Disclosure: This is my home program, so I have rotated and interviewed. I rotated at an outside hospital called Misericordia, or Mercy Hospital of Philadelphia (MHOP), which is one of the residents favorites (along with Mercy Fitzgerald) and a real gem of this residency.
Program: Drexel University (formerly MCP Hahnemann, in the tradition of Womens Medical college, and about a million other names)
Residents: Standard easy going EM people. Mix of families and singles, although with emphasis on singles. Very active socially as a group.
Faculty: I did not rotate at the main hospital, but at an affiliate. The faculty there are a mix of community oriented docs who like to be very hands on and primary their own patients as well as more academically minded faculty who will sit down with you to discus a case or give you a pearl. Great folks to work with. They let me see a ton of patients and do my own procedures. With some of them you have to be aggressive about you plan or they will just write the orders themselves. There are a couple faculty at Hahnemann who the residents and students dont like working with but in general they are pretty laid back and great to work with. At Hahnemann they are less busy and the patients are a little less sick so these tend to be you more academically minded faculty.
Facility: Lots of hospitals. As an intern you are the junior at Hahnemann a pretty new, modern ED with the glass doors and lots of hard wall space. Computer labs, PACS, and past medical but paper charts. MHOP is older and less modern with most everything being done on paper save PACS. I didnt see M-Fitz but I imagine its in between Hahnemann and MHOP in terms of amenities. No pod systems at either. St. Chris for Peds. The hospitals are within about 20 minutes of each other. The Hahemann, Mercy, and St Chris faculty are separate.
Ancillary Services: Not great at Hahnemann, but not as bad as what you hear about at the hard core county places. You wont be starting IVs or wheeling patients, but youll also notice that some of the nurses dont move too fast. Generally better at the community sites. Its hard to find good nurses in Philly and there are a lot of hospitals competing for them. At MHOP, they would do IVs, NG tubes, etc and were pretty quick about it except when the place got slammed.
Patients: At MHOP they are super super sick some of the sickest that youll ever meet. Tons of DKA, GI bleeders, gangsta style trauma dropoffs (although I never saw any but Im told it does happen. MHOP is not a trauma center), HIV, Hep C, ingestions, change in mental status. Thats all mixed in with your bread and butter stuff. Its an awesome mix of pathology. Hahnemann more tertiary care population, patients with weird diseases that are difficult to pronounce, and then your homeless-BS-cold-want a sandwich patients. Hahnemann is the only trauma center in the Drexel system so thats where you get you trauma patients. MFitz slightly more suburban but not much, didnt rotate there. St Chris mostly bread and butter with a smattering of the more complex patients. Most of the really complex stuff is going to go to CHOP. Good peds trauma exposure in the summer. At all the hospitals large African American population of course. Some of the patients are not particularly appreciative of the hard work you are doing for them.
Clinical Training:
The Mercy hospitals are the crown jewel of this program and you spend you entire R2 year as well as a few R3 months and 6 critical care months there. EM is relatively new at Hahnemann. MCP (Medical College of Pennsylvania) closed a few years ago and it was a real loss to the program for the following reasons: the hospital served a very sick yet diverse population, most of the other residencies were not based here, and EM had been there since 1972. EM was king at that hospital. Now, EM has been at Hahnemann for only a few years and this is where all the major university residencies such as surgery and internal medicine are based. Surgery runs all traumas as far as I could tell with EM alternating the airway day/night with anesthesia. EM also does the FAST exams and reads EKGs. There is also an internal medicine senior stationed in the ED to work up all the medicine admits before they go to their respective service so they have quite a presence in the ED as well. So Hahnemann is not where youre getting to get the king of the hospital feel. Fortunately you will get that at the Mercy hospitals and during your critical care months so I think this balances out. The only thing lost here is experience running traumas. You get some a the Mercy hospitals due to gangster style dropoffs but you dont rotate with the trauma service or alternate running traumas with them at Hahnemann. The faculty, save 2, are great at Hahnemann and there are a few big names still there for instance, Dr. Wagner who helped start the specialty. Most of the older, famous people dont work many shifts, however. During your senior year you are back at Hahnemann and I cant comment on whether or not they get supervisory experience there.
Didactic Training: Pretty good. Interactive. The first 90 minutes are in an oral board format where the senior has a case and the intern has to ask the senior questions about the case, then develop a ddx and plan. A lot of people really like this, but I actually prefer a critical case conference. The rest of the didactics are pretty well done and blocked out on one day.
Peds: At St Chris, which is a much smaller peds hospital than CHOP and sort of lives in its shadow. The peds experience here is great, however its a busy place and youll see lots of patients. Theres a peds EM fellowship there they take both Peds and EM trained residents. I think most of the faculty are pediatricians but dont quote me on that. You also have peds mixed in at the Mercy Hospitals. St. Chris is a peds trauma center and although the trauma volume isnt going to blow you away, its good. There arent as many fellows here as there are at the more high power peds academic centers, so I think youll be doing more.
U/S: I dont really know since I didnt rotate at Hahnemann, but they do have a U/S fellowship.
Research: MCP was very productive, then things dropped as the program was dealing with the challenge of restructuring during the Allegheny debacle and loss of MCP. About half the faculty at Hahnemann have strong research interests and they do require each resident to join a research group.
Other Curriculum Stuff: Theyve got fellowships in tox, U/S, and Peds. The critical care experience is a gem and is probably better than 90% of programs out there. You get 6 months, and you are the only residents in the general critical care unit at MHOP which is staffed by a private group. Residents say they get a ton of intubations, chest tubes, etc. Residents are very proud of this part of the program.
Location: Its Philadelphia. Pros are very sick patients, affordable city living compared to NYC or Boston, awesome BYOB restaurants, awesome bars, the city is small and easy to navigate, the beach is 1 hour away, the Poconos are within reach for mediocre hiking and skiing. Cons are that Philly is a gritty city, people pride themselves on being a little rough, the traffic on I-76 (nice PA suburbs) is horrible due to the fact that it is the main artery from the city to the burbs yet has only 2 lanes each direction.
Strengths: critical care, super sick patients at Mercy affiliates, laid back group of residents that are more single and more socially active than many, huge variety of hospitals and therefore variety of patients from bread and butter to super sick to tertiary care.
Weaknesses: EM is still gaining a foothold at Hahnemann. Research while the faculty have a lot of interests, this is a part of the program that they are rebuilding.
Rotation Specifics: My Rotation at MHOP was spectacular for being exposed to EM in charge and very sick patients. However, some of the attendings were more community oriented and not so interested in teaching so didnt push me to develop a plan. On the other hand, others would sit down with me and give me personal mini-lectures. I got to really push myself, see lots of patients, and have a lot of responsibility. I missed getting to know the faculty at Hahnemann, who are the real movers and shakers within the residency.
Overall: Solid program with great critical care experience and good variety of training sites.
