University of Pittsburgh (Pitt) Residency Reviews

I am basically at the point where I am going to go out on a limb and say that there is really no bad EM progam around. In fact, I am starting to believe that most of it is just how you get along with the people and whether you like the area. With the exception of a spaceage facility like Mayo, the constant sunny weather of El Paso, the Jeep experience at Pitt, or the flight experience at Case or Indy, there is really nothing that is a standout. I am just having a total blast coming the country and I have to admit that every place has its perks.

Today I interviewed in the coolest kept secret of a city, Pittsburgh. I think it is the San Fran of the east coast terrain wise. And it has just the right amount of winter to give you that Christmas feel. This place has turned out to be one of my favorites quite frankly because it has awesome people, and it has the Jeep experience. This is a unique experience where you do a couple of your assigned shifts per month in 2nd and 3rd year in a mini-SUV where you drive to the scenes of complicated medical and trauma patients and function as the on scene physician. This is not only incredible for teaching young docs how to be leaders, but it helps them learn EMS from a different vantage point. Pitt also has several star faculty like the other programs I am mentioned before. They like Indy, have a great mixture of county and private in UPMC Presby and Mercy Hospital. Residents were outstanding and a tight knit group that likes to eat, drink, and play together. This is one of the top 3 programs for EMS in the country in my opinion.

Case:
I showed up tonight a bit late driving in from Pittsburgh, but I still got to meet MikeCWRU and several other residents and applicants. They were on par with Pitt regarding hanging out and having fun. I laughed more with these guys than I did with any of the other groups. It was like an episode of the Drew Carey show where they hang at the Warsaw Pub. And why the hec has everyone been lying to me about these midwest cities telling me that they are all suffering from sprawl and depression? Pittsburgh was incredible, and driving into Cleveland tonight I felt the city was a really cool city. Its not too big or small, it has a great downtown stadium and a lakefront like Chicago. The drive to the Pizza parlor was lined with 1920's homes that were all gorgeous and lit up. I'll finish writing tomorrow about the Metrohealth/Cleveland Clinic program but I predict it will be be equally as impressive as Pitt was today. Its great to know that we are all entering a profession where everyone is laid back, where people all like to hang out together and where where the community of EM is still small enough so that we will all be able to get to know each other for decades to come.

Pittsburgh:

Pro's:
-Strong EMS training with renowned "jeep" (EMS/flight exposure is more than just observational)
-ED's seemed nice
-Residents were fun
-Pittsburgh is an affordable place to live, and I actually liked the city

Con's:
-Only 1 elective month
-Weak ultrasound exposure
-Peds exposure seemed mediocre

Overall I think this is a strong program and I would be happy to train there, but in my opinion it doesn't quite live up to its reputation.

Rental Cars -- with hidden fees, way more $$$ than you think
Driving sleepily thru the Midwest between interviews-- mind-numbing
Anonymously posting residency reviews -- PRICELESS

So the interview day at Pitt definitely leaves you with the gut feeling that the program is "upper crust," as Dr. Yealy describes the program. Everything is strong. I don't want to get details wrong, so this will be pretty overview-ish. And I don't think these are "only for MS4s," since any of us might get a question answered by a resident that reveals a tasty tidbit or opinion that is high yield.

Residents: 46 total now I think, as they recently increased the class to 16 / year, and now have 3 chiefs. Seemed like mostly midwest and east coast people. All are down to earth, a mix of single to married with kids. Up to 1/4 of each class is from UPitt, but this shouldn't raise any flags: Yealy himself said almost disparagingly that they didn't give any benefit to UPitt grads in the process although they do interview most/all of them.

Shifts: A mix I believe of 8s & 10s, but no 12's. Jeep shifts mixed in from home, as long as you live within city boundaries, use your downtime to catch up on whatever. Truly a unique experience--you may be delivering babies in highway tunnels, intubating a trapped patient in the back of the bus, etc. Stat (helicopter) shifts mixed in as well.

Facilities: Good at 2/3 sites (didn't see West Penn), but how much should this really affect your decision?

Peds: Their Peds hospital is their highest volume site at 60k+. They're still working out how to mix Peds into the year so residents see kiddies throughout the year. Right now they're doing 2 week blocks to do so--not integrated shifts.

Trauma: Most of it seen at Mercy which is Trauma & Burn. West Penn is a burn center, and there is also more trauma at UPMC Presby.

Faculty: Met 4-5 faculty over the dayDynamic folks who are highly academic, but of note, pretty down to earth and fun people to talk to.

Curriculum: Notably there is 1 month on the medicine wards--a resident described the IM folks as "good" compared with GenSurg folks who were "very good." Conferences are one day / week, and vary from formal-ish didactics to lectures during which there is banter.

Patient Pop: Diverse and sick.

Location: Pittsburgh is what it is. Definitely agree with great cost of living compared to big cities. One resident lived 10-15 minutes from most of the hospitals right at the edge of town (so he could hang out at home during Jeep shift downtime)--he paid a little over 100K for his townhouse which houses his wife and 2 kids, surrounded by trees/parks, etc.

Random facts:
1. Moonlighting: Sounds like you can do it in the 3rd year if you want.
2. EMS: haven't seen anything else stronger in 9 interviews, and I'll see much that tops it.
3. The program has huge depth and balance--everything is solid.

Overall: "Upper crust" program that speaks for itself. You can go pretty much anywhere academically if you take advantage of the deep and balanced opportunities here, probably including 4 year programs (Yealy cited an example of this). That said, one of the more respected residents in the program is going community--this is no problem, and going community is totally ok with the faculty. Probably could be the EMS medical director in a small city without the Probably comes down to if you can get in and what you think about Pittsburgh.

Feel free to PM me with questions.

SecretReviewer did a great job on his review so I'll just add in the following:

1. Research is required (i.e. not "scholarly project", has to be real research)
2. If I remember correctly, you get paid on the STAT shift (choper). Pitt owns 23 chopers and 2 or 3 fixed wings!!
3. Has inpatient tox unit run by PA/NP so residents get the benefit of getting exposure to tox without having to do the admission/discharge paperwork, 3am fever work-up, etc.
4. In addition to the EMS jeep and flight experience, you can also join the river rescue team
5. Trauma airway - EM gets the airway during daytime, Anesthesia gets the airway at night
6. Great simulation center
7. u/s credential possible but comparing to other programs, Pitt requires more effort on the residents' part to document it and be more aggressive in getting the scans

Great job everyone on the program reviews so far! As an applicant last year, I found every review that was posted to be very helpful last year and it looks like this year there is no different. As one of the current Pittsburgh EM interns I'd like to comment on a couple of the reviews of the program here. Feel free to send any questions directly my way as well if you so desire.

Our manditory research requirement: You can take it as far as you'd like from designing an RCT to piggybacking on an existing project to doing a chart review. We are currently set up with local EMS to have a waiver of informed consent for most studies which makes it easy to do clinical trials. For instance, one of the residents is testing out the clinical application of a lactate meter that works like a glucometer for first responders. Another is using our simulation lab to look at optimal ACLS and airway management training strategies for first responders using simulation. In the past, one of our residents did a study showing two-thumb CPR to be superior than two-finger CPR for neonatal recussitation, the results of which were incorporated into PALS.

For our helicopter experience, we work closely with a company called STAT which owns 17 bases spread throughout western PA, northern WV, Ohio, Maryland, and one in DC as well; however, we only work at 2 bases that are both about 45 min from Pittsburgh. We work as 2nd and 3rd years as flight physicians (working equally with a flight nurse or medic). About 20-40% of the flights are scene runs and occasionally we do a fixed wing transport as well. As interns, we do 5 observation flights to get oriented to the helicopter and get a taste of the future as well. It's a great experience!

Our tox rotation (2 weeks 1st and 2nd year) is case and lecture based from some of the best faculty in the hospital and some of the greatest teachers I've met anywhere. If there's anything interesting on the wards, we'll also round with the tox attending. It's mostly a low key couple of weeks with some great learning and time spent at the same poision center where Mr. Yuk was invented.

The river rescue aspect mentioned above is not part of the residency, but a lot of the residents do work with EMS or other groups as part of their experience. One of the sports-medicine inclined 3rd year residents has a side interest in being the trainer at local high school football and basketball games. One of the attendings is the head of the bioterrorism planning for the city as well as has a hand in tactical EMS (something a few residents have become involved in as well). Keep in mind, though, we do a lot of EMS already between the Jeep, event medicine, and STAT that most people get their fill by their 3rd year.

Finally, a couple comments were made about our peds and ultrasound. The comments about U/S are likely true. In its current iteration, our U/S is mediocre, although we do a lot during our shifts at Mercy hospital and we just hired a couple U/S trained faculty there. As for peds, I think we do ok - we do 2 weeks to 1.5 months a year in the ED at Pittsbugh Children's hospital. We do dedicated blocks instead of having the peds shifts spread out which I think would be optimal. However, having done 2 weeks there already, you do see a LOT of sick kids and the faculty are exceptional. We also see low to moderate acuity kids on urgent care shifts at Mercy and in all of our West Penn ED months (one per year).

Overall, the attraction to the program is clearly the EMS experience, the city of Pittsbugh (which is awesome by the way), and I would say working at multiple hospitals which prepares you for both community and academic practice.

Ok, time to stop being lazy. Here are a few of my reviews. As with everyone, these are very subjective....enjoy.

University of Michigan:
Stats: 4yr program, 12 res/class, started 1992
General: 3 Hospitals: U of M (74K) – Tertiary care center, trauma, flight, Peds, majority of off-service rotations. St. Joes (85K) – Community “teaching” hospital, bread and butter, level 2 trauma. 15 min from main hospital. Hurly Medical Center (78K) – County hospital in Flint, significant trauma (penetrating and blunt); ~5 months total, 1 hr commute.
Separate and integrated Peds experience depending on location.
Pros: Very well run, impressive program with strong leadership and highly regarded faculty (i.e. - Dr. Barsan). Sold the 4 year program to me – significant ICU experience (9 months), extra elective time, teaching and administrative responsibilities for 4th year residents; overall a well rounded experience. Strong academic feel – relatively high percentage of residents go on to academic positions and fellowships. U of M is large and highly ranked hospital. Research is not required (“academic project” instead), but variety of projects readily accessible. Program director seems very well organized and passionate about program. Residents come from a variety of regions and are well marketed across country for future positions. Diversity of patients and experiences at different locations – plenty of pathology and trauma experience. Flight experience. Very nice facilities. Ann Arbor is a great town.
Cons: 5 months away in Flint which is a 1 hour commute each way. Resident classes didn’t seem as social and cohesive. Although a few ultrasound teaching attendings, ultrasound training not as well developed.


University of Pittsburgh:
Stats: 3yr program, 16 res/class, began in 1981
General: 4 Hospitals. UPMC – Tertiary care 50K, trauma, flight. Mercy 60K – community hospital downtown, bread and butter + trauma. Children’s Hospital. + 1-2 other community hospitals doing ED shifts and ICU. All hospitals within 15 min.
Pros: Residents seem very happy and all seem to get along – great camaraderie within classes. “Work hard, play hard” feeling. Residents raved about program. Strong, established, academic program with several fellowships (EMS, Tox, Peds, Research). Faculty approachable and good teaching. Great EMS program with “Jeep Shifts” – 2nd and 3rd year residents drive Jeep around town and are 1rst responders. Flight experience. Variety of clinical settings with separate pediatric emergency department. Pittsburgh is a surprisingly nice city which is very affordable.
Cons: 4-5 different hospitals with different charting systems. Most hospitals use paper charting. Average appearing facilities (from what I saw). Parking is apparently an issue for residents. Residents said Peds training “so/so”. Ultrasound training not emphasized.

Wash U:
Stats: 4yr program, 12 res/class, started 1997
General: Majority of time spent at Barnes-Jewish (main) ED – 80K as well as Children’s - 60 K; few community rotations scattered. Research required.
Pros: Heavy academic – required research (if that is your thing) and several months set aside for projects, frequent didactics and conferences (M&M, EKG, etc.), medical student teaching. Strong off service rotations at Barnes-Jewish/Wash U; emphasis on ICU rotations. Great pediatric experience at Children’s. Strong u/s program (looking to add fellowship). Great facilities – all computer charting. Well-organized program. Significant time for electives. St Louis very affordable (most residents had bought houses). 4wks vaca/year.
Cons: 4 year program – although many of the residents swear on it, many were talking about how they would only spend 30 hrs/wk during elective time (wonder if it is necessary??). Extra year allows more ICU, ent/optho, research months, elective time, etc. Required research project (if that is not your thing). The residents generally spoke well of the program, but many admitted that it was their 2nd, 3rd, 4th choice. Not its own department, for what it is worth. PD is very nice but “anal” and residents complain of “significant amount of paper work” . Although Central-West End is nice, none of the residents seemed thrilled with city.


Metrohealth/Cleveland Clinic:
Stats: 3yr program, 12-13 res/class, started 1991
General: 2/3 spent at Metrohealth – Large (90K+) county hospital with significant trauma, peds (integrated), and “bread & butter” ED cases. 1/3 spent at Cleveland Clinic – 40K+, less acuity, but are seeing unique CC pathology. Hospitals about 15min apart.
Pros: Nice balance b/w county and academic hospitals. Facilities generally very nice at both locations (CC ED brand new). Residents seem very happy and seem to get along. Residents are well prepared, although they admit to “working very hard” in their 3 years. Faculty are generally well-liked and lobby for residents. Excellent flight program with opportunities for residents. U/S training and fellowship available.
Cons: Seemed like a “local” program – most residents from upper Midwest and it seemed like many were planning to stay nearby. Cleveland is a livable, but mediocre setting (low cost of living, though). Was not an emphasis on non-ED rotations. Very little time for electives. No separate pediatric training (this did not seem to be an issue, however).

Residents: 16 residents per year. I rotated here and spent a lot of time with the residents, so I got to know them pretty well. They were all very friendly, down-to-earth, and intelligent. Everyone I spoke to had UPMC as their top choice. There is a good mix of married and single residents, and a bunch of them have kids. I was told the program is family friendly, and I believe it. The program is large, so it seems like there are a lot of different personality types – which I like. The seniors seem confident and capable, and due to the jeep experience and the number of hospitals they rotate through they all seemed to have a great grasp of EM as a whole (from EMS to community ED’s to huge academic center’s and research).

Faculty: A big strength of the program. Everyone I met was very friendly and pro-resident – there was a lot of joking and laughing during shifts. Faculty members at Presby are extremely academic, and the program is always at or near the top in NIH funding (see more below). The residents all raved about faculty at Mercy, and the few I met from there were very nice. It seems like a lot of the faculty trained at UPMC. The PD, Dr. Wolfson, is as well-regarded by the residents as anyone I have heard of in the EM world so far.

Hospital:
There are three major sites, and extensive time is spent at each one. This can be a pro or a con, depending on who you talk to. There are different dictating, charting, and ordering systems at all three, and apparently it takes some getting used to.

- Presbyterian is the tertiary (practically quaternary) referral center, a major academic site with a busy Level 1 trauma center and some very interesting academic center-type patients in addition to the usual suspects. It’s located on the main campus of Pitt, surrounded by the academic center. The ED is large, but efficient. The hallways can get filled when it’s really busy. On-site X-ray and CT scanner. It has computerized tracking and charting, since it’s the academic center there are lots of consults called. The Center for Emergency Medicine is located in a nearby building, containing office, conference space, and an amazing simulator center. About half of the year is spent there.

- Mercy Hospital is a more bread-and-butter ED, although it’s also a Level 1 trauma center. It is located downtown. The ED is smaller, but it also has on-site radiology. Mercy has the region’s burn center. Residents all seemed to love this hospital – less consults, more autonomy.

- Western Penn is also a more community-type hospital. I didn’t spend any time here, so I can’t speak for it.

Ancillary Stuff: At all sites, the ancillary support is amazing. Residents only do IV’s, blood draws, and other minor procedures if they want to do them. There are clerks who document and place all your calls.

Admitting/Documentation: Full admitting privileges. As mentioned before, documentation is different at each site. Some find this annoying; others say it’s a good skill to learn and that they are prepared to work with many different systems now.

Curriculum: Pretty standard 3-year curriculum, with one medicine ward month, about 3 ICU months, and 3 Ped ED months. Only one elective month. However, the jewel of the curriculum is the EMS experience. Throughout the curriculum, residents take shifts in the Jeep – a medic response vehicle. While on these shifts they act as quasi-EMS directors, taking calls from the field and consulting on treatment. They respond to major calls and get a ton of hands-on and leadership experience. There is also substantial flight time, if you’re interested. Off-service rotations have a solid reputation, especially critical care.

Didactics/Research: Standard didactics, one morning a week (personally, I feel like didactics at most programs are very similar, and it isn’t really a breaking/selling point for me unless it really stands out as amazing or terrible). The research is second to none. Top NIH funding. True translational research in resuscitation – from rodent, to swine, to human, as well as substantial EMS research. Multiple members of faculty hold editorial positions at your favorite journals. There is a research fellowship, and the entire research group (which includes a PhD and an MD/PhD) is awesome. This is definitely a huge strength of the program.

City: Pittsburgh is a drawback for many, but a positive aspect for me. I went to undergrad here, and I have a lot of love for this city. It’s probably one of the best kept secrets in the US – plenty of art/music culture, amazing pro sports, a couple great universities, and Very cheap real estate. It’s the ultimate river town. I also have friends and family here, so I’m biased. My biggest concerns with the Burgh are the weather (cold, gray, winters that are longer than I like), the fact that it’s nowhere near the beach, and the ability of Mrs. UE to find work here.

Extras: Good salary considering low cost of living in Pgh, excellent benefits, and plenty of moonlighting opportunities in the smaller UPMC hospitals for senior residents.

Negatives: The residents don’t feel they have enough Ped’s exposure (seems common among EM programs). If this matters to you, there seems to be a parking issue at some sites. Location may be a negative for some.

Overall: A well-established, well-respected program with good reason. I had high expectations of this place, and they were largely exceeded. A great, family-friendly place to train, with world-class research, really cool EMS training, good faculty, and great exposure to lots of types of practice. If you’re an MS3 looking for a great place to rotate – look no further, you get amazing Sim experience (with ACLS certification), a day in the jeep, a day on the chopper, and a great ED to work in.

Residents: There are now 16 residents per class, up from 14 a couple of years ago. I spent a month here, so I got to meet alot them in the ED as well as outside the ED. Mind you, I'm from out of town (west coast) so I'm not too familiar with Pittsburgh. I think this is one of the greatest thing about the program, the residents are really a great bunch of people. Most I've met are from the east coast and mid area, although there are a few form the west coast like me. The one's are outgoing, but also work hard and are dedicated to the field. This is definitely a strong selling point to the program, they seem to do a good job recruiting smart, but down-to-earth people.

Faculty: All positives so far, the ones I worked with were are great at teaching and seeme to love the job. Most of them are academic, but still very down to earth. A good amount of them have positions for the major journels like the Annals and AEM.

Hospital:
Three major sites along with Children's. I feel each offers a unique traning area with all three complementing each other.

- Presbyterian is the tertiary (practically quaternary) referral center, a major academic site with a busy Level 1 trauma center where you get alot of transplant patients. This is where I did my rotation and I loved it, I thought the experience was great and I know alot of the residents love it here, although they do admit it can be tough. Since it is a mjor referral center, alot of calls are made so not as much as autonomy, but the positive is the really interesting patients and the other residents are great and strong like neurosurg, etc.

- Mercy Hospital The mix between academic and community, is by far the place all the residents raved about. All agree it is probably more representative where most will practice and speak highly of all the attendings there.

- Western Penn is more of the typical community place. You do a month a year, most residents enjoy there time there and feel you have alot of autonomy.


Curriculum: LIke most other three-year programs. First year is very off-service heavy, but most residents agree it is very useful like CCM (which Pitt has one of the strongest programs in) and trauma, also very busy, but they do feel they do alot. Second year and thrid year is much more EM months with the Jeep, probably one of the most unique aspects of the program where you do medical command with the paramedics and respond to the big stuff like trauma and cardiac arrests. One of their residents just did a prehospital cric! Something you probably couldn't do anywhere else.

Didactics/Research: Standard didactics, one morning a week on Thursday, which seems like at any other place. I think another strong selling point is the research they have. Some of the big research is in EMS, but many of the residents I talked to mention that you can do research in anything you want to. The PD, Dr. Wolfson, is editor for one of the major texts in EM (Harwood-Nuss) and one of the residents authored a review book (Deja Review: EM) so it seems they are also very active in other aspects of EM aside from research.

Negatives: I think a common negative comment is the location. I actually like Pittsburgh alot and find it very affortable and more livable to others places I've visited.

Overall: Overall, part of the reason I rotated here is that my wife's family is in pittsburgh and also the reputation of the program. Everyone I've talked with at home all agree Pitt is top-notch program with alot of strengths, and after spending a month here, I definitely agree with this and would love to come here to train.

I need to bust this out before Wallowa does so and influences me!

University of Pittsburgh Affiliated Residency in Emergency Medicine

Residents: 16 residents in the intern class. Pitt was at or near the top of everyone's list. They seem very content and laid back. Most were in a stable relationship or married. Quite a number had kids or at least a bun in the oven. The low cost of living in Pittsburgh meant many could raise a family on a resident's income! Residents come from all over but many end up wanting to stay.

Faculty: It does tend to get a big inbred (about 50-50) due to the unwillingness of so many residents to actually leave Pittsburgh (although they easily can). However, they have many big-wigs on staff. Cliff Callaway is a renowned researcher, and many faculty are entrenched in EM national societies. Allan Wolfson is the PD, everyone seems to love him and he is funny as hell. The department chairman (I must have misremembered his name) is more hands-off and doesn't work shifts in the ED, etc.

Hospital: Training occurs primarily at UPMC-Presbyterian and Mercy (more inner city). Obviously, UPMC is more tertiary care-oriented with lots of residencies and great off-service opportunities, but the ED still has plenty of power and gets to do stuff. Mercy on the other hand has only a General Surgery residency, so Pitt residents get to do their own thing for the most part. Documentation is via a dictation system that types out your words as you talk.

Ancillary Stuff: As with many places, great ancillary services, you won't have to do any wheeling people around, starting IVs, or making your own phone calls. They say the RNs have a good relationship with the residents and are on a first name basis.

Admitting: No idea, sorry.

Curriculum: Pretty basic, including a medicine floor month. The jeep rotations are their big innovation; a 12 hr shift where you do consults for medics and ENTs and go to critical scenes as needed. People have gotten tubes, crics, and more out of this rotation, plus they get to turn on the lights and sirens. There is no graded responsibility - what you get is what you get. However, at Mercy PGY3s do a "pitt boss" rotation where they run the ED, and a PGYII ICU month where they are it - no in house attending.

Didactics: Simulation is nicely integrated, they boast the world famous Wiser center with more high fidelity sims than I've ever seen. The residents swear by it and say that they were able to bust out crics on their own without problems based on their sim training. The lectures are broken up over two days. A nice touch is the September lectures for the interns, a month of concentrated didactics once their feet are wet that includes 5 ED shifts.

City: Pittsburgh is a pleasant surprise! It is beautiful with lots of water and things to do, and they love to boast that it was voted 2007's Most Livable City. The cost of living is excellent, and the salary is plenty to buy a house. Many who come want to stay.

Negatives: no real county experience, and the patient population is mainly black and white.

Overall: The reputation of this program seems well-deserved. Residents come out confident and well-trained for academic and community EM. As a big city girl that loves county experience, it may not be near the top of my list but I would be very happy to train here, nonetheless.

I'm one of the PGY-II Pitt residents and I wanted to respond to a couple of things in this review. Most of the material included in this review is factually correct, but I remember as an applicant that I would comb over every little tidbit I could find about my top programs and I want anyone considering Pitt to get the most accurate info. I'm also available for PM if anyone has further questions. I made a few corrections/observations below:

Hard24Get said:

University of Pittsburgh Affiliated Residency in Emergency Medicine

Residents: 16 residents in the intern class. Pitt was at or near the top of everyone's list. They seem very content and laid back. Most were in a stable relationship or married. Quite a number had kids or at least a bun in the oven. The low cost of living in Pittsburgh meant many could raise a family on a resident's income! Residents come from all over but many end up wanting to stay.

Faculty: It does tend to get a big inbred due to the unwillingness of so many residents to actually leave Pittsburgh. However, they have many big-wigs on staff. Cliff Callaway is a renowned researcher, and many faculty are entrenched in EM national societies. Allan Wolfson is the PD, everyone seems to love him and he is funny as hell. The PD Dr. Campbell is more hands-off and doesn't work shifts in the ED, etc.

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We actually have a good bit of our faculty from outside the program - I'd say probably 50% didn't train here. I would submit that one of the defining traits of our program is that people DO have the ability to leave and work elsewhere - especially since we bring in a lot of people from all over. For example, among last year's class which was the last with 14 residents, only 1 stayed in a residency-affiliated hospital, 5 stayed as fellows, and 2 stayed in the area at private hospitals, the other 6 left. This year, out of 16 residents, only 5 people are staying in the area. 2 are going to the bay area, 2 are doing U/S fellowships, 2 are doing EMS, and the rest are either undecided or miscellanious.

Also, Dr. Campbell is not a PD - he's the head of the ED @ West Penn Hospital which is another of our community affiliates. He works about 7-8 shifts a month.

Hospital: Training occurs primarily at UPMC-Shadyside and Mercy (more inner city). Obviously, UPMC is more tertiary care-oriented with lots of residencies and great off-service opportunities. Mercy on the other hand has only a General Surgery residency, so Pitt residents get to do their own thing for the most part. Documentation is via a dictation system that types out your words as you talk.

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We actually don't rotate at UPMC-Shadyside which is the cancer hospital. We do rotate UPMC-Presbyterian which has basically everything else amd is as Ivory Tower as you can get as tertiary care centers go. Mercy (our commuity affiliate) actually has residencies in internal medicine, OB, surgery, family medicine, radiology, and anesthesia many of which rotate through the department. However, we get a large amount of autonomy as procedures, splinting, etc and it makes it feel like a community environment.

Ancillary Stuff: As with many places, great ancillary services, you won't have to do any wheeling people around, starting IVs, or making your own phone calls. They say the RNs have a good relationship with the residents and are on a first name basis.

Admitting: No idea, sorry.

Curriculum: Pretty basic, including a medicine floor month. The jeep rotations are their big innovation; a 12 hr shift where you do consults for medics and ENTs and go to critical scenes as needed. People have gotten tubes, crics, and more out of this rotation, plus they get to turn on the lights and sirens. There is no graded responsibility - what you get is what you get. However, at Mercy PGY3s do a "pitt boss" rotation where they run the ED, and an ICU month where they are it - no in house attending.

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We do our "no in house attending" ICU month as a PGY-II. It's sort of our rite of passage but basically you make all the calls and respond to any and all in-hospital emergencies where you're the code leader. I just completed my rotation at it was the best off service month I've had so far.

Didactics: Simulation is nicely integrated, they boast the world famous Wiser center with more high fidelity sims than I've ever seen. The residents swear by it and say that they were able to bust out crics on their own without problems based on their sim training. The lectures are broken up over two days. A nice touch is the September lectures for the interns, a month of concentrated didactics once their feet are wet that includes 5 ED shifts.

City: Pittsburgh is a pleasant surprise! It is beautiful with lots of water and things to do, and they love to boast that it was voted 2007's Most Livable City. The cost of living is excellent, and the salary is plenty to buy a house. Many who come want to stay.

Negatives: no real county experience, and the patient population is mainly black and white.

Overall: The reputation of this program seems well-deserved. Residents come out confident and well-trained for academic and community EM. As a big city girl that loves county experience, it may not be near the top of my list but I would be very happy to train here, nonetheless.[/QUOTE]

Thought I would throw in some things that are changing @ Pitt this coming year and my overall impression of the program. I don't care to post anonymous anymore.

Overview: very established EM program, with big name faculty. Main post is @ UPMC Presby in Oakland (where the university is) a Level 1 trauma with every specialty known to man. Peds is @ Children's, "community" is done @ Mercy which is about a 2 minute drive from Oakland/Presby.
*CHANGE*: Another community site, West Penn in Shadyside is no longer going to be in the rotation schedule. UPMC Shadyside is going to take it's place.
*CHANGE*: A brand spanking new Children's hospital is opening in like 2 months....it's NIIIICCCCEEE.

Interview day: The night before we had dinner, the usual sioree so nothing special. A lot of residents showed up to support the program and were very friendly people. Interview day started out with the coordinator greeting everyone, she was nice. Breakfast was the usual, with fun snacks layed out on the table to munch on between interviews. Power point presentation on the program given by senior resident. 5 interviews total, with chairman, PD, 3 faculty... all very laid back. Hardest question I was asked was regarding research I had done... so basically just shooting the crap. PD, Dr. Wolfson AKA "Abby", is an awesome dude. I think we talked for like a half hour about anything non-EM. He is definitely a positive aspect of the program, someone I would actually want to be my boss. After interviews we went on a tour of the 'burgh.... Presby, Mercy, then drive-bys @ Children's and Shadyside. Driving tour was done in one of the "Jeeps" so you got to check it out. Lunch was at an expensive restraunt on Mt. Washington overlooking the city. They have a lot of $.

Curriculum: Pretty much the same as mentioned in previous posts. 10 hour shifts. You still do Jeep shifts starting 2nd yr during your ED months, and into 3rd year. Didactics every thursday. In Sept. the interns have an "intern" month where they bond and do nothing but lectures and spend time together. This is an EMS-heavy residency with a ton of prehospital exposure and opportunity for research. Required scholarly research project and another project.... obviously, the time for a double-blinded RTC isn't something time-appropriate in residency (and they know this) but they want you to do something meaningful. 1 elective month senior year. WISER center is the biggest in the nation (that's what they said), and has been featured on Dateline or one of those news shows. According to the residents though, you get simulation during 1st year, but won't be spending too much time in it thereafter. During your 3rd year, you serve as a "pit boss" AKA junior attending, and med students, interns, and off-service residents will present to you so you can assume your would-be boss role in the next year to come. UPMC has STAT/MedEVAC, flight optional.
*CHANGE*: they are ditching the medicine month and replacing it with a split month of cardiac respose team/EMS....something like that. It sounded beneficial.

Faculty: some big names in EM, a lot have lived in p-burgh for many many years, and some grad from Pitt's program. Kinda got an inbred vibe. I rotated through here, and I must say that I received some of the best teaching. It's hard to find faculty that can find the time to teach during EM shifts, but they do it and they make it look easy. These guys know the literature inside and out, and will regurgitate it effortlessly. Pretty much walking Tintinalli's and Rosen's. The important thing is that 99% of them are approachable and don't act academically snobby... if that makes sense. I didn't feel intimidated every day, maybe once every 2 weeks

Residents: 16 per class. A few usually from Pitt. Residents are diverse, from all different locations, and some local. A pretty good mix of males and females, married and single, kids and no kids. I thought this was the hidden gem of the program. The residents are pretty fun, goofy, and wicked smart....reminded me of the faculty actually. Very energetic. Since I've seen the senior residents in action I can tell you what I think: they run the ED. They know their stuff. They know their procedures

Benefits: The usual. Really nice North Face EM jackets.
Program benefits: JEEP, medical command for Steelers, Pens, Pitt panthers, Pirates. Tons of EMS exposure.


Location: Pittsburgh is a really fun city, very affordable, great people. All ethnicities. Geographically, it reminds me of a smaller San Fran with all the hills. Parking sucks as with most cities. 2008 "most liveable city".Taxes aren't 4% like Philly. Traffic isn't too bad, except for that 7am part where it gets congested. It's Steeler country, and it's a religion...kinda like the Red Sox and Boston. There's theatre's here and artsy stuff if you're into that scene. Southside has 150 bars if you ever get the urge to do a bar crawl. There's no tax on clothing in PA and tons of shopping to do. Airport is easily accessible and close.

Pros: you can get the drift from what I mentioned. I got the feeling it's a pretty prestigious program, and the name won't hurt you when job hunting. Seniors said they got an interview for every position applied for without sending much info off when applying. Residents and faculty a huge pro. JEEP. Event medicine.

Cons: 1 elective month. Weaker ultrasound than other programs. Not a huge peds emphasis.


PM me if you want to know anything else. Hope this helps.

I'll post this caveat before each of my reviews: I'm not really a numbers person, so I don't really remember all the details like annual number of patients seen, board pass rates, etc. etc. So, forgive me if some of my details are slightly off and feel free to correct them.

Residents: This was probably my favorite group of residents from the places I visited. Seemed to be a lot of fun, easy to get along with, self-effacing, and not too intense. A number of residents were married with kids and they all seemed to love being at Pitt.

Faculty: All of the faculty I met seemed great and easy to get along with. We had our introductory talk from the department chair. My interview with the Dr. Wolfson, the PD, was great. Everything was very conversational, get-to-know-you kind of discussion. I didn't have a bad experience with any person I met there.

I was told by the residents, and I have read online, about how well-known and respected the faculty from this program are in the EM community and how Pitt grads can go anywhere after residency.

I've heard some people complain that Pitt is kind of an in-bred program, meaning they hire a lot of their own faculty. I believe 2 of my 4 interviewers had done residency at Pitt. But so what?

I know Dr. Wolfson has interests in international medicine, but I didn't run across too many others who were actively involved in international activities or disaster medicine (two interests of mine). But it may have just been sample size.

Curriculum: 3 year program with lots of ICU months. I was told that off-service rotations were great by the residents, with the exception of the medicine month. But I believe Dr. Wolfson said that that month would be going away in this upcoming year (very responsive to resident concerns, no?).

This program is known for its EMS emphasis and you get to ride a helicopter and respond to scenes in a specialty jeep thing with sirens and everything that you have to take a course how to drive. All the residents said how cool that was, and I hadn't really thought about it before visiting, but yeah, that sounded very cool.

This program only has 1 elective, which is a negative for me. But they do have that set-up where you can go to Hawaii for a month, expenses paid, which is cool. Apparently about half of the residents do that each year.

I did ask the PD about leadership positions, and they have a system where everyone chairs some sort of committee. So you have Chief residents, a social chair, a recruiting chair, a curriculum chair, etc. I thought that was cool.

Facilities: You work in 3 different hospitals. All the EDs seem small except for the one in the Children's hospital. I heard parking was a pain.

Location: I guess some people will disagree, but I absolutely loved Pittsburgh. It has tons of little neighborhoods with very distinct flavors. Lots of restaurants and unique little shops. Great geography with water, hills, parks. I went back for a second look and it was colder than ****, but there were still plenty of people out shopping and seeing the sights. And from what I can tell housing is reasonable, though according to the internets, property taxes are a bitch in Pittsburgh. This quickly became one of my favorite cities, and I've been to most of the major cities in the US.

Negatives: Uh, I guess the paucity of electives. Some people complain about working at 3 different sites. The parking. Nothing major or even close to being a deal-breaker.

Other points: At my current institution I worked with a resident who had gone to Pitt. He was saying it's a great place to train but not a great place to practice due to malpractice insurance or something. Not something to be concerned about for residency unless you plan on being there long-term.

I asked also about moonlighting, and you can do it your 3rd year, but not your 2nd due to PA law. But you can pick up extra 24-hour EMS shifts your 2nd year.

Like at Indianapolis, you get to work the sidelines of Steelers games, Pitt games, and (I think) Penguins games.

Overall: Outstanding program. Wonderful location (though cold). Easily in my top 1 or 2.

monkeybutt said:

Facilities: You work in 3 different hospitals. All the EDs seem small except for the one in the Children's hospital. I heard parking was a pain.

Click to expand...

Just a minor update--at Pitt we work at 4 EDs, Presby (tertiary care academia), Mercy (more of inner city vibe), Children's, and starting in July, we change from West Penn to Shadyside (I hear they see a lot of oncology). Two of the EDs are small, but being expanded, and the Children's ED is so huge you literally can get lost in it. Going to these different sites can be frustrating, but also shows you a lot of different styles and pt populations. Also, the parking situation has been a pain, but was recently much improved--we now just swipe our badges to get into private parking sites at all our facilities.
As for the residents being really cool--that's 100% true.

Pittsburgh - Another impressive program, amazing prehospital experience if that is something you are interested in, very nice PD, work at three to four different hospitals, work 10 hour shifts, have several prehospital shifts per month in addition to working in the ED, both fly and drive the Jeep (really a Ford Explorer), Jeep consists of taking calls from EMS and sometimes responding to EMS calls, can be hard to make it to the scene in time, unclear to me how many scene calls the jeep went to on an average shift but I don't believe it was a lot, residents very down to earth and friendly, Pittsburg is a cool city with lots of neighborhoods, lots of Universities around the hospital

Posted anonymously on behalf of a student who interviewed there.

U Pitt Review

Pre-Interview Social: The pre-interview dinner was at the Church Brew Works, which is a really cool pub in what literally used to be a church. (The taps are sitting where the altar would have been.) All of the stained glass windows are still there, and it’s a great ambience.

Interview Day: The interview day started at 8:30 AM with breakfast and a talk by the chairman. He talked about their achievements and wanted to know what rumors we had heard about the program, which was kind of awkward. Except for the Jeep (see below), I couldn’t think of any rumors that I’d heard about Pitt. Afterward, we had a slideshow by one of the residents about the program, which was followed by a tour of the WISER sim center, interviews, lunch, and a city tour in the Jeep. (They take you around to see all of the main hospitals.) There were four interviews. Mine were with the PD, associate PD, assistant PD, and one other faculty. All of the interviews were pretty relaxed. I was asked why Pitt, tell them about myself, where I see myself in 15 years, and describe one of my ERAS activities. Everyone also asked me what questions I had, so make sure you’re prepared to ask questions!

Curriculum: Pitt is a three year program. The primary hospitals are UPMC Presbyterian (main campus tertiary referral center), UPMC Mercy (more of a community ED but still academic), Children’s Hospital of Pittsburgh, and UPMC Shadyside (community hospital). They also do one month at St. Clair’s, another community hospital. The main UPMC, Mercy, and Children’s are all trauma I. Shifts are scheduled rolling forward with five or less shifts in a row. PGY1s do 22 x 10’s per month. PGY2s do 20 x 10s per month plus two 12-hour Jeep shifts or one 24-hour STAT (helicopter) shift. PGY3s do 18 x 10s per month plus two Jeep shifts or one STAT shift. Flying on the helicopter is required. From what I can put together (see below), total EM time is 23.5 months, including peds EM. There are three ICU months.

They have their orientation month in September, which I thought was kind of weird and still don’t really understand the rationale for. There are lectures, 8-hour ED shifts, dental lab, a weekend trip, sim labs, and a course to prepare them to teach students. Also, there isn’t a list of their rotations on their website or in their interview day packet, so here is what I can piece together from the resident work schedule. PGY1 rotations are UPMC ED (3 months), CH ED (1 month), Shadyside ED (1 month), Mercy ED (1.5 months), Mercy Triple Threat (Anesthesia/US/OB) (1 month), Mercy ICU (1 month), UPMC MICU or SICU (1 month), UPMC Trauma (1 month), UPMC Cardiology (1 month), UPMC Toxicology (0.5 month). PGY2 rotations are UPMC ED (2.5 months), CH ED (1.5 months), Shadyside ED (1 month), Mercy ED (3 months), EMS (1 month), CH Triple Threat (Anesthesia/US/OB) (1 month), Mercy Trauma (1 month), Shadyside MICU (1 month). PGY3 rotations are UPMC ED (3 months), CH ED (1 month), Shadyside ED (1 month), Mercy ED (3 months), St. Clair ED (1 month), UPMC Trauma (1 month), EMS (1 month), Elective (1 month). As I said, there are longitudinal EMS shifts in PGY2 and PGY3, so I’m not sure if there are two additional months where they do nothing but EMS as well. I’m also not sure if the cards month in PGY1 is a floor month or an ED consult month.

EMS training at Pitt is extremely strong and one of this program’s biggest draws. The residents get tons of prehospital experience, including Medic Command, responding to emergency scenes in the EMS Physician Jeep (it’s an online/on-site medical command experience where they manage critical patients), and STAT MedEvac (serving as the flight physician on the helicopter). There is one elective month that many people spend away. Up to six people per year can go to Hawaii, and there are other away electives in St. Lucia, Russia, Italy, Qatar, and Australia. People have also done electives in tox, U/S, research, and peds EM. There is a yearly U/S course, and residents can get credentialed. Residents are heavily involved with teaching medical students, and teaching skills for residents is a major emphasis at Pitt.

Didactics: They have your standard five hours per week of didactics on Thursday mornings. Some of the activities include Grand Rounds, journal club, and the September intern core lecture series. They also do simulations at their super nice sim center. On top of the regular didactics and intern orientation, there is a lecture week for the PGY2s where they do a bunch of labs and workshops. There are also online tests to prepare residents for the in-service exam, and an interesting requirement for residents to Q & A each other’s charts.

Benefits: Benefits at Pitt are pretty good. Vacation is three weeks per year. They pay for your annual membership dues to EM organizations and will pay for residents to go present their research at conferences. It seems like a lot of residents take advantage of that and go present their research. The education allowance is more generous than most ($1000 per year), and they give you an EM book besides. Plus they give residents scrubs, health insurance, etc. The salary is a little lower than a lot of other places, but so is the COL.

Administration: We didn’t hear too much about resident wellness issues. But from what little I can tell, it seems like people like the PD and feel that he is supportive.

Pittsburgh: I don’t know why some people rag on Pittsburgh so much, because I thought it was a great city. It looks kind of like San Francisco with all of the hills, and it seems like there would be a lot of fun things to do and cool places to go hang out. (I would like to go back to the Church Brew Works some time!) They have all the usual cultural amenities that you find in most cities. COL is very reasonable with residents able to buy property if they want to. There is also a push to make Pittsburgh a more eco-friendly city.

Summary: Pitt was one of my top pre-interview choices, and I was super impressed with the program and opportunities available there. It’s definitely possible to go into community practice coming out of this program, but the overall slant and feel seems to be more academic than most programs. There are fellowships available in several of the EM subspecialties. Research is big, so if you want to do some during residency, this is a great program for it. It seems like they have projects going on in just about every major area of EM. Also, even for people who aren’t that into EMS, you can’t help but be impressed by the EMS training at Pitt, not only the Jeep, but the flying as well. It seems like the residents get a great experience as first responders and plenty of procedures out in the field. In addition, their U/S experience seems pretty strong. Even though it comes three months into the program, their orientation month sounds really helpful and high-yield, too. Another thing I really liked about Pitt was the emphasis on teaching. One of the problems with being thrust into a teaching role as a resident is that you may not have ever had any teaching experience before, and no one ever tells you how to teach better. At Pitt, they actively train residents to be effective teachers rather than having them try to learn how to teach on the fly. I already mentioned that they have the orientation course to teach the residents how to teach. But in addition, Dr. Dorfsman (assistant PD) does observed shifts for each resident where she watches them see patients and teach medical students, then gives them feedback afterward on how they can improve their teaching. I’m not aware of any other program that does this. Also, I really like Pittsburgh as a place to live.

As amazing as the program itself is, Pitt was the biggest disappointment on my interview trail. Maybe I just caught them during a bad week, but it seemed like most of the people I met on both days were negative, from trash-talking other programs to lots of venting about the curriculum. (The peds experience and having to learn multiple EMRs were the main topics being vented about, and having to use so many different EMRs does sound like a pain.) I also felt like there was way too much emphasis on how elite the program is.

Overall, I was so impressed by Pitt's program, and so sad to realize that I would not fit in well there at all.

Is anyone aware of the DO friendliness of this program?

Pure Anergy.... I am sure you are snug in your new residency by now - congrats on making it to intern year wherever you are!

I am so sorry that you had people complaining while on your interview. I think that Pitt is a great residency, and people are generally happy here! I think all residents get tired sometimes and its somewhat natural to complain about your job - (I have taken an unofficial poll of all my EM resident friends in various locales), but its too bad it happened around you in that setting. Specifically, we don't really learn different EMR's, it is just documentation that varies from hospital to hospital. One uses a voice recognition dictation program, one does straight dictation, and one uses a computer program to create a document (typed).

Otherwise, I think your review was pretty much right on in terms of the program.

If anyone has questions about the program, feel free to PM me!

engineeredout said:

Is anyone aware of the DO friendliness of this program?

Click to expand...

Reputation is that it's not. They hired their first DO just a couple years ago and she basically had to stalk to PD to even get an interview. Warning: this is hearsay from a DO I know who rotated there.

Pure Anergy said:

As amazing as the program itself is, Pitt was the biggest disappointment on my interview trail. Maybe I just caught them during a bad week, but it seemed like most of the people I met on both days were negative, from trash-talking other programs to lots of venting about the curriculum. (The peds experience and having to learn multiple EMRs were the main topics being vented about, and having to use so many different EMRs does sound like a pain.) I also felt like there was way too much emphasis on how elite the program is.

Click to expand...

The biggest disappointment for me was the sublime arrogance. I had asked Dr. Wolfson about the PA program they were starting (on my wife's behalf), and they had failed their initial accreditation review because (and this is a direct quote, with a little bit of haughtiness to it) "The board required a PA or physician to be the head of a PA program, they wouldn't accept a paramedic educator with 20 years experience." Most of the residents seemed amazed that anyone would think there was a better hospital anywhere in the world. (Of course, this was years before their transplant program transplanted a hep C positive kidney.) They were my second choice going in, and my second last coming out.

Drexmedic: I realize you go to the other residency in town, and you've decided they have the better program, which is great. One of the wonderful things about Pittsburgh is that it has 2 solid EM programs. I hang out with one of your chiefs all the time, and I know you guys get excellent training. If you think our residency is poor because of an arrogant attitude, I'm sorry you had that experience--it hasn't been mine. As for the transplant program and PA program, our residency doesn't have anything to do with them, so it seems odd to bring them up. Lastly, I can't speak to the "DO-friendliness," other than to say we just graduated one and our Chair just hired 2 in the past 2 years.

Muscletoe said:

Drexmedic: I realize you go to the other residency in town, and you've decided they have the better program, which is great. One of the wonderful things about Pittsburgh is that it has 2 solid EM programs. I hang out with one of your chiefs all the time, and I know you guys get excellent training. If you think our residency is poor because of an arrogant attitude, I'm sorry you had that experience--it hasn't been mine. As for the transplant program and PA program, our residency doesn't have anything to do with them, so it seems odd to bring them up. Lastly, I can't speak to the "DO-friendliness," other than to say we just graduated one and our Chair just hired 2 in the past 2 years.

Click to expand...

Glad they're hiring more DOs now--perhaps that first one opened the PD's eyes?

I only brought up the PA thing as an example of how UPMC operates in this town--they think they don't have to follow the rules, and the transplant only as evidence that people shouldn't be so starry-eyed about a whole hospital when there is evidence that theirs isn't the bestest bestest ever. Maybe I just got a bad sampling of residents on my interview day...but the whole PA thing really got me fired up.

Pitt

PROS: Great mix of sites: Presby has tertiary/complex pts, Mercy is more county, and peds at a huge free standing children's hospital; very personable PD and aPD; had a great time with the residents who are super smart but funny and humble; time in the peds ED reportedly going to be increasing and residents feel they get solid autonomy when taking care of really sick kids (and there are apparently plenty of them); EMS is likely the strongest you'll find anywhere and the Jeep gives you a chance to make autonomous decisions and do procedures in a resource limited environment; they have crazy amounts of research to can get involved with; 3rd year moonlighting seems terrific; Pittsburgh has a great COL and is a surprisingly nice city with nice people; UPMC health system is massive and residents seem well taken care of (ie free health insurance IIRC)

CONS: the rotation schedule isn't as progressive as other places; things like ultrasound seem to be sacrificed to accommodate the heavy amount of EMS time; some competition for procedures at Presby; only 1 elective; peds not integrated and get the sense that peds could be stronger (but efforts seem underway to address this);

pitt review: The pitt stop of your life

Summary
This program apparently has a reputation (according to themselves, it ranks with Cincinnati, Colorado and Hennepin). Coming from the West coast I wasn't sure what I was getting into but I whole-heartedly say that this is the residency that time forgot. The program touts itself as being proudly “steeped in tradition” however, it is more of an attitude of “we do it better than everyone combined so if you don't do it our way, how can you be that dumb!".
I seriously question the integrity of this program when the chief residents asks us to openly to lie about our work hours and when we attempt to report accurate data, are bullied by our program director, Dr. ABW, into lying about our schedules.
Over the last year here, I have come to realize that yes, this program does probably provide good training—in the same way that cancer provides great weight loss. And don't worry, admins will tell you that this is "The best program in the world!"... just like how this past inauguration was the most attended ever (period), and how the last admin tapppppped phone lines.


My Learning Experience
The population of the rust belt is english-speaking, low education, low income, obese, and chronically sick so you'll have plenty of opportunity to do things to the locals. Tubes in man y forms and central lines galore. Procedure on kids at the children's hospital are a bit tougher since they have em-peds fellows which pretty much will take your procedures. Since you'll be working A LOT, you'll have plenty of opportunities to see the sick, though the environment has something to be desired. Questions to staff are usually meet with "you should know this by now" or "let me tell you story of how great I am!" Many attendings pretty much put you down to make themselves feel better (middle school social dynamics, if you thrived there, you'll be fine here). We are also required to become flight physicians at Stat MedEvac and work around a helicopter, a mechanical monstrosity, with only minimal training. Residents have almost died in the past, nearly walking into the rotors—we joke about these stories during grand rounds. When asked about the safety risks while working at these sites, we were told, “don’t worry, you’ll be dead before you know anything’s wrong”. Research is available in theory. Attendings are more than happy to have you help in doing the scutwork of their research for them. This place has several high caliber research projects occurring with some prior big names (you'll hear no end of PROCESS here!), but the problem is that they don’t really let residents becoming seriously involved in these projects.


My schedule
10 hour shifts roughly 26+ times a month along with journal clubs and Thursday morning lectures (once a month twice a week grand rounds), sim labs and random meetings. During trauma months, it runs 100+ hours as week (though don't worry, you'll be forced to report otherwise). Helicopter shifts are 24 hour shifts where you sleep on base. Side note: a proud fact that is touted many times by the staff here is that we work more than 99% more than other residencies (as seen apparently at an ACEP presentation a few years ago). You'll easily find other reviews online of how they tend to overwork residents at this program; it's no joke.


My life and environment.
The so called "charm" of this part of the country is pretty much lost on anyone who was experienced a small phenomenon known as "reality". People call the city Sh*tsburg for a reason. What the city lacks in diversity, a night life, real food and weather, it more than makes up for in cheap alcohol, obesity and aggressive poverty. Lucky for us, we work more than about 99% of other EM residencies out there (the staff proudly touts this fact since it was placed up on a slide at ACEP one year). So don’t worry about the lack of an outside life when you actually have time to do things. Journal clubs are sometimes held at local bars that serve the local delicacies: cigarette smoke and grease.

spicer6663 said:

pitt review: The pitt stop of your life

Summary
This program apparently has a reputation (according to themselves, it ranks with Cincinnati, Colorado and Hennepin). Coming from the West coast I wasn't sure what I was getting into but I whole-heartedly say that this is the residency that time forgot. The program touts itself as being proudly “steeped in tradition” however, it is more of an attitude of “we do it better than everyone combined so if you don't do it our way, how can you be that dumb!".
I seriously question the integrity of this program when the chief residents asks us to openly to lie about our work hours and when we attempt to report accurate data, are bullied by our program director, Dr. ABW, into lying about our schedules.
Over the last year here, I have come to realize that yes, this program does probably provide good training—in the same way that cancer provides great weight loss, the way that this past election was the most attended election ever (period), and how the last admin tapppppped phone lines.


My Learning Experience
The population of the rust belt is english-speaking, low education, low income, obese, and chronically sick so you'll have plenty of opportunity to do things to the locals. Tubes in man y forms and central lines galore. Procedure on kids at the children's hospital are a bit tougher since they have em-peds fellows which pretty much will take your procedures. Since you'll be working A LOT, you'll have plenty of opportunities to see the sick, though the environment has something to be desired. Questions to staff are usually meet with "you should know this by now" or "let me tell you story of how great I am!" Many attendings pretty much put you down to make themselves feel better (middle school social dynamics, if you thrived there, you'll be fine here). We are also required to become flight physicians at Stat MedEvac and work around a helicopter, a mechanical monstrosity, with only minimal training. Residents have almost died in the past, nearly walking into the rotors—we joke about these stories during grand rounds. When asked about the safety risks while working at these sites, we were told, “don’t worry, you’ll be dead before you know anything’s wrong”. Research is available in theory. Attendings are more than happy to have you help in doing the scutwork of their research for them. This place has several high caliber research projects occurring with some prior big names (you'll hear no end of PROCESS here!), but the problem is that they don’t really let residents becoming seriously involved in these projects.


My schedule
10 hour shifts roughly 26+ times a month along with journal clubs and Thursday morning lectures (once a month twice a week grand rounds), sim labs and random meetings. During trauma months, it runs 100+ hours as week (though don't worry, you'll be forced to report otherwise). Helicopter shifts are 24 hour shifts where you sleep on base. Side note: a proud fact that is touted many times by the staff here is that we work more than 99% more than other residencies (as seen apparently at an ACEP presentation a few years ago). You'll easily find other reviews online of how they tend to overwork residents at this program; it's no joke.


My life and environment.
The so called "charm" of this part of the country is pretty much lost on anyone who was experienced a small phenomenon known as "reality". People call the city Sh*tsburg for a reason. What the city lacks in diversity, a night life, real food and weather, it more than makes up for in cheap alcohol, obesity and aggressive poverty. Lucky for us, we work more than about 99% of other EM residencies out there (the staff proudly touts this fact since it was placed up on a slide at ACEP one year). So don’t worry about the lack of an outside life when you actually have time to do things. Journal clubs are sometimes held at local bars that serve the local delicacies: cigarette smoke and grease.

Click to expand...

Woah, shots fired.

spicer6663 said:

pitt review: The pitt stop of your life

Summary
This program apparently has a reputation (according to themselves, it ranks with Cincinnati, Colorado and Hennepin). Coming from the West coast I wasn't sure what I was getting into but I whole-heartedly say that this is the residency that time forgot. The program touts itself as being proudly “steeped in tradition” however, it is more of an attitude of “we do it better than everyone combined so if you don't do it our way, how can you be that dumb!"....

Click to expand...

18 as

Wow. Well to play devil's advocate I'll provide my perspective on the program, although I graduated a couple years ago, so take it with a grain of salt.

1) Work/life balance. Residency is hard work. Anywhere. At a 4 year program you'd work just as hard and for an extra year. On service, we work 22 shifts (10s) a month as interns, 20 as 2nd years and 18 as third years. Not sure where 26 came from in the above review. As second and third years you also work 24 prehospital hours a month. Either 2 12 hour jeep shifts or 1 stat shifts. Jeep shifts were great: a mix of crazy scene runs and getting to play attending out in the field with quiet nights of uninterrupted sleep. Stat shifts were a great experience also, and I understand that they are now optional if you're not into HEMS. Off service rotations are roughly 6 on 1 off on trauma or in various ICUs. This is pretty standard. We also have a minimum of BS off service. No floor medicine. No floor peds. Trauma is split between floors and running traumas and that's your only floor time.

2) I was never asked to lie about hours. On service you never come anywhere close to violating hours in the ED. Off service they are serious about preventing hours violations (at least they were.) Trauma was a problem my 1st year, but by 2nd year they had hired a ton of midlevels to offload residents and resolved that problem. I was nowhere close to hours violations off service in my 2nd or 3rd year.

3) Attendings: I can count the malignant attendings on 1 finger. The rest are great. Many hang out with residents. I regularly cycled with a couple of them. Sure there are a couple attendings that make you groan when you're working with them. But it's because they're slower than you like, or order more tests than you like, but never because they talk down to you or on a power trip. I can't even think of who the prior poster would be describing with their comments. And the residency leadership is motivated to continue to improve the program. Abby retired as PD and Michele and the associate PDs really care about the program and residents and continuing to evolve and improve the program.

4) Reputation/research/training: I have been in practice in busy, high acuity community hospitals for a couple years now and have never felt unprepared by my training, ever. I like to think that any EM residency would provide the same comfort, but I know that Pitt's training does. If research is your thing, it's here. All the high powered research attendings are incredibly accomodating and would bend over backwards for someone genuinely interested in research. The bigger gripe from most residents is that there was a research requirement at all. (Don't worry if research isn't your thing, it's pretty minimal.)

4) Pittsburgh is a great, overlooked city. I miss the mountains I was used to out west, but the outdoor opportunities are phenomenal for a city. You're less than an hour from hiking in Ohiopyle, rafting on the Yough. You can ride the GAP from downtown PGH to Washington DC. You can mountain bike in the city in Frick, South Park, North Park or Boyce. The restaurant scene is exploding and Pittsburgh is regularly written up as the next big place to be in various national publications. (NY Times, Vice, etc.) And let's face it, you're not going to have enough time in ANY residency to take advantage of all the cultural advantages a city like NY, DC Boston etc has over a small city like PGH.

TL;DR: I don't know what residency Spicer6663 is describing, it certainly wasn't the one I graduated from. Pitt and Pittsburgh aren't perfect, nowhere is, but it's a great place to train and a great place to live.

Current resident at Pitt here. Above post by Spicer 6663 is pretty absurd. I know as a med student I checked this site when applying and the above post would have been a "red flag", but there is just a ridiculous amount of inaccurate information in the post and it almost seems in jest or out of extreme bitterness (like written by somebody who doesn't go to our program or no longer goes here). Additionally, the specifics mentioned about our program are outdated (ABW is not our PD and we do 12 hour helicopter shifts now). We don't really even have enough residents from the west coast (sadly) to even make the opening line applicable btw (especially those who experienced the outdated changes mentioned above). Here is a more up to date and hopefully fair depiction (in my opinion of course).

Schedule:
All our shifts are 8, 9, or 10 hours. Most overnights are 8 or nine hours. Many Spicer shifts are just 8 hours, and all shifts after grand rounds are 8 hours. The rest are generally 10, never more. Shifts are per calendar month and in certain months (like February) everybody gets a reduction. There are a bunch of rules here and there that give certain reductions as well.

PGY-1=22 shifts

PGY-2=22

PGY-3=20 shifts (reductions for chiefs and recruiting residents during interview season)

Pgy-2/3 schedules are a bit more complicated as you are introduced to the prehospital aspect of our curriculum which includes the helicopter and the "jeep". The helicopter is optional but encouraged. If you do two twelve hour shifts at the helicopter base you get a 1 shift reduction So an example of a schedule for a PGY-2 would be 19 ED shifts usually of which maybe 4-6 are 8 hour and the rest are 10. Then in addition to that would be 2 twelve hour helicopter shifts (so 21 shifts total). We also started doing our jeep and prehospital experience in two week blocks so this makes some months look like 8 or so jeep shifts, plus some "other" preshospital days where you may be asked to cover an event such as a pitt or steelers game.
Will go into more detail about prehospital stuff later.

I don't know where we fall amongst other residency programs with regards to total hours worked in month. I have been told that we are not in the highest quartile and are more in the "above average category". Haven't viewed the data myself.

Shift Documentation:
We have Cerner for our EMR. You can type your notes, but dragon dictation software is ubiquitous and highly encouraged. Once I got a stronger grip on this plus the shortcuts of the EMR....the documentation became a lot easier.

Sometimes people stay late to document but this seems to improve as you learn how to document efficiently on your shift. We are strongly encouraged to document as you see patients as that is what you will be doing in the real world. There are times were things are falling apart and this isn't hospital but our attendings also see patients on their own so generally if you plan well you see a good amount of patients and get out on time. I would say on average I leave 30 minutes to an hour late from shifts, but this is partly because I sometimes don't like signing certain things off (personal issue of mine). I have gotten out an hour early from shifts as you stop picking up patients an hour before your shift ends. I stayed 4 hours late ONCE my intern year on an overnight at the peds hospital because things were complete chaos and I saw way more patients than I was expected too and didn't do any documentation. This was by far my personal record for staying late. Maybe once or twice a month I stay two hours late because the place fell apart and/or I wanted to do a procedure at the end of my shift instead of going home.

Attendings:
I love most of the attendings I work with. My biggest grievance is that it is a bit inbred but I don't think there is a "Pitt way" that is particularly pervasive. They have also hired a lot of new attendings since I have been here that are from other programs and are very active on the academic/teaching side which has been awesome. We have gatherings at the houses of our attendings throughout the year in which food/beverages are provided. It is somewhat of a tradition to go out for a few beers with some of the nurses and attendings after weekend overnights. Of the 40+ attendings I have worked with off the top of my head I can think of less than 5 who i don't like working with as much and nobody who makes it totally unbearable. There are far more who I generally get excited to go to work and see.

Residents:
Obviously varies by year but generally a good mix of single, married, and married with kids. Midatlantic/Northeast heavy but we do have people from around the country (and the world).

Curriculum:
We no longer call our weekly meetings "grand rounds" but rather EMEC (emergency medicine education conference). The name change reflects a paradigm shift (I think) away from large group lectures to more of a mix of small group activities/discussions, sims, and of course large group lectures (c'mon it's still medicine). Residents are required to give one hour-long presentation during 2nd year and one during third year. Additionally, third years do an M&M as well, which are frankly my favorite presentations to attend because they are heartfelt, extremely valuable, and funny (in the self-deprecating sense). This has drastically changed since I started here and a lot of our faculty have become more progressive (FOAMed, podcasts, etc). We are working on starting a blog (can't help ourselves) and we have a twitter account which is run by multiple residents.

We do EMEC for four hours almost every Thursday. We used to do some sim sessions in addition to this but we integrated them into the 4 hours. We also do an additional two hour EMEC on the first Tuesday of almost every month which is more resident-run and has small case/ultrasound/procedure/CT scan of the month. The procedure part is great because it's good to brush up on the more rare procedures such as transvenous pacing and compartment pressure measurement. We also do about 2 hours of journal club which are at the same smoke-free pizza beer joint in which we rent out a room with a bar. Attendings generally pay for a few rounds of beers and we go over two articles with multiple other articles that are given to us but not required or discussed. Occasionally we do journal club in a park.Our second years run journal club for 8 months of the year and the other 4 are run entirely by faculty of our various EDs.

Throughout the year we have a few other events which require you to come in on your own time such as mock oral board review.

Pittsburgh:
Pros: The cost of living is great. You can buy a house here if you pick the right location. It's a great city to have a pet in and 50% of our residents have dogs. The city was more populated in the early 20th century and you will see various museums and parks that almost seem like they are too big for the size of the city....which they are. There are many "gifts to the city" adorned with the names of various robber barons from ages ago (E.g Carnegie). You can play golf and mountain bike in the city limits for free/minimal cost. The restaurant scene has vastly improved in the past few years. There is a casino in the city if that's your thing. There are three great sports teams although I dislike all of them because I didn't grow up here. People takes sports here very seriously. The ED is usually significantly less busy during a Steelers game. The topography of the city is cool and there are fairly good outdoorsy things to do within an hour drive (it's not in the same league as Utah or Colorado though). Tons of bars (smoking in bars is still legal sadly but there are a lot of non-smoking bars)

Cons: Pittsburgh is beautiful in the summer, but does get cold in the winter (although curiously this seems to be improving each year.....). Sunlight also is a bit scarce from October through March. The upside is there are a range of winter activities to such as skiing, sledding, ice skating, etc. I've lived in 3 other Northeastern cities and it's not much different overall. It's a 6 hour drive to NYC, 4 hours to Baltimore/DC, 5 hours to Philly, and 2 hours to Cleveland. Flights out of the city to a lot of desirable places generally require a connection although the airport is never painfully busy. Public transportation sucks and a car is almost required (I know of one resident who managed to get away without one for almost all of my intern year). Uber and Lyft have made everything drastically better though. We also occassionally have the resident in the Jeep help out with transportation (we're on it 24/7 and 365).

Research:
Our faculty to a done and we do have a lot of opportunities to obtain a mentor. Given that we are a three year program it is generally hard to accomplish anything substantial but it has been done/attempted. Most of our scholarly project requirement is fulfilled with stuff like case reports, abstracts, book chapters, and various other smaller projects. We are less often affiliated with the larger trials going on here.

Experience:
We see a wide variety of pathology here and we serve a county that is filled with an old and sick population filled with many people who spent most of their lives smoking and working blue collar jobs. That was the way of life here and you can still see remnants of that in the culture of the area as well. I have taken care of people who were flown in from central Pennsylvania, Ohio, New York, and West Virginia (to give you an idea of the catchment area). Most of us have all of our required procedures done by 2nd year. The procedure that takes us longest to get as chest tubes as Pittsburgh is fairly safe although we sadly see our fair share of GSWs (lots of guns in western PA).

Peds/Children's Hospital of Pittsburgh: Maybe 80k per year? Level 1 Peds trauma center. Our peds experience is done in two week blocks. I think we get adequately trained in peds as we rotate through one of the best children's hospital in the country (or so they tell me who knows what those rankings actually mean). We do see peds at some of our other sites but really not too many at UPMC Presbyterian. Procedures are less common in the children's hospital but I have gotten tubes and done a nauseating amount of sedations and lumbar punctures there. Overall, when we moonlight our residents generally feel comfortable and see patients at a pace on par with other providers (although this is all anecdotal). Never done an umbilical line but we do get trained on how to do them (IOs have replaced this).

UPMC Presby: Between 50-60k per year. Level 1 Trauma Center. Main academic hospital. Basically all adults. High admission rate and I want to say a quarter of the patient's here are transferred from other sites. Consultant for anything you can think of. Whether you use them is up to you/the attending but inevitably some procedures get sniped from time to time. That being said we are usually running around dealing with super complicated patients (transplants/LVADs/etc). We have an ECMO team here who will cannulate your patient in the ED at any hour of the day. There is a lot of cutting edge medicine here which I wouldn't want to miss in training even if it is sometimes less fun for us as residents.

UPMC Mercy: I think around 70k per year. Level 1 Trauma Center. Our closest thing to a "county" hospital. More of an uninsured population with a higher rate of penetrating trauma (although overall less trauma than Presby). Where we spend the most times. Fewer in-house consults which means we own all the procedures here.

UPMC Shadyside: Do about 1 month a year here. Fantastic experience that everybody loves. They see like 50k or so per year and the population is sick. This is affiliated with a cancer center so you see a ton of cancer-related pathology. Usually only one resident at a time at any time in the ED so you get a higher concentration of procedures here than anywhere else.

UPMC Magee: Women's hospital that does most of the OB-GYN for the area. We rotate here as interns

St.Clair: Community hospital we spend one month at during our third year. Good experience.

Other Stuff:
Prehospital: Probably our strongest extra....We have a EMS Vehicle we drive around and switch off every 12 hours. We do medical command for the city via radio at that time. We respond to any really bad stuff such as cardiac arrests. Lots of good stories and allows you to operate more independently early on (there is faculty back-up over the radio).

Helicopter: Run via STAT Medevac. Huge operation. We fly out of one base with really good medics/nurses as crew-members in addition to pilots all of which (or the ones I have flown with) who are ex-military
badasses. Really cool experience. Fair amount of downtime on the base to watch TV and take care of paperwork when it's not busy.

Ultrasound: I think used to be a negative of our program but we have awesome equipment and 4 fellowship-trained faculty (it was half that two years ago) who have really developed the curriculum and improved the software. Dedicated ultrasound shifts with the fellowship-trained faculty as well as a weekly review for those on US rotation.

Triple Threat Month: During 1st and 2nd year. That resident is the jeopardy resident. All shifts covered are paid back later (didn't used to be this way). During 1st year this month consists of anesthesia, OB deliveries (we just show up and catch babies), and ultrasound. During 2nd year this is a jeopardy month again plus peds shifts, peds anesthesia, and ultrasound.

Tox: one month elective, fan favorite as the faculty is great. You work 6 ED shifts and take 4 24 hour tox calls during the month. Otherwise weekends off (unless working or on call). Daily rounding which usually ends before noon and culminated in small group talk and occasionally the a trip to the pancake house or indian buffet on the faculty dime.




-->PM me with any questions.

With all the turmoil recently on the posting boards I figured I weigh in. First off, Yes, I did go to this program so yes, I know what I'm talking about and yes, I use to be a chief, yes my name is on that plaque by abby's office on the 5th floor. Is this ia malignant residency? Debatable.


Given the times and being a woman, I feel like I should say something about this, you'll have no short of stories for your #metoo. Dodging complaints about the work hours is one thing however, complaints against sexual harassment are only met with "That's just how things are here in pittsburgh, let's talk about something else!"


Like the dying city it is in, this residency might have seen better days. Apply if you want, maybe you can make it great again. Also don't worry if I've said something you don't like, just chalk it up to fake news. If I could do it again, I would not rank this program, it was one of the worst decisions I have ever made.


PS: Beware of anyone in leadership named "Donald"



My schedule
If you add up all the other lecture requirements, random classes, and EMS shifts you do about 28 shifts a month. Yes you are in training but there's also The law of diminishing returns. Shifts run about 10+ hours a lot of lectures. Working with in colleagues from other programs, they're just as well off and with a lot less hours doing useless stuff. Residents work over duty hours and are not allowed to log the extra hours so that duty hours don't get violated


My learning experience
Yes you do pick up emergency medicine, but then again you can do it anywhere else too. Locals tout this place as "the best em program in the world"--that's a narcissistic lie people tell themselves here in order to feel significant. You will probably learn something from time to time, then again spending 90+ hours a week becoming a hospital zombie something's bound to rub off. Teaching here more like watching an attending whip out their ego and swing it around till it pokes someone's eye out. Most of the learning you do is on your own. The attendings are a really odd lot. Like with American Pickers in a hoarder's garage, yeah there might be some gems but a lot of strange relics and junk. You got your EM Ajit Pai who needs to , random condescension with Mac Attack and the "war vet" who keeps talking about Fallujah like the game winning touchdown of their high school homecoming game. Let's not forget all the time you get to spend at the children's hospital ED. There's a lady there that swears by her "ultrasound fellowship". No you didn’t do a fellowship in ultrasound, we called the director and confirmed it. You did a research fellowship where you happened to have touched an ultrasound machine once in a while. Trauma gets a special mention here. You spend one month every year on a trauma rotation. Since the general population is so old, the majority of the "trauma patients" you will see are old people who fell and now have head bleeds. Consult neurosurgery, start seizure meds and admit for obs. Sounds rewarding, right? This isn't the guns and knives clubs of Chicago or Atlanta. You will get to watch, please don't touch, surgery crack a chest once every few years. "Crazy" trauma stories are everywhere, this place is subpar. M&M and journal club are a joke and there is normally no good formal take home lessons learned.



My life and environment
Rust-belt folk here are some of America's poorest and most uneducated. You'll be a fan of this place if you're a fan of Manifest Destiny. For a city that touts itself for being the world's flagship establishment, it has an unsurprising paucity of value to offer the world. Ask the people here what's there to do and they'll always talk about the bars. Because you know, places that serve alcohol are fried food are unique. Yes, life exits beyond the walls of the hospital though the rust belt is likened to Solzhenitsyn's Gulag Archipelago. The "city" itself is nothing special. A sign of how pitiful life is here is how the locals have a nazi zeal about the sport teams, reality here sucks that much. Small town aspirations and even smaller mindsets. Though you will work almost all the time, you'll have ample opportunity to "hang out" with your fellow class since you'll be working with them A LOT. Also, if you want to get together outside on your off time, that's fine as well. You'll have plenty of opportunities to stand in a circle and drink, and talk about work. Or go to a bar and sit in a circle, drink and talk about work. Or go to a restaurant and sit in a circle, drink and talk about work. Interesting side note, my chief showed up to work smelling of alcohol with slurred speech, it happens everywhere, right?

guff.tuff said:

With all the turmoil recently on the posting boards I figured I weigh in. First off, Yes, I did go to this program so yes, I know what I'm talking about and yes, I use to be a chief, yes my name is on that plaque by abby's office on the 5th floor. Is this ia malignant residency? Debatable...

Click to expand...

More shots fired.

Dartmein said:

Current resident at Pitt here.

UPMC Presby: Consultant for anything you can think of. Whether you use them is up to you/the attending but inevitably some procedures get sniped from time to time. That being said we are usually running around dealing with super complicated patients (transplants/LVADs/etc). We have an ECMO team here who will cannulate your patient in the ED at any hour of the day.

Click to expand...

I will leave most of your post alone, but this quote (especially the bolded/underlined) should make readers suspicious of the rest of your post. It has some truth, but only in the sense that a paramedic who frequently brings patients into a big center says "we" cath all STEMIs in less than an hour.

Your glasses are not just rosy, they contain some serious virtual reality technology.

Please note, I am not saying you are the only one with these glasses. In fact, it seems to me the politicians -- errr, program directors -- hand them out at interviews and orientation. You, Dartmein, just happen to be the latest contributor to catch my eye. Please don't take this somewhat harsh post personally. It is actually directed at MS4s who are trying to find the right EM program and at current residents who write reviews (often including information that doesn't pertain to EM training and about which they have no idea what they are talking about). I hope it helps everyone consider what is really important in training.

HH

also went to this residency, can confirm — if you know who Solzhenitsyn is, this is not the program for you.

guff.tuff said:

With all the turmoil recently on the posting boards I figured I weigh in. First off, Yes, I did go to this program so yes, I know what I'm talking about and yes, I use to be a chief, yes my name is on that plaque by abby's office on the 5th floor. Is this ia malignant residency? Debatable.


Given the times and being a woman, I feel like I should say something about this, you'll have no short of stories for your #metoo. Dodging complaints about the work hours is one thing however, complaints against sexual harassment are only met with "That's just how things are here in pittsburgh, let's talk about something else!"


Like the dying city it is in, this residency might have seen better days. Apply if you want, maybe you can make it great again. Also don't worry if I've said something you don't like, just chalk it up to fake news. If I could do it again, I would not rank this program, it was one of the worst decisions I have ever made.


PS: Beware of anyone in leadership named "Donald"



My schedule
If you add up all the other lecture requirements, random classes, and EMS shifts you do about 28 shifts a month. Yes you are in training but there's also The law of diminishing returns. Shifts run about 10+ hours a lot of lectures. Working with in colleagues from other programs, they're just as well off and with a lot less hours doing useless stuff. Residents work over duty hours and are not allowed to log the extra hours so that duty hours don't get violated


My learning experience
Yes you do pick up emergency medicine, but then again you can do it anywhere else too. Locals tout this place as "the best em program in the world"--that's a narcissistic lie people tell themselves here in order to feel significant. You will probably learn something from time to time, then again spending 90+ hours a week becoming a hospital zombie something's bound to rub off. Teaching here more like watching an attending whip out their ego and swing it around till it pokes someone's eye out. Most of the learning you do is on your own. The attendings are a really odd lot. Like with American Pickers in a hoarder's garage, yeah there might be some gems but a lot of strange relics and junk. You got your EM Ajit Pai who needs to , random condescension with Mac Attack and the "war vet" who keeps talking about Fallujah like the game winning touchdown of their high school homecoming game. Let's not forget all the time you get to spend at the children's hospital ED. There's a lady there that swears by her "ultrasound fellowship". No you didn’t do a fellowship in ultrasound, we called the director and confirmed it. You did a research fellowship where you happened to have touched an ultrasound machine once in a while. Trauma gets a special mention here. You spend one month every year on a trauma rotation. Since the general population is so old, the majority of the "trauma patients" you will see are old people who fell and now have head bleeds. Consult neurosurgery, start seizure meds and admit for obs. Sounds rewarding, right? This isn't the guns and knives clubs of Chicago or Atlanta. You will get to watch, please don't touch, surgery crack a chest once every few years. "Crazy" trauma stories are everywhere, this place is subpar. M&M and journal club are a joke and there is normally no good formal take home lessons learned.



My life and environment
Rust-belt folk here are some of America's poorest and most uneducated. You'll be a fan of this place if you're a fan of Manifest Destiny. For a city that touts itself for being the world's flagship establishment, it has an unsurprising paucity of value to offer the world. Ask the people here what's there to do and they'll always talk about the bars. Because you know, places that serve alcohol are fried food are unique. Yes, life exits beyond the walls of the hospital though the rust belt is likened to Solzhenitsyn's Gulag Archipelago. The "city" itself is nothing special. A sign of how pitiful life is here is how the locals have a nazi zeal about the sport teams, reality here sucks that much. Small town aspirations and even smaller mindsets. Though you will work almost all the time, you'll have ample opportunity to "hang out" with your fellow class since you'll be working with them A LOT. Also, if you want to get together outside on your off time, that's fine as well. You'll have plenty of opportunities to stand in a circle and drink, and talk about work. Or go to a bar and sit in a circle, drink and talk about work. Or go to a restaurant and sit in a circle, drink and talk about work. Interesting side note, my chief showed up to work smelling of alcohol with slurred speech, it happens everywhere, right?

Click to expand...

Yikes - the only two people I know from there (current faculty) are good guys. Or, alternately, I believe are good guys.

Don’t know if I would trust a one off post out of the blue to rez a thread that last posted more than a year ago.

Hamhock said:

I will leave most of your post alone, but this quote (especially the bolded/underlined) should make readers suspicious of the rest of your post. It has some truth, but only in the sense that a paramedic who frequently brings patients into a big center says "we" cath all STEMIs in less than an hour.

Your glasses are not just rosy, they contain some serious virtual reality technology.

Please note, I am not saying you are the only one with these glasses. In fact, it seems to me the politicians -- errr, program directors -- hand them out at interviews and orientation. You, Dartmein, just happen to be the latest contributor to catch my eye. Please don't take this somewhat harsh post personally. It is actually directed at MS4s who are trying to find the right EM program and at current residents who write reviews (often including information that doesn't pertain to EM training and about which they have no idea what they are talking about). I hope it helps everyone consider what is really important in training.

HH

Click to expand...

I am not quite sure what your underlying point is (I think you are saying that this type of post is one that would be planted by a program director--which I am not) but I am going to just respond quickly to the ECMO part.

When I did residency here I never saw an EM resident directly cannulate for ECMO. Our CCM (often EM trained) or CT surgery people would do that. One time they did rewire my line I just placed and dilated which was kind of interesting. I have seen EM faculty/residents/EMS fellows activate for eCPR from the EMS side. Anyway, I don't think being at a place that does eCPR or ECMO, in general, is a requirement for EM residency nor do I think it is that relevant to the vast majority of EM docs. My point is that getting exposure to that sort of thing in residency is not a bad thing. Sure, if you're at an academic center that does that sort of thing then the likelihood of having less autonomy is also higher but in the case of Pitt I think they probably still rotate at enough different sites that it doesn't matter. I came out of it having a better understanding of indications and types of ECMO (VV/VA). I want the specialty to grow in scope of practice.

To your other point:
I wouldn't want to train at a place that doesn't have a cath lab despite the fact "we" don't personally do caths. I think there is a benefit from getting a large volume of people via EMS coming to your shop because EMS thinks they have a STEMI (as opposed to only seeing them from the waiting room occasionally). Seeing the complications of people having a heart attack and picking up on the subtleties on history/physical of patient's that may actually be dissecting is an important part of training in my opinion.

Overall, I think the benefit of working at a place that does more tertiary/quaternary-level stuff is getting exposure to the next level medicine/technology and potentially piquing interest in future careers and fellowships. I think it would be badass if one day our specialty was integrated enough into the CCM side of things that the norm would be non-CCM EM docs doing stuff like ECMO/REBOA but I imagine that will continue to be more of the exception.

Any updated reviews/ impressions of this place? I have an interview coming up and this is by far the most "prestigious" place I'll be interviewing with, so would like to know if they're actually still malignant or what.