Denver Health Residency Reviews

This will be the last review I post (I aplogize for not posting a UofMD one, I got lazy...but quick review here: Awesome program with a bad$$ PD who is committed to those he works with). Anyways...hope you guys enjoyed my adventures, I know I have. If anyone has any questions on the places I interviewd, PM me and I'll gladly share any other inside info I may have. Good luck and I sign off with Denver...

Denver Health

Residents: There are 14 residents per year in a PGY1-4 format (this format change is new as of 2 or 3 years ago). Everyone here is super happy, and the majority of them ranked Denver #1 (the newest class, only 1 person did not rank it first). Everyone works and plays hard here, especially with the mountains and snow about 30 minutes away. The residents spoke of the rumor that the program is malignant, but said it's malignant if your definition of malignant means you work very hard. Otherwise there were a few minor complaints, mainly being that there are only 8 weeks of elective time, and 3 weeks of vacation time per year (although they are adding 1 week of CME each year to somewhat make it a 4 week vacation). Otherwise, the residents love the program.

Faculty: The faculty are stacked with some big names in the field, and the residents only had great things to say about them. The faculty I met all seemed approachable and down to earth. Dr. Wolf, the PD, is 2 or 3 years out of residency (he's a Denver Grad). There is some diversity in the faculty, so no need to worry too much about inbreeding. We did sit in through MandM the day I was there, and I'll be honest, it seemed pretty intimidating compared to other places I've seen. It's hard to judge based on a 2 hour session.

Facilities/Ancillary services: The ED surprisingly looked very nice. There are two sides, medicine and trauma, with a total of about 30-40 beds including hallways. There are two resus. bays that can hold 4 patients total. The only other place we got to see was the MiCU, which is the nicest MICU I've ever seen, and it's large. This is one of the few county hospitals that makes a profit, and a lot is put into the facilities, as we can see. There will be a Peds ED built, that will be completed in 2010. Right now, Uof Colorado is the process of moving hospitals, and the move will be complete by the time the next class comes through. As for ancillary staff, there wasn't one single complaint. There is little to no scut.

Curriculum: This is a very front loaded program, with most of the off-service/ICU rotations occurring throughout the first two years. You work 8's at DG, and 12's every where else. These 8's quickly end up 9-10's as the residents don't really sign much out. It's a circadian rhythm, with 2 mornings, 2 afternoons, 2 nights, then a day off (1 day off per week is how it works here…it's a tough schedule). There is graded responsibility, which I'll touch on later.

Trauma: Run by EM. You being working trauma the second half of your PGY2 year, as the junior. You get a ton of procedures. At all the other sites, you help run trauma as a first year. As a EM3, you run the traumas, and run airway. Plenty of trauma coming through DG.

Peds: 5 dedicated months (used to be 4 but the UofCol. Hospital move will free up 4 months since they will no longer have to cover two sites). EM1 year, you do peds surg, giving you procedures like lines and intubations. Peds ED will be built by 2010 (although they aren't sure how the curriculum will adapt to it). Otherwise, there are peds cases that flow to the other hospitals, so there is plenty around. Denver childrens (which you get 2 blocks at) will be moving to a new location in the next two years, causing the overall DG peds volume to increase anywhere from 15-20%...plenty of peds experience). Fellowship is available

Subspecialty/Electives: There is an integrated 4 weeks of both tox and EMS, both as an EM3. There will be opportunities to fly, as they are bringing that back into the curriculum (optional). Otherwise, there are only 8 weeks of elective time starting your EM 3 year. International opportunities are available for electives. There are fellowships in tox, EMS, ,and research.

US: A 2 week US block is being added to the EM2 year. Otherwise, it's pretty active in the department. There is an US fellowship, also.

Didactics: Strong, protected unless on a unit month. Otherwise, your basic package with plenty of lectures/activities to keep things fresh. Teaching month is being added to EM 3 year.

Responsibility: Graded increase. 4th year runs Denver Health. 3rd year runs trauma and is the senior at the outside places, etc. etc. Same as many of the other places.

Patient Pop: DH is the safety net/county hospital, with plenty of trauma. Denver Children's gets the kids, UofColorado gets the tertiary care stuff, Kaiser/St. Joe's rounds out the community experience. Very well rounded clinical experience with plenty of sick people around. Very diverse population.

Location: Denver. This is an awesome place to live and everyone I talked to is enjoying it. It's a city surrounded by plenty of mountains and snow…and the residents actually pitch in to get a cabin. Many work, drive up to the cabin to sleep, wake up and board/ski, drive down for their shift. The night life is plenty, and it's an affordable place to live. About half and half own/rent.

Overall: I really loved this program. The curriculum is strong, the faculty is awesome, the clinical experience is diverse, and the location is excellent. I loved the city just as much as the location. I will be ranking this very highly, likely in my top 2 or 3. It has stiff competition with the other two programs I fell in love with on the trail. It will ultimately come down to my gut feeling of the place.

I am happy to elaborate more about the places I interviewed...
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1) Denver: (+): amazing program, amazing location, 4th years blew me away managing ED. (-): almost no elective time
2) Hennepin: (+): very surgery-based program, Pitbosses run the ED 3rd year, critical care emphasis. (-): Minnesota.
3) Highland: (+): autonomous training, great group of people, nice location, self-sufficient residents. (-): unsure about strength of off-service rotations.
4) MGH/BWH: (+): great city, great resources, phenomenal international health program. (-) young program, 1 million potential consultants to be called
5) New Mexico: (+): great program, super nice people, SICK patients, nice outdoor recreation nearby, critical care strong. (-): location seemed a little ghost-townish for me, issues with movement of pts through department & flow
6) UMichigan: (+): huge critical care, no medicine wards, diverse training sites. (-): not a huge fan of the location/weather, worried about the # of consultants that could be called.
7) Bellevue: (+): big time autonomy, self-sufficient residents, reputation. (-) I am a little intimidated about the idea of living in Manhattan .
8) Maine: (+): the most friendly people ever, location. (-) seemed a little cushy for me
9) BMC: (+): location, underserved patient population, lots of trauma. (-): 2-4, PGY2s do ALL procedures in dept.
10) OHSU: (+): location. (-): didn't gel with the people
11) UC Davis: (+): sick pts. (-): nothing really set them apart, location
12) UCSF Fresno: (+): Yosemite, nice people. (-): couldn't really see value of 4th year, living in Fresno.
13) Stanford: (+): Paul Auerbach, lots of resources, bay area. (-): pts not sick enough, a little too academically snooty for me
14) BIDMC: (+): location. (-): unfriendly, extremely academically snooty people
15) Indiana: (+): fantastic program. (-): location

I also interviewed for the UVM Preliminary Medicine Year and the Transitional year at UC San Diego, so feel free to ask me about those...

Please note: the (+) and (-) are only my opinion. I'm sure there are several other people who had totally different experiences and therefore completely opposite opinions (which is why the match works!)

Denver - 4 Year Program

Residents - 14 residents per class. Some classes have more men than women...other classes its the other way around. Most recent intern class has 6 women and 8 men. From talking with the residents it seem that about 50% are married and the other are single with many that have significant others. Not as many residents with children...about 1-2 residents with kids in the EM 1 and 2 years. More residents with children in the EM 3 and 4 years. Last year's class had a lot (6) residents from the University of Colorado. The remaining classes seem to attract residents from all over. Many of the residents like to ski and spend time outdoors. Program director said that about 75% of the graduates stay in Colorado since many were attracted to the program in the first place because of the location. All the residents seemed friendly and easy to get along with.

Faculty - Dr. Wolf is pretty young program director. This is I think both a positive and a negative. He has some great ideas on how to make this program even better and he spent several years as an associate PD before taking on the role of PD. He has been program director for about 3 years. I think the negative here is in terms of experience but all the residents seem very happy with the changes he has implemented. The other faculty I met all seemed very approachable and easy to talk with. None of the residents picked out any one faculty that was difficult to work with. It seems like there is an older group of faculty that have been at Denver for quite a bit of time and a younger group (many of whom are graduates of Denver). The physician who wrote the book on EM Ultrasound (John Kendall) is on faculty at Denver.

Interviews - Four 20 minute interviews. Two interviews with University Hospital faculty and two with Denver faculty. One of the interviews is either with the program director or one of the associate program directors. The interviews were all laid back and focused on wanting to know the applicant and motivation for going into EM. Most of the interviewing faculty had looked over your file but some some do not so that it doesn't influence their interview.

Hospitals - The majority of time is spent at either Denver (county hospital) or University Hospital. There are a couple of months spent at other private hospital like Saint Joseph. We only spent time at Denver Health and so I'll just comment about that hospital. The ED is not the largest I've seen. There are two sides to the ED - a medical section and a surgical/trauma section. The facilities definitively have a county feel to it - although it is very clean and kept up. There is also a separate area in the ED for psych patients. There are several major resuscitation rooms in the surgical area with one that can also be used for pediatrics resuscitations. Denver uses a paper charting system in the ED. Once patient encounters are done, it appears that they scan those documents into the computer so that it is easier to get access to that information although it still doesn't have the advantages of being electronic and thereby legible and easily searchable. The other hospitals have electronic medical records. The rest of the impatient hospital looks quite nice for a county hospital. They have 1-2 CT scanners available for the ED...not sure about MRIs available. They are planning on a new separate pediatric ED at Denver that should open in 2010 since the Children's Hospital moved to the suburbs. Even though they see pediatric patients at Denver, I don't think it is an ideal environment for kids and so this new pediatric area dedicated to taking care of kids should be a welcome improvement. They don't have a high peds volume (11%) at Denver but they report that number has increased significantly now that Children's has moved to a different location outside downtown Denver. There is 24 hour faculty coverage at Denver with double attending coverage for 81 hours a week.

Patients - about 40% of patients at Denver are Hispanic. About 10-15% African American. The remaining are Caucasian. Denver Health sees the county patients and thus higher acuity. University Hospital sees more patients with insurance and the private hospitals deal with HMO patients. I think you get exposure to a good amount of pathology at Denver because of the diversity of settings you train in.

Ancillary - Residents had no problems with nursing and other support staff. There is a good mix of ages for the nursing staff. Residents don't do IV draws or transport patients unless they want to. Support staff seemed excellent.

Curriculum - 4 year program with increasing responsibility as you get further along in your training. The first year is closer to an internship than a typical EM first year. You spend 3 months in the ED during the first year with quite a few months on floor services, ICUs and surgical teams. I think this is a positive to spend a couple of months on the floor so that you get to work with the other interns. Many residents commented about how that first year with other interns makes their life a lot easier during years 2-4 because when they call up to admit a patient they are often talking with other interns that they know personally. Year 2 residents work primarily with the medical patients at Denver and work on surgery/trauma at University. Year 3 residents work in the surgical/trauma area at Denver and function in supervisory roles at University. Year 4 residents run the ED at Denver and spend the most of their remaining time at the private hospitals. There is less elective time that what is available at other 4 year programs but they emphasize that most of what you would do during elective time has already been included in their curriculum like Ultrasound/Toxicology/EMS/Teaching months ect. There are only 6 weeks of true elective time which you can use to pursue other areas you are interested in. They have an interesting block where they spend time at a malpractice insurance company reviewing cases so that they can learn how to avoid such problems in the future. There are a couple months spent exclusively at Children's for pediatrics but the remainder is peds patients seen at Denver on your regular shifts. I think they get a good amount of procedure experience with many residents getting opportunities to do ED thoracotomies. It also seems that they get good experience with fracture reductions with ortho backup as necessary.

Didactics - Every Wednesday there is a five hour conference in a beautiful new auditorium. Somewhat different from other programs, they have weekly M&Ms which seemed informative but benign. Faculty give most of the main talks but residents are expected to give talks several times a year. EM2s participate in clinical debates where the residents taking differing positions on some aspect of patient management and try to find literature to support their viewpoint. The EM core curriculum is covered in 24 months and thus you are exposed to that information twice during your residency. Didactic time is protected and so attendings cover the ED during that time. Also there is a 10 minute didactic teaching session at the end of each shift and so you get two more teaching sessions / rounds with staff twice in each shift.

Research - There are several active areas of research going on the ED although the amount of research and resident involvement in research seems less than at other institutions. I think if you want to do research here, there should be plenty of opportunities available.

City - Denver is a beautiful city with lots of do outdoors and the mountains are just a couple of hours away. Median home price for the Denver area for the last month of sales were about 220k and condo prices were about 135k. Cheaper than the coasts but still more expensive that some other areas. 300 days of sunshine in Denver. Weather is pretty mild and even though there is snow during winter it is not nearly as cold as other parts of the country. Residents seem to live all around the city. There is a light rail system in Denver but I'm unsure as to what are all the areas it covers. Traffic can be pretty bad in the mornings if you are driving into the city.

Negatives - I think the biggest thing for me was lack of dedicated pediatric ED at Denver with consistent access to pediatric patients throughout the four years but that should be addressed soon with the creation of a pediatric ED. Other than that just a complaint about where they decided to do the preinterview get together - it was ridiculously loud and thus we could hardly hear the residents as they tried to talk with us even if they were standing next to us!

Positives - The fourth years that come out of the program are truly impressive. It was amazing to watch the seniors sign out to one another and to know that they felt comfortable managing over 20-30 patients at a time in the ED. I think this program does a great job of helping you get ready to teach and work in an ED with confidence by the time you are done. The amount of autonomy available for patient care at Denver seems unmatched. It was very clear why so many of the leaders in EM came from here. Also they have a good retirement program (401a) that they put money away for you during your residency and so it adds up to another 40-50k in your retirement account by the time you finish at Denver.

Overall - Denver is a great program with many years of experience in resident education. The department of EM revolves around residency education. I think you would be well prepared to face anything after leaving residency here. I would be happy to match here.

Denver Health-University of Colorado

Residents: 14 residents per year. I was able to meet several of the residents the night before the interview at the social. The residents were very nice and seemed to get along well with each other. Different from other places I’ve been, I really felt like I had to extend myself to talk to the CU residents at the social. Otherwise, I noted two themes for the night, emphasis on the “intensity” of the program and fabulous recreational opportunities that abound in and around Denver. The residents I met were from all over the country. About 75% of DH graduates go into private practice.

Faculty: Dr. Wolf is the PD. He is a young, bright, enthusiastic leader that believes that the mission of Denver Health EM is to train leaders in EM. The department reports being committed from top to bottom to the mission of residency education. The other faculty members that I met with were all very friendly, engaging, thoughtful and excited about their program; of note, they were also all graduates of Denver Health residency program.

Ancillary Stuff: By all reports, the ancillary staff is amazing.

Curriculum: They use a PGY 1-4 format. The intern year looks similar to a transitional year with general medicine wards, general surgery, ped surgery, and neurosurgery 1 month rotations. However, they steep you in critical care as a PGY1 with 3 ICU months (2 MICU, 1Burn ICU). PGY 2-4 schedule definitely puts greater emphasis on EM time; however, elective time is limited to 8 weeks for the four years. Dr. Wolf, the PD, was quick to point out that rather than giving free elective time, they have created required rotations in areas that would otherwise be frequently selected as elective time, such as ultrasound or administration.

Facilities: The primary training facility is Denver health. The hospital is located in downtown Denver and is, I believe, 1 of 2 level I trauma centers in the city; the ED was renovated in 1994. Though a publicly run hospital it is reportedly well managed and has no known financial issues. Residents also rotate at University hospital, St Joes (community), and Childrens. Denver health is in the process of building a children’s ED.

Negatives: Academic emphasis seems to be on teaching, with little emphasis on clinical research. Also, just to address an issue that some may feel is negative, Dr. Wolf directly responded to the rumor that the program was “malignant” (something I’d not heard) stating that he believed all residents were treated with respect but that they work very hard. Likewise, the residents reported feeling like they had a say in their education but all echoed the mantra: work hard, play hard.

Interview Side Note: For those interviewing at Denver Health…if you require a morning cup of coffee, have it before you arrive at your interview as none was offered to my interview group…

Overall: This is a strong program with a wonderful reputation. The clinical education is solid; we were told that graduates get to pick their ultimate destination, even in the tightest job markets. I was left with the feeling that I would be very happy with my training coming from this program. I asked one of the faculty members (and grads of the program) why he had selected DH for his residency he said, “I wanted my worst day in the ED to be while I was a resident…not once I was an attending.”

Disclosure: I rotated and interviewed at Denver. I will evaluate the residency program first from the perspective of an interviewee, and will then provide comments about the rotation specifically.

Program: Denver Health Medical Center (formerly Denver General) I’ll abbreviate DH and DG just to keep you on your toes.

Intro Note: I am only reviewing Denver Health, but almost half of the EM months are at University Hospital. With a few exceptions, the faculty do not overlap but the faculty at University do have full academic appointments. From what I’ve heard, people like University and they get lots of responsibility there as well.

Residents: The residents are awesome. Friendly, high energy people who are very laid back but at the same time very intense if that makes any sense at all. They’ll joke around with you when things slow down and they were very proactive in getting to know me. They do go for breakfast after night shifts and beers after evening shifts – sometimes this group includes nurses and techs as well. They’ve been known to go skiing between night shifts – I guess this is what they mean by work hard play hard!

Faculty: The faculty are pretty amazing. You’ve got a handful of the old guard who had a hand in starting our field and a lot of young energy as well. It seems like maybe 60-70% trained at Denver and 30-40% elsewhere – including many top programs such as Harbor, HCMC, Highland, and Arizona. These are accomplished faculty members who are producing a ton of high quality clinical research. They are also excellent clinicians who enjoy doing emergency medicine.

Facility: Well, it’s county. No sliding glass doors here. This is not important to me, but if it is to you then you’ve got to take a look at it. I actually prefer the older ED’s to the new ones – they are set up better for doing critical care because there’s not so much emphasis on privacy and you can see all the rooms from the physician’s station. Plans for a new ED are in the works after the new children’s ED gets built but I don’t know when it will happen. Currently divided into a trauma and medical side – trauma has 6 monitored critical care beds, 12 general beds, and 10 hall beds. Medical has 15 private rooms. There’s a grease board on each side and all the charts are paper – It’s old school and I love it that way. EKGs and past medical records are on the computer. They have PACS

Ancillary Services: Bar none. Most of the nurses and techs are young and love what they do. They love to work hard. That being said, sometimes they are stretched thin.

Patients: Distinctly urban and county at Denver Health. Lots of critically ill medical patients, lots of codes, crazy Friday and Saturday nights, crazy trauma. Lots of drunks and psych patients which are not separated out. It’s a little noisy, a little chaotic on a busy night – just like an ED should be. There’s a lot of bread of butter stuff thrown in as well. I hear that University gets you some urban poor as well, but also your referral patients.

Clinical Training: One of the stand out features. These folks wrote the book on progressive responsibility. R1’s are mostly off service as the R1 year is more of a prelim year split between medicine and surgery. R1’s in the ED present one patient at a time and are closer to medical students than R2’s (in fact, we were allowed to switch shifts with interns). R2’s at DG take the monster jump to running the medicine side – that’s 12 beds of sick patients minus what the interns/students see which averages to about 6-8 at any one time. The R4 checks in with the R2 occasionally and the attending might even say hi to you as well. The ED is single coverage 7-3 and 11-7 so during those shifts the attending may not come back to the medicine side much if there are lots of critical cases in the front rooms. On the flip side, sometimes the attending spends lots of time back there, so you have to be comfortable with both styles. At University, the experience is quite complementary as the R2 sees the trauma and critical patients there. The R3 runs the DG trauma side, doing tons of procedures and getting every airway, while doing medical and supervision at University. R4’s do DG and privates only – no UH. At DG, they run the entire department including precepting the medical students + interns and providing guidance for the R2’s and R3’s. At sign out, everyone gathers in front of the grease board as the outgoing R4 signs out the entire department to the incoming senior, which is impressive to see. They are expected to know everyone in the department. The attendings don’t fully staff every patient, which means they are very available for teaching and interesting cases.

Didactic Training: Conference is impressive. The first 90 minutes every week is “M and M” but it’s not all M and M – some are just interesting cases. Some weeks are dedicated to Peds and others to prehospital. The paramedics attend the prehospital M and M and the folks from Denver Children’s attend the peds M and M. M and M is very well attended by UH and DG faculty. It gets some lively discussion going amongst the senior residents and faculty but is not confrontational. It is, however, on the more formal side. R4s present the cases with juniors at their side to add in the details and the attending on the case ad libs from the audience. There rest of the conference is the usual and very well done.

Peds: They see some kids at DH but not a ton. DH is opening a Peds ED soon that DH faculty will run and I think that’s pretty exciting. Denver Children’s is the current Peds exposure and I’ve heard it’s great. I think it’s all in blocks however, not integrated.

U/S: U/S is very strong. They have Dr. Kendal who wrote the book. They U/S everything. And, a bonus, you get to do all this with antique US machines, so you feel very connected with the roots of U/S. I hear they are getting new machines but the 4 beasts they have know look like they came from ‘Nam. That doesn’t stop them from using them al the time. They do their own transvag US and often send the patient for a formal study to confirm. The fellowship trained folks and the U/S fellows do crazy ultrasounds for nerve blocks, pneumothorax, underwater, etc.

Research: Dr. Haukoos, the Research Director, has some top-notch multi-center NIH funded projects going and there are tons of research assistants crawling the department. Research wise, the most active department I have seen so far.

Other Curriculum Stuff: The R4’s are some of the most capable physicians I have seen in my short emergency medicine career and I think they have magical powers to be in more than one place at a time. After seeing them run the department, all I can say is that I want to learn to be like them.

Location: I don’t think I need to sell Denver to a group of people who tend to be interested in the outdoors. It’s an incredible city in it’s own right, even without all the super-close outdoors stuff.

Strengths: Progressive responsibility done right, R4’s are incredible role models and some of the best physicians I have seen so far, living in Denver, evenly split time between a county and university hospital, very sick patients, one of the birthplaces of emergency medicine, incredible reputation, one of the top EM clinical research centers, very active and outdoorsy nurses/techs/residents/faculty, open door to jobs in a very tight market if you want to stay in Colorado, awesome prehospital system with R4’s getting lots of experience answering med calls from the pareamedics, safety net hospital. ED autonomy – consultants are rarely called, you do your own crics, thoracotamies, etc. Great off service relations. The sign out rounds, pearl, and student-intern lecture really make this place feel different – it is very team oriented, and very evidence based. I really felt like I was part of something special here.


Weaknesses: The R1 year is a prelim year split between Medicine and Surgery. You have several general surgery and several general medicine months. Given the increasing rate of anyphylactoid reactions of many interviewees to wards months, I suppose this will be a negative for some. The PD argues (and I agree with him) that since you will be admitting 80% of your patients to the wards it doesn’t hurt to get some experience working on those wards. In addition, It’s a great chance to develop rapport with your colleagues who you will be admitting to for the next 3 years. Potential negative number 2 is that these guys work very very hard – I think something like 23 shifts a month for 4 years. The schedule is 2 days, 2 evenings, 2 overnights, and 2 days off. Your first of the 2 days off is your post-overnight day (i.e. you’ve already worked 8 hours that day) so I think it’s really debatable whether that’s considered a “day off”. This does not slow down as an R3 or R4, so you have to be OK with only really having 1 solid day off per week for 4 years. Then there’s the thing about less elective time but this has been beaten to the ground so I will just echo what other have mentioned that a lot of the would-be elective time is dedicated to things most people do electives in anyway like Tox, EMS, US, etc.

Rotation Specifics: Awesome rotation that I highly recommend. A quintessential emergency medicine experience. You get lots of responsibility to work up your patients and present mostly to the R4, although depending on how aggressive you are you can present to the attending as well. The R4’s are incredible teachers that give lots of pearls when they have time, although sometimes they are crazy busy and don’t have much time to spend with you – but this is common in ED’s that your teaching is somewhat dependent on how busy it is. There’s a 30 minute student intern lecture given by faculty at the beginning and end of every shift, which means that over the course of the rotation you will get 30 short faculty lectures. In addition, there’s the pearl for everyone at the beginning of every shift so you’ll get 30 of those to. Denver rotates a lot of students, and sometimes there are 4 students and 2 interns working in the department. In these situations, it gets challenging for the R4 to take all those presentations so things get a little backed up. Also, with 6 students/interns on many shifts I often felt like there weren’t quite enough patients. All but one or two interns in this years class did a rotation at DG, so that’s something to think about as well. I had the time of my life working here and would do it again in a second.

Overall: This is one of the best residency’s I’ve seen and will be ranking it very highly.

Denver Health


I rotated at Denver Health and interviewed there in July so some of my memories are a little foggy.

Residents:.They have 14 residents a year. I worked with the chiefs for my month there and they were amazing. It was their first month acting as 4th years and they were very prepared. The chiefs were all awesome teachers and leaders of the ED. The interns, 2nd and 3rd years were also top notch, very friendly and always willing to teach and help a medical student look the best they could.

Faculty: The faculty was great, a few older docs who have been around awhile and know how to uphold the “DG” reputation. Lots of young new blood from places like Harbor, Hennipen and Denver itself. All of these doctors were amazing teachers. They all expected a lot from students and residents, but I’m convinced that this is not a bad thing, the harder they push you to learn the better you will be. And I have to say I didn’t see one that was malignant, and even the one who is a little more gruff brought food every shift for the ancillary staff and residents. Dr Wolf is the PD and is very loyal and exvited about the residency, he is making changes and this is impressive since Denver is such a well established program. I didn’t work at the University but from interactions at lectures the faculty there seemed great too.


Ancillary Stuff: Honestly, at DH the staff was amazing. Everyone is very proud to work there and they work very hard. The Techs are busting their butts as well as the nurses and I never saw a resident do any true scut unless they wanted to, the worst it got was getting your own supplies for procedures and cleaning up afterwards, but I don’t think we are above that.

Curriculum: 1-4 program. The intern year is pretty much a split between surgery and medicine with a few ED rotations thrown in there but really just a transitional year half the time as a medicine intern and the other half as a surgery intern. In the ED you are expected to act like a “Med student on steroids” (not that they condone performance enhancement). As a PGY 2 you are upgraded to a PGY2 on steroids and you are mostly in charge of the medicine side of the ED(I’m not sure the role played at the university). The PGY3 is a PGY 3 on steroids, they run all of the trauma bays and just seem to be doing procedures all day and night. They are busting their tails and are awesome to watch in action. At the university they run the ED just like the PGY4s do at DH. Th PGY 4s like I stated previously are awesome, running a county hospital with attending supervision but rarely needing attendings to step in. They are supposed to know what is going on in every bed(almost 50 if the hall beds are used). They sign out to each other at the end of shifts and talk about every patient, pretty amazing if you ask me. Some notes. Ultrasound is built in with everyone taking a month. They are building a children’s ED at DH so that will change the peds experience.

Facilities: DH is pretty nice for a county hospital but not as fancy as some of the private hospitals I interviewed at. The University should be very nice since it is new. Children’s is also new and you rotate at ST Joes a private hospital during your 4th year.
Negatives: They do work hard, they work 6 shifts on 1.5 days off, but they are only 8-hour shifts. They don’t really sign out very much at the end of shifts when you are a second and third year, most ended up staying quite awhile after their shifts. The 4th years however seemed to always leave within an hour.

Overall: Great program, very strong and deserving of the reputation it has upheld for years. Lots of young energetic faculty ready to carry on the tradition. Whether you like a fourth year or not is personal, but this program really does turn out great physicians. Denver is a nice city with a great downtown and mountains fairly close. The residents seemed happy with their training and often stated they felt like they could go anywhere they wanted to work. I thoroughly enjoyed rotating at Denver and it will be ranked very highly on my rank list and I would be very excited to match there.

Denver Review

Pre-Interview Social: The night before interviews started with a tour of University Hospital, followed by dinner at Pasquini’s, which is a pizza place. A bunch of residents showed up, all years. They seemed pretty tired, especially the PGY2s, but all of them said that they liked the program and were glad that they had come. I was asking the residents around me a lot of questions about the work environment, and the general consensus was that they worked hard but that the program is not malignant in the sense of abusing them.

Interview Day: We started at 7:30 AM with an M & M conference, followed by a talk by the PD. Then we had some interviews, lunch, more interviews, and a tour of Denver Health. (There were two interviews before lunch and two interviews after. Not sure why they break it up.) I had four interviews with two associate PDs and two other faculty. Some people had interviews with the PC, which I had never heard of a program doing before! The interviews were 15 minutes each with four 15 minute breaks. All of the interviews were pretty relaxed. I was asked about my support system, where I want to be in 10-15 years, why I was interested in a four year program, and to tell about myself. Everyone also asked me what questions I had, so make sure you’re prepared to ask questions!

Curriculum: Denver is a four year program. Hospitals include Denver Health (county hospital), University Hospital (academic), Denver Emergency Center for Children (at DH), Children’s Hospital, and St. Joseph (community hospital). They schedule shifts for 42 hours per week on EM rotations, with 8 hour shifts (but 12 hour shifts at the private hospitals). They try not to sign out patients. Residents said that they typically stay over about two hours at DH, but there isn’t any time over at the private hospitals. So it’s more like they’re working 10s at DH and 12s at the other sites. They follow a circadian schedule of two days, two afternoons, two nights, and two days off. The number of shifts doesn’t decrease by year, but they have easier rotations in later years. They have 1-2 blocks of PEM each year and longitudinal peds exposure at St. Joseph and Children’s. There are 32.5 total months of EM, including six months of peds EM and two months of EBM/teaching. There are four months of ICU and two months of elective time.

There isn’t an orientation block, but they have two days of orientation at the end of June that are mainly for administrative chores. There are also some didactics and a new resident picnic. PGY2s have a five day orientation with didactics, labs, ATLS, and social events. Denver used to be a 2-3-4 program that is now a 1-2-3-4 program, and the intern year still has floor months in gen surg, IM, and neurosurg. Basically the intern year is 1/3 each of medicine, surgery, and EM/anesthesia. They do two weeks of anesthesia and two weeks of EM cards now instead of four weeks of anesthesia. Ortho is ED consults. PGY2s abstract the medical literature for JEM and get a pub. Their OB is in PGY4, which is kind of odd, but they said it’s because the PGY4s are able to focus on resuscitation rather than on the mechanics of delivering a baby.

All major EM subspecialties are covered, including tox, trauma, U/S, and EMS, though there isn’t an actual trauma block. The associate PD I talked to is kind of anti-certification (in general, not just for U/S), but the residents can get credentialed. EMS includes ridealongs, captain shifts, optional flying, administration, and paramedic lectures. There are two unique and really cool rotations. One is their medicolegal week, where they work at a medical liability insurance office. The other is the two EBM/teaching blocks. The PGY3s are on teams with an attending, two residents, and four med students. The PGY3s lecture to the med students and also teach med students one-on-one, plus do sim cases with them. They are observed by faculty during these activities and given feedback on their teaching, as well as on their ability to give feedback to the students. In addition, Denver has optional academic tracks in administration/leadership, global health, med education, research, and wilderness med.

Didactics: Didactics at Denver seem to be a high priority, and they are working to make the curriculum more interactive. Besides the usual faculty lectures, M&M, etc, residents are expected to give several talks starting in PGY2. There is a modular reading curriculum with assigned readings, weekly quizzes, and group discussion of the quiz questions. They also do sim cases, oral board reviews, and journal clubs.

Benefits: Benefits are good, the same for residents as for faculty. They are given books for the first three years and lots of support for research, including a resident research fund, a stipend to present research, and a research associate program (college students who help enroll patients in the ED). Residents with IRB approval and a reason for needing extra research time can get up to four additional research weeks (taken from EM rotation time) on top of their elective time.

Administration: The PD addressed the reputation of the program for being malignant and emphasized the resident wellness resources. First, there is their ACES program, which is an optional group that meets several times per year to discuss a variety of topics like dealing with difficult patients, ethics, art, and literature. They have a residency advisory committee chaired by the wellness chief resident. All residents attend their meetings and no faculty are present. There is also a residency wellness committee where a peer-selected resident and faculty discuss issues brought up by the advisory committee. Several support systems exist, including a buddy program with upperclassmen, a mentor program (they get a new mentor each year), and class wellness reps. They have yearly retreats for each class (2.5 days long).

Denver: Great city, really beautiful, bike-friendly, great for outdoor activities. COL isn’t too bad.

Summary: Denver is a pretty amazing program that seems to be strong in just about every area of importance to EM. They have tremendous research experiences, but also strong county experience and plenty of community experience. I really love the idea of the EBM/teaching blocks, the medicolegal week, and the academic tracks. The ACES program sounds terrific and something I’d definitely be interested in doing. It’s cool that everyone gets to write something for JEM and graduate with a pub, too. If you want to do research, there are tons of resources in place to help you. They really emphasize EBM. There are also a lot of opportunities for teaching med students, paramedics, etc. They have great benefits and the city is really nice. It seems like there are a lot of resources in place to hep with resident wellness, and the residents themselves don’t seem to feel like the program is malignant. They do work hard, but that’s not the same thing as being abused, which is how I would define “malignant.” There’s no doubt that people come out of there extremely well trained and prepared for whatever they want to do in EM. Like everyone else, I was very impressed with how the PGY4s do their signouts.

Probably the major thing to consider in terms of cons is whether you want to spend four years in an environment that is this intense. It’s not only the work environment itself that is so intense—it’s the general way of life. What I mean is that these people don’t just go for a jog after work; they run an ultramarathon! As far as malignancy goes, I think it’s in the eye of the beholder. It didn’t seem malignant to me, but I was only there for two days of interview. So I talked to two students who rotated there. One did feel that the environment was malignant, and the other felt that it wasn’t but that the residents work too hard. They are increasing the class size to 17 for our year, so that should help ease the work schedule a little. Also, of course a lot of people are going to be turned off by the extra year and the floor months. I’m still not convinced about the value of so many floor months, but I do think the extra year can be valuable if you’re interested in an academic career. I also don’t like that there is no orientation month.

Overall, I was very impressed with this program, but I just don’t think I’m man enough for it. My motto is probably more like “work hard, rest hard” rather than “work hard, play hard.”

so to all those applying/interviewing at Denver this year.. a few caveats from a current anonymous resident (ie take this fwiw):

- yes, we are STILL having problems with hour restrictions. this has made a lot of our lives miserable, even until the bitter end of fourth year. they are trying to make more elective time but we always get pulled from them for sick call! and intern year just sucks.

- yes, even residents within the program still think we are 'malignant' - yet another resident was fired this year without due process, only because of a visa problem. the lack of transparency and tyranny of the PACs meetings here is terrifying.

by all means, i love 95% of the residents, and probably 60% of the attendings, love working at DG (where you spend half your ED time) and know i can work anywhere after finishing here, but wanted people to know what they are getting themselves into. ask residents in private when you are here! i would have chosen somewhere else if i had known.

peace!

coinUntossed said:

so to all those applying/interviewing at Denver this year.. a few caveats from a current anonymous resident (ie take this fwiw):

- yes, we are STILL having problems with hour restrictions. this has made a lot of our lives miserable, even until the bitter end of fourth year. they are trying to make more elective time but we always get pulled from them for sick call! and intern year just sucks.

- yes, even residents within the program still think we are 'malignant' - yet another resident was fired this year without due process, only because of a visa problem. the lack of transparency and tyranny of the PACs meetings here is terrifying.

by all means, i love 95% of the residents, and probably 60% of the attendings, love working at DG (where you spend half your ED time) and know i can work anywhere after finishing here, but wanted people to know what they are getting themselves into. ask residents in private when you are here! i would have chosen somewhere else if i had known.

peace!

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If you decide to come back and post, answer me this... Why is the program so reluctant to join the rest of the country in terms of hour restrictions and looking out for their residents? I thought the old guard left quite a few years ago?

coinUntossed said:

so to all those applying/interviewing at Denver this year.. a few caveats from a current anonymous resident (ie take this fwiw):

- yes, we are STILL having problems with hour restrictions. this has made a lot of our lives miserable, even until the bitter end of fourth year. they are trying to make more elective time but we always get pulled from them for sick call! and intern year just sucks.

- yes, even residents within the program still think we are 'malignant' - yet another resident was fired this year without due process, only because of a visa problem. the lack of transparency and tyranny of the PACs meetings here is terrifying.

by all means, i love 95% of the residents, and probably 60% of the attendings, love working at DG (where you spend half your ED time) and know i can work anywhere after finishing here, but wanted people to know what they are getting themselves into. ask residents in private when you are here! i would have chosen somewhere else if i had known.

peace!

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As a current Denver Health EM resident I totally disagree with the above post.

#1 over the past 2 years our program has undergone dramatic changes to improve work hours. This includes expanding the number of residents. There is a zero tolerance policy from the residency leadership and they take the task very seriously in my experience, addressing any hours violations individually with the resident in a productive and non-threatening way. The intern year was the main offender, and it has been improved substantially.

#2 I thought intern year was awesome. Yes, being awake for 30 hours and carrying 7 pagers sucks (although that rarely happens now with the new work hour restrictions), and dealing with some of the day to day tasks on the off-service rotations can be painful, but I learned a ton during my intern year; it taught me how to be self sufficient, decisive, and efficient; it laid the foundation for the rest of my resident education. Our intern year is modeled after a traditional intern year, with a strong focus on critical care. At the end of the year I felt confident with the majority of ED procedures (including central lines and intubations), well trained in critical care, and I had a strong appreciation for my inpatient colleague’s day-to-day lives as well as their approach to patients.

#3 I really don’t think we are “malignant” at all. I’m happy. I’m also excited to go to my shifts. I love the people I work with. We work a lot, but I’m always within hours. I knew I was going to be working a lot when I signed up, that’s why I signed up. Don’t get me wrong, it can be really difficult physically and emotionally; this model is not for everyone. But, part of the reason that we are so badass when we finish this program is because we seen a lot of patients.

Even if you accept everything that was said in the previous post you should know that our leadership wants nothing but to train the best EM physicians in the country. They’re not out to ruin our lives. In the years that I’ve been here I’ve seen things change a lot, all for the better, and all in response to resident feedback and hours rules.

I too encourage you to talk to the residents when you’re here. Ask us the tough questions. I think you’ll find that the sentiment described in the above post is really in the minority.

As another DG resident, I wanted to second DGresident's post and add my own two cents.

First of all, I think it is very unfortunate that our program has the stigma of being "malignant". I think that reputation was formed long ago and has continued to be perpetuated despite many changes that have all but eliminated any element of "malignancy".

Admittedly, when I first matched into this program I had some fear that I would get here and be subject to some injustice or mistreatment that was not evident from the outside. However, that couldn't be further from the truth. I love this program, and I have yet to ever feel like I am the victim of some abuse or that I am in a place where the staff or my fellow residents weren't trying to help and support each other. In fact, I am very impressed by the level of support we have here.

Most of the program leadership (PD and APD's) has been in place for less than ten years. They bring a nice blend of faculty that has trained here and others that completed their residency at other high quality training programs. This has allowed them to combine the qualities that have made Denver Health one of the highest quality and most well respected programs in the country since its inception (training at two excellent facilities, including one of the top trauma centers in the country, bringing in motivated residents that are willing to work hard, seeing a high volume of patients, having a graded responsibility system in which residents are forced to push themselves and grow over the four years, allowing hands on teaching from intern year on, focusing on teaching leadership skills as well as clinical skills, fostering an atmosphere in which residents look out for one another) with a newfound focus on maintaining resident wellness (an almost annoyingly strict monitoring of duty hours, threatening to pull our residents from off service rotations if they aren't allowing us to comply with duty hours, changing curriculum based on resident feedback, having leadership in place that is clearly passionate about the residents and are always available to discuss any issues that come up). With no disrespect to some of the prior administration at this program, who were some of the forefathers and pioneers of emergency medicine but had the reputation of being a little rough around the edges, the leadership in place now clearly wants us to be trained as excellent emergency medicine physicians and understand the importance of keeping us happy and healthy in the process.

Addressing some specific points:

-As for upper level residents getting pulled for sick call, it certainly has happened more this year. That is due to a few unfortunate circumstances in which classes have lost a resident. All of these situations were unique to the resident, and in my opinion were not a direct result of the program itself.

-I totally disagree with the idea that our PACs meetings are tyrannous or not transparent. I have never seen said tyranny. And the lack of transparency thought stems from the leadership being unwilling to disclose the details of a situation in which a resident had to leave the program. They were trying to protect that resident's right to privacy, not trying to hide things from us.

-Intern year is awesome here! There is a focus on critical care and building foundational relationships with our off-service colleagues that we will work with for the next four years. They have also made changes to some of our rotations based on prior resident feedback that have greatly enhanced the usefulness and enjoyment of those rotations. When you are in the ED, the entire focus is on building your knowledge base and doing procedures. There is no pressure to move the department, only to work one on one with the senior residents and attendings, to ask a lot of questions, and to push yourself as the year progresses.

-I can't think of a single attending here that is universally disliked by the residents. Some attendings may still be a little gruff or intimidating, but I'm sure we have no more of those than any other program. And I have no doubt that every attending that works here does so because they enjoy training highly competent EM physicians.

-Finally, I will concede that we work hard at this program. We work a lot of shifts, and from second year on each shift pushes you to see a lot of patients. In the end, I think this is a large part about what makes us such great EM physicians. If your learning style is more conducive to having a light clinical workload and relying on a lot of reading to be the base of your learning, this is not the place for you. But if you are willing to bust your butt every shift while working with good people and having fun doing so, I don't think you can beat DG.

I agree with coinunflipped on one important point – when you come here to rotate/interview, ask the residents their opinion of the program. With the possible rare exception, I think you will find all of us are generally happy, excited to be here, are proud of this program, and if we had the chance to do it all again, we would choose Denver Health again in a heartbeat.

Best of luck on the interview trail!

peace!

Hi, since it’s been some time since the last major update, can someone familiar with the program (preferably a current resident or recent grad) comment on the following?

• What are the average number and length of shifts (in hours) per month for each PGY year? Is there enough time to pursue academic/professional/extracurricular interests?
  
  
• Are shifts stratified by acuity (e.g., “trauma” shift or “resuscitative” shift), or is the entire spectrum of pathology/trauma seen on each shift?
  
  
• Who runs the trauma, EM or surgery residents, or is it an alternating schedule?
  
  
• Who does the emergency procedures (intubations, chest tubes, resuscitative thoracotomies, etc), is it shared with anesthesia/surgery residents based on an alternating schedule?
  
  
• Are there any emergency procedures that EM residents are not allowed to do (RSI, thoracotomies)?
  
  
• Is there frequent commuting between off-site locations (not including the dedicated training blocks)?

Thanks so much for your time and contribution.

• What are the average number and length of shifts (in hours) per month for each PGY year? Is there enough time to pursue academic/professional/extracurricular interests

The curriculum focuses on graded responsibility. Intern year you spend lots of time in the ICUs plus some other off service time (EKG class, anesthesia rotation and so on). In the ED, you work a rotating schedule where you work 6 of 8 days while at Denver Health and University. 2-4th year, another clinic site gets added and you usually work 3-4 days/week when at the community site. As you progress through residency, the shifts/month does not change at each site, but the time you spend at each site changes resulting in significantly less shifts during your later years of residency but averaged over the year (excluding elective time).

I think there is plenty of time to do other stuff, academic or not. Every year, there is a resident who sets some ridiculous number of days on the ski hill, usually 40+. Usually we all rent a ski condo together for a place to stay in the mountains, although there are plenty of non skiers here. People do lots of academic projects as well, there is time for both, depends on what you like to do in your free time. You also get time throughout the residents to devote to projects with no clinic shifts scheduled but not considered elective time. I think its formally called "scholarly project time" on the schedule.

• Are shifts stratified by acuity (e.g., “trauma” shift or “resuscitative” shift), or is the entire spectrum of pathology/trauma seen on each shift?

The DH ED is divided into a "trauma" and "medicine" side. At the university, there is a high acuity area of the ED that residents work primarily. DH and University both have a fast track/urgent care that residents do not work due to low acuity. Both sites have very high acuity and you can see anything on any shift, and you will. The goal is to make you a great ED doctor, and that experience comes from caring for lots of sick patients.

• Who runs the trauma, EM or surgery residents, or is it an alternating schedule?

The ED runs the trauma. Surgery gets called based on certain criteria then it becomes a collaborative approach. I guarantee that you will not feel like you lack trauma management experience.

• Who does the emergency procedures (intubations, chest tubes, resuscitative thoracotomies, etc), is it shared with anesthesia/surgery residents based on an alternating schedule?

Intubations-> ED, never seen surgery or anesthesia intubate a patient. Chest tubes-> most of them are done by the ED. At some point, I heard there was a rotating schedule or side or something, but never seen it actually put in place. If it's not the ED resident, it's often the ED resident rotating on the surgery team. I don't think the surgery residents are hurting for chest tubes. Thoracotomy->usually collaborative with the 2 senior residents from the services and the trauma fellow. I don't know of a resident who has graduated without plenty of the above procedures.

• Are there any emergency procedures that EM residents are not allowed to do (RSI, thoracotomies)?

I can't think of anything. I even drilled a few burr holes with NSGY as an intern.

• Is there frequent commuting between off-site locations (not including the dedicated training blocks)?

No.
Thanks so much for your time and contribution.[/QUOTE]

Interviewed at Denver recently and really liked it. Having said, what's up with the PGY2 class missing a resident? There are only 16 of them (class size is 17) listed as current PGY2s on the Denver EM website. Was that person fired? left the program voluntarily? I want to dismiss the malignancy rumors.... but I found that to be weird.

You work very hard at Denver and there's definitely a work-life balance sacrifice involved.

Some people like the intense training environment while others think its "malignant".

1. Maine Medical Center (+) No sub-specialty residency program (ortho, oto, ophtho) means you will be doing all reductions and procedures. Only level 1 trauma center in state. Majority of faculty are fellowship trained. Portland is an amazing city that is close to mountains and right on the ocean. By far the friendliest group of residents. 85K volume with only 10 residents/year. (-) diversity.
2. Hennepin (+) Prestigious. High volume >100K, lots of diversity. Lots of critical care. down to earth group of residents. Minneapolis is a great city. Manage whole ED as 3rd year "pitt boss", trauma surgery comes to level 1 trauma IF consulted (-) learn by brute force, very very high level of autonomy, no airway until 3rd year, lots of neurosurgery
3. UC-Davis (+) good balance of academic and county feel. high acuity, good volume 85K, Outdoorsy group - close to Tahoe. Bike to work 365 days/year. Spend time at Kaiser and academic center, good fellowship opportunities (-) serious boarding problem
4. Denver Health (+) prestigious. High volume. Spend time at both academic and county hospitals. Location. Reputation will take you anywhere after graduating (-) malignant, 4 year program, proud to be worked to the bone
5. New Mexico (+) good balance of academic and county access hospital, lots of diversity, residents were super cool, Sandias mountains extremely close, full time U/S teacher, 9 double boarded EM/CC faculty (-) albuquerque was a little too weird for me
6. Iowa (+) distinguished faculty, global health opportunities, good critical care, 9hr shifts (-) Iowa city, 60K/year
7. Oregon (+) location, variety of training sites, awesome turnout at interview dinner (-) 50K volume at main site, very small ED.
8. Utah (+) location, outdoors access. Community site was amazing, but only spend a few months out of three years there. (-) small academic low volume ED, pretentious.
9. Pitt (+) good variety of training sites, great reputation, jeep seems baller and great way to get admin and field experience (-) Pittsburgh seems a little rough, not much going on outside of pro-sports, new PD this year,
10. Cincinnati (+) well-oiled machine, prestigious, 6 mo. elective time, 90K volume and 100K at Cincinnati childrens, PD lets you transcutaneously pace him on interview day, full time U/S teacher (-) 4 years, location, 12 hour shifts
11. Regions (+) very laid back, 80K volume, international fellowship opportunity (-) didn't get a great gut feeling, only work evenings and nights 1st year
12. Arizona - University (+) diverse patient population, border health, global health, 85K/year, Rosen on faculty (-) Tucson is not super cool, 1 resident came to pre-interview dinner, like to do research, recently acquired by Banner HMO

Denver health review
Pros: residents seem very well trained, prestige, good mix of pathology
Cons: 4 year, location, proud to be overworked, paper charts still used in 2016 (though I believe they mentioned this was changing)

@Cinematographer that is from interviewing, shadowing, blah blah. spent a few days out there and felt like i had a good grip but obviously a few days is diff than doing residency haha

If anyone has questions about the program, post them here or shoot me a DM. Happy to help.

Can someone familiar with the program talk a little bit about how peds is done here? It seems like it is done in blocks, which is a bit unusual nowadays. Every other program I interviewed at has longitudinal peds shifts in each EM month, which I think make sense. Am I missing something or does someone have an explanation for why it is done that way? Thanks.

itsnotmeitsyou said:

Can someone familiar with the program talk a little bit about how peds is done here? It seems like it is done in blocks, which is a bit unusual nowadays. Every other program I interviewed at has longitudinal peds shifts in each EM month, which I think make sense. Am I missing something or does someone have an explanation for why it is done that way? Thanks.

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I asked this question when I interviewed and they confirmed they were distinct months; though they did say they make a point to spread them across the seasons from year to year.

mega_colon said:

I asked this question when I interviewed and they confirmed they were distinct months; though they did say they make a point to spread them across the seasons from year to year.

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That's the impression I was under as well - it's a bit different, but I guess they do end up getting 6 months of pediatrics overall as opposed to the usual 4. Longitudinal shifts seem to make a bit more sense, but maybe it just works better with their schedule that way.

itsnotmeitsyou said:

That's the impression I was under as well - it's a bit different, but I guess they do end up getting 6 months of pediatrics overall as opposed to the usual 4. Longitudinal shifts seem to make a bit more sense, but maybe it just works better with their schedule that way.

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What I was told is that peds shifts are 12s(?) and so they have difficulty fitting them longitudinally in their 6 of 8 schedule...though I was told peds shifts may be going to 8s and so these would line up nicely.

mega_colon said:

What I was told is that peds shifts are 12s(?) and so they have difficulty fitting them longitudinally in their 6 of 8 schedule...though I was told peds shifts may be going to 8s and so these would line up nicely.

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Currently the peds ED shifts are 10-hour shifts, not 12. Also, peds ED is done in a longitudinal fashion, not in individual blocks. PICU on the other hand is it's own block with 12-hour shifts.

Cinematographer said:

Currently the peds ED shifts are 10-hour shifts, not 12. Also, peds ED is done in a longitudinal fashion, not in individual blocks. PICU on the other hand is it's own block with 12-hour shifts.

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When you say longitudinal, do you mean peds shifts are integrated into each ED month? Or that they do separate blocks of peds throughout the year (e.g. 2 weeks in summer, two weeks in winter, etc.)? I thought they told us it was something like the latter, but I may have misunderstood.

The latter. Guess we have different understanding of what "block" means.

.

gutonc said:

Actually, I think you have a different understanding of what "integrated" and "longitudinal" mean as they generally refer to peds ED shifts sprinkled throughout each month/year rather than a run/block of them all in a row.

In either case, I can't quite figure out how big of a deal this would be in deciding whether you liked a place or not. But perhaps I'm an idiot.

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Some EM programs argue that since many pediatric illnesses are "seasonal" its better to have integrated exposure (a few shifts every month) rather than longitudinal exposure (a couple months every year). Examples would be things like asthma/viral infections (winter) and trauma/heat exhaustion (summer).

gutonc said:

Actually, I think you have a different understanding of what "integrated" and "longitudinal" mean as they generally refer to peds ED shifts sprinkled throughout each month/year rather than a run/block of them all in a row.

In either case, I can't quite figure out how big of a deal this would be in deciding whether you liked a place or not. But perhaps I'm an idiot.

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It's a big deal when you're an applicant. Then you start residency and realize that, apart from "fit", it's the cafeteria, parking situation, and ability to do fun stuff in your off time matter more than any of the crap you spent so much time asking about at interviews...

Has the Denver ER converted to an EMR or is it still using paper charts?

DO class of 2018 said:

Has the Denver ER converted to an EMR or is it still using paper charts?

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They've got Epic now.

Any update on this program from current/former residents?

Burgundymilk said:

Is it possible to be accepted as a DO with a 240s step 1? Very interested in permanently living in Denver and they don't seem to take in many DOs.

Any advice?

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I think most of us are interested in living in Denver.

Advice pls.

Burgundymilk said:

Is it possible to be accepted as a DO with a 240s step 1? Very interested in permanently living in Denver and they don't seem to take in many DOs.

Any advice?

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If you have an in, yes. If you are aiming blindly and hoping to get in, probably not.

Burgundymilk said:

Is it possible to be accepted as a DO with a 240s step 1? Very interested in permanently living in Denver and they don't seem to take in many DOs.

Any advice?

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Invited for interview or ranked to match?

jw3600 said:

Invited for interview or ranked to match?

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Once you get the interview are you considered to be on even ground, or are you still at a disadvantage?

MelMcT2009 said:

Once you get the interview are you considered to be on even ground, or are you still at a disadvantage?

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I'm sure it's program dependent. But in my opinion it's still a disadvantage.

jw3600 said:

I'm sure it's program dependent. But in my opinion it's still a disadvantage.

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Thanks for the response! Are you a resident??

MelMcT2009 said:

Thanks for the response! Are you a resident??

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Nope. 4th year DO like you.

So Denver is getting a bit beat up on the spreadsheet chat. Any truth or rebuttal to it being a malignant program that breeds exhausted and worn-out (though well-trained) residents?

jw3600 said:

Nope. 4th year DO like you.

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Ah, best of luck this season!

GorillaPanic said:

Any update on this program from current/former residents?

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I’m a second year there. Currently loving it. Busy, but the training and acuity we see is already paying off. Denver is a chill city, too. Wish I knew how to skii though.

So I'm curious why Denver is often regarded as THE top EM program. It's not the oldest, not the busiest, and doesn't seem to have the sickest or the most bullet-ridden patient population. What's the secret?

@Cinematographer

Jabbed said:

So I'm curious why Denver is often regarded as THE top EM program. It's not the oldest, not the busiest, and doesn't seem to have the sickest or the most bullet-ridden patient population. What's the secret?

@Cinematographer

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As someone who interviewed at reputable programs, including Denver, nobody on the trail, including myself, thought Denver was THE top EM program. It's definitely one of the best, but every applicant probably has a different idea of what the best program looks like to him or her. Like every other program, it has its strengths and it has his weaknesses.

Gray Fox said:

As someone who interviewed at reputable programs, including Denver, nobody on the trail, including myself, thought Denver was THE top EM program. It's definitely one of the best, but every applicant probably has a different idea of what the best program looks like to him or her. Like every other program, it has its strengths and it has his weaknesses.

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Does it have any other weaknesses other than you work too much? That’s not even a weakness really. Just an undesirable charareristic of the program.

jw3600 said:

Does it have any other weaknesses other than you work too much? That’s not even a weakness really. Just an undesirable charareristic of the program.

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What you see as a strength, others may see as a weakness. I don't think they are a malignant program, but they embrace a certain culture that could be interpreted as such.

To answer your question, yes, in my mind, they had a few glaring weaknesses for what I want out of my career.

Others may consider those weaknesses to be strengths. Again, it's all relative. Sorry I don't want to elaborate, as it could be compromise my anonymity.

EDIT: DH is a premier program that I and anyone else would count themselves lucky to match at. They have outstanding strengths. My point is that there is no perfect program. Any attempts to meaningfully rank emergency medicine residency programs is misguided.

Gray Fox said:

As someone who interviewed at reputable programs, including Denver, nobody on the trail, including myself, thought Denver was THE top EM program. It's definitely one of the best, but every applicant probably has a different idea of what the best program looks like to him or her. Like every other program, it has its strengths and it has his weaknesses.

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Agree that everyone will have a different "top" program, but based on my impressions this interview cycle from conversations with other applicants and advisors, it seems that a lot of
people regard Denver as having the strongest clinical training in the country.