Washington University/B-JH/SLCH (Wash U) Residency Reviews

[SolidGold]

Washington University at St. Louis

Residents: 12 per class. All seemed very happy with their training. A second year said the intern year was a good one with little call. Residents got along well and the ones I met seemed pretty laid back.

Faculty: I was very impressed with Dr. Char the program director. He seems to have a lot of passion for residency education and genuinely seems to care about making sure everything that the residents do is worthwhile. Residents also praised the faculty and despite Wash I being a top medical center, the atmosphere is far from malignant.

Facilities: Barnes-Jewish is ranked as the #6 hospital, but that is all arbitrary of course. Very impressed with the ED and all of the cool toys they had at their disposal. The difficult airway cart they had was awesome which included 4 endoscopic laryngoscopes. Built in in-room xray machines in each of the 6 trauma bays was another nice feature. Top notch brand new facilities that are all organized to make sense. And the ICU’s are incredible as well which is also nice since you rotate through most of their units. St. Louis Childrens is #3 in the nation for Peds EM, and also had an impressive ED including 2 of their own trauma bays.

Curriculum: Did not like the fact that there are 3 ward months intern year: medicine, peds, AND surgery. Interns rotate through the CT-ICU as well, which all the residents felt was a very strong learning experience with very little call during that month. Second years rotate through the NeuroICU, PICU, MICU, and SICU. Since it’s a 4 year program, their moonlighting policy was important to me, and they do allow it. Most of them do it in a hospital to the west and those who work there feel it is a great experience, one that has actually helped graduates get their choice jobs.

Patient population: This is a unique place in that the facilities are like a rich private hospital but the patients that come in are similar to patients that go to county hospitals. They get very sick patients here so managing septic patients, CHF, traumas, etc. will be cake after 4 years. The great thing is that these patients get top notch care as opposed to those at some county hospitals since they have a lot of things at their disposal to diagnose and treat their patients.

Location: I’m not a big fan of the mid-west area but there are so many good EM programs out there that I had to check some of them out. St. Louis seems like an ok city, the crime rate is high, but most of the good EM programs are in locations with high crime. There seems to be plenty of things to do though, and it’s an affordable place to live.

Overall: I was pleasantly surprised by Wash U. It’s a big name institution, but the program is only 9 years old and still a division of surgery, so I had my doubts at first, but I can’t imagine any of the graduates of the program not being up to par with the best EM programs around. I feel that this place will be ranked fairly high in the end.

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[jojo14]

Overall: I was pleasantly surprised by Wash U. It’s a big name institution, but the program is only 9 years old and still a division of surgery, so I had my doubts at first, but I can’t imagine any of the graduates of the program not being up to par with the best EM programs around. I feel that this place will be ranked fairly high in the end.

At my interview this season, the associate pd, Dr. Brooks said that the department IS an independent division- they do not have departmental status, but they are not part of surgery or medicine. They answer directly to an associate dean. He attributed this independent division status as a result of 1. it is still a relatively young program 2. it takes a hell of a lot to get departmental status at Wash U. He said he thought they would get departmental status eventually, but not in the near future.

 

[EctopicFetus]

fwiw wash u impressed the hell out of me last yr.. IMO the biggest downside is being in St Louis and the fact it is a 4 yr program.. I found the residents to be super nice, cool and had good job opps.

 

[SolidGold]

fwiw wash u impressed the hell out of me last yr.. IMO the biggest downside is being in St Louis and the fact it is a 4 yr program.. I found the residents to be super nice, cool and had good job opps.

I don't mind the 4 years as much as most people do, but I agree that St. Louis is a downside.

 

[SolidGold]

At my interview this season, the associate pd, Dr. Brooks said that the department IS an independent division- they do not have departmental status, but they are not part of surgery or medicine. They answer directly to an associate dean. He attributed this independent division status as a result of 1. it is still a relatively young program 2. it takes a hell of a lot to get departmental status at Wash U. He said he thought they would get departmental status eventually, but not in the near future.

You are correct, I remember being told this...I believe I got the division of surgery mixed up with another program. Honestly, the whole division/department thing isn't all that important to me anymore. 2 of my current top 5 choices are divisions.

 

[CS_22]

I don't mind the 4 years as much as most people do, but I agree that St. Louis is a downside.

I'm a little late to respond, but you could argue St Louis is an advantage for those going into emergency medicine -- it was deemed the most dangerous city in america this year. Good for business.

 

[SolidGold]

I'm a little late to respond, but you could argue St Louis is an advantage for those going into emergency medicine -- it was deemed the most dangerous city in america this year. Good for business.

Emergency medicine isn't all about trauma. It's the medical emergencies that attracted me to EM.

 

[goblue1]

Ok, time to stop being lazy. Here are a few of my reviews. As with everyone, these are very subjective....enjoy.

University of Michigan:
Stats: 4yr program, 12 res/class, started 1992
General: 3 Hospitals: U of M (74K) – Tertiary care center, trauma, flight, Peds, majority of off-service rotations. St. Joes (85K) – Community “teaching” hospital, bread and butter, level 2 trauma. 15 min from main hospital. Hurly Medical Center (78K) – County hospital in Flint, significant trauma (penetrating and blunt); ~5 months total, 1 hr commute.
Separate and integrated Peds experience depending on location.
Pros: Very well run, impressive program with strong leadership and highly regarded faculty (i.e. - Dr. Barsan). Sold the 4 year program to me – significant ICU experience (9 months), extra elective time, teaching and administrative responsibilities for 4th year residents; overall a well rounded experience. Strong academic feel – relatively high percentage of residents go on to academic positions and fellowships. U of M is large and highly ranked hospital. Research is not required (“academic project” instead), but variety of projects readily accessible. Program director seems very well organized and passionate about program. Residents come from a variety of regions and are well marketed across country for future positions. Diversity of patients and experiences at different locations – plenty of pathology and trauma experience. Flight experience. Very nice facilities. Ann Arbor is a great town.
Cons: 5 months away in Flint which is a 1 hour commute each way. Resident classes didn’t seem as social and cohesive. Although a few ultrasound teaching attendings, ultrasound training not as well developed.


University of Pittsburgh:
Stats: 3yr program, 16 res/class, began in 1981
General: 4 Hospitals. UPMC – Tertiary care 50K, trauma, flight. Mercy 60K – community hospital downtown, bread and butter + trauma. Children’s Hospital. + 1-2 other community hospitals doing ED shifts and ICU. All hospitals within 15 min.
Pros: Residents seem very happy and all seem to get along – great camaraderie within classes. “Work hard, play hard” feeling. Residents raved about program. Strong, established, academic program with several fellowships (EMS, Tox, Peds, Research). Faculty approachable and good teaching. Great EMS program with “Jeep Shifts” – 2nd and 3rd year residents drive Jeep around town and are 1rst responders. Flight experience. Variety of clinical settings with separate pediatric emergency department. Pittsburgh is a surprisingly nice city which is very affordable.
Cons: 4-5 different hospitals with different charting systems. Most hospitals use paper charting. Average appearing facilities (from what I saw). Parking is apparently an issue for residents. Residents said Peds training “so/so”. Ultrasound training not emphasized.

Wash U:
Stats: 4yr program, 12 res/class, started 1997
General: Majority of time spent at Barnes-Jewish (main) ED – 80K as well as Children’s - 60 K; few community rotations scattered. Research required.
Pros: Heavy academic – required research (if that is your thing) and several months set aside for projects, frequent didactics and conferences (M&M, EKG, etc.), medical student teaching. Strong off service rotations at Barnes-Jewish/Wash U; emphasis on ICU rotations. Great pediatric experience at Children’s. Strong u/s program (looking to add fellowship). Great facilities – all computer charting. Well-organized program. Significant time for electives. St Louis very affordable (most residents had bought houses). 4wks vaca/year.
Cons: 4 year program – although many of the residents swear on it, many were talking about how they would only spend 30 hrs/wk during elective time (wonder if it is necessary??). Extra year allows more ICU, ent/optho, research months, elective time, etc. Required research project (if that is not your thing). The residents generally spoke well of the program, but many admitted that it was their 2nd, 3rd, 4th choice. Not its own department, for what it is worth. PD is very nice but “anal” and residents complain of “significant amount of paper work” . Although Central-West End is nice, none of the residents seemed thrilled with city.


Metrohealth/Cleveland Clinic:
Stats: 3yr program, 12-13 res/class, started 1991
General: 2/3 spent at Metrohealth – Large (90K+) county hospital with significant trauma, peds (integrated), and “bread & butter” ED cases. 1/3 spent at Cleveland Clinic – 40K+, less acuity, but are seeing unique CC pathology. Hospitals about 15min apart.
Pros: Nice balance b/w county and academic hospitals. Facilities generally very nice at both locations (CC ED brand new). Residents seem very happy and seem to get along. Residents are well prepared, although they admit to “working very hard” in their 3 years. Faculty are generally well-liked and lobby for residents. Excellent flight program with opportunities for residents. U/S training and fellowship available.
Cons: Seemed like a “local” program – most residents from upper Midwest and it seemed like many were planning to stay nearby. Cleveland is a livable, but mediocre setting (low cost of living, though). Was not an emphasis on non-ED rotations. Very little time for electives. No separate pediatric training (this did not seem to be an issue, however).

 

[CS_22]

Emergency medicine isn't all about trauma. It's the medical emergencies that attracted me to EM.

Look, didn't mean for it to be a big deal... Was merely pointing out that St. Louis isn't all that bad.

The real appeal of Wash U is the diverse mixture of the wealthy population (who come because BJH is considered top ten in the nation in health care) and the true inner-city population (because of the close proximity to some of the worst neighborhoods in the country).

 

[CS_22]

Wash U:
Stats: 4yr program, 12 res/class, started 1997
General: Majority of time spent at Barnes-Jewish (main) ED – 80K as well as Children’s - 60 K; few community rotations scattered. Research required.
Pros: Heavy academic – required research (if that is your thing) and several months set aside for projects, frequent didactics and conferences (M&M, EKG, etc.), medical student teaching. Strong off service rotations at Barnes-Jewish/Wash U; emphasis on ICU rotations. Great pediatric experience at Children’s. Strong u/s program (looking to add fellowship). Great facilities – all computer charting. Well-organized program. Significant time for electives. St Louis very affordable (most residents had bought houses). 4wks vaca/year.
Cons: 4 year program – although many of the residents swear on it, many were talking about how they would only spend 30 hrs/wk during elective time (wonder if it is necessary??). Extra year allows more ICU, ent/optho, research months, elective time, etc. Required research project (if that is not your thing). The residents generally spoke well of the program, but many admitted that it was their 2nd, 3rd, 4th choice. Not its own department, for what it is worth. PD is very nice but “anal” and residents complain of “significant amount of paper work” . Although Central-West End is nice, none of the residents seemed thrilled with city.

Research project can be daunting, but the real reason the requirement exists is to introduce us to research during our second year. All that has to come of it is a quality paper that is publishable (not necessarily published). For example, I - having not come from a major medical center in medical school - am enjoying the opportunity to find out if research is something I would want to do.

The paperwork does suck here, but we keep hearing from Dr. Char that it has more to do with us staying on the forefront of what's going to be required by the RRC (ie. that before long, all the other residencies will have to find a way to get done what we've been doing all along). He compares us pretty favorably with some of the California programs who are ahead of the game too.

And, Wash U was definately my first choice, and many of my classmates that I know too. I'm thrilled to be here.

True Cons from an insider prospective -- I hate the paperwork too, but view it as a necessary evil. Ward months are brutal, but where aren't they, plus you're working with some of the smartest people in the country as attendings. Money is a little scarce, would be nice to have a little more of allowance every year for books. That's about all I can think of.

Overall though, goblue, very nice review. I truly respect your opinions. Just thought I'd try to help explain some of the negatives you saw.

 

[CS_22]

Since interview season is wrapping up, I thought I'd make sure no one has any questions about Wash U. Either post or pm me if there's anything I can answer.

CS

 

[iheartem]

I'll be interviewing there soon, and I heard great things about the program. How do you like St. Louis? I've never been there. Good music scene, restaurants, etc.? Thanks!

 

[CS_22]

St. Louis is an interesting city. Its kind of like a big, small city. The metro area has about 2.8 million people, but its really a city of smaller neighborhoods.

Very active music scene -- and not just Nelly. Chuck Berry still plays at a local restaurant once a month. Restaurants are great -- the Hill (mom and pop Italian), Soulard, Downtown, etc.

Lots to do otherwise. Forest Park -- right next to the hospital -- is the second largest park in the US with a free zoo, history museum, science center, etc. And there's a really active outdoor community.

The thing I like best, though, is that I feel like I get a "small town" feel with all of the big city amenities -- Cardinals, Rams, Fox Theatre (Broadway Productions).

If I can help anymore, just let me know.

CS

 

[Pure Anergy]

Posted anonymously on behalf of a student who interviewed there.

Wash U in St Louis: 2010-2011

Faculty/PD/Chair: Did not meet the chair, which was a little strange and was not explained. The PD however, was great: very down-to-earth, emphasized the importance of having a life outside of residency, and funny. Faculty were otherwise fine- nothing especially notable about them but they seemed nice enough and accomplished. Didn’t really get to talk to many of them outside of the interview.

Residents: Vast majority are Midwestern. Very nice, friendly, funny. Spend a lot of time together, especially PGY-1 and 2. Seem close and have some fun social activities. Reportedly ½ are married and ½ are single.

Curriculum: 4 years.
PGY1: 10 day orientation in July. 4 months of EM, 1 month of ED ultrasound, 1 month PEM. Lots of off-service (IM floor month- which the residents said really really sucked, CVICU, general surgery ward month- which the residents said you basically serve as a scut monkey, 2 weeks of OB at Maricopa in Arizona- housing and rental car provided, 1 month of peds, also some time in the nursery, adult anesthesia, and peds anesthesia.) In regard to the medicine ward month, one person told me they used to do a MICU month but it was not helpful so it was cancelled, while someone else told me that the MICU could not “accommodate” the EM residents so that’s why it isn’t done…unsure what the real deal is??
Dedicated research month in PGY-2 year. PEM is separated during first year and integrated with adult EM shifts in PGY-2 to 4. 2 months community EM total (1 each during PGY 3&4). 4 ICU months total. 4 months of electives during PGY-4 (include sports, tox, Hawaii, PEM, rads, cruise ship medicine- so cool!, wilderness, palliative, EMS, u/s). Flying is optional.

Lifestyle: 3 weeks vacation/year plus 1 week “reading period” (have to be within a certain distance from the hospital since you’re second call). PGY-1 seems to suck- lots and lots of off-service and call. But after that, lifestyle seems pretty good. The PD really emphasized having a life outside of residency. Some residents with kids- the chief resident apparently just had a baby. PGY-1 shifts: 18 (60% 8 hour and 40% 12 hour). PGY-2 to 4: 17 shifts (same breakdown).

Hospital(s): Barnes-Jewish is obviously awesome. Seems like EM may not be quite as well-respected as other depts, but this was not explicitly confirmed by anyone, just a feeling I got. St. Louis Children’s is also extremely nice. The BJH ED is HUGE and super super nice- it is divided into different pods including a trauma/critical care pod that was very busy when we toured. Looked very exciting! EM is not a department- was reportedly going to become one a couple years ago but “money ran out.” As a division though, they are independent- meaning they sit on boards with all of the depts and they do not report to any department.

City: St. Louis was better than I had expected. There is a lot of crime (which I personally think is good for trauma…) but not in the parts where residents live. There is a very cute, hip part of town near the hospital with lots of shops, bars, restaurants, and sidewalk cafes. Apparently a lot of residents live very close to the hospital (i.e. within a mile or so) and cost of living is very good for such a big city. There is an awesome park right next to the hospital that has lots of free activities including a zoo, concerts, and ice skating. It’s a dog-friendly city.

Interview day itself: Laid-back. First a light breakfast and slideshow with the PD, then half of the group goes on a tour while the other half does interviews. Interviews consist of three 20 minute meetings- one with a chief resident, one with the PD, and one with another faculty member. Not much waiting between interviews, which is always nice. After interviews and tour, lunch with the residents. Then wrap-up session with the PD, and done!

Negatives: Relatively new program (1997- new at least compared to other BJH residency programs) in a very very strong medical center. Most residents very Midwestern (that could be + or -, depending on who you ask). A lot of annoying rotations 1st year which the residents admit suck. Division status (though reportedly has no impact on the program).

Overall: Good, Midwestern 4-year program in a very busy ED with a great deal of variety. First year seems to kind of suck but the rest of the curriculum is awesome, with very cool elective possibilities. Almost a county-style busy-ness of the ED but with much more attending support. Would be happy to train here!

 

[cls4n6]

OK- sorta non-medical person talking- so this is about STL. Wash U is in a lovely area of town- as are its hospitals. Great Pharmacy College near. Phenomernal restaurants, etc. Tier 2 city- so you get great concerts/shows/entertainment, but not the top. Buffet comes to towen, off-Broadway shows, lots of muscians. Zoo and Botanical gardens are top of the line. Beer, sports, and even a terrific wine country are for the asking. There are casino boats for the so-inclined. East St Louis- don't even venture there.... We are very Catholic, if that matters. Saint Louis University also has a medical college. My area- forensics. The ME of the City is Dr. G--he's just great. But the county has Dr. Case- world class child trauma, head trauma--- if that's an interest we have some geat forensics programs that you can access. Not exactly EM- but it is associated. Weather is mild-ish. Cold in winter (~3 snows each year) , hot/humid in summer (duh). Cost of living is moderate- I can survive on a teacher's salary without starving. Roads are okay- kinda confusing, but so are other places. Public transport only in the city proper. Multicultural environment. Not typical midwest- but watch the outlying areas- rednecky to say the least.
Someone else can tell you about the actual program; I'm just telling you about the city area. FWIW.

 

[SuziQ]

This is a couples' match list...if it were just me, my list would likely look pretty different. Some programs would have been higher on the list (especially Cinci), but Vandy definitely would still have been my #1.

I interviewed at 18 programs, and ranked all 18. This ROL is obviously just my (and my fiance's) opinion- no offense to anyone is intended. It was really helpful for me to look through ROLs from past years, so I thought I should reciprocate by posting mine.

I felt so fortunate to get to interview at these programs and honestly thought each of them had notable strengths. The couples match certainly complicates things (and requires LOTS of negotiation) but luckily I feel like I would be happy at a lot of these places.

Let me know if you have any questions about my list or the programs I visited. I'm happy to give my advice/thoughts to next year's applicants too- just message me!

1) Vandy: I am absolutely in love with this program. Love the faculty, love the Chair and PD, love the residents. It's one of the most resident-centric programs I have seen, with the best teaching in the country. Very busy ED with so many critical care patients. Tons of trauma because of huge cachement area; great relationship with trauma surg. Curriculum extremely well thought-out, including no floor months. Residents are very close and are amazing people. Very diverse patient population (tertiary care, uninsured/underinsured, bread and butter EM, peds, immigrants). Nashville is a really fun city, great COL, easy to live right by the hospital. Grads go anywhere in the country they want. This program has everything I want.

2) UCLA-Olive View: Truly amazing PD who has the residents over to his incredible house (and he was the medical director for the show ER- I thought that was pretty cool), and distinguished faculty. Well thought-out integration of county and tertiary care experience. Ronald Reagan is an incredible facility, and Olive View is a nice little hospital that has a new ED opening this April. Program curriculum is "front-heavy" (easier 3rd and 4th years), which I liked. Intern year is getting much better every year- there will be 6 months of EM during intern year 2011-2012 and fewer medicine/surgery ward months. PD described the program as a "liberal arts EM program," which I thought was an apt description and a pretty neat concept. Amazing international opportunities and a lot of elective time. My Spanish is mediocre at best, and that seems pretty essential (especially at Olive View). Trauma not as extensive as at other LA area programs. COL high and lots of commuting in nasty LA traffic.

3) UNC: Residents were very happy and welcoming. I really liked the dual hospital system. I went back to do a second look and shadowed at both hospitals, which only served to increase my enthusiasm about their way of training. Of course, it does result in a lot of commuting but the traffic isn't bad so that didn't bother me. Amazing PD who is an outstanding teacher and very supportive of the residents. Program produces very well-trained EPs who also have satisfying personal lives. I love the location and the COL. Great moonlighting opportunities. Medicine and surgery ward months intern year (but at WakeMed so relatively laid-back). Not as much trauma as some other programs. Duke is obviously nearby so there is some division of patient populations, but I felt that was made up for by the WakeMed experience.

4) Highland: This is a well-known program that I felt lived up to its strong reputation. Faculty and residents are all very laid-back and fun. Strong family feel. A lot of the faculty trained at Highland (which may be a negative), but of course they stayed on faculty because they love it so much there. GI rounds TID seem like a great idea. Not an "official" Level 1 trauma center but there is none in the county, so serves as the de facto trauma center and see a lot of trauma. Not a stroke center, so do a month of neuro at UCSF. Amazing U/S experience. Peds is not integrated (no peds beds in HGH). Highest salary I saw on the trail (because they are unionized). Tahoe ski cabin sounds like fun. Sounds like they have everything worked out in regard to UCSF's EM program, but still made me a tiny tiny bit nervous.

5) BIDMC: The 3+1 (Junior attending year) is an amazing opportunity that I was very excited about. The curriculum is very well thought-out with a clear graduated responsibility. Rotate through 5 "affiliate" hospitals (community sites), which seems like a good experience to see how different systems work. Amazing EMR. Peds not integrated. Trauma pretty good but obviously there are a lot of hospitals (including four Level 1 trauma centers) in Boston. Relatively new program (10ish years) but has established itself extremely well. Had a great feeling about this program on the interview day and it was initially higher on my list; in the end, I decided that Boston is not at all ideal for me and that's what pushed it down the list a bit.

6) LA County: Another program that was initially much higher on my list. I was in awe of this program during the entire interview day. Very sick patients and a lot of trauma, in which EM has a huge role (they do essentially all procedures). EM also manages airways during codes on the floors (which at most other places is done by anesthesia or MICU)- I thought that was cool. Residents were really fun people and amazingly impressive. Work 12s all four years (except on peds). Facilities are amazing but very much divided up into pods. Not as many academic opportunities as a lot of other programs I looked at. This place, in my opinion, provides the best clinical training in the county but wasn't the best fit for my career aspirations and personal life once I got over the "sexiness" of the amazing clinical experience. Location also not ideal for me personally.

7) Wake Forest: I love this place. PD and Chair were both very enthusiastic. Very well-established (30 years old) program with a long history of producing great EPs. Residents were very family-oriented. Very busy ED, which pleasantly surprised me. Loved the city (can get an amazing house for very little money) but it did feel a bit isolated.

8) Emory: So many faculty, and a lot of them are really well known in EM. Increasing focus on research- get a lot of NIH funding. Grady is Grady- tons of trauma (only Level 1 in Atlanta). Hugely busy, exciting ED. Patient population at Grady not very diverse- primarily African American. ED divided into red (surgery/trauma) and blue (medical) pods. Residents were very diverse and most were single. Atlanta is amazing but of course the traffic sucks and it's relatively expensive. I expected to like the program more than I did, but I got a weird vibe on interview day. It was probably just me, though!

9) Indianapolis: LOVED this program but in the end the location just wasn't going to work well. Residents were incredible- really sociable, welcoming, and proud of their program. Outstanding clinical experience, with time split between Wishard (county) and Methodist (tertiary care). Residents have a huge role in their program (49% ownership) which I thought was amazing. Very much a team attitude. In ICUs, work one-on-one with CC-trained EM faculty- so a great experience. Residents were more regional than I had expected for a nationally well-known program.

10) BWH/MGH: Strong academic program. Well-known faculty and lots of research opportunities. Felt like this was a great place to jump-start a career in academics. Lots of elective time. Program grads are highly recruited and go wherever they want after training. From talking to the residents, seems like they do fewer procedures than most other programs I looked at. Also, medicine and surgery ward months. Residents said they felt a bit "looked down on" by other residency programs at the hospitals, for what that's worth. I'm not a fan of Boston.

11) UAB: Their PD is awesome. Very responsive program leadership. The residents are pretty Southern and a lot of them have kids. Great lifestyle. Do LOTS of moonlighting. 10-year old program but feels like it's been around longer (that's a good thing). Birmingham was a very pleasant surprise. Great physical set-up of the ED. Very impressed by the program but realized as interview season progressed that I wanted a place that produces more academicians.

12) Wash U: Very busy ED. Great elective opportunities. Strong off-service rotations, but lots of ward stuff 1st year. Division status (I asked about this and the program leadership said it's not an issue). Didn't really care for St. Louis.

13) Cincinnati: LOVED this program- would have been among my top few programs, but my fiancé really disliked it for his specialty. Oh well.

14) UVA: Very nice program leadership, good reputation. Relatively low volume (although also smaller class so it works out.) Not much trauma. I didn't really click with the residents. City was too small and isolated for me. Great program but not a good fit for me.

15) Michigan: Awesome program. Love the PD. Survival Flight sounds great, as does the trauma experience in Flint. I didn't really click with the residents. The main problem for me was the location. I just don't think I could tolerate those winters- I almost crashed my car about 5 times just while I was up there interviewing.

16) Duke: I thought the PD was incredible and the faculty were very impressive. Residents were nice but seemed pretty guy-dominated. The program seems to be still fighting some battles. Wasn't a good fit for me.

17) Louisville: Had a really weird interview day, in my opinion. I found the group interviews to be awkward. Relatively low volume ED but lots of trauma. Not what I was looking for, but it had a lot to offer.

18) Harbor: This one was a surprise. Very well known program with great pathology and amazing faculty, but not a good fit for me. I personally don't want to have to deal with the transition from 3 to 4 years and the move to a new physical ED. I greatly preferred USC-LAC, but that's obviously just me and it's good that not everyone loves the same program!

 

[Pure Anergy]

Posted anonymously on behalf of a student who interviewed there.

Wash U Review

Pre-Interview Social: Dinner with the residents was at the Tortilleria, a Mexican restaurant near campus. It was very casual with appetizer, dinner, and dessert. It was hard to tell who was a resident and who was an applicant, but it was a really good turnout with maybe a few dozen people coming, and it was a lot of fun.

Interview Day: I was in the afternoon session, which started at 10:15. We had a presentation by the assistant PD, then chatted with the PD for a little while until it was time for lunch. A bunch of residents we hadn’t met yet showed up for lunch, and it was helpful to have some fresh people to ask about the program. After lunch, we had our tour, and then we had interviews. We had a brief wrap up session with the PD and assistant PD at the end, and we were done by 3:30.

There were three interviews with the PD, the assistant PD, and a resident. As a previous poster said, we didn’t meet with the division chief, but it didn’t seem like that big of a deal to me. The interviews were each supposed to be 20 minutes, plus two scheduled 20 minute breaks, but the actual schedule turned out to be a little less organized than that. We got back late from our tour, and I spent more like 30 minutes talking to the assistant PD and 15-20 minutes each talking to the PD and resident. I don’t think I did any of my interviews at the times they were scheduled, but it seemed to work out fine somehow. During the breaks, we hung out at the front desk and chatted with the administration and other people (residents and faculty) who were dropping by to say hi. All of the interviews were pretty relaxed. I was asked why EM, how do I feel about a four year program, why do I think some people are so opposed to four year programs, what do I do for fun, and to tell more about two of the activities I listed on ERAS. Everyone also asked me what questions I had, so make sure you’re prepared to ask questions!

Curriculum: Wash U is a four year program. PGY1/2s work ~16 shifts/month (8s on weekdays, 9s on conference Tuesdays, and 12s on weekends). All shifts are done in three weeks on any EM month with a vacation week. PGY3/4s work 14 shifts/month. Shifts are scheduled together in blocks. The hospitals include Barnes-Jewish Hospital, St. Louis Children’s (located on the same campus as BJH), and Barnes-Jewish St. Peters, which is the community hospital site. They have one month of peds EM during PGY1, and then peds shifts are integrated into the regular EM months for the other three years to provide longitudinal exposure. There are 28 total months of EM, including two months of community EM at St. Peters during PGY3 and PGY4.

Wash U doesn’t have an actual orientation month, but they do have a ten day orientation period in late June before residency starts. (Since they start PGY1 ten days early, this is why there are ten days of unpaid leave at the end of PGY1.) As others have already said, there are three floor months (IM, surg, and peds) during PGY1, and unsurprisingly, these are not anyone’s favorite rotations. There are four ICU months. For OB/gyn, they go to Maricopa in Phoenix for two weeks because there aren’t enough deliveries at BJH. Other rotations are the usual like anesthesia, ortho, rads, administration.

They have several subspecialty months (tox, EMS, US) and two academic EM months (research, teaching). The scholarly project requirement is more extensive than at many other programs, with residents required to submit a poster or abstract/paper for publication (though it’s ok if it doesn’t actually get published). There is also a required education project that is separate from the scholarly project. There are four months of elective time in PGY4, of which three can be done away and one must be done at Wash U. The away electives have to be approved by Dr. Char and should be things that can’t be done at Wash U, such as an international elective. Options include a month in Hawaii, cruise medicine, and more.

About 1/3 of the residents do fellowships or go into academics after graduation, and they have all the major EM fellowships at Wash U, including critical care. CC can be done through surgery or IM, although if you want to be able to get board certified, you have to do the IM CC program. One other cool thing about fellowships at Wash U is that you can combine them and do more than one at a time. So, you could do CC/EMS and get boarded in both. Wash U also has begun doing scholarly tracks, which are areas of focus in clinical subspecialties (tox, EMS, US), education, or research. Residents choose their track in the winter of PGY2.

Didactics: Along with weekly lectures, Wash U has one day per month of simulation at the med school. The journal club is once per month. They go over four articles per session (one per class), and the department funds it, not drug companies. Attendance to JC is optional, but the junior and senior residents who have the best participation record each get $1500 for educational expenses. They track your procedures and resuscitations electronically.

Benefits: Benefits are decent but not as good as at some other programs. Vacation is three weeks per year, plus a reading week each year. Med/dental insurance is subsidized. Residents get discounts on cafeteria meals but they only get free food for call (that doesn’t include overnight shifts). Parking is free. EM organization memberships are paid for, and the program will pay for you to attend any conference where you present, plus SAEM for PGY1s.

Administration: Dr. Char and Dr. Brooks are informal (they’ll tell you not to send them thank you notes) and seem to set a tone of levity. The residents organize a hospital Halloween party and have an annual Turkey Bowl against the surgery residents to win the “golden bedpan.” There is a residents’ retreat weekend every April to review residency goals and priorities. Also, the government only funds 3 years of EM residency, so all four year programs have to fund the last year themselves. Wash U sees this as part of their commitment to resident education.

St. Louis: I love St. Louis as a city. Cost of living is very reasonable. You can afford to buy a house or condo on a resident’s salary, and a lot of residents do. The Central West End area around the hospital is nice, and some residents and students live nearby within walking distance of the hospital. Forest Park is the second largest municipal park in the country after Central Park, and there is a free zoo, science center, museums, hiking trails, and more there.

Summary: Wash U’s program has a ton of great features, especially if you’re interested in academic EM: required research month, required abstract/pub submission, journal club, required teaching month. There are some cool elective options, and the PD seemed open to suggestions for other ideas as long as they have educational value. I really like the idea of the hybrid fellowships, since it would give an easy solution for people who want to do more than one thing and is more efficient too. St. Louis is a fun city with a cheap COL compared to a lot of others. The automatic consult system (you put in the consult and it pages the specialist to call you) is pretty sweet, and the EDs are paperless. They have an overnight obs unit for patients who need early morning procedures so that they don’t wind up boarding in the actual ED.

For cons, of course a lot of people are going to be turned off by the extra year and the three floor months. I’m still not convinced about the value of so many floor months, but I do think the extra year can be valuable if you’re interested in an academic career. There are current residents who publish a lot, apply for grants, etc. The other thing is that they start in mid-June, and I'm not thrilled about starting two weeks early. Especially since so many three year programs are giving up one of their months for an orientation, it seems odd that a four year program wouldn’t!

Overall, I really liked this program and would be very happy to match here.

 

[Pure Anergy]

Posted anonymously on behalf of a student who interviewed here.

I loved this program after my interview day.

Clinical exposure: Very high acuity, high trauma volume (decent amount of penetrating, North St. Louis very violent area) with EM residents very involved in all trauma activations, owns airway, tons of procedural experience in terms of lines and tubes (senior residents have done so many so they give them away to interns and R2's), switch trauma lead with surgery on odd/even days. Relationship with surgery seemed to be excellent. The ED residents felt like they got ownership of all their patients (including trauma). Extremely strong critical care experience with outstanding fellowship opportunities. Many of the critical care attendings are EM trained and you get to work with them on your ICU rotations. Great peds exposure (a real strength of the program), scattered peds shifts throughout curriculum as opposed to dedicated block (get to see more diverse pathology), St. Louis Childrens is fantastic level 1 pediatric trauma center.

People: PD Jason Wagner one of the most awesome people I've met during interview season, an innovator at the forefront of medical education, has a goal to make the future leaders of the field. He is very passionate about resident education, and helping residents become better educators themselves. Residents were all awesome, several gave me their personal numbers after interview day to call/text them and talked with me extensively. Great turnout at pre-interview dinner and post-interview happy hour.

Facilities/sites: Loved the facilities, massive medical campus and huge ED. Barnes Jewish is safety net hospital for St. Louis (no county hospital in STL), get all the resources and amazing technology of WashU with all the acuity and pathology of a very deserving county patient population. Amazing ancillary support. One thing I loved about this program is that you do pretty much everything at one hospital (Barnes Jewish). You don't need to commute to distant sites. St. Louis Childrens is part of the same medical campus. With the exception of 1 month of community EM in third and fourth year and 2 weeks for OB in Phoenix, you get all your training at one site. The program is so well rounded and has everything you need in one place.

Job Prospects: 1/3 go into academics, 1/3 fellowship, 1/3 community. As a program, there is a lot of opportunities for academics/research if that's your thing. However, a ton of their residents choose to work in the community as well. They don't force residents to become academicians if they don't want to. Senior residents were very excited about their future and felt like they got whatever jobs they wanted. The reputation of WashU speaks for itself.

City: St. Louis as a city is extremely affordable with lots to do. You get all the amenities of a bigger city with a small town feel. Forest Park is amazing and literally across the street from the hospital. The Central West End area around the hospital is safe with lots of great restaurants and bars.

Cons: medicine floor month, peds floor month. STL is not NYC or Chicago if you are looking for the best shows and a bumping club scene. No more pro football in this town (doesn't matter because they bleed Cardinals here). Summers are hot as hell (winters relatively mild compared to other midwestern cities). 4 year program, but all the residents universally stated that the extra year was justified to them.

Summary: On interview day, I really got the sense that WashU offered a very robust and well thought out curriculum where you get the opportunity to work hard and excel from a clinical and academic standpoint. There are a lot of great opportunities available at this program. You also get the chance to take care of very sick patients. At the same time being happy outside of work was very much emphasized and you could definitely appreciate this when talking with the residents.

Would be very happy to match here!