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(About Ads) 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!!