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deleted52758
what are all the county programs? which ones are 1-3's and which ones are 2-4's??? thanks!
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http://www.saem.org/rescat/contents.htm
That's the complete list of EM residency programs. Just by looking at the list and selecting anything with the word "County" in its name (do a ctrl-F "find" for the word, if on a PC), I find just two.
Hennepin is a 1-3.
Cook County is a 2-4.
Among the 1-4's, nothing has 'county' in the name.
So... the answer might be two. Unless anyone knows of a County program that does not have 'county' in its name.
That's the complete list of EM residency programs. Just by looking at the list and selecting anything with the word "County" in its name (do a ctrl-F "find" for the word, if on a PC), I find just two.
Hennepin is a 1-3.
Cook County is a 2-4.
Among the 1-4's, nothing has 'county' in the name.
So... the answer might be two. Unless anyone knows of a County program that does not have 'county' in its name.
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I'm too lazy to look this up, but I believe Highland in Oakland (which is a county program without 'county' in its name) is 1-4. USC (at LAC+USC hospital) is, I think, 2-4. Probably there are many others.
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It also depends on what someone means by county. Do you mean a real public, govt funded hospital or do you just mean a tertiary, inner-city place with big trauma volume. For example UC Davis is not the former but it is the latter.
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docB said:
something similar to cook county, or grady or something like that.
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willlynilly said:
So you're looking for a list of all the high-volume, innercity, trauma heavy places? Other than the obvious ones you mentioned and some other obvious places like Charity, Parkland, Bellvue, etc. you should spend some time on the
saem page linking to the individual program sites.
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Actually, bellevue's trauma is way down. But it is a big 'classic' county hospital, otw.
SUNY-downstate aka Kings county is a huge classic. As is Lincoln Medical. UT-SW is newer, but parkland is 'county'.
I have never really understood this question. 😛
SUNY-downstate aka Kings county is a huge classic. As is Lincoln Medical. UT-SW is newer, but parkland is 'county'.
I have never really understood this question. 😛
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roja said:
It's a question that gets asked all the time. The problem is that most med students are ignorant of the distinction between a real county hospital and other models because it's a financial/ orgizational difference. In this arena when people talk of "county" they just mean inner city, trauma, etc. The distinction becomes important if you're talking about financial things like billing and med mal. For instance if you work for many true county hospitals you have limited liability because you're a county employee.
PS to the OP: Please don't be offended by the term ignorant. I just mean something you don't know because you haven?t had to really learn it yet. I myself am ignorant of a great many things. 🙂
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Yeah- I suppose once upon a time, until I did a rotation at Kings County, I had no idea of what it meant either. And now, I feel all the more certain in my decision of ranking... i just rotated with a number of residents from another 'county'. they have huge problems with thier contracts as multiple hospitals 'bid' for thier resident contracts, which basically means they may or may not end up with insurance, etc.
and it really seems to have little bearing on the number of truama's, sick patients, etc... I havent' really heard of any 'cushy' ED rotations where its all private private private... Seems like EMtala pretty much gaurantee's that you will see anything that walks through the door. 🙂
and it really seems to have little bearing on the number of truama's, sick patients, etc... I havent' really heard of any 'cushy' ED rotations where its all private private private... Seems like EMtala pretty much gaurantee's that you will see anything that walks through the door. 🙂
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There are definitely programs that are known to be if not "cushy" at least considerably less "hard-core". Near me, UC Irvine's program is reputed to be more towards the didactic than the "trial by fire". EMTALA, while not a great equalizer, does equalize to a certain extent.roja said:
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True... I have met a number of 'county' residents/attendings.. While most of them thought thier training strong, the vast majority felt like, when compared with others, the only thing that they got more than others was the 'badge' of saying they trained in horrible conditions... they dont really feel that they got better training.
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there is a powerpoint file from USC (with interesting thoracotomy slides) that lists some of the "classic" county hospitals on slide 8 of 48 at http://www.facs.org/education/gs2003/gs39asensio.pdf
parkland is county but in an interesting location. it is in a typical county hospital area, close to the barrio and lower income areas, but it is also very close to Highland Park (richest school district in Texas) and the Uptown area (just north of downtown with really nice bars, restaurants, and apts). One of the major reasons for choosing Parkland for me was that I could live in a safe/nice area 3 minutes from the hospital and have a huge volume of patients.
I rotated at U of Louisville. It was the county hospital that got lots of trauma via helicopter from pick up truck and ATV accidents in Western KY. It was in the ghetto... it is across the street and down the street and I heard gunshots one night while walking to my car.
I also rotated at UC-Davis in Sacramento and like someone mentioned earlier, Dr. Sokolove mentioned that the hospital is no longer a "county" hospital but the patients don't know that.
I did the ultrasound rotation at UC-Irvine and it was a nicer hospital that I was used to (it was different being close to Disneyland and parking at a nice shopping mall called "The Block" across the street from the hospital... ummm boba tea) but they still had a good amount of blunt trauma from I-5 and I saw some penetrating trauma there as well. I guess they did have some very slow nights where they could send interns home.
When I interviewed at Christiana in Delaware, I thought they made the comment that Delaware didn't have a "county" hospital system so that most hospitals took in their fair share of uninsured pts. (I toured Christiana Hospital and drove by the one in Wilmington, but I didn't go inside the latter so I didn't know how "urban" the Wilmington hospital was.)
-andy
parkland is county but in an interesting location. it is in a typical county hospital area, close to the barrio and lower income areas, but it is also very close to Highland Park (richest school district in Texas) and the Uptown area (just north of downtown with really nice bars, restaurants, and apts). One of the major reasons for choosing Parkland for me was that I could live in a safe/nice area 3 minutes from the hospital and have a huge volume of patients.
I rotated at U of Louisville. It was the county hospital that got lots of trauma via helicopter from pick up truck and ATV accidents in Western KY. It was in the ghetto... it is across the street and down the street and I heard gunshots one night while walking to my car.
I also rotated at UC-Davis in Sacramento and like someone mentioned earlier, Dr. Sokolove mentioned that the hospital is no longer a "county" hospital but the patients don't know that.
I did the ultrasound rotation at UC-Irvine and it was a nicer hospital that I was used to (it was different being close to Disneyland and parking at a nice shopping mall called "The Block" across the street from the hospital... ummm boba tea) but they still had a good amount of blunt trauma from I-5 and I saw some penetrating trauma there as well. I guess they did have some very slow nights where they could send interns home.
When I interviewed at Christiana in Delaware, I thought they made the comment that Delaware didn't have a "county" hospital system so that most hospitals took in their fair share of uninsured pts. (I toured Christiana Hospital and drove by the one in Wilmington, but I didn't go inside the latter so I didn't know how "urban" the Wilmington hospital was.)
-andy
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Ahhhh, but the questions then become: in what neighborhood is your door located, and who is most likely to walk through it?roja said:
One time, I was working at triage and the RN and I called for activation of the trauma team, because "these two dudes" just stumbled through the front entrance clutching their brand-new bullet wounds. Some days are more interesting than others.
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docB said:
dont worry, i dont get offended very easily. i have no problems admitting my ignorance in a GREAT many things.
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Febrifuge said:
Tell me about it. My last shift I looked at our list of patients that were still in the waiting room, and one chief complaint was: "Gunshot to lower extremity."
Later that night, 'this one dude' staggered into the ED saying he'd been shot in the arm. True....he had been shot in the arm...but the bullet had gone through his arm and into his chest! They ended up doing bilateral thoracotomies trying to save him.
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