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Applicant Summary:
Step 1: 265, Step 2: 270, Step 2 CS: Pass
EM rotations: HP/H
Medical school region: Mid-Atlantic
Anything else that made you more competitive:
Grades and scores. Presumably SLOEs were good because I got a decent number of interviews...they weren't really mentioned by many interviewers honestly. PS was also brought up a few times. Quality headshot for ERAS?
Main Considerations in Creating this ROL:
Location, good/varied pathology, fit with residents, quality of faculty teaching, emphasis on work-life balance.SO and I don't really care for big cities. 3 > 4 however 4 not the end of the world, wanted to avoid 12s if at all possible. Didn't care too much about prestige or fellowships since I want to do community EM. As interviews went on, realized I valued programs where EM is one of the strongest residencies in the hospital and isn't neglected or dumped on and doesn't get procedures stolen by other residencies.
This is what my list would look like if I were single, actual list is a little different as SO preferred to remain closer to family. Thought giving my personal list would be more helpful to future applicants. Also will be posting individual program impressions in the next few weeks since those were really helpful to me during the application process.
1) Temple University
Loved this program. Pathology and acuity are amazing. North Philadelphia is a poor area, so patients unfortunately have tons of social issues and do not generally have access to primary care and therefore come in really sick. Tons of penetrating trauma = tons of procedures...chest tubes and even thoracotomies. Main ED has county feel but more resources. Rotations at other sites (Jeanes and Episcopal) seem like a good additions to main Temple ED experience. Work 10s as intern, 8s as senior. Combined longitudinal Peds at St. Chris and blocks at CHOP so no shortage of Peds exposure. Solid ICU experience with 5 months, burn ICU sounds awesome. Faculty are great, had some really enjoyable interviews. Loved the residents. They all seemed really happy and had great things to say about each other and the program. N64 in resident lounge. Monthly resident night out where ED is covered by faculty and residents get to hang out. EM is one of the stronger, more-respected residency programs in hospital.
Neutral: Dr. McNamara does have a poker face in interviews. Feel like you could tell him you just torched his car and he'd look up, raise his eyebrows, say "uh huh", scribble some notes, and ask another question. It was kind of funny actually.
Cons: Limited patient diversity, >90% are black. Maybe not enough community, bread and butter ED experience. Not sure how I feel about template shift schedule (2 day, 2 evening, 2 night, 2 off) as it seems like you work more days than at other places, don't have many weekends off, and have to transition from days to nights frequently. Philadelphia isn’t my favorite city but I could tolerate living in Manayunk or Roxborough.
2) Christiana
Really hard to decide between here and Temple for #1. Maybe should have had this at #1, but too late now. This is an amazing program and I was blown away on interview day. The Christiana ED is huge and gorgeous. Everything seems to run smoothly so despite crazy volume you don't have to deal with BS and get to learn instead. Acuity and pathology are great. No surgical subspecialty residencies, so all ortho, ophtho, etc. is yours. Wilmington ED is a good inner-city, community experience as well. Shifts are 9s with 1 hour overlap, except nights which are straight 8s. Interns do 20 shifts/month and there's 1 block of nights per year so other months have few nights. Peds and PICU at DuPont, longitudinal Peds shifts. Solid ICU experience with 5.5 months. No off-service BS rotations. U/S seems strong as well. 2 elective months and 1 teaching month. Also has an admin block which I like, as admin might be something I’d like to do in the future. Residents were laid back and definitely happy with the program. Faculty and PD seem great as well. Run by a private group, DFES which would be helpful for learning about the business side of EM. Program has good reputation. EM is easily the strongest program in the hospital.
Cons: Did not care for Delaware and really don't want to commute down 95 from PA. SO did not like location either. Other than that, no real cons, would be very happy here.
3) St. Luke’s Bethlehem
Definitely a hidden gem program. Community program but does have a branch of Temple Medical School so a bit academic too. Pathology and acuity seem relatively good; the Lehigh Valley is more diverse than most people realize so you do see a mix of rural patients transferred in, suburbanites, elderly people, and a more inner-city type crowd. Acuity/pathology obviously not at the level of Temple or Christiana but you would definitely see enough and be well-trained here. The main hospital in Bethlehem is modern and totally updated. ED was also pretty nice. Shifts are 10s and you don’t work many nights though many evening shifts do extend into the early hours. No Ophtho residents to take eye procedures or Anesthesia residents to take airways. Ortho residency program is small, relatively new, and only comes to the ED when called or if residents are in conference. Great curriculum, little off-service. 2.5 months of electives. ICU experience is good with 5.5 months. Main hospital sees 20% peds patients, so you get longitudinal experience. Also do blocks of Peds EM and PICU at St. Chris as PGY-2. Great moonlighting at smaller St. Luke’s community sites and moonlighting is encouraged by the PD! Pretty awesome. Residents were fun to talk to and very happy. All had great things to say about the program. Dr. Melanson, the PD, seemed like a great guy who really looks out for residents. EM seems to be the strongest program in the hospital which is also a plus. SO and I love the area, and it is close to my family and SO’s family so the location is ideal for us.
Cons: Not as big of a name in EM. Acuity and pathology might be a bit less than some other places on my list. Peds acuity might suffer as Lehigh, a nearby program, has a dedicated Peds ED and PICU while St. Luke’s does not. Again, few cons. Would be very happy here.
4) Cooper
Pros: Very similar to Temple. In fact, most residents I met at either place wound up deciding between Temple and Cooper. Camden is a disaster of a city with tons of crime and poverty, but this leads to great acuity and pathology. Cooper ED (and the whole hospital) is really nice though. Shifts are 9s with 1 hour overlap except for 12s on the weekends. The weekend 12s pay off though, as they strive to give residents 2 free weekends per month which is great. Longitudinal Peds in PGY-2 and PGY-3 after Peds EM block in PGY-1. Great trauma experience as it is the only Level 1 center for all of South Jersey and Camden sees plenty of penetrating trauma. 6.5 months ICU. Chair is fantastic and all of the faculty who interviewed me were incredibly nice. Residents were a great bunch and clearly very happy. EM is a well-respected program in the hospital and there are no issues with other services taking procedures.
Cons: Camden. Would not want to live in NJ or center city Philly really. Not sure how feasible it would be to commute from more suburban type areas in PA. See your usual minor traumas in ED months but more serious traumas are surgery run and really only seen in your trauma months. Didn’t really gel with the PD in the interview. Still would be happy here.
5) Lehigh Valley
Pros: Rotated here and had a great experience. Maybe I just missed it, but the residents I worked with all seemed to like the program. Did not feel unwelcome in any way as an MD student. Pathology and acuity are solid, as I said before the Lehigh Valley is a more diverse area than most people think. ICU experience seemed really good. Most faculty were great to work with. PD is a super nice guy. Moonlighting is available to (somewhat) soften the blow of losing out on a year of attending salary. SO and I like the area.
Cons: 4 years. Work a lot of shifts and even as a 4th year you still work a lot. Floor months are of questionable utility. Still would be happy here.
6) Penn State
Pros: Good volume and acuity due to wide catchment area. Mainly sick medical patients but see a fair amount of blunt trauma. Rotate at Pinnacle in Harrisburg for urban/community experience. Strong EMS with Life Lion flight program. Great Peds experience with longitudinal shifts; Penn State is only Level 1 Peds center between Philadelphia and Pittsburgh. Shifts are 9s with 1 hour overlap. Interns work 22 shifts/month. New PD seemed pretty good. Moonlighting is allowed. Hershey is a nice small town but not too far from cities.
Cons: Many residents made it clear that this wasn’t their 1st (or even 2nd) choice. Didn’t gel with residents, though they seemed nice. Also didn’t gel with some interviewers. Signout apparently isn’t always very quick and used to take hours per residents. Ortho takes tons of procedures. EM only does airway on level 1 or 2 traumas. EMS isn’t really my interest.
7) UPMC/Pitt
Pros: Amazing reputation in EM. Love that they rotate at a variety of hospitals, from more academic Presby to Mercy for county-type experience. Multiple rotation sites ensures a variety of pathology, from crazy complex to bread and butter. EMS is among strongest in nation, “Jeep” sounds awesome. ICU experience is great. Children’s see very sick kids so Peds seems solid. Reputation allows grads to do almost anything: get great community jobs, fellowships, or academic jobs. Liked the residents, who were happy, laid back, and diverse. PD and faculty were very nice as well. Pittsburgh seemed like a nice, affordable city with plenty to do.
Cons: Pittsburgh, SO and I don’t know anyone out there, it’s far from family, and the climate is awful. U/S could be stronger. Don’t like that Peds is in 2 week blocks…why can’t they just do longitudinal shifts? Work 22 10s per month as an intern. Definitely a workhorse program but not at all malignant. At the end of the day, EMS isn’t really my thing so the fact that it is so emphasized is a negative.
8) Geisinger
Pros: Well-established program. Surprisingly decent volume due to many transfers and wide catchment area. Shifts are 9s. Peds exposure seems good. 6 months of ICU. Residents were all really happy and lived pretty well (owning houses, nice vacations) since COL is so cheap. Close relationship with attendings who are all laid back and good teachers per residents. PD was a nice guy who would look out for residents. EMS is strong, you start flying as PGY-1 and aren’t just an observer. Danville is a nice, quiet town with plenty of outdoor activities.
Cons: EMS is not my area of interest (see a pattern?). Danville is nice but too remote for me and SO. Don’t like that so much volume is from transfers. Wonder whether I would see enough pathology. A good program, just not for me.
9) Drexel
Pros: Rotate at multiple hospitals (Hahnemann, Mercy Fitz, Mercy Philadelphia, Roxborough for community, and St. Chris for Peds) so you see a variety of patients/pathology. ICU experience sounds amazing with 6 months of EM-run ICU at Mercy. New PD is a great guy who I think will help to restore program to its previous standard. Interviewers were all great. Residents mostly seemed happy from what I saw.
Cons: Probation. They were really open about this at my interview day, with chair, PD, and residents all addressing it but they still won’t find out if they’re off probation until April. Program reputation has really taken a hit in recent years. A few residents seemed unhappy. All of PGY-2 away from main site, though Mercy system sounds like a great experience. Not sure how I like the 2 days, 2 evening, 2 night, 2 off schedule at main ED. 12s at Mercy sites.
10) Maryland
Pros: Amazing reputation in EM. Grads can get jobs/fellowships of their choice. PD really emphasizes producing leaders in EM. Residents were all clearly very smart and involved. Rotate at a variety of sites to get exposure to different patient populations/pathology. Prince George’s, their community site, sounds like a great experience in particular. Trauma at STC. Trauma Anesthesia rotation seems like a really valuable rotation. Quality didactics with quarterly cadaver lab and lectures based on recent journal articles. Baltimore surprisingly livable and nice, at least the parts where residents live.
Cons: Interview with PD was kind of uncomfortable. Too academic as 50% of grads do academics on average. Do 12s mostly, and those typically turn into 13s or 14s per residents. Residents seemed tired. Very poor resident turnout to dinner…definitely a red flag. Have to commute in crappy Maryland traffic to Children’s National for Peds. After some thought, don’t like the thought of only seeing significant trauma on STC rotations. STC also seems to be Surgery-centric. SO and I don’t know anyone or have family near Baltimore, so location is a net negative.
11) Hopkins
Pros: Residents were significantly more happy (and less tired) here than at Maryland. Rotate at 3 hospitals (main JHU, Bayview, and Howard County) which provides exposure to a variety of patient populations/pathology. Strong off-service given Hopkins name. Trauma no longer at STC, JHU sees plenty of trauma including high % of penetrating. Still do trauma Anesthesia at STC. Peds is longitudinal for PGY-2 and PGY-3. 4th year at least seems worthwhile as you work attending hours and choose a niche (“FAST”) within EM.
Cons: 4 years. Work 12s as PGY-1 and PGY-2 and there is no overlap so residents are usually there 1-1.5 hours after shift to tie things up. Very academic and I got the sense that residents are gently pushed into academics as only a few grads do community each year. Though residents were nice, I didn’t really fit with them. Peds in blocks as PGY-1 and only 2 weeks as PGY-4. Only 4 months ICU as of now. Worried that the strength of other departments might make EM less respected. Maybe a slight air of “we’re Hopkins therefore we’re awesome” on interview day. Baltimore for reasons listed above.
12) Jefferson
Did not really get a great feel on interview day. I didn’t fit with current PD or incoming PD, but the other faculty seemed cool. Though I like the idea of multiple rotation sites, Jefferson takes it a bit too far with so many sites that are pretty far apart. Work 12s as intern. Worried that other departments, i.e. Ortho and Neuro, might be too strong relative to EM. Do not like location in Center City. Residents seemed okay, just not my people for whatever reason.
13) Rutgers RWJ
Got a weird vibe on interview day. Probably the worst interviews of the entire trail; many were uncomfortable. ED is small and dated though there are plans for a new one. Bizarre EMRs, have separate ones for charting and orders. Work all 12s with no overlap. Only 4 months of ICU and Peds is in blocks for PGY-1/PGY-2. Liked the residents but the class size is small. No moonlighting allowed at all, which isn’t a dealbreaker but isn’t great either. SO and I are do not care for the location in NJ.
14) Crozer-Chester
The program is just too new, as they are on their first PGY-1 class. It seems like Crozer sees a ton of pathology. Shifts are 9s with 2 morning, 2 evening, 2 night, 2 off format which I don’t really like. Peds will be in blocks. Only 4 ICU months. Residents hadn’t done ICU or other rotations yet so it was unclear how strong off-service will actually be. Met only a few residents but the few that were there seemed okay. PD was not great but not terrible either; other faculty members were also decent. Overall I think this program has potential but is just too new for me to rank high.
15) Hackensack
Rotated here and just didn’t have a great experience. I didn’t fit with the residents, though they were mostly nice. Some attendings were decent teachers while others acted like I (and even the residents) didn’t exist. Work some 12s. ED is not adequately staffed or designed for the volume it sees. The PD, Dr. Finefrock, is probably the biggest pro as he is enthusiastic, a great resident advocate, and has a clear vision for making this a great program. SO and I do not like location at all. COL is too high.
Other:
Decided on EM rather late and I didn’t have great EM advising. Applied to 40 programs from mid-Atlantic down to FL, avoided NY and New England. In total, I received 26 invites and 14 rejections, although many rejections were silent. Regional bias is real. I got plenty of love from the Mid-Atlantic, but not so much from NC, GA, or FL. At the end of the day, I’m happy everything turned out so well and that I got to interview at many great programs.
Declined/canceled interviews: George Washington, Orlando, Carolinas, Wake Forest, Morristown, Rutgers NJMS, Greenville/USC, Allegheny, Palmetto/USC, EVMS, VCU
Rejected: Georgetown, UCF, UF Jax, USF, Emory, Medical College of Georgia, Duke, UNC, Newark Beth Israel, Einstein Philadelphia, Penn, MUSC, UVA, VA Tech
), amazing location, as a resident you are actually needed to keep the hospital functioning and not just there to learn. Active member in the ICUs.
Rochester is in NY
