University of Pennsylvania (Penn) Residency Reviews

Since many of us are interviewing at the same places, I thought it would be helpful to start a thread with reviews of interviews. Please include positive and negative aspects of the program. Keep in mind that "One man's junk is another man's treasure", so what one may consider to be negative someone else may be looking for that aspect in a program.

Disclaimer: This thread is not meant to disrespect any programs out there! These are meant to be honest opinions of our experiences on the trail.

Good luck to all!

UPenn:

The morning started at 7:45. 12 people were on the interivew. The rooms where the ground rounds and introductions were held seemed a bit small. Half of the group went on the tour, while the other half interviewed. We visited CHOP, the HUP ED, and SICU. The SICU has a computer in every room. During rounds, at least three residents enter orders with portable laptops. THe hospital is huge, it felt as if we were walking forever.

I had four interviews, conducted by the PD, resident and two other attendings. Interviews varied, just shot the breeze and talked about our interests with two, one interview was based almost entirely on my questions on the program. The last was a little more in depth with why I considered a four year program and what qualities did a good teacher possess.

For lunch, they took us to the Inn at Penne! Probably a 4 star restaurant! Fabulous place and I could only imagine what they spent on it. By far the best lunch and pampering on any interview yet.

+++ The name!! Of course it's an Ivy league! Once you graduate, you will have no problem securing a great job (even if you're the least capable resident).

+++ International medicine. About 1/4 of the program attendings are avidly interested in travel medicine. The travel director is planning a trip to Botswana with his family in a few months. Another attending is well known in the field for his frequent forays to third world countries and working with their EMS systems.

+++ Research. Along with travel medicine these same attendings conduct research in the foreign countries. Other attendings sit on the SAEM editorial board.

+++ Teaching on the other services. Learn from world renowned and incredibly bright physicians in IM and Surgery while rotating on their services.

+++ CHOP!! Not to offend the pediatricians out there, but CHOP is known as the #1 place in the country and possibly the world. You will see everything there, probably less of the bread and butter stuff but everything including Goldenharr syndrome to at least one Cornelia de Lange per day. One of the graduating residents is currently looking for jobs. He was told that he could work at a large pediatric ED without a fellowship just because he trained at CHOP! WOW! By the way, CHOP is amazing. It was my first time at the institution and I felt like a kid at FAO Schwartz!

++ Very nice ED facilities. Everything in the ED is computerized with the electronic "board" and PACS system

+ Good mixed population with eniabriated UPenn students, suburbanites and a working class during the day.


+/- 4 year program. Depends on how you look at it. I tend to think 4 year programs allow the time for you to learn how to manage an ED as Junior attendings. But I know it's the $200,000 mistake.

-- The ED is a relatively new department and still trying to establish their niche in a world class hospital with world class IM and Surgery. I got the impression from the residents that things are manageable between the departments but not 100% peachy keen.

-- The ED does not run trauma, even though their residents say they get enough...there are months set aside to rotate through the trauma service.

--- Residents admitted to a 1 in 40 Spanish speaking pt. If you spent a good amount learning spanish and taking medical spanish courses, you will most likely lose the ability to speak spanish by the time you graduate.

--- Mid range volume....enough to keep you busy but I'm not sure you will see everything there is to be seen.

----- Premiums for insurance are up to $1000!!! I'm sorry but I paid outrageous premiums for med school ($1500) and never used it. I want healthcare without having it come out of my paycheck. The paycheck is small enough already!

Overall...sounds like a great program. Great resources, fabulous opportunities, definitely more cush than a county program

hope this helps...feel free to contribute and add your own experiences.

Here's my review of HUP (UPenn)...

Residents: 9 per class, following the PGY 1-4 format. All the residents seem to be very happy with their choice and are enjoying the program. They all say there is great camaraderie and that they do spend a lot of time together outside of the hospital. While I was there, there was a group of 5 of them or so, who were trying to get tickets for some event.

Faculty: Dr. DeRoos was a pleasure to meet. He is really supportive of the residents and the program has a great philosophy. The residents said the factuly was excellent and very easy to get along with. Everyone is on a first name basis. The residents and faculty seem to spend time together outside of the hospital also.

Facilities: 40 bed ED plus trauma bays split into different acuities. Being that this ED is located at HUP, I expected it to be nicer, but it's a minor complaint. CHOP is right next door, and their ED more than makes up for it. CHOP has the nicest ED/trauma bays I have ever seen. Very modernized with lots of technology (computers in each ED room, flat panel tv's, overhead radiology, hanging airway carts, etc.). There's also an icee/slushie maching at CHOP (a favorite of many). Residents say there is no scut.

Curriculum: UPenn has a great curriculum, with one of it's strengths being the off service rotations. You are at HUP, with leaders in every field that you will learn from. You definitely get a solid basis in all of these fields as a result. The peds experience is top notch, also. As I said, CHOP is next door and it is one of the top two children's hospital in the nation (20 weeks of ED time, 3 weeks of peds ortho, 1 week of anesthesia, 4 weeks of PICU, for a grand total of 28 weeks). There is also 4.5 months of elective time to find your niche in EM, with plenty of international opportunities as well. The trauma experience is also relatively strong. You spend 2 months in the SICU, 1month on trauma, and as a 4th year, split being trauma chief with the trauma service (with plenty of procedures to go around). Didactics are very strong, with so many different activities to keep it fresh.

Patient Pop: 75% are the underserved of west philadelphia, with the rest being tertiary care. The ED treats about 60,000 per year, which is lower than some other places. The residents said there were many nights were they would clear the waiting room, although this has changed over the last year. The patients are really sick as well.


City: Philadelphia is a great city with plenty to do. The city is more affordable than some. About 50% own, with the rest renting. Parking is taken care of by the hospital, and if you don't own a car, they provide you with a bus pass to get around.

Overall: I was impressed with this program. The curriculum is solid, with great off-service and peds opportunities. It is a very supportive environment and the happiness factor is high. The teaching you would receive here is awesome, being that you spend your time at HUP and CHOP.

PM me with questions.

UPENN
Residents: Lots of residents showed up to the happy-hour and were all happy with their choice of program. The one caveat was that during the interview day everyone was saying .“.We work really hard.”. (and it showed), however this statement was never followed with a .“.we also play hard..”. What this means who knows?

Faculty: Dr. DeRoos, the PD, had a very casual presentation about the program. I think what stood out was how Penn presented themselves, i.e. in a informal manner that still let you know what opportunities Penn had available. During the lunch, had a chance to speak with the Chair of EM and he was a real laidback and funny guy. All the faculty I interviewed with were very relaxed as well.

Facilities: This is a UPenn program and you will stay at HUP/CHOP for about 90% of your 4 years. The HUP ED is very modern and holds about 35 beds; oftentimes they fill the hallways as well. The CHOP ED is freaking amazing .–. it is bar none the most ridiculous children.’.s ED I have ever seen. Brand new with all the bells and whistles, as well as a Slurpee machine we got to try!

Curriculum: A four year program (I still have to decide if this is necessary to myself). The off-service rotations are supposed to be monsters, but they do teach you a lot. One thing I did not like was that as PGY-4 you run the trauma team on the floor as the trauma-chief. While, this speaks volumes of their relationship with trauma surgery, it just doesn.’.t seem like a valuable experience to me. The peds experience is something that is very attractive about this place .–. I have yet to find a program that has impressed me more. 20 weeks of elective time (they encourage international electives), which I think is great! Lots of little add-in months to round out your training, such as psych/derm/ENT/optho/hyperbaric/tox (I guess the advantages of a 4-year program). Also, the program is very flexible to what the residents do and do not want in the curriculum.

Patient population: West Philly (home of the Fresh Prince) has a lot of sick inner-city patients, but you also have the tertiary care patients that Penn attracts..

Overall: Penn is a very impressive program, with great training in pediatrics, off-service and lots of additional training in other fields (not found in many other programs). Without a doubt, you will become a great clinical and academic (if that.’.s what you want) EM attending upon graduation. Also, Philadelphia is a great place to live, as it is relatively affordable and a fun town to live in. I think the problem I have with this place is that nothing about Penn really convinced me to take on the extra year.

I am an academic asst PD and have had exposure with graduates from the Penn program as attendings when I was a resident, and as colleagues in my current position. I can tell you that I an unimpressed with Penn's graduates. In my experience, Penn graduates have not seen many high acuity patients and cannot practice in a busy, high volume, high acuity EDs. The research name is impressive, but is carried on the databasing skils of Richard Levitan and Judd Hollander. I have found graduates from the program who attempt to do research are relatively unskilled in research methodlogy. Nice facilities are always a bonus, but in the end you need to be challenged with a busy ED with a lot of sick people in order to achieve clinical competence. I don't Penn has what it takes

I guess someone who rotated there should review UPenn. Why not me?

4 year program

Residents: 9 per yr. Residents are from all over but mostly the NE. Everyone is pretty jovial overall. There is a mix of married and single and a lot of socializing within and between years. The senior residents are confident and run 1/2 of the ED as junior attendings (everyone presents to them). US and research are very strong.

Faculty: UPenn is about as academic as it gets. Huge names in clinical and basic research abound, and it is a top NIH-funded program. Faculty have a huge research requirement and evidence-based medicine is emphasized but none I've met are snotty or esoteric. Everyone is on a first name basis with each other from the janitors to the attendings. The PD is relaxed, down-to-earth, and approachable.

Hospital:
The main facility at the Hospital of the University of Pennsylvania (HUP) is a Level I Trauma Center with 25+hallway beds in the ED and 56K+ visits/yr, a separate fast track staffed by NPs and PAs. Pediatrics is all done in the next door dedicated CHOP ED (gorgeous and state of the art). There is a CDU and excellent beds that convert to a full pelvic exam table (no bedpans needed ). Wonderful electronic systems abound.
There is some limited time at Pennsylvania Hospital for a more community experience.

Ancillary Stuff: The RNs are skilled, very experienced, and fun to be around. There are also a good number of friendly neighborhood transporters and paramedics, so you really only do IVs, etc if you specifically want to. Zero scut.
Penn houses many of the best residencies in the country - positions in surgery, medicine, neurology, etc are very competitive and top-ranked. EM gets airway during the trauma alerts and has a nice relationship with surgery. Great off-service experiences.

Documentation: No charts except for dingy ones for storing EKGs, etc. There is an electronic board, EMTRAC that tells you how many are in the waiting room, gives you lab results, lets you place orders, and look up old records. Simply right-click to assign yourself to a patient. Create templates if you wish to make your charting faster. No writing except for your own personal record-keeping. A computer-lover's dream! Love it!!!!

Curriculum: MICU, SICU, and CCU time, one medicine floor month. Hours are 12s for residents and 8s for attendings. 8s for senior residents except on weekends. The hours don't really expand by much - people are good about nudging each other out and you rarely stay more than an hour past your shift, if that (depends on how fast you type, frankly ). You do an US month where people page you to do most of the scans. Most attendings are also certified in regular and transvaginal US. Research requirement, of course. The EMS rotation seems super sexy with fire-fighter training, flying opportunities, and more.

Didactics: Wednesday conference from 8-1pm, including off-service grand rounds. There are post-am rounds sessions with a senior resident or attending and anyone who is going on or off to discuss a case/subject. Also radiology conference on Thurs am for those who are around. Monthly journal club at a faculty member's house.

City: Philly! Supplies a fabulously diverse patient population, and HUP is well-positioned to give you a nice mix. There are a lot of cultural activities available, independent films, great foods, and the city is going smoke-free. only 1.5hrs from NY, Chinatown bus is $20 round trip.

Extras: Decent salary, benefits, and moonlighting for seniors in the fast-track is available

Negatives: As mentioned above, Penn houses many of the best residencies in the country. EM really doesn't rank and the residents are picked based on different criteria. As a relatively new program, EM doesn't generally get the respect it deserves, in part because the residents are not all from top-twenty medical schools like many of the house staff . You don't notice the contempt so much in the ED - I think the med students get flak but they won't say it to the residents' faces. Patients are generally diagnosed and well-packaged by the time they are sent upstairs, so unsure what most of the complaining is about. You will learn a ton off-service because of these top programs, but will not be top-dog. Also, a few attendings can get consult happy 'cause everyone's in house and so much the easier to butt-cover. If you have a thick skin (which you should for EM) it doesn't matter much, and doesn't seem to detract from the training (ie very few off-service procedures are done in the ED, work-ups are generally complete and consults are for "blessings").

Away Rotation itself: As a Sub-I, you pick up patients just like any other intern and present to the attending or the junior attending/senior resident just like the interns. Your diagnostic orders (labs, radiology) stand on their own, only medication orders need be verified. Thus, you can be very independent and have a lot of the work-up done by the time someone is available to present to. A great experience. Residents and Attendings love to teach, though most of it is on the fly, of course.

Overall: A highly academic EM program with a great patient population, powerful off-service rotations, a fancy electronic ED, and overall a fertile training ground. I would be honored to match here. Please feel free to PM me with any questions, and any residents/lurker classmates, feel free to correct the inaccuracies.

U Penn - 4 year program

Residents: 10 per class, with a mix of single and married. They all seemed very close and knew about each other's lives and little quirks - a lot of joking around and teasing among different classes and even faculty, which was nice to see. Many are from the Northeast region and many had Penn as their first or second choice. 1/3 choose to go into academics, 1/3 to academic affiliates, 1/3 to pure community spots.

Faculty: Dr. DeRoos (he is known as Francis to everyone) seems like an amazing program director. He is friendly, enthusiastic, and down to earth. The rest of the faculty that I interviewed with all seem very laid back and are on a first name basis with the residents and nurses. They come from a range of different programs (Chair from UCSD, PD and a few others from Harbor, Jacobi, U Chicago, Penn) and residents say that they are all very dedicated to teaching. The chairman, Dr. Baxt, also came to talk to us for a while - he seems very laid back and residents say he continues to work shifts and teach. There are faculty boarded in tox, ultrasound, and critical care and some attendings actually split time between ICU and ED.

Interviews: 4 15-minute interviews, one with a senior resident. They are very serious about keeping you on track with the time, so these 15-minute things whiz by very quickly. Otherwise, intro talk about Philly from residents, intro talk about program from Dr. DeRoos.

Hospitals: HUP (Hospital of the University of Pennsylvania) is the main hospital where most of the adult ED rotations are done. It is NICE! Individual glass door rooms with full monitoring, stocked carts, lots of computers and sitting and writing space. That being said, when we toured through the ED at around noon, the place was pretty packed with patients on stretchers in the halls. It did not seem chaotic, but definitely busy.

The ED is split into three sides -- low, middle, high -- not named for acuity, named for the numbered rooms. The low side is staffed by a senior PGY4 and usually an intern of PGY2. The middle and high sides are staffed by 1 attending each and residents (usually 1-2) who work directly under them. The residents said that working on a "team" is a nice feeling, especially at night when you get to work with an attending one on one. There is also an overnight chest pain unit and fast track which is mostly staffed by nurse practitioners.

Trauma bay is connected to the low side and the PGY4 who is working there is responsible for airway when they come in. On the trauma team itself, there is always an EM senior who runs the codes and is in charge of the entire team of surgical and EM residents on trauma. This attests to the good relationship between trauma and EM here. The trauma attendings trust the residents and are very willing to teach them.

Really nice ED administration area that is directly connected to the ED. All the attending offices are here, as well as the conference room and residents room so it's all in a contained area. On call rooms are immediately in the resident's room as well, so people can sleep off a little bit of their overnight shift before driving home, etc.

CHOP is the Children's Hospital right next door. It looked like the Disney World of hospitals, from what I could see, but it was a very short part of the tour and I didn't get to see that much.

Patients: A mix- The local West Philadelphia population is lower to middle class, underserved and often with no PMD, with pathology stemming from undiagnosed or untreated diabetes, HTN, etc. There are also people who come in from the suburbs because "it's Penn" or their surgeon is here or whatever the reason and people who come from Center City, the nicer area, which is 10 minutes away. Good amount of both penetrating trauma from W. Philly (although probably not as much as Temple) and blunt trauma from the surrounding highways.

Ancillary: EMT's who are based on the ED will place IV"s and draw all bloods for you before you even walk into the room. Nurses are all relatively young, "go-getter" type of emergency nurses who work hard. They were joking with many of the residents who were walking through and seem to have a good relationship.

Curriculum: 4 years with a total of 18 months of adult ED, plus some Peds as well. I feel that the emphasis is that you will get the same amount of EM training, but will have extra time to have an easier residency and time to develop your own areas of interest. There are 6 months of elective time and more time to research. Some residents have taken that time to obtain an MPH and others pursue various interests or research. There are also random 2-week rotations like Derm, Emergency Psych, Hyperbaric Medicine, Tox, which seem cool, but also just seem like easy rotations. Kind of feels a bit like med school when you have these easy rotations and you just want to get by. Recent additional of a resuscitation month, details are being hammered out, but ideally would get to run hypothermia protocols for patients s/p cardiac arrest, etc.

Didactics: 5 hours every Wednesday with grand rounds in a very nice leather seated auditorium. The faculty all show up to grand rounds and there is a lot of discussion about different topics. The rest of the lectures are usually only for residents and most of the time, EM faculty will give the talks with occasional visiting lecturers from other departments or famous EM people. PGY4's are expected to give grand rounds talks at times, other residents give "Evidence Based" talks as well. I don't think residents get the night before didactics off, but they are covered by attendings from 7am to 1pm the day of.

Research: Incredible research going on here... I would imagine this is a place where research could just fall into your lap if you wanted it. Judd Hollander is president of SAEM and editor of Annals of Emergency Medicine, big researcher on chest pain stuff. There is also a lot of work going on with critical care and resuscitation - both basic science and clinically. There was a bulletin board in the hallway where residents post their published research and there were tons on it.

City: Philadelphia may be too tame for those coming from NYC, too crazy for those coming from less urban areas. Either way, it's relatively affordable, with rent for a 1BR $800-1200 in nicest area of town. Residents can afford to buy condos and houses 15-20 minutes from the city in the suburbs and you are provided with either free parking or a free monthly bus/subway pass. Lots of restaurants and shops in Center City, which is where most residents live. The area immediately outside of HUP

Negatives: I think if this were a three year program with the faculty this place has and the general vibe, it was be one of the best and most competitive residencies in the country. The fact is, they do the same number of months in the ED as most three year programs, only more spread out so you have more time to explore electives, making residency a little less rough. Great relationship with surgery, but I did not hear the same compliments about Medicine, Gen Surg, or OB. You will probably learn from and be pushed by the best of the best residents on the off-service months, but will probably also get some ego and attitude from the Ivy League crowd.

Overall: Amazing program with a great, long-standing faculty in an affordable and easy to live in city. This place has a balance of underserved poor and middle/upper class all within one hospital - with great ancillary services and a nice and comfortable ED to work in. People get along and everybody, from the nurses to the residents to the attendings are happy. You will go places after graduating from Penn, as the attendings have ties all over the country and you will be able to pursue any aspect of research/fellowship interests that you would like to do. To me, it's got everything I want in a program, with the price to pay being that extra year.

University of Pennsylvania

Residents: 10 residents per year. Residents play a role in the selection process (one interview is with a resident, and they were in and out all day to talk to us – plus there was a well-attended happy hour). I met a lot of individual residents here, and they were all really friendly, outgoing, down-to-earth, and impressive. They also genuinely seem to be friends – many of them live in the same neighborhoods and buildings, and there is fraternizing between the classes (and the attendings). Everyone I spoke to ranked it first. There are a lot of single residents, but still a mix of married and a few with kids. All of them were very happy.

Faculty: An incredible strength of this program. Some of the biggest names in EM are here, and I was surprised at how down-to-earth they were. The PD, Dr. DeRoos, is extremely enthusiastic and outgoing, and appears willing to mold the curriculum to suit individual residents. Dr. Hollander is hilarious, and seems incredibly approachable considering his stature in the EM community (he came out for beers with us after the interview day). Dr. Neumar is one of the premier basic scientists in EM (there was an article about him in Newsweek this summer), and the Chairman, Dr. Baxt, also came in and joked with us for awhile (he was in the ED pulling a shift while we interviewed). A group of the senior faculty members all trained together at different times at Pitt and Harbor, and are obviously old friends – which seems like a cool dynamic. Residents report a first-name-basis relationship with everyone, and the faculty attends - and plans - social events. They respond to resident input on curriculum and other issues.

Hospital:
Most rotations are at the Hospital of the University of Pennsylvania (HUP) and Children's Hospital of Philadelphia (CHOP). Residents also rotate at a few community hospitals in the region.

HUP: 700+ bed academic university hospital, Level 1 Trauma center (blunt and penetrating), and just about every referral service known to man. The academic resources here are world-renown, and Penn is not shy about flaunting it. The adult ED is a good facility with about 30 or so beds, mostly private rooms and hallway beds. There are plans to double its size, but it is only just on the horizon. Split into three "levels", each with a team. Everything is computerized. There is a fast track staffed with PA and NP's, and the residents rarely work there unless moonlighting – there is also a chest pain observation unit that is not staffed by residents. Four trauma bays, EM takes the airways and the PGY4 is usually in charge. Dedicated CT scanner and X-ray (may add a second CT in the new addition). This ED gets about 55,000 people a year - a mix of insured and uninsured (county-types and crazy acdemic-types), with a high acuity level (30% admission rate).

CHOP: The end-all-be-all of children's hospitals, CHOP is a fabulous facility from top to bottom, and likely one of the best funded hospitals in the country. The ED is new (Again! They had just renovated it a few years ago I think) and amazing – huge (50+ beds), private rooms, all the bells and whistles (including the famous slushy machine). This is where you'll see the stuff that's only in text books.

Ancillary Stuff: We were told the ancillary support is great in the ED. Nurses, faculty and staff seem to have a good relationship.

Admitting/Documentation: ED has admission privileges. Considering the reputation of the off-service residencies here, I was told there is rarely an issue with arguing over admissions (with the possible exception of OB). At HUP everything is computerized, at CHOP there is paper charting with computerized ordering and tracking.

Curriculum: In my opinion, one of the most dynamic of the 4 year curriculums (I would throw Cinci in this category as well). There is nearly half a year of elective time over the course of the curriculum, and some unique rotations. The core emphasizes critical care (specifically surgical critical care) and ED time – with extensive Peds ED exposure. There are about 21 total months in adult ED (18 at HUP and 3 at community hospitals), and 5mo in the CHOP ED. There are 5-6 blocks of critical care, including a month in the PICU at CHOP, a month as the "resuscitation" resident (basically on call to take care of any sepsis or hypothermia protocols – likely very procedure heavy, but has only just begun), and a month as the chief of the trauma service essentially running a portion of the SICU. There's a month of Anesthesia (room to room throwing tubes) and a week of Peds anesthesia. There are unique rotations like dermatology/emergency psych and Peds ortho. There is exposure to practically every sub-specialty; ultrasound (dedicated month), EMS (air and ground transport, but largely observation), Tox/Hyperbarics, and research. The faculty consists of national leaders in all of these areas so there is a ton of exposure to cutting edge stuff. Interns have to do 1mo of floor medicine and an unpopular month of OB. PGY1-2 do 18 12hr shifts and seniors do a mix of 8's and 12's. Teaching is paramount here; attendings teach at the bedside and residents are all expected to teach Penn med students during their required rotation. As was mentioned before, it seems like the curriculum was set up to mix some pretty chill months with more hardcore rotations – some residents admitted that they essentially worked half days or less during certain months. This could be a pro or a con – some residents use this extra time to do research or outside activities, but some do not. Dr. DeRoos does not try to convince anyone of the 4yr mantra like some other PDs, but will tout how his curriculum differs from many of the other 4-year places.

Didactics/Research: Didactics once a week. Penn has top NIH-funded research and big names in practically every field. Interestingly, they do not require research, and made it clear that the program is not looking to have a reputation as a place for only those interested in academics. That said they have amazing basic science facilities (a 1 year-old lab) with funding and the flexibility in the schedule for residents to actually complete projects. There is extensive resuscitation, neurology, and cardiology research. This isn't even taking into account the multiple Fellowship programs or the massive amount of clinical research here – even in bioethics. All of the attendings mentioned how easy it was to collaborate with outside services, and the resources at Penn are simply amazing.

City: The Penn campus is in West Philly. Within the city itself, the University City area has improved quite a bit, and is easily accessible from some very nice parts of town (Rittenhouse Square, Art Museum district, Center City). Philadelphia has all the attributes of a huge city – thriving arts and theatre scene, amazing restaurants, nightlife, and emotionally unstable sports fans . It also has the same awful inner city issues, with an increasing violent crime rate and some terrifying neighborhoods. Cost of living is average for the Mid-Atlantic, which means more than the rest of the country but less than NYC/SF/Boston. Affordable housing can be found. You can live in certain parts without a car, but having one opens up a lot more opportunities. Philly's location in the country is a huge asset – in less than 2 hours in any direction you will find something great to do; jersey shore to the east, pocono mountains to the northwest, NYC to the north, and DC to the south. Philadelphia has typical Mid-Atlantic weather (hot, humid summers, cold, crappy winters, gorgeous falls and springs). As for me, it's near family and friends with multiple career options for Mrs. UE.

Extras: Salary starts at $44,800+ as PGY1, and the residents seem relatively comfortable with their lifestyle. Either free parking or a bus pass is provided. 4 weeks vacation, not including time off for either Christmas or new years every year. Excellent insurance, and a retirement package is offered but no matching of funds. The program pays for Step 3, which must be taken as an intern. Moonlighting is allowed as a PGY3-4 working extra shifts at HUP or CHOP. Access to Penn's gym for a reduced cost. There is a two week intern survival course with a lot of free social events, and a "resident's day" where everyone is off. The usual society memberships and conferences are paid for.

Negatives: Not very many. The fourth year is a turn-off for some - I felt that they justified it well with the flexibility and research opportunities - but it's still a tough sell. The "lighter" off-service months may not be necessary, but I think you get out what you put in. This curriculum is definitely not for everybody, but personally I think it's awesome. I would rather not do a month of floor medicine, and everyone seemed to hate the OB experience. It would be nice if they matched retirement funds (apparently, Penn has fabulous retirement benefits for faculty).

Overall: I really liked this program. I got a great vibe from the relationship between the faculty and the residents, who are as happy as anyone I've met thus far and definitely my kind of people. The resources of this program are unmatched, and the academic potential here seems limitless. They have great clinical exposure, including an incredible amount of Peds and Critical Care. I believe Penn would be an outstanding place to train.

Cornell/Columbia
(+): amazing resources with the two hospitals; nice mix of academic medicine and "community" like experience. cool electives, excellent peds exposure, NYC with housing help
(-) residents i met there said they were working a 'residency and a half'......they work 20 12 hours for the first two years!!! and when you throw in the commute time between hospitals, it adds up to very long days.

Penn
(+) great use of the 4 years with interesting electives placed throughout...residents said the PD was really invested in them and willing to tailor the curriculum to specific interests (one resident actualy worked out a plan where he worked half shifts for several months while doing a research project which combined his elective months the shifts).
(-) trauma exposure seemed lighter compared to other philly programs

Hopkins
(+): excellent faculty who were really excited about the 4 year switch....PD seemed flexible with directions to take for the 4th year. very strong off service rotations and residents seemed pleased with their experiences off-sites and at the different hospitals.
(-) 4th year details still being worked out....seemed a bit like the original 3 year curriculum with a 4th year tacked on. i spoke to some of the 3rd years and one mentioned that the PD offered the optional 4th year to the seniors and none of the 3rd years took him up on it. baltimore(+/-)?? although the bus tour they gave us was pretty fun and made me see baltimore in a new light!

Posted anonymously on behalf of a student who interviewed there.

U Penn Review

Pre-Interview Social: The night before my interview coincided with the monthly journal club, which was at a restaurant called Lovers and Madmen. We had the whole place to ourselves (I think one of the faculty owns it?), and they brought in a catered Chinese food dinner. After dinner, we discussed the two articles. The residents had sent them out to us beforehand so that we could read them and follow the discussion. Great turnout for faculty and residents, and it was a lot less awkward than your typical, “so, where are you from?” dinner small talk.

Interview Day: We started at 7 AM with breakfast and a presentation about Philadelphia by the residents, followed by a presentation about the program by the PD and chairman. We then went to a Grand Rounds session by a trauma surgeon, which was followed by interviews, lunch, and a tour of the adult and peds EDs. I was hyped up about the slurpee machine from reading previous reviews, but the slurpees were way too syrupy for me. Kids sure like them though!

There were four interviews with the PD, the assistant PD, another faculty, and a resident. The interviews were 15 minutes each, plus two scheduled 15 minute breaks. All of the interviews were pretty relaxed. I was asked why EM, why U Penn, why Philly, tell me about yourself, who is your best friend and what would they say is your greatest strength/weakness, and what three people would you have dinner with and why. Everyone also asked me what questions I had, so make sure you’re prepared to ask questions!

Curriculum: Penn is a four year program. PGY1/2s work 12s, PGY3s work a mixture of 12s and 8s, and PGY4s work 8s. Shifts are scheduled together in blocks with 3 days on followed by 1-2 days off, so there can be 18-20 shifts in a month. The hospitals include HUP, CHOP (peds hospital right next door), and three community hospitals (Presbyterian, Holy Redeemer, and Pennsylvania Hospital). There aren’t any official integrated peds shifts, but they do 4-6 weeks of peds EM at CHOP every year, and they also see peds cases at the three community hospitals. Also, the peds EM blocks are broken up into 2-3 two-week blocks each year so that residents aren’t only seeing peds patients during one season. There are 26 total months of EM, including five months of peds EM at CHOP and one month each at the three community sites.

Penn starts with a two week intern survival series, which is their version of an orientation block. It’s held at the end of June and is basically time to do workshops, get to know the system, and get to know people. You need to already have your ACLS certification before you start. They have some unique rotations in their curriculum. There is a cool resuscitation month where you do all the critical care stuff in the ED, like taking care of septic patients. There is also a month-long psych EM rotation with a few afternoons of derm clinic thrown in. There is no ortho month but you spend two weeks in sports medicine. There is one week of ophtho and one week of peds anesthesia. There are five months of ICU. Other rotations are the usual like anesthesia, trauma, administration, EMS, and tox. No required rads. There are 18 weeks for elective time, which is relatively flexible. I proposed an idea to the PD that he said I could even start as a PGY1. The downside is that there is one medicine ward month, which residents here dislike as much as residents anywhere else dislike ward months.

Although Penn is a research-oriented institution, everyone I met was very adamant that you don’t have to do research or be interested in academics to come here. In fact, I got a bit of an anti-research vibe from several of the residents, which really surprised me. However, these residents also said that the people who are happiest at this program are the people who like academics. When I asked the non-academic residents why they chose Penn, they said it was because they liked the setup of the clinical teaching, and they also thought the Penn name would be helpful for getting jobs, etc.

Didactics: Didactics at Penn seem pretty good. There is a brief (15-20 minute) case-based discussion each morning after sign-out. They have your usual five hours per week of didactics, including Grand Rounds, core lectures, case conferences, procedure conferences, EKG workshops, and sim cases. The core curriculum is covered twice during the four years. My experience was that the journal club (done monthly) was very good. There is also a city-wide EM conference held in concert with the other Philly programs every year for three days, which sounds pretty cool. The PD wants the residents to learn to be good speakers, so he has the PGY3s pick and present journal club articles and evidence in the ED sessions (15 minute talk about a topic). They also run the simulations. PGY4s do a Grand Rounds lecture and run the clinical case conferences. They are supposed to make it interactive.

Benefits: Benefits are decent but not as good as at some other programs. Vacation is four weeks per year. Med/dental insurance is deducted from your stipend. Residents get $250 of CME money per year which they can use to buy their own books, and the program also pays for your Step 3 fee. No discount on meals, but parking at the hospital is free (or they buy you a bus pass if you don’t have a car). EM organization memberships are paid for, and the program will pay for you to attend any conference where you present, plus ACEP for PGY4s.

Administration: I really like Dr. DeRoos, who goes by Francis to all the residents. (I even got the impression that it would be ok for us applicants to call him Francis, but I didn’t feel ballsy enough to try it!) In general, the relationship between faculty and residents seems very informal and friendly. The program has a Residents Day every year which all residents get off.

Philadelphia: Philly seems like a pretty good place to live. There are a lot of fun things to do in the area, and we were told that the food is especially good because most restaurants have no liquor license. (That’s why most places are BYOB!) Cost of living is fairly reasonable for an east coast city, especially compared to places like Boston or NYC. You can mostly get by without a car if you want, although it will be hard for the month that you’re at Holy Redeemer. Some people still do it though by renting a car, joining Philly Share, or taking the train.

Summary: Penn’s program has a ton of great features, especially if you’re interested in academic EM: great research opportunities, teaching opportunities, journal club. They have a few unusual rotations (especially resuscitation and psych EM) that most other programs don’t have. According to the PD, their greatest strengths are peds EM and resuscitation, which makes sense. The PD seemed open to suggestions for elective ideas as long as they have educational value, and he is even willing to rearrange the training schedule to allow people to have elective time during PGY1 if they need it for some reason. There are some great international opportunities (Guatemala, Botswana, Malawi) for people interested in that, and the department is also active in Project Salud (S. Philly clinic for Mexican immigrants). Philly is a fun city with a cheap COL compared to a lot of others. You can get by without a car for most of the time, and there is even a shuttle that can take you home in the local area at night.

For cons, of course a lot of people are going to be turned off by the extra year and the floor month. I’m still not convinced about the value of a floor month, but I do think the extra year can be valuable if you’re interested in an academic career. Another thing is that I'm not gung-ho about having to start in mid-June for the orientation block. Especially since so many three year programs are giving up one of their months for an orientation, it seems odd that a four year program wouldn’t! Finally, I just got a weird vibe from some of the residents.

As much as I like the program itself and think the curriculum would be a good fit for me, I’m not sure that Penn is socially the best fit.

1. Brigham/MGH: POS: Two amazing institutions, The Name (Partners) which helps if you want to do something in addition to medicine, faculty, resources, admitting powers, off-service education, true SIM-lab along with true integration into curriculum, fellowship in US (not that i'm interested in doing US fellowship, but having a fellowship makes it more likely that we will get a good ultrasound experience), getting an expanded ED at MGH, impressed with 4th years (they get experience running obs unit and getting presentation from PAs- say what you will about the importance of knowing how to run OBS unit and PAs, but all you need to do is look at the news and realize the possible future of EM), can use propofol, You get bread and butter at both hospitals (albeit, you're more likely to see zebras at these hospitals). NEG: Surgery floor rotation (I don't mind medicine floor), only 4 ICU months (I wish there was one more instead of surgery floor), slightly worried about admission pushback (but ED has admitting powers, so it's okay).
2. BMC: POS: "Boston City Hospital"- so many people have trained there, admitting powers, ED is powerful there, trauma is truly run by ED, largest ED visits in the New England area, largest number of trauma (penetrating) in Boston, sees the most number of patients in the New England area, Boston EMS medical control, great number of fellowships. NEG: Ortho experience is what you make of it, POTENTIALLY a weaker peds experience as it's a Level II peds center, limited propoful use, trauma is run sort of inefficiently (3rd year does tube AND leads the trauma, which is contrary to the principles of leadership)
3. UPenn: POS: this place has everything I want (perfect number of ICU rotations), true integration with trauma, residents can use propofol, admitting powers, great off-service rotations, great airway toys, Pharmacy is in the ED to help with codes (drug calculations) and drug questions. NEG: The number of ED visits they see seems a little low, weaker/building from scratch a SIM lab curriculum.
4. NYP (columbia and cornell): POS: Two great hospitals, best peds experience in NYC (which is tough in NYC), subsidized housing available, resources, admitting powers, can use propofol. NEG: relatively new (that being said, it's made a name for itself). High cost of living in NYC
5. Beth Israel Deaconess Medical Center: POS: Academic, 3+1 option, the name, the residents, the faculty. NEG: lower number of ED visits compared to other programs in Boston, many off-site rotations (which are worth it for this program, but driving can be a hassle)
6. UMass: POS: Great toys, helicopter- TRUE integration of residents and nurses as a team, residents, the BEST facilities of any program on my list, PD is AMAZING, busy level 1 adult/peds, great number of fellowships, ED is very powerful here. NEG: location in Worcester (but that being said, cost of living is great with it still being relatively close to Boston)
7. Brown: POS: Amazing number of fellowships in everything you could want to do in the future, VERY busy with large volumes of patients (second largest in New England), Large sim lab, has access to basic science research (if you're into that thing). NEG: location
8. Northwestern: POS: perfect number of ICU rotations, well known, great facilities, great location in Chicago, gets a lot of trauma from the South side of Chicago (since U. Chicago is not a level I trauma center). NEG: No fellowships, except a research fellowship (I'm worried I won't get a good US experience if there is no US fellowship)

As a paramedic who frequently brings patients to HUP you would do well picking this city and this hospital. The attendings, the facility, and staff are great. Good luck to all and maybe I'll see you on an EMS ride along one day.

I'm now midway through my intern year here, and can answer any questions you might have, just message me.

Hello all,
I recently interviewed at Penn and really enjoyed it. I was wondering if any current residents have any recent info/reviews about this program. I'm particularly interested in how you feel about the volume here. When we walked through, the ED seemed a little quiet. I was also interested in how you feel about the other sites you rotate at apart from HUP.

Having rotated at a hospital along side HUP EM residents, I can say that some of them (2-3 in my experience) are not shy about how much they dislike their program. Talk to an EM resident who graduated from UPenn and many will tell you that they were told to go elsewhere by HUP residents. I've heard that the program leadership is "trying" to improve things, but I don't know any specifics other than them adding an attending at HUP to make up for a new lack of off-service residents.

[double post]