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Wayne State University/DMC (Sinai-Grace) Residency Reviews

Discussion in 'Emergency Medicine' started by docB, Nov 22, 2008.

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  1. docB

    docB Chronically painful Administrator SDN Senior Moderator Lifetime Donor

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    I was asked to post this review:

    OVERALL: heavy path/trauma, little evidence based medicine/academia, heavy push to see more and more patients but get less and less teaching, malignant atmosphere, poor didactics, 20-21 shifts per month often staying over to dictate and catch up, poor nursing/facilities & unstable economy
    RESIDENTS: 12 per yr. mix of local and out of state
    SHIFTS: 20-21 (10 minus days of the month) 10 hr shifts that often exceed that in order to dictate (yes we dictate every pt encounter) all your charts, very little time to read
    FACILITIES: ER is run down, small cubicles double bunked, small trauma room, shortage of computers where all orders and test reviewing is done, equipment such as otoscope lights/heads often not working, lecture room is small, cant see or hear lectures well
    NURSING: the worst nursing care and attitude imagineable in the ER (where obviously most time is spent), very good nice respectable nurses on off service rotations esp ICU. what few good nurses are in the dept are leaving or have left due to poor nursing mgmt. professionalism and morale is very low!
    SCUTWORK: lots of scutwork and baby sitting in the ER, ive pushed pts to cat scan, started my own IV, foleys. you are constantly having to chase down labs that never got sent, drips that were never hung, etc.
    TRAUMA: hands down tons of trauma and the best part of this residency but trauma isnt everything and certainly doesnt make up for the vast deficiencies of this program. dont get me wrong i love the trauma, but most of us will end up in a community setting where we wont see a lot of trauma or if you do work in a trauma center trauma surg pretty much runs the show. however we are the exception here as trauma sits back and watches. besides trauma codes are very cookbook and algorithmic
    EMS: we answer every ems radio call which can get very taxing and annoying at times because the detroit ems is such a mess they only have one radio and they call our ER for med control to relay ems traffic to other surrounding hospitals so your constanly playing call around on top of seeing 20-30 pts.
    CURRICULUM: standard curriculum i think. you have more ED months as you get more senior. you dont do any medicine floor months which is really nice, this is off set by more ICU time which is rough but you learn a lot on your ICU months.
    FACULTY: very hit and miss, most are clinical and you wont learn evidence based medicine here. you often get "thats just the way we do it here" a lot. most are litigation paranoid so you will order everything under the sun with no basis behind it. if you take too long to get a good history and physical your "too slow" and need to step it up to get your "numbers up". this is the mentality here. and realize the attendings get paid based on productivity (number of pts seen) so of course they are wanting you to see more and more. most of us have no problem with that because when we are attendings you want to be efficient and be able to see many patients, but when it cuts into teaching and doing a good job, i draw the line!
    DIDACTICS: protected lecture time 5 hrs per week, mostly resident presentations which is fine, but there is little EM faculty discussion or expansion of the topic, off service specialists do come in which are nice, tox/trauma/cardiac conferences are held periodically on a rolling annual basis which can be good. it seems this yrs lectures are better than lasts but we will see. i do like the practice oral board cases we do monthly for senior residents
    CAMARADERIE: our class gets along great but this is the exception. there is much tension among most of the senior residents esp with the ones gunning for chief. some of the seniors complain about the interns and they just started and have caused a bunch of problems among the interns.
    ATMOSPHERE: lots of politics here. overall malignant atmosphere
    LOCATION: good or bad whatever your take is. training wise lots of advanced path, indigent care, trauma, etc. living/social wise another story. the weather is horrible, the economy as you know is the worst in the country, socially not the greatest city either. in fact with the auto industry in flux a lot of us are worried about the ripple effect here as the majority of the working pts are in some way tied to the industry and if they go under we will likely lose hospitals, physicians, patients, etc. not to mention the detroit med center is not in a very stable financial situation anyway so we are all a little nervous right now.
    ADVICE: talk to residents at each program you interview at. ask for names, emails, etc. talk to several residents to get a consensus. dont just believe the ones that take you to lunch or give you a tour. they can be biased and reluctant to give you a candid view as it would be pretty obvious to the admin who told those candidates things. so if a program is reluctant to give you additional names of other residents not involved in the interview process be cautious! i was warned by residents when i interviewed here, but just thought they were typical over worked and underpaid residents but i wished now i would have listened more.

    good luck and do your homework/research!!
  2. RxnMan

    RxnMan Who, me? A doctor? Moderator Emeritus

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    This is a review sent to me by a SDN user who interviewed there and wishes to remain anonymous. I am posting it verbatim as a service for the SDN community.

    Sinai Grace (Detroit, MI)

    Pros: Tons of trauma, very busy urban ED.

    Cons: You work your tail off for the lowest pay I came across.

    Impression: I felt during my interviews that they think they’re the poop and you should feel lucky to even be allowed to interview there. I was really rubbed the wrong way here. We also had to pay for our own drinks at the pre-interview social (not a big deal, it was just awkward when we each got a $5 bill for our beer).
  3. RxnMan

    RxnMan Who, me? A doctor? Moderator Emeritus

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    See more here.
  4. emclark

    emclark

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    Anybody have anything positive to say about this program??
  5. EMDO

    EMDO

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    Yeah. I trained in Detroit and I know and have worked with several people in various specialties that have trained at Sinai, as well as DRH. They were all excellent, well trained docs.

    I never rotated at Siniai, but I did a couple rotations at DRH and I feel I am better off for it. Both hospitals are in the some of the worst parts of Detroit, and both are known for being tough places to train. I can definitely see why there may be some disgruntled residents there, but anyone graduating from those programs will be tough as nails.

    As for Detroit being a horrible place to live, I think that is totally ridiculous. First off, the vast majority of residents in the area live in one of the many outlying cities within a 20 minute drive of Detroit proper. And if you can't find anything fun to do in the area you got serious issues. There are great restaurants, a nice downtown, 3 pro sports teams, and about every band on tour stops off in the area. It may not be New York or Paris, but it is far from the hell on Earth it is made out to be.

    The whole point of residency is to get good training, and that typically involves having your butt kicked for a few years. I would think that most people going into EM would want to train in the city that was the poorest, the most violent, and had roads covered with oil slicks.
  6. Deuce Doc

    Deuce Doc Half-done, not yet half-smart

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    Sinai Grace
    .Residents: Tough to say. I met very few. Only two came to the dinner and there was not a whole lot of presence during interviews. The couple that I spoke to seemed like nice folks. I spent way more time talking to applicants though, with fairly mixed results..

    .Lifestyle/City: I'm told that none of the docs actually live in Detroit as much as the surrounding suburbs/towns. I did not get mugged on my way to the interview. The residents work 17, 18, and 16 nine and a half hour shifts per block..
    .
    Curriculum: This place is no joke. They say it has the highest acuity, volume and most penetrating trauma in Detroit. They also do 6 months of ICU time. It sounds like most of the ED teaching can't happen during the shift because folks are working too hard. The problem is, I think due to rapid turnover and inadequate staffing, some of the residents' work is doing the jobs normally performed by ancillary services. I didn't get a great sense for the quality of conferences, but I believe they are protected on off-service months. If you want to learn by doing, this place might suit you well. These guys are giving away procedures by the end of intern year because they have too many. I interviewed at another place where they don't get enough live chest tubes--that will not be a problem here. They are dictating their notes to transcriptionists currently, but may be moving to dragonspeak.

    Facilities: Old-style, cramped ED. Honestly, not the greatest workstation setup, but the some residents seemed to prefer the close quarters. At some other programs, where isolated, large rooms have replaced curtains and chaos, some people seem to miss the old-style setup.

    Interview Day: Definitely among the most serious interviews that I had—it definitely felt like a job interview, rather than the typical get-to-know you kind of feel. My application has some shortcomings and I was definitely made to answer for them by each of the faculty (not just one hard-nosed person). Nothing about it was in any way hostile or unfair, but you should know going in, that you are still proving yourself..
    .
    Summary: I was very impressed with the program director and her commitment to resident education. She even took some residents to Haiti for disaster relief for the hurricaine. . The thing that bothered me about this place was that every resident felt compelled to start his opinion with "well, we work really hard, but…" This was unusual on the trail. I am certain that lots of other places I interviewed demanded hard work, but typically the first thing out of the resident's mouths was how much they loved it. While I think that there is a certain street cred that comes with going to a tough residency like this one, but there is no learning in suffering, and I think I will want a more balanced approach to the facets beyond moving the meat.
    Last edited: Feb 22, 2012
  7. Forte007

    Forte007

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    Pros:
    - residents are really friendly and seem like fun people to hang outwith
    - program director really cares about the residency
    - tons of trauma
    - residents and interns report directly to the attending
    - fast track run by PAs (u don't have to deal with HA, F, etc)


    Cons:
    - random shifts (not grouped)
    - residents look over worked
    - detroit
    - seems like more work less teaching
  8. RandomChaos

    RandomChaos

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    Residents: 12 residents a year. Unfortunately was unable to attend social due to travel issues. However, met 6 residents during the interview and all of them seemed happy and very approachable.

    Alumni: All over the US. Send people to fellowship, academics, you name it. National recognition very good for getting a job.

    Facilities: Currently incredibly run down and bare bones ED. For the busiest trauma center in Detroit cant believe they only have 2 tiny trauma rooms. But general ED is very countyesque, curtains as only divider, lots of patients in hall. However this will all change come next year when new ED opens and is supposed to be twice the size and with 4 trauma bays.

    Peds: Technically level 2 for Peds but was told they get tons of level 1 peds cases cuz theyre the closest. Was told that PICU away at childrens was a bad rotation due to lack of autonomy

    Trauma: Its the busiest in detroit

    Faculty: Growing. Recently picked up a Board Certified US guy, BC International guy, as well as a BC Research guy. PD seems to really care about improving program. Constantly changing the program for the best. Very involved in ACEP and will go to bat for you if you bust your ass, and it seems like she has some pull with hooking you up post residency.

    Curriculum: Lots of Critical Care time. 1 month of internal medicine. Hospital is run by former ED docs which are now higher up administration so off service months are solid. EM residents come across as strongest residents of hospital.

    Patient Pop: Blue collar working class. About 9% uninsured. Most patients are medicare. 86% of patients are medicine complaints, 23% Pediatric patients. Tons of advance pathology with very sick people

    Location: North Detroit, very slummy run down neighborhood. But very separated from Ford and DRH so they get the worst patients and dont have to share. Detroit not really as bad as everyone makes it out to be. Very pretty city, but does at times feel like a ghost town with lots of abandoned buildings

    Overall: During the interview everyone seemed very honest and forth coming about strengths and weaknesses of program. Great place to train if you dont mind being pushed and busting your ass. With new U/S, research, and international opportunities plus the new ED opening and such an extensive alumni network I think this program will be one of more competitive programs in the years to come. The EM residents are def the strongest in the hospital and have the most responsibility, I really feel like you would come out of here as a rock star, and it shows with the extensive alumni. Has a feel very similar to Christ in Oak Lawn.
  9. Dr.Evil1

    Dr.Evil1 Senior Member

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    I believe that the initial review posted here is very misleading, posted by someone who does not match with the program.

    I trained at Detroit Receiving (2008) which is the sister program to Sinai. My best friend was a chief resident there (2009). Sinai does have poor facilities which are (apparently) changing. You will work hard there. They are busy and are not the kind of place where you all gather around a patient and have the subspecialist give a presentation about the interesting case that was sent in from the other side of the state. Sinai has a 29 min guarantee to see a physician from patient arrival which does pressure you to have to actually pick up extra patients.

    If you are going into EM with a plan for future grand academics or are someone who is always looking for that next needle in the haystack then this is not the place for you. If you are a self-motivated, hard worker who wants a chance to wade through the muck of the sickest patients with the most pathology you can imagine then this is the place. You will get excellent experience and I guarantee that you won't be scared by anything you see after graduation. You will learn by seeing at Sinai. Melissa Barton is a very passionate woman and cares greatly for her residents. She will assure that you are a great ED doctor when you graduate.

    I now work in a busy community hospital in South Carolina. I am involved in hiring people to join our group. I would look very favorably at a graduate of Sinai and would not hesitate to hire them.
  10. CTRadAid

    CTRadAid

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    PRO: You can hang out with me in CT while I try to squeeze morbidly obese patients through the scanner.

    CON: We're understaffed and I will make you help me move 200kg patient onto the scanner.

    :)

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