Emory University Residency Reviews

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Program: Emory, 3-years

Residents: The most diverse group of residents I've met. There are 18/class making Emory one of the largest programs in the country. Residents are both married & single, several have taken time off for varied pursuits before medical school, also very good racial diversity. They are all incredibly happy, too. There was a fantastic turnout at the dinner the night before. They have a lot of fun together outside the hospital. There was a big "ER" party in October that many residents from other programs attended as well.

Faculty: the PD is a standout. He's a huge resident advocate, one of the nicest guys you'll ever meet. Many faculty are nationally very well-respected, including the chair Dr. Kellerman and the acting chair Dr. Heilpern.

Facilities: the primary location is Grady Memorial Hospital, the quintesential county experience. The ED is big, smelly, and crazy fun looking. The 3 (expandable to 6) trauma bays were full in the middle of the day during a tour. Grady is the only Level 1 trauma center for the entire city of Atlanta plus most of the surrounding area (I think the next closest is in Chatannoga, TN). Emory has a helicopter service and the main city EMS response is affiliated with Grady, so all 911 calls basically go to the Grady ambulances. The ED is huge, old, but well-lit. There is still a white grease-board (adds character?) and all paper charting, but labs and old EKGs and old hospital admission records are all computerized. The other facilities include Emory University Hospital (tertiary care facility, computerized, patients with weird rare complaints referred from all over the Southeast) and Crawford Long Hospital (very nice community hospital [where James Brown went right before he died], bread and butter EM, has a 24-hr cath lab, computerized on same system as Emory Hospital).

Peds: affiliated with 2 different peds hospitals, Egleston and Hughes Spalding. HS is the "county" like peds hospital right across the street from Grady. Egleston is the fancy "Emory" like hospital where all the rare interesting things go. Peds seems very strong here.

Trauma: Huge trauma volume. EDPs manage the airway, trauma team is activated on all major stuff. Some of the original research on the FAST scan came from the trauma surgery department at Emory, so the trauma team does most of the scans in the ED. The EM resident, of course, rotates on the trauma service a couple of times.

Curriculum: didactics were not emphasized a ton on the interview day, I sense that this program is more of a learn by autonomy and doing lots and lots of stuff program. But there are lectures once a week for 5 hours or so, whatever the RRC requirement is. Also requires the standard quality improvement and scholarly projects.

Patient population: classic county population at Grady - poorest of the poor, prisoners, disenfranchised ex-middle class, lots of trauma and very sick medical patients. More upper class professer types at Emory, everything in between at CLH.

City: Atlanta has a lot to offer. There are some beautiful sections of town like the Virginia Highlands and Decatur that are reminiscent of some of the walking cities of the Northeast, but there are also lots of modern developed areas like Buckhead with fancy shopping, clubs, bars, restaurants, etc. The cost of living is also very do-able for a big city; you can easily get a 2-bedroom in one of the nicest sections of town for $1200. You could get a 1-bedroom in a less-nice section for as little as $500.

Overall: The most autonomy I've seen in any three year program. Huge volume, no competition with other area hospitals for trauma and sick patients. Residents come out super-prepared as they get to run an ENTIRE zone of the 110K ED as a PGY-3. The only downside is that it seems if you want to read a lot and focus on brainy stuff you have to be really focused and motivated to self-teach. Don't get me wrong, there is a lot of bedside teaching, but studying for the boards and didactic stuff might be a little lacking in the curriculum. I absolutely fell in love with this program, it will probably end up very near the top of my list if not number one.

ps - Grady isn't scary, it looks fun as hell. That's why we all became EP's, for the chaos! Also, the ancillary staffing issues in the ED are reportedly much-improved (no more taking patients to X-ray, no more blood draws).

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I agree with the previous anonymous review of Emory. Grady isn't that scary, but it is not aesthetically pleasing. The odd choice of tile colors on the wall make it look a lot more worn down than it really is. The ED was isn't that old, finished in 1992, but whoever added the decorating details should never design another hospital again. :D The new wing of the hospital looks great, but its for outpatient stuff and for surgery. Enough about the appearance though...

Without a doubt, the strength of this program is the autonomy and the patient volume/acuity. Training in this program will prepare anyone for EM anywhere.

I really liked how diverse of a group of residents they have at Emory, something that they emphasize. Since they have 18 residents per class, it seemed like they didn't get to see each other often, but they do have a lot of fun when they do.

Research is very strong, and the faculty has some big names. Residents praised how good they were. They even find little moments here and there to teach even with the craziness of Grady. What is also rather unique about this program is that they have multiple groups of faculty that are involved within niches of EM, ie having 4-5 people involved with EMS, instead of just one.

Overall, I was impressed with Emory and once I decide what I really want in a program, Emory has the potential to be my top choice.
 
Emory University

Residents: 18 residents per year. Residents take you out the night before for a casual dinner, interview, attend the lunch, and lead tours. They are energetic, diverse, from all over the country, and fun and crazy as hell. :laugh: What's not to love??? They get crazy clinical training with graded responsibility, and every 2nd year I talked to said if they were kicked out now, they would feel confident running a community ED already. :cool:

Faculty: The PD is Dr. Philip Shayne, who has a relatively blunted affect, especially compared with the team he leads. The contrast is quite amusing, actually, and he has a kindness and a deadpan sense of humor that is most endearing. The residents warn he doesn't change his facial expression very much during the interview (he takes each person aside), but it is not hostile at all. In stark contrast to him is the assistant PD Dr. Sheryl Heron, who is a ball of Jamaican energy and preaches diversity, love, and wellness, then puts on music for us to listen to between interviews. They play off each other wonderfully and are just delightful. The faculty include phenomenons like Dr. Kate Heilpern, who chairs the EM dept and made time to come by and talk to each of us during our stay. This lady is a real class act. The rest of the faculty I met are equally down to earth and easily the most diverse I've seen or ever heard of. Many also have joint appointments at the CDC.

Hospital:
Who hasn't heard of Grady? You will hear of its interesting history during your interview. I couldn't wait for this tour! This hospital is huge, with multiple zones and multiple hallway beds, yet is still packed to the brim. The average waiting times are in the double digits:eek:. Grady is the only Level I trauma center in Atlanta, and it shows! Well over 100K pt visits a year. I have heard that it is in disrepair but didn't notice any of that on the tour. It looks like a county hospital, but it is clean and the wall ain't chipping off. On the other hand, these patients are sick as hell and just keep coming. You will get crazy experience here. And, there is great news for those who have heard Grady might close - there was a recent battle, and the do-gooders have won. Grady will be transitioning towards a non-profit model, which will help to bring in more funds. The future looks bright for this hospital now (which is good since it is all ATL has for trauma).

You will also work at Emory University Hospital, which gets 35K patients but many are tertiary care folks with rare diseases. It is about 20 mins down the road. Emory Crawford Long Hospital is a fancy smancy community hospital a few blocks from Grady to give you a well-needed rounded experience.

Ancillary Stuff: Occasionally you may have to start an IV to get a patient moving but no taking patients to the scanner, etc (unless a trauma/unstable of course). On off-service rotations, residents are often asked to do IVs the nurses can't get, etc.

Admitting/Documentation: Emory has strong programs in just about every clinical arena and muscle flexing will arise. However, EMs relationship with the other services is good, despite some disparaging comments about EM by other SDN members like XXXXXX Grady is all paper charting with electronic labs and radiology (but online discharge summaries), and Emory Crawford is all electronic.

Curriculum: 3 year curriculum with 6mos of the ED as an intern. 1 medicine floor month, 4 ICU mos. The program philosophy is that you learn the nuts and bolts during PGY1, critical care during PGY2, and leadership during PGY3. Shifts are 10 hrs for interns, 8 hrs for 2s and 3s with 12hrs on the weekend to earn 2 weekends off.

Didactics/Research: Didactics are once a week and modular with a test at the end of each module. There are also simulations to practice the "see one, screw one, do one, teach one" technique on fake patients :smuggrin:. Emory runs the Poison Control Center for Georgia and collaborates with the CDC and GeorgiaTech. In addition to ground-breaking work in diversity, they are leading the way in TBI research and their new progesterone treatment is advancing in terms of clinical trials and basic science research.

City: Atlanta is a great mix of east and west coast to me, culturally diverse yet clean and pretty warm.

Extras: Salary is 41K+ or something with great benefits, which is supposedly fabulous for Atlanta. Many residents cab afford to buy houses. Teh graduates go wherever they want, and many chose academics.

Negatives: One thing I really loved about the program is that they opened their hearts to say, "this is what we are about, and these are the type of people we are looking for". A crazy busy county-type, service-oriented academic place like this isn't for everybody (I think it's terrific). The one negative I would have said would be Grady's tenuous funding situation, but that seems to be markedly improving. :)

Overall: This program has heart, personality, energy, and diversity and is looking for the same in its next class. Top-notch clinical training, excellent research opportunities, fabulous residents, and dedicated faculty make this program tough to beat. I would say its reputation is well-deserved yet probably still underestimates its caliber :).
 
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Getting caught up now that my SICU month is over...

Emory
[+] Residents were really friendly and nice at the night before dinner; training at both community and county hospitals; Grady seems like an awesome place to train with a lot of trauma and pathology(added bonus: there's a small gym in the hospital for residents); lots of ED time in the first year (6months); administration responsive to resident complaints (recently changed their ortho month to an ortho-ED month because the residents didn't feel like the ortho service month was beneficial) Great diversity among residents. The program goes beyond simply providing care to the indigent by offering multiple opportunities to get involved in community service. The residents have programs that collect clothes for trauma victims and there are multiple free clinics to volunteer in.

[-] Surgery does all the trauma team activation FAST scans, which I feel like is an important thing for an ED resident to become comfortable with. They say that there are enough traumas where the trauma team isn't activated that the ED residents get enough FAST experience. Grady's financial situation is shaky...supposedly being resolved and everyone says it can't close, but I remember hearing the same thing about MLK.

Cook County
[+] Couldn't make it to their happy hour, but really liked the residents I met during the day. The ancillary staff seemed nice and helpful too. The faculty appears to be very supportive of the residents. Their ultrasound program was really well-developed (they beta test machines for GE). They have a cool MICU month where the ED resident acts like the fellow and doesn't have to write notes; just does procedures and codes. The residents get TONS of procedures overall.

[-] The responsibility level is very sharply graded. The progam seems to be structured more toward immersion in a single area, rather than spread out over four years. (For example, trauma is done as an off-service rotation. The volume is high enough that the residents get lots of exposure during this time, but are not otherwise part of the trauma team)

LSU-NO
[+] Really liked the faculty here. They seemed very open and honest about the program's strengths as well as the drawbacks. The residents seem happy. The ED is new and fully functional. The pictures they showed of working immediately post-katrina were intense and made me feel like this is a program that would really prepare you for anything. They alternate trauma responsibility with surgery. You can moonlight and there are a lot of well-paying opportunities. They have some really interesting research going on.

[-] The residents told me that as an intern you are primarily responsible for running codes at one of the community hospitals. While I love autonomy, I'd also like to have someone more senior standing behind me in case I got into trouble. New Olreans as a city lost a lot with Katrina and it hasn't all come back.

Ohio State
[+] LOVE the faculty here. They are totally supportive, intelligent and dedicated to the residents. The ultrasound program is a real strength. This program also has incredible peds exposure. The ED is very nice and charting is done on computers. The residents are very friendly.
[-] The patient population isn't as diverse as some other hospitals.
 
This year I've found the reviews posted here to be helpful and insightful so I thought that I would say thanks by posting some of my own reviews. Please understand that these simply reflect my opinion and my biases.


Residents: 18 residents a year. I’ve rotated in this program and all residents are of a high caliber and seem to enjoy their program greatly. All are quite laid back, and very fun-loving. The residents are diverse representing a broad cross section of race, geography, religion etc. In the ED there is a graded responsibility with the senior residents (PGY 3s) running the show in each of the two main zones in the Grady ED. Additionally, PGY3s have teaching responsibilities working with the rotating medical students and supervising interns. In the ED, the PGY2s are managing the critical care patients and also are expected to teach PA students when they are in the ED. PGY1s are there to learn the ropes. Attendings hear about all patients and see all patients allowing teaching to be focused and efficient.

Faculty: This place if full of stars. Dr. Shayne is the PD and while not known for his effusive nature, he is extremely sincere, seems like a true resident advocate, and most importantly has the respect of each of his residents. The Chair, Dr. Heilpern, is one of the kindest, smartest and most gracious people I’ve ever met; and as the current president of SAEM she is quite well known in EM circles; she also still works shifts in the ED. I believe this is quite telling about her leadership style. The clinical faculty that I worked with were excellent teachers and clinicians. Lots of research opportunities are available from traumatic brain injury, hypertension, toxicology to domestic violence and public health.

Ancillary Stuff: Staffing is quality but limited; I believe this is secondary to financial issues at Grady. In order to expedite patient-care residents will, not infrequently, push patients to CT, start IV’s etc. I didn’t find one resident who felt that this was an inordinate amount of effort, however.

Curriculum: Pretty traditional 3 year program. Total ED time is 19 months with an additional 4 months of peds ED. Two months of elective time are available in the 3 years. Intern year seems like a potpourri of the house of medicine.

Facilities: Grady is a huge, urban teaching hospital known in the community for outstanding trauma and emergency care as well as the “safety net” hospital for the indigent and disenfranchised. This past fall major funding issues came to a head at Grady. The hospital has not turned a profit in about 10 years and was in the red hundreds of millions of dollars. However, a plan has been initiated to turn the hospital into a non-profit institution which it is thought will facilitate the return of the institution to profitability. During the interview it seemed that nobody was concerned that Grady will actually close at this point. As to the physical plant, this hospital is old but I wouldn’t call it run down. There is nothing fancy, just functional. One downside in the ED is that there is no PACS system. If you order a CXR on your patient you will have to walk (seriously, only 45 sec walk) to the reading room if you want to see the image.

Emory residents also rotate through Crawford-Long Hospital and Emory University Hospital. CWL is a “community” style hospital while University is a tertiary care facility. Both ED’s run very well.

Negatives: I think that Grady is a double edged sword for this program. It is a genuine county experience. Grady provides huge volume, great pathology but requires the residents to, on occasion, act as transportation, social work, etc to provide thorough care for their patients. Another negative is that patients often board in the ED for several hours limiting throughput and therefore, the amount of different patients that you can see in a shift. Residents also commented that the education you get here seems proportional to what you put in. No one will give you reading assignments for example. Self-directed learning is expected-not sure if this is a negative but just worth noting as everyone learns differently.

Overall: I really liked my time at Grady and Emory. This program is outstanding and I appreciate what they seem to stand for: care for the disenfranchised, diversity, clinical excellence. All of this is in an environment where it felt as though I would have any and every opportunity that I wanted; I’d just have to work for it. In sum, I’d be thrilled to train here and will rank them highly.
 
.I just updated this as of February 27, 2011:

Just wanted to update another time as I will be graduating from Emory EM residency in June:

Where are we going? 6 are going into fellowships- two in Ultrasound (Emory and UC Irvine), EMS/Global Health (Emory), two in Admin (both at Emory), Informatics (Harvard BIDMC); community out of state (Utah, Texas, Washington DC, New Orleans), about half practicing community in-state (Macon and Atlanta, GA). Six months before residency is over and NO ONE has problems finding a job!
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  • .Financial troubles at Grady:.. This was big news in 2008 and drew largely inaccurate comparisons to Drew-MLK. Thanks to the Woodruff Foundation and local donors, as well as some shrewd budget cuts by the new private board and CEO, Grady turned a profit in 2009! In addition, JCAHO came for a visit in Nov 08 and has given Grady full accreditation. Check out this website for updates.
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  • .Through-put.. at Grady: it is fair to say that as a county hospital, our patients may spend more time in our ED than at other places. Part of this is due to genuine delays in labs and radiology, but I think they come in sicker as well. Two of the Grady medical directors are EM attendings, so there has been improvement in both since I've been here. This has included better relationships with other services and a switch to all digital PACS and EMR. Our average ED length of stay--from triage to getting a bed or discharge--is under eight hours, which for a county hospital is not too shabby.
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  • .Ancillary staff.. at Grady: I think most are excellent and have a lot of pride in what they do. You'll encounter a few who don't have pride, but they are known by all and do not tend to last long in the ED. I have yet to start my own IV unless the RN's have tried, then we do EJs or ultrasound-guided PIVs. I have pushed my own patients to radiology (about 10 seconds to walk, under a minute to push) only when the patient is unstable or I want to expedite care. At the other hospitals, the ancillary staff is seamless..
  • .Interaction with Surgery: ..In general, there is so much trauma at Grady that both general surgery and the subspecialties are glad for any help, and this frequently involves doing our own procedures. ..This is especially true of Ortho; if you are confident with your skills, you can consult them but do the fracture reduction and splinting yourself. ..When we consult the Trauma service for major traumas, we manage airway but share in responsibility for all of ATLS. With the volume it is not uncommon that you run ATLS on major traumas yourself before they show up. I would like to see us trade days for running trauma codes, but for reasons of volume and manpower, this is not realistic. You are going to see this at any major academic center, especially one where the main editor (Dr. Feliciano) of the Trauma text is based. There is good and bad to this, but we still get a fair number of central lines, chest tubes, etc. We supplement this with cadaver, pig, and simulation labs. For those traumas where surgery is not consulted, we do our own resuscitations, FASTs, procedures, etc. In addition, there will be a new Trauma Center opening later in 2011, so there will be changes...
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  • .Interaction with Medicine: ..On the medical side (blue zone), we do all resuscitations, procedures, etc. This is where we get most of our lines and chest tubes, coupled with the rare cric's and pericardiocenteses. Interaction with medicine is excellent; it is rare that they try to block an admission. Of note, we have full admitting privileges for both medical and surgical services.
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  • .EMR..: All PACS and EMR are digital at all of the hospitals. Emory Hospitals use Cerner and Centricity for EMR and PACS, respectively. CHOA uses IBEX and EPIC. Grady was the last to convert with Phillips iSite and EPIC as well. This includes computerized orders and charting.
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  • .Didactics..: We work hard and have to develop our own habits in terms of reading after shifts. During shifts, our attendings have many years of experience and lots of enthusiasm to teach; we also try to have quick teaching moments during our change-of-shift walk rounds. The Tuesday conferences are well-organized, and are based on an 18 month module. However it would be nice if more attendings showed up for commentary. We use MD Challenger for online board review. In addition we have a nice sim lab and many other procedural labs throughout the year. We are excused from all off-service rotations to attend conference. Our department is well-recognized in resident education: our PD Philip Shayne is the current CORD president, and our chair is past president of SAEM along with another faculty member who sits on the SAEM board. One of our associate directors left to start the new UT Austin program, which will be killer!
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  • .Research: ..It's definitely possible to do in residency, but our primary goal should be to learn to be emergency physicians. We have the resources- a large (about 80), well-published faculty, as well as a well-funded department with research assistants and statistician available. Our research director, Deb Houry--who sits on the SAEM board--encourages resident research and conference participation. This is not to mention the other resources, including a well-recognized public health school and the CDC. In 2010, our department received NIH funding for about $25 million for a multi-center RCT of progesterone in TBI. The bottom line is that if you have an interest, you will find at least a few attendings who are working towards that interest and who are willing to involve you. .

  • .Subspecialties: ..In general our fellowships embrace public health and policywork as our faculty has a long history of being involved at the national and international level for many subspecialties in EM. .
  • .Health Policy: ..Dr. Kellerman left to join RAND in Washington, DC, but there is still a strong health policy presence. We have a CDC-funded Injury Prevention Center and there are still several faculty with DC connections. .
  • .Ultrasound:.. We have a three young faculty in a budding Ultrasound program. Fellowship started in 2010. There is a dedicated intern year combined anesthesia and ultrasound rotation, tubes in the morning and ultrasound in the afternoon. In addition, we have also sent graduates in the past two years to fellowship programs in ultrasound.
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  • .PEDS: ..Childrens HC of ATL (CHOA) is one of the top peds hospitals in the country, ranked #3 by Child magazine and a top 100 employer by Fortune. We rotate between two CHOA pediatric EDs. The Peds EM faculty is great and the fellows I've worked with so far are impressive. One actually graduated from the SUNY Brooklyn EM program, did an Ultrasound fellowship at St. Luke's, and is now a Peds EM fellow..
  • .EMS/Injury Prevention..: One of our EMS guys is the chief editor of the WHO manual on Pre-Hospital Care, along with Arthur Kellermann who has done a lot of work on injury prevention and healthcare policy. The CDC-funded and university-wide Emory Center for Injury Control is headed by our department. Another attending, Ricardo Martinez, ran the National Highway Traffic Safety Administration under Clinton's presidency. Both Kellermann and Martinez are in the Institute of Medicine..
  • .Tox:.. we have the only CDC-sponsored tox fellowship in the country, along with working at the third-busiest poison control center (which is part of Grady) in the country. Grads of the program go thoughout the country (one left for UC Davis last year) or work at the CDC or other state/federal positions..
  • .Admin: set to start in July 2011, will be taking two of our current chiefs.
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  • .Shifts..: First years are largely responsible for hallway and room patients. The goal is to learn the bread-n-butter of diagnosis, treatment, and dispo. It is strongly emphasized that we don't move the meat. Second years are responsible for patients that require critical care (procedures, resuscitations, etc.), while third years supervise the entire zone, teach students, and are more responsible for administration and throughput. The 3rd year will pick up critical care or major trauma patients if there are too many for the 2nd year to see. Shifts are 18-20 per month, 10hrs for 1st years, and 8 for weekday and 12 for weekend for 2nd/3rd years. I usually get out about one hour after my shift ends at Grady, which I think is typical..

  • .Rotations:.. they are summarized on the website. For the most part, the program is responsive to residents not being indentured servants on off-service rotations. An example is the ortho rotation which used to be ortho floor work and OR, but now has been changed to ortho consults and procedures in the ED. Also, on OB, we do 12 hour shifts in both L&D and the WUCC--where we get experience with ectopic pregnacies as well as other presentations in previable pregnant women. A key point is that while other specialties are also strong at Emory, many (including Ortho, ENT, Ophtho, OMFS, Psych, Neurosurg, OB, and Medicine) rotate in EM with us, so there is a lot of mutual respect and goodwill that goes around. This leads to smoother consults and admits, and emphasis on learning during off-service rotations. We have most of these during first year, but we do have six months of EM time, with all of us starting off at Grady in July. Second year is critical care year, so we have two ICU months along with 7 EM months, and 3 EM s/elective months. Third year we have 8 EM months, 2 EM s/elective months, a trauma surgery month, and a PICU month. In total, we have 21 EM months (at least 4 of which are Peds EM), 5 EM s/elective months, 4 ICU months, one med floor month, one OB, one ENT/Ophtho, one Anesthesia, one ED Ortho, one Trauma, and no general surgery floor month..

  • .Atlanta..: A metropolis of over 5 million, it is made up of many neighborhoods with some cool spots with clubs, bars, restaurants, etc., and some areas you don't want to be at 3am. It is the major hub of the Southeast and has many cheap flights nationwide and internationally. I feel just as safe here as in Los Angeles or any other big city. Several in my class have condos or townhouses with commutes under 15 minutes to Grady. All of the five hospitals are under 20 minutes apart from each other, and most residents live within 15-20 minutes of each hospital. Also, as a major hub (a Federal Reserve branch is here, the 11th Federal Circuit is based here, it is ranked fifth for most Fortune 500 companies, etc.) it has a strong job market, for those with S.O.'s. And for those without, Forbes ranked Atlanta as the top city for singles in 2009. There are a lot of national parks and lakes nearby as well for nature lovers..

  • .Residents..: there is a lot of diversity in ethnicity, background, and interests. I feel like our class gets along really well, and we try to get together on weekends, for happy hour, etc. All of the residents are supportive of each other, but because our program is large (54 total residents, now 19 per class), I have not hung out with residents from the other classes that much. Our residents are from all over, just look at our website. The vast majority in my class interviewed throughout the country in other "big-name places" and ranked Emory first for the combo of great clinical training, academics, research, policy, and public health...all in a three-year program!.
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Thanks for reading. Good luck y'all. Hope you rotate and/or interview with us. PM me if you have any questions. .
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Ok, long time poster, but I'm posting under a different name to maintain anonymity.

Overview: Storied program with a long EM history in a large urban setting that predominantly serves an indigent population. Emory also boasts outstanding leadership along with the support of a prestigious university.

Residents
: Very large class with 18 residents per year. The residents are perhaps the most diverse (ethnically, geographically, etc...) group of any program in the nation, and the Emory prides itself on this fact. A good showing at the pre-interview dinner and they were all down to earth, fun loving, and willing to answer our questions in a candid fashion, acknowledging that you will work your butt off here. Having rotated here, I know this theme is universal and not just limited to the ones at the dinner.

Faculty
: Large department with approximately 90 faculty that serve in various roles in the program with some having more of a teaching roles than others. There are a ton of different styles to learn from to help you develop your own. The PD, Dr. Shayne is extremely nice (with an odd sense of humor…but I like it) and very pro-resident. In fact, one resident joked that they sometimes compete to see who can make him laugh. He meets with you informally during the interview day to answer any questions you may have. Also with so many faculty, come lots of different interests to help you find your niche in EM. As mentioned above, the leadership here is amazing with the chair being president of SAEM and other faculty serving on the board.

Ancillary staff
: There are always a lot of rumors about this aspect of the program. Since I rotated here maybe I can give more insight. So being at Grady won’t spoil you as far a nursing goes. Yes there are occasional problems with staffing, but I have never had to push a patient to xray, nor bring them back. I have only started IVs or drawn blood when I wanted more practice and almost all of our orders were carried out in a timely manner. Also, being courteous and introducing yourself to the nurses doesn’t hurt as far as facilitating patient care. The ancillary staff at the other hospitals is phenomenal.

Curriculum
: I won’t rehash the curriculum as it is readily accessible from the website. However some highlights include all PGY-1s spend the first month at Grady as somewhat of an orientation. There is also an airway workshop the first month with sim labs, etc. Off-service rotations are catered to EM interests ie. Ortho is ED consults, OB is spent with 12-hr shifts in L&D, and Anes. is at a private hospital with no Anes. residents so lots of opportunities to intubate. Second year is critical care experience and running all trauma/medical resuscitations and third year is learning how to manage an ED with teaching responsibilities. ED shifts are 10s in PGY1, 8s in PGY2-3 with 12s on weekends.
Didactics are on Wednesday AMs with interactive quizzes after each lecture. Mostly faculty run, but some resident presentations as well. Emory is certainly a “learn by doing” environment so don’t expect to be spoon-fed if that’s your style.

Facilities
: The majority of training is done at Grady, the quintessential county experience with ~100/000 visits/yr. There is a grease board, paper charts/orders (kind of like T-sheets), computerized labs, old ekgs, discharge summaries, and now imaging with radiology only a very short walk for quick reads. ED divided into zones with single coverage in red zone, mostly surgical pts and double coverage in blue zone mostly medical pts, but sometimes anything can go anywhere. 3 trauma bays that fit two beds each that can fill up at any moment. ED handles airway on all traumas and FAST scans are usually done by surgery, but I have often seen the ED physician do them as well and there are lots of traumas where surgey isn't called. Funding is secure thanks to private donors and a revamped board. Crawford-Long and Emory Hospital are beautiful private facilities with all the expected perks including completely computerized systems. Peds is split between Egelston ~ Emory and Hughes Spaulding ~ Grady.

Location
: It’s Atlanta…a sprawling southern city with some east coast flare. Although the cost of living is higher than that of other southern cities, it is still very manageable. There is a lot to do within the city and the suburbs, sports, music, arts, shopping, entertainment, jobs, schools, whatever you’re looking for. Nice weather. Most of the residents live within 20 mins of the hospital. Delta has a hub making travel easy. Tons of opportunities in EM related fields.

Negatives
: Emphasis on independent learning (if that’s not your cup of tea…then Emory is not for you) and “all county, all the time” or “most of the time” can get tiring for some. But these aren't negatives for me.

Overall
: I loved my elective experience there and my return visit as an interviewee. The program definitely seeks those with an interest in serving the indigent. Solid 3 year curriculum. Work very hard, play very hard. I felt at home and will rank this program very high.





 

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Thank you all for the above, it has been helpful for me to read, I will post where I have been below:

Jacobi/Montie--Have rotated here. Amazing program serving a community with some diverse and esoteric pathology. The prgram provdes a comfortable split bewteen trauma and medicine. Montie gets no trauma and all acute medical cases. The ordering system is electronic and the ancillary services including the nurses are excellent. Jacobi is a big inner city hospital and with that comes an amazing patient population and no ancillary services. be prepared to draw your own bloods, start all your IV's and wheel your patients to rads when you need it done. However with that also comes the fact that the resdents handle EVERYTHING including all trauma that comes through their ER. They are a pretty amazing bunch.

Maine--Amazing town. Portland might be one of the most beautiful cities I have ever visited in the country. The residents all seem happy, apparantly work 22 9 hour shifts and only take patients for 8 hours with the last hour dedicated to wrapping up all of the loose ends of a shift. The prgram is very new (only 5 years old) and still seems to be finding its niche. They have a lot of young excited faculty who are very friendly. Their new PD was recruited from Carolina's. The biggest drawback from my persepctive is the lack of diverse pathology (the resident o example had not taken care of an AIDS patient in 2 years).

Emory--Was blown away but this interview and presentation day. Seems as though a lot of strong research is being done by their amazing faculty. They have close ties with the cdc and have 6 attendings who work in both the ed and for the cdc. A great deal of their faculty have mph's and take an active role in both public policy and public health research. They also have a basic science laboratory where they are studying traumatic neuronal inujury. The only drawback (for me at least) about this program was Atlanta. Appears to be a very violent city (though it has some nice parts), and its hot. (I have a cold bias). But this program is amazingly strong.

Penn-- Another great program. Residents work 18 12 hour shifts while in their ED. Thanks to the proximity of CHOP they get an amazing amoutn of peds exposure. The ED was very nice and modern with both electronic charting and lab ordering. All of the residents seemed very happy. The only drawback I found with this program is that the only role the ED has in trauma is to manage the airway and nothing else. However, the faculty are all very friendly, their PD was a geniunely cool guy and they have very strong residents.

I think thats all for now.
 
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.
 
Previous years' ROL threads were a great help to me when I decided where to interview, so here's my part this year.

My list would also be much different were it not for 1) a spouse in the picture and 2) my interest in international EM, so take it with a grain of salt and to echo SuziQ, feel free to PM me with questions regarding any of the programs I interviewed at. Honestly, I'd be thrilled to land anywhere on my list.

1. Vandy Pros: INCREDIBLE faculty, residents, unparalleled teaching, the PD and chair are a dynamic duo that are very involved in resident education. Busy, busy university ED where you see ALL the trauma in a large catchment area, plus all the weird tertiary stuff, and your bread and butter. Great international opportunities with the Guyana residency, New Zealand, ect. Off service rotations are great, peds shifts are mixed into your regular ED months, residents are happy, 10 hr shifts with 1 hr built-in overlap, COL is incredibly low, Nashville has a great live music scene. Cons: Less diversity (in both staff and patient population), you're in a smaller southern city (+/-). Caveat: I rotated here, so I'm bias in that I'd already spent a month getting to know and love the people. But honestly, couldn't find a better program on the interview trail.

2. Brown Pros: this was the program that snuck up on me. I even considered canceling the interview. Like Vandy, a university program with a large single hospital program with a huge catchment area, very busy ED. Happy residents, warm faculty, great peds experience, strong support for international work and opportunities (currently setting up a training program in Nicaragua), 9 hrs shifts all 4 years, Providence has surprisingly low COL for the northeast and is a great little town with amazing food and recreational opportunities. Cons: It's in Rhode Island, 4 yrs > 3yrs.

3. New Mexico Pros: another single-hospital system with a huge catchment area (which I like for the reasons above), incredibly nice PD, down to earth faculty, happy happy residents, strong commitment to underserved care with a large indigent community, great international/wilderness opportunities, one of the best programs for critical care exposure, great reputation, large Spanish-speaking population, only 4 months of call all 3 yrs of residency, 9 hr shifts with 1 hr built-in overlap, you have skiing and hiking less than an hour away. Cons: the city's economy somewhat depressed, less job opportunities for spouse (this program would be my #1 or #2 if not for this), less ethnically diverse.

4. Highland Pros: well-respected program, hard-core county training, in a beautiful part of the country. Great service commitment, residents are happy, strong pedi exposure at CHO, tox at SFGH, 8 hr shifts. Cons: the faculty are quirky (+/-) and somewhat inbred, very weird interviews, draw your own labs as PGY1, ED itself felt a little small, not a Level 1, the cafeteria food (yes, that's picky).

5. OHSU Pros: old, well-respected program with happy residents in a beautiful part of the country, diverse hospital exposure (university, VA, community), faculty very supportive of residents, 1:1 with attending as PGY2.10 hr shifts PGY1, 8 hr shifts PGY 2-3. Cons: low-volume primary ED, only 1 mo elective time, have to drive a lot.

6. Stanford Pros: Dynamic faculty, content residents, 3 hospital system with exposure to university (Stanford), community (Kaiser) and county (Valley), an AMAZING amount of resources for anything you could possibly be interested in, great fellowships, great international and wilderness opportunities, beautiful part of the country to live,time for research/scholarly project built into rotation schedule. Cons: COL (highest of anywhere I interviewed-this was huge for me), low-volume at primary ED (Stanford) which is where you spend 1/3-1/2 of your time, intern year spent with a lot of off-service rotations (including medicine and surgery wards and NICU time), 12 hr shifts, "country club" feel (the catered lunch comes to mind).

7. Carolinas Pros: incredible community program with great training, I loved the PD and faculty I met, residents are very tight and social, 1 hr conferences daily instead of a 5 hr block, single-hospital system, great U/S experience, starting an international fellowship, great COL. Cons: I thought Vandy was a better fit for me when it comes to Southern programs, their int'l focus is in Tanzania (my interest is Latin America), medicine and peds wards months, Charlotte, a very "proud" program.

8. USC Pros: Incredible faculty and residents who obviously enjoy working at LAC, probably the most amazing county training out there (certainly busiest ED in the country). Great diversity in both staff and patients, huge volume ED that probably sees some of the craziest trauma and pathology, residents run their own "pods" and jail ED, commitment to indigent care, in SoCal. Cons: 12 hr shifts all 4 years, maybe a little too autonomous for my taste, can only do international rotations on your vacation time, LA is not my favorite city.

9. BWH Pros: amazing resources for international EM, great U/S program, friendly, well-connected faculty, great opportunities for research and an interesting mix of pathology, shifts are a mix of 8,9, and 12 hrs. Cons: residents were the geekiest bunch of the trail (but seemed very happy!), greater focus on research, Mass Gen's ED felt very cramped, COL in Boston, 4>3 yrs.

10. Emory Pros: great service commitment, huge county program that is also academic, diverse residents and patients, busy ED. Cons: the number of patients I saw in hallway beds!, not as much international support, very county feeling, strange interview.

11. Harbor UCLA Pros: amazing country program in LA, great training, well-respected, good autonomy. Cons: not much international support, LA.

12. Baylor Pros: amazing county hospital with incredible pathology and young, enthusiastic faculty. Shifts 8's on weekdays, 12's on weekends. Cons: too new of a residency program.

13. Duke Pros: Dynamic PD, good mix of faculty, happy residents, time for scholarly track, COL. Cons: not very diverse, Durham, still young residency program, hard PGY1 year with lots of off service rotations, not as many intl opportunities.
 
ROL
The city for each program played a big role in my list.
1. Baylor: Pros: I liked Houston a lot and grew up in and still have most of my family in the SW. I liked the residents. Faculty seemed cool and are from all over. I think I would like to end up in the SW when I'm done with residency. Ben Taub was nicer than I was expecting and the Texas Medical Center was impressive, some Peds EM at Texas Children's Hospital. 6 months of ICU. I'd get to work on my Spanish. Free lunch everyday while working in the ED. 8's during the week and 12's on weekends to allow for a weekend off a month while in the ED. (I've forgotten how many shifts- 20-22ish?)
Cons: Newer Program (In its first year). Houston Traffic. Moonlight starting 3rd year. Residents Pay for parking.
2.Univ. of TN- Chattanooga: Pros: I rotated here and like the faculty and the residents. No floor months (Peds or IM). About 5 ICU months. Nice hospital, Nice ED. Free food + parking. Newer program (in it's 3rd year) but has a lot of support from the college of Medicine and Hospital- the Dean of the College of Med is an EP and the president elect of ACEP. Good "outdoor activities." Variety of good food- I've was pleasantly surprised. I'd be very happy to end up here, and thought about putting them number 1 but chose Houston over Chatt. 17 12's as an R1, 17 10's as R2, and 16 10's as an R3 (or something close to that).
Cons: Not a big city, although Nashville and Atlanta are close by (not a plus for me). Not a great place to fly out of- most flights take you to Nashville or Atl first. No family nearby.
3. JPS: Pros: Some of the faculty seemed pretty cool. Fort Worth seemed ok from what I saw during my 1 day visit. I like most of the curriculum- about 6 months of ICU. 1 mo of Cardiology is a plus in my book. Nice ED. Free food + parking. Good benefits package. Dallas nearby. This program could have gone lower on my list, but I like the city more than the ones below, and although the idea of being at a brand new program is a little scary it didn't scare me off. Also, it could be cool to be the senior-most resident in the ED on day 1 and not have 2 classes above to compete with for procedures and cool cases.
Cons: Brand New Program. Hard to get a feel for things because no residents to talk with. PD not at interview day. 2 months of Medicine. No Peds EM integrated into Adult EM months (this was the issue that most worried me, but the Assoc. PD said that they will see what the residents think and are working on some of the hospitals nearby but have nothing solid as of the time I interviewed. They do however, have 3 months of Peds EM- 1mo as an R2 and 2mo's as an R3 at Children's Hosp. of Dallas. Nothing R1 year).
4. Kansas City (KUMC): Pros: Nice people, Nice ED
Cons: 1 mo of Medicine + 1 mo of Peds, Newer program ( in 1st year), I think KC may be a bit colder or more snowy than what I'm looking for
5. Arkansas: Pros: Established program. Nice people. Newly built ED that was pretty nice. I believe an EM resident is involved in/runs all of the Traumas. A lot of moonlighting opportunities.
Cons: Little Rock. Residents give a lot of the lectures. 1 mo of Medicine at the VA (I think they may consider changing this?) 1 Month of Peds Flight experience (I think this is a combined EMS/Flight experience. You can opt out of the helicopter rides and do an additional month of PICU instead, but most people don't). All 12's (R1- 18, R2-17, R3- 16)
6. Christus Spohn: Pros: The beach. Good weather year round. Family is the only other program, so when you are off service you are working w/attendings. EM handles the all of the traumas (no surgery residents). No call, except for one service.. PICU, I think. Everything else is shift work. When on Trauma, it's 12 hr shifts. Moonlighting opportunites. 9 hr ED shifts (20/19/18 for R1/2/3). Weekly quizzes to go with reading (+/-) Free food + gated parking. Optional flight experience. 1 mo of Cardiology.
Cons: Older EDs. Level Two Trauma center (although they say they see plenty, plus no surgery residents to compete with). 1 mo of Neurology (they say it's beneficial, bc you're often consulting Neuro, good experience, etc.) 1 mo of Medicine
7. Emory: Pros: I rotated here for a month. I loved Emory (EUH, Emory Hospital- Midtown, etc) but wasn't a fan of Grady. Lots of sick pt.s at all of the EDs. At Grady, at the beginning/end of each shift the teams sort-of mini round on all of the pts. , it's brief (about 10 min max) and usually an attending, resident, and med student will share something cool that they saw or learned. Now have EMR. Some cool residents. The SICU month is supposed to put hair on your chest. During intern year (it may be during the first month in the ED) you get a month to cherry-pick procedures and can take some from the upper levels so that you get more comfortable and more experienced during that month. A lot of the faculty were very nice and the residents seem to like each other. I believe Emory gets the most NIH research money for EM. 8hr shifts during week, 12's on weekend to allow for 1 weekend off a month while in ED. Around 22 shifts a month(?).
Cons: Grady just wasn't really my style. Very crowded. Lots of pts on stretchers in the hallway, my 3rd year wheeled a pt to CT and then I took him to X-ray. A lot of the rooms don't have functioning ophthalmoscopes or otoscopes. Some of the labs didn't get drawn on a few pts. Very large class size (19, likely going up to 20). 1 mo of Medicine. ATL traffic. I'm also not a big fan of ATL and I think that colored my experience as well. I think it is a good program. Most of my mentors in EM went to Emory and they are awesome, that's one of the reasons why I wanted to check it out. I think when you come through the program you'll be very well prepared. 75% of the program is at Grady, 25% at Emory. Because of this and since I didn't like the city either, It had to be a lower ranking for me. I agree that Grady really is a place you should rotate at if you very interested in going there for residency. You'll find out if you like it or not during that month and they take heavily from those who have rotated (in one class, I think 18 of the 19 did a rotation there).
8. St. Louis (SLU): Pros: 1 mo of Tox + 1 mo of Burn Unit. St. Louis can be a violent city (trauma).
Cons: St. Louis can be a violent city. Small ED with lower pt census (I believe around 35K/yr). Interview day was a bit disorganized. Newer program (in it's 2nd year) 1 mo of Peds, IM, and Neuro. A couple of awkward interviews, although PD seemed cool. I also missed the pre-interview dinner and didn't get to meet some of the residents.
9. MS: Pros: A lot of moonlighting opportunities. Since it's a 4 yr program, they have room for all of the things that other programs pick only a few of (Cardio, Radiology, EKG, Tox, Ultrasound, Peds Sedation, TeleMedicine). Most of the resident were pretty cool.
Cons: 4 years is about 1 year too long for me. Jackson. 1 mo IM. 1st year is very off-service heavy, only 3 mos of EM (2 adult + 1 Peds).
 
Posted anonymously on behalf of a student who interviewed there.

Emory Review


Pre-Interview Social: The pre-interview dinner was at a resident’s house. I wasn’t able to attend, but realistically you probably will need to rent a car or take a cab if you want to go to the pre-interview dinner. Most of them seem to be held at random people’s houses or other places that aren’t very close to the hospital.

Interview Day:
The interview day started at 7:30 AM with breakfast and a Fox News video about Grady’s ER. Then the PD, assistant PD, and EM chief each did a presentation about the program, which was followed by interviews, lunch, and a tour.

I had three interviews with the associate PD, one other faculty, and a fellow, and I also met briefly with the PD. The interviews were 20 minutes each, plus four 5 minute breaks. All of the interviews were pretty relaxed. I was asked what I wanted them to remember about me, what I think they should look for in a candidate, to tell about a conflict I had with a resident/attending and how I handled it, and to give a weakness of mine and what I’ve done to work on it. All in all, much more thought-provoking than your typical why EM and what do you do for fun interviews. Everyone also asked me what questions I had, so make sure you’re prepared to ask questions!

Curriculum: Emory is a three year program. The confusing array of hospitals include Grady (county hospital that is the only trauma I and indigent care provider in Atlanta), Emory University Midtown (a community hospital, also called Crawford Long), Emory University main campus (university hospital across the street from the CDC and a boutique experience for PGY3s), and Children’s Hospital of Atlanta (CHOA). There are two CHOA sites: Hughes Spalding (on the Grady campus) and Egleston (Emory’s peds teaching hospital). There are 18-20 shifts per month that are scheduled in blocks and rolling later (AM, PM, nights). PGY1s do 10s, while PGY2s/3s do 8s on weekdays and 12s on weekends. There are two peds EM months in PGY1, plus one peds EM month and one PICU month in PGY2. No longitudinal peds shifts although they are considering changing this. Total EM time is 22 months, including the community EM, ED administration, and peds EM blocks. There are four ICU months. The ED at Grady has a medical side (blue) and a surgical side (red). The red zone has two pods, one run by PGY2s and the other run by PGY3s.

There is an orientation block where all of the residents start off at Grady in July, and the interns get to be the medical directors for the Peachtree Road Race on July 4. (This is one of the largest 10K races in the country.) The residents stressed that off-service rotations are very strong. Ortho consists of ED consults. OB is on labor and delivery as well as urgent care. There is one medicine ward month and one anesthesia month. There are two selective blocks, with options that include rads, EKG, EMS in Georgia (the republic, not the state!), neuro ICU. One selective is scheduled in PGY2 and the other in PGY3.

All major EM subspecialties are covered. I already mentioned peds and ICU. There is an EMS/observation medicine block with optional flying. There is a tox block at the Georgia PCC that the residents spoke very highly of. They don’t have a dedicated US block, but the PGY1s get fully certified. PGY3s have a trauma surgery block. There is an administration/academics EM block for PGY3s also, which I assume is like a teaching block, but I didn’t ask about it. They have a strong international health focus, with multiple possibilities to go abroad (Mozambique, Rwanda, Republic of Georgia, India, Saudi Arabia, Jamaica). Injury prevention is also big, and they have a Center for Injury Control that studies things like poisonings, bomb injuries, and domestic violence. There is also a significant research focus, with traumatic brain injury being the major area. (Emory is running a study on the use of progesterone in TBI.) They have an emergency pharmacist in the ED who helps run the codes and a separate psych ER.

Didactics: They have your standard five hours per week of didactics on Tuesdays. We didn’t hear anything at all about didactics during the interview day, and I suspect that formal didactics are not a huge priority of the program. However, the residents do get protected time to attend conference even on off-service rotations. They go through the EM core content twice during residency and have access to MD Challenger. They put on an airway course, do cadaver labs, and an ACLS instructor course.

Benefits: Emory has decent benefits. They give you a copy of Rosen’s, the MD Challenger CD, pay for your EM organization memberships and certifications, travel allowance. There is a legislative day when the residents all go to the Capitol and meet with their state legislators.

Administration: Resident wellness was emphasized during the assistant PD’s presentation. They have a STAR program that assigns each resident a faculty advisor as well as a resident big brother or big sister. The program also maintains an online wellness tab to give residents information about attractions, restaurant options, outdoor things to do, etc. There is an annual retreat. Emory also prides itself on its diversity (both residents and faculty), and they want residents who fit in with their mission of serving the underserved. (The PD told us that they look for evidence of community service among applicants when selecting who to interview.) They also teach residents how to deliver bad news, and there is even a palliative care fellowship.

Atlanta: I love the city. The winters are mild, the people are nice, and they have all of the regular cultural amenities like sports teams, museums, art, and so on. Residents can afford to buy homes in the suburbs if they want. You’re only a few hours away from the mountains or from the beach. There are plenty of historical sites to visit in the area if that’s your thing.

Summary: This is a big program (19 residents) that manages to make itself feel intimate and community-oriented. It probably helps that all of the interns spend July together. I really liked the residents I met and admire the sense of service that the program has. They don’t just talk the talk when it comes to helping the underserved. Grady is the only safety net and trauma I center in the area, and the residents and faculty seem committed to giving back to their community. They are heavily involved in EM organizations and participate in community events like the Peachtree Road Race and public policy. I also got the impression that resident wellness is taken seriously at Emory, which I think is important when you’re working in an intense environment like Grady, and also since you’re part of a program that’s as large as this one is. They seem to take resident feedback seriously, and even applicant feedback. (This was the only interview where I was asked to take a survey about how they could improve their website and interview day.) The program seems to offer something for everyone: great training for any kind of practice, access to lots of research, international electives, public policy, multiple fellowships, and many other academic opportunities. In particular, their affiliation with the CDC provides for some unique opportunities that aren’t available anywhere else. COL is cheap and I would love to live in Atlanta. All of the major EM subspecialties are represented, with tox and EMS seeming particularly strong. US also seems strong with all of the residents getting certified. I don’t think there are any major weaknesses in the program.

One of the negatives for me is that there are so many hospitals, especially since they all have their own EMRs to learn. But I guess that could be a positive after graduation when looking for a job. Also, they don’t have longitudinal peds shifts, but they do enough peds EM blocks that their seasonal exposure seems like it would be good. They have one IM floor month, but that’s tolerable. Finally, in spite of how much research is available, it doesn’t seem like academics and didactics is as high of a priority compared with a lot of other programs.

Overall, I think I’d get great training at Emory and would be very happy to match there.
 
This is a couples' match list...if it were just me, my list would likely look pretty different. Some programs would have been higher on the list (especially Cinci), but Vandy definitely would still have been my #1. :love:

I interviewed at 18 programs, and ranked all 18. This ROL is obviously just my (and my fiance's) opinion- no offense to anyone is intended. It was really helpful for me to look through ROLs from past years, so I thought I should reciprocate by posting mine.

I felt so fortunate to get to interview at these programs and honestly thought each of them had notable strengths. The couples match certainly complicates things (and requires LOTS of negotiation) but luckily I feel like I would be happy at a lot of these places.

Let me know if you have any questions about my list or the programs I visited. I'm happy to give my advice/thoughts to next year's applicants too- just message me!

1) Vandy: I am absolutely in love with this program. Love the faculty, love the Chair and PD, love the residents. It's one of the most resident-centric programs I have seen, with the best teaching in the country. Very busy ED with so many critical care patients. Tons of trauma because of huge cachement area; great relationship with trauma surg. Curriculum extremely well thought-out, including no floor months. Residents are very close and are amazing people. Very diverse patient population (tertiary care, uninsured/underinsured, bread and butter EM, peds, immigrants). Nashville is a really fun city, great COL, easy to live right by the hospital. Grads go anywhere in the country they want. This program has everything I want.

2) UCLA-Olive View: Truly amazing PD who has the residents over to his incredible house (and he was the medical director for the show ER- I thought that was pretty cool), and distinguished faculty. Well thought-out integration of county and tertiary care experience. Ronald Reagan is an incredible facility, and Olive View is a nice little hospital that has a new ED opening this April. Program curriculum is "front-heavy" (easier 3rd and 4th years), which I liked. Intern year is getting much better every year- there will be 6 months of EM during intern year 2011-2012 and fewer medicine/surgery ward months. PD described the program as a "liberal arts EM program," which I thought was an apt description and a pretty neat concept. Amazing international opportunities and a lot of elective time. My Spanish is mediocre at best, and that seems pretty essential (especially at Olive View). Trauma not as extensive as at other LA area programs. COL high and lots of commuting in nasty LA traffic.

3) UNC: Residents were very happy and welcoming. I really liked the dual hospital system. I went back to do a second look and shadowed at both hospitals, which only served to increase my enthusiasm about their way of training. Of course, it does result in a lot of commuting but the traffic isn't bad so that didn't bother me. Amazing PD who is an outstanding teacher and very supportive of the residents. Program produces very well-trained EPs who also have satisfying personal lives. I love the location and the COL. Great moonlighting opportunities. Medicine and surgery ward months intern year (but at WakeMed so relatively laid-back). Not as much trauma as some other programs. Duke is obviously nearby so there is some division of patient populations, but I felt that was made up for by the WakeMed experience.

4) Highland: This is a well-known program that I felt lived up to its strong reputation. Faculty and residents are all very laid-back and fun. Strong family feel. A lot of the faculty trained at Highland (which may be a negative), but of course they stayed on faculty because they love it so much there. GI rounds TID seem like a great idea. Not an "official" Level 1 trauma center but there is none in the county, so serves as the de facto trauma center and see a lot of trauma. Not a stroke center, so do a month of neuro at UCSF. Amazing U/S experience. Peds is not integrated (no peds beds in HGH). Highest salary I saw on the trail (because they are unionized). Tahoe ski cabin sounds like fun. Sounds like they have everything worked out in regard to UCSF's EM program, but still made me a tiny tiny bit nervous.

5) BIDMC: The 3+1 (Junior attending year) is an amazing opportunity that I was very excited about. The curriculum is very well thought-out with a clear graduated responsibility. Rotate through 5 "affiliate" hospitals (community sites), which seems like a good experience to see how different systems work. Amazing EMR. Peds not integrated. Trauma pretty good but obviously there are a lot of hospitals (including four Level 1 trauma centers) in Boston. Relatively new program (10ish years) but has established itself extremely well. Had a great feeling about this program on the interview day and it was initially higher on my list; in the end, I decided that Boston is not at all ideal for me and that's what pushed it down the list a bit.

6) LA County: Another program that was initially much higher on my list. I was in awe of this program during the entire interview day. Very sick patients and a lot of trauma, in which EM has a huge role (they do essentially all procedures). EM also manages airways during codes on the floors (which at most other places is done by anesthesia or MICU)- I thought that was cool. Residents were really fun people and amazingly impressive. Work 12s all four years (except on peds). Facilities are amazing but very much divided up into pods. Not as many academic opportunities as a lot of other programs I looked at. This place, in my opinion, provides the best clinical training in the county but wasn't the best fit for my career aspirations and personal life once I got over the "sexiness" of the amazing clinical experience. Location also not ideal for me personally.

7) Wake Forest: I love this place. PD and Chair were both very enthusiastic. Very well-established (30 years old) program with a long history of producing great EPs. Residents were very family-oriented. Very busy ED, which pleasantly surprised me. Loved the city (can get an amazing house for very little money) but it did feel a bit isolated.

8) Emory: So many faculty, and a lot of them are really well known in EM. Increasing focus on research- get a lot of NIH funding. Grady is Grady- tons of trauma (only Level 1 in Atlanta). Hugely busy, exciting ED. Patient population at Grady not very diverse- primarily African American. ED divided into red (surgery/trauma) and blue (medical) pods. Residents were very diverse and most were single. Atlanta is amazing but of course the traffic sucks and it's relatively expensive. I expected to like the program more than I did, but I got a weird vibe on interview day. It was probably just me, though!

9) Indianapolis: LOVED this program but in the end the location just wasn't going to work well. Residents were incredible- really sociable, welcoming, and proud of their program. Outstanding clinical experience, with time split between Wishard (county) and Methodist (tertiary care). Residents have a huge role in their program (49% ownership) which I thought was amazing. Very much a team attitude. In ICUs, work one-on-one with CC-trained EM faculty- so a great experience. Residents were more regional than I had expected for a nationally well-known program.

10) BWH/MGH: Strong academic program. Well-known faculty and lots of research opportunities. Felt like this was a great place to jump-start a career in academics. Lots of elective time. Program grads are highly recruited and go wherever they want after training. From talking to the residents, seems like they do fewer procedures than most other programs I looked at. Also, medicine and surgery ward months. Residents said they felt a bit "looked down on" by other residency programs at the hospitals, for what that's worth. I'm not a fan of Boston.

11) UAB: Their PD is awesome. Very responsive program leadership. The residents are pretty Southern and a lot of them have kids. Great lifestyle. Do LOTS of moonlighting. 10-year old program but feels like it's been around longer (that's a good thing). Birmingham was a very pleasant surprise. Great physical set-up of the ED. Very impressed by the program but realized as interview season progressed that I wanted a place that produces more academicians.

12) Wash U: Very busy ED. Great elective opportunities. Strong off-service rotations, but lots of ward stuff 1st year. Division status (I asked about this and the program leadership said it's not an issue). Didn't really care for St. Louis.

13) Cincinnati: LOVED this program- would have been among my top few programs, but my fiancé really disliked it for his specialty. Oh well.

14) UVA: Very nice program leadership, good reputation. Relatively low volume (although also smaller class so it works out.) Not much trauma. I didn't really click with the residents. City was too small and isolated for me. Great program but not a good fit for me.

15) Michigan: Awesome program. Love the PD. Survival Flight sounds great, as does the trauma experience in Flint. I didn't really click with the residents. The main problem for me was the location. I just don't think I could tolerate those winters- I almost crashed my car about 5 times just while I was up there interviewing.

16) Duke: I thought the PD was incredible and the faculty were very impressive. Residents were nice but seemed pretty guy-dominated. The program seems to be still fighting some battles. Wasn't a good fit for me.

17) Louisville: Had a really weird interview day, in my opinion. I found the group interviews to be awkward. Relatively low volume ED but lots of trauma. Not what I was looking for, but it had a lot to offer.

18) Harbor: This one was a surprise. Very well known program with great pathology and amazing faculty, but not a good fit for me. I personally don't want to have to deal with the transition from 3 to 4 years and the move to a new physical ED. I greatly preferred USC-LAC, but that's obviously just me and it's good that not everyone loves the same program!
 
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Not much to add to the above review, except you should note that this year marked the opening of a new addition to their EM square footage that should alleviate the famous crowding/shadiness of Grady. Ultramodern, very spacious, looks fantastic.

Only disagreement I have with the above review was my interview experience with faculty. Residents were extremely cool and layed back, friendly and welcoming. Had somewhat the opposite experience with the faculty. Very cold and unprepared for interview. No other questions than "tell me your life story", "tell me about yourself", etc. Several applicants said the very same thing. Maybe we just caught them on an off day, or behind schedule.

Still woulda loved to have gone here. One of the VERY best designed and respected residencies in the country. Number one in the nation for EM research funding, in a large part based on their virtual reality testing for sports related concusions and TIA. Heavy involvement with faculty in NIH and CDC work. Amazing pathology and resident autonomy. Amazing rock climbing north near chattenouga (solid bouldering located in SW Atlanta itself), excellent weather, nightlife, cosmopolitan city. Poor traffic but good housing not far from hospital. Residents didn't moonlight much but the option is there. Residents heavily recruited for jobs, many signing early in second year and recieving a monthly stipend from future employer every month of their third.
 
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Posted anonymously on behalf of a student who interviewed there:

*****

I applied in the south east area. Top quarter of my class, 254 step 2, Honors in EM x3, 2 away 1 home, Couple of publications. Sent out like30 apps. Only interviewed at 3 year programs.

My top 4 programs (in alphabetical order):

UAB
Pros: Outstanding program, outstanding reputation. The guys that write harrison’s internal medicine txt are from UAB. Great research support. Used to be a 4 year program, only been a 3 year program for a few years. The program director is a huge highlight. Resident advocate. My favorite interview on the trail. Resident centered program. Best moonlighting opportunities I encountered. They have internal moonlight at an urgent care type facility for so-so pay. Also have external moonlighting where you are paired up with more experienced physician and cover 2 physician EDs. A majority of the residents moonlight at least some. ED is brand new and state of the art. New children’s hospital/ED opening this year. 10 residents.
Pros/Cons: Birmingham.

Carolinas-
Pros: Outstanding program. Long history and great reputation in the field. Top of the top researchers in EM. Jeff Klein for instance is THE pulmonary embolism guy. Program directory is absolutely awesome. One of my favorite interviews of the trail. I just read one of her chapters in Rosen’s actually. They treat their residents amazingly. Great benefits. One of the best cities to live in period. Cool patient population, you get both underserved and the private type patients in the same ED. 12 residents per year.
Cons: No external moonlighting, although they do have internal moonlighting that pays so-so. No medical school affiliation (although I think they are working on this). I wasn’t a big fan of the ER, Kind of seemed cramped and older.

Emory
Pros: Again, outstanding program, great reputation in the field. Tons of top people have trained at emory. New trauma area is super nice. Lots of freedom as a resident. High patient volume. High acuity. Clinically, arguably the #1 program in the southeast. The research here is on another level. The CDC is located there in Atl and has large ties with the EM department.
Pro/con: Giant program 21 residents. Grady. I think it would be awesome to work there. Tons of action. Lower socioeconomic patient population. Atlanta is a pro/con, either you like it or you don’t .
Cons: No one moonlights there. Apparently it is allowed, but just no one does it for some reason. I asked about it and they had maybe 1-2 third years that do any moonlighting at all. They don’t do integrated Peds shifts, this is the only program on the list that does full Peds months exclusively with no year round type of experience. I felt that the program was less resident centered and more research/attending centered.

Vanderbilt
Pros: Outstanding program, outstanding reputation. Best resident education I encountered on the trail. Wrenn and Slovis are on a plane of their own. World renowned lecturers/educators. Resident centered program. Great moonlighting opportunities (external only I believe), most of the residents did some moonlighting. Ed and Childrens ED both have excellent layout and look nice. Great reputation in the area, with wide patient diversity and high acuity. Good relationship with trauma dept. Nashville is an awesome city with tons to do. 12 residents.
Pro/con: Medical record isn’t one of the big professional ones, it is one that was created in house. Seems good, with all the features you would expect/need.
Con: no real cons to the program.
 
Do residents often wheel patients to CT and XR (or draw their own labs/etc)? I always thought this was a myth and didn't occur at ANY programs so I never asked at any of my interviews, but a post above made it seem like this is what is done at Emory... is there a lot of scut work?
 
Anyone know the status of moonlighting at Emory? Above posters show some conflicting responses. I forgot to ask about this during the residency dinner. So I guess do people moonlight? When do they typically start? And what are the opportunities like?
 
Anyone know the status of moonlighting at Emory? Above posters show some conflicting responses. I forgot to ask about this during the residency dinner. So I guess do people moonlight? When do they typically start? And what are the opportunities like?

According to the chief, you can start year 3 and there are decent opportunities. COL is low enough that nobody needs to do it for the money though. it's about half that choose to.
 
Had a weird question from one of the residents at dinner. They asked "what bad things have you heard about us online like SDN?" I hadn't heard anything bad but now I'm a little concerned about what they might have been referring to/if there's something I should be concerned about.
 
Interviewed here not long ago and just wanted to say that the PD was one of the kindest/nicest ones I met on the interview trail. I wanted to post this as he has been described negatively on here ("socially awkward," "blunt affect"). Your meeting with him is brief and he can be blunt/direct about your application, but by no means was he unpleasant (an applicant I spoke to on the interview trail "advised" me to cancel based on their negative interview experience there... Not sure if this was a thinly veiled attempt to dissuade others from ranking Emory highly).
 
Few questions that I wanted to confirm:

1) What was the total number of shifts emory residents did PGY1, PGY2, and PGY3?

2) Did they do 8 hr shifts on weekdays and 12 hour shifts on the weekends?
 
Can somebody please confirm the 12 hour weekend shifts at Emory?
 
Long time lurker, posting on alternate account in order to remain anonymous. These threads greatly helped me and as such I am paying it forward. Good luck for future medical students. I won't go into the curriculum details or specifics since those are mostly readily available on their websites, but rather I made a long pro/con detail list along my interview trail and I will highlight my thoughts from that list.

Pro: happy residents, good work life balance, affordable, huge institution with great volume, only trauma in area, #1 in EM research funding, progressive leadership, 8 hours IIRC, CDC

Con: we only saw Grady but it was a very indigent population (not my calling, may be yours), 1 interview was late and didn't quite hit it off with PD (but he was exceptional and polite, strictly personality), IM month, didn't get to see 2nd/3rd years on interview day or really at dinner, bad traffic, felt like the program targets people that are hard into service

Overall impressions
Gut feeling: 6/10
Location: 6/10
Facilities/resources: 6/10, building new ER, new trauma bay was awesome
Didactics: Can't comment
Prestige: 8/10
Research: 9/10
Shift/hours/wellness: 10/10
 
I'm a PGY-2 at Emory and wanted to post my review of the program for anyone considering matching here (posting on alternate account to remain anonymous). I was excited to match here as it was in my top 3 and had an enjoyable PGY-1 year, but the program has really gone downhill since then. We've since lost our PD who took a promotion to work elsewhere at Emory, and we are losing one of our assistant residency directors in the next few months who is leaving to go to another program. I understand those things happen but both of these people are well respected and approachable teachers and will be a huge loss for us.

For anyone who's interviewed here you know you'll spend the majority of your time at Grady. We get a crap-ton of trauma so there's no shortage of clinical experience. The only problem is you sometimes get more than what the facility was built for. It's not uncommon to be undressing patients in hallways and putting critically ill pts out there - which is fine except then it bottlenecks the rest of the hospital. The biggest challenge I have is that all the patients we board in the ED - they all remain our responsibility. It's not uncommon for us to be managing intubated patients for an entire shift. When we do signouts we have to take signouts on all the admitted patients even if the floor team has seen them. Not only is this burdensome for the new resident taking them, but it means the off-going resident stays a MINIMUM of one hour and usually two, just wrapping up loose ends. Then it's time to go home and START charting. And because the already-admitted can take up so much of your time, the attendings are moving past seeing new patients and criticizing you for being too slow. VERY few attendings actually take the time to teach you anything on shift. And the teaching points are usually more style points than anything else - 'do a secondary survey in this order' or 'always stop and get the EMS report first' - only to have the next attending tell you the way he does it is the opposite. On top of running inpatient units, we're asked at least once/shift to get IV access and blood on patients so we have to lug around the ultrasound to establish a peripheral IV (note: not for a central line, for a peripheral IV). Which again is okay, except it's literally every shift on top of everything else you have to do. Oh and did I mention SANE exams? Yes, we do our own sexual assault exams, and it's only the PGY 1 and 2 classes.

Resident camaraderie is at an all time low. This being interview season I can remember all the valuable feedback I got from 2nd and 3rd year residents when I would interview. Many times we have dinners the night before and there won't be a single third year present. In fact when someone asked about it, the chief resident shouted back "you're the ones who have to work with them so you're the ones who should go to the dinners". Unfortunately that seems to be the mentality here.

We do a lot of research. I was told that we'd have one project to do and that's all, which was great for me because it's not my cup of tea. But then we find out that we have a mandatory EBM project to do on top of our research project, and in the third year there's another mandatory project. Great if you like research, not for me.

Off-service months are generally pretty good - IM and MICU can vary depending on who you have to work with but you know what you're getting. Oh and we do overnight calls meaning 30 hour shifts when we're on those months.

Overall I wouldn't come here again given the choice. I've talked to residents at other programs and there are a lot of things we have to do here that don't happen in other programs. I hate to seem like I'm complaining but running an ICU unit in the ED plus doing SANE exams plus never getting out on time plus poor camaraderie and it actually has me wondering if I should transfer and finish 0ut elsewhere. Anyway, those are my thoughts...
 
I'm a PGY-2 at Emory and wanted to post my review of the program for anyone considering matching here (posting on alternate account to remain anonymous). I was excited to match here as it was in my top 3 and had an enjoyable PGY-1 year, but the program has really gone downhill since then. We've since lost our PD who took a promotion to work elsewhere at Emory, and we are losing one of our assistant residency directors in the next few months who is leaving to go to another program. I understand those things happen but both of these people are well respected and approachable teachers and will be a huge loss for us.

For anyone who's interviewed here you know you'll spend the majority of your time at Grady. We get a crap-ton of trauma so there's no shortage of clinical experience. The only problem is you sometimes get more than what the facility was built for. It's not uncommon to be undressing patients in hallways and putting critically ill pts out there - which is fine except then it bottlenecks the rest of the hospital. The biggest challenge I have is that all the patients we board in the ED - they all remain our responsibility. It's not uncommon for us to be managing intubated patients for an entire shift. When we do signouts we have to take signouts on all the admitted patients even if the floor team has seen them. Not only is this burdensome for the new resident taking them, but it means the off-going resident stays a MINIMUM of one hour and usually two, just wrapping up loose ends. Then it's time to go home and START charting. And because the already-admitted can take up so much of your time, the attendings are moving past seeing new patients and criticizing you for being too slow. VERY few attendings actually take the time to teach you anything on shift. And the teaching points are usually more style points than anything else - 'do a secondary survey in this order' or 'always stop and get the EMS report first' - only to have the next attending tell you the way he does it is the opposite. On top of running inpatient units, we're asked at least once/shift to get IV access and blood on patients so we have to lug around the ultrasound to establish a peripheral IV (note: not for a central line, for a peripheral IV). Which again is okay, except it's literally every shift on top of everything else you have to do. Oh and did I mention SANE exams? Yes, we do our own sexual assault exams, and it's only the PGY 1 and 2 classes.

Resident camaraderie is at an all time low. This being interview season I can remember all the valuable feedback I got from 2nd and 3rd year residents when I would interview. Many times we have dinners the night before and there won't be a single third year present. In fact when someone asked about it, the chief resident shouted back "you're the ones who have to work with them so you're the ones who should go to the dinners". Unfortunately that seems to be the mentality here.

We do a lot of research. I was told that we'd have one project to do and that's all, which was great for me because it's not my cup of tea. But then we find out that we have a mandatory EBM project to do on top of our research project, and in the third year there's another mandatory project. Great if you like research, not for me.

Off-service months are generally pretty good - IM and MICU can vary depending on who you have to work with but you know what you're getting. Oh and we do overnight calls meaning 30 hour shifts when we're on those months.

Overall I wouldn't come here again given the choice. I've talked to residents at other programs and there are a lot of things we have to do here that don't happen in other programs. I hate to seem like I'm complaining but running an ICU unit in the ED plus doing SANE exams plus never getting out on time plus poor camaraderie and it actually has me wondering if I should transfer and finish 0ut elsewhere. Anyway, those are my thoughts...

Wow, that's very disconcerting. I've been on the lookout for this review. Only a first-year but I've had a lot of pre-exposure to EM, I'm setting myself up for that route, and Emory has peaked my interest on location and reputation. Hopefully things get immensely better when my time comes.
 
I'm a PGY-2 at Emory and wanted to post my review of the program for anyone considering matching here (posting on alternate account to remain anonymous). I was excited to match here as it was in my top 3 and had an enjoyable PGY-1 year, but the program has really gone downhill since then. We've since lost our PD who took a promotion to work elsewhere at Emory, and we are losing one of our assistant residency directors in the next few months who is leaving to go to another program. I understand those things happen but both of these people are well respected and approachable teachers and will be a huge loss for us.

For anyone who's interviewed here you know you'll spend the majority of your time at Grady. We get a crap-ton of trauma so there's no shortage of clinical experience. The only problem is you sometimes get more than what the facility was built for. It's not uncommon to be undressing patients in hallways and putting critically ill pts out there - which is fine except then it bottlenecks the rest of the hospital. The biggest challenge I have is that all the patients we board in the ED - they all remain our responsibility. It's not uncommon for us to be managing intubated patients for an entire shift. When we do signouts we have to take signouts on all the admitted patients even if the floor team has seen them. Not only is this burdensome for the new resident taking them, but it means the off-going resident stays a MINIMUM of one hour and usually two, just wrapping up loose ends. Then it's time to go home and START charting. And because the already-admitted can take up so much of your time, the attendings are moving past seeing new patients and criticizing you for being too slow. VERY few attendings actually take the time to teach you anything on shift. And the teaching points are usually more style points than anything else - 'do a secondary survey in this order' or 'always stop and get the EMS report first' - only to have the next attending tell you the way he does it is the opposite. On top of running inpatient units, we're asked at least once/shift to get IV access and blood on patients so we have to lug around the ultrasound to establish a peripheral IV (note: not for a central line, for a peripheral IV). Which again is okay, except it's literally every shift on top of everything else you have to do. Oh and did I mention SANE exams? Yes, we do our own sexual assault exams, and it's only the PGY 1 and 2 classes.

Resident camaraderie is at an all time low. This being interview season I can remember all the valuable feedback I got from 2nd and 3rd year residents when I would interview. Many times we have dinners the night before and there won't be a single third year present. In fact when someone asked about it, the chief resident shouted back "you're the ones who have to work with them so you're the ones who should go to the dinners". Unfortunately that seems to be the mentality here.

We do a lot of research. I was told that we'd have one project to do and that's all, which was great for me because it's not my cup of tea. But then we find out that we have a mandatory EBM project to do on top of our research project, and in the third year there's another mandatory project. Great if you like research, not for me.

Off-service months are generally pretty good - IM and MICU can vary depending on who you have to work with but you know what you're getting. Oh and we do overnight calls meaning 30 hour shifts when we're on those months.

Overall I wouldn't come here again given the choice. I've talked to residents at other programs and there are a lot of things we have to do here that don't happen in other programs. I hate to seem like I'm complaining but running an ICU unit in the ED plus doing SANE exams plus never getting out on time plus poor camaraderie and it actually has me wondering if I should transfer and finish 0ut elsewhere. Anyway, those are my thoughts...

Some of that is just a matter of fact for EM now, some of that is a function of choosing to go to a county hospital. Losing the PD and APDs sucks, but if you replace them with good folks, you'll be fine. Plus, they are leaving under good terms. A lot of what you're talking about sounds fairly typical of modern EM, particularly at a large, county hospital. Placing one US-guided PIV during a shift? So what? You're the expert. If your nurses can't get acccess, that's your job. If they don't try, that's a different problem. I'm a critical care fellow and I get PIVs for nurses all the time. Attending anesthesiologists or ER docs place PIVs frequently in some private practice places. And the third years are right, who you take doesn't matter to them except for wanting the program to stay good. Third years need to worry about finding a job, moonlighting, getting a license for next year, etc. The charting and leaving on time is something you need to figure out. I know people at my residency complained about staying late - but they were bad at time management. This is when you start to figure it out. I would advise you to remember that you're in the middle of your second year. That's a rough time. Keep your head up and keep working. This is when you really start to be an ER doctor, when you start to just do month after month after EM (instead of rotating topics ever few months like you've done for the past decade). This is when you see the warts.

Morale being low and poor teaching are concerning. But a big part of second year is being pushed by your attendings and not having your hand held. You need to be forced to make decisions and go home and read about what you have questions about.

Go have a beer. Spend some time with your family. Work out. It gets better.

To others, this is the reality of EM and particularly true of county hospitals. Go into this field with eyes open.
 
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I am a current Intern at Emory and would like to provide my experience thus far as it seems to differ from that above post, and in my opinion is more in line with the experience of the vast majority of the people in my class. My experience at Emory thus far has completely blown my expectations out of the water. I actually did not do an away here, but during my interview was thoroughly convinced it was an incredibly unique program and was thrilled to match here. We are halfway through intern year right now, and there are many many reasons that I think this is a great program, but I have laid out my top reasons here:

1) The volume: Grady (where we spend 80% of our time) is incredibly busy. The hospital is on pace to see about 140,000 people this year. It is the busiest level 1 trauma center in the Southeast, and the only one major trauma center for the entire metro ATL area of 6 million people. On the medical side of things, we see tons of really sick people. I have yet to work a shift without multiple unresponsive/ cardiac arrests, etc. On the trauma side of things, the programs history sort of speaks for itself. The Marcus Trauma center is a beautiful facility, and it is always full. We work about 1/2 of our shifts on ED months in the trauma center and 1/2 on the medical side of the ER. There is a lot (A LOT) of penetrating trauma and plenty of chances for procedures.
2) The early acuity. They have you seeing sick patients early, which I really like. A lot of programs do graduated responsibility where you see less sick people the first year. With close guidance, interns see really sick people all day long. You do all of your own procedures on your own patients, and have more than enough opportunity to help others out with cool procedures too.
3) The patients. Grady takes care of a very medically challenging primarily urban poor population. Most patients have not seen a doctor in years, and their social situations are challenging. It makes being a resident very difficult, but the challenge makes you learn so much. The patients are also incredibly gracious. Working at a public hospital like Grady feels really good.
4) The faculty. This was huge for me on the interview trail. I had to get along with people, because I cannot stand unapproachable or mean faculty. I have yet to have a bad shift with ANY one of our faculty members. They are all so nice, compassionate, and excellent teachers. They certainly work at a very fast pace, and although formal teaching is a bit limited because of this, I walk out of every shift having learned a tremendous amount.
5) The residents. A very fun and diverse group of young people. We all get along so well and take care of each other. There is an instant sense of pride in being a "grady-made" doctor, and you feel it in our residency group. We all go out together after shifts, on outings, and when we have days off together. Our residency retreat was one of the funnest weekends of my life.
6) Atlanta: Its warm, very diverse and liberal population. Great music, great food, relatively low cost of living.

To specifically address some concerns:
-Our PD Dr Shayne did recently leave his post, but this was for a move to dean of Graduate Medical Education for all of Emory. He still works clinically at Grady, and is present at our conferences. He very much is still involved in our program, and it is great to have one of our own in such a high leadership position. Our interim program director, Dr. White, is Emory trained and has been here forever. She is one of the most compassionate doctors I have ever met, and wants nothing but the best for our program. I am confident we are in very good hands with her in the lead. We have a really, really talented group of approachable faculty and it in my opinion is one of the perks of this program.
- The work load. Although I am not a second year, I will say that we all definitely work hard during our shift. I do very often put in ultrasound guided IV's (I actually dont mind doing this at all), and I occasionally draw blood on patients (although this is rare). If it is what the patient needs and I can get it done fast, then why not? I am currently on an off-service rotation and have found my IV skills really useful when critical patients are on the unit and no one is around to get access.
-Resident camaraderie: It is really unfortunate that this was brought up, as this has not at all been my experience. I spend time with my classmates on about 95% of my free time, and our class spends a lot of time together. We all work very hard, but also have each others backs 100%. I have become incredibly close with a large majority of my classmates. Our relationship with the upper levels has been really good in my opinion as well. Because our schedules are so different, it has generally been easier to spend time outside of work with our own class, but I really enjoy all of my colleagues, not just my class. I do agree with the poster that there has been a lack of 3rd years at interview dinners, but as has already been mentioned, it truly does mean less to them, and they have more pressing issues currently.

Overall, I was sad to see this post. I love just about every minute of my job here, and have learned more than I could have ever imagined in 6 months and had the incredibly opportunity to take care of some really sick people. I hope that the poster knows that there are so many of us that are there for them and just a text or phone call away if they want to talk about anything, have a drink, or just vent!
 
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hallways, US PIV was standard fare at my program as well. not unusual to do 3-4 a shift. critical care boarding. unforunately this is standard fare for the county and residency programs. my current ED as an attending- no boarding, still do an iv every couple months.

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I understand that boarding patients is not unique to Emory - but I doubt that many others are managing repeat mag/phos levels and following up on ABGs for patients that have been intubated for eight hours. Also, we have a new system starting next month where we will alternate with surgery as far as who runs the airway/trauma (even/odd days) and are instituting a mandatory morning report for residents who saw trauma patients overnight. Which means if you saw trauma patients overnight, you stay for a morning report and present all of these patients again to a surgery attending. Then you get to wrap up loose ends and then finish charting and then your overnight shift is over. It's a program in flux. It's not the same as it was presented to me when I was interviewing and these are questions worth asking when you have the chance.
 
While I agree with the US IV comments above (we also do 1-2 during day shifts and sometimes 3-4 during night shifts when there's no US resident) its not normal to be boarding tons of ICU patients for 8+ hours or staying 2+ hours after shift tying up loose ends. Nearly all county hospitals are boarding ICU patients nowadays but it shouldn't be an every shift event or for more than a few hours at a time while waiting for a bed upstairs. At the same time you shouldn't be staying that long after shift tying up loose ends except for the occasional crazy shift once or twice a month.

This is just my 2 cents but the fact that 3rd years don't come out to interview dinners speaks volumes about how they feel about the program. Its obviously hard to get a good turnout at some dinners, but if you really care about the program its not that hard to have at least 3-4 residents from each class at every dinner. Not to mention the fact that they're the only ones who can accurately speak about the anything other than intern year.
 
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Personally I'm shocked that not every program is sunshine and rainbows like the interview day.
 
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I understand that boarding patients is not unique to Emory - but I doubt that many others are managing repeat mag/phos levels and following up on ABGs for patients that have been intubated for eight hours. Also, we have a new system starting next month where we will alternate with surgery as far as who runs the airway/trauma (even/odd days) and are instituting a mandatory morning report for residents who saw trauma patients overnight. Which means if you saw trauma patients overnight, you stay for a morning report and present all of these patients again to a surgery attending. Then you get to wrap up loose ends and then finish charting and then your overnight shift is over. It's a program in flux. It's not the same as it was presented to me when I was interviewing and these are questions worth asking when you have the chance.
ouch that sounds horrible. airway is very important in EM. id wouldnt want to share that. in addition why are you presenting to surgery attendings during ED months.

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I'm a current 3rd year EM resident at Emory, and I feel pretty confident in saying that JsmithJsmith is in the minority with his/her opinions on the state of the residency program. I'm using my day off tomorrow to conduct medical student interviews so I wouldn't say the 3rd year class is 'checked out'. During these interviews I usually stress that working in a resource-poor inner city hospital is not for everyone, and really try to make sure the applicant is committed to this work and all the associated frustrations (and rewards) that it entails. Emory is a rigorous program compared to many community ER programs, but honestly the ER program is way more focused on wellness than any other Emory residency program and we work comparably less than pretty much any other field (even anesthesia, radiology, ophthalmology, etc).

Currently as a third year I work 19, 8-hour shifts, and I almost never stay later than an hour after my shifts because I am reasonably efficient, which, as another poster noted, is a hard won skill that you develop 2nd year. That's 12 days off this month, not bad for a resident. All of our shifts are 8 hours (including weekends) with the rare exception of the holidays which we usually work 12's so more people can have off, but we vote on this yearly.

If you want a cushy community program there are plenty out there, this place is not for everyone. But please don't doubt the quality of the faculty, or the camaraderie between residents (most of us have found life long friendships and mentors here), or the skills you will learn here, or that Dr. White (the interim PD) is an exceptional replacement for Dr. Shayne (leaving PD).

Feel free to PM me with any questions about the program, and good luck out there to the applicants. Remember, it's all about fit.
 
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Hello people of SDN,

I'm a current and slightly less than anonymous intern. After reading the above posts, I wanted to throw in my $0.02 because I have had a very different experience I want to share.

"We've since lost our PD who took a promotion to work elsewhere at Emory, and we are losing one of our assistant residency directors in the next few months who is leaving to go to another program. I understand those things happen but both of these people are well respected and approachable teachers and will be a huge loss for us."

I don't feel that we have lost our PD at all. Philip Shayne has been at every conference, still says hi to me by name in passing in the hallways, and is still in his office across the street from the ED at least twice/week. He is a badass emergency doc and still very much an asset to this program, albeit now with that much more pull in the system as a whole. For having not "lost" our PD, we have been very lucky to gain more interaction with Dr. White, who I absolutely adore. She provides a very warm, supportive, and extremely approachable spin the program director. She clearly cares A LOT about us and this residency program. Oh, and she is also a total badass. Dr. Stettner will be leaving to start a new EM residency program in GA as their new PD. We will miss him for sure, but isn't it more of a positive to have our faculty going off to start residencies and run programs elsewhere?

"For anyone who's interviewed here you know you'll spend the majority of your time at Grady. We get a crap-ton of trauma so there's no shortage of clinical experience. The only problem is you sometimes get more than what the facility was built for. It's not uncommon to be undressing patients in hallways and putting critically ill pts out there - which is fine except then it bottlenecks the rest of the hospital. The biggest challenge I have is that all the patients we board in the ED - they all remain our responsibility. It's not uncommon for us to be managing intubated patients for an entire shift. When we do signouts we have to take signouts on all the admitted patients even if the floor team has seen them. Not only is this burdensome for the new resident taking them, but it means the off-going resident stays a MINIMUM of one hour and usually two, just wrapping up loose ends."

This is the reality of every EM program in the country, especially county EM. We board patients, true, but not nearly as badly as other county programs I rotated at as a medical student. And staying an hour or two on occasion after our shift is not that big of a deal when we work 8 hours shifts-- that basically just puts us on par with average. No one ever told me working at Grady would be a cake-walk. I'm challenged every day, but I'm learning so much more than I knew I could and that is what I wanted out of residency and why I chose to go to a county program.

"Then it's time to go home and START charting. And because the already-admitted can take up so much of your time, the attendings are moving past seeing new patients and criticizing you for being too slow. VERY few attendings actually take the time to teach you anything on shift. And the teaching points are usually more style points than anything else - 'do a secondary survey in this order' or 'always stop and get the EMS report first' - only to have the next attending tell you the way he does it is the opposite."

I have had a very different experience with attendings taking time to do teaching. On the majority of my shifts the attendings have taken time to sit down and teach me something. For example, on the last 3 shifts ive had it's probably been 10-15 min talking about the Ishoo trial for which angio-edema patients are unlikely to progress to airway compromise, how to tell with reasonable certainty that an HIV+ patient has a CD4 count >200 by the absolute lymphocyte count, how to tell BER from STEMI, had a really tough airway the attending talked me through instead of pushing me out of the way and I got, etc etc.

"On top of running inpatient units, we're asked at least once/shift to get IV access and blood on patients so we have to lug around the ultrasound to establish a peripheral IV (note: not for a central line, for a peripheral IV). Which again is okay, except it's literally every shift on top of everything else you have to do. Oh and did I mention SANE exams? Yes, we do our own sexual assault exams, and it's only the PGY 1 and 2 classes"

Nurses everywhere will ask for assistance when they cannot get an IV, and ultrasound guided IVs are good practice. And out nurses are really pretty great at getting IVs. We also don't have to wheel our patients to CT (unless they are super unstable), get our own IVs routinely, and draw labs like a many other programs. And as for the SANE stuff, we do have 24/7 SANE nurses who do the vast majority of those exams. PGY1s definitely don't do SANE exams.

"Resident camaraderie is at an all time low. This being interview season I can remember all the valuable feedback I got from 2nd and 3rd year residents when I would interview. Many times we have dinners the night before and there won't be a single third year present. In fact when someone asked about it, the chief resident shouted back "you're the ones who have to work with them so you're the ones who should go to the dinners". Unfortunately that seems to be the mentality here."

???The second year class is really tight, and there are a lot of really fun people to hang out with in all three classes ( a perk of having 60 odd residents). I love everyone I've met in this residency. Text me anytime and we'll grab a beer! If you've had a bad day, I'd love to hear about it. Venting is an important part of social support in residency (and not specific to any given program). I'm also not sure the reason for the antagonism of the chiefs. Our chiefs do have a very hard job and work very hard to accommodate everyone's vacation and suggestions. They try very hard and are able to accommodate the vast majority of requests and the majority of us really do appreciate the work they do for us.

"We do a lot of research. I was told that we'd have one project to do and that's all, which was great for me because it's not my cup of tea. But then we find out that we have a mandatory EBM project to do on top of our research project, and in the third year there's another mandatory project. Great if you like research, not for me. "

Isn't it a GME requirement for graduation from any EM residency to do a research/scholarly project? I dont know much about a third year specific project, but I think research is an important part of practicing medicine (even if it isn't always the most fun thing to do).

"Off-service months are generally pretty good - IM and MICU can vary depending on who you have to work with but you know what you're getting. Oh and we do overnight calls meaning 30 hour shifts when we're on those months."

We definitely don't do 30 hour calls on medicine. MICU is our only 30 hour calls month, but we also get every 4th day off. I loved my MICU rotation.

Also, we have a new system starting next month where we will alternate with surgery as far as who runs the airway/trauma (even/odd days) and are instituting a mandatory morning report for residents who saw trauma patients overnight. Which means if you saw trauma patients overnight, you stay for a morning report and present all of these patients again to a surgery attending. Then you get to wrap up loose ends and then finish charting and then your overnight shift is over. It's a program in flux. It's not the same as it was presented to me when I was interviewing and these are questions worth asking when you have the chance.

This is was an EM lead initiative that has been put forth but we still haven't reached a final agreement. That being said, I think it is important that EM DOES run traumas. I rotated at programs where that was the case, and I thought that system worked great. We SHOULD be running traumas and procedures with the trauma surgeons. Presenting at morning rounds with the trauma surgery crew is only for 3rd years on overnight shifts with admitted patients, so it will be a handful of times in our entire residency. It isn't finalized about the airway either, but I take it to be a give and take on the airway. I would love to have every airway, but the reality is that the surgical critical care fellows need intubations too. We still will get PLENTY of airways, and if they aren't able to successfully intubate, we will still be at bedside to help.

"Overall I wouldn't come here again given the choice. I've talked to residents at other programs and there are a lot of things we have to do here that don't happen in other programs. I hate to seem like I'm complaining but running an ICU unit in the ED plus doing SANE exams plus never getting out on time plus poor camaraderie and it actually has me wondering if I should transfer and finish 0ut elsewhere. Anyway, those are my thoughts..."

This makes me sad. But it is an important reminder to think about what you want out of residency before you make your rank-list. County EM has challenges for sure. We see a ton of sick patients in often under-resourced conditions. But for all the hardship, we are privy to a wealth of practical, hands-on experience. I have learned more in the last 6 months than I knew I was capable of, and made tremendous impacts on people's lives. I have bad days, but I absolutely love my job and wouldn't give it up to go anywhere else for the world.

If anyone has any questions or wants to chat more, PM me. I am not on SDN that much anymore, so I may be a little slow to respond, but I will see it eventually.

- Alex theNotSoAnonymousInternAtEmory

Edit: I didn't see the second post about the EM running traumas, so added that too
 
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Hi - any update on how the new trauma situation is working out? or what has been agreed to?
 
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Recently interviewed here, here's what I thought/found:

Emory: 3 year program. Scholarly tracks and pathways available, such as CCM, ultrasound, med ed, health equity/advocacy/policy. High volume high acuity. Most time at Grady (county) but also spend time at academic and community sites. Emphasis on service and advocacy, clinical experience. Split trauma procedures, but get all airways, Grady is very busy Trauma center. High autonomy. Ortho does most reductions but can advocate to do more. Ultrasound is average, no TEE, can do ultrasound track or electives for more experience. Very active EMS group. Moonlighting as PGY2.
 
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