UC San Diego (UCSD) Residency Reviews

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EvoDevo

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UC San Diego

Overview

An average 2-4 year program with a built-in transitional year at a nearby private hospital. Nothing about this program stood out to me as exceptional or unique, aside from their excellent exposure to Hyperbarics (They have eight faculty members who are board certified in it!) and the optional opportunity to fly on their helicopters during your 3rd and 4th years (about 1-2 shifts per month once you're trained). Good research opportunities, nice residents, and SD is a pretty good place to be if that's your cup of tea. However, to me, the numerous negatives of the program were notable and definitely outweighed the positives: Having to rotate at FIVE hospitals, the main ED not being especially busy and also TINY, a very strong surgery/trauma program that clearly holds the reigns, and definitely not a very academic or intense flavor to the program.

Curriculum

2-4 with a built-in transitional year at Scripps Mercy.
Scripps is a private hospital just down the street with a very cush transitional year program with about half being UCSD EM interns and the others going into radiology, anesthesia, derm, etc. Nice group of people, lots of perks (free food, pretty easy hours, lots of great electives like ortho trauma). Pretty cush, if that's what you're looking for.

The curriculum for PGY 2-4s felt haphazard - all of your EM shifts are interspersed between five different hospitals (including a dedicated Children's hospital) and you're generally at different places for every shift. So Monday you could be at one, then Tuesday at another, etc...! All of the other hospitals, aside from UCSD and Children's, are private. Moonlighting is allowed starting halfway through 3rd year.

Facilities
This was definitely the big negative for me. You rotate through FIVE different hospitals during all three years. They mostly all driving distance from each other, so even if you live right across from UCSD you'll still have to drive to about half of your rotations. The UCSD ED itself is tiny - only 27 beds, the smallest one I've seen on the interview trail. Additionally, while the ED is on the 1st floor, the trauma bay is on the 2nd floor (run by trauma surgery)- so all of the 'trauma activations' go there almost directly. EM residents do rotate on the trauma team, but only for two months (1st and 4th years). They claim to get a decent amount of trauma, but the residents just said that they get "enough" to feel competent. Ultrasound is used fairly regularly, though it was unclear how well it was incorporated into the curriculum.

Research/Opportunities
As of 2002, they had the most publications per faculty member of any program in the country - I know this because I was told about it during the interview day THREE times. I don't think this is true anymore, but they do still publish quite a bit. The residents I spoke with - all except one - were not actively involved in research beyond the requirement, and no one this year is pursuing a fellowship. They admitted that their international connections weren't strong, but would be willing to work with an interested resident to set one up. In the past, several residents have done rotations on USS Mercy, a navy ship that runs humanitarian missions abroad.

Fellowships
Hyperbaric Medicine
EMS/Disaster
Medical Toxicology
Pediatric EM
*Currently working on getting an ultrasound fellowship, but sounded like it wouldn't happen for another 1-2 years

Residents
Really nice group of people, from diverse backgrounds and of varying ages. Most were married and a few with kids, but there were a few singles who outright said that SD was not a great singles scene. Many told me they chose this program because they wanted to be in SD for family/life reasons, though one mentioned that the 2002 article about them producing the most research swayed his decision :cool:.

Location
It's in San Diego, just a quick drive from the beach and tons of beautiful scenery. A lot of the faculty and residents are into sailing, surfing, rock climbing, etc., so if you're an outdoors enthusiast you'll certainly find your niche here. Not a great social life (compared to NYC, LA, SF) but not bad.

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Can anyone give a more recent update with the residency program at UCSD?

From what I can gather based on the above review and their official website is this:

1-4 year program
5 locations: UCSD, Tri-city in Oceanside, Palomar in Escondido, Rady Children's in San Diego, Scripps Mercy in San Diego. It's worth noting that Tri-city and Palomar are 30-40 miles away from UCSD.
Trauma gets seen by surgery on a different floor from EM. EM residents spend 2 months with surgery doing trauma.

I'm a little disappointed if the above bullet points are true. Driving to 5 different locations is a big negative, and not seeing the majority of the trauma at UCSD is the biggest negative.

Can someone comment on the number and length of shifts per PGY year, how much time is spent at each of the 5 locations, how much driving between locations is required, and the amount of trauma one sees? Thanks.
 
Based on the curriculum posted on the official UCSD EM residency website, the commute is not as bad as it originally sounded.

The residency training is spread across 6 locations:
1. UCSD medical center (home institution)
2. Scripps Mercy (.4 miles SE of UCSD)
3. Rady Children's (5.7 mi N of UCSD)
4. Palomar medical center (29.7 mi N of UCSD)
5. Tri-City medical center (38.2 mi N of UCSD)
6. Pioneers medical center (120 mi E of UCSD)

The only real commutes are the Palomar, Tri-City and Pioneers locations, and only a total of 4.5 months is spent at those locations in the PGY-2-4 years.

If anyone who recently trained at UCSD, or is currently training at UCSD, can answer some of my questions, that would be greatly appreciated. Thanks.

Questions:
  • Number and length of shifts per month for each PGY year

  • Are shifts stratified by acuity (e.g., “trauma” shift or “resuscitative” shift), or is the entire spectrum of pathology seen on each shift? In other words, will I only see trauma during concentrated blocks of training or throughout my entire residency experience in the ED?

  • Which team runs the trauma? Is it an alternating schedule with the surgery residents? Who does the procedures (intubations, chest tubes, resuscitative thoracotomies, etc), is it shared with anesthesia/surgery residents based on odd/even days or MRN numbers? Are there any emergency procedures that EM residents are not allowed to do (RSI, thoracotomies)?

  • Is there any commuting between site locations (outside of the dedicated PGY 2-4 weeks)? I'm looking for programs with minimal commuting.

  • Is there an EMR? Is it Epic quality or a horrendous excuse for a computer program? Is there still paper charting?

  • How is the scut work for EM and non-EM months (e.g., transporting own pts to CT, obtaining vitals).

  • Is the environment family friendly? What percentage of the residents are married, have children?
 
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Hi everyone,

I graduated from this program a couple years ago, so thought I would throw in my two cents. Some of this info might be slightly outdated so do not take it as gospel. Overall should still be fairly accurate as I finished in 2013.

Regarding the commuting, it did not seem so bad but you will definitely need to have your own car. Traffic in SD is pretty manageable except during rush hour and the main residency sites are centrally located and easy to access. I often had time to surf before or after shifts as the beaches are close by as well.

This is a PGY1-4 program and you will spend the majority of your time at UCSD Hillcrest throughout the residency. This is centrally located in San Diego and there are many nice places to live within a short (10-15 min) drive or even within walking distance from the hospital. During your PGY3 and 4 years you will do several shifts a month at the UCSD La Jolla ED, 15-20 min drive from the Hillcrest site. Rady Children's is about 10-15 minute drive as well and after an initial 2 week block you will continue to do shifts there a couple times a month throughout the residency. The rotation at Pioneers Hospital is a 2 week block during your PGY2 year. You will have 3 shifts in a row each week, and will be provided with free lodging and free access to the hospital cafeteria. This is a 2+ hour drive from San Diego and you will definitely not feel like driving back to SD if you have another shift at Pioneers the next day. The rotations at Palomar and Tri City are during your PGY 3-4 years for a total of 4 months. Drive time 30-45 min. It will be roughly 12 shifts/month plus an additional 4 pullback shifts at UCSD. You will also commute to Mercy Air a couple times a month PGY2-4 (sites in El Cajon and Carlsbad again 35-40 min drive). Scripps Mercy I think is only for the OB rotation PGY1 and it is walking distance from Hillcrest.

Regarding scheduling, you will do around 20 ED shifts/month as a PGY1. This decreases throughout the residency to 17-18/month as a senior. Shift length 8-10 hours. Usually they will follow a circadian progression.

You will routinely see a variety of minor trauma in the ED. Occasionally a patient will be mistriaged by EMS or walk in and you will see major trauma in the ED. Trauma team activations however are triaged to the trauma bay which is in a physically separate area from the ED and run by the trauma surgery service. You will rotate there for I think 4 weeks as a PGY1 and 6 weeks as PGY 4. Your role as an intern will be to assist with resuscitations and manage floor patients. Your role as a senior will be to run the resuscitations as doc 1 and you will do all the airways and some of the chest tubes. Will manage only ICU patients. In my experience the surgeons did the thoracotomies.

Strengths of the program:
-quality of faculty
-graduated levels of responsibility as you progress from PGY1-4
-tox, ultrasound, simulation are excellent
-research opportunities
-Mercy Air--you will serve as an actual crew member on a helicopter air ambulance service, not an extra or an observer. Mostly scene calls for trauma but will also do interfacility transport for a variety of critical cares.
-multiple community hospital rotations will prepare you for the "real world" outside of academics/residency
-San Diego is a difficult job market, and you will develop connections that will help you get a job here after residency
-location

Weaknesses:
-While the trauma experience is definitely adequate, don't come here expecting constant "knife and gun club" action like in LA county, etc.
-Pediatrics: your exposure to interesting cases and procedures is watered down by the presence of multiple other trainees at Radys. Low % of pediatric cases in main ED sites at UCSD. My only peds intubations were in the OR.
-The main site at Hillcrest can be high acuity but isnt' always. Lots of psych boarding and malingerers
 
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Hey EM:Rat, thanks so much for your review. It was very helpful. Love the profile pic btw!
 
Does anyone have the average step scores for this program?
 
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