Posted anonymously on behalf of a student who interviewed there.
UTSW Review
Pre-Interview Social: The pre-interview dinner was at Mannys Uptown Tex Mex. There was a large turnout of residents and a few significant others. The residents seemed to be a fairly cohesive bunch considering how large the classes are at UTSW (19 residents per class).
Interview Day: The interview day started at 7:30 AM with breakfast and a talk by the chairman. It was one of the odder interview day talks I sat through. First he went around and asked each of us where were from and why we were interested in UTSW. As each person gave an answer, hed use it as a springboard to talk about the strengths of UTSW, as well as emphasizing all of the famous people who are there. This went on for over an hour, and then he gave a brief powerpoint about common questions asked to the chairman, which included does he support the residency, financial stability, what he plans to change, and whats for lunch? Next the PD gave his slideshow, which was more the typical thing you expect that went over the curriculum, didactics, benefits, etc. This was followed by interviews, lunch, and a tour.
I had four interviews with the assistant PD, two other faculty, and a resident, and I also spoke briefly with the PD. The interviews were 20 minutes each, plus two 20 minute breaks. All of the interviews were pretty relaxed. I was asked why EM, what do I see myself doing ten years from now, why UTSW, and to talk about one of the experiences I had listed on ERAS. Everyone also asked me what questions I had, so make sure youre prepared to ask questions!
Curriculum: UTSW is a three year program. The main hospitals are Parkland (county type hospital on the UTSW campus that is also a tertiary referral center) and Childrens Medical Center (also on the UTSW campus). In addition, there is one rotation each at the VA, Methodist (community site), and one other community hospital. For shifts, PGY1s do a combination of 9s and 11s (not overlapping), while PGY2s/3s do overlapping 10s where they see patients for the first eight hours and then spend the last two hours cleaning up. Childrens shifts are 12s. Im not sure how many shifts they do now that theyre on this new schedule instead of all 12s. There are two peds EM months in PGY1, and then peds shifts mixed in with the EM months for PGY2s and PGY3s. Total EM time is 25 months, including the community EM blocks and the teaching block. There are three ICU months.
There is no orientation block, but interns can practice procedures like putting in IVs and foleys during their first EM block if they want. The PD stressed that off-service rotations are very strong. Ortho consists of ED consults. OB is on labor and delivery. There is also a month of gyn urgent care. There is one medicine ward month. They do a lot of anesthesia: three weeks of adult and two weeks of peds. There are two elective blocks, one of which can be an all expense-paid month in New Zealand. Both electives are scheduled for PGY3 year, but residents can rearrange their blocks to have elective time during PGY2.
All major EM subspecialties are covered. I already mentioned peds and ICU. There is no EMS block, but they offer optional flying, and the PGY2s and PGY3s provide radio EMS medical control. There is a tox block at the North Texas PCC, and one combined block of U/S and rads. The residents can all get U/S credentialed. They have one block of trauma and a two week neonatal resuscitation block, although the PD said that the residents end up doing resuscitations on every shift because of Parkland being such a busy receiving hospital. EM does the airway and leads the resuscitations. PGY3s have a teaching block. PGY2s and 3s also run four of the five pods, each having 12 beds (80 beds total including asthma and eye rooms, OB/gyn area, psych area). One pod is for urgent care and open 16 hours per day. Each pod has its own faculty plus a resident and maybe an intern. The PD said the pods have made patient flow more efficient. They have an emergency pharmacist in the ED 24 hours per day.
Didactics: They have your standard five hours per week of didactics. This is protected time even on off-service rotations. Interns have their own conference series for two hours each week, and they do sixty hours of procedures in Ft. Worth. This is the kind of program where you are responsible for your own learning, and there are no assigned readings or quizzes. Also, they do what they call asynchronous learning, where there are various optional didactics like journal club, board review, etc. The residents have to attend a certain number of hours of these didactics, but they get to choose which ones they want to attend.
Benefits: UTSW has decent benefits. There are three weeks of vacation and two weeks of sick leave per year. The salary is very reasonable for the COL in the area. Residents have to pay for parking, but its pretty cheap ($15/mo). They can moonlight as PGY2s and PGY3s after passing Step 3. They have a retirement plan and flexible spending account, get funded to go present research at conferences, etc.
Administration: The chairman told us that the fact that he spends so much time talking to applicants should be taken as a sign of his commitment and support for the program. He wants this program to be the best (however you define that). I got the impression that the UTSW culture in general is kind of intense, both on-service and off-service. Residents select a faculty mentor during their PGY1 year.
Dallas: Its your typical large city with hot, dry summers and relatively mild winters. We didnt hear too much about things to do during the interview day, but 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.
Summary: I left my interview day feeling like Id be prepared for just about anything after going through this program. Parkland is one of those hospitals where you are going to see a huge variety of pathology, and as a public hospital, you will also be the safety net for the indigent population in Dallas. Its also a hospital where all of the departments are very strong, not just EM, so the off-service teaching is top notch. I liked the residents I met, and they went out of their way to make sure that we had a good visit. Most of the EM subspecialties are very strong. Their tox department is enormous, with around a dozen toxicologists. U/S has been greatly improved to the point where the residents can get credentialed now. No one has any problem getting enough procedures. The New Zealand elective sounds awesome. There is graduated responsibility, and the residents get a lot of administrative experience by running the pods and teaching the medical students. They have longitudinal peds shifts, which gives them good seasonal variety. The new overlapping shift schedule has helped a lot with getting people out on time since they have two hours of cleanup time built in. Also, now the shifts are only ten hours total instead of twelve hours plus cleanup time like they used to be. That seems to have made a big difference in terms of resident wellness. The institution as a whole is very research-oriented, so if you want to do research here, you can. But its not expected, and more than half of the residents end up going into community practice.
The biggest negative to me was that the chairman kept emphasizing how he is working to make UTSW be the best EM program in the country, to the point that it makes me wonder just how high the pressure to be the best is ratcheted up. Considering how stressful working in this kind of high pressure environment can get in and of itself, Im not sure that all of this extra pressure to reach some undefined level of good reputation is really necessary! Id also like to have an orientation block, which they dont have. Finally, doing a ward month is bad enough, but the idea of doing a gyn urgent care block is beyond unappealing.
Overall, I think Id get great training at UTSW, but the culture there might be a little too intense for me.