Overview
3 year program. Very busy with a great mix of trauma and medical patients with large percentage of critical care admissions. Growing research (3rd largest amount of EM research grants in country).
Residents
8 per class. We are looking to go to 10 people in very near future.
These are great people with diverse backgrounds. There are a lot with "real world" experience (non-traditional types) and a few with previous experience in the military or other specialty training. A good mix of married with children types and enough single people to find someone to hang out with for a beer.
Faculty
A good mix of young and not so young attendings with a passion for teaching.. Many with vast backgrounds everywhere from very community type thinking to the most academic of attendings. Diverse interests from research, EMS, U/S, disaster preparedness, etc.
Ancillary staff
Plenty of nurses, techs, etc., that we not only work with, but become good friends with and go out with for dinner/drinks. Residents are involved in all interesting/obscure cases or procedures (especially rare ones). Residents get first refusal for every procedure, with most procedures being offered up by senior residents to interns. Nursing seek out residents to give "heads up" of the sickest of the sick coming in. And will grab you for the "crumping" patient. Plus they'll watch your "six".
Curriculum
PGY1
EM orientation and getting your feet wet for one month, EM 4 months (total of 5 EM months), then one month each of MICU, Peds, Cards, Ortho, Trauma, Anesthesia, OB.
PGY2
EM 8 months at Penn State Hershey, 1 month of EM in the community ED (Harrisburg), EMS (including becoming Medical Command certified), Tox (huge strong point where you take phone Tox consults for almost all hospitals throughout the state and one of the only inpatient Tox units in the nation), SICU.
PGY3
EM 11 months with one in the community, and 1 month Elective (can go anywhere and basically do anything --ie no worries about hospital not letting you go due to CMS monies)
Interns are allowed to progress at a pace comfortable to them (as much autonomy as you want/earn).
Starting second year you are basically running the ED. You assume responsibility for the majority of patients (and pretty much all critical patients/resuscitations) for the shift.
EM 3s still get to see plenty of patients, but take on more of a "running the ED" mentality. Thus preparing them for being out on their own.
Our EMS experience is diverse. Residents are "Medical Command" for the area's EMS agencies. Medical direction for the air medical program is provided by our faculty. There is not a "flight requirement", but the opportunities are there if one chooses. We also get to work all the Penn State Home football games providing medical care to the ~110,000 fans there.
Plenty of local interstates, being the only local level 1 trauma center, and lousy Pennsylvania drivers give a huge trauma exposure. A majority of the trauma is blunt, but we receive the Harrisburg "knife and gun club" members. Relations with surgery are good; plenty of shared procedures. We have some really unique trauma situations. (How many hay hole injuries or buggy crashes can others say they have?)
Unique populations (Amish) and lots of really rare diseases (tons of Peds congenital stuff) to learn from.
Fellowships
Toxicology at our community hospital with the Tox unit and busy Tox consultation service. Newly developed EM/Critical Care fellowship. Starting an EMS fellowship. You are basically able to establish your own fellowship (Dept Chair, PD, and hospital administration supportive and puts their money where their mouths are) for other EM sub-specialties. Some current residents are looking at possible disaster medicine, tactical medicine, etc.
Facilities
The Penn State Hershey campus is a large and expansive area. We are seeing 50,000+ visits a year (and quickly rising) with a fair percentage of these being pediatric. Large percent of both adult and peds admissions being critical care. The community ED we work in sees 60,000 + pts. a year and is also growing quickly. The attendings are part of a group that can really teach you how to move patients through an ED, plus how to make sure you are billing to ensure you're getting paid.
The ED is currently undergoing expansion that will grow our visits significantly. We have an 8 bed CDU (clinical decision unit) in place that stays very active. Interns run this in place of an IM rotation.
Charting
We have one of the most advanced EMR systems in the country (with plenty of computers) with all aspects of the medical system being plugged into it (from ED to clinics to you name it). One of the ED attendings is the CMIO (Chief Medical Information Officer); so things are implemented with the ED in mind. At current time we dictate our charts (great practice for the real world) with computer entry charts on the very near horizon. Computerized order entry.
Location
Hershey is a wonderful area to live in. Most residents do own their own homes. It's a beautiful and safe area with plenty of urban opportunities very near. Baltimore 1 1/2 hours, Philly 1 1/2, DC 2, NYC 3 hours, etc. Plenty of outdoors activities. Tons of concerts by the biggest names. Plenty of unique local areas to visit.
Negatives
Hershey is not and will never be confused with a large urban city, we're probably not what most would think of as a vacation spot (although thousands do vacate here each year). Not a singles meat market if you are seeking such.
Positives
We are amongst the top programs in total EM months (you get to do what you went into training for). Residents are happy (we're usually recognized on our off service months as the ones with a smile on their face; well that and the hard working ones). We are routinely referred to as some of (if not the) strongest residents in the hospital.
The department is growing by leaps and bounds. The PD and faculty are aggressive advocates for the program. Being a young program; the PD and Dept. Chair are responsive to resident input for improvements. While young, the department is establishing itself as a leader in the hospital system. The training here is excellent.
Almost all of our patients have insurance and PCPs. This makes such a huge difference for follow-up and reducing your ED becoming the clinic.
The program will more than prepare you for any type of EM practice you seek; whether academic, community, or even locums. We have graduates scattered from coast to coast already, with some in all types of practices.
