Help Me Decide on My ROL

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

cyanide12345678

Full Member
10+ Year Member
Joined
Jul 27, 2011
Messages
2,237
Reaction score
2,896
I'm constantly going back and forth between Beth Israel Deaconness and Emory as my number one. I just want to hear different opinions on these two programs, and what y'all would do if you had to pick between the two. Here is my personal list of pros and cons.

BIDMC:

Pros: Good reputation.
3rd year managerial role
3 + 1 structure. Optional 4th year with attending part time salary and guaranteed opportunity to be harvard medical school faculty for the 4th year.
Very cool residents.
Harvard affiliated hospital (although not the same thing as being at Mass gen but lets just say I grew up with a childhood dream of one day being a part of Harvard)
Sister 1 hour away with the little nephew and niece
8-9 hour shifts. Seems like a place with really good workload
High acuity. 38% admit rate
Excellent culture of doing procedures yourself and not calling a consult

Cons:
Boston is expensive -_-
Boston is cold -_-
No moonlighting done by any of the residents
Large emphasis on research and academics (personally not a big fan of doing research). Seems like every resident is involved in research since it is a program focused on academics.
Low trauma numbers since Boston has 4 tertiary care centers
New-ish program. Small alumni network, especially in the South where I want to eventually practice.


EMORY:

Pros:
County environment - Love this kind of an environment. Their hospital ED is getting an upgrade too.
Excellent reputation for their ED program
Excellent alumni network, especially in the southern parts of the US.
Atlanta is cheap + weather is more in tune with my liking
Cool residents
+ moonlighting

Cons:
Lower acuity like most county programs
"Emory" brand recognition may be not as recognized as the "harvard" brand name.

Members don't see this ad.
 
Ask here?

In all seriousness though, I liked Emory, although I wouldn't call the residents I met there cool at all (more like spoiled, whiney affluent kids).
 
  • Like
Reactions: 1 users
Members don't see this ad :)
Why would you think a county program had lower acuity?

Well using the admit rate as a surrogate for acuity. The admit rate at Emory is around mid 20s, while the admit rate at BIDMC is around 38%, one of the highest around the interview trail I think. Having gone to a med school with one of the largest county ED volume as well and spent quite a lot of time there, I've seen that most patients are not that sick. Having said that, you see so many patients at a county place that you end up seeing quite a few sick patients but you definitely see a lot more non acute primary care issues since the county population lacks primary care physicians.
 
  • Like
Reactions: 1 user
Actually my home programs PD herself said on the interview trail that "our acuity is on the lower side, like most county hospitals since our patient population lacks primary care". But 200,000 visits a year is a whole different beast. So you get quite a lot of sick patients in the grand scheme of things.
 
Working at a place where patients have no primary care means you see both ends of the spectrum. Not sick and incredibly sick.

My training took place at multiple sites.
The county place saw the sickest patients.

I would worry about admit rates.
Where I work now, I have shifts where I literally admit every patient, but none of them are really that sick.

In training I'd have days where I saw 15 bs patients that didn't need anything, but 2 that needed everything.
 
  • Like
Reactions: 1 user
I'm constantly going back and forth between these as my number one. I just want to hear different opinions on these programs, and what you would do if you had to pick between them. Location is big for me and I want to stay in Philly.

EDIT: Sorry, seems like the poll was having some trouble.

The programs--

Cooper:

Pros:
3 years
Great acuity (Camden, NJ)/Admit rate/Pathology
Great Faculty (Awesome involved Chair, good PD, just hired Haney Mallemat)
9 hr shifts
Great Crit Care/Peds experience
Ample Trauma
Residents are helpful/friendly and many live in Philly and take the train in no problem
EPIC EMR for the whole hospital
Specialized Tracks available

Cons:
Noticeably inbred faculty -- residents say that they all have different styles though
Not as recognizable brand


Jefferson:

Pros:
3 years
Tertiary center with good pathology
Great faculty (Judd Hollander, Al Saccheti etc)
Great vision as a system
Awesome residents
Located in Center City Philly
Opportunity to work Eagles/Philies games
Brand name

Cons:
12/10 hour shifts depending on location

Not sure if this is a pro or con:
7 hospitals to provide diversity and specialty training (Wills Eye for Optho, Cooper for Trauma, Methodist for some ED/ICU, Dupoint for PICU, Paoli and Lourdes for community ED etc)
 
Last edited:
Do you expect us to psychically know what programs you're talking about?
 
Weird, I've been on a desktop and mobile and it doesn't show up. Maybe it doesn't show up on Chrome.
 
Do you expect us to psychically know what programs you're talking about?

I edited the post and poll...see if it works now. Thanks for the heads up.
 
Members don't see this ad :)
Having trouble putting these in order on the ROL. Same city, hospitals across the street from each other. Any thoughts?

My thoughts -
UTH: Good vibe on interview day and at pre-interview social, residents seem happy. Not as good vibes during shadowing, resident seemed pretty stressed out. Great trauma exposure, life flight, paid global health experience.

Baylor: Good vibe at pre-interview social and during shadowing. Residents seemed happy. During shadowing, seemed like a lot of autonomy, good relationship between attending and residents. Not as good vibes on interview day, short interviews with canned questions. Pride themselves on service, county hospital.
 
This would probably be best asked in the general thread.

This is the third "x or y" thread in the past two days, the EM forum is going to become clogged up with them.
 
  • Like
Reactions: 1 user
I am an osteopath going through AOA match. So, the odd of me having to go through ACGME match is pretty slim. But, I did apply to some ACGME programs as a backup and interviewed at 5 programs.

JPS > Ford > WVU > ? > ?

Toledo is also not where I wanna end up. On the other hand, it's better to match than not match at all. I wanna hear what others think about these programs - which ones a better program.

I thought Toledo University Program has a nice setup... but for ER, it doesn't really matter. Interns I met were kind of socially awkward. Last year, the program did not fill a few of their spots. I wondered why.

Mercy St. Vincent program - I thought you would get a pretty good training. But, there were so many residents per shift and the ratio of attending ot resident was not what I'd like. Not very fond of the area either. Said there were shootings in the area day and night.
 
can't help you with the programs but in terms of toledo not matching i remember reading somewhere (too lazy to google it right now) that it was some computer error and there was nothing that could be done about it
 
  • Like
Reactions: 1 user
Programs are very similar, both incredibly busy. Actually your "thoughts" stated above in the OP post are very accurate. You will have more autonomy at Baylor, it's intended that way (same autonomy culture across their residency programs). UT-H is a large program with 18 residents per year, Baylor 14. One thing, Department of Emergency Medicine chair, Dr. McCarthy is the current president of the medical staff at Memorial Hermann Hospital.
 
Thanks for response, esp. Danbo. Will post in general thread.
 
can't help you with the programs but in terms of toledo not matching i remember reading somewhere (too lazy to google it right now) that it was some computer error and there was nothing that could be done about it

As a UTMC grad, I can confirm this.

I loved my program.
 
I would put St V's ahead of a lot the other programs you have listed.

The area I can't help but from a training program it is the gun and knife shop you would expect. The 6 helicopters make for some nice blunt trauma. The residents I know left with over 10,000 procedures. The residents have more autonomy than other programs I have been involved with from day 1. There could be 5 more residents and plenty to go around. The third years should be managing/teaching the department and 1/2 yrs, this why the attending ratio is low.

Depending on your desired location there is likely a St.V's grad close including New Zealand, England, and Middle East. Most grads serve as program directors, attendings, department directors, chief of staff, authors. This is the benefit of being one of the oldest programs in the country. This also helps with networking in the future.
 
I would put St V's ahead of a lot the other programs you have listed.

The area I can't help but from a training program it is the gun and knife shop you would expect. The 6 helicopters make for some nice blunt trauma. The residents I know left with over 10,000 procedures. The residents have more autonomy than other programs I have been involved with from day 1. There could be 5 more residents and plenty to go around. The third years should be managing/teaching the department and 1/2 yrs, this why the attending ratio is low.

Depending on your desired location there is likely a St.V's grad close including New Zealand, England, and Middle East. Most grads serve as program directors, attendings, department directors, chief of staff, authors. This is the benefit of being one of the oldest programs in the country. This also helps with networking in the future.


10,000 procedures? Seems unlikely... even if you count peripheral IVs (which I wouldnt)

60 hrs/week X 49 weeks (3 off for vacation) X 3 years = 8820 hours. There is no way someone averaged more than 1 procedure an hour for EVERY hour of residency.
 
  • Like
Reactions: 5 users
10,000 procedures? Seems unlikely... even if you count peripheral IVs (which I wouldnt)

60 hrs/week X 49 weeks (3 off for vacation) X 3 years = 8820 hours. There is no way someone averaged more than 1 procedure an hour for EVERY hour of residency.
To expound on this, I think procedure logs are such a load of crap. We have one intern in my class log over 300 procedures within the first 4 months of residency and she easily had the least amount of procedures during that time (she had something like only 3-4 intubations, 2 central lines and no chest tubes). She was just logging a bunch of minor things (lac repairs, suture removals, peripheral IVs, splinting, etc.).
 
To expound on this, I think procedure logs are such a load of crap. We have one intern in my class log over 300 procedures within the first 4 months of residency and she easily had the least amount of procedures during that time (she had something like only 3-4 intubations, 2 central lines and no chest tubes). She was just logging a bunch of minor things (lac repairs, suture removals, peripheral IVs, splinting, etc.).

Agree. I got flak from my higher ups during residency for not keeping my procedure log up to date, and I was like: "for real guys, logging stuff is for teh lolz".
 
One attending told me some procedure logs, like US, are important since once you meet the minimum requirements for residency some jobs may be looking for more scans logged than minimum. Dunno how big a factor that is.
 
One attending told me some procedure logs, like US, are important since once you meet the minimum requirements for residency some jobs may be looking for more scans logged than minimum. Dunno how big a factor that is.

Categorically, no.
 
  • Like
Reactions: 1 user
The residents that I have been involved with from that particular program are all very close to 10K, and most average between 5-8K. I have no need to lie about something as trivial as procedures in a program. Just like no one should focus on that one fact. The OP asked for an opinion I gave mine hoping to help. I wish EMDO the best in his endeavor and if you have any further questions I will be more than happy to help.
 
I have several buddies at St Vs... I've heard excellent things
 
The residents that I have been involved with from that particular program are all very close to 10K, and most average between 5-8K. I have no need to lie about something as trivial as procedures in a program. Just like no one should focus on that one fact. The OP asked for an opinion I gave mine hoping to help. I wish EMDO the best in his endeavor and if you have any further questions I will be more than happy to help.
If they tell you that number, they're a) focusing on it, and b) lying. That's an absurd number, and as mentioned above, impossible to reach unless they have no offservice months, and log 1 procedure/hour throughout residency. I'm not sure I've reached that number 5 years after residency.
One attending told me some procedure logs, like US, are important since once you meet the minimum requirements for residency some jobs may be looking for more scans logged than minimum. Dunno how big a factor that is.
It's not. The only place I've ever had ask for a number is a peds hospital and for sedation privileges. Unless you're in an utter ****hole, residency training is the standard, period.
 
10k "procedures" in 3 years? Doesn't pass ths sniff test.

Are they drawing their own labs and starting their own IVs on every patient? Are they sedating every patient with an attitude? Maybe it's possible.

If they're saying 10k central lines and tubes and more invasive things...there'd be no time to learn emergency medicine.
 
  • Like
Reactions: 1 user
10k "procedures" in 3 years? Doesn't pass ths sniff test.

Are they drawing their own labs and starting their own IVs on every patient? Are they sedating every patient with an attitude? Maybe it's possible.

If they're saying 10k central lines and tubes and more invasive things...there'd be no time to learn emergency medicine.


At Mercy, nurses do all IVs and blood draws, including traumas and resus. It's probably a fabricated number.
 
Since everyone is doubting the procedure log and focusing on one procedure an hour number. A few times a year we had this trauma case role in at my residency: MVC blunt trauma unstable procedures

FAST x4 quad
ETT attempt fail >>trach
Bilateral chest tube
IO
Subclavian
Chemical and electrical cardio version
Foley catheter


In New Innovations that is 13 procedures in 30 minutes. If you look you can also count this if witnessed or performed. See one, do one, teach one.


And at V's they have a pig lab available 7-8 times a year to do as many IO's,abdominal paracentesis (open/needle), pericardial paracentesis, chest tubes, suturing, thoracotomy,cricothyrotomy techniques,intubation, canthotomy.


Most residents do 5-6 us a day in the department, run all of the codes in the hospital, gets called to do intubations and lines on the floor during ED shifts, most ortho basic procedures. If you remember NI then you know how many easy procedures there are i.e. cerumen disimpaction, splinting, trephination etc. So I promise it is possible to do more than one procedure an hour. Again I wish the OP the best of luck and the more procedures you do the more efficient you are. At my hospital there are a lot of procedures that only I do because my partners never did them in training.
 
Wait, you count 1 FAST exam as 4 procedures?
You're chemically and electrically cardioverting a trauma patient?
YOU'RE PUTTING IN THE FOLEY?

How dead was this guy/girl?

If you're counting stuff that isn't required, you either have a PD that harps on that stuff, or you really get off on numbers (which we already referenced). Hot tip, nobody cares how many of anything you've done, except maybe ETT and procedural sedations.
 
  • Like
Reactions: 3 users
Since everyone is doubting the procedure log and focusing on one procedure an hour number. A few times a year we had this trauma case role in at my residency: MVC blunt trauma unstable procedures

FAST x4 quad
ETT attempt fail >>trach
Bilateral chest tube
IO
Subclavian
Chemical and electrical cardio version
Foley catheter


In New Innovations that is 13 procedures in 30 minutes. If you look you can also count this if witnessed or performed. See one, do one, teach one.


And at V's they have a pig lab available 7-8 times a year to do as many IO's,abdominal paracentesis (open/needle), pericardial paracentesis, chest tubes, suturing, thoracotomy,cricothyrotomy techniques,intubation, canthotomy.


Most residents do 5-6 us a day in the department, run all of the codes in the hospital, gets called to do intubations and lines on the floor during ED shifts, most ortho basic procedures. If you remember NI then you know how many easy procedures there are i.e. cerumen disimpaction, splinting, trephination etc. So I promise it is possible to do more than one procedure an hour. Again I wish the OP the best of luck and the more procedures you do the more efficient you are. At my hospital there are a lot of procedures that only I do because my partners never did them in training.

Yes we all see this a FEW times a year but even doing this 10 times a month will not get you 10,000 procedures
 
  • Like
Reactions: 1 user
I'm constantly going back and forth between these as my number one. I just want to hear different opinions on these programs, and what you would do if you had to pick between them. Location is big for me and I want to stay in Philly.

EDIT: Sorry, seems like the poll was having some trouble.

The programs--

Cooper:

Pros:
3 years
Great acuity (Camden, NJ)/Admit rate/Pathology
Great Faculty (Awesome involved Chair, good PD, just hired Haney Mallemat)
9 hr shifts
Great Crit Care/Peds experience
Ample Trauma
Residents are helpful/friendly and many live in Philly and take the train in no problem
EPIC EMR for the whole hospital
Specialized Tracks available

Cons:
Noticeably inbred faculty -- residents say that they all have different styles though
Not as recognizable brand


Jefferson:

Pros:
3 years
Tertiary center with good pathology
Great faculty (Judd Hollander, Al Saccheti etc)
Great vision as a system
Awesome residents
Located in Center City Philly
Opportunity to work Eagles/Philies games
Brand name

Cons:
12/10 hour shifts depending on location

Not sure if this is a pro or con:
7 hospitals to provide diversity and specialty training (Wills Eye for Optho, Cooper for Trauma, Methodist for some ED/ICU, Dupoint for PICU, Paoli and Lourdes for community ED etc)

I trained in Philly.
I'd pick Cooper.
 
  • Like
Reactions: 1 user
Help me decide.. St.Lukes-Roosevelt or MGH/BWH. Loved both on the interview days, got an awesome vibe from the residents at both places, think I'd be really happy at either, and I'm confident they both offer superb clinical training.

SLR
+3 years, +NYC, +PD seems to resident centered and super approachable

MGH/BWH
+ridiculous resources and opportunity to pursue whatever you're interested in, +Harvard affiliated/name recognition?, +/-seemed more academic

Anyone do aways there or have experiences with either program? Do the reputations or career opportunities differ greatly between the two?
 
Help me decide.. St.Lukes-Roosevelt or MGH/BWH. Loved both on the interview days, got an awesome vibe from the residents at both places, think I'd be really happy at either, and I'm confident they both offer superb clinical training.

SLR
+3 years, +NYC, +PD seems to resident centered and super approachable

MGH/BWH
+ridiculous resources and opportunity to pursue whatever you're interested in, +Harvard affiliated/name recognition?, +/-seemed more academic

Anyone do aways there or have experiences with either program? Do the reputations or career opportunities differ greatly between the two?

Close your eyes and imagine you're opening your letter on match day.

Which program would you be happiest to see written on there?

There's your answer.
 
  • Like
Reactions: 1 user
Help me decide.. St.Lukes-Roosevelt or MGH/BWH. Loved both on the interview days, got an awesome vibe from the residents at both places, think I'd be really happy at either, and I'm confident they both offer superb clinical training.

SLR
+3 years, +NYC, +PD seems to resident centered and super approachable

MGH/BWH
+ridiculous resources and opportunity to pursue whatever you're interested in, +Harvard affiliated/name recognition?, +/-seemed more academic

Anyone do aways there or have experiences with either program? Do the reputations or career opportunities differ greatly between the two?
Always pick the three year program if all else is equal. I can't imagine doing another year now as a pgy3.
 
  • Like
Reactions: 1 users
Always pick the three year program if all else is equal. I can't imagine doing another year now as a pgy3.

Preach.

I can't imagine having to check out a healthy snotty nose kid, septic shock or chest pain patient for another year. I still get uncomfortable with the congenital heart/genetic kids, pulm HTN patient and lvads, but usually if I need help, its from a consultant, not my attending.
 
  • Like
Reactions: 1 users
Top