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Thank you for the insight!
[2016-2017] Emergency Medicine Rank Order List Thread
- Thread starter doggydog
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Uninsured patients are sicker in that they have a lot more acute or subacute issues that haven't been medically managed, usually due to the patient's unwillingness to follow up and decreased access to care. Insured gomers have a lot of chronic illnesses (htn, dm, cad, ckd, hld, previous stroke) that are being seen by multiple specialists and are stably sick.
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Although this NOT rank list is anonymous, why do this? This is especially lame, considering nearly 2/3 of that list is random. Why waste your time?
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So you may know that these programs were not up to par as the ranked ones for this gentleman or gentlewoman and can think less of them when creating your own rank list. That is why
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Which one is #6? Which one is #15? Why are they not up to par?
If you rank a program lower because an anonymous internet poster didn't feel like ranking them highly and provided no explaination of why...
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You know that there are some who find the DMC Sinai Grace folks to be the strongest in Detroit when they're all done...
All that to say a little bit more of a thorough thought process to half the list can be helpful to people. Not everybody is going to only compare those 5 described. Not unreasonable to find explanations for all of the rankings desirable.
All that to say a little bit more of a thorough thought process to half the list can be helpful to people. Not everybody is going to only compare those 5 described. Not unreasonable to find explanations for all of the rankings desirable.
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Or, even if not detailed explanations, at least an accurate list. The last, or second last, on the list can be much more intriguing.
As I said last year, the guy who quits the marathon at the 25th mile has a story, sad as it is, to tell.
As I said last year, the guy who quits the marathon at the 25th mile has a story, sad as it is, to tell.
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Is that what a Grace resident said to you? They tend to talk **** about other Detroit programs since they think that getting the most penetrating trauma makes them better. All Detroit programs are pretty strong as far as training goes, but honestly, Sinai Grace has some major systemic issues unfortunately. If you want to talk about reputation, Henry Ford and Detroit Receiving are the two top programs in Detroit.
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This was from two different attendings - neither of whom were currently at any of the Detroit programs but each had been faculty at different Detroit programs in the past (neither had been residents at Grace).
They absolutely do have issues with their nursing support by all accounts, and that can absolutely detract from a resident's training and should be considered. I would say that it's a little more than just the penetrating trauma, however. Both attendings similarly cited their independent critical care and ED orthopedics experience as factors that made their residents stand out.
I'm not here to get into a pissing match on what makes one program absolutely universally better than another, however. The value of having all these programs is that they have different styles for different people (best for one kind of person isn't best for all people) and certainly the academic reputations at Henry Ford and DRC are a big advantage for them and shouldn't be discounted.
I was mostly just responding to this idea that a rank list isn't very helpful when one person's opinion only lists half of their thought process.
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Of course, no need for a pissing match, I am at neither of those programs either, but I wouldn't want some misconceptions out there. For instance Grace doesn't do anything special with respect to critical care. They are actually currently in the process of remodeling their ED critical care rotation to more closely resemble DRH's (I know someone directly involved with this), and Henry Ford has a huge emphasis on critical care especially with Manny Rivers there. Grace doesn't have in-house Ortho, that is true, but from what I hear from my friends at DRH, ortho doesn't steal their reductions. I am not sure what ortho is like at Henry Ford or St. Johns so I can't speak for them. Grace residents are strong, don't get me wrong, they get great training, but I wouldn't make a blanket statement that they are the strongest in Detroit.
Eh, I disagree. What is the difference if he/she only interviewed at 5 places, or just listed 5 places? Knowing that he/she interviewed at more places invalidates their list? More information would probably be better, but no need to get upset at this individual for not writing out stuff for the other programs.
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It's not that issue that I find lame. It is going out of one's way to intentionally jumble information for no legitimate, mature, reasonable reason. That is black letter stupid.
Seems like decent results for a DO. Gives me hope.
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Some thoughts:
1) I really appreciate those who take the time and actually consider the real cons of each program they interview at. I feel as though that those are the main differentiating factors between my own programs as I make my ROL.
2) It's interesting to see how SDN really seems to mold the public opinion on certain programs. I'm not saying that the opinions are incorrect or unwarranted, I just think the bias is real.
3) Speaking of bias, it's disheartening that region really plays a huge part in all of this. I know that people say to do aways in areas that you might want to train and I'm sure that's true, but a lot of people tried to do that and were not able to. I know I applied for 12+ rotations in a region I was hoping to train in, rejected by all. Now I'm not sure if regional bias has anything to do with that as well or if I was just unlucky, but it did make me question my competitiveness until interviews started coming in.
4) As I'm posting these I'm realizing how many of the posters I have met on the interview trail. Hi friends.
1) I really appreciate those who take the time and actually consider the real cons of each program they interview at. I feel as though that those are the main differentiating factors between my own programs as I make my ROL.
2) It's interesting to see how SDN really seems to mold the public opinion on certain programs. I'm not saying that the opinions are incorrect or unwarranted, I just think the bias is real.
3) Speaking of bias, it's disheartening that region really plays a huge part in all of this. I know that people say to do aways in areas that you might want to train and I'm sure that's true, but a lot of people tried to do that and were not able to. I know I applied for 12+ rotations in a region I was hoping to train in, rejected by all. Now I'm not sure if regional bias has anything to do with that as well or if I was just unlucky, but it did make me question my competitiveness until interviews started coming in.
4) As I'm posting these I'm realizing how many of the posters I have met on the interview trail. Hi friends.
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Definitely. Are you thinking of any programs specifically?
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Spot on. Grace is fine, but you match there in Detroit only if you've failed to secure a spot at HF or DRH.
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Curious as to how you know some programs already submitted...
-fellow love letter procrastinator
Was talking to EM faculty at my place about my rank list, was mentioned that my home program already submitted theirs... no idea about other programs but I would not be surprised if it has already been submitted at other places as well
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My home program has also submitted their list, according to a resident/friend. But who knows - maybe they can certify more than once, as we can?
It is time to be decisive, people. You know what you want. Get after it!
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Deadline is coming up in 10 days. I'm sure a bunch have submitted, or will do so by the end of this week.
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WashU and UNM were both wildly different for better or for worse than what I was expecting after reading stuff on here.
I've talked to classmates who felt the same about other places as well.
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Any informed thoughts on not sending a love letter at all? I will be visiting the cities of programs 1 and 2 (deadlocked) with my spouse to help break the tie in the next 10 days...
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Submitted anonymously, via Google Form.
Applicant Summary:
Step 1: high 230s, Step 2: high 260s
EM rotations: H/H
AOA
Medical school region: East Coast
Anything else that made you more competitive:
Nothing, really. Just another dorky–ass med student. Couples matching, so went on a lot more interviews than I would have otherwise. This is obviously therefore my ranking of the programs as a whole rather than my specific rank list.
Main Considerations in Creating this ROL:
(in decreasing order of importance): Strength of clinical training; the vaunted “fit”; location, location, location, 4 > 3. (Descriptions got shorter as I got further down, sorry about that. Was on my third Macallan by the time I was done.)
1) LAC+USC -
Pros: Pt census is “the” county population; challenging at times to work with but most really trust the hospital. The residents are dedicated to the social mission of the hospital, but express it through what they do clinically rather than wearing it on their sleeves (which I found refreshing as this tended to be paraded about at other county programs I interviewed at). Word on the street is that the people here are pretentious; I didn’t catch a whiff of this during my interview (with the exception of the PD, see below). EM seems to rule the roost at this hospital, which has pluses (although also minuses; see below). Minimal scut despite being a county hospital. Very strong sense of tradition and history at the place, which I really like. The fourth years (the “two–stars”) were without a doubt the most badass residents I saw on the trail. Conference is unequaled among all the other places I went to. (Addendum: I assigned absolutely ZERO value to the EM:RAP or Code Black factors as neither would have any effect on me as a resident.)
Cons: 12–hour shifts with no overlap (although word on the street is that this may be changing); LOW, LOW, LOW salaries given the COL (R1 year ≈ $52k) despite the fact that the residents are unionized, so–so community experience at Long Beach Memorial (the residents were open about the fact that they didn’t care for it all that much – although supposedly they have added Verdugo Hills as a community site), other departments in the hospital are relatively weak => possibly weak off service rotations. The PD seemed to be rather unapproachable and acted like she was “put upon” to have to talk to us. Fairly underresourced given the USC imprimatur on the program; I get it that resource management is an important skill to have, but I can see it being frustrating as a provider over time.
2) Highland -
Pros: Great fit with the residents/attendings. County population. High salaries makes COL bearable (without kids, that is), excellent benefits, moving stipend. Very influential resident union that seems to do a good job of addressing QOL/COL issues. Small, phenomenally approachable faculty who love to teach. Really liked the PD.
Cons: High COL, mostly weak off–service rotations. A little bit of frat–like (or even a bit cult–like?) attitude among the residents when they were in groups (although didn’t notice this when talking to them individually). The matching black–and–red hoodies seemed a bit overkill and Sieg Heil(and)–ish.
3) UCSD -
Pros: Was not expecting to like this place that much, given relatively low patient volumes at the main site. However, everyone seemed legitimately happy and not in the plastic–politicianesque–smile–dog–and–pony–show way. (I’m guessing living in San Diego may have something to do with this). Really liked the PD; his personal story is very compelling. They have recently added a community site that sees nearly 90k a year (with 9 residents per class). Clicked well with the faculty and residents here (although being jacked seems to be the rule rather than the exception among the residents. Pro or con? You decide).
Cons: Didn’t get a good sense of how EM interacts with the other specialties. Trauma is in a separate area on a separate floor of the ED, which seemed a bit odd to me. Some concerns with patient volume (the volume–to–resident ratio being the sine qua non of clinical training) and will I be seeing enough variety in patients.
4) UCSF–Fresno -
Pros: Long–established EM program with a very sick countyesque population. The Central Valley may as well be in another state cf. the Bay area and Socal. Very strong clinical training. In some ways, seemed more “countyesque” than many of the other county programs (huge ED, but still packed and a lot of hallway beds). Big WM involvement with Yosemite nearby if that’s your thing (I was agnostic on this point. I think I am among the 0.0000001% of EM–aspiring med students who DON’T rock climb, or eat a paleo diet, or what have you).
Cons: Fresno. Not as bad a location as I was thinking it would be – much more realistic COL than the Bay area – but still, NYC, SF, or LA it ain’t. A lot of the salesmanship was about how “few” hours it would take to get to other, more desirable places.
5) UCSF–SFGH -
Pros: Very impressed with the program overall, particularly given how young the program is. Two major sites, ZSFG (brand new hospital, county population) and UCSF (world–class 4° care center with correspondingly strong off–service rotations and consultants, perhaps this belongs in the “con” area as well). Same residents rotate at both. New peds hospital. Relatively high salaries.
Cons: High salaries, but not enough to make up for living in the city proper. Residents were open about the fact that “there was no way” one could live alone in the city w/o roommates. The EM people seemed down to earth but some of the consulting services have a bit of an attitude problem. EM program not as well–established.
6) BMC -
Pros: Really loved the place. Outstanding faculty, amazing residents who seemed to put a priority on getting the job done for patients but still having fun at work. (I won’t insult everyone reading this by using that silly, stale–cat–vomit–like–cliché–cutesy “work hard, play hard” remark.) Definitely a county facility – but with substantial resources. Loved the PD here.
Cons: Boston is expensive, also I’m not thrilled about New England. A lot of traveling to community sites.
7) Cincinnati -
Pros: You can really feel the tradition and history at the place, which turns some people off but definitely appealed to me. The most well–resourced program of any I interviewed at. Residents seemed super chill, very hardworking but not obnoxious about it. The PD is amazing – my most enjoyable PD interview of the trail. Apparently his shtick is to have various procedures performed on himself while involving interviewees. The day I was there was an ankle block. Apparently he also does auto–transcutaneous–pacing as well. (Without any sedation beforehand.)
Cons: Not 100% sold on Cincinnati, despite its very low COL and how friendly and pleasant people were. Seemed to be not a lot to do here. The intern year seemed to have somewhat of a sink–or–swim mentality which was a bit concerning.
8) Michigan -
Pros: Phenomenal resources and very, very strong research component. Interesting arrangement with community site where time is literally split evenly between UM (4° care) and St. Joe’s (community; 40% of time at each of these, with 20% time at Hurley, the “countyesque” site). Very friendly, down to earth faculty. Low COL. Ann Arbor seems like the quintessential college town.
Cons: Hurley program seems like a great experience….but it’s an hour’s drive. Very cold. Even though I did like Ann Arbor, I can see it getting a bit repetitive over time. Did I mention that it’s cold?
9) Brown -
Pros: I’d have ranked this place much higher, with the location bumping it so far down (vide infra). Really amazing residency program staff. I absolutely loved the PD here. Huge ED (12–bed resus area), very well resourced (two CTs, an MR (!), and a cath lab in the ED itself). Very large catchment area since they are the only game in town. Somewhat lower COL (although not as low as you might think given the locale), very easy to get around with a ten–minute drive being “long”. (Apparently many RI people plan on staying overnight when going to Boston, which is about an hour’s drive north.)
Cons: I’d have a hard time hacking it in Providence for 4 years. More a large town than a small city. Everyone seems to be up in everyone else’s business. Apparently there is a charm to the city; I just wasn’t able to figure out what it was (granted, only over the course of a day). The Rhode Islanders in general are a rather quirky, peculiar folk that seem to take pride in how small and insular the state is, and their flinty (read: occasionally fairly rude) southern New–Englandness. Also, EM doesn’t seem to have the greatest relationship with some of the other services.
10) GW -
Pros: I didn’t expect to like this place as much as I did. Small faculty, very approachable and down–to–earth, also very diverse pt population. Deceptively high acuity and patient volume. Also, COL is high on an absolute scale, but not on a large–US–city scale. Cheaper than NY, Bay area, or Socal.
Cons: They seem to be very political here, which makes sense given the location but was a bit of a turnoff for me. Kind of a hike to get to INOVA for community training.
11) UW -
Pros: Liked the residents a lot here. Seemed to genuinely care about each other. The department chair came to talk to us and seemed rather charmless and unfriendly in the manner of a parking enforcement officer writing parking tickets while someone is begging him/her not to do so. The research component here is very strong. County population at Harborview and 4° care center at UW.
Cons: You can tell that they are still trying to find their niche within the pantheon of hospital departments. EM seems less strong and also until recently, the hospital didn’t seem to take residents’ (of all departments) QOL/COL concerns (given it’s in Seattle) seriously.
12) Northwestern -
Pros: Very strong academic program (most similar to Brown in that respect). Best explanation of why the 4th year is important and NOT just third-year-redux. They seem to walk the walk on training people for leadership here, very interesting talk by the dept chair on this topic. Nice combination of academic/county population.
Cons: PD is phenomenal…aaaaaaand also decamping for Stanford. Although the APDs seem very able to step in without any interruption, there definitely feels like there’s a “hole” in the program. Chicago is cold and hard to justify the COL for what it is. I could easily see Chicago becoming somewhat dystopic (à la Detroit) in the next 10–20 years…which means nothing for residency per se, but definitely if I were to end up staying after residency.
13) Hennepin County -
Pros: Major reason this place is so low is because of the location and weather; only 3–year program I ranked. Really outstanding training, very impressed with the faculty and residents. Went to the STAB conference and really enjoyed it; second only to LAC in terms of quality and the–value–of–time–spent–listening parameter. They did a decent job selling the “pitboss” role, corny title notwithstanding.
Cons: La météo. Hace mucho frío. Das Wetter. (Or whatever language you prefer.) Also, I don’t know anyone in Minnesota or have any connections there.
Other -
Did not rank:
Denver:
Was very excited going to this interview given its reputation. Perhaps my expectations here were too high as I was quite disappointed. Seemed like a lot of the attendings/residents were very into themselves and this went beyond pride in the program to arrogance. Obviously the training is top–notch. It may or may not be perfunctory at any given shop, but they didn’t even pay lip service to the idea that it was possible to get decent training elsewhere. High numbers of shifts, very cold. Denver is overrated IMHO (it’s between this and Portland for the prototypical SWPL city; I also don’t ski or snowboard, so there’s that). Attitude was a real turnoff as mentioned above. You can tell this program has a strong surgical influence. The mentality seemed to be to put people through the ringer, and mirabile dictu! out pops an amazing EM clinician 4 years later. Certainly their alumni prove that there is some validity to this, but they seemed to feel their way was the only way to do accomplish this goal, for which there is no evidence whatsoever, and therefore upon which I was not at all sold.
Harbor–UCLA:
Outstanding program and great reputation. Great clinical training. Didn’t really click with the PD who seemed standoffish and unapproachable. The residents seemed somewhat full of themselves and that it was an imposition to have to talk to us during the interview (which it was, but still). They seem to have a major inferiority complex with the other LA county hospitals that they tried (vigorously, yet unsuccessfully) to conceal.
Stanford:
Really wanted to like this place. Very impressive resources. New hospital on the way. Highest salaries in the country (yes, that’s country, with an “R”). So much time spent selling the “bells and whistles” that I felt they were trying to distract people from the relatively weak clinical experience. That being said, I really liked the PD who is a phenomenal salesperson with a very inspiring personal story. Didn’t care for some of the other faculty who seemed somewhat arrogant, particularly some of the faculty from SCVH.
Hopkins:
Impressive program, but just didn’t click with the residents. PD somewhat cold and unapproachable. The ethos here was definitely “just be glad we saw fit to invite you to our hallowed program” (which is true, I did feel lucky….but didn’t enjoy having my face rubbed in it during the interview day. Certainly some other schools I went to had equally amazing reputations and history but didn’t have the associated attitude that Hopkins did). Also, didn’t buy into the “hidden gem” sales pitch re: Baltimore.
Invited, Declined (mainly due to financial limitations): NYU, Utah, OHSU, Emory, UC Davis, UCLA Olive View, Advocate Christ, BIDMC, Henry Ford, Jacobi, Mt. Sinai, KP San Diego, UC Riverside, MGH/BWH, NY Pres.
Rejected (silent or otherwise): Cook County, Carolinas, Detroit Receiving, Vanderbilt, UC Irvine, Univ Maryland, UNC, Penn, Pitt.
Applicant Summary:
Step 1: high 230s, Step 2: high 260s
EM rotations: H/H
AOA
Medical school region: East Coast
Anything else that made you more competitive:
Nothing, really. Just another dorky–ass med student. Couples matching, so went on a lot more interviews than I would have otherwise. This is obviously therefore my ranking of the programs as a whole rather than my specific rank list.
Main Considerations in Creating this ROL:
(in decreasing order of importance): Strength of clinical training; the vaunted “fit”; location, location, location, 4 > 3. (Descriptions got shorter as I got further down, sorry about that. Was on my third Macallan by the time I was done.)
1) LAC+USC -
Pros: Pt census is “the” county population; challenging at times to work with but most really trust the hospital. The residents are dedicated to the social mission of the hospital, but express it through what they do clinically rather than wearing it on their sleeves (which I found refreshing as this tended to be paraded about at other county programs I interviewed at). Word on the street is that the people here are pretentious; I didn’t catch a whiff of this during my interview (with the exception of the PD, see below). EM seems to rule the roost at this hospital, which has pluses (although also minuses; see below). Minimal scut despite being a county hospital. Very strong sense of tradition and history at the place, which I really like. The fourth years (the “two–stars”) were without a doubt the most badass residents I saw on the trail. Conference is unequaled among all the other places I went to. (Addendum: I assigned absolutely ZERO value to the EM:RAP or Code Black factors as neither would have any effect on me as a resident.)
Cons: 12–hour shifts with no overlap (although word on the street is that this may be changing); LOW, LOW, LOW salaries given the COL (R1 year ≈ $52k) despite the fact that the residents are unionized, so–so community experience at Long Beach Memorial (the residents were open about the fact that they didn’t care for it all that much – although supposedly they have added Verdugo Hills as a community site), other departments in the hospital are relatively weak => possibly weak off service rotations. The PD seemed to be rather unapproachable and acted like she was “put upon” to have to talk to us. Fairly underresourced given the USC imprimatur on the program; I get it that resource management is an important skill to have, but I can see it being frustrating as a provider over time.
2) Highland -
Pros: Great fit with the residents/attendings. County population. High salaries makes COL bearable (without kids, that is), excellent benefits, moving stipend. Very influential resident union that seems to do a good job of addressing QOL/COL issues. Small, phenomenally approachable faculty who love to teach. Really liked the PD.
Cons: High COL, mostly weak off–service rotations. A little bit of frat–like (or even a bit cult–like?) attitude among the residents when they were in groups (although didn’t notice this when talking to them individually). The matching black–and–red hoodies seemed a bit overkill and Sieg Heil(and)–ish.
3) UCSD -
Pros: Was not expecting to like this place that much, given relatively low patient volumes at the main site. However, everyone seemed legitimately happy and not in the plastic–politicianesque–smile–dog–and–pony–show way. (I’m guessing living in San Diego may have something to do with this). Really liked the PD; his personal story is very compelling. They have recently added a community site that sees nearly 90k a year (with 9 residents per class). Clicked well with the faculty and residents here (although being jacked seems to be the rule rather than the exception among the residents. Pro or con? You decide).
Cons: Didn’t get a good sense of how EM interacts with the other specialties. Trauma is in a separate area on a separate floor of the ED, which seemed a bit odd to me. Some concerns with patient volume (the volume–to–resident ratio being the sine qua non of clinical training) and will I be seeing enough variety in patients.
4) UCSF–Fresno -
Pros: Long–established EM program with a very sick countyesque population. The Central Valley may as well be in another state cf. the Bay area and Socal. Very strong clinical training. In some ways, seemed more “countyesque” than many of the other county programs (huge ED, but still packed and a lot of hallway beds). Big WM involvement with Yosemite nearby if that’s your thing (I was agnostic on this point. I think I am among the 0.0000001% of EM–aspiring med students who DON’T rock climb, or eat a paleo diet, or what have you).
Cons: Fresno. Not as bad a location as I was thinking it would be – much more realistic COL than the Bay area – but still, NYC, SF, or LA it ain’t. A lot of the salesmanship was about how “few” hours it would take to get to other, more desirable places.
5) UCSF–SFGH -
Pros: Very impressed with the program overall, particularly given how young the program is. Two major sites, ZSFG (brand new hospital, county population) and UCSF (world–class 4° care center with correspondingly strong off–service rotations and consultants, perhaps this belongs in the “con” area as well). Same residents rotate at both. New peds hospital. Relatively high salaries.
Cons: High salaries, but not enough to make up for living in the city proper. Residents were open about the fact that “there was no way” one could live alone in the city w/o roommates. The EM people seemed down to earth but some of the consulting services have a bit of an attitude problem. EM program not as well–established.
6) BMC -
Pros: Really loved the place. Outstanding faculty, amazing residents who seemed to put a priority on getting the job done for patients but still having fun at work. (I won’t insult everyone reading this by using that silly, stale–cat–vomit–like–cliché–cutesy “work hard, play hard” remark.) Definitely a county facility – but with substantial resources. Loved the PD here.
Cons: Boston is expensive, also I’m not thrilled about New England. A lot of traveling to community sites.
7) Cincinnati -
Pros: You can really feel the tradition and history at the place, which turns some people off but definitely appealed to me. The most well–resourced program of any I interviewed at. Residents seemed super chill, very hardworking but not obnoxious about it. The PD is amazing – my most enjoyable PD interview of the trail. Apparently his shtick is to have various procedures performed on himself while involving interviewees. The day I was there was an ankle block. Apparently he also does auto–transcutaneous–pacing as well. (Without any sedation beforehand.)
Cons: Not 100% sold on Cincinnati, despite its very low COL and how friendly and pleasant people were. Seemed to be not a lot to do here. The intern year seemed to have somewhat of a sink–or–swim mentality which was a bit concerning.
8) Michigan -
Pros: Phenomenal resources and very, very strong research component. Interesting arrangement with community site where time is literally split evenly between UM (4° care) and St. Joe’s (community; 40% of time at each of these, with 20% time at Hurley, the “countyesque” site). Very friendly, down to earth faculty. Low COL. Ann Arbor seems like the quintessential college town.
Cons: Hurley program seems like a great experience….but it’s an hour’s drive. Very cold. Even though I did like Ann Arbor, I can see it getting a bit repetitive over time. Did I mention that it’s cold?
9) Brown -
Pros: I’d have ranked this place much higher, with the location bumping it so far down (vide infra). Really amazing residency program staff. I absolutely loved the PD here. Huge ED (12–bed resus area), very well resourced (two CTs, an MR (!), and a cath lab in the ED itself). Very large catchment area since they are the only game in town. Somewhat lower COL (although not as low as you might think given the locale), very easy to get around with a ten–minute drive being “long”. (Apparently many RI people plan on staying overnight when going to Boston, which is about an hour’s drive north.)
Cons: I’d have a hard time hacking it in Providence for 4 years. More a large town than a small city. Everyone seems to be up in everyone else’s business. Apparently there is a charm to the city; I just wasn’t able to figure out what it was (granted, only over the course of a day). The Rhode Islanders in general are a rather quirky, peculiar folk that seem to take pride in how small and insular the state is, and their flinty (read: occasionally fairly rude) southern New–Englandness. Also, EM doesn’t seem to have the greatest relationship with some of the other services.
10) GW -
Pros: I didn’t expect to like this place as much as I did. Small faculty, very approachable and down–to–earth, also very diverse pt population. Deceptively high acuity and patient volume. Also, COL is high on an absolute scale, but not on a large–US–city scale. Cheaper than NY, Bay area, or Socal.
Cons: They seem to be very political here, which makes sense given the location but was a bit of a turnoff for me. Kind of a hike to get to INOVA for community training.
11) UW -
Pros: Liked the residents a lot here. Seemed to genuinely care about each other. The department chair came to talk to us and seemed rather charmless and unfriendly in the manner of a parking enforcement officer writing parking tickets while someone is begging him/her not to do so. The research component here is very strong. County population at Harborview and 4° care center at UW.
Cons: You can tell that they are still trying to find their niche within the pantheon of hospital departments. EM seems less strong and also until recently, the hospital didn’t seem to take residents’ (of all departments) QOL/COL concerns (given it’s in Seattle) seriously.
12) Northwestern -
Pros: Very strong academic program (most similar to Brown in that respect). Best explanation of why the 4th year is important and NOT just third-year-redux. They seem to walk the walk on training people for leadership here, very interesting talk by the dept chair on this topic. Nice combination of academic/county population.
Cons: PD is phenomenal…aaaaaaand also decamping for Stanford. Although the APDs seem very able to step in without any interruption, there definitely feels like there’s a “hole” in the program. Chicago is cold and hard to justify the COL for what it is. I could easily see Chicago becoming somewhat dystopic (à la Detroit) in the next 10–20 years…which means nothing for residency per se, but definitely if I were to end up staying after residency.
13) Hennepin County -
Pros: Major reason this place is so low is because of the location and weather; only 3–year program I ranked. Really outstanding training, very impressed with the faculty and residents. Went to the STAB conference and really enjoyed it; second only to LAC in terms of quality and the–value–of–time–spent–listening parameter. They did a decent job selling the “pitboss” role, corny title notwithstanding.
Cons: La météo. Hace mucho frío. Das Wetter. (Or whatever language you prefer.) Also, I don’t know anyone in Minnesota or have any connections there.
Other -
Did not rank:
Denver:
Was very excited going to this interview given its reputation. Perhaps my expectations here were too high as I was quite disappointed. Seemed like a lot of the attendings/residents were very into themselves and this went beyond pride in the program to arrogance. Obviously the training is top–notch. It may or may not be perfunctory at any given shop, but they didn’t even pay lip service to the idea that it was possible to get decent training elsewhere. High numbers of shifts, very cold. Denver is overrated IMHO (it’s between this and Portland for the prototypical SWPL city; I also don’t ski or snowboard, so there’s that). Attitude was a real turnoff as mentioned above. You can tell this program has a strong surgical influence. The mentality seemed to be to put people through the ringer, and mirabile dictu! out pops an amazing EM clinician 4 years later. Certainly their alumni prove that there is some validity to this, but they seemed to feel their way was the only way to do accomplish this goal, for which there is no evidence whatsoever, and therefore upon which I was not at all sold.
Harbor–UCLA:
Outstanding program and great reputation. Great clinical training. Didn’t really click with the PD who seemed standoffish and unapproachable. The residents seemed somewhat full of themselves and that it was an imposition to have to talk to us during the interview (which it was, but still). They seem to have a major inferiority complex with the other LA county hospitals that they tried (vigorously, yet unsuccessfully) to conceal.
Stanford:
Really wanted to like this place. Very impressive resources. New hospital on the way. Highest salaries in the country (yes, that’s country, with an “R”). So much time spent selling the “bells and whistles” that I felt they were trying to distract people from the relatively weak clinical experience. That being said, I really liked the PD who is a phenomenal salesperson with a very inspiring personal story. Didn’t care for some of the other faculty who seemed somewhat arrogant, particularly some of the faculty from SCVH.
Hopkins:
Impressive program, but just didn’t click with the residents. PD somewhat cold and unapproachable. The ethos here was definitely “just be glad we saw fit to invite you to our hallowed program” (which is true, I did feel lucky….but didn’t enjoy having my face rubbed in it during the interview day. Certainly some other schools I went to had equally amazing reputations and history but didn’t have the associated attitude that Hopkins did). Also, didn’t buy into the “hidden gem” sales pitch re: Baltimore.
Invited, Declined (mainly due to financial limitations): NYU, Utah, OHSU, Emory, UC Davis, UCLA Olive View, Advocate Christ, BIDMC, Henry Ford, Jacobi, Mt. Sinai, KP San Diego, UC Riverside, MGH/BWH, NY Pres.
Rejected (silent or otherwise): Cook County, Carolinas, Detroit Receiving, Vanderbilt, UC Irvine, Univ Maryland, UNC, Penn, Pitt.
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You must be a superstar, congrats!
It takes someone like you who interviews across many well known programs to see who's got real stuff and who's just bluffin. Very insightful information. Thanks for sharing!
Do not expect a love letter or a second look to change your spot on the rank list. The second look is for you and you alone.
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I'd say this is true 90% of the time, however, we have had students in the past come back and do a second look and their personality really gelled with the people they worked with and they moved a bit up the list. I'm not saying 30 spots or anything drastic, but occasionally it does help people a bit. But its certainly not always the case.
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However, of course, that is tempered by the more numerous folks that burned their chances when they did the second look, when they should have just left well enough alone.
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Submitted anonymously, via Google Form.
Applicant Summary:
Step 1: 250s-260s, Step 2: 250s-260s
EM rotations: H/H
Medical school region: Midwest
Anything else that made you more competitive:
Supposedly good SLOEs
Main Considerations in Creating this ROL:
Quality of training and "fit," geography/quality of life for family, perceived "hands-on-ness" of training philosophy, small consideration for reputation strictly for possible fellowship opportunities
Sorry in advance for the wall of text. This is sort of a collection of my notes about each program that I wrote down after interviewing there and contains some of the stuff that I thought was helpful in applying to/ranking the programs. Overall, though I want to repeat the sentiment that some previous posters have echoed - emergency medicine is the best specialty, and it's really hard to find a truly "bad" program. I would be really happy to end up anywhere on this list and really anywhere in my top 4 would be great geographically. I do have a bit of a "program crush" on my first one, but all of these programs are awesome.
1) Advocate Christ:
This place is top-notch. Super-busy community program with a county feel and an academic flair. Would absolutely love to train here. Really cool people, incredibly intelligent and very strong senior residents. Definitely one of the best programs in Chicago, and maybe even the best, depending on who you ask. All rotations at one site – Advocate Christ in Oak Lawn (>100k/year, expanding current ED into what is now the old separate peds department, plans for newer ED within 6 years or so since the current one was built for a volume of ~60k/year or so). Huge catchment area compared the rest of the Chicagoland programs. Work about 18 10s every 28 days with around 1.5 hrs overlap. 4.5 hours of didactics weekly with 30 minutes of asynchronous learning. Curriculum notable for lack of graduated responsibility (throw you into the fire with as much support as you need), orientation month, 4 months of critical care (MICU x2, SICU, PICU, +some more time covering the trauma ICU while on trauma months; also recently changed out some time on the neuro floor for neuro ICU time based on resident feedback); 3 elective months (a ton of elective time for a 3 year program). A couple of ED CC docs work in the ICU there and are supposedly a ton of fun to work with and would be a great resource for me since I’m interested in a CC fellowship. Use Cerner with dragon. Epic is probably slightly better but you can actually do a lot from the trackboard with Cerner, which is pretty helpful. 12 residents/year; salary $53/56/58 + decent allowance for meals each year; shared medical insurance. Can start internal moonlighting in department (work overnight shifts) pretty early for extra cash plus obviously external moonlighting later if desired. Everyone’s really a big family here; all residents on first name basis with attendings. Awesome culture. These residents are probably some of the happiest I saw on the trail; tons showed up for the dinner and even for lunch on the day of the interview and they all get along really well. Dr. Lovell is taking over for Dr. Girzadas as PD; he’ll stay on (previous PD Dr. Harwood is also still there) but she’s awesome and is going to do an excellent job. Most everyone commutes a decent bit to get to Oak Lawn, many from downtown.
2) Denver Health:
Incredible program. Has the reputation it does for a reason. Fourth years are absolute bosses. Denver is an awesome place to live, too, and would be close to family for us, which is a huge plus. Has had a lingering reputation for being “malignant,” which I tried to delve into as much as I could during my brief visit. I think in distant years past it may have been true, but at least now that absolutely was not the impression I got. The program’s leadership are all fairly new, young, and all about resident wellness. The residents certainly work hard, but their actual schedule isn’t actually terrible – comes out to about ~42 hours/week in the ED at DH/University (at least on paper), maybe a bit less when at community sites (more community shifts each year as you progress from 2nd - 4th year). They work 8s on a rotating schedule where they work 6 out of 8 days: 7a-3p x2, off, 3p-11p x2, 11p-7a x2, off, repeat. An intern I spoke to said they tended to stay ½ - 1 hr. post-shift to clean up charting and whatnot. Really not too bad. Main sites are Denver Health (county site, about 78k/year with another 32k funneled off to an urgent care that’s only open during the day, 11% peds patients in a separate ED within the hospital, ED-run obs unit, Level 1 trauma center), University Hospital (Level 2 trauma center, burn ICU), St. Joseph (community site, 56k/year), and Children’s Hospital (45k/year). Curriculum is pretty solid overall, with most notable highlights/deviations including a 4 day orientation, a floor month and neurosurgery rotation during first year, 5 critical care months (MICU x2, SICU, BICU, PICU), 3.5 elective blocks. A couple of different things were OB in fourth year and seasonal peds blocks instead of longitudinal shifts during EM months. Fourth years run the department at DH. 17 residents/class, salary is 53/55/57/60 (64 if chief), moonlighting in fourth year, shared medical insurance (but not bad in terms of cost). Using Epic now. A number of residents with significant others/young children. Fourth year isn’t ideal but you can’t argue with the product this program creates and I would gladly train an “extra” year to be able to train here at all. Grads of this program truly live up to the “can go anywhere, do anything” mantra that you hear so often on the trail. Mix of fit + proximity to family puts this near the top.
3) JPS (John Peter Smith, Fort Worth):
Busy county program. Newer (graduated 2-3 classes at this point) but was unexpectedly blown away by the program; definitely will be a program to watch in the near future. Facilities include JPS (Level 1 trauma center, 113k, 54 beds, urgent care funnels off another 70k low-acuity patients), Children’s Hopsital in Dallas (Level 1 peds, 76k, longitudinal shifts here in 2nd/3rd year after 1 month rotation in intern year). Work 22/20/18 shifts per month (not 28 days), 10 hours with 2 hours built-in clean up time intern year and 1 hour 2nd/3rd years, shifts at 6a/2p/10p. Weekly didactics (4 hrs + 1 asynchronous hour) run by new hire who did education fellowship, night off before, monthly EM-RAP meetings instead of traditional journal club. Curriculum with 4 months CC time (MICU x2, STICU, L&D/NICU), skills month intern year, one month orientation, one elective month, ½ block of cards and ortho first year; lots of procedures. Good relationship with trauma, technically ED runs trauma from 7a-7p and does airway overnight but that bends here and there and everything seems collegial. 12 residents/year, salary 50/52/55 with great benefits (relocation allowance, full med/dental for you+dependents, meals/very close parking - lots of oil money). Emphasis on doing definitive care in the ED as much as possible rather than just consulting/admitting for things they should be able to handle (the example that was given was if someone comes in with a massive PE, they will be doing the echo and making the decision to push tPA rather than waiting for someone to get there and say it’s ok). Recent grad to crit care fellowship at Pittsburgh (an awesome program), made some curriculum changes to help him get his prerequisites out of the way. Working on developing dedicated ED CC area with newly acquired bed space. Staffed by private EM group. Low COL, lots of stuff for family in Ft. Worth, nothing super special but less congested than Dallas. Emphasis on a few reasonable metrics (not in a judgmental way, but so that the residents know where they stand and have friendly competitions among themselves). New PD (Dr. Leuck) from Carolinas taking over for Dr. Robinson, but he is staying on. Overall huge surprise, really liked this place, seems like great training experience in a livable city with some really friendly people.
4) Scott and White (Temple, TX):
This is a program with a different feel than the ones above, but I really liked it. Not a super crazy county place, but very busy and seems like an absolutely solid place to train. Excellent reputation within Texas and to some extent outside as well; grads seemed like they were pretty heavily recruited. Not really county but very busy nonetheless. Main facilities were Scott and White (level 1 trauma center, huge catchment area – essentially all of central Texas, tertiary care referral center, 47 ED beds w/ 6 resuscitation bays, 110k/year), McLane Children’s (14 beds, 35k/year), and VA site (do a floor month here since they fund some of the residency spots). Work 19 12 hour shifts as intern with 2 hours of clean up built-in, 17 9 hours as second year with 1 hour of overlap, and 16 9 hours as a third year also with 1 hour of overlap. Curriculum fairly standard; notable for floor month in intern year, 4 months of critical care (MICU, CVICU, SICU, PICU); longitudinal peds shifts during EM months, orientation week, sim center; 2 week block of electives in second and third year. Use Epic. For trauma, first years do procedures, second years do airway, 3rd years run them. 14 residents per year, some from Texas but most not in recent classes. Salary 52/53/~55. Really awesome people. Tons of families and young children. Free food/parking. Sweet moonlighting opportunities started halfway through second year. Temple itself and the surrounding areas are (for me, with a family) awesome places to live and the type of place I could see us potentially staying. Incredibly low cost of living. Maybe not the best place if someone is single and looking to mingle, but close (<1 hr) to Austin. The PD, Dr. Drigalla, is probably the nicest person I met on the interview trail. Incredibly down to earth and it would be a pleasure to train there.
5) Vegas (University of Nevada Las Vegas):
County program with academic flare. Main facilities are University Medical Center (77k/year adult, 33k/year peds, adult level 1 trauma center and peds level 2 trauma, 56 bed main ED; 11 bed separate trauma center within the hospital with 20 beds, 13k/year) and VA (community site, 12 beds, 36k). Work 12 hour shifts, 18/17/16 with one hour of sign out built in; 6 to 6. Weekly conference. Curriculum – no graduated responsibility, tons of procedures (most residents exceed requirements by end of intern year), ENT and neurosurgery blocks first year, 5 CC months (MICU, CICUx2, TICU, PICU) + two months of trauma. Longitudinal peds and trauma shifts on EM months. 2 elective months. Two week intern orientation with fire day, ballistics, skills labs, etc. EM residents carry airway pager for hospital. 10 residents a year (8 +2 airforce), good mix of single/SOs/+kids. Most live in Summerlin, Green Valley, or NW of downtown. No state income tax, salary ~50/52/54, free food/parking, medical covered by program for you and dependents. EM is well-respected within the hospital and has lots of pull; departmental mindset of taking care of ED stuff in the ED rather than just sending it upstairs; third years were getting jobs wherever they wanted. Awesome event medicine (burning man, EDC, etc.). EMR is McKesson now but supposedly transitioning to Epic by the time we’d start. Direct admit privileges. Combination of solid training + proximity to family puts this one near the top; was my first choice until I interviewed at Denver and would be very happy to end up here. Not super crazy about living in Vegas (although it would be fine) or the 12 hr shifts.
6) Vanderbilt:
Incredible program in a really cool city. People are great. Would be higher up but proximity to family is a huge factor for us. Main site is the University Medical Center (125k adults, 60k in children’s ED; really cool mix of community/county/university-type patients all at one site; adult trauma center there with 4k level 1 traumas/year). Work about 19 10s intern year and 18 9s 2nd/3rd year with one hour of overlap every 28 days. Use Epic with dragon. Incredibly strong teaching, especially with Slovis and Wrenn. Curriculum notable for orientation, quite a few critical care months (MICU x2, CCU/MICU at VA, Trauma ICU, PICU, plus some other trauma months where you are in the trauma ICU part of the time), longitudinal peds shifts on EM months. 13 residents/year, salary 53/54/57 with tons of moonlighting opportunities in the community or on flight shifts. Meal allowance, free parking. No state income tax; stay on for 4th year if chief. Wrenn, the current PD, is stepping down from the official position in July but will be staying with the program and functionally things won’t change much. Slovis, the Chair, will likely stay with the program through at least what would be our senior year. In Slovis’ words, “We are no longer the program.” Also, “We create experts” – which I think is certainly true. Great place to train. Nashville is growing and getting busier, but seems like a good place to live.
7) UT Southwestern (UTSW, Dallas, TX):
This is overall an awesome program and an absolutely solid place to train. In many people’s minds, this is probably “the” place to be if you are in Texas. I really, really wanted to like this place a ton, and I certainly came away very impressed and would be very happy to be here. That being said – they are sold as a “county” program, and it’s true or at least has been in the past, but I really felt like it was more of a busy university program. Which is fine, if that’s what you are looking for. My primary concern with that was that I got the impression that the residents were so busy, but had so many resources at their disposal, that they tended to consult other services more than they’d like to or because they just had too since the services are there and have residents too. That may or not actually be the case, but that’s just what I walked away with. The residents’ justification was that they had a ton of community months in their third year where they had the opportunity to do some of things they didn’t get quite as much of at Parkland, but I guess I’d rather have that experience throughout residency. Parkland is the main site (new, 150k/patients each year with another 50k triaged out to a lower-acuity area), as well as Children’s Medical Center (level 1 peds trauma center, 90k/year), some university sites, and five different community sites in their third year. Work around 18-20 11s intern year, 20-22 10s 2nd year, 18-20 10s 3rd year all with one hour of overlap. Everyone that I talked to felt that intern year was pretty easy, or at least doable, but second year was pretty intense. Curriculum notable for 4 hrs weekly didactics with 1 hour of asynchronous learning; special EM intern monthly lecture series, longitudinal peds shifts on EM months, 4.5 months of critical care (CCU, ½ block in burn ICU, neuro ICU, peds/neo ICU, SICU, and a full month of MICU), 2 elective months, a couple weeks of plastics, and trauma shifts on EM months where they do the airway. Huge class of 22 residents/year – was a little worried that I would just be another face but they didn’t seem to feel that way. Salary 57/59/62 with shared medical (~500 monthly). They are really excited about spending a couple elective months in New Zealand during their third year. Own department since 2014. Use Epic. PD (Velez) is super nice. This is probably the one program that I could see moving a little higher on our list before it’s time to actually rank things, but while I really liked the idea of UTSW I came away slightly underwhelmed by the reality. We’ll see.
8) MetroHealth/Cleveland Clinic:
Very busy and hands-on place; produce solid residents. Very proud about how hard they work. A little bit of an odd vibe from some of the residents but everyone was nice. Main site is Metro (level 1 trauma center/burn center, 105k/year with about 17% of those being peds patients) and also Cleveland Clinic (all the really weird, rare patients are here; 60k/year, spend about 1/3 of shifts here). Work 21/20/18 10 hours shifts/28 days. Weekly resident-driven didactics. 6 months of critical care time. Flight month 3rd year if desired. 1 elective month. Cleveland is probably fine; didn’t seem as bad as everyone makes it out to be (although the recommendation was to stay out of the east (I think?) side).
9) Austin:
Fairly new program, slightly newer than JPS. County/community feel. Primarily at UMC Brackridge (75k year, moving to new facility in May 2017), Dell Children’s (75k /year), Seton (35k, community site), one month in third year at rural community site (Seton Highlands). Work 18 9 hour shifts with one hour built in for clean-up, five nights in a row/month, off night before didactics, 2 weekends off a month. Pretty standard curriculum. 8 residents per year; salary 59/61/64 (some of the best paid I saw on the trail), shared medical insurance, free parking/food. EM and surgery are the strongest departments in the hospital and have a great relationship. Lots of families. Living in Austin is a draw for many people. Not their own department, but not really a big deal since they have separate funding from surgery, which is sort of the point of becoming a separate department anyway. Seems like a solid place to train overall. I wasn’t personally “smitten” or whatever but would be happy to end up here.
10) Cincinnati:
University-based program. First EM residency and definitely a name-brand place. Not crazy about the four years or the location (Cinci itself isn’t terrible but isn’t our ideal geography either). Main site is the University (95k/year), two community sites with longitudinal shifts there after first year, Children’s hospital (67k). Work 22 11s intern year, 20 8s 2nd year, 18 8s 3rd year, 16 12s fourth year. Standard curriculum notable for 6.5 months of elective time (a ton) and a “supervisory” role in fourth year where they oversee an 18 bed unit with interns, off-service residents, and students. 14 residents/year, salary 54/55/56/58 and shared medical. Emphasis on producing leaders in the field. Sweet flight program; can moonlight on helicopter starting second year and elsewhere starting second half of third year, if I remember correctly. The current PD, Brian Stettler, transcutaneously paced himself during the introduction to the day. He’ll actually be stepping down this year but it’ll be a smooth transition and he’s staying on in a faculty development position.
11) University of Michigan:
University-based program. Great place with great people; Ann Arbor is a beautiful place to live – sort of your ideal small Midwestern town and a beautiful place to boot. Main site at the University (85k/year, separate children’s ED), St. Joseph (community site, 85k/year), Hurley (county site in Flint, about 45 minute drive). Work 20-22 8-9 hr shifts in years 1-3, 18 shifts in 4th year with shift reduction down to 16 if participating in a professional development track (can gain expertise in EMS, US, critical care, administration, etc). Otherwise fairly standard curriculum with orientation month and 4 months of elective time. 16 residents/year; salary 54/57/60/63 with bonus at the end of the year (there is a resident union). Has a pretty unique ED-ICU (the EM Critical Care Center, or EC3) that is awesome, although it sounds like they are still working out some kinks in terms of resident workflow (it sounds like initially sick patients were just getting transferred there and/or any procedures on patients that went to the EC3 were done there and not by the resident who saw them initially, but that’s changed and now they do all of the educational stuff before transfer and if there are any procedures to be done in the EC3 they try and grab the admitting resident if they are still in the ED). Overall a great program; not totally sold on the value of the fourth year here (although the professional development tracks are pretty cool) and Ann Arbor, while beautiful, is less than ideal geographically for us. Really doesn't deserve to be ranked last, but probably just one of the least ideal programs geographically for us, although Ann Arbor really is nice.
Other:
And the rest in no particular order.....
Just kidding. That's it.
A couple more pieces of info for future applicants: I applied to 34 places, which in retrospect was a little more than I probably needed to (although it's usually better to be safe than sorry when it comes to this stuff). I received 22 invites, withdrew from about 9 places before hearing anything, and never heard from 2 places (looking at you, Maricopa and Indiana). Rejected from New Mexico (I was actually looking forward to interviewing there, so that was a bummer). Ended up scheduling 14 interviews but canceling a few after starting interview season and quickly getting tired of the game. Overall it was really fun to see the different programs and meet all of the faculty, residents and applicants I did but I'm glad to be done with this whole thing and looking forward to match day. Good luck everyone!
Applicant Summary:
Step 1: 250s-260s, Step 2: 250s-260s
EM rotations: H/H
Medical school region: Midwest
Anything else that made you more competitive:
Supposedly good SLOEs
Main Considerations in Creating this ROL:
Quality of training and "fit," geography/quality of life for family, perceived "hands-on-ness" of training philosophy, small consideration for reputation strictly for possible fellowship opportunities
Sorry in advance for the wall of text. This is sort of a collection of my notes about each program that I wrote down after interviewing there and contains some of the stuff that I thought was helpful in applying to/ranking the programs. Overall, though I want to repeat the sentiment that some previous posters have echoed - emergency medicine is the best specialty, and it's really hard to find a truly "bad" program. I would be really happy to end up anywhere on this list and really anywhere in my top 4 would be great geographically. I do have a bit of a "program crush" on my first one, but all of these programs are awesome.
1) Advocate Christ:
This place is top-notch. Super-busy community program with a county feel and an academic flair. Would absolutely love to train here. Really cool people, incredibly intelligent and very strong senior residents. Definitely one of the best programs in Chicago, and maybe even the best, depending on who you ask. All rotations at one site – Advocate Christ in Oak Lawn (>100k/year, expanding current ED into what is now the old separate peds department, plans for newer ED within 6 years or so since the current one was built for a volume of ~60k/year or so). Huge catchment area compared the rest of the Chicagoland programs. Work about 18 10s every 28 days with around 1.5 hrs overlap. 4.5 hours of didactics weekly with 30 minutes of asynchronous learning. Curriculum notable for lack of graduated responsibility (throw you into the fire with as much support as you need), orientation month, 4 months of critical care (MICU x2, SICU, PICU, +some more time covering the trauma ICU while on trauma months; also recently changed out some time on the neuro floor for neuro ICU time based on resident feedback); 3 elective months (a ton of elective time for a 3 year program). A couple of ED CC docs work in the ICU there and are supposedly a ton of fun to work with and would be a great resource for me since I’m interested in a CC fellowship. Use Cerner with dragon. Epic is probably slightly better but you can actually do a lot from the trackboard with Cerner, which is pretty helpful. 12 residents/year; salary $53/56/58 + decent allowance for meals each year; shared medical insurance. Can start internal moonlighting in department (work overnight shifts) pretty early for extra cash plus obviously external moonlighting later if desired. Everyone’s really a big family here; all residents on first name basis with attendings. Awesome culture. These residents are probably some of the happiest I saw on the trail; tons showed up for the dinner and even for lunch on the day of the interview and they all get along really well. Dr. Lovell is taking over for Dr. Girzadas as PD; he’ll stay on (previous PD Dr. Harwood is also still there) but she’s awesome and is going to do an excellent job. Most everyone commutes a decent bit to get to Oak Lawn, many from downtown.
2) Denver Health:
Incredible program. Has the reputation it does for a reason. Fourth years are absolute bosses. Denver is an awesome place to live, too, and would be close to family for us, which is a huge plus. Has had a lingering reputation for being “malignant,” which I tried to delve into as much as I could during my brief visit. I think in distant years past it may have been true, but at least now that absolutely was not the impression I got. The program’s leadership are all fairly new, young, and all about resident wellness. The residents certainly work hard, but their actual schedule isn’t actually terrible – comes out to about ~42 hours/week in the ED at DH/University (at least on paper), maybe a bit less when at community sites (more community shifts each year as you progress from 2nd - 4th year). They work 8s on a rotating schedule where they work 6 out of 8 days: 7a-3p x2, off, 3p-11p x2, 11p-7a x2, off, repeat. An intern I spoke to said they tended to stay ½ - 1 hr. post-shift to clean up charting and whatnot. Really not too bad. Main sites are Denver Health (county site, about 78k/year with another 32k funneled off to an urgent care that’s only open during the day, 11% peds patients in a separate ED within the hospital, ED-run obs unit, Level 1 trauma center), University Hospital (Level 2 trauma center, burn ICU), St. Joseph (community site, 56k/year), and Children’s Hospital (45k/year). Curriculum is pretty solid overall, with most notable highlights/deviations including a 4 day orientation, a floor month and neurosurgery rotation during first year, 5 critical care months (MICU x2, SICU, BICU, PICU), 3.5 elective blocks. A couple of different things were OB in fourth year and seasonal peds blocks instead of longitudinal shifts during EM months. Fourth years run the department at DH. 17 residents/class, salary is 53/55/57/60 (64 if chief), moonlighting in fourth year, shared medical insurance (but not bad in terms of cost). Using Epic now. A number of residents with significant others/young children. Fourth year isn’t ideal but you can’t argue with the product this program creates and I would gladly train an “extra” year to be able to train here at all. Grads of this program truly live up to the “can go anywhere, do anything” mantra that you hear so often on the trail. Mix of fit + proximity to family puts this near the top.
3) JPS (John Peter Smith, Fort Worth):
Busy county program. Newer (graduated 2-3 classes at this point) but was unexpectedly blown away by the program; definitely will be a program to watch in the near future. Facilities include JPS (Level 1 trauma center, 113k, 54 beds, urgent care funnels off another 70k low-acuity patients), Children’s Hopsital in Dallas (Level 1 peds, 76k, longitudinal shifts here in 2nd/3rd year after 1 month rotation in intern year). Work 22/20/18 shifts per month (not 28 days), 10 hours with 2 hours built-in clean up time intern year and 1 hour 2nd/3rd years, shifts at 6a/2p/10p. Weekly didactics (4 hrs + 1 asynchronous hour) run by new hire who did education fellowship, night off before, monthly EM-RAP meetings instead of traditional journal club. Curriculum with 4 months CC time (MICU x2, STICU, L&D/NICU), skills month intern year, one month orientation, one elective month, ½ block of cards and ortho first year; lots of procedures. Good relationship with trauma, technically ED runs trauma from 7a-7p and does airway overnight but that bends here and there and everything seems collegial. 12 residents/year, salary 50/52/55 with great benefits (relocation allowance, full med/dental for you+dependents, meals/very close parking - lots of oil money). Emphasis on doing definitive care in the ED as much as possible rather than just consulting/admitting for things they should be able to handle (the example that was given was if someone comes in with a massive PE, they will be doing the echo and making the decision to push tPA rather than waiting for someone to get there and say it’s ok). Recent grad to crit care fellowship at Pittsburgh (an awesome program), made some curriculum changes to help him get his prerequisites out of the way. Working on developing dedicated ED CC area with newly acquired bed space. Staffed by private EM group. Low COL, lots of stuff for family in Ft. Worth, nothing super special but less congested than Dallas. Emphasis on a few reasonable metrics (not in a judgmental way, but so that the residents know where they stand and have friendly competitions among themselves). New PD (Dr. Leuck) from Carolinas taking over for Dr. Robinson, but he is staying on. Overall huge surprise, really liked this place, seems like great training experience in a livable city with some really friendly people.
4) Scott and White (Temple, TX):
This is a program with a different feel than the ones above, but I really liked it. Not a super crazy county place, but very busy and seems like an absolutely solid place to train. Excellent reputation within Texas and to some extent outside as well; grads seemed like they were pretty heavily recruited. Not really county but very busy nonetheless. Main facilities were Scott and White (level 1 trauma center, huge catchment area – essentially all of central Texas, tertiary care referral center, 47 ED beds w/ 6 resuscitation bays, 110k/year), McLane Children’s (14 beds, 35k/year), and VA site (do a floor month here since they fund some of the residency spots). Work 19 12 hour shifts as intern with 2 hours of clean up built-in, 17 9 hours as second year with 1 hour of overlap, and 16 9 hours as a third year also with 1 hour of overlap. Curriculum fairly standard; notable for floor month in intern year, 4 months of critical care (MICU, CVICU, SICU, PICU); longitudinal peds shifts during EM months, orientation week, sim center; 2 week block of electives in second and third year. Use Epic. For trauma, first years do procedures, second years do airway, 3rd years run them. 14 residents per year, some from Texas but most not in recent classes. Salary 52/53/~55. Really awesome people. Tons of families and young children. Free food/parking. Sweet moonlighting opportunities started halfway through second year. Temple itself and the surrounding areas are (for me, with a family) awesome places to live and the type of place I could see us potentially staying. Incredibly low cost of living. Maybe not the best place if someone is single and looking to mingle, but close (<1 hr) to Austin. The PD, Dr. Drigalla, is probably the nicest person I met on the interview trail. Incredibly down to earth and it would be a pleasure to train there.
5) Vegas (University of Nevada Las Vegas):
County program with academic flare. Main facilities are University Medical Center (77k/year adult, 33k/year peds, adult level 1 trauma center and peds level 2 trauma, 56 bed main ED; 11 bed separate trauma center within the hospital with 20 beds, 13k/year) and VA (community site, 12 beds, 36k). Work 12 hour shifts, 18/17/16 with one hour of sign out built in; 6 to 6. Weekly conference. Curriculum – no graduated responsibility, tons of procedures (most residents exceed requirements by end of intern year), ENT and neurosurgery blocks first year, 5 CC months (MICU, CICUx2, TICU, PICU) + two months of trauma. Longitudinal peds and trauma shifts on EM months. 2 elective months. Two week intern orientation with fire day, ballistics, skills labs, etc. EM residents carry airway pager for hospital. 10 residents a year (8 +2 airforce), good mix of single/SOs/+kids. Most live in Summerlin, Green Valley, or NW of downtown. No state income tax, salary ~50/52/54, free food/parking, medical covered by program for you and dependents. EM is well-respected within the hospital and has lots of pull; departmental mindset of taking care of ED stuff in the ED rather than just sending it upstairs; third years were getting jobs wherever they wanted. Awesome event medicine (burning man, EDC, etc.). EMR is McKesson now but supposedly transitioning to Epic by the time we’d start. Direct admit privileges. Combination of solid training + proximity to family puts this one near the top; was my first choice until I interviewed at Denver and would be very happy to end up here. Not super crazy about living in Vegas (although it would be fine) or the 12 hr shifts.
6) Vanderbilt:
Incredible program in a really cool city. People are great. Would be higher up but proximity to family is a huge factor for us. Main site is the University Medical Center (125k adults, 60k in children’s ED; really cool mix of community/county/university-type patients all at one site; adult trauma center there with 4k level 1 traumas/year). Work about 19 10s intern year and 18 9s 2nd/3rd year with one hour of overlap every 28 days. Use Epic with dragon. Incredibly strong teaching, especially with Slovis and Wrenn. Curriculum notable for orientation, quite a few critical care months (MICU x2, CCU/MICU at VA, Trauma ICU, PICU, plus some other trauma months where you are in the trauma ICU part of the time), longitudinal peds shifts on EM months. 13 residents/year, salary 53/54/57 with tons of moonlighting opportunities in the community or on flight shifts. Meal allowance, free parking. No state income tax; stay on for 4th year if chief. Wrenn, the current PD, is stepping down from the official position in July but will be staying with the program and functionally things won’t change much. Slovis, the Chair, will likely stay with the program through at least what would be our senior year. In Slovis’ words, “We are no longer the program.” Also, “We create experts” – which I think is certainly true. Great place to train. Nashville is growing and getting busier, but seems like a good place to live.
7) UT Southwestern (UTSW, Dallas, TX):
This is overall an awesome program and an absolutely solid place to train. In many people’s minds, this is probably “the” place to be if you are in Texas. I really, really wanted to like this place a ton, and I certainly came away very impressed and would be very happy to be here. That being said – they are sold as a “county” program, and it’s true or at least has been in the past, but I really felt like it was more of a busy university program. Which is fine, if that’s what you are looking for. My primary concern with that was that I got the impression that the residents were so busy, but had so many resources at their disposal, that they tended to consult other services more than they’d like to or because they just had too since the services are there and have residents too. That may or not actually be the case, but that’s just what I walked away with. The residents’ justification was that they had a ton of community months in their third year where they had the opportunity to do some of things they didn’t get quite as much of at Parkland, but I guess I’d rather have that experience throughout residency. Parkland is the main site (new, 150k/patients each year with another 50k triaged out to a lower-acuity area), as well as Children’s Medical Center (level 1 peds trauma center, 90k/year), some university sites, and five different community sites in their third year. Work around 18-20 11s intern year, 20-22 10s 2nd year, 18-20 10s 3rd year all with one hour of overlap. Everyone that I talked to felt that intern year was pretty easy, or at least doable, but second year was pretty intense. Curriculum notable for 4 hrs weekly didactics with 1 hour of asynchronous learning; special EM intern monthly lecture series, longitudinal peds shifts on EM months, 4.5 months of critical care (CCU, ½ block in burn ICU, neuro ICU, peds/neo ICU, SICU, and a full month of MICU), 2 elective months, a couple weeks of plastics, and trauma shifts on EM months where they do the airway. Huge class of 22 residents/year – was a little worried that I would just be another face but they didn’t seem to feel that way. Salary 57/59/62 with shared medical (~500 monthly). They are really excited about spending a couple elective months in New Zealand during their third year. Own department since 2014. Use Epic. PD (Velez) is super nice. This is probably the one program that I could see moving a little higher on our list before it’s time to actually rank things, but while I really liked the idea of UTSW I came away slightly underwhelmed by the reality. We’ll see.
8) MetroHealth/Cleveland Clinic:
Very busy and hands-on place; produce solid residents. Very proud about how hard they work. A little bit of an odd vibe from some of the residents but everyone was nice. Main site is Metro (level 1 trauma center/burn center, 105k/year with about 17% of those being peds patients) and also Cleveland Clinic (all the really weird, rare patients are here; 60k/year, spend about 1/3 of shifts here). Work 21/20/18 10 hours shifts/28 days. Weekly resident-driven didactics. 6 months of critical care time. Flight month 3rd year if desired. 1 elective month. Cleveland is probably fine; didn’t seem as bad as everyone makes it out to be (although the recommendation was to stay out of the east (I think?) side).
9) Austin:
Fairly new program, slightly newer than JPS. County/community feel. Primarily at UMC Brackridge (75k year, moving to new facility in May 2017), Dell Children’s (75k /year), Seton (35k, community site), one month in third year at rural community site (Seton Highlands). Work 18 9 hour shifts with one hour built in for clean-up, five nights in a row/month, off night before didactics, 2 weekends off a month. Pretty standard curriculum. 8 residents per year; salary 59/61/64 (some of the best paid I saw on the trail), shared medical insurance, free parking/food. EM and surgery are the strongest departments in the hospital and have a great relationship. Lots of families. Living in Austin is a draw for many people. Not their own department, but not really a big deal since they have separate funding from surgery, which is sort of the point of becoming a separate department anyway. Seems like a solid place to train overall. I wasn’t personally “smitten” or whatever but would be happy to end up here.
10) Cincinnati:
University-based program. First EM residency and definitely a name-brand place. Not crazy about the four years or the location (Cinci itself isn’t terrible but isn’t our ideal geography either). Main site is the University (95k/year), two community sites with longitudinal shifts there after first year, Children’s hospital (67k). Work 22 11s intern year, 20 8s 2nd year, 18 8s 3rd year, 16 12s fourth year. Standard curriculum notable for 6.5 months of elective time (a ton) and a “supervisory” role in fourth year where they oversee an 18 bed unit with interns, off-service residents, and students. 14 residents/year, salary 54/55/56/58 and shared medical. Emphasis on producing leaders in the field. Sweet flight program; can moonlight on helicopter starting second year and elsewhere starting second half of third year, if I remember correctly. The current PD, Brian Stettler, transcutaneously paced himself during the introduction to the day. He’ll actually be stepping down this year but it’ll be a smooth transition and he’s staying on in a faculty development position.
11) University of Michigan:
University-based program. Great place with great people; Ann Arbor is a beautiful place to live – sort of your ideal small Midwestern town and a beautiful place to boot. Main site at the University (85k/year, separate children’s ED), St. Joseph (community site, 85k/year), Hurley (county site in Flint, about 45 minute drive). Work 20-22 8-9 hr shifts in years 1-3, 18 shifts in 4th year with shift reduction down to 16 if participating in a professional development track (can gain expertise in EMS, US, critical care, administration, etc). Otherwise fairly standard curriculum with orientation month and 4 months of elective time. 16 residents/year; salary 54/57/60/63 with bonus at the end of the year (there is a resident union). Has a pretty unique ED-ICU (the EM Critical Care Center, or EC3) that is awesome, although it sounds like they are still working out some kinks in terms of resident workflow (it sounds like initially sick patients were just getting transferred there and/or any procedures on patients that went to the EC3 were done there and not by the resident who saw them initially, but that’s changed and now they do all of the educational stuff before transfer and if there are any procedures to be done in the EC3 they try and grab the admitting resident if they are still in the ED). Overall a great program; not totally sold on the value of the fourth year here (although the professional development tracks are pretty cool) and Ann Arbor, while beautiful, is less than ideal geographically for us. Really doesn't deserve to be ranked last, but probably just one of the least ideal programs geographically for us, although Ann Arbor really is nice.
Other:
And the rest in no particular order.....
Just kidding. That's it.
A couple more pieces of info for future applicants: I applied to 34 places, which in retrospect was a little more than I probably needed to (although it's usually better to be safe than sorry when it comes to this stuff). I received 22 invites, withdrew from about 9 places before hearing anything, and never heard from 2 places (looking at you, Maricopa and Indiana). Rejected from New Mexico (I was actually looking forward to interviewing there, so that was a bummer). Ended up scheduling 14 interviews but canceling a few after starting interview season and quickly getting tired of the game. Overall it was really fun to see the different programs and meet all of the faculty, residents and applicants I did but I'm glad to be done with this whole thing and looking forward to match day. Good luck everyone!
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Just curious, how do people burn their chances at second look?
Hit on the resident, swear, be awkward
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It's easy to hide psychosis or being a d-bag for a little bit of time. No matter what anyone who DOES know says - that the second look is for you - students still tell each other that it matters, and still think they will outsmart others, and score points. Notwithstanding the Assoc PD's statement above, if you have some personality quirks, the more time you spend there, the more likely you are to make a misstep.
Now, you may say, "but what if I match there?" Once you match there, you got 'em! They're stuck with you, then!
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I would say 90% of the time, the second look doesn't help. I think maybe 10% of the time it helps a little. I've yet to have anyone hurt their chances by a second look. Usually the folks who were odd were odd in their interview and already had left a bad impression, the second look just verified what was already thought of them. I haven't had someone who we thought highly of come and do a second look and really shoot themselves in the foot. I'm sure it happens though. I've definitely had people that I've interviewed who would've ranked way higher than they did because they rotated with you. Sometimes it's easier to look good on paper and act normal for a 4 hour period of time than hide personality flaws for a month. This honestly isn't common though. Most people are normal professional human beings. I wouldn't worry about a second look hurting you, but on the other hand, I wouldn't plan on it helping either. I second the notion mentioned above that a second look is for you to learn more about the program, not in anyway a means of improving your chances at a place. If that's what you think you are doing, improving your chances, you are likely wasting your time.
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All that being said, I generally discourage people from doing a second look unless they feel like they need to see the ED run. When asked in an interview, I flat out tell people it doesn't help them, and that interview season is already long and expensive for the student, so we certainly don't expect it. Still, and handful of students every year still want to do a second look. Which is ok. Its a free country. But students have to understand that the second look is just for their own info to see the clinical environment of the place. And if you don't feel like you need to see that, then definitely don't spend the money going back to places.
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We offer second looks and the chance to hang out in the ED after interview days.
YMMV but it is absolutely brought up at our rank list meeting and usually results in the applicant moving up a few spots on our list. At least at our program its very rare for someone to hurt their chances by acting like a total jackass. That being said its extremely hard to offend most of us and we like applicants a little on the crazy side.
True story but one of our applicants this year told one of our second years to f**k off and go suck a d**k at our interview dinner.
She's currently ranked #1 on our list.
(The above was all in good fun and everyone was completely joking).
YMMV but it is absolutely brought up at our rank list meeting and usually results in the applicant moving up a few spots on our list. At least at our program its very rare for someone to hurt their chances by acting like a total jackass. That being said its extremely hard to offend most of us and we like applicants a little on the crazy side.
True story but one of our applicants this year told one of our second years to f**k off and go suck a d**k at our interview dinner.
She's currently ranked #1 on our list.
(The above was all in good fun and everyone was completely joking).
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now you can you tell us what program this is?
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Sounds like my kind of people
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^^^^^
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OK SDN, we've just narrowed it down to ~50% of the applicant pool. Now do what you do best and neuroticize over it for the next few weeks until you figure out who it is.
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Haha. Yep, she'll fit right in with EM. Certainly wouldnt suggest this strategy to people until you know the folks you are working with, but plenty of students are at home using colorful language once they feel a place out.
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33% of the applicant pool!
Plot twist: She reads that post and feels awesome for a second, then realizes she said the same thing to multiple second years at multiple interviews.
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This has to be an EM thing for sure. The applicants I like the most were the ones freely cursing at the interviewee dinners haha.
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Haven't popped into the med student threads on this forums in awhile...a couple of unrelated observations from reading the most recent few pages of this thread:
1) I'm very uncomfortable with the concept of moving applicants up (even just 1 spot) on a rank list because they did a second look. I think doing so discriminates against applicants who either don't physically have the time/money or simply don't want to spend it. They paid their app fee, jumped though the hoops, pretended to be enthralled at the interview. Now evaluate them based on fair criteria.
2) I'm seeing a lot of "interviewed here, but not ranking" categories on these ROLs. Please be very careful with this, especially if couples' matching. EM continues to be more and more competitive each year. Saw many qualified applicants humbled on my match day (in various specialties). Do you want a job or not?
Good luck to everyone! As a graduating PGY-4 I can say there is light at the end of the tunnel!
1) I'm very uncomfortable with the concept of moving applicants up (even just 1 spot) on a rank list because they did a second look. I think doing so discriminates against applicants who either don't physically have the time/money or simply don't want to spend it. They paid their app fee, jumped though the hoops, pretended to be enthralled at the interview. Now evaluate them based on fair criteria.
2) I'm seeing a lot of "interviewed here, but not ranking" categories on these ROLs. Please be very careful with this, especially if couples' matching. EM continues to be more and more competitive each year. Saw many qualified applicants humbled on my match day (in various specialties). Do you want a job or not?
Good luck to everyone! As a graduating PGY-4 I can say there is light at the end of the tunnel!
Great rank lists folks.
As a Georgetown EM grad, I just want to comment on a recurrent theme people are listing as a program con on this thread: DC's cost of living and traffic.
Cost of living: this was certainly my biggest concern about the program when I was applying. Housing in DC is indeed pricey compared to most of the country. However by the end of the interview trail I found it to be roughly on par with Boston and somewhat cheaper than some other major cities like NYC, LA, SF. There are tons of housing options in a number of price ranges between the two main hospitals and all over the DMV. During residency I went out with my co-residents all the time, vacationed in Europe, bought a car, and still managed to save a meaningful chunk of change. The salary was adequate when I was there (and I heard it's gone up a fair bit) and there are some perks which add a couple extra thousand non-taxed dollars per year (free food at the hospital, generous CME money, etc).
Traffic: I lived in DC during residency and drove to work 100% of the time. My commute generally ranged between 10-30 minutes for either of our main hospitals. Many people chose to live closer to Washington Hospital Center as we actually spend more of our clinical time there than at Georgetown since the ED at WHC is way busier and is DC's major trauma and burn center. When I commuted to rotations outside of the city (drive time generally 30-45 mins) I always felt they were justified. Awesome community and busy community peds rotations (a relative unicorn in EM training), a better PICU experience (no fellows) than available in DC, and a month at Shock for blunt trauma since there's mostly penetrating in DC and very few high speed roads for people to crash on (program give you a furnished apartment when you're there) .
The program itself is awesome. Biggest draw was the 1:1 attending : resident staffing in the vast majority of the ED time throughout residency. So much learning from this and it fully lived up to the hype. Program leadership/faculty is awesome. You see typical county sick patients at WHC along with lots of high end cardiac transplant and VADs, rare heme/onc/transplant type stuff at Georgetown, and get a solid community experience along the way. There was a generally low amount of consulting for a university program. They fit in about 11 months of critical care and peds into the three years and these experiences were outstanding. Trauma, sono, sim experience was very strong too. I'd say tox and EMS were the weak points when I was there.
Bottom line: If you're looking for the cheapest/no traffic place to live during residency this program probably isn't for you. That said you will hardly go broke or have to live on ramen if you train in DC. You will get to work one on one with some outstanding clinicians and you'll get terrific training. If you're considering programs in NYC, LA, Boston, SF, Chicago, etc and the cost/traffic those cities entail than Georgetown should be well on your radar.
Good luck to you all and don't sweat the match too much. There vast majority of programs out there will prepare you well for attendinghood, just focus on picking the place with the best fit for you.
As a Georgetown EM grad, I just want to comment on a recurrent theme people are listing as a program con on this thread: DC's cost of living and traffic.
Cost of living: this was certainly my biggest concern about the program when I was applying. Housing in DC is indeed pricey compared to most of the country. However by the end of the interview trail I found it to be roughly on par with Boston and somewhat cheaper than some other major cities like NYC, LA, SF. There are tons of housing options in a number of price ranges between the two main hospitals and all over the DMV. During residency I went out with my co-residents all the time, vacationed in Europe, bought a car, and still managed to save a meaningful chunk of change. The salary was adequate when I was there (and I heard it's gone up a fair bit) and there are some perks which add a couple extra thousand non-taxed dollars per year (free food at the hospital, generous CME money, etc).
Traffic: I lived in DC during residency and drove to work 100% of the time. My commute generally ranged between 10-30 minutes for either of our main hospitals. Many people chose to live closer to Washington Hospital Center as we actually spend more of our clinical time there than at Georgetown since the ED at WHC is way busier and is DC's major trauma and burn center. When I commuted to rotations outside of the city (drive time generally 30-45 mins) I always felt they were justified. Awesome community and busy community peds rotations (a relative unicorn in EM training), a better PICU experience (no fellows) than available in DC, and a month at Shock for blunt trauma since there's mostly penetrating in DC and very few high speed roads for people to crash on (program give you a furnished apartment when you're there) .
The program itself is awesome. Biggest draw was the 1:1 attending : resident staffing in the vast majority of the ED time throughout residency. So much learning from this and it fully lived up to the hype. Program leadership/faculty is awesome. You see typical county sick patients at WHC along with lots of high end cardiac transplant and VADs, rare heme/onc/transplant type stuff at Georgetown, and get a solid community experience along the way. There was a generally low amount of consulting for a university program. They fit in about 11 months of critical care and peds into the three years and these experiences were outstanding. Trauma, sono, sim experience was very strong too. I'd say tox and EMS were the weak points when I was there.
Bottom line: If you're looking for the cheapest/no traffic place to live during residency this program probably isn't for you. That said you will hardly go broke or have to live on ramen if you train in DC. You will get to work one on one with some outstanding clinicians and you'll get terrific training. If you're considering programs in NYC, LA, Boston, SF, Chicago, etc and the cost/traffic those cities entail than Georgetown should be well on your radar.
Good luck to you all and don't sweat the match too much. There vast majority of programs out there will prepare you well for attendinghood, just focus on picking the place with the best fit for you.
[QUOTE="GonnaBeADoc2222, post: ) I'm seeing a lot of "interviewed here, but not ranking" categories on these ROLs. Please be very careful with this, especially if couples' matching. EM continues to be more and more competitive each year. Saw many qualified applicants humbled on my match day (in various specialties). Do you want a job or not?[/QUOTE]
This is so important. SDN has some extremely strong applicants but rank every program that you interview at. If you don't, you are essentially saying to yourself that you would rather scramble into an open FM or IM in an undesirable part of the country than be at that program.
This is so important. SDN has some extremely strong applicants but rank every program that you interview at. If you don't, you are essentially saying to yourself that you would rather scramble into an open FM or IM in an undesirable part of the country than be at that program.
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As some of you may be aware, summa health as lost accreditation for this upcoming year.
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I mean, ideally a program wants to match people that want to be at their program. Not to match people who are just faking interest as you suggested. You certainly don't want to match people who don't want to be at your program.
In the end, formulating a rank list is an imperfect science. If you interview 100 people, you might've only have worked with 20 of those people. The ones you work with, You already get a sense of their personality and clinical ability, at least to a point. You just can't gauge this in a 20 min interview. So if somebody comes back and work the shift at your institution, and you find that they mesh well with your residency, I don't see any reason why you can't move that person up a few spots. And vice versa if they arent a fit. That being said, 90% of the time second looks don't really make any difference in someone's rank and I discourage students doing them for any reason beyond if they need to see more of the place to make a decision. But to be absolute about it and say that it should never affect things seem silly. If someone comes back for second look and helps themselves or hurts themselves by their actions, there should be no reason why you don't take that into consideration.
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- Reaction score
- 3,655
I guess I just don't see this as consistent policy. If you say, "this won't affect your ROL position, but come for yourself if you want," and then maybe move a few people up a few spots because they came, I think that's disingenuous. On the flipside, if you say "really bro, don't come, but *wink wink* it could help you a tiny bit" you create a culture where an effective "second interview" becomes incentivized, which is unfair to those who cannot afford the monetary or time cost. People will self select for "wanting to be at your program" by the programming of their ROL. Honestly, how much perspective are you gleaming from a candidate following you around for a couple hours while you order labs and talk to patients? The best interview is an audition rotation, and unfortunately if they didn't come for one, I believe you are stuck with their application + interview.
If I were a PD, I would totally have a policy of "no second looks, no thank-you's, no post interview communication." If you like them and they like you, this will be reflected in the match day result. In my opinion, anything other than this places undo pressure on the applicant to jump through further hoops, and contaminates the spirit of the match.
On the other hand, I totally agree with you that if they DO come, and exhibit some sort of deleterious behavior, you are 100% within your rights to lower their position from the ROL, or remove them completely.
