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Applicant Summary:
Step 1: 250, Step 2: 272
EM rotations: H/H
Medical school region: West Coast
Anything else that made you more competitive: Step scores, clinical grades (one HP 3rd year, the rest H's), strong SLOE from a respected program
Main Considerations in Creating this ROL:
1. Perceived fit with residents & faculty
2. Job prospects - breadth & depth of alumni network
3. Breadth of clinical experience - academic, county, community
4. Location
5. Critical care prospects - EM/CCM faculty, fellowship placement of recent grads
Of note: 1 = 2, > 3 >> 4 or 5. We make so many arbitrary distinctions in this process, based on such small snapshots we experience from each program, going into it with concrete criteria for judging programs can be very helpful. I want an academic experience where I can carve out a niche, with the possibility of doing whatever (fellowship, academic or good community gig), wherever, after I graduate.
1) Denver Health
Pros - felt very at home at the resident dinner and enjoyed the faculty I met, the breadth of clinical experiences is excellent with DH covering the county and UC covering the academic side, I really vibe with the "learn by experience/trial by fire" attitude, strong history and thus a huge alumni network (especially in the west), the program has an attitude of constant improvement, strong commitment to graduated responsibility, Denver has all the outdoor opportunities I'm into on the weekends, several EMCCM faculty on staff, although some might count the medicine floor month as a big downer, it's very useful to have an IM month already in place without taking out any elective time (since it's part of the ABIM CCM fellowship prereqs), recently has placed a few residents in fellowship programs I'm very interested in, one of the few places where I already have friends in the area
Cons - not as much elective time as some of the other 4 years
2) Cincinnati
Pros - fit very well with the faculty and residents, surprisingly diverse clinical settings (UC serves as a county type population, with an academic flair), department chair is an integral piece of the department and not a distant admin figure, unparalleled financial resources, room to carve out a CCM track with interest from new PD, several EMCCM faculty, PD transition will allow Stettler more time to work clinically (residents I spoke to were stoked about this prospect), ownership of the SRU in third year, graduated responsibility, Air Care shifts allow for excellent autonomy in critical care situations early in your training, oldest program in the country = huge alumni network replete with PD's/chairs/faculty in every geographic region, more elective time (6.5 mo) than any other program, program-wide commitment to continual improvement, COL in Cincinnati is a big improvement from my current spot and the recreational opportunities are not as bad as I initially thought
Cons - even being optimistic, Cinci as a city is not great, EM is the big dawg in the hospital, the resident population is not as diverse as some of the other programs I visited
3) Stanford
Pros - fit really well with the faculty and residents, probably the most welcoming interview experience I had, great academic support for research, critical care track through pathway programs, strong EMCCM faculty on staff, good diversity of clinical experience with SC Valley giving a high volume experience, would be able to live near friends, the bay is dope (rich of social opportunities), strong off service rotations, true commitment to resident wellness rather than bull**** lip service of some other programs, shiny new ED coming soon, for what that's worth.
Cons - the bay is expensive AF (COL, traffic), sites are far apart, newer program, although this could be overcome by the power of the name for some
4) Brown
Pros: total dark horse for me, felt very at home at the interview dinner, excellent diversity of faculty (in both background and medical interests), surprisingly large catchment with the volume per resident to match, strong diversity of sites without long commutes, graduated responsibility, critical care alley run by PGY2/3, awesome PD who is committed to her residents beyond the hospital, strong critical care experience, new EMCCM faculty, many residents involved in leadership of national organizations with lots of support from admin, improved US program with frequent reviews on Qpath, a lot of interesting resources (ED specific MRI, cath lab in ED, etc.), Newport ED rotation sounds dope, good amount of NIH money
Cons: Providence is not my jam
5) Indiana
Pros - awesome amount of critical care time for a 3 year, peds experience, diversity of clinical experiences, strong history and thus a huge alumni network, solid CCM faculty, academic track with CCM focus, chill residents overall, impressed with the size and diversity of faculty, very relatable PD, great new county hospital (gotta admit, I loved the roof top garden), all sites are high volume, large program for a 3 year (60 residents), strong emphasis on residents' ownership of the program
Cons - didn't quite fit, less time for ABIM prereqs if that's the way I wanted to go, Indy is less than ideal as a location for my interests
6) Wash U
Pros - strong critical care curriculum, great research opportunities (especially in critical care), several EMCCM faculty in the program and have fellowships in ABA/ABEM and ABIM/ABEM tracks, good patient mix of the affluent & inner city, supportive ancillary staff per the residents, ambitious program from the top down, cheap COL in STL, accessible hospital in a much nicer neighborhood than I expected, I appreciated the focus on training residents to teach, PD was very relatable, interested in innovation and a total badass; seemed genuinely interested in recruiting like-minded individuals to the program, strength of off-service rotations was a theme of the interview day.
Cons - less established program and thus smaller alumni network than others on my list, slightly worried about the status of EM at the institution (a division as of 2016), and getting pushed aside on off-service months, some suggestion at the interview that the residents are work averse, kind of luke-warm on faculty I met, limited community exposure, EM is a division (didn't delve into this on interview day).
7) U Michigan
Pros - UM may be THE place for EMCCM and the prospect of rotating through EC3 is enticing, plenty of EMCCM faculty and professional development tracks would be great prep for fellowship, in house ABA and ABIM pathway fellowships, huge amount of research opportunities, excellent off-service rotations, diverse experience with Flint/UM/Joe's, apparently great access to food at Joe's even during off site months, 4 weeks vacation sounds nice
Cons - Ann Arbor is not an ideal locale socially or topographically, I didn't quite fit with the residents and faculty as much as I wanted to, EM does not own airway at all times at all sites, I'm slightly worried that UM may be a bit too academic (but lots of time at SJMH could compensate for this).
8) MGH/BWH (HAEMR)
Pros - undeniable academic power, strong off service rotations, potentially learning from some of the most accomplished academic clinicians around, residents were surprisingly pretty chill, Boston was a bustling & interesting city, many opportunities for "something else", Brigham has a strong CCM fellowship
Cons - focus on extra stuff seems to be the main focus rather than training (as the PD put it) "badass docs", Boston (COL), exposure to community is limited, peds is done in blocks, the feel of MGH was very strange for me - the hospital is like a massive, impersonal machine, with a bunch of solo services, the fourth year allows for more time to take advantage of the "something else" activities but doesn't add much clinically .
9) University of Washington
Pros - Great diversity of clinical experience with maybe the best balance of county/academic/community of any program I went to, great CCM fellowship that is friendly to EM-trained folks, EMCCM faculty on staff, I did not expect to love Seattle as much as I did but am stoked on the city, love Harborview and their mission as an institution, strong critical care curriculum, faculty are from all over the country in terms of residency training, PD is one of the friendliest around.
Cons - newer program with a less established presence in the hospital, remains a division as of 2016 with several quirks (surgery rotates as primary docs through the trauma side of the department, EM does not own trauma, anesthesia does trauma airways), didn't vibe with a lot of the faculty/residents, low social capital in the hospital, several rotations where residents are reportedly scutted out hard (especially ortho).
10) Pittsburgh
Pros - strong & reputable critical care experience with their own CCM department, varied clinical experience with Presby & Mercy, Pittsburgh is much cooler than I anticipated, have some good friends in the area, RLT is responsive to resident feedback, new revamped curriculum sounds promising, COL in Pitt is solid.
Cons - didn't fit with the residents I met; at the interview dinner a couple residents spoke poorly of other EM programs and that really turned me off, I didn't vibe with the RLT and my interview with the PD was my least favorite of the whole season, only one month of elective time in a 3 year program makes it near impossible to get into CCM via the ABIM/ABEM pathway (unless it's Pitt's program, as a PGY3 was reportedly granted a spot in the E17 fellowship class), the RLT was unable espouse a vision for the future of the program, Pitt's presence in the western US is not as strong as other programs on my list.
11) Vanderbilt
Pros - really liked the residents I met at the dinner, undeniably solid educational environment, Nashville is a happening place with a lot of young people & solid night life, serious clout from Slovis in job search, reportedly solid peds experience, lots of critical care time for a 3 year, incoming PD was very welcoming and seemed to be supportive of creating a CCM fellowship track.
Cons - didn’t vibe with Slovis or Wrenn, program is overly focused on didactics for my taste - every answer on interview day went back to "teaching" and I'm more of a learn by doing kind of guy, no EMCCM faculty (although they are reportedly recruiting from UM?), likely transition in next couple years with Slovis retiring, don't own trauma in the ED, Vandy grads don't have the geographical spread that other shops have.
12) Utah
Pros - Salt Lake City, invested PD, Salt Lake City, ortho rotation on the mountain, Salt Lake City, overall residents were pretty chill.
Cons - honestly would have cancelled this one if I could've since two weeks into interview season I knew that I wouldn't want to be here, alas it was too late to cancel politely... I didn’t really fit with the residents, relatively new program, limited critical care exposure and no senior MICU time, only two months of elective, residents are oriented towards the place rather than the program (which is totally understandable, just not what I'm looking for culturally), only place I didn't interview with the PD, limited diversity of SLC, EM is a division, don't own trauma at the U, lack of a unified vision going forward from the program leadership, limited track record of fellowship placement compared to other shops I liked.
Other:
Invited to interview - Christiana, Cook County, Emory, Hennepin, Highland, Maine Med, New Mexico, Northwestern, OHSU, U Conneticut
Waitlisted - LAC/USC, UCSF-SFGH
Rejected - Maryland [really bummed about this one], Carolinas, UCLA-Harbor
