You receive patients from EMS and you will have to provide some degree of online medical direction and you could be tasked in the future with being a medical director for EMS. You should at least have some idea of the unique challenges of EMS and you should actually know what EMS is (or is not) capable of. Realistically, 1-2 weeks on an ambulance will only give you a tiny peek at the challenges of providing care in the prehospital setting. Many EM docs who don't have any relationship w/ EMS (e.g. through medical direction, etc.) have an embarrassing paucity of knowledge of EMS.
[2015-2016] EM Rank Order List Thread
- Thread starter Cinematographer
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You receive patients from EMS and you will have to provide some degree of online medical direction and you could be tasked in the future with being a medical director for EMS. You should at least have some idea of the unique challenges of EMS and you should actually know what EMS is (or is not) capable of. Realistically, 1-2 weeks on an ambulance will only give you a tiny peek at the challenges of providing care in the prehospital setting. Many EM docs who don't have any relationship w/ EMS (e.g. through medical direction, etc.) have an embarrassing paucity of knowledge of EMS.
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But that doesn't mean that riding around with a medic crew, sitting in the Dairy Queen parking lot, and taking a nap in the fire house is worth the time or gives the EM resident a better understanding of EMS capabilities.
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Actually, it kind of does. It helps to give context to the work environment that they are in, and getting to know the crews helps foster the kinds of relationships between EMS and medical direction. It isn't the most important thing in residency, but it is important.
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Just relax and enjoy the week off. It's a different pace than any other time in residency and medical school, but that doesn't mean you don't learn. You learn a lot about who the paramedics are, what they know, and what you can and cannot expect from them. That is valuable information, and worth a week of "wasted" days. Now if it were a whole month, I'd agree with you.
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Yeah EMS ride alongs should be limited to two weeks max and the rest of your EMS training should come from lectures.
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They are an amazing program and probably the best group of people (residents/faculty) that I have met on the interview trail. No negatives from my interactions including talks from people who rotated there.
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Does anyone have an opinion about how much annual volume is needed in a residency program to provide enough experience? There is some considerable variability between some programs (60k vs 100k+).
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It isn't just volume, it's volume per resident. A place which gets 100k visits and has 20 residents isn't necessarily a better experience than a place which gets 50k and has 8 residents.
I sent one in a week ago, so far no response.
D
deleted547339
That's true, to an extent. A high volume place with plenty of mid levels is ideal. A 100k place sees presumably 2x as many sick patients than a 50k place. If you have NPs and PAs or dedicated fast tracks to skim off the top, you're left with more high acuity people at the bigger shops(if it's done right).
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This is how it's done at my program. The PAs take care of a lot of the chaff, leaving the sick/complex to us. Though sometimes I do miss the 3 year old patient who stubbed their toe or the 23 year old upper abdominal pain and the occasional simple laceration
I'm getting a little tired of the medically complex 67 year old w/ ESRD, CAD, multiple stents, PAD s/p BKA, pacer placed 2 weeks ago is now coming in with worsening weakness above their baseline weakness. Answer? Order everything, admit regardless.
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Any idea which programs call/email their top applicants without being asked?
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THAT list would be much more helpful than anyone posting a ROL......
Denver's PD called me today to ask me how I was ranking the program. I've been trying to dodge all of her post interview communications but I accidentally answered a call today. Really hurt having to tell her I wasn't ranking them.
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Curious if anyone who interviewed at the new program at Crozer in Pennsylvania is ranking that program anything but last. I can't see it being a viable program where people actually enjoyed it lol
is this real life ^^???
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I like you
Glad to know I'm not alone lol.
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Go on.
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Submitted via Google Forms
Main Considerations in Creating this ROL: Feel, Fit, Location
1) MetroHealth/Cleveland Clinic: These residents may work a little more than most, but also seem happy and to enjoy what they do- I'd rather work hard in residency anyway and be ready for anything. This residency seems to have the best of both worlds- all the trauma you could ever want at Metro, and complicated medicine at Cleveland Clinic. Great flight, ultrasound, and moonlighting also. Cleveland doesn't seem as bad as everyone says.
2) Emory: Love the PD, even in the brief time I got to speak with him. The residents seemed like a great diverse bunch, and Grady seems like it be an amazing place to train. Really appreciated their dedication to the patient and seeing them through. A lot of opportunities in public health.
3) Cook County: Loved this program overall, would be higher if not a four year program.
4) Ohio State: Brand new ED, residents seem like a fun bunch, great training, new PD has big plans for the future of the program.
5) Baylor: Again with the county theme- residents seemed a little bit less happy overall. New PD Dr. Pillow is awesome.
Main Considerations in Creating this ROL: Feel, Fit, Location
1) MetroHealth/Cleveland Clinic: These residents may work a little more than most, but also seem happy and to enjoy what they do- I'd rather work hard in residency anyway and be ready for anything. This residency seems to have the best of both worlds- all the trauma you could ever want at Metro, and complicated medicine at Cleveland Clinic. Great flight, ultrasound, and moonlighting also. Cleveland doesn't seem as bad as everyone says.
2) Emory: Love the PD, even in the brief time I got to speak with him. The residents seemed like a great diverse bunch, and Grady seems like it be an amazing place to train. Really appreciated their dedication to the patient and seeing them through. A lot of opportunities in public health.
3) Cook County: Loved this program overall, would be higher if not a four year program.
4) Ohio State: Brand new ED, residents seem like a fun bunch, great training, new PD has big plans for the future of the program.
5) Baylor: Again with the county theme- residents seemed a little bit less happy overall. New PD Dr. Pillow is awesome.
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Cinematographer's Note: Please see bolded part. User is requesting opinions.
Submitted via Google Forms
Main Considerations in Creating this ROL: General feeling of fitting in with residents and faculty > training/faculty quality > reputation. I want to go into academics/education. I am couples matching Family Med which only mattered finding a city with good family programs but she'll match wherever city I match. A little worried that my top 5 are reaches since I feel EM had gotten so competitive so any opinion on that based on 242/256 scores, half clinical honors, high pass SLOE's and being able to hold a conversation is appreciated.
1) Denver: just reiterate everything already mentioned. Feels like the SEAL training of emergency medicine. Arguably best trained and capable of doing whatever career after. + Beautiful location with plenty of outdoor activity; Double Negative is rough hours that won't line up great with resident SO so may be doing a lot of enjoying the area without my wife. Feels like a real reach #1. I am not expecting to match there and mixed emotions between great training +'s and lifestyle -'s if I were to match there. May drop this to 3-4 by certification time.
2) University of Michigan: Amazingly friendly and intelligent residents and faculty. Liked the 3 training sites minus the drive to Flint. Great training in critical care and lots of opportunities create a niche in education. Still have a pretty active flight program but not as involved as UC. Happy with the location so no real negatives. Probably the place I knew the least about but got the warmest gut feels from.
3) Advocate Christ: This could easily be my #1 and may end there as I decide 4yr vs 3yr + Fellow. The residents are the most socially outgoing and fun I've met. Then you hear them discuss medicine during didactics or shifts and you're taken aback that such socially awesome people are equally intelligent and driven to be great physicians. Faculty there is also outstanding. They had a good amount of research, education and critical care opportunities. Many go on to fellowships and good split between community and academics.
4) UPenn: good feeling from residents and faculty. Has a nice ivy league name to it and still a strong name in emergency. Great critical care training and opportunities to get involved in education.
5) University of Cincinnati: fun but very eclectic group of residents and faculty. A few came off a little pretentious but they can support it based on the excellent training and research they do. Great opportunities for education as PGY4 is an acting attending. Flight program is awesome and fun but not something I see as mandatory for good training. Love the city with a really friendly midwest attitude. Negative is work really hard and long (12's) hours.
6 and beyond: Wake Forest, Pitt, UVA, Henry Ford
Submitted via Google Forms
Main Considerations in Creating this ROL: General feeling of fitting in with residents and faculty > training/faculty quality > reputation. I want to go into academics/education. I am couples matching Family Med which only mattered finding a city with good family programs but she'll match wherever city I match. A little worried that my top 5 are reaches since I feel EM had gotten so competitive so any opinion on that based on 242/256 scores, half clinical honors, high pass SLOE's and being able to hold a conversation is appreciated.
1) Denver: just reiterate everything already mentioned. Feels like the SEAL training of emergency medicine. Arguably best trained and capable of doing whatever career after. + Beautiful location with plenty of outdoor activity; Double Negative is rough hours that won't line up great with resident SO so may be doing a lot of enjoying the area without my wife. Feels like a real reach #1. I am not expecting to match there and mixed emotions between great training +'s and lifestyle -'s if I were to match there. May drop this to 3-4 by certification time.
2) University of Michigan: Amazingly friendly and intelligent residents and faculty. Liked the 3 training sites minus the drive to Flint. Great training in critical care and lots of opportunities create a niche in education. Still have a pretty active flight program but not as involved as UC. Happy with the location so no real negatives. Probably the place I knew the least about but got the warmest gut feels from.
3) Advocate Christ: This could easily be my #1 and may end there as I decide 4yr vs 3yr + Fellow. The residents are the most socially outgoing and fun I've met. Then you hear them discuss medicine during didactics or shifts and you're taken aback that such socially awesome people are equally intelligent and driven to be great physicians. Faculty there is also outstanding. They had a good amount of research, education and critical care opportunities. Many go on to fellowships and good split between community and academics.
4) UPenn: good feeling from residents and faculty. Has a nice ivy league name to it and still a strong name in emergency. Great critical care training and opportunities to get involved in education.
5) University of Cincinnati: fun but very eclectic group of residents and faculty. A few came off a little pretentious but they can support it based on the excellent training and research they do. Great opportunities for education as PGY4 is an acting attending. Flight program is awesome and fun but not something I see as mandatory for good training. Love the city with a really friendly midwest attitude. Negative is work really hard and long (12's) hours.
6 and beyond: Wake Forest, Pitt, UVA, Henry Ford
Hey quick question for anyone familiar with the issue. I'm a DO applicant, took Step 1 & Step 2 CK and released those scores to the programs (I did not take Step 2 CS). I took Comlex 1, 2 CE, 2 PE but did not release those scores because I dropped a bit from 1 --> 2 CE. My question is, do I have to release my Comlex scores at this point because the programs are going to require Comlex 2 PE before the ranking list is due? Or is Step 2 CS / Comlex 2 PE not required for ranking?
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Curious as to why those who interviewed at Cozer are turned off? Any specific reasons? (I did not interview there)
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Crozer is a new program, undesirable location, Program leadership were more than a little unclear as far as the direction and vision of the program. The shift schedule is truly something out of a frakenstein movie and I'm still trying to decipher just how many hours/shifts one actually does work, it's not a level 1 trauma center, PEDS are NOT run by the emergency medicine dept, but instead run by the PEDS dept, patient volume and acuity is still up for a huge debate. And did I mention it's a new program in an undesirable location lol. Definitely last on my list!
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Probably be fine, but at the very least can you not release the PE? Some of my peers that had half complete applications had less interviews initially, and even on my interviews it was commented that they liked my complete application. And fwiw I never had board scores brought up in 18 interviews.
I have no clue how it works with DO but I'm guessing the same as MD. There are programs that will not rank you if you haven't released your scores. In your case, I'd just release them and let the chips fall where they may as I'd rather have my position moved down a little from bad scores than not be ranked at all....
I had similar thoughts and agree with everything you said. Seems like they have some growing pains to deal with here, more so than the other two new programs in Brookdale and Miami. However, at least the program leadership appeared nice.
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Oh wow. I can definitely see why you would rank them last lol.
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I think I know at least three, and I was wondering about some of the other programs..
I can tell you 13 that haven't emailed me
, though I did get a response to my #1 email
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I can tell you 13 that haven't emailed me, though I did get a response to my #1 email
I've heard of basically every scenario as I'm sure many of you have. A few people never heard a thing in February and matched in their top 3. Some were told they were ranked to match and didn't. Some were sent multiple emails or received multiple phone calls from programs and matched at those places. Could be lies, could be the truth, just rank em' how you want em'. Especially with how competitive EM is now, just try to envision yourself at every place you're ranking and start focusing on the good things at all those places.
Yup that's what I did and I will be happy if I match anywhere in my top 8
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I only know of one program that completely runs the Peds emergency department. The vast majority of places probably let pedi em run their own Ed with a few em docs working there.
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http://www.nrmp.org/code-of-conduct/
If what you're saying is literally true, that sounds like an NRMP rules violation. If it's not literally true (e.g. they didn't actually ask you where you're ranking them, but more asked how you liked the program or how you were feeling about it), you probably shouldn't imply that Denver is violating match rules.
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Seems like it was a subtle brag post about how he/she wasn't even ranking Denver. Haha.
Anyway guys, don't fret over 3 or 4, pay etc. Rank based on where you think you will be happiest. If you are happy you will succeed wherever you are. Good luck guys. I am excited to see who our new incoming Interns will be
I'm sorry for any confusion. 5 times during the interview day and then in probably 3 mass emails through ERAS, Denver has made it very clear they don't partake in post interview communications regarding ranking or the match. I think they are actually one of the strongest voices against these actions among EM programs. Thought the sarcasm would translate through.
I ain't no snitch.
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Or, and I know this is hard to understand for everyone to understand.... a joke
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I don't know if that's true or not but at my program EM definitely runs our Peds EM dept. all the docs are either just EM or EM / Peds EM boarded. The only people that help us run the ED is Peds surgery for the trauma alerts. I would recommend finding a program like this that gives you an extremely solid Peds experience, I think this is one of the few things that some programs do way better than others
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Hilarious
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What has the general impression been of those who have gone on second looks. Have you been pimped do you just observe or are you actually seeing patients as well lol?!
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I mostly shadowed residents of different levels for a few hours. It was helpful to see the actual work flow in the ED (e.g. load of scut work, level of autonomy, difficulty with admission, how much bedside teaching, roles of ancillary staff/mid-levels, amount of customer service, etc.) Also tried to spot the grumpiest/happiest residents and get their perspectives. Everyone was pretty laid back and friendly, although I got "pimped" on EKG once or twice by attending/senior resident who just wanted to show/teach some cool findings. I took it as a good sign.
NOT being a level I will likely work in an EM residents favor. For a level II, they have pretty good volume (busier than some level Is in Philly). As far as I know the trauma service is not dominated by surgery residents. Chester City will provide a fair amount of penetrating trauma and 95 & 495 will some gnarly blunt trauma. As far as peds, it appears they go to Dupont as do a number of other programs in the Philly area, and they also do time in their own peds ED. Correct me if I'm wrong, but EM residents must work under board certified peds EM attendings, so whether or not the section of the dept actually falls under EM or not is not likely to make much of a difference. All the programs in the US that send EM residents to pediatric hospitals for peds EM are rotating in a dept that is essentially run by peds. As far as location, it shouldn't matter much. You aren't required to live there. Many Christiana residents commute to DE from Philly; Crozer is half the distance, so I think you can manage to live in a "desirable" area and your commute won't be too bad if you live in South or West Philly. And despite what some outsiders may think, there are some nice areas of Delaware County where you can be in Philly within 30 minutes or less.
Anyhow, for clarification, I am not in anyway associated with the program nor am I a friend of anyone that works there. I'm sure it will have some growing pains, but I imagine it will be a decent enough place to train. I think its worth keeping in mind that what may be a negative is likely what you'll find at many (most?) programs and in some cases the perceived negative may actually be a positive (e.g. trauma). As far as lack of vision, that could be an issue now, but likely resolve quickly in time.
Long time lurker 1st time caller here. Does anyone have much/any insight into the Chicago programs? People seem to love Advocate on here, but I had a better overall feeling about NW and UofC after those interview days. Still sorting out how to rank those...
I was curious why Brookday and Miami are better although they are much newer programs, right?
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Long time lurker 1st time caller here. Does anyone have much/any insight into the Chicago programs? People seem to love Advocate on here, but I had a better overall feeling about NW and UofC after those interview days. Still sorting out how to rank those...
They are three great yet very different programs. It really comes down to what you value the most in residency, long-term career goals, personal fit, etc. Any specific insight/information that you're looking for?
