University Hospitals/Case Medical Center Residency Reviews

[EvoDevo]

Sorry this is so long guys, Grab a vat of coffee!

Overview: New 1-3 program starting 07/09 in Cleveland, OH @ Case Medical Center (CMC). 1 of 38 residencies/fellowships in the 1,073-bed hospital which is the primary teaching affiliate of CWRU SOM. Their program will train in academic and community ED (more academic), with strong peds emphasis. ED @ CMC 70,000+ visits last year. If you hate research and huge hospitals, don't want much peds, this place will not be the one for you. A lot of the faculty are involved in some sort of research, but they're not as research-driven compared to a program, say like U of Mich. There has been talk for years @ CMC about starting their own EM residency, so they've finally got their wish.

Interview Day: The program split the cost of the hotel room at the Embassy, which had shuttle service to CMC. PD also provided info for a limo service for $30 (including tip) from airport to hotel. Convenient if you don't want to shell out more $ for renting a car.
Day started off @ 8am meeting in the new ED conference room, which is still being transformed into one. Breakfast was provided. Interviews were very laid back with the usual questions; i.e. "Why Cleveland or CWR. Notable character defining question: "Describe what you think agressive behavior is vs. assertiveness and give an example of a time you were aggressive".
4 interviews total: PD, assnt PD, 2 faculty-one of which is EMS director. Very friendly and academic people. Lunch was catered. Detailed slideshow with the EM Chairman about the new ED layout and new UH community hospital that's already being built in the east suburbs. The day concluded with a tour of Cleveland (optional).

Residents: 8 per class, this will be their 1st class. Pre-interview social the night before with the PD, research team, some nurses, all were all excited about the program. One of the medicine residents provided a tour and answered q's about the hospital and other services, so he kinda served as our "resident" and filled us in. Peds resident gave us tour of NICU.

Faculty: A major perk to the program and broad mix of well established faculty and some younger attendings. PD (MD,PhD) is former PD @ Arkansas, Chairman is former PD @ Northwestern, other faculty trained @ other top programs, very diverse. All of them have combined the best from their former programs with resources of Case for this residency. Very experienced and nationally recognized names in EM.

Assistant PD is on PEER-VII editorial board, writes questions for PEER-VII and oral ABEM board exams.
Ancillary staff: Came out for the social, and included some of the nurses and most of the research team. All were very friendly and excited to have EM residents. They also stated that other residents @CMC rotate through the ED, so having residents around is not a new thing for them. I got the impression they have an unusual amount of camaraderie, but in a good way. It's a nurse-magnet hospital, people want to work here.

Curriculum: PGY1-3. Residents are designated a "mentor" faculty member.

Shifts: All 10 hour shifts. PGY1= 18 shifts; PGY2= 17 shifts; PGY3 16 shifts. Direct obs cases 4,3,2, per month (PGY1-3 respectively), and 8 follow-up per month (at least 3 inpatient and 3 outpatient---basically you follow up outcome of a patient when they leave the ED. 1 shift/mo will be EMS air and ground transport. PD emphasized how you will work no more than 40-45 hr/wk in ED shifts
PGY1
3 months adult ED
1.5 months Peds ED
1.5 month Trauma ICU/SICU
1 month orientation
1 month MICU
1 month adult ortho
1 month rads/ultrasound
1 month peds
1 month anesthesia
1 month ob/gyn

PGY2
5 months adult ED
2 months peds ED
1 month Neuro/NeuroICU
1 month CICU
1 month peds ortho
1 month trauma
1 month selective
1 month elective

PGY3
7 months adult ED
1 month PICU
1 month MICU
1 month EMS/Flight
1 month Admin/Tox
2 months elective

Vacation= 4 wks/yr
Didactics: The usual. There will be a yearly cadaver lab to do procedures, and Case has a wicked cool Simulation Center (like the WISER center @Pitt, if you've ever been there). They have a lot of money. All topics of EM core curriculum will be included twice over during residency.

Research: actual meaningful research with a focus on clincal projects within the dept. Access to Wolestein Research Building and 3 onsite IRBs. Research assistant team are work-hard play-hard people that support the new EM program. There is an annual Case Research Showcase.
*NOTES*
1) Selective: choice of two, 2-week rotations in hand surgery, oral surgery, ENT, Derm, Optho.
2) Electives: May choose to stay in adult/peds ED, or more selectives which can be done in the ones listed above or other selective lists, or any other interests you have for the month.
3) Trauma/SICU is done @ MetroHealth/CCF
4) Peds/Peds trauma is done @ Rainbow's Babies and Children.

ORIENTATION= ACLS, ATLS, PALS, US course,etc.
OB/GYN= ED consults, US in clinic one morning each week. 10 deliveries expected.
ANESTHESIA= 3 wks adult, 1 wk peds including 2 days in peds sedation unit. You get all conscious sedation cases.
MICU= PGY1 to get your feet wet, 3rd year expected to function as senior med resident running the MICU.

CICU= responsible for all cardiac US. Has IABPs, LVAT, aquaphoresis, therapeutic hypothermia, cards transplant, and of course a cath lab.

ORTHO= respond to ED ortho consults, PGY1= adult, PGY2= peds
NEURO/NEUROICU= 2 wks neuro consult service responding with stroke team, 2 wks neuroICU.

EMS/Critical care transport= Certification to provide medical control, decontamination (HAZMAT), and mass casualty, ambulance call. Involves both air and ground critical care transport.

TOX/ADMIN= You will answer the Poison control hotline and perform tox consults.
Moonlighting: From my interview response, moonlighting will likely be approved 3rd year if you've earned it and faculty feels you're ready. No definite answer as of yet.

Fellowships: Talks of EMS, Tox, US. Not established yet.

Benefits:
PGY1 $43,733
PGY2 $45,824
PGY3 $47,267
You have access to Veale athletic facility, BioMedical Research building, Case SOM, Wolstein Sim center, library.

I can't remember what the educational stipend is, and for some reason I brainfarted and didn't write it down! If anyone knows it, please add the info.

Parking is available for unknown fee that is deducted from check to all residents/fellows in designated lots.

403b matched retirement savings plan.
On site fitness center with discount to residents.
Health, dental, life, disability insurance available.
Facilities:
*$1 billion (yes, billion) building spree under way

Case Medical Center= Huge hospital, home to CWR SOM. Ranked by "U.S. News & World Report" as one of the nation's top 50 hospitals in 13 medical and surgical subspecialties. JHCAHO certified stroke center. They are building a brand new 60-bed 54,000 sqft. ED set to be finished in 2010. Patient population is REALLY diverse, you get the rich, the poor, black, white, horses and zebras. CMC is a prestigious place, and I definitely got the vibe when I went there.

MetroHealth: Case's other EM residency is here, Level 1 trauma center, Burn Center, both with high acuity. 4600 trauma activations per year, 1700 burn cases/yr. Trauma has about 2000 admissions/yr with 25 beds.

Rainbow's Babies and Children: Ranked by "U.S. News & World Report" as the # 1 children's hospital in the entire Midwest, "Child" magazine as the #5 children's hospitals in America, #1 in neonatal congenital heart surgery by The National Database Outcomes Program of the Society of Thoracic Surgeons (STS). Level 1 Peds Trauma. Very high acuity Peds ED with 15% admissions rate, has PEDs EM fellowship.

UH Aluja Medical Center: This is the brand new UH community hospital (about 300 beds) that is currently being constructed in the east suburbs, about 15 min from CMC. They want this to be the EM residents community site.

Location: Cleveland is a fun city. There is a ton of nightlife for the single people, but it also has an abundance of "surburbia" if your married with kids (and good schools). Surprisingly very very affordable. Sports teams are Brown, Indians, and Cavs; tickets are usually not a problem to get if you want to hit up a game. I highly suggest that if you're not a Browns fan, don't ever, EVER sit in the Dawg Pound. Just some advice.

The lake is a popular place for summer activities and there are even beaches. It snows A TON. If you are anti-winter, then Cle is not the place for you. There are a few ski resorts in NE Ohio, and others are within a 2 hour driving radius in PA.

Traffic is the usual city traffic. Not nearly as bad as NYC. Population is VERY diverse.

Pros: It's Case (hate to name drop). Quality of offservice rotations, as Case is a mecca for brainpower. Strong neuro and peds. Tons of resources and $. Simulation center. Opportunity for developing independence and leadership during residency with tox call, Flight, Amb Call. Faculty is a bonus. New ED being built will be sweet, as is the new UH hospital. Metro is a bonus. Cleveland is a nice affordable area, so I would consider it a pro to the program.

Cons: New program and lots of unknowns. No senior residents/grads to show you the ropes. That's pretty much the only negative I can think of regarding the program. Case has a reputation to uphold, so I highly doubt they will let this program be average.



Hope this helps!

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[opb]

So to help pass the time until Match and ROL certification, I'll be posting one review a day up until Feb. 24... kinda like the 12 Days of Christmas. Haha. Anyways, these are in no particular order. If residents/other interviewees have things to add/correct, please feel free to do so.

Bonus: Today I will be posting 2 reviews! Yay!

Overview: New program in its second year looking for its second class of 8 residents. It's affiliated with Case Western Reserve and located in Cleveland, Ohio. The program is a 3 year curriculum with about 6 months of ICU rotations and 2 months of trauma at MetroHealth.

Residents: I went to the pre-interview dinner which was actually held in a small conference room on the medical campus. There were about 4 residents there to answer questions and chit-chat with. They all seemed pretty chill and easy to get along with. There are 8 residents per class, and I met most of them during the interview day. All were nice.

Interview Day: Started at 7:30a with light breakfast and coffee followed by an hour overview of the program by the PD. After, we were given a tour of the ED and hospital by one of the residents. There were a total of 7 applicants, and we were split into two groups, with one group interviewing first while the second group sat in on their conferences. I was interviewed by a total of 4 people (PD, associate PD, attending, resident), and each were about 15 minutes long. All were pretty conversational and low stress.

Faculty: I find it hard to come up with impressions of faculty based on such minimal interactions. However, I didn't get any negative vibes from any of the attendings I met. Per the residents, the attendings are interested in teaching and are open to suggestions regarding the program.

Curriculum: A three year program with 6 months of ICU and 2 months of trauma. Standard off-service rotations. 2 months of Electives and 1 month of Selective. 4 weeks of vacation. You can find their curriculum on their website.

Didactics are the standard 5 hours per week. They specifically talked about 1 hour of Rosen Club, 3 hours of lecture, and 1 hour of a case presentation. Journal club is held every 2 months or so.

Shifts are 10 hours long, starting with 18 shifts during your intern year and then one fewer shift per subsequent year.

Facilities: Pretty standard ED with about 40 or so beds. I don't remember much about it... sorry. They see about 72,000 per year, which is broken down into about 45k adults and about 28k peds. They are starting to build a new ED which will be bigger: 58 beds, CT/x-ray/lab in the department, 4 trauma/resus rooms. However, this won't be open until 2011, so the incoming class will spend half their time at the current ED and then the other half at the new one.

Location: Cleveland, Ohio. The hospital is located about 10 minutes east of downtown on the Case Western campus. I personally didn't find the Cleveland appealing, however I'm sure there would be enough stuff to do for 3 years. You have the Cleveland Browns, Indians, and Cavaliers for sports people. The Rock and Roll Hall of Fame is located here as well. Also, there is Lake Erie and numerous parks around the city. Also, there wasn't much traffic even during rush hour. While I was there, it was bitterly cold.

opb's final thoughts: I think the main thing you would need to ask yourself is if you are comfortable coming to such a new program. Although it's not brand new, it's pretty darn close. Going to a new program does afford you the opportunity to help shape the program. However, you will be the class that will be going through the "growing pains". I think the curriculum is pretty solid with manageable work hours (while on EM months), and the program is affiliated with Case Western Reserve (which is a pretty solid university). And, as with all other programs, location may or may not affect your decision.

 

[Pure Anergy]

Posted anonymously on behalf of a student who interviewed there.

University Hospitals/Case Medical Center Review

Pre-Interview Social: Dinner with the residents was at Jillian’s, a pool hall and sports bar near campus. It was very casual with a buffet and drinks. I am guessing that about half of the residents showed up, some interns and some second years. They seem happy with their program overall and were very friendly and willing to answer questions. Several of them are not straight out of medical school and have done previous intern years or even an entire residency in another specialty.

Interview Day: We started at 7:45 in the EM conference room near the administrative offices. A resident spoke with us until Dr. Brenner, the PD, got there. He went through a slide show about the program curriculum, the faculty, the new emergency medicine center that is currently being built (slated to open this summer), and fun things to do in Cleveland. Then we had a tour with one of the residents, including going out on the helo pad, which was plenty cold! After that they divided the group into two halves for interviews. Four of us went from 10:00 to 11:00, and the other four went from 11:00 to 12:00. During the hour of downtime, there was a resident who sat with us and answered questions about the program.

There were four interviews each lasting 15 minutes. I interviewed with a resident, the two associate PDs, and the PD. All of the interviews were pretty relaxed. I was asked where else I was applying, what my greatest challenge was, what people would remember about me by the time I graduated, and what my enemies would say about me. Everyone also asked me what questions I had, so make sure you’re prepared to ask questions!

After interviews, we had lunch with faculty and residents, and the chairman gave us a more detailed description of what the new EM center will be like. It’s a really nice set-up, with a lot more space (60,000 square feet) and rooms (58) than the current ED has. It will have its own dedicated CT scanner, its own lab, a hazardous exposure decontamination area, and seven resuscitation rooms. The university is completing a $1.2 billion series of projects that includes the new EM center, the new cancer center, a parking garage, refurbishing the NICU, and probably more things that I don’t remember.

Curriculum: UH/CMC is a three year program. The residents work 10 hour shifts, 18 during first year, 17 during second year, and 16 during third year. The hospitals include UH, Rainbow Babies (children’s hospital located on the same campus as UH), and Metro, which is the county hospital. UH is a not a trauma I hospital, so the residents go to Metro to do their trauma rotations. There is also a new suburban hospital, Ahuja, that will open in January. The chairman said that residents will probably work at Ahuja in the future, either as a required rotation or for third year moonlighting.

One of the things that most impressed me about the curriculum is that there is so much peds exposure, including a dedicated peds floor month. I’m not a big fan of floor months, but the Rainbow Babies hospital affiliated with UH is one of the best children’s hospitals in the country. The residents and PD also mentioned tox as a strength of the program, and the Cleveland Poison Control Center is located at UH. Research is big at UH also, with many possibilities for collaborating with other departments, and a dedicated EM research division that has student members who can help residents with their projects. They have required EMS shifts and an EMS month, but flying on the helicopter is optional. It seems like there is more elective time than many other programs have, with some cool options like hand surgery and dental emergencies.

Didactics: Highlights of the program include an ethics seminar that was created with resident input, and a required quality assurance project. This project is completed during the third year. Residents also have a required scholarly project (so two required projects total). There is a journal club that meets every month or two and is in a pro/con format. One example of a journal club that they did this year was looking at the pros and cons of doing abdominal CT scans with oral contrast versus IV contrast versus no contrast. No one has graduated yet, so there aren’t any data about where grads go or how they do on boards. But it seems like the program will prepare people well. They give all of the residents a copy of Rosen’s, and they go through the entire book set twice during the course of the residency. They also have a weekly “Rosen’s club” with board-style quizzes or a jeopardy session to go over the reading for that week. I asked the residents if they felt like this was too much of a reading load, but they said it has been manageable so far.

Administration: The chairman, PD, and assistant PDs seem dedicated to the program and supportive of the residents. They talked about their roles in designing the new program, and the PD mentioned that he decided to have the residents work fewer shifts compared to a lot of other places because he didn’t think it was necessary to work 22 shifts per month. They want residents to have time to read and do other things. There are four weeks of vacation per year.

Benefits: Besides the fact that the program is still so new, one of the major downsides is the benefits for residents. It seems like there are a lot of hidden fees for benefits that many other programs cover. The residents do get EM organization memberships, money to present at conferences, and free textbooks, and they get to use the Case gym for free. But they have to pay for parking, and they only get $200 for food per six month period. They also have to pay for their own health insurance. Interns are not eligible for the 403(b) matched retirement savings plan.

Cleveland: Dr. Brenner gave a detailed presentation about what there is to do around town. I knew about some of them already (Rock and Roll Hall of Fame, Severance Hall, the Metro Parks, museums, Cedar Point). But it turns out there are also things like a Lake Erie island you can go visit, a national park, and a safari park where the animals will come and stick their heads right into your car so that you can feed them. Obviously this is not NYC or Chicago, but I think Cleveland gets a much worse rap than it deserves. It’s also a lot more affordable than NYC or Chicago is on a resident’s salary.

Summary: It’s still fairly new, but I think once it gets going, UH/CMC will be a very strong and impressive academic program. The greatest strengths appear to be didactics, peds EM, tox, and research. EMS also seems pretty decent. There are faculty with an interest in U/S and international medicine, but those areas don’t seem to be quite as strong. The new emergency medicine center will open in time for our class, and it is going to be really nice. Cleveland is a decent and affordable place to live on a resident’s salary.

The other potential major downside besides the newness and the benefits is the winter weather. It is gray and cold in Cleveland all winter long, and they get a fair amount of lake effect snow. The residents told us that it’s worth the extra money to buy covered parking so that you don’t have to dig your car out every day. On the other hand, residents spend a lot of time in the hospital anyway, and people who like winter sports might enjoy the Cleveland winters. Plus, the summers and falls in Cleveland are really nice.

Overall, I was more impressed with this program than I expected to be. It’s worth checking out.

 

[Deuce Doc]

University Hospital

.Residents: I liked most of the folks that I ran across at this program, and they all seemed happy to be there. They seem to have a good relationship with each other and get together as a group at the end of each block. They talk a lot about cooking..
..
.Lifestyle/City: I am not from the Midwest, but I'm willing to allow that Cleveland may indeed, rock. Seems like there is a ton of stuff going on every day and for special events. I can't conceive of being bored in a place like this. Freezing to death seems much more likely. The work hours for the residents are. 18, 17, and 16 shifts, of 10 hours. Pay is 49-52K, plus 401K (with matching I think).
.
Curriculum: The number one most impressive claim that I heard on the interview trail happened when the PD said that if you used all your elective/selective time for worthwhile pursuits and still wanted to have another unscheduled rotation, he would be willing to change a month of EM to make that happen. I didn't go anywhere else where the curriculum was flexible based on the resident's needs/desires. This impressed me. I was also impressed by the idea of 3 electives to begin with. There is a lot of stuff I want to do with that time. Since the program is still in its infancy, they are making a lot of changes each year. This didn't scare me though, since the chair seems to have the gas to make it happen. He struck me as a very nice man, as did the PD. But the faculty on the whole seem to be a very quirky bunch. Time for conference (and the evening before!) is protected on all off-service rotations.

Facilities: Brand new ED. Gigantic hospital. The children's hospital is attached and has an adjacent ED. I got the impression that they don't see much trauma at UH, and get the bulk of their experience at the other hospital (and ED program) across town. Notes are dictated for a transcriptionist. The hospital was purported to be in financially solid shape.

Interview Day: Standard stuff with dinner the night before, interviews, tour, lunch. The most unique aspect was that the PD told me "If you are interested in coming here, you need to bring your wife out here for our second look dinner." Now I have heard that taking a second look isn't supposed to change your chances at all, but I was left with the distinct impression that it could make all the difference in this case. Basically, everybody who gets interviewed gets invited back for this dinner, at the end of interview season, and I think they use it to gauge applicants' interest..
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Summary: This was another place that I felt that I would be very happy to match. I did have a little bit of a reservation about the trauma experience, but the flexibility of the program suggested to me that I would be able to overcome any deficits in the curriculum. .

 

[imddr16]

Long time lurker, posting on alternate account in order to remain anonymous. These threads greatly helped me and as such I am paying it forward. Good luck for future medical students. I won't go into the curriculum details or specifics since those are mostly readily available on their websites, but rather I made a long pro/con detail list along my interview trail and I will highlight my thoughts from that list.

Pro: newer program, great resources, soon (or is) level 1 trauma, supportive faculty, happy residents, was pleasantly surprised, family friendly, good benefits, everything is nearby

Con: Cleveland, cold winters, long interview day, felt like some hostility between them and Metro,

Overall impressions
Gut feeling:6/10
Facilities/resources: 6/10
Location: 4/10
Didactics: can't comment
Prestige: 5/10
Research: 6/10
Shift/hours/wellness: 6/10