St Lukes Roosevelt Hospital Center
Residents: 14 residents per year. Residents are involved with the selection process hosting a pre-interview party, interviewing, and leading the tours. They have a reputation in NYC as a very happy group, and that seemed to be true. Most of them live in the same building, and they hang out socially. Everyone I spoke to ranked SLR first. Theyre from all over the place, probably more from the NY region than anywhere else but there is a group of them from New Orleans (we had homemade Gumbo and Pralines at the party
). Seems like more single than married, and few with kids.
Faculty: It seems like many people find the PD, Dr. Lanoix, to be hit or miss. He can be aloof, and is opinionated - but I happen to agree with most of his opinions, so I like him a lot. He is extremely passionate about his program and NYC in general. The assistant PD, Dr. Clark, is really nice. Residents report a first-name-basis relationship with almost everyone, and the attendings attend social events. Residents say bedside teaching is great. Additionally, the faculty responds very well to residents and has made recent changes based on resident input.
Hospital:
There are two sites, St Lukes Hospital and Roosevelt Hospital, where time is split almost evenly. They are both on the west side, and their coverage runs from the Upper west side practically down past Chelsea (a huge area by NYC standards). Between the 2 EDs there are nearly 190,000 visits, so they are very, very busy. Each site has its own identity, although I think the recent closure of a midtown hospital may be making the patients populations more similar at each site.
St Lukes Hospital: I think this one is bigger, its a level 1 trauma center located next to Columbias undergrad campus in Morningside Heights. This is where they report a more indigent population, with more autonomy in care. There is a separate Peds ED here, and lots of Spanish-speaking. The adult ED is standard for an inner-city place not modern by any means but electronic patient tracking and ordering. They have a couple of trauma bays. X-ray is on-site, but the CT is upstairs, which is a pain. Most off-service rotations are also here.
Roosevelt Hospital: The ED here is very tiny and crammed with people (especially with the closure of St Vincents Midtown down the street). They are currently expanding the ED, hopefully to be completed before next year. They report a more private patient population here, although Midtown was a service facility and Im sure the overflow they are getting from its closure is largely uninsured. Peds is intermixed with adult here. Same computer system (and attendings) at this hospital. Level 2 trauma center, I think. CT is upstairs here as well. This hospital is not a Cath center (for some reason they do diagnostic, but not therapeutic), so STEMIs must be shipped up to St Lukes.
Ancillary Stuff: Supposed to be pretty good residents told me Roosevelt was a little worse because of the recent overcrowding, but for an urban place nursing is reportedly very good at these sites.
Admitting/Documentation: No problems with admitting. Use of EMSTAT system (which they are very proud of) has supposedly helped them become one of the most efficient EDs in the country. Patients rarely wait more than an hour to be seen, which is pretty impressive considering the volume. They have plans to go completely computerized this spring.
Curriculum: 3 year curriculum with emphasis directly on ED time. This place has more ED months than some 4 year programs! However, it comes at the cost of critical care experience, which they have very little of. There is no graduated responsibility PGY1s see sick patients. Interns have almost a half year in the adult ED, plus 2mo of Peds ED. There are no floor medicine months. However, it seemed like the off-service time they had in Anesthesia and OB were sort of low-yield. Second and third year are more of the same lots and lots of ED time split between the two sites. Lanoix is one of the great defenders of the 3 year curriculum here in NYC (maybe to a fault sometimes he can seem almost defensive about it), and believes you learn emergency medicine in the ED so why waste time elsewhere. Its a refreshing, if slightly narrow view on training, and I think it works well here (between the crazy volume and the number of ED blocks, these residents see a heck of a lot of patients in 3 years). They have 2 electives, but one must be trauma (you can go anywhere, most go to Miami) since Manhattan is too darn safe. The other elective is open. Interns work 12hr shifts, second and third years do mostly 9hr shifts (recent change at resident suggestion they got rid of a Peds elective and went to 9hr shifts. Everyone seems happy about it). Experience with procedures seems OK, but they set it up so PGY1 do lines and PGY2 do airway, so it seemed like interns did not have a lot of intubation experience (outside the Anesthesia rotation). The program emphasizes ultrasound use. Unique to the curriculum is the Niche program a non-required mentor system for those that become interested in anything from research to business.
Didactics/Research: Didactics are once a week residents said they are pretty boring. There is a lot of research done here, both clinical and basic science. The basic science stuff is mostly toxicology, although there are some other projects. There is a lot of clinical research, and they have undergrad academic associates to do the paperwork. There are a bunch of Fellows, including ultrasound, tox, global medicine, and research/education (SDNs own Roja! I met her on the Jitney
), so there are many ongoing projects. They are very supportive of residents presenting abstracts, as well as residents with academic interests the niche program helps link interested residents with the proper support.
City: SLR basically covers the majority of Manhattans west side. Ill leave the cultural advantages of living on the west side (more trains, better parks, less uptight people) to those who know the city well. Among the EM programs in NYC, SLR may have the best location. As Ive mentioned before, NYC is one of the great cities of the world, but it comes with a very steep price. Housing here is excellent (see below), but will still be shocking to those who are new to the city. It comes down to wanting the NYC experience or not, and if you do SLR is in a great place to live and work.
Extras: Salary is excellent (starting $51,700+ as PGY1) but wont go far in NYC. Housing is the jewel of SLRs benefits they subsidize 3 buildings and guarantee housing. One high rise is on 59th with big studios (a steal for $1100), as well as 1 and 2 BR places for those with family. They have another place nearby, and then an older place up by St Lukes. All three are in great locations, near parks, trains and nightlife. There is a Jitney bus between the hospitals, which is a nice perk but the bus schedule seems to run the residents lives (its kind of like catching the school bus). 4 weeks vacation. Excellent insurance including spouses for no extra charge! Most CME money of anywhere Ive seen ($750 a year), plus they pay for Step3 and all conferences. Residents are unionized. The trauma month is totally paid for, including air fare.
Negatives: Personally, Id like some more time in the ICU but the ED-heavy curriculum is pretty cool otherwise. While the Jitney service is nice, going between 2 sites as often as they do may get old. The facilities arent that great. Since the ED is so efficient here, and that efficiency is touted so often, the residents did admit to feeling pressure to move the meat even as interns not by the faculty per se, but because of the overall culture.
Overall: Residents at SLR are among the happiest youll find, and this place undoubtedly has the best benefits of any program Ive seen, which contributes to the resident satisfaction. The PD is passionate, and the combination of high volume and ED-heavy curriculum likely produces excellent clinicians. You cant really call this place a diamond in the rough anymore, because it seems like everyone already knows about it! In a city of great programs, this one stands out.