Any news lately regarding Seattle residency?

They used to be teamed up with the Madigan Army Medical Center, but I looked yesterday and it said that they are no longer accepting civilian applications which is a total bummer. Looks like that was an awesome program.

The residency program is being started. Sue Stern from University of Michigan was hired to start it. I don't know the date of the first class.

You mean Sue Stern from University of Cincinnati, who then worked at U. Michigan!

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monkeybutt said:

The residency program is being started. Sue Stern from University of Michigan was hired to start it. I don't know the date of the first class.

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That sounds amazing then. I hope they get it up and running for when I graduate!

Dane07MD said:

The Madigan one crumbled in 2004 because a certain individual refused to allow any civilian EM residents at any hospital aside from his own. This hospital runs the ER with Internists and Trauma Surgeons (and thus cannot have their own residency without any EM trained attendings). Said individual has retired, and allowed for an opportunity to arise. The news as of about 2 years ago would be that Susan Stern would be heading up the new residency and the first class would be those who graduate medical school in 2012.

That's old news though, which was my reason to ask if anyone knew of anything more recent. An adviser of mine speculated that it might not get off the ground, but he didn't have much to back up that claim.

Anyway, I'll keep my ears open and let you guys know if I hear anything...

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There's going to definitely be some growing pains the first few years. Anesthesia has been running the airway for years and surgery all the traumas. In comes the new EM residents who really should be doing both. The location and affiliation with UW will be a definite plus and the program will likely end up being a competitive one, but the first few years will be a challenge. I'm sure they'll recruit great faculty.

Dane07MD said:

Very accurate.

If this gets off the ground by 2012, I would love to be a part of it, as I grew up in Seattle and would relish the chance to go home, but perhaps my residency years may be best served somewhere else as everyone is right, it's a system recovering from a bureaucratic nightmare. Shaky is an understatement of what the relationships around HMC might be like for new EM residents. However, I have heard that Susan Stern is awesome and I have heard that the staff she is recruiting is also top notch. We'll see what happens...

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They are seeking a residency director now, so I hear. 2012 sounds optimistic but is possible depending on how productive everyone can be.

NateintheED said:

Just to clarify - the Madigan EM residency is still alive and well. It just does not accept civilian residents anymore. The issue was actually that the above mentioned individual refused to staff his ED with Emergency Physicians and thus residents could not train there (under threat of the residency losing accreditation). This strained relations with the UW to the point that Madigan stopped accepting UW's civilian residents because the powers that be at UW would not stand up to said individual and straighten things out in that ED.

Madigan residents do still rotate at UWMC, which is staffed by Emergency Physicians, though less than they used to. Its going to take a lot of time before the HMC ED is staffed with Emergency Physicians, and even longer for the institutional culture to change to the point of accepting the role of EM residents.

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When I left last year, I heard that they hired an "EM Doc" straight out of IM training. It is going to take a LONG TIME to change the culture. Someday it might be a great program, because they certainly have the volume, pathology, and locations, but...

There is a residency program at Seattle Grace Hospital. It's pretty competitive from what I hear. Check it out - if you can handle the drama...

I don't know, it looks like the surgeons sorta run the ED, and I don't want to spend that much time treating wounded deer. Also don't know if I could handle being boarded in pediatric neurosurgery, neonatal surgery and foot surgery by the time I'm 30.

I really want to return to Washington for residency as well. I'm only a first year, so hopefully this program will be up and running by 2013. I recently wrote letters to the two Washington senators trying to get them to understand how with the only EM residency in Washington being Madigan, it is making it very hard for medical students to come back and practice there. Hopefully I struck a cord, especially since healthcare is such a prominent issue right now. Maybe the senators can push this along a little faster.

The residency was approved last month. The first class starts this July, as they conducted interviews this year while awaiting their approval. Here is the program page for more info, but the basics are:
4yrs
You rotate between Harborview, UWMC, Children's, VAMC, and a community hospital

http://depts.washington.edu/doemuw/education/residency

Anyone else notice that their listed faculty only includes ONE physician with fellow status in ACEP and lots of surgeons? Didn't take the time to see how many of the faculty are EPs, but I have a distinct feeling that this DIVISION is very heavily surgically controlled. I guess we'll see, and I could certainly be very wrong in my assumptions. It just makes me hesitant. Too bad too, cause I LOVE Seatle!

TerraMedicX said:

Anyone else notice that their listed faculty only includes ONE physician with fellow status in ACEP and lots of surgeons? Didn't take the time to see how many of the faculty are EPs, but I have a distinct feeling that this DIVISION is very heavily surgically controlled. I guess we'll see, and I could certainly be very wrong in my assumptions. It just makes me hesitant. Too bad too, cause I LOVE Seatle!

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I can see how EM being a division would seem unsettling, but considering that having EPs run the ED in Seattle seems to be a big shift in culture I think it's a one-step-at-a-time kinda thing. Just because you create a new residency program, I'm not sure it makes sense to throw out the baby with the bathwater...culture/people rarely change overnight.

But that's kinda besides the point actually--I just zipped around their faculty list and it seems that the majority are not surgeons (I only found one surgeon but I didn't go through the whole list). If you look at the EPs, most are on the younger side (probably recruited to help start this program), which might account for them only listing two FACEPers. Looking over their faculty list and infrastructure, it seems like anybody with an EMS/disaster medicine slant would probably have a great time there...as well as anybody interested in cardiac arrest/resuscitation (Nichol is big time).

Of course I'm only a second year and have spent 4 days on my life in Washington state...so hopefully somebody more knowledgeable comes along...

Ok, after spending some time going through the website (while waiting for my attending to get here), I have to back off my previous statement. They DO have a majority of EM trained and boarded faculty. However, as pointed out earlier, most of them are right out of residency! Of the 27 EM boarded attendings, only seven have been board certified for more than ten years. Two of those (the only two who are fellows of an EM college) were actually trained at internists and grandfathered in. Additionally, the faculty includes ten internees and one surgeon.

All of that being said, I am not in ANY way trying to minimize the knowledge, experience and teaching ability of any of their faculty! As pointed out, this is a HUGE shift in philosophy at this hospital (one for the better IMHO), and I think it has the potential to be an amazing program!! No, nothing happened overnight, and there will certainly be frowning pains.

I suppose that my comment more reflects my personal concerns about any new program, but I would also be slightly concerned myself in this program until the hospital has had time to adjust to recognizing EPs a little more equally.

It really is going to be a big shift, and I think that the surgeons having to share trauma and procedures isn't going to be well received at first. For now, it sounds like there will be rotations day to day to determine which service runs traumas, etc.

TerraMedicX said:

Anyone else notice that their listed faculty only includes ONE physician with fellow status in ACEP and lots of surgeons

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Impossible... if they are an RRC-approved residency, having only 2 EM-boarded physicians would get their accreditation removed in a heartbeat.

caliboy007 said:

Impossible... if they are an RRC-approved residency, having only 2 EM-boarded physicians would get their accreditation removed in a heartbeat.

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FACEP does not indicate board certification. They will all be ABEM certified, some will be FACEP and some likely FAAEM. FAAEM does require board certification.

The ED director at Harborview is a trauma surgeon, which was somewhat of a red flag for me. The ID badges say "ER Physician." On the other hand, Harborview probably only accounts for about half of the ED time and I'm sure stuff like that doesn't make a big difference on a day to day basis.

name? said:

FACEP does not indicate board certification. They will all be ABEM certified, some will be FACEP and some likely FAAEM. FAAEM does require board certification.

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That is correct except they dont *all* have to be ABEM, just a certain percentage (it's quite high). I was referring to the OP who said that he/she only saw 2 EM physicians in the faculty list. What I was saying is that per RRC regulations, if there were only 2 EM physicians in the residency, it would be shut down. What I mean be EM physician is ABEM/AOBEM-certified.

ACEP still has folks in there that are not ABEM-certified from before they stopped allowing non-EM boarded docs in there. AAEM is comprised of 100% ABEM or AOBEM-certified docs. In any case, RRC could care less about AAEM/ACEP fellows...what they care is that the faculty doing the teaching are ABEM/AOBEM-certified.