New York University (NYU)/Bellevue Residency Reviews

NYU:
-great didactics, morning report every day
-faculty mindful of other programs within the city, (lots of we got this much of this and they only have that much of that)
-good orientation month
-less exposure to trauma, but they do run them (as opposed to surgery-run)
-smart residents, friendly residents
-faculty are hit or miss, some are intense
-less peds (universal in NYC)
-less u/s (only one machine for the whole department)
-hours okay (12,12,10,8)
-less cards, but more neuro experience than at other programs

Jacobi:
-new ED coming (current one is tiny, but new one is phenomonal - have they moved into it yet? any day now, last i heard)
-good orientation month
-GREAT faculty resident relationships
-peds + or -
-GREAT trauma (all run by EPs!!!)
-good U/S
-less didactics, most is at the bedside (and beside teaching is done)
-tons of ED time and shifts (less off service)!!!
-graded responsibility (dept. flow and management during upper years)
-really really hard first year (huge time commitment) - all residents though happy were vocal about how "damn hard" the first year is
-friendly and down-to-earth faculty (VERY approachable)
-less ego-trips than other NYC programs
-more academically focused than other trauma-intense EM programs in the burrows

Mount Sinai:
-strong didactics (daily sign out, guest lecturers)
-good orientation month
-good ultrasound teaching
-half of ED months spent at Elmhurst – good staff, good ancillary support, less drunks, great trauma (peds mixed in) THIS IS THE TRUE PEARL OF SINAI!!!
-lacking peds (universal around the city)
-good residents - outgoing and friendly and smart
-faculty: some are intense, but most are benign
-commute to queens is ****ty
-ed shifts = all 12’s is bad, but only 18/month is good, not too tough, residents say they have a life outside the hospital
-mt. Sinai patients = mix between Spanish harlem and upper east side, medically complex and transplant patients
-learn 1) good clinician 2) good ED management
-nursing off-service isn’t malignant, but isn’t great, push you around some, and not the brightest
-trauma = 50% by EM vs Surgery, and most of the time primary command is EM

Good:
-Elmhurst in Queens is a great experience with bizarre differentials, and great faculty and great teaching. Sinai is filled with medically complex patients. Residents are fun to hang out with. Attending coverage is great. Peds not great (but electives available).

Bad:
-I've heard a few people say that Sinai is a second tier EM program, but I don't know why, this was one of the places I liked the most in NYC. Mt. Sinai is a trauma level 2 hospital, but 50% is ED time is at Elmhurst which is level 1 and sees more trauma than other trauma levels in the city
-commute to Queens isn’t that bad apparently (20 minutes by car? 45 min by subway), but still annoying

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!)

Residents: 15 residents per year. It is a large 4 year program, so even though I rotated here there were many residents I never met. For the most part, the residents were friendly and down to earth. The majority seemed to have NYU as their top choice. Historically speaking, training at Bellevue vastly increases the odds of getting an academic job in NYC, and many residents cited this as the reason they ranked it number 1. Some of the residents were married, but I did not meet any with children. The seniors are extremely capable, and don’t have trouble getting jobs (especially in NY). The second years seemed miserable, and are worked very hard – third year seems to be everyone’s favorite.

Faculty: What can you say? Every toxicologist you’ve heard of is faculty here or probably trained here. Goldfrank is an amazing guy, one of the most powerful people in the hospital, and a great teacher. The two most impressive things about NYU are the faculty and the reputation of the program. The PD, Eric Legome, seemed nice – but I didn’t get to spend much time with him.

Hospital:
There are a few sites, but the vast majority of time is spent at Bellevue.

- Bellevue Hospital is sort of the “Grand Dame” of emergency care in New York City. It’s old, it’s huge, and it’s County. I can’t imagine anywhere that has a more diverse and interesting patient population – the welcome sign in front of the ER is in 17 or so languages. This is where the prisoners from Riker’s island go, and it’s where a seemingly endless parade of immigrants, homeless, and substance abusers go. As such, the range of medical issues here is awesome, and you really do help an underserved population every day. However, this comes at a price. The physical plant is surprisingly nice – but the ancillary services are lacking, the place is an overcrowded madhouse at any given time, the patients can be abusive, and the nurses get overwhelmed. Radiology is connected to the ED. Paper charts and white board are used. There is an Urgent Care center that is quite busy, and a Pediatrics area. The ordering system is computerized, but maddeningly complicated at first. This is one of the few Level 1 trauma centers in Manhattan, but there simply isn’t a lot of trauma on the island.

- NYU’s university hospital (Tisch), has a smaller ED, with better ancillary help. These are private patients, and there are more consults called here. The ED did not seem very busy while I was there (compared to Bellevue, that isn’t saying much).

- The VA is a typical VA. Smaller ED, less busy.

Ancillary Stuff: At Bellevue, the residents draw their own blood, put in IV’s, page their own consults, and occasionally push their own patients to radiology. However, they recently started a phlebotomy service. I was told that ancillary help has improved recently, but if you were in a hurry it was just easier to do it yourself. As a student, I was happy to do it myself - it's the best way to learn.

Admitting/Documentation: Mostly paper at Bellevue, computerized at Tisch and the VA.

Curriculum: This is a four year program where the majority of intern year is spent off-service. There is a lot of ICU time, around 5mo total I think, and 3 elective months. Second year is about 50/50 ED and off-service, and the ED shifts are 12 hours. Third year is a lot of ED time, and they appear to get the first shot at big procedures (central lines, etc). Fourth years are sort of mini-attendings, running half of the ED during their shifts, and teaching. The Tox rotations are top-notch. Ped’s is believed to be lacking, and like many places in Manhattan, blunt trauma experience is not ideal.

Didactics/Research: Weekly didactics and book review, pretty standard. Amazing Tox lectures/rounds/seminars. Most of the research is based on Toxicology, but there didn’t seem to be much basic science.

City: The hospitals are in a sort of nameless part of Manhattan on the east side (sort of Murray Hill/sort of Gramercy), all located right in a row on 1st ave. New York is one of the great cities of the world, there are more reasons to live here (or not live here) than I can list. It’s heinously expensive, and unlike many of the NYC programs, I was told that NYU doesn’t guarantee subsidized housing. Living on a residents’ salary in NYC is not easy, but there are thousands of people who do it and love it every year. It really comes down to whether or not you want the NYC experience.

Extras: Salary is above average, as all places in NYC are, but you’ll still be broke by city standards. As I mentioned, the lack of subsidized housing is a big drawback (some residents get housing, but it’s not guaranteed). I think you can moonlight, but I didn’t meet anyone who found time to do so.

Negatives: Lack of Peds exposure, and relative lack of blunt trauma. As far as 4 year programs go, the curriculum doesn’t seem very innovative – internship year is mostly off-service and there are only 3 months of electives. Still drawing your own blood as a fourth year resident may get old...The residents weren’t as happy as other I have worked with in the city, and some admitted they were here because they knew the name would get them a job even though it wasn’t their favorite program while interviewing. Exceedingly expensive location without guaranteed housing help.

Overall: A well-established, well-respected program. As a public service, you really make a difference working at Bellevue. The patient diversity absolutely cannot be beat, the tox exposure is awesome, and some of the faculty members are very well-known. Every academic ED in NYC seems to have at least one Bellevue-trained attending – if you want to work in NYC, you cannot go wrong training here.

I noticed some of the residency reviews of Bellevue comment on how tired the residents were. I can't find a breakdown of shifts/month, but I was wondering if anyone knows if they work more on average than other residency programs? (esp. compared to ones in NYC)

Also, anyone know about subsidized housing there?

Thanks!

Chartres said:

I noticed some of the residency reviews of Bellevue comment on how tired the residents were. I can't find a breakdown of shifts/month, but I was wondering if anyone knows if they work more on average than other residency programs? (esp. compared to ones in NYC)

Also, anyone know about subsidized housing there?

Thanks!

Click to expand...

I'd like to know!

1. NYU - County + Academic. Patient population was major determining factor. Great didactics. I guess only drawbacks would include the extra year (only 4 year program on my list) and the poor ancillary staff at Bellevue. But, training here would be worth the extra work.
2. Emory - Again County + Academic. And, again liked the patient population at Grady - uninsured, underserved. Also, great didactics. Location was also a plus. It's a superb program overall. But, it's not the sort of program that is right for everybody. Some people would be very miserable here. Residents in general are outgoing and enthusiastic. I would recommend rotating or doing a second look before deciding.
3. UNC - Loved the program director and the residents. Community + Academic. Was not as thrilled about living in NC. This program is really well-rounded. Almost anyone would be happy here.
4. NYHQ/Cornell - Community. Very diverse, immigrant population (which is a plus for me). Great schedule and benefits (includes subsidized housing). Dr. Ryan is very friendly and active in resident education. A great group of fun residents. Would be very happy to match here. I guess it ended up not being in top 3 just because it isn't as academic as the ones above.
5. North Shore - Was really impressed with North Shore. Community hospital and population but an academic program. The best benefits ever (really high salary + great housing). I liked the critical care emphasis. Lots of high acuity stuff in the ED. So many fellowships available. The residents are super-friendly, laid-back. This one moved up and down my list alot. But, at the end, what didn't really do it for me is the patient population. Though most people would enjoy working with patients who are neatly dressed and have insurance, not exactly my cup of tea. (Just personal preference.) Like UNC, well-rounded program that almost anyone would be very happy with.
6. Thomas Jefferson - Overall, I liked this program and would be happy if I matched here. New global health fellowship with public health focus is a major plus. They also have a whole building dedicated to simulation, special course on intubation, and other unique opportunities that makes the program stand out from others. I was also impressed that some of the residents volunteered at local, nonprofit clinics (more impressed that they didn't think it was a big deal). Moreover, pretty diverse and some underserved patient population across its many sites (which is a plus for me). BUT, the drawback to this program is having too many sites. Though I prefer more than one site in general, having multiple sites gives diminishing returns after a certain number (I would say 3). Not only that, these many sites are not all that close to one another (one was in Delaware). I think the residents only have to go to Delaware like one month out of the year or less. But, still...
7. Metropolitan/NYMC- New PD at this program is very energetic, enthusiastic. I get the feeling he is the sort of person who would really advocate for his residents and try to get them far as he can. Considering how small the program is (8 per class), many (at least from this year's graduating class) seem to go onto do fellowships - impressive ones at that too. (This was a plus for me... not necessary a plus for everyone.) That said, the interview day in itself seemed very disorganized, which made me concerned. The Metropolitan ED needs to be bigger and better-equipped. Housing is cheap and available but dorm-style. And, again, number of sites is so that cost outweighs the benefits (at least for me).

Did not rank one program that I interviewed at. PM me if you have questions about the above programs.

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...

kirbydoc said:

Hey everyone - PGY1 here at NYU/Bellevue. Considering that interviews are going to be all virtual, we made a quick, updated compilation of our program this year with a few interns and PGY2s! Obviously, the opinions here are from residents of the program, so obviously it's going to be less "objective" per se, but it's not any different than if you talked to us in person!

@mods - If any verification is needed for my status, please DM me!

NYU BELLEVUE EM PROGRAM FAQ:

• Faculty
  • I've been very impressed with how approachable and knowledgeable faculty are. Most faculty members I have worked with are extremely up to date on their journals/research. Most of the faculty insist I call them by first name. I feel like they are more like my experienced colleague than a hierarchical supervisor.
  • Faculty genuinely have our best interests at heart, not just in clinical scenarios. They care about us as colleagues and human beings beyond being workhorses of the department. Multiple faculty have reached out to help my SO find a job in their field in order to help make the transition from medical school in a different city to NYC a smoother transition.
  • We benefit from having many different fellowships (ultrasound, simulation, toxicology, peds EM, health admin to name a few) who bring along with them faculty with a wide variety of skills.
  • Faculty dynamics are mostly on a first name basis and very non-hierarchal. The breadth of expertise (involvement in MedED, tox, social EM, sim, US, etc) really shows. I'm already learning a lot of tips and tricks that's respective of the attending's area of interest, and it's always great to feel like I've leveled up in some way.
• Residents
  • Genuinely some of the most down to earth and relatable people from all walks of life. It's easy to find someone that thinks like you and comes from a similar background thanks to the unique breadth of residents the PD has cultivated. And yet, somehow these disparate and diverse group of people feel like one large family willing to treat interns as colleagues and not subordinates. The ups and downs of residency feel possible thanks to the residents.
  • Of course, each class seems to bring its own thematic personalities, but all in all everyone brings the similar vibe of being extremely supportive and social-EM driven. It was initially difficult the past few months to meet up with people due to COVID times, but outdoor dining and bars have greatly improved the situation.
• 
  
• Facilities
  • You can't find a more opposite clinical training site than Bellevue (public) and Tisch/Kimmel (private). You really run the gamut of patients who have no health literacy at all to patients with multiple specialist referrals for all aspects of their medical care prior to entering the ED. Brooklyn really blends the two flavors of county/private into a true community ED and feels like a natural extension of the fabric of the community.
  • Bellevue provides a county hospital experience and it is the flagship public hospital in NYC. Patients will often travel from all over the city to seek care at Bellevue and it provides an opportunity to serve many uninsured patients. Patients who have medical issues requiring more specialized services or a full trauma evaluation will often be transferred to Bellevue, allowing us to see more complex patients. Tisch/Kimmel provides an experience in an academic environment that sees patients with medical conditions that you rarely heard about in med school because there are a variety of specialists and subspecialists there to treat them. Some of these patients are very chronically sick and it gives you appreciation for how to take care of patients with medical problems that you may not know the ins and outs of. Brooklyn is a middle ground - it is a community hospital with some consultants and a mix of underserved and middle class patients. The acuity level is high and it is very busy, allowing an opportunity to see what community bread and butter medicine is like.
• 
  
  
• Shifts (roles, relationship with ancillary staff)
  • I did a sub-i here, it's been a night and day difference in just the past year alone. Ancillary staff support used to be nonexistent at Bellevue, but now I reliably get labs drawn in the ED, lines/phlebotomy are a given expectation rather than a welcome surprise. Patient transport is a reliable service to/from radiology scans. This residency program really breaks the expectation of a traditional "NYC program with less-than-stellar ancillary staff" and delivers to its resident an experience that centers more on clinical care and hands-on procedures.
  • This has improved significantly, even over the last year. We have dedicated nurses in the ED who will draw labs, put in IVs, perform EKGs, etc. NYC often gets a bad wrap for poor ancillary staff and, while none of us are shy or hesitate to push our patients to CT or X-ray if it will expedite their care, it is much less common than it used to be.
• 
  
• Curriculum/Research:
  • Good emphasis on simulation which we try to do at conference at least once a month with our "multi-modal" days. We have a variety of fellowship trained alumni who have expertise in various interesting areas.
  • I love how well attended our morning report/conference days are. Everyone really participates and are excited for various talks. I think it says a lot that the residents will often be sending each other texts about a talk to applaud the presenter or clarify questions. Apart from conference days, there are many other 1 hour talks such as social justice report or randomly scheduled 1 hour talks. The overall engagement in education has really impressed me.
  • We have lots of opportunities for research ranging from social emergency medicine to ultrasound to ED flow issues (QI, admin).
• 
  
  
  
• Diversity/Social Mission
  • You can't really beat the social mission and diversity at NYU. They make a concerted effort to include LGBTQIA research and activities as a standard, rather than a "special" once-in-a-blue-moon event. Lewis Goldfrank is the father of the social emergency medicine tradition. The tradition in the Bellevue ED is to question what is the lesion in the healthcare system that brought the patient to the ED, rather than questioning what about the patient brought them to the ED. Dr. Goldfrank has taught the faculty/staff to understand patient encounters in the broader context of public health and as an extension of the relevant sociopolitical issues of the day.
  • This is a huge focus for NYU/Bellevue as we serve such a diverse patient population and it is the core of our program. We have a particularly active Social EM academy that has biweekly Zoom nights on various social EM topics with experts in issues like prison reform, healthcare for undocumented immigrants, and food security for our patients.
  • I attended medical school at a county hospital. I thought that the way the residents interacted with the undomiciled population was "normal." When I arrived at Bellevue, I saw what it looked like to be passionate about working with this underserved group of patients. I was truly blown away by the ease and tact with which my senior residents were able to address the social issues of patients from all walks of life.
• 
  
• City Living
  • While you likely won't save a ton of money or buy a property during residency, NYC is definitely affordable on our salary. In COVID times, rents have actually dropped substantially and finding housing is now even easier. People live in a variety of different neighborhoods from Manhattan to Brooklyn to Queens to Jersey - whatever suits your lifestyle is doable!
  • Thanks to COVID, living in the city is much cheaper now. I live a 15min walk from Bellevue/10min from Tisch. There is a bus that I can take when it gets colder, or I could ride a city bike with the free membership the program gives us. I feel very safe walking this route by myself, regardless of time of day. I live in a 1 bd apartment with my significant other. While the apartments do look a little on the small side, I was surprised that all the furniture I wanted fit just perfectly. I really enjoy my location since I am able to go for a run on the waterside, get authentic asian food, and go bar hoping all within a mile of my apartment/the hospital.
  • Honestly, pleasantly surprised. Every fiscal year aside from the initial 6 months of intern year I am expecting to max out a 403b in addition to a not-insignificant long term savings account. NYC living is much more affordable than I previously thought it would be, and the residency does a great job of finding "unique" benefits to alleviate the financial crunch even further: reimbursements on transportation, food/meal cards, wellness benefits (gyms, bike shares, etc.) in addition to fun planned social activities around NYC monthly.
• 
  
• Free flow thoughts:
  • NYU/Bellevue is a great program to experience the variety of different clinical experiences (academic, county, community) all in one program while also being a program that is very socially minded and treats a diverse patient population at our different sites.

Click to expand...

@kirbydoc you have to wonder about the social justice mission of a system that segregates the wealthy at one hospital and the poor at another. This endemic segregation was one reason I left New York. My current city has its issues, but at least we are all born, live, and die in the same hospital system, and receive similar care. My point is that if one is really into social justice, think twice about whether New York, with its high-end, pay to play care for the wealthy and its substandard hospital system for the poor is really a good paradigm for social justice. Is segregating the wealthy in one well-funded system while neglecting the poor in another system really equity? Or limousine liberalism at its absolutely most clueless?

The poor level of care in Health and Hospitals facilities is an absolute travesty. If people are so concerned about equity and social justice, I suggest they really consider whether this divided system is something they choose to support with their labor.

The outcomes for Covid at Health and Hospitals facilities were abysmal: Why Surviving the Virus Might Come Down to Which Hospital Admits You. I would think that those who advocate for social justice would be appalled by the poor outcomes due of this segregation, and work towards ending it.

Why do people think this is OK?