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UC San Fransisco (UCSF)/San Franscisco General Hospital (SFGH) Residency Reviews

Discussion in 'Emergency Medicine' started by grEMreapin, May 4, 2007.

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  1. grEMreapin

    grEMreapin

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    Long time reader...first time threader.

    Any thoughts out there about the new program starting at SFGH in 2008? I'm applying for the entering class and wonder what the risks/benefits/perceptions are of a new program?

    I haven't seen this kind of thread in any of the FAQs so forgive me if I pull a FMcFP.
  2. Apollyon

    Apollyon Screw the GST Lifetime Donor

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    Dr. Promes was my program director at Duke, and she could make something out of nothing. She is the most involved program director I've ever met (and I've known a LOT). She trained and worked at Highland, which is a UCSF affiliate just across the bridge. As such, she ties together two things: she knows the system, and has successfully started and run a program.

    Dude, it's in the bay! Time after time, I heard how people would be falling over each other to get an academic appointment there. SFGH and University Hospital are great, busy sources of pathology.

    I think it's going to be a division of medicine, but don't let that dissuade you.

    I can assure you - assuredly - that you WILL get what you need. Guaranteed. As I was undergrad at VMI, I say the same thing about VMI as I did about Duke - horrible to be at, great to be from. Likewise, UCSF will be a kick-ass program that will kick your ass while you are there, and you will be able to return the favor when you are done.

    And, think of it - Golden Gate Park! The Presidio! Fisherman's Wharf (the "Tourist Ghetto")! The Embarcadero! The Financial District! The Metreon! Paramount's Great America! The Raiders! The A's! The San Jose Sharks! Chinatown! You're NOT in LA!

    Damn - I want to go now!!
    ncbmmd likes this.
  3. grEMreapin

    grEMreapin

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    Ditto that. I've loved SF everytime I've been up there, and I've heard great things about the ED (ie. volume, patho, trauma) at SFGH. From what it sounds like, it seems that the fact that a program is in its 1st year matters less than who it has for a PD/faculty...is that correct to assume? Thanks for the advice! :D
  4. Peter Parker

    Peter Parker Senior Member

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    Residents: Brand-new program with 12 residents/yr. Currently, Highland and Stanford residents rotating through UCSF Moffitt-Long and SFGH will be the upper-levels, and they are expected to continue in that capacity until UCSF reaches its full 4-year complement of residents.

    Faculty: Of all the programs out there, it doesn’t get better than the faculty here. The PD made a point of introducing us to 10+ faculty including the hilarious Chairman (who races a classic Ferrari on weekends and just happens to be editor-in-chief of Annals!), the Associate PD who is the most down-to-earth dynamo out there, and many others. They all came across as universally normal but terribly bright yet committed to public service. Residents will be paired with a ‘faculty mentor’ right after Match Day and there’s lots of resident/faculty get-togethers planned. The energy and excitement of the faculty finally getting to see their dreams of a residency at UCSF/SFGH come to fruition were clearly evident at the pre-interview dinner when 5+ professors showed up for casual talk!

    Interviews: 3 interviews, all with faculty, 20 minutes each. They’re looking to strike up an interesting discussion ... no real typical “questions.” I felt like I was at a bar with friends!

    Hospitals: Two main primary sites: UCSF Moffitt-Long -- tertiary-care, high acuity, state-of-the-art ED, NIH Stroke and STEMI Center; and SFGH -- county, divided up into 4 zones (Zone 1=high acuity, Zones 2-4 = middle-acuity), only level I for SF, ED under total renovation. Hospitals are connected by a UCSF shuttle service (maybe about 20 min. apart). Everything computerized at Moffitt-Long and SFGH.

    Ancillary: OUTSTANDING. These people have seen it all and they were all saying hello and joking with us on the tour. There were some at SFGH that have been there 15+ yrs and love every day of it! There seems to be an effort to make resident shifts line up with nursing shifts, in order to facilitate post-shift get-togethers like a big family! Wow! UCSF nursing gave us a tour of the ED, and they were awesome, too. What do they put in the water here? Everyone was smiling and so happy the entire time!

    Curriculum: 4 yrs, 4 months electives. Dr. Promes has clearly put a lot of thought into selecting the rotations. She has focused on graduated responsibility and by the 4th year, you WILL be running the ED. No real malignant rotations here, and off-service months look to be excellent with world-class teachers.

    Didactics: 5 hrs (protected time on ALL rotations) every Tuesday, and will be innovative in design – not just straight lectures, but rather a combo of case-based small groups, hands-on didactics, simulation, etc. They mentioned they are looking to be leaders in revolutionizing didactics since many faculty have degrees/interests in medical education.

    City: Can SF really be beat?! It was 62F and sunny and most people at the hospitals take full advantage of the great food and sights in SF. There is something for everybody in this city!

    Negatives: I’m hard-pressed to think of anything right now, because they paid attention to every last detail here. They’ve done their homework, and are fully cognizant and prepared for growing pains.

    Overall: This is going to be tops in no time! With Dr. Promes and Dr. Michelle Lin at the helm, there’s lots of fun to be had while learning from well-established leaders (Callaham, Tabas, Chin, Weber and the list goes on … ). The ED environment and camaraderie between current nursing and faculty is second to none. Would love to train here, and this place will be hard to beat on my list!
  5. loomis

    loomis Lifetime Student

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    UCSF

    I really enjoyed the interview day. it seems like it would be a great blend with the stuff at SFGH, Oakland (peds), UCSF, and Kaiser. The faculty seemed super excited and were keen to point out that while it was a new program, they have had lots of experience with stanford and highland residents rotating through SFGH in the past.
    (+): amazing off services, SFGH only level 1 in SF, super dedicated faculty,
    Minuses: while well organized, it seems that faculty are not super clear about how the shifts would work (how many 12H shifts, any 8H, etc). the residency director gave a very general statement that she was open to communication with the residents about the shift but was vague. this could be good but it could be brutal if we find out we signed up for 4 years of 20 12 hour shifts!!!


    harbor:

    (+) amazing history and variety....it was pretty cool walking into their chaotic ED and seeing the residents in action. amazing U/S training, interesting "college" section program that they will be putting into use for our class. residents seemed very happy
    (-) some offsite services....some of the residents i spoke to were thought some of the offservice sites (like neuro) were pretty low yield. facilities are pretty old.
  6. Hard24Get

    Hard24Get The black sleepymed

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    UCSF/SFGH

    A brand spankin' new 4yr EM program looking for its 1st class!

    Residents: None yet, but there will be 12 residents per year. They seemed to be interviewing people with capacity for leadership, great people skills, and a passion for innovation. I really liked most people I met on interview day and have a feeling the first class will be a force to be reckoned with. :) The leadership is not only flexible and open to change but are actively seeking residents whose input will help shape the program.

    Faculty: Many of the faculty are super-stars - Michelle Lin, Susan Promes, Mike Callaham (one of 3 EPs in the IOM), EM journal editors, etc, etc, etc. To me the best thing about them was the dinner and the lunch the next day was so fun we didn't miss the residents! Everyone I met is so down to earth! The new program is the brainchild of Michelle Lin (who is SOOOO funny) and the recently recruited Susan Promes, who started Duke's program. I heard some interesting rumors about Dr. Promes, but I love her energy. She is clearly compassionate and excited about the program, but she is also a TIGER. Frankly, I think she is just the type of PD that is needed to help EM infiltrate UCSF.

    Hospital:
    There are two main sites, UCSF's hospital (Moffitt-Long) and San Francisco General. Though most faculty work at one or another, the Susan Promes splits her time between the two sites, just like the residents will do!:

    Moffitt-Long - The uber prestigious hospital that is a mecca for outstanding programs in medicine, peds, surgery, etc, etc, etc.... ED visits are around 39K with a 22% admission rate and 14% peds, clerks to make all your calls, and electronic charting. It seems like a lower census but this is Cali - less urgent-seeming complaints in adults and peds get punted to urgent care, so you are only caring for the sickies that need you unless it is 2am, etc. Though all attendings are EM certified greats, most of the residents are off-service or from other sites and will be eased out as the new class eases in.

    San Francisco General - A crazy county ED, the only level I trauma center in SF that boasts the highest ambulance volume in the city. Again, people get punted to primary care urgent clinic if they aren't that sick. And wowsa, are the people in that ED sick! As they were doing the tour, I saw multiple patients that obviously were in great distress and had multiple medical problems roll by. Charting is paper. There is also a mix of trauma and a lot of it - the current deal is that EM runs all minor traumas, and alternate every other day with surgery on major traumas (non-leading team does procedures). Currently, anesthesia gets most of the trauma airways (EM gets all medical and 2days/week trauma) and they are negotiating to alternate on that as well. Most residents are from medicine or highland/other site EM residents that are being phased out.

    Of note, during RRC accreditation, UCSF was criticized for having too-high of an acuity, so new residents will also be going to the VA urgent care clinic and Kaiser Permanente. Not to mention Children's hospital in Oakland for more Peds exposure.

    Ancillary Stuff: Ancillary is supposed to be great at both sites, but as you know county is always a bit sketchy and you might have to rise to the occasion. The RNs seem excited about having new residents and greeted us as we went by. Clerks make calls for you.

    Admitting/Documentation: Not sure about admitting privileges. Electronic at Moffitt-Long, paper at SFGH.

    Curriculum: 4-year curriculum with a pgy2-4 area of concentration in clinical and translational science, community health, global and public health, health systems and policy, medical education, molecular medicine, social and behavioral sciences, or something you help design, and will lead to a certificate or master's degree. These endeavors are designed to be longitudinal rather than accomplished in a paltry month or two. There is a medicine floor month, but the rest includes 3mos of ED, 2mos of urgent care, 1mo of radiology, and 2mos of ICU during intern year. There is 1 mo of vacation. Hours are currently being worked out. Right now UCSF is 20 10hr shifts and some 12s, SFGH is mostly 12s, but they are tapering the hours down with the goal of getting to 8hrs. They are trying to do this without compromising the # of EM residents in the ED.

    Didactics/Research: 5hrs per week, they are working on getting residents excused from off-service rotations to come. They have also submitted an innovative web-based and simulation-containing curriculum to the RRC for approval. In terms of research, they are doing ground-breaking stuff in detecting HIV, spinal cord injury, and US, and are affiliated with an awesome research powerhouse whose faculty they often collaborate with.

    City: San Francisco is wonderful of course, an active city featuring the beach, tons of entertainment, a NYC-like downtown, public transit, beautiful suburbia, fabulous food, and... crazy expensive housing! There do seem to be some affordable places around, and the med student certainly survive, but it is a matter that requires further investigation.

    Extras: Salary starts at 44K (goes by UC salary which is hard to change) with a $500 housing "stipend" (added to salary) that brings you up to 50K, full health benefits, 26 days of vacation, a $2400 relocation stipend, national meetings, a PDA, textbook allowance, medical license fees, etc.

    Negatives: Well, it is a new program in a super-strong academic environment. Though the faculty have trained resident before, the first class has to be ready for the turf wars and glitches. I believe Dr. Promes when she says we wouldn't have a problem finding a job, but it is tough to think of fighting external issues while trying to train.

    Overall: A real new kid on the block in one of the best hospitals in the country, featuring academic, county, and community experiences and wonderful leadership, as well as an opportunity to be the first class and mold a new program. A frighteningly huge task that may none the less be very difficult to turn down.
  7. EMbound08

    EMbound08

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    Anyone heard anything from the residents as to how this program is going? Are they happy? Good PD? Any info would be appreciated.
  8. Eric1332

    Eric1332 Junior Member

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    Hi EMBound,

    Everything is going very well. We're 1/3 done with internship and so far my year has been great.

    We all started with an orientation party with faculty, got to know each other, and had a blast. Our first month we all worked in the ED, 2 weeks at each site. It was great to start in our "home" and work together, and the spectrum of disease is ridiculous. The faculy at UC and The General are amazing and so fun to work with.

    Then we all began our regular schedule of off-service stuff and more ED blocks. I did a month (3 weeks + vacation) of L&D, caught 22 babies and then did a month at the VA Urgent care where I swear I tapped every joint in the human body that can be tapped. The medicine month at Moffit-Long (UCSF Medical Center) is straight-up Q4 call but it's a cool month and you carry ICU patients which is always good learning. From what I hear from classmates, cardiology is high-yield, neuro is the best off-service rotation ever (neuro ICU and consult service, including acute stroke team), anesthesia is long days but good airway experience (tubes, advanced airway, lots of drug familiarity), radiology is mellow but good learning from the award-winning radiology teaching faculty, and our EM conference has been awesome (great lectures like grand rounds with Amal Mattu, small groups, workships, cadaver lab).

    I'm in the ED at SFGH now, having so much fun and learning a ton. The volume is huge, the teaching is great, and we're running low-acuity traumas as interns. There are tons of procedures, and the nurses/techs/residents/attendings work together with a comraderie that makes work so much fun. Working with the Stanford and Highland residents is great, they're all super strong and drop the knowlege on us.

    We're only 4 months old, it's going so well. The issues we're having are minor and we meet monthly with Susan and Michelle to discuss the program. They and Barbara Kilian (associate PD) have been so cool about listening to us, working with other depts, and making sure we're having the best experience possible.

    We all live in SF, hang out almost every week, and have fun while we're off.
    Some of us are starting to think about research and projects, some of us are newly married, some of us like beer, and all of us are glad we came here as the first class. As interns we're all just focusing on being good doctors, but the upcoming opportunities for leadership, research, education and travel are pretty sweet.

    We're all stoked to help recruit our next class, so thanks for your interest, and let me know if you have any questions.

    -Eric Silman
    [email protected]
    www.emresidency.ucsf.edu
  9. EvoDevo

    EvoDevo Sm00th... Moderator Emeritus

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    Overview
    Newish 1-4 program recruiting its second intern class. Started in 2007 with lots of flair and excitement and a whirling dervish of a program director in Susan Promes. Looking over last year's reviews, it became apparent that this program was on a lot of people's wish lists. Went there myself and I can definitely see why: the program has that "X-factor" that really outstanding organizations all have. Program is now its own department (as of July 08) and appears to have solid support from the other UCSF programs. Gorgeous but expensive city with international appeal.

    Interview Day
    Met in the Moffett ED and went over to an executive conference room, where we were served a nice continental breakfast and Dr. Promes gave us a nice, brief overview. We were then broken up into a tour and an interview group. Four 20 minute interviews (all too short by far – great conversations were had), and then each group switched. Each tour group has a 30 min "open session" with Dr. Promes. Then we all boarded a bus over to SFGH and had the tour there. Lunch at SFGH, then back over to Moffett to end the day (around 3 pm).

    o Interviews: pretty much how most EM interviews are, you know? Non-confrontational, chatty, why UCSF and the bay area, where do you see yourself, etc. Susan Promes basically says that if your only goal is to be a clock-punching EP then you would probably not wish to come to her program.

    o Tours: Moffett is a gorgeous hospital with pretty much the most amazing ICU I've even heard of. Open ICU concept which means that you gett good ICU experience even when on a general medicine month. Lots of large windows with great views, and one giant window with a spectacular view of Golden Gate Park. SFGH is a lot more crowded and beat down looking, but plans are apparently afoot to refurb the place. SFGH's location is pretty prime and there are plans to build an additional building to the hospital starting next year. Together, the hospitals make for a very nice and integrated University/County hospital training environment.

    o Lunch: Pretty awesome. Get a cookie at the start or else they will be gone!

    Residents
    12 per class. Freshman class has a definite West and West Coast feel and mix. Pre-interview meet and greet was at Park Chow's, which was tasty and low-key. Some (non-interviewing) faculty were there at the beginning abut left halfway through. The residents were definitely an eclectic bunch, but I mean that in a nice way. =) The description "Nice" is the most apt one to describe the class. Very helpful before, during, and after the interview. There was an overall theme of wanting to get in on the ground floor of a soon-to-be-outstanding program. Most had time to go mountain biking, surfing, wine tasting, etc in their spare time. As you would expect, they loved living in San Fran.

    Overall, I'd feel happy and very comfortable working with this group of residents and having them as seniors.

    Faculty
    I'm almost tempted to say "What more needs to be said??" because, well, it's UCSF. But that would be a cop-out, I think, so let me give my impressions. Susan Promes is every good thing that you've heard about. Whip-smart, funny, and aggressive, she's the reason why this program is headed on an upward trajectory. A natural leader. Michelle Lin is known as an oustanding teacher and I can see why. I interviewed with her and it was one of the more stimulating encounters that I've had in years. She throws off ideas like a downed power line throws off sparks. The rest of the faculty that I met was similarly engaging. I tell you no lies: I was impressed by each and every one, and it had nothing to do with their CVs. Rather, their smarts and energy were palpable things. Very motivating.

    Ancillary staff
    Reported as good. The staff at Moffett and SFGH seemed experienced but not jaded and full of humor. Good sense of teamwork with the physicians. I liked ‘em.

    Curriculum
    o PGY1-4: Look it up on the website.

    o Other notes: Dr. Promes is reportedly pretty aggressive about making sure that rotations are high-yield, and has apparently had good success in getting other departments to play along. From what the residents told me, they haven't encountered any grief from the off-service folks. Rather, because UCSF has such a stellar rep in medicine, surgery, etc, they feel that they have to go above and beyond to establish a great reputation for the program. Which is a good thing in my book. Trauma is reported as being a part of the program but not the big enchilada by any means.

    o Shifts:: Interesting mix of 8s during the week and 12s on weekends so that they get more weekends off. Split time between the hospitals.

    o Seniors: Currently Highland and Stanford seniors cover the hospitals and there is some crosstalk between the programs.

    o Bennies: You get about $500/month as a housing stipend which combined with the base salary give you about $51,0000/year to live on. As Good health, dental, etc. according to the residents.

    No word on moonlighting at this time.

    Fellowships: Can't recall.

    Facilities: as above

    Charting
    Mix of paper and electronic, if I recall correctly.

    Location
    San Francisco. Gorgeous, cosmopolitan, expensive. 2BR/1B apartments close to Moffett were reported to go for ~$1,700 (note that this was reported to be a rent-controlled place so YMMV). Yikes. Lots of things to do in your off time. Awesome restaurants in the city. Airport is relatively accessable. Parking is awful so rent a place with a paid spot. OTOH, great municipal train/rail system. Windy.

    Negatives
    [NB: I've been a plankowner of two previous startup organizations outside of medicine, so I'm not a newcomer to this rodeo.]

    o New program. No seniors who've gone where you're headed to hand out advice. The inevitable bugs that will have to be worked out of the system.

    o Michelle Lin won't be the Associate PD by next summer, as she has decided to pursue other pathways at UCSF. [She'll still be on faculty and teaching though.]

    o Cost of Living: yeah, it's expensive. Doable on two incomes. However, if you had a family then I think that it'd be a dicier proposition. Remember, it's not just the rents that are expensive in SF, so do your homework.

    o Funding comes from both UCSF and the City of San Francisco. So when you're working at the VA or Moffett-Long, you'll be paid once a month. But at SFGH, you get your pay twice a month. Even stranger, the amount varies by hospital, so you never know from month to month when or exactly how much you'll be receiving. One resident told me, "don't worry man, it all works out." Not so sure that I or my family could be so sanguine about that. Stupid system.

    o No network of previous grads to grease the wheels post-residency. I don't think that it's going to be as much of an issue as one might think, given the reputations of both UCSF and Dr. Promes.

    Positives

    It's UCSF. Standout PD with a track record of building a good program. Faculty who are committed to excellence and are really, truly excited about building a phenomenal program in the Bay area. Good pay for singles and DINKs. Broad range of patient populations, from well-insured to "Yo, I'm just gonna drop my friend off. He fell on a knife" to Mauled By Tiger But I Swear That I Wasn't Provoking Him.

    Overall

    New program with lots of energy, financial resources, and the ability to execute its plan of World Domination. :) I think that the training is going to be excellent and that the graduates will prove to live up to the UCSF reputation. I don't think that this program is a great choice if you have a family with a stay-at-home spouse given the COL, but maybe I'm wrong. Despite the newness and the inevitable rough edges, I loved my interview and got a truly fantastic vibe from the people. The program is going to be one of my top choices, no doubt.
    Last edited: Feb 23, 2009
  10. EvoDevo

    EvoDevo Sm00th... Moderator Emeritus

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    I originally posted this in the Unofficial 2009 ROL thread but I'm posting here so that folks down the line can get more hits when they search for various programs.

    1. Texas A&M-Scott & White - Loved the facilities, great reputation in Texas and surrounding regions, LOVED the residents and faculty. Feels like home. Brought my wife back for a second look and it was a giant love-fest. :) Training is extremely good, great location, and extremely family friendly.

    2. Duke Univ Med Ctr-NC - I loved the PD (Sarah Stahmer), the faculty, and the residents. I definitely felt as if I could spend three years with these guys. The feel-goodness started at the resident social and continued on. I was also impressed by the group of applicants who were there with me (one of my hidden indicators). Excellent training, though a bit too university hospital biased. Duke name and reputation, facilities, and Raleigh-Durham is gorgeous. Family in the area. Would be excited to end up here.

    3. UC San Francisco-CA - One of those programs with that "X-factor" that's hard to describe; yet you know it when you see it. Really liked the PD and Assistant PD. ;) Fantastic facilities, really top-notch faculty, residents were nice and very welcoming. New program and that brings with it problems; however, I've made something of a habit of helping to establish new organizations and I love a challenge. Though SF is hideously expensive, we think that we can make it happen. Plus it's SF! Gorgeous city and TONS to do when we're not working. Family (a well-traveled bunch) would be thrilled too and have already promised to visit all the time if we end up there. :)

    4. University Hosp-Cincinnati-OH - My favorite program by far when considered in and of itself. However, when those "other factors" get thrown in, it was hard to rank them higher. Spent a month there, absolutely LOVED the program. Seriously. This is truly one of those X-factor places and watching their fourth years was insanely impressive. Wish that I could have ranked them higher. But if by some ridiculous longshot we end up there, then I will probably be their most enthusiastic resident EVER. :)

    5. U Texas Med Sch-Houston - solid program in a city that I love, close to family and friends, good research available, extremely familiar with the medical center and area.

    6. University of Virginia - Very good program that a friend rotated with, so I know it's dirt to a degree. Gorgeous town, decently close to family. Kind of isolated and would be harder for my wife to find a job since it's primarily a college town.

    7. Ohio State Univ Med Ctr-OH - Heard great things about the program, really enjoyed my interview, residents at my med school rave about the city. Would be very happy to end up there.

    8. Christiana Care-DE - One of those programs that I wish that I'd been able to rotate with because I hear so many great things. Really clicked with the faculty, kind so-so with the residents. Newark didn't really impress me much as it reminded me of the concrete suburbia that I wouldn't mind leaving behind. Nonetheless, would be happy to match there.

    9. U Michigan Hosps-Ann Arbor - Fantastic program, not really thrilled about the amount of snow/winter/winter schmutz we'd have to deal with. Not looking forward to buying a light box and possibly dealing with SAD.

    10. U Arkansas-Little Rock - One of the most relaxed and enjoyable interview days I had on the trail. Brand-spanking new ED which is gorgeous and well thought out. A little concerned about the volume and pathology that they see there. Good faculty and the residents seem like people I'd want to be friends with outside of work. Little Rock seems like a very pleasant place to live, and quite affordable.

    11. Christus Spohn Mem Hosp-TX - I think that this program is going to be really outstanding in a couple of years. I had a great interview and with the relative lack of other residencies, you get treated like royalty by the hospital - Close, free parking, free food in the Dr.'s Lounge, relatively few low-yield rotations. However, the wife and I weren't too thrilled at the prospect of living in Corpus for three years, and their are still some rough edges to the program. Nonetheless, I believe that you'd come out of this program a very well trained EP.

    12. Pitt County Mem Hosp/Brody SOM-NC - Solid program, had a so-so interview day. Location was a bit of a negative for me as Greenville is so small. On the other hand, it is only about forty minutes from family and it's insanely cheap to live in. I've known some folks from the school and they had very good things to say about the program. Would be okay with matching here.

    Bottom line is that I didn't interview at a single place that I wouldn't mind training at. I do think that there is a nearly intangible but real difference (for me) between the top-tier and other programs. Having said that though, the one thing that I've learned from this interview season is that the saying "You get a solid education at any of these places because of the RRC," is probably pretty close to the mark.
  11. quicknss

    quicknss

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  12. 13770

    13770

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  13. MountainEM

    MountainEM Mountain Man

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    someone should be banning you shortly. please hold.
  14. Elessarcr

    Elessarcr

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    In an attempt to bring this post back to what the original spirit was about (reviewing the UCSF EM program), I thought I would share my thoughts on this program after being a SubI there.

    I chose to visit here as I had friends from college and medical school in the program and they seemed to LOVE it. I really enjoyed the experience at my home institution and I thought it would be hard to compare to that experience, but I was wrong. Where my program had academics and a large tertiary care center, the UCSF program was comparable. The attendings were smart and did a lot of teaching on the fly and in specific didactic sessions. They do great work on disaster preparedness and have researchers (not film the film maker) like Rob Rodriguez working on NEXUS decision aids. But, what's more, the program has The General, which is the only level-1 trauma center in the city and a major public hospital... if you're into that kind of thing.

    Outside of the hospital, there is the obvious appeal of San Francisco. I'm "outdoorsy" so the ability to run or ride right over the Golden Gate and into beautiful preserve land and cycling tracks is an awesome appeal. There are great outdoor activities within 10 - 15 minutes of the door.

    In the end, much like choosing emergency medicine in the first place because I want a bit of everything, I find that the UCSF-SFGH program also has a bit of everything: community, academics, research and location.
  15. Mbekweni

    Mbekweni

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    I'll also add my thoughts about this program since there hasn't been much posted in a while:

    Pros: Several excellent training facilities including one of the best county hospitals in the country with lots of trauma exposure but also a busy tertiary academic center at UCSF Moffitt/Long. Excellent faculty who are both well respected in the field but really approachable and collegial. Outstanding off service rotations, plus extra exposure to other systems (Children's Hospital Oakland- now merged with UCSF to be one of the largest children's hospital system in the US along with VA, Kaiser) to broaden the educational experience and help with choosing the right career path. Great overall name both within Emergency Medicine, but also outside of it in case I would decide to do a fellowship in Critical Care, work in national/international health policy, be part of the huge silicon valley startup scene, consulting etc. Great exposure to a wide variety of opportunities with a huge institution that is growing really fast...both as an EM program and medical institution that is only going to be better and better with more contacts and opportunities in the years to come. Bay Area is awesome (weather, culture, city itself). Approachable, close knit group of really bright residents who have a lot of fun together and seem really happy with a solid work/life balance. Multiple new hospitals coming online 2014-2015 including what should be the best pediatric EM exposure in the country once CHO and the new UCSF Women's and Children's hospitals are merged and running together in early 2015 and the residency takes the primary role of managing the peds ED.

    Cons: Not as many procedures as quickly (compared to LA County, Highland etc)...though all the residents get there soon enough and are well prepared by graduation time. Also while there is great training in County, government, and academics, there is a comparatively weak exposure to community emergency medicine (just one month at Kaiser SF) making moonlighting really important for a complete EM experience.

    +/-: Cost of living in SF. San Francisco really is expensive, but just about the same as LA (Santa Monica area where a lot of the residents live), New York, even some areas of downtown Chicago etc. Salary is standard UC base rate plus $705 monthly housing allowance ( total $59750 PGY1 for 2013-14, increasing 2-3% per year for those reading this in the future). Add in other things like bilingual provider bonus ~600-700 yearly if you speak another language, $800-1200 annual performance bonus, $650 educational materials stipend, $1800 moving allowance first year (not everyone gets it but it's at least a reasonable option) and the end result is a salary that was highest I found in the country which more than compensated for the cost of living as related to monthly rent/monthly income when I was comparing it to a lot of the other highly desirable (and high COL places) that were also high on my rank list. You would have to make some cost of living compromises to get a nice one bedroom but if you get a modest studio or share a place with roommates it's not bad. UCSF also has subsidized housing available to new residents for the first 2 years to ease the transition to a new city.

    Quick thoughts on the other Bay Area programs:

    Highland- sort of the sister program to UCSF. Good relationship between the two institutions and really a great place to train. I loved my sub-i there. Wonderful "Highland family" environment. Great procedural exposure. Great high need, high acuity patient population. Probably the best place to train by far if you were planning to go out into community practice right after residency as you get lots of exposure doing your own procedures, and not having as much consultant backup. I was sure I'd be ready to fly solo out of this program. Excellent salary and benefits. +/-: Residents live all over, many in SF, some in East Bay for a more fragmented group that's harder to get together spontaneously...plus the commute from SF to East Bay can be brutal sometimes if not carefully planned. Highland is a great name for getting a job in EM anywhere in the country. Not sure sure how much weight it would have outside of the field for those who aren't 100% into clinical emergency medicine. Less chance to learn from world class specialists from other fields.+/- Highland does all of their own trauma airways while UCSF shares trauma airways with anesthesia (but does all the medical ones), however at UCSF the EM residents run all the traumas while at Highland that goes to Trauma surg. Residents at both places rotate on the other services too so it seems to come out about even overall- though people seem to talk about these differences a lot.

    Stanford: Similar setup to the UCSF program with a strong county program in San Jose and great academic center, along with VA. Great approachable faculty, fun residents. Expensive cost of living but a high salary that allows you to actually live in Palo Alto's altered Google and Facebook economy. Great suburban environment with easy hiking, biking etc right out the back door. Bad: commute time between training sites. Their 3 year approach seemed like a tough sell. Way more shifts per month, 12hrs and didn't seem like the same quality of life for residents compared to most 4 year programs. Worth it in exchange for being an attending a year earlier? Harder to say both financially since with a relaxed 4th year schedule most 4yr programs can do more moonlighting, and also personally as there seems to be more personal growth and exploration with weekly/monthly time to engage with evolving interests rather than some compressed elevtive weeks. In the end I didn't rank Stanford that highly for residency for those reasons, but love the institution, faculty and would strongly consider it for fellowship or an academic position later when the 3yr program drawbacks that were a bigger deal for me were no longer in play.

    Other programs I loved:
    UCLA Olive View, Univ of Washington, UCSD, Northwestern, Harvard BWH/MGH
    Last edited: Apr 13, 2014
  16. nerdilicious

    nerdilicious

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    1. UCSF/SFGH:
    pros: one of the only programs where you really get to split your time between a county hospital and a tertiary care center. SFGH is a level 1 trauma center, safety net hospital. UCSF is an everybody has insurance but are still sick as stink kinda place- post- transplant, late-stage cancer, etc. Also a big referral center so you get to see the patients that nobody else can figure out a diagnosis. On my sub-I here I saw ECMO done in the ED! I really liked the residents, they all seemed super nice and like a tight-knit group. I was struck by how many people mentioned to me how happy they were. As mentioned above, off-service at Children's in Oakland, VA and Kaiser so exposure to everything. Also, its in San Francisco, which is awesome.
    cons: San Francisco is expensive. Really expensive. You get a higher salary at UCSF than a lot of other programs, plus $700 a month for housing, but I'm not sure if that really makes up the difference in price. Some residents live in other parts of the Bay Area, but its a long commute and doesn't seem like a great option.

    2. Highland/ Alameda County
    pros: Great county experience, safety net hospital. Even though its a level 2 trauma center you see a TON of trauma, especially penetrating. Residents seem super happy and like a tight-knit bunch. Do pretty much all their own procedures since the only training programs there are EM and IM. Especially good ultrasound program. Do off-service at Kaiser and neuro/EM at UCSF. In Oakland, which has beautiful areas. Free parking for residents.

    Cons: Primarily a county experience; not much training in post-transplant, chemo patients etc. Because there aren't many ancillary services there aren't specialists to learn from. Also, follow-up/referrals/dispo for patients can be a nightmare. Food in the cafeteria is terrible (I know this is picky but its really bad).

    3. Cook County:
    pros: Great county experience. Residents and faculty seemed happy. Do all your own splinting/casting/resetting of bones. Huge trauma center that is its own section of the ER so you aren't pulled away from your other patients any time a trauma rolls in. In Chicago, which is an amazing city but is more affordable than most big cities.

    cons: County hospital only without much tertiary care. You push your own patients to xray. Nurses are terrible. Really terrible. Nothing gets done without you asking over and over. I ended up putting in a lot of my own IVs and drawing my own labs on my sub-I because it was easier than finding a nurse to do it. That said; you will be great at IVs when youre done.
  17. SoyMilk

    SoyMilk SDN Gold Donor Gold Donor

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    What kind of stats do you need to be competitive here?
  18. Mbekweni

    Mbekweni

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    General response: UCSF/SFGH, like most other residency programs likely has an admissions criteria that is a lot more complex than any of the posts on SDN can accurately capture, and nobody can really know outside of the program director. The quantitative stats of boards scores and honors from a few people are easy enough to post online, but once past the initial decision of how to cut down the huge barrage of applications to start reading- those people who come across as down to earth, interesting, collegial and would be fun to work with will likely do much better in the match. In the end, if you think you would be interested in this program or any other you should apply. It's well worth the $10 or so to see if you get an interview.

    That being said, this is a competitive program so a few honors in 3rd year clerkships, honors in EM sub-is (do 2) with excellent SLORs, and above average Step scores would be a good goal as any residency program will have a quantitative way to score applicants based on these factors to grant interviews and then again as a portion of how the list is made up come rank day. There are always exceptions for diverse and interesting people along the way though, so definitely apply where you could see yourself working and let other people tell you no if needed. Averages are just that- half the class will be above them, and the other half below. Good luck!
    Last edited: Mar 22, 2014

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