Often times, the real gems for EM are, in fact, exactly the hospitals that would never ever make a US News ranking of the best hospitals . . .[
People are always posting and referencing these "hidden" gems of em residencies but no one ever wants to name them. Why is this? Drop names people!
I can tell ya 2 programs that are definitely stellar programs, and what I would consider "hidden" gems because they're not huge names, but provide you with an AWESOME experience.
1) Wright State - Dayton, OH. I read & heard about it, and interviewed there as well, and was thoroughly impressed.
http://www.med.wright.edu/em/res/
2) York Hospital - York, PA. I'm about to start my 3rd (and final) year there. I rep the hell outta the program every chance I get, because I genuinely believe it's an *amazing* program.
http://www.yorkhospital.edu/default.aspx?program=2
To address some of the points/questions that Amaranthine mentioned, with respect to my program:
1) NUMEROUS times I've had rotating and interviewing med students tell us our residents were the happiest they've ever met of any program.
2) There's a ton of autonomy, especially in your 2nd year, and definitely during your 3rd year - while ensuring you have appropriate Attending supervision as needed/requested/appropriate. And upper levels (2nd & 3rd year residents) often walk 1st year residents through sicker/critical patients, without stealing experiences from them.
3) The volume is HUGE (around 80,000/yr), with only 33 residents in the program. The result is you get your butt whipped into shape, learning how to manage a very high volume of patients, and master the skill of multitasking and prioritizing. But volume is nothing without acuity. We have a VERY high acuity of patients. York County nationally has one of the greatest percentage of obese residents, which translates to the vast majority of our patients having a ton of co-morbidities (DM, CAD, PVD, CHF, OSA, COPD, etc). Our admission rate is about 30%, well above the national average. Sick for us is SICK.
This doesn't interfere with teaching time, either. Attendings STILL make the time & effort to teach, instruct, and provide feedback, even in the crazy busy environment we have. And that's unique, because we have a major urban experience/environment in the setting of a community hospital. So we have the funding (more on that later) without the overbearing fellows coming down to steal procedures from us - in fact, we do pretty much all of our own procedures with our EM faculty, and only consult if/when appropriate/needed.
4) Our attendings are from all over. We have a bunch of local Yorkians and former residents of our own program, as well as others from all over. We have some 30+ year faculty as well as some "fresh blood" from top programs like Christiana. We have some traditional EM docs, a few former Internal Medicine, a few former Surgeons, a few Paramedics, etc. ALL are EM Board Certified. But quite a varied background, for a variety of approaches & strengths. And we have young and old, including Ultrasound-trained fellows + U/S Fellowship. So diversity isn't a problem here.
And for me, who wants to go down south, our attendings and former residents have placed throughout the US. So I often hear from attendings about job opportunities in areas I'd like to practice, the ppl they know there, and how they can talk to people to get me interviews etc. Def. a positive to know that no matter where you wanna practice, we have Alumni there and/or current faculty with connections to there.
5) Our Program Director (who's been the same program director for over 20 years) is VERY receptive to change based on faculty & RESIDENT feedback. As such, we've ditched low-yield rotations (so we no longer have any floor months of anything), and custom tailored several off-service rotations so we get the experience we want & need, without having to do all the crappy scuttwork to achieve it. He makes sure our residents are the best taken care of in the hospital. The PD is also one of the Oral Board Examiners as well as on the Board of Examiners (so he writes questions for the board exam). In fact pretty much our entire Program Leadership are nationally recognized "big-wigs." So their letters of rec carry sig. weight.
6) Despite what you're interested in, we have people that do it, and will help you do it as well. AND, we'll front you the money to help you do it to boot. We get over $1,500 spending cash on pretty much anything medically related/yr, from textbooks & iPhone apps (including PEPID, etc) to whatever course/conference/experience you'd like to attend. Ultrasound, Wilderness Medicine, Tactical & Prehospital (like me), International, you name it, we do it.
On that note, Wellspan (the healthcare group that owns the hospital and several surrounding it) is the 4th largest employer in the state, so it has TONS of money. So in turn, we as residents get one of the highest salaries of any residents in the country - save places like NY, where all your salary's gonna get spent on your apartment rent anyway. This also means the HOSPITAL has tons of money. So with our crazy volume, we have the MONEY for techs, aids, support staff, and equipment! So you don't waste your time doing non-doc stuff (like pushing patients to imaging, drawing your own blood, getting your EKGs etc), albeit there are merits to learning how to do so. But by in large it is NOT your responsibility, and you can rest assured it WILL be done by the appropriate staff.
In addition, since Wellspan is so huge, the vast majority of our patients (I'd argue above 90%) have electronic medical records readily available. So I can look up PMH, meds, allergies, surgeries, previous EKGs, studies, labs, etc from their PCP and specialists, before I ever set foot in the room. And that is NICE.
7) The program (attendings) challenge you to do things diff ways, to get out of your comfort zone & learn how to approach problems in different ways. And they themselves have very different prespectives. Some guys are very hands-on, others are more laxed. Some are super thorough and detail-oriented, and others are minimalists. So you really see the different ways to skin a cat, and develop an arsenal of how to solve a particular problem, while developing your own preference of how you'd like to do things as an attending in the future.
9) Our residency is certainly the strongest in the hospital, without a doubt - despite it being a Level I Trauma, Peds, Stroke, Cath Lab, etc, so we have the full range of services & residencies (Medicine, FP, Surgery, etc). And on a regional & national level, our residents have won several awards for their research & presentation. No surprise there.
10 ) Lastly there are a ton of perks, like unlimited free food for residents, free for resident families while on-call (off-service) or on the weekends, program coverage for all sorts of medical-related expenses, free Rx as long as it's written by a doc within the Wellspan network, etc etc.
Alright, I think that's long enough haha. You get the idea.
