Hello, I was hoping I could ask you a couple questions about UIC's EM residency. Could you provide some info on the program's anesthesia and ortho rotations? Can you also comment on the autonomy and procedure exposure? Given that UIC is a big academic institution, do you feel you have to compete for procedures at UIH--the main academic site--with residents from other specialities? How has your autonomy/procedural exposure differed at Masonic, Lutheran, and Mercy? How are your critical care rotations at each of these sites?
Heyo -
Sorry about the delay; was waiting to hear back from some of my current residents in regards to the non-UIH sites as things have changed significantly since I went through the residency. Their responses are below; good luck!
-d
Resident #1:
Could you provide some info on the program's anesthesia and ortho rotations?
So there is no adult anesthesia rotation, you get plenty of intubations at all 4 hospitals so it is not needed. But there is a pediatric anesthesia rotation incorporated in the Pediatric Critical Care rotation (time split between the OR and PICU). There is also no ortho rotation as the residents are expected to their own splints and reductions in the ED. Also at Lutheran, the physicians are REQUIRED to do their own splints, so no getting away with asking a tech to do it for you.
Can you also comment on the autonomy and procedure exposure? Given that UIC is a big academic institution, do you feel you have to compete for procedures at UIH--the main academic site--with residents from other specialties?
As a recent graduate, you definitely don't have to compete for procedures ever, not even at UIH. You only call consultants to do a procedure if the ED team was unsuccessful at the procedure or if it is out of the ED scope of practice.
How has your autonomy/procedural exposure differed at Masonic, Lutheran, and Mercy?
Mercy is a very busy hospital with a very sick patient population. When you rotate through the ICU as a PGY2, you co-manage the ICU with an IM senior but you end up doing all procedures as they aren't as experienced (intubations, cardioversions, central lines, chest tubes). As Lutheran and Masonic are trauma sites so there are always plenty of procedures to go around (both are not stand alone which means all patient are seen by the ED team and Trauma team vs stand alone is only managed by the trauma team). The UIC residents also split the trauma team at Christ with the Christ EM residents (Surgery seniors are UIC surgery residents)
.
How are your critical care rotations at each of these sites?
Lutheran: PICU as it is a tertiary Children's Hospital & SICU on trauma
Masonic: SICU on Trauma
UIC: CCU and MICU
Mercy: MICU/SICU
Resident #2:
Hi there,
Thanks for the interest in our program, I'm a current third year and have had a fantastic training experience here. I ranked UIC #1 and would do it again today.
Briefly, our program is a 4 site 'consortium' residency based out of UIC, Mercy Hospital, Advocate Lutheran General, and Advocate Illinois Masonic. UIC is our major academic center with a patient population comprised largely of very sick, chronically ill patients, often with rare and interesting pathology. This is a pretty busy ED, seeing just under 50k patients per year. Mercy hospital is a very busy (approximately 70k patients/year) urban ED, with a large underserved patient population that tend to be very acutely ill when presenting to the ED. We often see our sickest patients here, with a significant number of resuscitations occuring on every shift. Advocate Lutheran General is a level I trauma, hybrid academic-community hospital in the northwest suburbs, serving a middle to upper middle class population. There is very high acuity and volume here (approximately 75k last year), and has brand new adult and pediatric ED's. Advocate Illinois Masonic is a level I trauma, community ED located in the north side of Chicago in the Wrigleyville neighborhood. This is our most 'community style' practice environment, and also has a fairly decent volume of penetrating trauma as well. While 4 separate ED's, they are all unified by our residency training program, and are considered UIC EM residency faculty.
Could you provide some info on the program's anesthesia and ortho rotations?
We do not have specific anesthesia and orthopedic rotations, excepting pediatric anesthesia as a second year. I don't think that we are missing out due to the absence of an anesthesia rotation, as we manage such a high number of airways in our ED's (many of my classmates have logged anywhere from 70-100 airways thus far in residency). Regarding orthopedics, my class was the first year where this rotation was phased out, due to many of the prior residency classes feeling that it was lower yield (in general), as such a significant amount of this experience is gained while on trauma rotations (and while rotating at Lutheran General, where we perform all of our own splinting). I tend to agree, as I feel very comfortable managing most orthopedic conditions in the ED.
Can you also comment on the autonomy and procedure exposure? How has your autonomy/procedural exposure differed at Masonic, Lutheran, and Mercy? Given that UIC is a big academic institution, do you feel you have to compete for procedures at UIH--the main academic site--with residents from other specialities? How are your critical care rotations at each of these sites?
We have great autonomy, during both our training in the ED, as well as with our off-service rotations. As we progress in residency, at 3 of our sites (Mercy/Masonic/Lutheran General), we learn to run our specific 'pods', while teaching medical students and junior residents (on our 'Pre-Attending' shifts). Our faculty really get to know us well (both in the ED and outside of it) over the course of our training and do an excellent job of providing the appropriate level of autonomy as needed for each resident by level. For example, as third years, many attendings that we have worked with over the course of our training will stand quietly just outside of the room while we are leading a resuscitation, whereas there would be much greater help/supervision provided if this were an intern on the case. They are absolutely there when we need them in these situations, however. This is across the board - regardless of specific site - with our attending groups.
We work in the MICU at UIC as interns, which is an outstanding exposure to CCM with a focus on medically complex, very acutely ill patients. We have a great amount of autonomy, but also have oversight from a senior IM resident and CC fellow. On our off-service rotations as a second year, you are the senior resident on the trauma, ICU and PICU services. Specifically during our second year ICU rotations at Mercy as the senior ICU residents, we run the unit overnight without the aid of a fellow or attending in house (who can be reached very easily if needed, as well as the ED attendings). This autonomy allows us to further develop our resuscitation skills, as well as how to become independent decision-makers. These are excellent rotations, with a very high volume of critically ill patients with abundant opportunities for procedures.
Procedure wise, there is more than abundance at all of our sites, although I think I've probably done a greater percentage at Lutheran General and Mercy. I have more than logged all required procedures at this point in my training, and will generally teach the interns how to do these procedures when my patients require airway management, central lines, etc. We do not turf procedures at UIH - All of our procedures in the ED are ours, unless we give them to consultants to perform.
I hope that this answers some of your questions, and please don't hesitate to reach out to us at our program directly, if you have further questions. All the best.
