoa/acgme merger are finalized, there is a unified match, etc etc.

that said, just because the program is likely to be able meet minimum rrc standards in one way or another doesn't mean that the critiques posted above are unfounded. it is reasonable to worry about volume, pathology, and acuity bypassing the hospital in any program with the basic stats listed. in general, i'd suggest that the program will be best suited for someone who is very sure of their intention to practice in a setting similar to or smaller than that of the program's main teaching site and someone who is interested in the southeast/appalachian area of the country for training and probably practice. training in the setting of future practice and being teed up to seamlessly step into that role was kind of the whole pitch of the program.