Maricopa Residency Reviews

Anybody been to maricopa yet? Wondering about any opinions....

melvindo said:

Anybody been to maricopa yet? Wondering about any opinions....

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Funny you should ask.

Maricopa, just got back tonight!

Great place to train if you like county systems, autonomy, being the big cheese in a small academic place with only a handful of other residencies that all seem to be lower on the totum pole than the EM guys. Their PD is very laid back and eclectic and their chair is the 2nd author on the Tintinalli text. They have many well known faculty and much published research. They do 10 hour shifts, and Spanish would be a great help so if you can't speak it start working on it now. They have full time interpretors so you can get by easily without it, but you miss a great deal of the interaction that way. Phoenix is a cool city and growing. Outdoor activities are galore with skiing, hiking, biking, climbing, sight seeing, all in one half day's drive and many of those things in Phoenix itself. The heat is dry so not as bad as a place like Houston in reality. The hospital is in a pretty bad part of town for Phoenix, but aren't all county hospitals? They get a good mix of community experiences at their affilliate places in Scottsdale and such. I think they are easily a top program but it really depends on what you are looking for. If you don't thrive in a county place, you might do better in a more community based EM program with more daunting facilities. You should check it out though.

Also did my first second look this week. Don't know how many I will do but I am only going back if I am seriously considering them. The wife went as well so the cost factor starts to add up. Now don't start freaking out about 2nd looks because from what I hear there is no requirement to match someplace. Its just for me personally to see some things again and show the wife around. You know how it is, if the wife is happy then we're all happy

I wish we had a nice standard template that I could just fill in to make it easy, since we don't I will just ramble whatever comes to my head....
Residents, very cool, hang out together, drink beer, party. Seem to get along well.
Location: hot as hell. Some really cool places to live outside phoenix, like scottsdale and tempe.
facility: ****ty, small ED. The "trauma" bays are so small I have no idea how they get everything done. The PD was talking about how too many people were in the rooms while codes were being run.....I actually think the problem is the rooms are too small. They have another code room in the Peds ED. Wow, it is smaller than most private rooms at a normal hospital. I don't know if the portable XR could fit in if the door was closed!
County: yeah, it's county, but they passed some local tax initiative and now have "money" to spend, so I think things are better than at many county places.
PD: New to program. Very awesome. Seems to have the place headed in the right direction. I think in 5 years this will be a great program.
Off service: sounds like most services are full of DOs and FMGs. Some call this a positive because you as the EM intern, often run the show, but I would like actually learn something in my intern off service, not work on my autonomy.
Misc: Seem to have a cool orientation month, only 10 shifts, get to know your class the ED and party lots. U. of Arizona has a new med school in phoenix and maricopa thinks there will be a new big hospital merger thing. I'm willing to bet U. of Az. takes over Maricopa in the next 5 years and it gets a whole lot better.

Overall, I think this is a decent program with an awesome PD. I think this program will be much better in 5 years, which doesn't do me any good.

Looking for some info on Maricopa . . . I have done a search and there's not much info. I read the scutwork reviews and they range from very good to very bad. Anyone out there with current knowledge of the program? I am trying to decide if it's worth the expense to interview there.

I interviewed there and I think it's definitely a place worth checking out. One word: county. No one is going there for the facilities. According to the presentation, recent financial restructuring has improved funding, but there are no plans to improve the infrastructure. The new PD (Dr. Katz) is very approachable and apparently is moving the program in a more academic direction. Research is huge there, Dr. Lovecchio has 2 NIH grants and there is an entire department with staffing devoted solely to EM research. In terms of clinical experiences, tons of Spanish-only patients as well as Native Americans from the surrounding reservations. Mostly underserved, uninsured population. The residents seemed fun and happy, living all over Tempe, Scottsdale, and Phoenix. Make sure not to miss the interview lunch- it's at a really nice mexican restaurant. If possible, schedule your interviews in the morning (there are 2 sessions per day). Also, don't get a hotel near the hospital- it's a pretty crappy neighborhood.

WallowaWanderer said:

Looking for some info on Maricopa . . . I have done a search and there's not much info. I read the scutwork reviews and they range from very good to very bad. Anyone out there with current knowledge of the program? I am trying to decide if it's worth the expense to interview there.

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Amazing trauma experience with greatly diverse and unique pathology in a beautiful big city.

Treat mostly Mexicans and prisoners in a dirty old ER with tiny trauma bays.

Choose what's important to you. I did a month there and you can PM me. I will rank the program as one of my top, because I'm not choosing residency based on facilities and patient population.

The program has great academics.

I'm from the valley and would suggest the Embassy Suites at 40th st and McDowell or the Marriott at the 202 & 143 freeways. They are both in decent areas for being so close to the medical center. They're also easy access to the airport.

Just a question, MVEMSNP -- what do you mean by becoming more academically focused? How would this change a residents experiences there? PM me if you like.

I thought this was a great program; the faculty are excellent, and you have great fellowship opportunities in the area. Not to mention, if you end up liking Phoenix, the job market and salaries in the area are very favorable. The PD seems very focused on making sure the EM residents get the most out of their off-service rotations. They do have a couple DOs every year, but that seems more a consequence of their location in the SW, where many of the nearest medical schools are osteopathic, rather than a reflection of the quality of the training program. Definitely a quality program where you see all the pathology you need and live in a great, young, affordable city. The major drawback I inferred was not so much with the EM program, but that the other residency programs in the hospital were somewhat inconsistent.

Wow. It is nice to hear some good chi about my program.

For what its worth, I've been out of residency at The Copa for about 6 months now. I think I got exceptional training there, and it has prepared me to practice in the real world. As someone mentioned, it is a true county experience, which suits my personality and practice style. Down, dirty, utilitarian and practicle. Medicine for the masses shall we say. On the other hand, now that I'm an attending out in the community, I feel I've been very well prepared to serve that population as well.

Anyway, yes I thought is was a great experience. Is it worth you time or money to interview? I guess only you can answer that. Ask yourself where you want to live, and try to interview in those places.

Good luck.

They do have a couple DOs every year, but that seems more a consequence of their location in the SW, where many of the nearest medical schools are osteopathic, rather than a reflection of the quality of the training program.


Please, do you honestly believe that in the competitive nature of EM a program would rank an Osteopathic student simply based on geography. I guarantee that the PD there must feel that they are just as qualified as any of their allopathic counterparts. There are good and bad allopathic and osteopathic students, the fact that a program like Maricopa matches DOs doesn't so much reflect on the quality of the program. Rather it demonstrates the forward thinking of the PD who isn't stuck in 1960 and realizes that a good applicant is a good applicant regardless of the initials behind their name.

tsn15 said:

They do have a couple DOs every year, but that seems more a consequence of their location in the SW, where many of the nearest medical schools are osteopathic, rather than a reflection of the quality of the training program.


Please, do you honestly believe that in the competitive nature of EM a program would rank an Osteopathic student simply based on geography. I guarantee that the PD there must feel that they are just as qualified as any of their allopathic counterparts. There are good and bad allopathic and osteopathic students, the fact that a program like Maricopa matches DOs doesn't so much reflect on the quality of the program. Rather it demonstrates the forward thinking of the PD who isn't stuck in 1960 and realizes that a good applicant is a good applicant regardless of the initials behind their name.

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To echo this, the best resident according to all of the other residents and attendings at this program is a DO.

Maricopa is on monthly blocks.

The ER shifts are a mixture of backroom (10 hours) and frontroom (critical care area, 8 hours).

Interns work app. 22 shifts a month
Juniors work app. 20 shifts a month
Seniors work app. 19 shifts a month

Maricopa's EM Residency program just underwent a significant expansion (new residents, new attendings, new program coordinator...). It's been fun making the best even better... With the increase in number of residents per year, the scheduling has changed quite a bit. It's still a three year program, but the residents work less shifts than originally quoted in the thread.

In the past few years, Maricopa has done the impossible...it has made an excellent EM Residency program EVEN BETTER. The new PD has made some revolutionary changes to the curriculum and the general flow of the program. The new ED Chairman is a wonderful and kind, nationally recognized EM superstar. They have hired a few new faculty members who are inspirational leaders in their own respective fields. The core faculty members are all actively involved in enhancing resident education, in addition to furthering the field of EM via their participation in national and international committees and ventures. 'Copa has an amazing group of residents who are bright and driven, but who relish in the "work hard, play hard" mentality of EM. The greater Phoenix area offers so many awesome amenities. It's one of the best places to live in the US. Watch out, 'Copa is going to be doing some pretty awe-inspiring things over the next few years! You won't want to miss out!

Amaranthine said:

Maricopa's EM Residency program just underwent a significant expansion (new residents, new attendings, new program coordinator...). It's been fun making the best even better... With the increase in number of residents per year, the scheduling has changed quite a bit. It's still a three year program, but the residents work less shifts than originally quoted in the thread.

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Since you're in the know at maricopa, do you guys, or have you ever offered a spot out of the match to a DO?

just morbid curiosity really.

Also, how many are you guys taking a year now?

fergustsi said:

Since you're in the know at maricopa, do you guys, or have you ever offered a spot out of the match to a DO?

just morbid curiosity really.

Also, how many are you guys taking a year now?

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They definitely do - just check their website: http://www.maricopaemergencymedicine.com/faculty-and-residents/residents

EM residency websites are your friend...they're often very helpful for a number of reasons.

Would be thrilled at any of my top 5, especially top 3. Kind of wondering if I should have ranked Vanderbilt higher in retrospect. I was extremely impressed by that place (they pretty much have it all!) but just didn't feel like I could legitimately pick Nashville over LA or Boston...oh well, too late now! And I really do love LA, not so sure about the south. Why can't Vanderbilt be in a bigger city?!? Anyway, we will see what happens on Match Day.

1- LAC/USC: +top-notch clinical experience, +tons of procedures, +very hands-on, +autonomy, +work in jail ED, +residents a lot of fun, +EM is top program in hospital, +brand new enormous ED, +/-tons of Spanish speaking patients, +intern year months alternate ED and offservice, -pods isolated (i.e. in one shift, only work in resuscitation area), +ED residents get all ED procedures except thoracotomies, -all 12 hour shifts all 4 years, -attendings are reportedly hit or miss in terms of availability, +love LA (and family in area), -not that many opportunities for research

2- BWH/MGH: +tons of amazing, cutting-edge research (affiliation w/ MIT, so tons of biomedical technology), +supportive environment, +big names in EM, +/-two pretty diverse clinical sites (trauma, more county-style at MGH and lots of cancer/gyn/superspecialized stuff at BWH), +great didactics, +strong reputation, +other top residency programs at the hospitals, -floor months, -Boston is a little oversaturated in terms of hospitals so not your "typical" EM experience, +Boston, -tons of PAs in the EDs, -not nearly as much trauma as my #1 and #3, +spouse prefers Boston

3- Vanderbilt: -NOT a county program but +they get all the trauma in Nashville (lots of penetrating), +outstanding program leadership, +incredible didactics, +residents exceptionally happy, +great reputation, +really really sick patients in busy ED, +no floor months and lots of ICU experience, +/- nearly all at one site (exception- community EM months), +get tons of procedures, +trauma time is ICU only, +/- Nashville (seems like very nice city, good COL and weather, but not as exciting as LA or Boston), +strong and integrated peds EM experience, strong EMS

4- UCLA/Harbor: +getting a nice new ED in 2013ish, +residents live by the beach, +plenty of autonomy but attendings are available and involved, +county experience but big name, +great reputation, +very appreciative patients, -transitioning from 3 to 4 years, +trauma, +LA (lived there before- love it), +changing/improving didactics, -not as intense a clinical experience as USC.

5- Cincinnati: +Love the flight program, +/-pretty intense residency, +great reputation, +faculty are great, +1st/4th year mentorship, -not ideal place to live, +/- nearly all at one site (exception- community EM months), -might kind of suck to get pulled out of your shifts to fly

6- Maryland: +Shock Trauma is incredible (but -separate trauma months), great program leadership, residents happy and friendly, +no floor months, -Baltimore, -Hopkins interaction seems a little odd

7- Indiana: +great county and academic experience, +Methodist and Wishard very close together, +friendly residents, +well-known program, +huge patient volumes at the two hospitals combined, -Indianapolis is kind of blah, -ready to get out of Midwest, -liked Cinci a bit better when comparing Midwestern programs

8- Maricopa: +location (family in area), +autonomy, +residents very nice, +program leadership impressive, -facilities, - offservice rotations, -other residencies in the hospital

9- Carolinas: +great atmosphere, +great reputation, -floor months (medicine and peds, I think), -not as much trauma and medically sick patients as my top choices, -honestly thought Vanderbilt was a stronger program when comparing Southern programs

10- Bellevue: +autonomy, +great reputation, +lots of ICU time, -peds experience, -trauma experience, -cost of living (decided NYC is not for me)


Plus a few others...

Posted anonymously on behalf of a student who interviewed there.

Maricopa Review

Pre-Interview Social: Dinner with the residents was at Oregano’s, which is a restaurant in Scottsdale. My flight got in too late and I wasn’t able to go, but I heard it was really good. Also, if you’re staying near the hospital and you don’t have a car, you’ll need to take a cab there since it’s like 7-8 miles away.

Interview Day: I was in the afternoon group. We started at 10:00 with a presentation by Dr. Wu, the assistant PD. She is very enthusiastic about the program and the presentation was actually fun to sit through. After that, we had a few minutes to talk to some residents before they took us out to lunch at a really good Mexican place where we sat outside. I guess it’s no secret that the weather in Phoenix is beautiful in the winter, and that is a good recruiting technique on their part! At the end there was a brief wrap-up for last minute questions and then we were done a little after 4:00.

There were four interviews each lasting 20 minutes, plus one 20 minute break. I interviewed with the PD, the assistant PD, the department chairman, and one other faculty. Most of the interviews were pretty relaxed except my interview with the PD, who was kind of aggressive about wanting me to name other programs where I was applying. I was asked why EM, where else was I applying, what I do for fun, what are my future goals, to tell a story about something that affected me deeply, and to tell more about one 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: Maricopa is a three year program. The hospitals are Maricopa (county hospital), Banner Good Samaritan (Good Sam), Phoenix Children’s, Scottsdale Healthcare Osborne (community hospital), and Banner Thunderbird (another community hospital, and wow, I love that name!). At Maricopa, the residents work 20-22 ten hour shifts as PGY1s, 18-20 eights and tens as PGY2s, and 16-18 eights and tens as PGY3s. They work 12s at the other hospitals. Interns don’t do any nights, and PGY2s and PGY3s do one month of nights each, Sunday through Thursday. (Other upper levels on regular EM months do their overnight shifts on Fridays and Saturdays.) Scheduling is based on blocks, not circadian, and there are five days off either at Christmas or New Years.

The first rotation for all residents is an orientation month that has didactics with some nursing shifts thrown in. The idea is for the new interns to have a chance to ease into the system, review all of the basic EM things that they need to know to hit the ground running, and get to know one another. There are peds EM months during PGY1 and PGY2, and then during each EM month, the residents do some shifts at the children’s hospital so that they get longitudinal peds exposure. They have a month of PICU too, so it seems like their peds exposure is pretty good. There are no floor months. There are two MICU months, one during PGY1 and the other in PGY3. The EM intern is paired with the EM senior in the MICU so that the intern gets a high yield experience. They also do simulations, and they have the largest sim center in the world.

Another thing they focused on quite a bit was US. Dr. Wu is in charge of the US training, and she will certify residents who do enough ultrasounds to meet the criteria for credentialing. This could be something helpful to have on your resume for the future. For trauma, they share the codes with surgery. EM always gets the airway. On even days, EM is the captain and surgery gets the procedures, and on odd days, it’s the other way around. They said they have a good relationship with trauma surgery and there is not any problem with getting their procedures or being able to do primary survey when it’s their turn. They also have a teaching resident role, where interns and MS4s present to the PGY3 resident.

Didactics: We really didn’t hear much about the didactics, and I gathered from the residents that they’re probably ok but not amazing. There is a reading group with assignments from Rosen’s and Wednesday morning conferences every week. They have a journal club once per month during the regular weekly conference time. There are a bunch of fellowships in tox, EMS, peds, and US. It seems like all of those areas are pretty strong.

Benefits: Benefits are really good compared to a lot of other programs. A lot of residents buy houses or condos. Vacation is four weeks per year for PGY1s and PGY3s, and three weeks for PGY2s. No one was exactly sure why the PGY2s got a week less. Some kind of scheduling thing, I guess. They give you free meals, up to $18 per day. Interns all get to go to SAEM. Everyone gets copies of Rosen and Tintinalli, plus an educational allowance of $1500 total for the three years that you can use to pay for Step 3 and other review materials. They get $250 for a PDA. Parking is free. Other benefits are the usual like insurance, EM society memberships, free travel to conferences if you present something.

Administration: The chairman and PD seem very dedicated to the program and supportive of the residents. They have been making changes in response to resident feedback, like hiring Dr. Wu to increase their strength in U/S. I really liked her a lot.

Phoenix: I love Phoenix as a city. Cost of living is very reasonable. The area is pretty and there are a lot of things to do, especially if you like hiking and other outdoor things. They have sports teams, parks, good restaurants, and all the other amenities you would expect from a larger city but the city doesn’t feel overly large. I can’t really explain why, but maybe it’s because there seems to be so much space. I think if I moved there that I would have to take up photography, because watching the sun set on the mountains was pretty incredible.

Summary: There are a ton of things to love about this program, from the enthusiasm of the residents and faculty to the great weather to the opportunities to do just about anything in EM that you want to do. US and peds in particular seem very strong, and people mentioned the tox and research resources several times as well. They have over $1 million in NIH funding and clinical research support staff who will help you put your project together, apply for IRB approval, collect data for you, etc. The residents seem really happy and everyone there is very proud of the program and how competitive it is, though not to the point of being obnoxious about it. You will see every kind of pathology imaginable, and having a department of EM research people to help with your scholarly project is pretty cool. The benefits are super, and Phoenix is a really nice city with a lot of fun things to do. Plus, they use EPIC, which is the EMR we use at my school. It seems like they listen to resident input and try to make improvements based on what the residents say. One example I was given was with getting the new US faculty and improving didactics. Since they have good urgent care clinics, their patient acuity in the ED is pretty high. Even though Maricopa is a county hospital, they stressed that their finances are very good. They are building a new ED which will be completed in about two years.

I think the biggest downside is that there are so many rotation sites. It seems like it could become a drag to drive around so much. But the residents didn’t seem to think it was a huge problem, and I guess Phoenix traffic is not too horrible even during rush hour. I’m also not sure about the didactics. They really didn’t discuss didactics, and there isn’t much info about it on the website or in the packet they give you either. It makes me think that didactics probably hasn’t been a major focus, even though the residents said they’ve been working to improve it. Finally, I was a little turned off that my interview with the PD focused so much on where else I was applying instead of on getting to know me or talking about Maricopa.

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

So I'm going to give a quick and dirty review of Maricopa. I rotated here, and probably had one of the worst experiences of my life. I will remain as un-biased as possible though.

My second shift here, 4 days into the start of the rotation, I get paired up with a certain Attending. Mind you, I'm still getting used to the computer system, and how the flow works, and how all the charting works. So I pick up my 2nd patient, get an H&P, come back and present. I had a couple of questions about the patient, so of course, I asked. However, thing started going downhill from here. The Attending started getting very annoyed at me asking questions. At this point I should have listened to my gut, but instead I asked a couple more because I was curious and didn't know what to do in this type of patient. The Attending very rudely and bluntly told me to look at the chart. So I get on the computer and try to find the information, about 2 min have passed and he asked me if I found it. I told him no I wasn't sure where to find it, and then BOOM a grenade exploded. He went off on me for a good 5 min, in front of EVERYONE (other attendings, residents, nurses, techs) about how I was the worst student he had ever worked with in his years there, and mocked me that they were actually going to allow me to graduate and become a resident in a few months.

I was literally stunned, and everyone had their wtf look on their faces. Of course I kept my distance from him, but with my luck, I was paired up with him for another 4 shifts. Each shift, he would say something derogatory to me, either that we have a communication problem, or I'm below par on my medical knowledge. However, every other resident and attending I worked with gave me honors/high pass on their shift evals, and told me I'm doing an oustanding job with my presentations, data gathering, DDx, etc...

On top of that, speaking with a few residents, I got the vibe that some of attendings don't support some of the residents and don't have their back. Looks like there is some internal conflicts here.

With that being said, the program seems to be a solid one. The residents get along real well and support each other. They like to go out and have fun. Seemed like a majority were married though. Of course, Scottsdale is about 30-45 min from the hospital and that is one of the ritziest cities around.

SO OVERALL, I will NOT be ranking this program. I would rather do IM than match here. I'm sure everyone has their own experiences, and many people would love it here, but it is not for me.

the following comments are based on my opinion and my discussions with recent grads and current residence in this program.

the program in brief: three-year EM program that converted to three-year program from a four-year program sometime ago, current program director Eric Katz. It is the only emergency medicine residency program in Phoenix Arizona which is significant for a city of this that size. Many residents are very happy, as Phoenix has outstanding weather excluding the summer, and there many outdoor activities to enjoy nearby. The residency program has a strong presence in the hospital, and is well regarded and thought by most in the hospital to have the best residents. I am told that the program has switched from one-month blocks, to four-week blocks to provide a wider range of opportunities and experiences for the residence. This is demonstrative of a forward thinking leadership, and a group that is willing to change.

Rotations in the emergency department are done at Maricopa medical center, and a variety of community settings predominately in your second and third year. The hospital the majority EM shifts are performed are at Maricopa, which is a level I Trauma Ctr., they have a dedicated pediatric emergency department.

The perception of attending's in the emergency department, is one of mixed and controversy depending on the residents that I have spoken with. My personal experiences with a copa attending was pleasant and informative. It appears to be well known, and expressed freely by the residence to rotating medical students, and other residents that some of the attending's can be both aggressive, inappropriate, and belittling to the EM, rotating internal medicine residents, as well as medical students. Based on my gestalt from opinions is that the majority of attendings are kindhearted, excellent teachers, and a pleasure to work with. This is not unlike many residency programs in that there will always be one or two people, that can be difficult to interact with. Maricopa does not appear to be immune to this fact.

The most controversial subject that was recently brought to my attention by a rotating medical student, which was verified is that the residency program has had in the last several years a difficult time keeping residence. The rough figure was a loss of three residents in three years. The details of why these residents have left the program I am not privy to, and did not pursue details as to why such a regular trend has occurred.

In summary: historically a well-respected program with excellent teaching, in a city that many would consider desirable to live in. Personally, I find the attrition of residents to be concerning, and would not recommend a friend to go to a residency were this was occurring regularly unless I had better insight into what was going on, which is going to be difficult as I don't imagine rotating medical students would walk up to a program director and ask, and they would likely not get a very clear explanation.

Perhaps someone who has rotated their recently, or a current resident could clarify if it matters to anyone. my friends who have gone there were very happy and are well trained.

The "Attrition" you described is really nothing to be concerned about. None of the residents here live in fear of their jobs.

Most of it can be attributed to the program directors willingness to support residents who wish to pursue a different specialty.

To the med student above with the bad experience with one attending, have you considered that they may have just been completely joking with you? There isn't a single attending I can think of that I would even begin to be described as "malignant". Each attending has their own style and scene of humor and there is something to be learned from each one.

Also med students arn't really "paired" with an attending so this story sounds kinda questionable to me. Don't let this one posters experience scare anyone away from an excellent program!

I found these reviews helpful so figured I would add a few of mine that I remembered to write up...

1) General: 3 year program mainly based at Maricopa medical center which is a county hospital. ~55K adult Ed visits and ~25K pediatric visits yearly. For a county hospital things run rather smoothly here, minimal gridlock and sufficient resources. Patient population is the working poor mainly at Maricopa. As upper level residents you spend several ED months at outside facilities that provides exposure to the other end of the spectrum e.g. Scottsdale. This seems to broaden your exposure base. Great benefits including huge daily meal budget, $18 which is a nice touch. EM is main program in hospital and has a lot of power and thus lots of perks/benefits for EM residents.

2) Curriculum: No medicine ward months, fantastic! 4.5 ICU months currently but likely changing to 5 months for next year. Didactic lectures are Wednesdays 7am-1pm and seem to be well liked by the residents. I did an away rotation here and enjoyed them a lot, a good mix of resident and faculty speakers. All residents become certified in ultrasound during the program which is a great addition. US program has been completely revamped recently with addition of Dr. Wu who is a great teacher. All residents start off with orientation month consisting of a few ED shifts, simulator labs, and lecture. A great way to get to know fellow residents and ease into the intern year. Seems to be good relationship with trauma team and rotate Captain and procedures with them during trauma calls.

3) Pre-interview dinner: Held at Oregano’s Pizza in Scottsdale. Great pizza and a great showing of residents, literally 15 or so residents showed up. Very laid back atmosphere, pizza, beer, and chatting for several hours. Definitely recommend attending this if at all possible.

4) Interview: Started at 7am with orientation and introduction from PD. Funny and personable guy with a good attitude about the program. 5 total interviews, 15 minutes each. 1 with PD, 3 with faculty, and 1 with chief resident. Very straight forward, just trying to get to know you. No trick questions or anything difficult. Setting was comfortable and non-stressful! Afterwards was lunch with residents at Chelsea’s Kitchen in Arcadia area of town, very nice Mexican food. Yes I know that seems contradictory Again, 10 or so residents showed up to this event.

5) Summary: I rotated here for an away rotation and absolutely loved the experience. I cannot say enough about the people here; both residents and faculty were great and made the entire experience very fun and educational. Patient care is top priority but residents/faculty also had fun when the situation permitted. It was an easy transition into a new hospital setting because everyone is very laid back and welcoming. Residents all seem very active with outdoor activities. There is a ton of stuff to do in Phoenix and surrounding areas. Definitely very active people which is completely my style. County program will provide lots of exposure to high acuity patients but well funded and well run hospital limits “negatives” of most county programs. Overall I was very impressed with the program and especially the people and will likely rank this very high.

Does anyone know if maricopa is as malignant as everyone is saying it has become? There is a new program director there and the residents seem really unhappy. I heard a few of them say that they just come to work because they have to and they wish they hadn't matched there. Has anyone else rotated there and heard about the new program changes?
Also looking at new mexico and california programs but was hoping to move to phoenix. How does maricopa compare to new mexico and the southern cali progrrams?

EMPipeDream said:

Does anyone know if maricopa is as malignant as everyone is saying it has become?

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Where is "everyone" saying this?

hoot504 said:

Where is "everyone" saying this?

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That one guy in this thread >1.5 years ago as well as OP. Other than that, ...?

EMPipeDream said:

Does anyone know if maricopa is as malignant as everyone is saying it has become? There is a new program director there and the residents seem really unhappy. I heard a few of them say that they just come to work because they have to and they wish they hadn't matched there. Has anyone else rotated there and heard about the new program changes?
Also looking at new mexico and california programs but was hoping to move to phoenix. How does maricopa compare to new mexico and the southern cali progrrams?

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As a recent grad I can assure you Maricopa is not even remotely a malignant program. There have been some leadership changes but the majority of the staff remains unchanged. The program's reputation as a very laid back county program is slowly shifting towards a more academic feel. As a result the conference lectures have dramatically improved.

I really didn't get the impression at all that residents were unhappy there.

Medical students on the trail are talking about maricopa losing many of their attendings because the program isn't as fun or as laid back as it used to be. I heard on my rotation that the new program director is really malignant and weird and maricopa has fired multiple residents in the past and many are on probation right now. Does anyone know if new mexico is a better program to train at or how Harbor and USC and Irvine compare? How about San Diego? Which southwest programs are supportive of their residents?

EMPipeDream said:

Medical students on the trail are talking about maricopa losing many of their attendings because the program isn't as fun or as laid back as it used to be. I heard on my rotation that the new program director is really malignant and weird and maricopa has fired multiple residents in the past and many are on probation right now. Does anyone know if new mexico is a better program to train at or how Harbor and USC and Irvine compare? How about San Diego? Which southwest programs are supportive of their residents?

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You heard this from recent interviewees? This doesn't even seem like interview day fodder - so it would have to be info from residents or something.

Robinson EM said:

You heard this from recent interviewees? This doesn't even seem like interview day fodder - so it would have to be info from residents or something.

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It's an applicant trying to scare other applicants away so that they rank the program lower and he/she has a higher chance of matching.

EMPipeDream said:

Medical students on the trail are talking about maricopa losing many of their attendings because the program isn't as fun or as laid back as it used to be. I heard on my rotation that the new program director is really malignant and weird and maricopa has fired multiple residents in the past and many are on probation right now. Does anyone know if new mexico is a better program to train at or how Harbor and USC and Irvine compare? How about San Diego? Which southwest programs are supportive of their residents?

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I have no skin in the game and know nothing about maricopa, but their PD Mike Epter is the antithesis of malignant. In my experience he's very down to earth, and is passionate about resident education. Your post is very trollish..

cyclohexanol said:

I have no skin in the game and know nothing about maricopa, but their PD Mike Epter is the opposite of antithesis of malignant. In my experience he's very down to earth, and is passionate about resident education. Your post is very trollish..

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The "opposite of the antithesis", which is the opposite of the opposite, is the affirmative. I think you put an extra step in there.

Apollyon said:

The "opposite of the antithesis", which is the opposite of the opposite, is the affirmative. I think you put an extra step in there.

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Ah yes, I seem to have accidentally a word

Fixed, thanks

I've heard poor things about the program from several individuals on the interview trail, 2 of which did rotations there. I take everything I hear on the trail with a grain of salt, but their critique of the program gave me pause.

Zebra Hunter said:

I've heard poor things about the program from several individuals on the interview trail, 2 of which did rotations there. I take everything I hear on the trail with a grain of salt, but their critique of the program gave me pause.

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I rotated here this summer and I loved this program. In some ways what I'm about to say is kind of foolish since I'm going to be ranking this program very highly, potentially number 1. But, if there is one thing I can't stand it's false rumors, reminds me of high-school. Anyway, I couldn't disagree more about this program being malignant. The PD was a super chill guy who went out of his way to talk with me and teach me things on shift. I worked with some of the coolest and most down to earth attendings I've ever met (Dr. Blackburn, loved this guy). The residents were also phenomenal and super chill, took time out of their shift to teach me things or pulled me aside to do cool procedures. Conference was hilarious, seemed like a comedy show. Residents seemed really comfortable debating topics with attendings which I think speaks to benign relationship that exists between the two groups. The only thing I could think of that might lead one to say this program is malignant is that people here aren't really the hand-holdy constant positive reinforcement types. Sarcasm and jokes run rampant and sometimes I think more sensitive people are weirded out by this but I found it welcoming and highly entertaining. You know what they say, "one man's trash, is another man's treasure."

And lest you think I'm just blindly supporting this program let me mention it is COUNTY! and has all the associated problems. Lots of drug seekers, slow throughput, not so many fancy toys, etc.. By no means am I trying to say it's a perfect program for everybody but I just felt compelled to defend the PD and faculty from internet rumor.

Serous Demilune said:

It's an applicant trying to scare other applicants away so that they rank the program lower and he/she has a higher chance of matching.

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I heard the same and didn't believe it until I rotated there. A student from my home institution had highly recommended the rotation the previous year and I wish I hadn't followed his advice (though I honored the rotation, and I believe all rotating students were interviewed).
Cons: All the faculty and residents state "Phoenix" as the reason they chose Maricopa, rather than the patients that make the county experience or anything else that I was looking for in a program. Residents routinely don't pick up charts (and ask the students not to as well) because they "don't feel like working," and will make you chart for them (though you do get to use Dragon) in addition to you as the student having to handwrite your notes for every patient you see. Lots of incompetence ranging from lack of adequate supervision to third years not knowing basic A&Ps and catering to whichever attending with whom they are working, using a videolaryngoscope (cmac/glidescope) for every airway, and getting kicked out of traumas by surgery so no idea how they get all their procedures. You can blame this on it being a county program but my home institution is also county and this is definitely not the norm. Their didactics are primarily resident run, and several residents told me they rely on podcasts and other resources because they don't learn enough through conference. Off-service rotations are weak except for Burn. The PD's favorite word is "gestalt," and he seems to believe that qualifies all decisions in life. The "sarcasm and jokes" that another applicant mentioned are actually quite crude and unprofessional (only a handful of residents but def bordering sexual harassment for males/females alike) but I guess some people seem to like that.
Pros: Phoenix - COL, weather overall, lifestyle both in (8 hour overlapping shifts, meal stipend, etc) and out of the hospital. Patients are amazing - very diverse pathology - and the nurses rock. Residents are for the most part pretty cool people and so are the attendings - they stress that they are a family and they all really seem to like each other - doesn't make up for the cons for me but it might for others Also, very DO-friendly. Despite the way they practice, residents seem to do well on boards and they get prepped well because a lot of the faculty have experience as examiners. Some famous faculty like the editor of Tintinalli's and the ultrasound attending.
- disclaimer: not a troll, just don't like posting because I'm sure this will get ripped apart but I also heard so many varying things on the trail that I'm hoping this might help clear some confusion.

FYI: Lots of places are using mostly video scopes.

Where there's smoke, there's fire, and there is definitely a lot of smoke in this thread. I'm glad some people have the stones to speak up (assuming the information is accurate).

hoot504 said:

Where there's smoke, there's fire, and there is definitely a lot of smoke in this thread. I'm glad some people have the stones to speak up (assuming the information is accurate).

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The stones to speak up? I'm not sure about someone with only one post really counting as "speaking up." I really have no dog in this fight as I only spent a month there and didn't end up ranking them very highly due to SO concerns but something just doesn't feel right about these reviews. The residents are sexually harassing both males and females? What? Can PoodlePoodle give some examples of this?
Maybe I just got lucky and rotated there on a good month, or maybe I'm a huge jerk and as such I'm unable to see other jerks for what they really are. However, in my humble opinion the residents and faculty at Maricopa were pretty cool and down to earth. Maybe a couple were a little rougher around the edges but I thought they seemed right at home in that kind of a county program.

Obviously, the most important message for future applicants is to NOT give much credence to what you read on the internet and if you are interested in a program do an away and/or talk to other people on the interview trail. Feel free to PM me if you have questions about my month at the copa.

Hey friends!

Current Copa resident here. I was pretty active on this forum last year and thought I'd jump on to take a peek at the pre-match-day craziness, but I noticed my program on the front page and decided to jump into the convo.

I'm an intern and absolutely love my program. I'm surprised residents mentioned "phoenix" as the reason why they chose to come to Copa - I chose it for the people and the family feel (glad you felt it too during your month rotation!), along with the awesome training. I don't know of any intern that chose Copa for Phoenix, actually. We're from a pretty diverse range of locations. I'm super happy with both the program and the PD. The DrE is totally not malignant in any way (saw that comment above and literally lol-ed). Epter's the most resident-centered PD I came across on the trail last year, and he's an awesome advocate for us and one of the best educators I've met. After you witness him pulling practical jokes on the nurses (personally watched him chase a nurse down the hall the other day squirting her with a flush... but then again, she DID put lube on his diet coke bottle), there's no way you can take anyone calling him malignant seriously.

Couple of other things that seem to have been mentioned...
1) Never once felt inadequately supervised. We definitely have gradually increased responsibilities and the third years really run the show and have a lot of independence, but our uppers and attendings are super supportive and always available to help out.
2) We choose what we intubate with. We do so much DL on anesthesiology that a lot of us like to play with the glidescope. It's always up to the intubating resident what they want to use. We do use glidescope if there's suspicion of a C-spine fracture, though. I'm not sure if that's standard across programs.
3) We split procedures and captain/survey even and odd days with Trauma Surgery. I've never once witnessed EM getting kicked out a trauma. If you saw that happen, it would have been a once-in-a-residency occurrence, and that would have resulted in an immediate Chair-to-Chair discussion. Katz is our new Chair, and I've seen him fight for us once when we had difficulty admitting a patient (result: patient got admitted immediately after his call). Trauma kicking EM out of the room wouldn't be tolerated, and that's not our relationship with the trauma service at all. We're on really good terms (we even have parties together).
4) Off-service is actually surprisingly strong. I thought it would be weak coming here since EM is considered such a strong program within the hospital, but people are getting lines and chest tubes everywhere on MICU, we have a brand new CCU/cardiology intensive care month where we'll be paired directly with an attending with no other residents on service and get procedures galore, and our tox fellowship/month is arguably one of the best in the nation. No medicine/gen surg floor months. I'd be interested in knowing which rotations you've heard are weak.
5) Didactics are resident-run, but we have attending and fellow lecturers as well, and we always have comments from the peanut gallery composed of attendings in the back at every conference to weigh in. We do use EMrap, ALIEM AIR, and lots of other resources to learn as well to supplement conference and our own reading. If you rely only on conference at any program, you're not getting the most out of residency that you can.
6) Sarcasm and jokes... errr, well, yeah. We walk up behind each other in the DocBox and whisper "that's what she said." We sometimes write accidental innuendos up on the board. Attendings and residents alike mess around with each other. I've never once felt sexually harrassed in any way (I'm female btw), and I really think our sense of humor shows our comfort level with one another. None of us take ourselves too seriously here. The humor at Copa was one of the reasons why I loved the program when I came to interview last year, and I thought it was pretty unique among residencies. This is why the Match is a personality fit more than anything else. Some people will really fit in here, others won't. People who don't like penis jokes tend not to match at Copa.

If you guys have any questions about the program from the stance of a resident, feel free to PM! I used this forum a lot when applying last year and would love to give back.

Hey guys. I've been on the site for years but made a new profile for anonymity. I'm a 4th year going into EM and I found these threads so incredibly helpful that I want to help contribute to keeping them up to date.

I interviewed at Maricopa so I thought I would share my thoughts:

Pros

• Lots of freedom to customize the curriculum however you'd like. This was big for me as I would love to incorporate global health work and I feel confident that Maricopa would let me do that
• 1 elective month per year (see point #1)
• Most respected residency in the hospital
• Burn rotation sounds like it's super scary but you learn a ton which is a win if you ask me
• faculty are awesome and receptive to resident feedback
• EM and trauma switch off in their roles for procedure vs. survey. This seems like the best way to avoid trauma/EM arguments so it's very comforting to have a set schedule in place

Cons

• Sounds like there's a fair amount of hand-holding as an intern. Just judging by some of the responses to my questions during my actual interview
• The critical patients you see as an intern is dependent on whatever the senior resident thinks is "appropriate" for you. I'm more of a "throw me in the fire but don't let me kill people" type of learner so this doesn't jive super well with me. I guess some residents could be pretty open to letting you experience stuff but there's always the risk of having a more conservative resident and you don't get to have that. I guess I just don't like having that in the hands of another resident. (hence the hand-holding mentioned above)
• The city itself is just not my thing. It seems like the big thing to do (and honestly maybe the ONLY thing to do) is outdoorsy stuff (hiking, biking, rock climbing, etc). Which is great, I love doing stuff like that, but I need more options. One of the residents said that you would probably get through all of the physical structures of the city (bars, clubs, etc.) within a year or two but there are endless outdoor activities to try. I just think that when it's cold or I don't feel like climbing a mountain I would be hopelessly bored.
• Didn't vibe with the residents as much. Perfectly nice and social people but maybe just not my kind of people.

Overall, solid program. Think anyone that goes here would be well-trained. I just don't think the city and the residents are my perfect fit. The freedom to customize your schedule is pretty great and would be nice to have, honestly.

ERorPBR said:

Anyone else have input on this program? I interviewed there and really wanted to like it, but left kind of disappointed. Not many residents (2, I think) showed up to the interview dinner. I didn't even get a chance to talk to either of them. Then the interview day was totally bland. We had our normal interviews, a very brief tour, then sat through 2 hours of conference, ate lunch (only time I had a decent conversation with 1 resident), and left. I was hoping to feel good about this program, but it was totally meh..

Did anyone else have a different experience? I hate putting so much emphasis on a 24 hr visit when it could have easily been just an "off" day.

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I interviewed there (mid december) and actually was very surprised with how much I liked it.

At the pre-interview dinner, 5 residents came and 2 of them brought their families. They did kind of stick to themselves a little but some tried making an effort to sit between us and talk. This kinda did rub me the wrong way because they weren't being aggressive to talk to us but I still tried to keep an open mind

the interview itself really turned it around for me. The PD is hilarious and you could tell that he had a great relationship with the residents. It was cool how they all joke around and play pranks on each other. My interview with him was pretty fun as well. The other interviewers were all laid back, chill, and joked around the entire time. There was only one that was kind of "off" in my opinion.

Our lunch was at a restaurant. The residents during the lunch were actually a lot more interactive and interested in us. They do have a bro-y vibe for sure but the girls could hang. They are half and half as far as married and single

Phoenix itself was eh to me, I kind of like the big-city vibe. Phoenix seems like a more spread out city, where there are little pockets and neighborhoods. It was december and it was 75....

we all learned about the nitty gritty parts of the program so I won't go into that but as far as feel that was my opinion. They may just be tired because it is late in the interview season

ERorPBR said:

Anyone else have input on this program? I interviewed there and really wanted to like it, but left kind of disappointed. Not many residents (2, I think) showed up to the interview dinner. I didn't even get a chance to talk to either of them. Then the interview day was totally bland. We had our normal interviews, a very brief tour, then sat through 2 hours of conference, ate lunch (only time I had a decent conversation with 1 resident), and left. I was hoping to feel good about this program, but it was totally meh..

Did anyone else have a different experience? I hate putting so much emphasis on a 24 hr visit when it could have easily been just an "off" day.

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Hey, our pre-interview thing was a t a brewery and it was great. Tons of residents and we all stayed pretty late. It was the most outgoing group of residents along with Highland that I saw on the trail. PD was awesome, and the rest of interviews were great. They have a superstar PGY3 who gave us the tour and they blew me away at all the resources and opportunities they have despite being a 3 year county program. everyone seemed pretty fun and intelligent.

Well, it has been awhile (10 years!) but I've decided to check-in. It is interesting to read the history of this thread, and I had to chuckle a bit looking back. All our collective anxiety about matching and program suitability has remained remarkably constant throughout the years.

I realize this will probably not sooth many nerves or speak to the core questions current interviewees have, but will offer some perspective as a Maricopa residency grad, and attending physician for about 10 years:

1. You will get out of residency what you put into it - I must admit if someone told me this in residency after a brutal night on call, only one gesture would have come to mind. Some people excel in a program or job, while other others will not. You can’t control the challenges you will confront, but you can control how you face those challenges. Which brings me to….

2. Being adaptable isn’t a luxury, it is a necessity – in the 10 years I’ve been out, EM has changed on a structural level. The medicine is the same, but the system is changing. On a more granular level, each department that I’ve worked in is soooo very different in structure, work flow, leadership, and culture that adaptability is the only way to interface with a new job/system. Some fight it, other successfully adapt. Which brings me to….

3. Your job success as a physician will largely depend on your ability to get along with other people – This is where most of us get tripped up. Nothing I learned in medical school or residency prepared me for this universal truism. Of all the physicians I know that moved on from their positions prematurely, all were deficient in getting along with people to a significant degree. On the flip side, there are amazing stories of career resilience because people liked those individuals and helped them when they fell very, very badly. Your ability to relate to the people your work with (RNs, Techs, physicians, administrators) well help or harm you in ways that are hard to measure. Don’t forget that….

4. Your career satisfaction as a physician will depend largely on your mindset – what do you value at your core? What broad ethical principles are important to you? What is your purpose as a physician? If you consciously know the answers to these questions your career will naturally take you in a satisfying direction. If you are unhappy, as I was at one point, figure out what values or principles are in conflict and work to reconcile them. In my case, I needed to move to a mission driven health system with career development opportunities and a better community for my family. It will be different for different people. Don’t stop asking yourself those core questions, they may change over time.

I will admit I was not ready to hear or answer these points when I was a resident. In fact, I was a bit of a slacker at times and learned many of these principles by falling flat on my face. You probably will too. If this all seems too abstract, try coming back in a few years and see if it resonates more.


For Maricopa:

From my residency class, 2/10 went into academics, but later switched to community practice that had rotating EM residents. 2/10 (or maybe more) became medical directors at large hospitals, and one of these went on to become system medical director, chief of staff, and has reached higher levels of leadership in a major health system. One went into private practice, did a one year research project in Europe, and is also venturing into some digital entrepreneurial areas. One practiced in urban Phoenix several years, then moved to rural Vermont with her family. And the others went to practice at community hospitals and are still doing just that.


It was a good program for me, and I still think highly of it.

Somewhere above, there was an accusation of an applicant trying to scare others away from ranking Copa highly. I'm going to do the opposite, because they will be one of my top ranked places, and if that's where I end up, I'd like good co-residents.

I rotated here over the summer. I had a blast, looked forward to coming to work every day, and all my fellow co-rotators felt the same. The vast majority of residents and attendings were really excited to teach, show you interesting things and keep you involved, chat about your non-EM interests, and it was just a good environment to work in. As in many county hospitals, the learning and service go hand-in-hand, and every single one (seriously) of my patients were kind and appreciative, even if at times a bit rowdy. By time I left I seriously felt like the residents were real friends

Basic stuff: schedule is among the more humane of places I interviewed (including almost all nights clumped into one month per year! Hallelujah!), the PD Epter is awesome and wrote a textbook chapter on wellness, they pay you more than enough to live well in Phoenix, its a county program and the facility/patient population reflects this but everyone is really excited to support your academic endeavors (or non-academic endeavors, if you're rather spend your free time mountain biking), graduating seniors match really well into both community and fellowships. On the interview trail, at many of the big name places I got an "ooooh you rotated at Copa!". Oh yeah, and 3 months of elective time over 3 years, if you haven't heard

Addressing some comments from above (hope I didn't miss anything). One reason I came here was that I had never really spent time in the Southwest and was intrigued, but also read some of the mixed messages above, so wanted to come see for myself despite it being far from home, family, and friends. Something about the comraderie sounded different than the SDN page for every other residency (sure, everyone chooses their residency for "the people"). I loved it, and feel like it could take you anywhere you want to go, and give you a good time along the way
- maybe 1/3 of patients were Spanish speaking, 1/3 were a smattering of other languages, and 1/3 English. I felt like I had adequate support from both in-person and phone interpreters
- it doesn't seem like a classic academic place, where you get emails every other day trying to get you involved in big projects. Its more of DIY academic experience. Anything you're into, they are SUPER STOKED to support you, and likely had someone do something like that already. Copa is all about encouraging you to chase your specific interests. That being said, more recent classes have had much more interest in academics than past classes from what I hear, but there's no pressure. One residents just got a grant to teach opioid harm reduction strategies, one matched to the GW disaster med fellowship, one got a gig at the WHO (and another just managed to spend 2 months of elective there), one has a sweet job in Carmel in California. Everyone goes more or less where they want, as academicky as they want
- trauma: there is more than enough (penetrating and blunt). sure, it gets split to a few level 1's around town, but there's only one EM residency in Phoenix, so guess who is also rotating in those ED's? you spent most of your time at Copa but the other sites get you the mix of academix/community hospital exposure too. and everyone sees more than enough crazy stuff
- there was maybe one attending who any of the rotators worked with during my subinternship that was not particularly nice. Everyone else is great. Show me a place where that doesn't happen. But I suspect the writer above had particularly bad luck, I don't know. Meanness is not cool anywhere, but that was never a thing I saw at Copa and definitely not systemic
- the docbox is very much a happy place, people are constantly joking and swapping knowledge, its different from the more organized pod system, but I enjoy the chaos of having everything going down in one room. the humor and sarcasm flow freely, but I never saw anything inappropriate like the reviewer up there mentioned. everyone just seems so comfortable with each other, that they deal with the tough county things in a humorous way
- yeah the facilities don't look great (shrug emoji). Apparently they're having a huge new hospital built in the next year or so
- the didactics do seem super residents run, but it seems less because attendings aren't interested, and more because residents are excited to take leadership. attendings are quite active in the sessions
- pathology was incredible when I was there. multiple thoracotomies, bizarre infectious diseases, lots of zebras
- yeah Phoenix in the summer is hot. escape up to Flagstaff when you can, go hiking at sunrise. but then its perfect for 9 months. unless you're in California, your summer is probably uncomfortably hot (and likely humid) in most of the rest of the country, then you have months of winter. suit yourself
- outdoors stuff in Phoenix is amazing. you're never more than 15 minutes from an awesome trailhead. but the city itself is underrated. its not very walkable, but with a car you have access to a wide variety of restaurants, music clubs, artsy areas, cute shopping areas. Sure its not NYC or LA, but most of your favorite bands that hit those places will likely come through town, and you will find most cuisines you're looking for
- literally no idea what this is about the program being malignant, or the residents being lazy. like I said above, the vast majority of attendings are great. You won't get 100% anywhere, but the program leadership is 100% supportive and the mutual respect is there. And I've never seen resident laziness or ineptness in my time there. Rather they seemed eager to jump in and help each other out, teach other and the med students
- the Creighton thing sounds like nothing to be scared of. Maricopa will still be Maricopa. They'll probably just get better access to Pubmed or something now

(pardon any typos)

I'm going to echo EarlyCharlemagne and lay out why I ranked Copa highly because I just matched there and also want strong co-residents (but mostly want to psych myself up for residency). I didn't rotate there but two of my classmates did and loved it, although they opted for more academic four year programs and also saw the large Spanish speaking population as a possible hindrance since they don't speak Spanish. I've seen some recent hate for Copa on SDN and want to counter some of the more common points:

- Some people said that rotating at so many sites is a red flag for the program. But I gotta say that I interviewed at a ton of awesome programs that rotate at multiple sites and believe this makes them all stronger. Northwestern ships their residents to Cook and Gary, IN for the gun and knife club experience to compliment their main tertiary site. Olive View has a county/academic split and also rotates at Antelope Valley for more procedural volume. Pitt has three hospitals to cover academic, county, and community. These are all very reputable programs that crank out awesome clinicians and leaders in the field. And talking to these residents, everybody preferred the county or "county-esque" hospital. And guess where you spend the majority of your time at Maricopa? The county hospital. It generally means more respect and autonomy for the ED, which was important to me. Just met an NP since matching who worked at Copa twenty years ago and said all her best stories come from the year she spent at county.

- Another complaint was that Maricopa is not a stroke or STEMI center. I rotated at two pretty academic shops which are stroke and STEMI centers and gotta say for the former the neuro team takes over and pushes tPA and for the latter you just activate the cath lab and send them upstairs. Sure, that's only my impression as an MSIV with two months in the ED, but I'd rather have a dedicated month of being the neuro team (which Copa does) than consult neuro for three years. Plus, you'll see those complaints at the community and academic hospitals you rotate at. Harbor is also not a stroke center, but I don't see anyone claiming they don't provide great training.

- Acuity: I saw some people who were worried about Maricopa's admission rate which is around 20-some percent. I truly believe that admission rate does NOT equal acuity. Nearly every transfer to a tertiary hospital gets admitted and by that time they're usually already stabilized with a working diagnosis. Automatic admission, but poor learning opportunity imo. At my home program there is a dedicated oncology section of the ED where the admission rate is super high but the residents don't even rotate through there because it's plagued by boarding and every cancer patient has a super low threshold for admission. It seems like anyone on chemo who records a fever at their outpatient appointment gets a full infectious workup and automatic admission. I'm going into EM because it's at the frontline of the hospital and county environments are at the frontline of EM.

- Trauma: Yeah, there are a bunch of level ones in downtown Phoenix but both of my classmates who rotated felt there was more than enough trauma with solid penetrating. I'll also compare it to the academic centers I rotated at where all the traumas were either transfers (also already stabilized) and falls from standing height outside of Bob Evans. And I interviewed at super busy trauma centers (Carolinas and UW) where the seniors said there was "almost too much trauma" and that after your third chest tube you kinda already get the hang of it. It seems that Copa gets above average trauma and for most people the magic and sexiness of trauma eventually wears off. And if I don't get my fill, I'll do the South Africa elective at Copa where you're allegedly drowning in chest tubes and GSW's.

- Saw several complaints about the weakness of other residencies in the hospital and off-service rotations. Meh. Nobody I know going into IM have heard of Hennepin or Highland, but they for sure produce badass emergency physicians. I'm going into Emergency Medicine and Maricopa is a name within the specialty (even though my grandmother called it Capricola County when she found out where I matched).

So why did I rank Copa highly? It all came down to fit. It took a while for me to accept putting it above more legendary or prestigious programs with more resources, but I met several people along the trail who said the only people they knew who were disappointed with their residency picked their program based off ego. I just knew I would be super happy here: fun and sarcastic residents, cowboy county program, 3 years with 3 months of electives, blocked nights, best PD I met on the trail, sunny and affordable city with great outdoor access, and a bunch of Spanish-speaking patients which was something I was specifically looking for. Copa Pride is palpable and I didn't experience anything like it on the interview trail (except maybe the Slovis phenomenon at Vandy which, although enticing at the time, reaches almost cult-like status in retrospect).

And as somebody who grew up in a pretty middle American small town in a middle-class family, something about the desert was especially tempting. Rattlesnakes and scorpions that provide one of the best tox rotations in the country. Summer heat that will melt your feet and send you to the Burn ICU if you walk barefoot down the driveway to grab your mail. Dust storms and monsoons in July. I know this scared some people away, but holy **** this is the kind of environment that makes for great Emergency Medicine training. So if any of this resonates with you, I think you should check out the program for yourself. Hopefully I'll see you there.